On Sunday, I cycled 30 miles around my constituency in order to raise money for the local hospice, Katherine house. You will therefore understand, Madam Deputy Speaker, why I prefer to stand.

I applied for this Adjournment debate before I took part in that sponsored bike ride, but because hospices such as Katherine house provide care for terminally ill adults, their care for the elderly is relevant to the debate. Katherine house and hospices like it raise a phenomenal amount of money by voluntary means, but it is important that we, the decision makers in charge of spending public money, should properly value the work done by hospices to ensure appropriate support from the public sector as well as from voluntary organisations.

I intend to focus on three issues relevant to the care of the elderly—the well-known problem of delayed discharges from hospital, what help is available for elderly people in their own homes and residential care for the elderly.

It is common ground among politicians that hospital is no place to be once medical treatment has been completed. Social isolation and the absence of purposeful activity are especially harmful for older patients. I regularly receive complaints from elderly constituents—and from their relatives—about the wait for their needs to be assessed before they can be discharged, or about having to wait for the services that have been identified by that assessment of need to be provided or for the funding to pay for that provision.

It is not only patients and their relatives who complain to me—so do hospital managers, who would like to use the beds to help other people with urgent medical needs, and who would very much like those who should not be in hospital to be discharged as soon as possible. It is important to bear in mind that hospital managers are also under pressure to meet targets and deal with the demand for hospital services.

I say well done to the Government for the extra £300 million provided late last year for helping with this problem. Staffordshire's share was £1.7 million last November and another £3.6 million this April. The director of social services in Staffordshire was upbeat about that when I spoke to him, and in the short term at least the money will go a long way to ending the unnecessary delay in people's discharge from hospital in Staffordshire.

In the longer term, we must look for more lasting solutions. One encouraging feature of the final Wanless report, which was published at the time of the Budget, was that subsequent to the interim report Derek Wanless had received many representations about the important link between adequate social services and a satisfactory and efficient health service. In his final report, he identified the need for more support for social services. The Chancellor rose to that challenge magnificently in the Budget by announcing a 6 per cent. increase in social services spending for each of the next three years.

Before the hon. Gentleman gets carried away in his praise of the Government, let me put one point. I presume that he is also aware that directors of social services are concerned about the impact that the increase in national insurance contributions will have on that sector.

I am grateful to the hon. Gentleman for that intervention. I was about to show that I am not carried away by identifying more of the challenges that face directors of social services. I do not minimise the challenge that he mentioned, but I would add several others, which I shall deal with now if he will permit me.

I still hear of many instances of delay in which money is a factor, but working practices cause problems as well. For example, in multi-agency assessments, one professional after another seems to queue to ask the same questions of the same people. The social services department tells relatives to find a residential home placement for a patient in a hospital bed, and then takes months to say what payments it will make towards it. Families are either forced to lose the places that they have found, or put under pressure to pay out of their own pockets to keep the places open until social services funding kicks in.

To answer such problems, could we not have an effective single assessment of a person's needs? Could we not have some up-front assessment of financial eligibility and availability of funding for people while they are in the hospital bed at the outset? I am reminded of the old problem of people looking to rent a home, but being unable to find out whether they would receive housing benefit for the place that they wanted until they were in and running up arrears. Eventually, the Government said that people could have an advance assessment of their housing benefit entitlement, so that they could look with confidence for a place to rent. The issue of people in hospital beds looking for a residential care placement seems similar.

On departure from the hospital bed, short-term intensive care is sometimes helpful for older patients while they get used to being back in their homes and living independently again. However, intensive care packages are a rarity in my part of the country. I suspect that that is true throughout the country, although good work is being done in some places. The professionals involved need to sharpen up their act on that.

The strain is inevitably taken by the army of carers, the relatives and other volunteers who save the state a staggering £57 billion every year, according to Carers UK when it recently launched its new service "Carers Online". There have been some good developments to support carers since 1997, such as the publication of the first national strategy for carers. There has been funding for support, including respite care. Carers grant this year is £85 million and will go up to £100 million next year. There have been improvements in social security provision, with an extra £500 million to be put into social security benefit over three years. Perhaps the most glittering prize recently announced was the new state second pension, which gives carers pension credits for the first time. I am pleased to see all those good developments, as carers are, and will remain for the foreseeable future, an integral part of help for elderly people. I hope that we continue to support them with such commitment.

Alongside respite care, intermediate care is extremely valuable to people who try their best to survive in their own homes but need help from time to time. In my constituency, our new primary care trust has managed to put together the basics of a good intermediate care strategy. However, it is run on a shoestring. Obviously, there must be adequate funding if intermediate care is to be a reality for the large numbers of people likely to demand it in future.

People want to stay in their own homes, but older people in particular need help to keep their homes habitable. Sometimes homes need major adaptations such as ramps to the front door, or stairlifts and walk-in showers, and sometimes only minor works of maintenance and repair. I generally find that social services departments are under-resourced for adaptations, which leads to long waits for the simplest tasks. However, care and repair services, where they exist, are extremely flexible and responsive to people's needs. Could we not bring together the two types of service to provide a comprehensive social home care service, so that people can have a speedy response when they need minor help with their homes?

The other great aid to people who live in their own homes with help is domiciliary care. I am not sure how unusual Staffordshire is in relying entirely on private sector provision of domiciliary care. I recently met representatives of providers in my constituency, who warned of the imminent collapse of the service that they provide. They said that fees were too low throughout the system and that there were problems with recruiting and training staff, enabling them to gain qualifications, and paying them good wages.

That very neatly brings me to residential care. The last time that I met representatives of the proprietors of privately owned residential homes in my constituency, they raised exactly the same issues: low fees, training, qualifications and low pay for staff. Raising the pay of those who work in the sector is obviously closely related to the ability of social services departments to raise rates for places in homes and for domiciliary care. Providing training, qualifications and status for care workers is, however, not simply a matter of money. Could there not be closer partnership working between social services departments and private owners to tackle such human resources challenges?

I recently came across a Government announcement about employer training pilots, which combine employee leave for learning with employer compensation for costs and free training. The pilots will cover six geographical areas at a cost of £40 million. Is there any chance of the Department of Health, the Department for Education and Skills and the Learning and Skills Council discussing an additional sector-based pilot to cover domiciliary and residential care and to raise training and qualifications issues and the status of those who work in the sector? To quote a famous line, which I cannot attribute, "If you think education is expensive, try ignorance."

Unfortunately, there is a lack of trust between the social services department and private owners in my area, which is, I think, replicated in many parts of the country. I publicly urge both sectors to work more closely together as partners and to keep at the forefront of their minds the fact that they exist to provide a service to vulnerable and valuable members of our society.

I say bluntly that fees must rise; otherwise many residential care home owners will find that it is not worth the candle to run the business.

The other issue that is often raised is national standards for residential homes, and I expect that some hon. Members will mention it. Such standards would be a good thing, but must be enforced sensitively and constructively.

It is a little unrealistic to separate those three issues—hospital discharges, people with help at home, and residential care—in the way that I have done, because, in reality, the challenges involved in tackling them are interrelated. Solutions, of course, require money, but other things, too. For their part, the Government must demonstrate some ownership of the issue and show that they are interested in solving the problems. They have, for example, done good work in developing the national service framework for older people, but on the ground, I still have difficulty identifying older people's champions in local organisations. Furthermore, people tell me that the Government are not committed to the framework, and it would be sad if that became the general view. I therefore urge the Government to take a grip and show that they are concerned about the issue and want to solve the problems.

Last year's King's Fund report on care and support, which was called "Future Imperfect?", identified several national issues that it is important to tackle. The first was the pressure on agencies to contain costs, which cause difficulties when it comes to deciding how to provide services. The report also said that two thirds of the work force lacked a relevant qualification and that there was a problem with low pay and the resulting high staff turnover. It made several recommendations, of which some are relevant to this debate. One was that that there must be funding growth, which was, in part, recognised in the recent Budget. Service users need to be involved and empowered. the national vocational qualifications in care need to be strengthened, skills and standards for all care staff must be improved and the voluntary sector and individual volunteers should be strategically involved.

Those messages were, interestingly, reflected at a conference that I held in my constituency on 19 April to consider care of the elderly in Stafford. The conference attracted 130 people, representing health and social services, private sector providers, housing providers, the voluntary sector and older people and their carers. I had to turn away 40 people because we were full up. A pack was produced for everyone who attended. The keynote speaker, Robin Wendt, a member of the Sutherland commission, made a thought-provoking presentation, which caused me to wonder whether we have yet drawn the line between nursing and personal care in the right place. In his view, the commission was right and the Government wrong.

The people representing the many interests in my constituency made a number of points that are relevant to the national debate, the first of which was that good communication is key—that includes listening to older people and their carers. Suggestions were made about challenging existing ways of working, which will be music to the ears of the Minister, who is demanding modernisation for funding. They included more joint working between the agencies; more preventive work, which is music to my ears in terms of keeping people healthy for more years of their lives; higher pensions, which was not an unexpected contribution from many of the older participants; good quality provision, particularly respite care; and a directory of agencies offering help, advice and advocacy. They also provided some action points for health and social services departments including an effective single assessment procedure, more collaboration in order to end delayed discharges, better provision to help individuals to remain in their own homes and better attention to recruitment, retention and recognition of staff.

Other recommendations covered carers, funding and housing providers; I shall not list them all. However, I shall draw attention to the need for rapid response when people need help, with the allied requirement for out-of-hours respite care, and the growing issue of pensioners who are themselves carers and who find that when they become eligible for state retirement pension, they lose invalid care allowance—shortly to become carers allowance—because of the rule about overlapping benefits. The Government are about to make new regulations allowing over-65-year-olds to claim for carers allowance. However. the rule about overlapping benefits will still apply. That is increasingly an issue, and greatly unfair. People provide help that would otherwise cost the state much money, yet they cannot keep the allowance that is provided specifically for caring for another person. I hope that that will be given urgent consideration.

At the end of the conference, I made three commitments: first, that I would produce a conference report and send it to everyone, including the 40 people who were not there; secondly, that I would report the findings to Parliament; and thirdly, that I would meet the heads of the various agencies in my constituency to devise an action plan for Stafford. I am pleased to say that by the end of this debate only the third will remain to be completed. I do not want to boast, but it was a worthwhile exercise in identifying local pressures and getting good ideas from local people about how to solve immediate problems. I commend it to other MPs as an approach for their constituencies, so that we can tackle the problems nationally by contributing to the debate, as well as locally by doing something personally.

It is important to recognise, and give thanks to, all the dedicated workers in that sector. As I have said, the pay is not always great, but the dedication of the workers and the importance of their work is clear. A factsheet sent to me by the Royal College of Nursing called "The health of older people" sets out the demographic change that we can expect in the next 30 years and underlines the challenges posed. Some common themes run through everything that I have read, including the King's Fund report, the Royal College of Nursing factsheet, and the work that I did for my own conference, such as getting the funding right, valuing staff and voluntary carers, and putting older people at the centre of the services provided for them. The Budget gave a terrific boost to that work, but plenty more remains to be done. As a society, we do not lack the resources, and the vision of affordable quality services for all older people is exciting and achievable. I look forward to being able to stand in the midst of the community in my constituency and say, "We are all good neighbours now."

I congratulate the hon. Member for Stafford (Mr. Kidney) on securing this interesting and important debate. I shall begin by considering what older people want—which is the same as everyone else: normal care; normal services or, in the jargon of my previous profession, social work, normalised services; to be partners with those who provide the services; and to be seen as contributors, rather than as a burden. They want to give as well as to receive, and they want to be part of society, not a forgotten addition.

I want to address some particular issues, not only those that are peculiar to Wales. Everyone needs good quality information and advice to inform their choices. That advice and information is not always available, either from advice agencies or from social services departments in my constituency or elsewhere. Language is a particular issue in my constituency because, often, in the south and east of Wales, information is not available, face-to-face, in Welsh. In my constituency, and in the north and west of Wales, the majority of people speak Welsh, and services for older people and for others are available in Welsh as a matter of course. However, half the people who speak Welsh live in the south and east, where they form a minority of 5 or 6 per cent., but where those normalised services in the medium of Welsh are not available and older people who need those services, and who are perhaps unable to speak English because of an illness or a stroke, are unable to access them. The 1991 census showed that 23 per cent. of the population of Wales who spoke Welsh were over retirement age; that is 110,000 of 500,000 people.

Older people want services to be provided locally, and the threat to post offices and local council services certainly has a disproportionate effect on older people. They also want improvements in the built environment, in terms of access to buildings and the provision of ramps and lifts, so that they can use buildings in the same way as everyone else. They want adequate community policing and freedom from the fear of crime. That is especially pertinent in rural areas, where crime rates might be lower, but the perception of the danger of crime is as high as elsewhere. Some of those who live in rural areas and visit my surgery are extremely worried about crime.

Those issues affect older people throughout Wales and the United Kingdom. One issue of particular interest to me, given my previous career in teaching, is non-discriminatory access to lifelong learning and recreational activity. At a recent Carers National Association meeting, I met a lady in her late 70s who is about to undertake a degree course. She was extremely interested in my work and very capable and lively in her mind but, because she was over 75, she could not get insurance for her car to drive the 10 miles to the local college. That had nothing to do with her condition or abilities—it was an example of structural discrimination against her as an older person.

In Wales, as elsewhere, problems have arisen with providing an integrated public transport system, especially in rural areas. Efforts have been made to counter that, and everyone in Wales will welcome the National Assembly's programme of free transport for older people, which has liberated older people and allowed them to travel when before they could not, or when there were different provisions for different local authorities. That free transport does not extend to the train service, however. People can travel by bus but, in some areas, the train service is the service of choice. If we want an integrated transport system for older people, we should integrate the trains as well as the buses.

I should like to draw the House's attention to some innovative projects. Cyngor Henoed Gwynedd, the Gwynedd Council for the Elderly, is providing a day centre, not on the fringes of a village, in a local authority building or a church hall, but next to the bus station, so that older people can pop in for a cup of tea before they get on the bus. Older people who come along with their carers can find a safe, warm and interesting environment and have a bit of a rest while their carers go off and do some shopping. That sort of innovative project is what we need. There are problems in the provision of such services, which I have discussed with the Council for the Elderly. Inevitably, one of those problems is funding.

Two years ago, I had the privilege of advising the Welsh Affairs Committee in its investigation into social exclusion. Some of the conclusions of the Committee's report are pertinent, including those relating to the funding of community groups. I accept that the same problems affect all sorts of community groups, but they have a particular effect on services for older people. The Committee discovered that short-termism was chronic and that planning by community groups providing services was blighted by the fact that they could not plan more than a year or two ahead. The report also stated that staff felt insecure and that the providers of services were forced to waste time in continual justification of the value of services when applying for extra money. Funding must be secure and long-term and take account of on-costs. In my opinion, five-year rolling funding should be the norm.

The University of Wales Swansea issued a report on domiciliary charging for care services, called "Charging for Care in Wales", which was commissioned by the National Assembly. Unsurprisingly, the report found that there were many difficulties with the charging system. First, and most obviously, there is the postcode lottery, which means that each of the 22 local authorities in Wales has its own system and charges at a different level. People who lived on the border of two local authorities were particularly affected. They might be charged more or provided with a worse service merely because of where they lived, with no regard to their needs. That is the theme of the report. The local authorities and user groups in Wales want an all-Wales policy, which is relevant for not only the National Assembly for Wales but the Department of Health. The report noted that guidance was not strong enough and that the bewildering array of charging policies was causing problems. Those charging policies reflect not need but local circumstance, especially in respect of local authority finances.

The report said that there was pressure on local authorities to charge. Of course, they have been allowed to charge since the Health and Social Services and Social Security Adjudications Act 1983 but, significantly, most of them did not charge until they were subject to pressure. I understand that local authorities are pressured to raise 9 per cent. of their funding through charging, irrespective of the wealth or poverty of the area. That is a blunt instrument, considering the variety of poverty and wealth not only in Wales, but throughout the United Kingdom.

The University of Wales Swansea found a powerful case for disregarding disability benefits. It suggested that that would simplify the system of charging and make it fair for all and cheaper to run. Significantly, it found that local authorities with simpler systems also monitored debts more effectively, stating that those

"with more basic charging arrangements tended to monitor debt on a case by case basis".

Those authorities tended to encounter fewer users who fell into debt, perhaps because other instruments were not as detailed as individual assessments. Those local authorities took much more notice of the problems caused by the system. There is a lack of clarity about carers' income, certainly in Wales, where most local authorities are reviewing their positions on the matter.

Charging should be a way to develop the service, but the report found that it was not. It stated that the use of charging income to develop new or existing services

"was the exception rather than the rule".

Development has been used as a justification for charging, but it is not a good one, so I would be interested in the Minister's response to that.

Many saw charging as effectively a cut in their benefits. During last year's election campaign, I visited many homes for the elderly in my constituency, which was sometimes a sad and sometimes an inspiring experience. I remember asking one gentleman—in Welsh, of course—"What do you want?" Simple questions often give revealing answers. He said, "What you've got," referring to my freedom to walk in and out, the freedom that my wallet and family support give to me, my ability to travel and other such things. That was eloquent testimony of what we need to provide for older people, and what we do not provide at present.

I declare an interest as a member of the trade union Unison. I thank my hon. Friend the Member for Stafford (Mr. Kidney) for the way in which he introduced the subject of our debate, which was challenging as well as sensible and constructive. So often, Members of Parliament are not given credit in the House for their work. People in Stafford should be proud of my hon. Friend's huge amount of detailed work on the delivery of health care. He may not want to boast about that, but he can be proud of what he has done. It is so important that MPs make a difference on the ground in that way.

We all hope to be elderly one day, and I want to set the debate in the context of inter-generational issues. I hope that when my hon. Friend the Minister replies, she will place her remarks within the context of public health as a whole. Elderly care is not only about care given to people when they become elderly, or hospital care that we may or—we hope—may not need. It is not only about domiciliary care or the social services care that we may need when we get old, but about how we increase life expectancy. We should not do that simply for the sake of it, but so that we can all look forward to a long, happy and healthy life. Emphasis should be on health promotion so that our NHS and other public services, particularly those provided by local government, do what they can to help us to look forward to as healthy a life as possible.

Will the Minister consider the public health context? As vice-president of the Chartered Institute of Environmental Health, I should like to think that we develop policy by linking public health issues with the whole health agenda. The question is not simply about the money spent on hospitals, but about wider issues. None the less, the Government can do a great deal more now that the Chancellor has given a commitment to extra funding for health.

I shall put the debate in a spending context. It is wonderful that we now have extra money for the NHS, but we must address how we spend it to achieve the most efficient delivery services. My hon. Friend the Member for Stafford has already said that we desperately need a reform of the standard spending assessment so that places such as my constituency, which covers Stoke-on-Trent and other parts of Staffordshire, have a fair funding formula. I am pleased that the Government have promised reform in 2003—it cannot come a moment too soon. Between now and then, we must ensure that there is full consultation with local authority leaders and local government associations so that social services, which are integral to full health care for the elderly, are properly funded. In certain parts of the country—usually the parts with deprived populations—the shortfall from the target amount that should be spent to deal with problems is so great that we cannot catch up.

When I first set out in politics, some 20 or so years ago, there was something known as RAWP—the resource allocation working party. In health, that formula helped to raise the areas furthest from the target level and put them on a level playing field; only then would extra money be given. In the review of the SSAs, we must put areas such as Stoke-on-Trent, which has such great deprivation, on a level playing field to allow our social services to invest money that will complement services provided by the NHS, as happens elsewhere.

Another service that is important for keeping elderly people in their homes, when that is where they wish to be, is provided by local social services, and is called Lifeline. In my constituency—I assume that the same applies elsewhere—only people on housing benefit can access that service. If we want people to stay in their own homes rather than in care beds or intermediate care, we must fund the services that all elderly people need to be able to stay at home.

In her reply, I should like the Minister to consider the fact that elderly people who stay in their own homes desperately need to feel safe and secure. I am aware of that not just because I have been out over the past few weekends for the local election campaign, but because I have regular phone calls and correspondence from constituents throughout my Stoke-on-Trent, North constituency. They say, "Joan, we don't always feel safe." They want local crime partnerships with police. Above all, those who live in council accommodation, which can consist of wonderful bungalows, do not always have the fencing that they need to make them feel secure.

If we had a standing spending assessment that treated our area fairly so that we could invest in council houses, and if we had a level playing field between council houses and other forms of social ownership resulting from transfers, we would be able to provide both the fencing to make elderly people feel secure in their homes and better elderly care.

During the 15 years that I have been in Parliament, I have worked with local people to ensure that we have sufficient continuing care beds for our needs. That campaign came about as a result of the standards, which were not fit for the 20th century let alone the 21st century, at Westcliffe hospital—a former workhouse known locally as the old poorhouse, which is now a large hospital with many continuing care beds. I have been involved with a campaign not to close Westcliffe hospital but to agree a delivery plan to provide sufficient continuing care beds in the context of health care, domiciliary care and intermediate care.

The campaign has had huge success. The Under-Secretary responsible for public health, my hon. Friend the Member for Pontefract and Castleford (Yvette Cooper), set up the Edwards report, which brought together health care professionals, and considered how we can move from putting people into long-stay beds to using all our community resources to provide the ongoing care needed across north Staffordshire. We had various meetings with my hon. Friend, and were given an undertaking that the Edwards report would be implemented. I am happy to report that under the fit for the future programme, considerable progress has been made towards building both a new hospital at the North Staffordshire royal infirmary and a medical school, for which I have waited 40 years, since I was a small child.

Under the fit for the future scheme, there is a proposal called the north Stoke development, which is going to provide us with the continuing care beds that we need. Will my hon. Friend the Minister take time out after the debate to get back to me, and to other north Staffordshire Members of Parliament who are similarly concerned, to give us an update on the progress that has been made? We need to know whether the number of beds that we were promised will be put in place. Are we going to get the development money for those beds? We were given undertakings following a lengthy formal consultation procedure that involved the community health council.

The Edwards report anticipated that a number of beds would be shared between the NHS and independent sectors. The proportion of the beds that would provide continuing care in the independent sector was never properly specified, but it was suggested that it would be about 20 per cent. As I understand it, however, as many as 48 per cent. of beds will be provided in the independent sector, although they will be paid for by the NHS.

I want to make sure that the Government are giving their full attention to the community health council in north Staffordshire, which wrote to my hon. Friend on 18 April, as it is particularly concerned that no further public consultation has been undertaken

"on what we consider to be significant changes to these agreed proposals. We feel it important to apprise you of this and if we do not receive a satisfactory response from the Health Authority I shall write to you again."

There is genuine concern that the Edwards proposals, to which we all signed up in good faith and which set out a way forward for continuing care beds, have somehow been superseded by a further consultation, undertaken by the health authority, which looks at the number of intermediate care beds needed. We all recognise the need for intermediate care beds, but there is a suspicion that unless we have full openness and transparency, the wonderful commitment given on intermediate care beds will be at the direct expense of the continuing health care beds to which we all agreed under the Edwards report.

My hon. Friend the Member for Stafford has hosted debates and conferences in Staffordshire. We need the Government to get back to local MPs in north Staffordshire and ensure that we can have full, open and transparent debates on every bit of progress being made on every aspect of the Edwards report. If they can do that, there will be much joy and optimism among all those who care so deeply about providing long-term care for elderly people.

I shall briefly raise one final issue. Encouraging people to get the very best care and continuing health care beds, and also providing intermediate care beds and care in people's homes, raises a point about adaptations, which my hon. Friend the Member for Stafford made graphically. I have been campaigning about wheelchairs for a significant time. The wheelchair service in my constituency is based at Haywood hospital, and people sometimes have to wait for 13 months to get a wheelchair. How can we discharge people from hospital into their own homes if they cannot be mobile?

Two years ago, during the spending round, I went to the then chief executive of the hospital trust responsible for wheelchairs, who is now the chief adviser on the modernisation of the Government's health agenda. I set out for him the importance of increased investment in, and reorganisation and modernisation of, the wheelchair service in north Staffordshire. He as much as gave me an undertaking that that would be dealt with in the service and financial framework round. I heard nothing further and, in good faith, assumed that that spending had increased. As I said, that chief executive now advises the Government on their modernisation policy.

Some months later I realised, with a great shock, that the SAFF round had not agreed the money for increased investment in wheelchairs. It should come as no surprise that I felt it important to campaign to ensure that there was a sufficiently well researched, competent and businesslike plan for wheelchair services in this year's SAFF. Again, I made a point of contacting the chairman of the then North Staffordshire health authority and the then chief executive of the hospital trust. I was assured that everything possible would be done about wheelchairs. but, to my deep disappointment, the SAFF round did not agree an increase for the wheelchair service.

Perhaps as a result of my perseverance, and that of others, the silver lining to the tale is that the hospital trust, recognising our points about the wheelchair service, provided extra money to start investment in its long-term business plan for the service. Some one third of the money needed over a three-year period has now been committed, and I am very grateful to the North Staffordshire hospital trust for making that money available.

That story shows that we all have a responsibility to look into joined-up thinking right across NHS services and the different forms of care that need to be provided. The whole system can be completely undermined if one part of it is not right. It is important to get all the pieces of the jigsaw in place so that people in north Staffordshire have the services that they need. I have no doubt that we have an ambitious plan for elderly care in north Staffordshire, but delivery must be open and transparent. I ask the Minister to consider carefully, together with north Staffordshire Members, how we can ensure that our hopes and vision are backed up by delivery of services, so that nobody is without the care that they need.

rose—

Order. Perhaps I should remind hon. Members, after one day's holiday, that the three Front-Bench spokespeople routinely commence their winding-up speeches 30 minutes before the termination of the debate.

I rise to speak because this issue is of huge concern to my constituents. They raise it with me in advice session after advice session in my tours of residential nursing homes in the royal borough, so I felt it right to attend today's debate.

I congratulate the hon. Member for Stafford (Mr. Kidney) not only on his measured and well considered remarks but on the work that he has done in his constituency. I have always regarded him as one of the most impressive Labour Members, and his performance today has only confirmed that judgment. I hope that he will share some of the papers from his conference with me, so that I can see whether I can organise a similar conference in my constituency. I am currently undertaking a survey of care home owners in the royal borough, using a pack produced for me by my hon. Friend the Member for Sutton and Cheam (Mr. Burstow), which is producing some interesting results. To follow that up with a conference may be the next step forward and, as with the hon. Member for Stafford, it may be the best service that I can provide for my constituents.

I should declare an interest: I have an elderly grandmother who is recovering in Fordingbridge convalescent hospital because she recently broke her hip for the second year running. She was about to come out of care to go back to her warden-controlled flat when she fell over in hospital and broke her left wrist. Family members, including me, are increasingly concerned about the care provision that we make for her in the future. Therefore, the experience that I bring to the debate comes not only from my constituents but from the questions that my family and I are having to ask about my grandmother.

Some basic issues arise when one begins to look at the individual families and their concerns. The first question is: where is my relative to go? Is there a place available for him or her? Because so many care homes have closed down in my constituency, the number of places available is limited. People must wait, either in hospital, like my grandmother, blocking much needed NHS beds, or at home, where the quality of care is not good enough. Neither case is satisfactory, so one of the most important questions concerns the number of places.

It is easy to see why there are so many closures in my constituency. First, the labour market is very tight. The number of qualified people available to nurse and care for the elderly in homes is increasingly limited. It is noticeable when one goes round the care homes that many of the nursing care assistants are from countries such as the Philippines, having been brought over by different agencies to fill the gap. However, that is not an easy or cheap solution, and the pressure of costs on care home owners is increasing because of the tight labour market. I welcome the tight labour market because it helps to drive down unemployment, but it has that knock-on effect, which must be addressed by other areas of Government policy.

The lack of places in my area is also driven by two other factors. First, because of rising property values in areas such as Kingston, many care home owners coming towards the end of their working lives are being offered sizeable sums by property developers. One cannot blame them for wanting a decent pension, but a number of homes are closing for that reason.

Secondly, that desire to cash in on the value of the property is being exacerbated by new regulations. We know that there has been all-party support for those regulations, and I am not undermining the thrust of them, but in an area such as Surbiton where many of the houses were built in the Victorian era, although adaptations have been made, it would be extremely costly for care home owners to make the changes necessary to meet some of the more stringent standards in 2006–07.

There is insufficient help available to make that worth owners' while, so many of them are having to say, "We can't make that room a little bit larger—it's impossible. We can't afford to knock those two rooms into one to meet the standards, either, so we'll have to sell up." The problem is huge. Kingston has some of the most severe pressures in the country on its care sector because of those problems. The borough's senior citizens are suffering as a result, and we have to tackle that quite urgently.

There are other issues that we ask about immediately after finding places for our loved ones, such as the quality of the care. As I go round the residential nursing homes in my constituency I find a high quality of care, and I have seen some very dedicated people, but the owners tell me that they have problems in finding qualified staff. The hon. Member for Stafford touched on that during his speech.

Another issue germane to myself and my constituents is that people like their relatives to be near. Often, grandmothers or grandfathers live some way away in a different authority area. They may live in a home or a warden-controlled flat, or benefit from domiciliary care. Then may come the moment when they need to go into residential care. The complexities and difficulties of moving someone from one authority to another are large. If people want their relatives to be near to them when they move to a care home, that can be extremely difficult, given the different financial regimes. Will the Minister comment on that problem?

The Government have slowly been trying to address the problems, and after a lot of pressure and campaigning by my hon. Friend the Member for Sutton and Cheam they have begun to change policies. In the Budget they announced some increases of more than 6 per cent. in real terms for social services over the next three years. The question is whether that is sufficient, particularly if one subtracts from that settlement the extra cost of employers' national insurance contributions. The real-terms increase is significantly less when that extra taxation is taken into account. I am not convinced that the settlement is up to the job. I know that the Minister will not like that, but the extent of the challenge in the sector, and its high relevance to the challenge in the NHS, is such that that sector ought to be getting a better settlement than the NHS.

That sector has been the Cinderella sector, and has been underfunded for many years. The catching up that it needs to do is even greater than that required in the NHS. I found the Budget settlement in that area disappointing. The arguments that the Government rightly used to back the current funding mechanism for the NHS apply in this sector too—in spades. The Chancellor quite rightly argued that a taxpayer-funded health service is needed because in society we should pool risk. We come together as a community and decide that that is the most effective and efficient way of funding that type of service. That argument applies just as much to the care sector—yet people are charged, the quality of service is not sufficient, and the sector has been severely underfunded for a long period. I urge the Minister to press the case for extra funding in future negotiations with her colleagues.

Because the time is approaching the witching hour for Back Benchers I will draw my remarks to a close, Mr. Deputy Speaker— save to say that I can tell the Minister and her colleagues that areas such as mine, which many Government Members believe are prosperous and do not require funding, experience pressures that are as severe as those anywhere in the country, and our budgets and council settlements have not been up to the task of meeting that huge challenge.

I congratulate the hon. Member for Stafford (Mr. Kidney) on securing the debate and also on the conference that he organised, the information that has come out of it and the work that he is doing. I want to address some of the important issues that he raised.

Delayed discharge has been the focus of Government anxiety, but all too often the initiatives treat the symptoms but do not tackle the underlying causes. The causes of delayed discharge are a lack of prevention upstream and a lack of capacity downstream in home or residential care. Other speakers have touched on the latter, and I want to focus on prevention, about which we should be doing so much more. The hon. Member for Stoke-on-Trent, North (Ms Walley) rightly identified the need for it to be seen as part of a wider public health agenda, because a little help early on could make an immense difference to an individual's quality of life and could arrest and prevent a downward decline into dependency and a greater need for more intensive support later on in life.

There is a story that is often used to illustrate how powerful a little bit of help can be, and it is about mucky nets. Many people, when they get to a certain age, can no longer climb up a stepladder or on to a chair to take down mucky nets. For many, keeping up appearances is important to mental well-being, which in turn feeds through into their health. If the ability to keep up appearances is lost, the slide down the path of dependency may begin. As the hon. Member for Stoke-on-Trent, North said, feeling safe is also very important. There really is a crying need for services that provide a little bit of help, whether essential gardening services, essential property maintenance, basic do-it-yourself or the auditing of safety, security or energy efficiency.

However, the figures show that the number of people receiving basic care in their own homes has dropped by 109,900 during the past five years. We are told that those people are now living independently, but I suspect that they are the ones who turn up in the accident and emergency departments and end up as the delayed discharge cases in the national health service. They needed a little bit of help, but ended up getting it through the NHS rather than as it should have been given.

The hon. Lady spoke about budgets and resources. One of the measures of the pressure on social services departments is the extent to which rationing is now the norm, such as by denying care and support to those with moderate care needs who have carers—it is a widespread practice in social services departments that those who have carers often do not have access to any care at all. Rationing is also imposed by making those with high care needs wait, whether in hospital beds or in their own homes, hidden out of sight and out of mind, and by limiting the quality or quantity of care provided. Social services departments regularly deploy those tools to try to make their very stretched budgets go just a bit further.

The Secretary of State and the Chancellor recently spoke about the need to do something about delayed discharge by introducing financial incentives or penalties. Not surprisingly, people in local government and many others have expressed their concern, not least because there was no consultation about the proposals. I am very concerned about the introduction of a penalty system, the details of which are still rather vague, because of the potential distortion of priorities that it could produce.

We all know that there are serious pressures on local authority budgets for children's services. Indeed, two thirds of the overspend in social services budgets is on children's services. Therefore, a system that imposes more pressure to spend money on elderly people—right though that may be—without putting in extra resources in the first place, could result in yet more pressure on the budgets for children's services. The Wanless report, which was published on Budget day, made the following useful point:

"The processes of objective setting incentivisation and targeting have to be sensitively designed to ensure they achieve the required result rather than distort resource allocation."

I fear that we are about to see a distortion of resource allocation.

Hon. Members have referred to loss of capacity in the care home sector. As my hon. Friend the Member for Kingston and Surbiton (Mr. Davey) said, there is a real possibility of people not being given the opportunity and choice of residential care in their own communities, and being bussed miles away. Kent comes to mind, because the consequence of a substantial loss of capacity there is that people are bussed miles away from Kent, and from their families and loved ones.

The focus has been on delayed discharge, but there has been an 18 per cent. increase in emergency readmissions during the past two years alone. I understand that there will be a scheme of penalties to deal with that, but the details are much vaguer. Perhaps the Minister will comment on whether the system of penalties will simply recreate the cost shunting that already exists in health and social care. Social services will provide inappropriate packages of care, and when someone comes back into hospital as an emergency readmission, who will pick up the bill?

Hon. Members have spoken about residential care, and I shall touch on the important subject of training. I hope that the Minister will give a positive response to the suggestion by the hon. Member for Stafford for a pilot scheme. There is almost a revolving door in care homes at the moment. Unqualified, ill-equipped, untrained staff come in. They pick up the skills and ability to care for frail, elderly people, acquire NVQs and then leave for better paid jobs in the NHS and the statutory part of the state sector of social care. The same happens with domiciliary care, and the consequence is high levels of staff turnover and many vacancies.

We must consider what can be done about that. I hope that the Minister will tell us today what work she and her Department are doing, particularly in parts of the country where there is a tight labour market, to ensure that we can not only recruit but retain the necessary qualified and quality staff. Some parts of the country, such as Kent, Somerset and elsewhere, have lost a massive number of care home beds. What is being done to identify ways of regenerating the sector? When a home is knocked down or turned into flats, the land is lost and the opportunity is lost. It would be helpful if the Minister could tell us what is being done, in areas where the costs of entry into the market are so much higher than elsewhere, to ensure that the barriers are lowered and capacity can be retrieved.

We have discussed budgets and the need for SSA reform. Amen—weall agree about that. However, that is a holy grail that will deliver only if there is an increase in the size of the cake being distributed. The Budget settlement announced by the Chancellor a little while ago does not address the crying needs in social care throughout the country. The Chancellor rightly identified the fact that social services have been a neglected part of the caring services for too long, but it is not clear from the detail—I hope that the Minister can help us with that today—whether social services' extra spending during the next few years will be borne almost entirely by council tax payers forking out more, or whether substantial extra funds will be made available through grant to fund the necessary improvements. When the Local Government Association and others look at the figures they are alarmed that the resources going in are not sufficient to meet the Government's national service framework aspirations or arrest the collapse of confidence in the independent care sector in many parts of the country.

The hon. Member for Stafford referred to his conference, and I was interested to hear that his keynote speaker was Robin Wendt. I agree with him that there is still a debate to be had and a conclusion to be reached about the boundary between personal and social care. It is interesting that Wales is moving in the same direction as Scotland has taken, and I look forward to hearing more details about that.

Finally, I want to ask the Minister about the guidance document "No secrets", which concerns the abuse of older people. When will we have a report from the Department on its implementation, the budgets that will be made available and the staff who will be put in place? What initiatives are being undertaken to ensure that the document, which was published two years ago, is not a worthless set of words but a meaningful mechanism for delivering services on the ground and protecting the elderly?

In conclusion, I repeat that the care of the elderly must be a priority for us, and I congratulate the hon. Member for Stafford on giving us a further opportunity to debate the issue.

I, too, begin by congratulating the hon. Member for Stafford (Mr. Kidney) on providing us with the opportunity for this useful and opportune debate. Sadly, as we have heard in several speeches, there is a crisis in long-term care and the care of the elderly. The problem is not restricted to particular parts of the country, although there are some in which it is more pronounced.

In the past five years, 50,000 residential care beds have been lost across all sectors. That has put a desperate strain on elderly people who can no longer remain in their homes with domiciliary care. The loss of care home beds has not been uniform, and in some parts of the country, particularly in the south-east and East Anglia, a significant number of beds have been lost as homes are sold and local authorities use their bulk purchasing power to force down the amount that they pay to care for the elderly. The shortage of beds has had a distressing knock-on effect on many people who have been unable to find a home in the area in which they have lived all their lives. As a result, they have had to move ever further from their roots, from family connections and from the communities in which they used to live.

Unfortunately, as many hon. Members have said, we also have a problem with delayed discharge. Figures given in written answers have shown that more than 30 per cent. of those who are caught up in the delayed discharge system remain in hospital for more than a month. There is no medical or clinical reason for them to do so, but they remain in hospital because no beds are available elsewhere, or because there is no back-up for a domiciliary care package to allow them to return home.

Interestingly, last year's social services inspectorate report noted that 39 per cent. of delayed discharges were caused by delays in public funding, 36 per cent. by people having to wait for residential home placements as a result of the loss of beds and consequent shortage of spaces, and 18 per cent. by delays in the provision of domiciliary care packages. It is staggering that 39 per cent. of delays are due to people having to wait for public funding because there is not enough money in the social services budget to fund a place or domiciliary care, and that the national health service must meet the exorbitant cost of keeping such people in hospital for no clinical reason. That is an utter waste of taxpayers' money, and it is a disgrace that people are languishing in beds that are urgently needed for the acute care of other patients.

Reference has been made to this year's 6 per cent. real-terms increase in social services spending. Of course that is a step forward—it would be churlish to say otherwise. However, we should examine more closely the balance in the NHS funding budget between acute care in the NHS and personal social services.

Since community care was introduced in the early 1980s, there has been a significant increase in PSS funding, in percentage terms. As no doubt the Minister will tell us, the recent Budget contained a significant increase in such funding, although some of the gloss will be removed from that increase next year by the 1 per cent. increase in national insurance contributions, which will have a considerable impact on the NHS budget and place even greater financial burdens on care home owners and those in the care sector. The Department of Health did not examine closely enough the implications of an across-the-board increase in this personal tax and its impact on an area that is already struggling with other problems.

Some 62 per cent. of social services clients being looked after are from the elderly section of our community, but only 47 per cent. of the total funding is spent on social services, so there is a gap. Local government spending is significantly more than the SSA for social services, running at about 8.9 per cent. in 2000–01. It is estimated that for the financial year that has just ended, the difference rose to 9.7 per cent. In personal social services and social care, the amount of money has not increased to keep pace with increased demand and the highly sensitive and difficult nature of the care required by that vulnerable section of our community.

The gap between health and social care funding is inexorably widening. It will continue to do so because of the demographic changes brought about by more people living longer and because the extent and the complexities of the care that many people require will increase year on year. That is producing a vicious circle in which the pressure caused by delayed discharges is passed on from the health sector to the social care sector and then to the care market, where funding pressures affect capacity, leading to another increase in the pressures on the health sector.

As the hon. Member for Sutton and Cheam (Mr. Burstow) mentioned, there are other pressures involved in getting people out of hospital and into care or domiciliary care packages in their own homes as soon as it is clinically possible. However, I suspect that corners have been cut. Emergency readmission levels have significantly increased—another vicious circle that exacerbates the problems with acute care.

After the Budget, the Secretary of State published a document called "Delivering the NHS Plan", which contains the ludicrous and self-defeating proposal to fine local authority social services departments for delayed discharges. That is an ill-conceived gimmick, which, if it ever sees the light of day, will cause even more problems. The carrot rather than the stick should be used to overcome such problems. The Secretary of State and his successors will rue the day that that proposal was conceived.

We need an urgent and fundamental review of short, medium and long-term financial planning and a proper assessment of the necessary balance between health funding and local authority funding for social care. That will ensure that the problem of funding, which has continued to grow year in, year out as demand rises inexorably, is analysed and rectified to enhance and improve the provision of social care and health care for the most vulnerable, fragile and weak in our society.

Like others, I shall start by congratulating my hon. Friend the Member for Stafford (Mr. Kidney) on securing this debate, on his valiant efforts on his bike during the bank holiday and on the good and useful way in which he opened our discussion. I particularly congratulate him on the lessons that he learned from the conference held in his constituency. That was heartening, because we have made it clear that although the Government can set standards and targets, improve funding and offer clear guidance, local action is required to improve services on the ground. The local partnerships and plans that my hon. Friend is leading and contributing to will be important for his constituents.

Importantly, most contributors to the debate have recognised the complexity of the matter. Hon. Members have recognised that it is about more than the number of residential care places and that a range of policies will contribute to the provision of the high quality care that we want for older people.

Many older people lead happy and fulfilled lives with a minimum of assistance from formal services. Many of them make an important and positive contribution to their families and their communities. They do so by giving up their free time to work for voluntary organisations and by working with children in their own families and in schools.

The hon. Member for Caernarfon (Hywel Williams) rightly emphasised the range of older people's needs. We ought to aim to support older people and their families in their choices and lifestyles. We should ensure that, as far as possible, people are not removed from their communities and social networks and we should find ways to underpin existing relationships and situations that minimise risk and disruption and maximise continuity, familiarity and social inclusion.

Hon. Members also made the important point that responsibility for that goes across agencies. Local councils, working with partners, have a fundamental role to play, as does the private and independent sector. The voluntary sector also makes an important contribution to the care of older people in our communities.

From talking to older people—my hon. Friend the Member for Stoke-on-Trent, North (Ms Walley) made this point—we know that fears about safety and security are high up on their agenda, as is access to reliable transport, local shops, good leisure facilities and primary health care. It is vital for councils to work with local agencies such as those for health, fire, police, housing, education and social care to make our communities safe and supportive places for older people to live.

My hon. Friend made an important link with the Government's overall public health agenda. Our development of good health throughout our lives will affect us in older age. As a Worcestershire MP I heard, as, I am sure, did my colleagues in the Department for Transport, Local Government and the Regions, her plea for SSA reform. I assure her that there will be consultation with local government throughout the summer as we move towards the implementation of the new regime in the next financial year.

Many hon. Members raised the issue of delayed discharge. I agree that it is bad for the system as a whole; even more significantly, it is bad for individuals. That is why the Government's investment in the system is important—and it is important that it should work.

My hon. Friend the Member for Stafford spoke about the £5.4 million going to Staffordshire. He will be pleased to know that it led to a reduction in delayed discharges in Staffordshire; they were down from 224 in September 2001 to 127 in March 2002, and the target is for a further reduction by March 2003. The investment has allowed extra publicly funded care home places, extra intermediary care beds and more intensive care packages; it has been a successful start in tackling the problem of delayed discharges.

I agree that we need extra investment. I was therefore pleased, as were my hon. Friends—we should not be too surprised that the Liberal Democrats thought that it was not enough—that my right hon. Friend the Chancellor was able to give personal social services a significant annual average real-terms growth of 6 per cent. in 2003–04, rising again in 2005–06. That demonstrates the Government's firm commitment to social care. It contrasts with an average real-terms increase, on a like-for-like basis, of less than 0.5 per cent. a year under the last Conservative Government. That new cash includes resources to cover the cost of hospital beds that are needlessly blocked through delayed discharges.

Councils will be able to use that extra money to expand care at home and to ensure that all older people are able to leave hospital once their treatment is completed. We shall introduce stronger incentives to ensure that people do not have to wait so long before being discharged. Older people and other service users have the right to expect that local services should work together as a coherent whole, and that the policy that underpins them should promote joint working rather than letting them act perversely, as sometimes seems to be the case.

The hon. Members for Kingston and Surbiton (Mr. Davey) and for West Chelmsford (Mr. Burns) raised the issue of residential care fees. Once again, we heard the wrong figure for a fall in residential care beds of 50,000; even Laing and Buisson accept that it was a net figure of 19,000. However, we share their concern about residential care placements. As my right hon. Friends the Secretary of State and the Prime Minister have said, higher resources in social services should lead to higher residential care fees. For example, I was glad to see that what Staffordshire received of the £300 million went into increasing residential care fees.

Other hon. Members pointed out the importance that the Government place on promoting independence and allowing people to remain within their own homes. The number of people receiving intensive domiciliary care increased nationally by 6 per cent. to September 2001. That is an important and encouraging trend, and we want to see it continue.

The hon. Member for Caernarfon (Hywel Williams) raised the issue of non-residential care charging. The guidance issued by the Government in England takes an important step in helping to overcome the discrepancies between authorities, and for the local authorities to charge where they choose, which will be much fairer.

My hon. Friend the Member for Stafford and other hon. Members raised the important issue of training, and training support, in residential and domiciliary care. The national minimum standards put in place by the Government will ensure higher levels of training, but we are also matching it through increased investment—for example, through the training organisation for personal social services, which increased from £2 million last year to £15 million this year—to ensure the sort of training that is crucial to recruit and retain staff and to ensure quality in the residential and domiciliary care sector. My hon. Friend's point on how we can take forward that training is important, and I shall certainly consider it.

Several hon. Members made the important link with housing issues. I assure them that my Department is working closely with colleagues across Government to ensure that local authorities recognise those links, and the importance of developing new forms of housing. More extra care at sheltered housing, for example, could play an important role. We are reaching and exceeding our targets on intermediate care. As several hon. Members have said, that is an important bridge between hospital and home, which helps to prevent some admissions to hospital. It is a key part of the national service framework for older people, which remains a high priority for the Government. I shall ensure that my hon. Friend the Member for Stoke-on-Trent, North, receives a reply about the north Staffordshire elderly care strategy.

I welcome the chance to introduce the debate. It was prompted by the realisation that I had dealt with a number of constituents who had had less than happy experiences in cases in which a cancer had been diagnosed. A glance at Hansard shows that other hon. Members have had similar experiences, and I hoped to be able to share those today. However, not many of those concerned seem to be here.

Almost invariably, my constituents have nothing but praise for the staff who treat them. It is important to mention that, because when we say things that might have a negative feel, staff may believe that we are getting at them. We are not getting at staff; indeed, in many cases, they are just as frustrated by the problems as are the patients. Most health professionals went into the profession because they wanted to make things better for people, and it is frustrating if they cannot solve problems quickly. In many cases, staff have verified my constituents' stories and have expressed a great deal of dismay at the difficulties that they have faced from time to time.

I want to touch on a number of matters: first, the problems surrounding diagnosis; secondly, waiting times for radiotherapy, without which the debate would not be complete; thirdly, access to drug treatments; fourthly, funding; and finally, a brief recognition of local cancer support services. Much of what I have to say has a national context, but as much as possible I shall restrict my remarks to those relating to the southeast of England.

I shall start by considering diagnosis. The Government have set a two-week standard for patients who have been urgently referred by their general practitioners. That means that they have to see the relevant specialists within that time. The latest available figures show a somewhat patchy compliance. Patients in the Surrey Hampshire Borders NHS trust, for example, come off best in that 99 per cent. of them are seen within the target time. Not so lucky are the people of Hastings and Rother; in that area, only 58.6 per cent. of patients see the relevant specialist within two weeks. I do not know the reasons for the differences—perhaps the Minister can enlighten us—but it will be interesting to know what performance level would ring alarm bells and, once those bells had sounded, what action would be taken, and by whom, to improve the service for patients in a particular area.

It is all very well if one has a lump or worrying symptoms and one's GP makes a referral. However, some say that GPs have a tendency to over-refer—I might not agree with that —because they know that it will put a patient's mind at rest. Others are more mindful of pressure on resources and may take certain decisions before referring, but that can lead to problems, as a constituent of mine in her early 20s discovered. She was a nursing mother, but was convinced that something was not quite right and found a lump in her breast. Her GP dismissed her as being over-concerned and suggested that her lumpy breast was caused by breastfeeding. He was wrong. By the time that the young woman was believed and the cancer properly diagnosed, it had spread, as it was of a particularly virulent type.

Also locally last year, the press highlighted the case of a teenage girl who had died of breast cancer. The press reported that she was the youngest person in the United Kingdom to die in that way. Unfortunately, the probability of those two young women having breast cancer was extremely low, as any GP would know. That may work against young women being taken seriously and referred when they visit the GP. I have tried, but have been unable to find figures to show whether the rate of breast cancer in young women is rising, but GPs should be aware that breast cancer can affect women of all ages. Are there any plans to ensure that age is not a factor in determining whether a woman's symptoms are taken seriously?

While I am on the subject of diagnosis, I want to put in a word on behalf of the medical and scientific laboratory officers. They are all graduates and many of them have a secondary qualification. They are essential to the long-term success of the cancer plan, but their wages are very low. My local organisation asked to speak to me about the subject because so many people were leaving the profession. The previous hon. Member for Isle of Wight made the front pages of the local papers with his revelation that highly qualified people earned less than chicken pluckers. The wages are a particular problem in the south-east of England, as property prices are high and there is a high cost of living. There will be implications for the future if the issue of salary levels is not addressed, as the profession will simply not attract the bright young people that it needs to attract.

As I am about to show, accessing some treatments may take time, and there is a debate to be had about whether the two-week target is appropriate or whether it should be longer. Would patients be better served by concentrating efforts following diagnosis to ensure that people are treated more quickly? I suspect that my hon. Friend the Member for Oxford, West and Abingdon (Dr. Harris) will want to elaborate on that point.

I shall now discuss waiting times for radiotherapy treatment. I was first alerted to the problem by a constituent who had developed a form of skin cancer. His specialist decided that he needed urgent radiotherapy and spent two hours on the telephone trying to book treatment for him. He telephoned places all around the south of England and no treatment was available for three months. My constituent had some savings, which he was reluctant to use, but he eventually decided that his life was worth it and his oncologist managed to book him into one of the London hospitals as a private patient. As my constituent did not know how he would be feeling, he had to travel from London by taxi, again at some expense. Although he accepted that it was his decision to access private medicine, he thought it reasonable to try to reclaim some of his travel costs— unfortunately, to no avail, as he had not agreed that before embarking on treatment. I suspect that he had other concerns at the time, focusing on the diagnosis of cancer, which does tend to concentrate the mind. The decision not to pay some of his travel costs, although they were a small portion of the cost that would have been incurred had he undergone radiotherapy under the national health service, seems perverse when we are shipping people to the continent for hip operations.

Currently, many people in the Southampton area are waiting 13 weeks or more to begin radiotherapy. Recent figures show that that appears to be a problem throughout the south-east. On 30 September 2001, 35 per cent. of in-patients were waiting for more than 12 months for radiology—I cannot believe that figure, but most have to wait more than three months. The latest figures for out-patients show that only 77.6 per cent. are seen within 13 weeks of referral. Is there spare capacity in other parts of the country? Would it be possible to treat patients from the south-east elsewhere?

The plot thickens. Two days ago, The Sunday Times pointed out:

"Many patients are having to wait months for tests for illnesses including cancer and heart disease before they are placed on official NHS waiting lists for surgery. Some die before they reach these lists."

That article specifies surgery, but do the same criteria apply before a patient is put on a waiting list for radiotherapy?

Worryingly, The Sunday Times also claimed that there were long waiting lists for magnetic resonance imaging and computerised tomography scans. Worse still, waiting times for MRI scans are not compiled, as revealed by the Minister in a written answer to me on 15 April. In the light of the importance of that procedure in diagnosis of cancers, does she have plans to collect the figures so that we can know whether our constituents receive a service that is good, bad or as we would expect? Constituents of mine have raised concerns about waiting for up to six months for such diagnostic procedures.

I developed a close interest in drug treatments when a constituent wrote to me in desperation. She had been told that Herceptin was her only chance, but at the time the National Institute for Clinical Excellence had not approved it. Her doctors were reluctant to provide it. She obtained the treatment eventually but, sadly, it was too late for her. In some ways, she was luckier than most, in that she was tested to see whether the drug would benefit her. A Europe-wide survey showed that only 18 per cent. of women with newly diagnosed breast cancer in Britain were tested for HER2. A positive test for that means that the drug will be useful. That compares with 67 per cent. of women in Germany and 87 per cent. in Spain.

Happily, NICE has approved the drug, but some interesting questions have been raised. If doctors still do not test for HER2, they will not be in a position to know whether the drug will be valuable. What steps is the Minister taking to ensure that all women, not only those in the south-east, have access to the test to suggest whether they should receive a NICE-approved treatment?

I have been lobbied by many drug companies since the subject of our debate has been known. I shall deal with a couple of their points briefly because they affect the south-east, although not exclusively so. Is the Minister happy with the delays in obtaining NICE guidance? What estimate has been made of patients who have been denied treatment because of the delay? When a drug is approved, what monitoring of uptake is there? How does the NHS monitor the number of patients and the cost that it bears, and make comparisons with the pre-approval phase of the drug? Without such comparisons, it is difficult to say with conviction that NICE guidance is being acted on. An undertaking to provide such information would be most welcome and add to the transparency of the process.

I want to touch briefly on aspects of funding. No one would deny that the extra money for cancer services was welcome. What is less clear is how it is allocated once it reaches a trust. Recently, the Select Committee on Science and Technology considered cancer research, and in one sitting with the Minister specific concerns were expressed about whether funding reached what it was designated for. Macmillan Cancer Relief had received reports that much of the money was diverted elsewhere to pay off debts. At the time, the Minister did not have a categoric answer because the accounts simply were not available. Is there any update on that position, and what action will the Minister take so that her Department—particularly in the south-east region because that is my concern—ensures that hypothecated resources get to the services on the ground?

I want to say a brief word about a couple of local cancer services. We are very lucky to have the Wessex Cancer Trust, which does sterling work. I have mixed feelings about whether such trusts should be funding hospital equipment, rather than the NHS, but it seems to be the way of the world these days. I want to mention briefly Jane Scarth house, which is part of something called Cancer Concern. It is a walk-in centre close to the local Waitrose, in the high street in Romsey—an excellent idea. It provides information, support and counselling. You name it, it does it—from helping women to look good when they have to wear a wig, and really do not want to, to providing counselling support for families, and more or less everything in between. It has suffered financial problems recently, due to the winding up of the parent charity. It has been so worth while and of such benefit to many local people that I wondered whether there was any way of extending that sort of scheme to other areas of the country. People do not always want to go into a medical environment to obtain the help and support that they need. It seems to me that such high street centres are well placed to cater for that.

I am disappointed that there are not more people present today because I have had a considerable mailbag on various aspects of the problem. I had thought that more concern would be shown here today. Of particular concern is the radiotherapy waiting list. I understand that there are plans afoot to put in new equipment, but that will take some time. In the interim, it would be useful to know what we are doing for those patients.

I congratulate the hon. Member for Romsey (Sandra Gidley) on obtaining the debate, and on her thoughtful speech. She was looking, quite rightly, at the full spectrum of cancer services, from primary care through the full range of hospital services and related support.

I want to focus on the narrower but absolutely critical issue of cancer centre services in east Kent. I am glad to see the Minister in her place again because I have had the opportunity to pursue the cancer issue with her in a small way. The debate will give me a little more time to focus on the cancer problems that arise out of the proposed reorganisation of hospitals in east Kent, particularly in the light of last week's revelations about cancer.

The cancer centre in Kent is unique in the country in being jointly delivered on two sites: Maidstone, which serves west Kent, and Canterbury, which serves east Kent. They have the ability to treat common cancers and provide specialist services for diagnosing and treating rarer tumours, radiotherapy, specialist nurses, diagnostic services, CAT scanners, MRI, endoscopy, pathology, in-patient medical care for complex treatments, a high-dependency unit for seriously ill patients and dedicated out-patient facilities. In other words, all the various strands that comprise a cancer centre are provided on both sites. That is partly because the logistics of Kent are so bad. To be readily accessible to people at both ends of the county, two sites were needed. There is also a capacity issue, to which I shall return.

Behind that dry list of services there exists an extraordinarily good cancer centre at Canterbury. Several very dear friends of mine have been treated there, in most cases extremely successfully. A former agent, Jo Chapman, who, tragically, did not survive, was none the less treated very professionally right up until the day she died. I saw her just before she died and she was full of praise for the treatment that she had received in the Mountbatten centre, the residential facility in Canterbury, whose construction was largely funded by outside money raised on appeal.

Several problems for the cancer centre arise from the proposed reorganisation of the three acute hospitals in east Kent. I have letters from two of the three consultants who operate in the joint cancer centre. One, from Dr. Stewart Coltart, lists the problems, saying:

"Ambulatory/outpatient model is untested in UK"

and

"Not advised by Canterbury and Maidstone consultants nor by the Royal College of Radiologists."

He mentions

"Difficult access for the poorer population from Thanet, Deal and Dover"

as well as from Canterbury. Thanet has the largest concentration of deprived people, we are told, in southeast England outside London; Deal and Dover have large amounts of deprivation and I have some extremely deprived wards in Canterbury.

Dr. Coltart raises the question of

"Who will look after seriously ill cancer patients in E Kent … when in patient care and consultants are based in Maidstone. It will not be specialist cancer doctors or nurses as happens now."

He mentions the enormous cost of transferring the facilities from Canterbury to Maidstone, which does not seem to have been included in the private finance initiative proposals at all because of the anomaly that, thanks to the East Kent health authority's last reorganisation, cancer services belong to the Maidstone and Tunbridge Wells trust and not to the East Kent hospitals trust, which designed the document. Listing a final problem, he says:

"Lack of access would mean that some patients would not be referred or be fit enough to receive radiotherapy."

Dr. Howard Smedley, another consultant, backed up his colleague's comments, saying:

"I have been involved in several meetings with middle management in East and West Kent recently as they try to resolve the issue of what to do with cancer services given the downgrading of the Kent and Canterbury. Despite the rhetoric it is quite clear that Canterbury is going to be left with an outpatient radiotherapy facility as the only treatment facility",

he alleges. He continues:

"It is clear that more chemotherapy may take place in Margate and Ashford and all the true cancer centre, i.e. complex work, will go to Maidstone."

Let us look for a moment at the process that has taken place. Cancer was excluded from it. The trust responsible for delivering the joint cancer centre in Canterbury is not a signatory of the document. Professor James, who heads the joint cancer centre, attended the meetings and claimed that he was closely involved with the writing of the appendix that appears in the back of the document on cancer. He said that his main thrust would be to restore confidence for the purpose of attracting new cancer consultants. He also claimed, at the Canterbury meeting, that all three of the Canterbury-based consultants were solidly behind the proposals in the document. He even listed them by name. Yet the two letters to which I have just referred, attacking the proposal, had been widely circulated some weeks before.

I asked Professor James at a subsequent meeting at Whitstable whether he supported the sentence on page 42 of the document that appears to be a direct attack on confidence in the centre. It says:

"This has led us to conclude, reluctantly, that for the longer term it is not possible to guarantee the continuous medical support and cover that is required to provide safe inpatient radiotherapy and chemotherapy services in Canterbury".

He was, of course, unable to answer, as his previous spiel had been all about building confidence in the viability of those services.

Asked whether he had seen the letters from two of his three Canterbury consultants vehemently opposing the proposals on the grounds that they would be clinically unsafe, Professor James again refused to answer. Just for the record, I understand that the third consultant was so angry about his claim, which mentioned her name and views, that she subsequently denounced him at a consultants' staff meeting.

I shall look for a moment or two longer at the detail of some of those problems. Page 43 of the cancer appendix—I should stress that it is only an appendix that sets out some ball park points rather than a firm proposal— to the document claims that

"in summary, the ambulatory/outpatient model of service at the Kent & Canterbury hospital will support for the next ten years … outpatient/radiotherapy and chemotherapy treatment".

That is stated as a bald fact. It was backed up—if that is the right phrase—by Professor James's claims at the Canterbury meeting that four fifths of the people who are currently treated in the cancer centre at Canterbury will continue to be treated there. We have heard the four-fifths figure in a quite different context before. It was claimed for the accident and emergency unit in its downgraded form as a minor injuries unit. That figure has now been abandoned and replaced with one of between 50 and 60 per cent. None the less, I mention that as the figure that Professor James was claiming. He made a bald claim that the ambulatory out-patient model would be good for at least 10 years at the lower level of 80 per cent. of current treatments.

After the cancer tsar visited Canterbury, however, he sent a letter headed "Provision of cancer services in Kent" to Dr. Stewart Coltart. It states that if Canterbury ultimately becomes a community ambulatory care centre, it would not be safe to provide in-patient oncology services there. More important, it states that day case treatment, including radiotherapy, "might be possible." All that the cancer tsar can say is that it "might" be possible.

Since then, Professor James has prepared another paper that he has actually signed—there is no signature on the mysterious appendix that appeared in the back of the proposal document. Indeed, as I remarked earlier, his trust was not a signatory to that document. This paper was produced in secret, prepared for his employers in Maidstone and, I imagine, sent to the new Kent health authority. It also happens to have fallen into my hands. As one would expect, it is worded in highly technical language. I shall therefore only quote its aims and final conclusion, both of which are extremely short. It examines the implications for Kent of

"the impact of haematology location on service delivery of solid tumour chemotherapy and complex cancer surgery"

and looks at

"alternatives for the co-location of solid and non-solid tumour chemotherapy".

I shall also quote the paper's first three conclusions. The first conclusion is:

"Planned changes in support services for cancer services in East Kent increase the need for co-location of complex cancer services in the Maidstone Cancer Centre."

Maidstone already has a 14-week waiting list as opposed to Canterbury's seven-week waiting list.

My hon. Friend the Member for Faversham and Mid-Kent (Hugh Robertson) tells me that he has written three times to the chairman of the Maidstone and Tunbridge Wells trust asking it to give an official response to the cancer appendix to the document. He has not yet received an answer of any kind. He asked me to state that, because he is attending another meeting booked some time ago that prevents him from joining us.

The second conclusion is:

"National guidance on the surgery for rare cancers (gynaecological, head and neck, upper gastrointestinal) recommends centralisation. For West Kent, the chosen site is the Cancer Centre in Maidstone."

The idea that gynaecological services will be taken away from Thanet, where they are now, has been neither canvassed nor discussed anywhere. Professor James uses the word "centralisation", reminding us that the centre for west Kent is now in Maidstone. The only other place where gynaecological services are delivered at present is Thanet. Is east Kent to lose gynaecological services too? It would be interesting to have an answer to that question.

The third quotation is the real killer:

"There are strong arguments for co-locating high-level haematological chemo with a cancer Centre. Parallels exist in service support for cancer surgery and the haematological malignancies and consideration should be given to merging and co-locating some of these support services."

Indeed, a large part of the paper, which I shall spare the Chamber, discusses the back-up services for haematological cancers—leukaemia and the other blood-related cancers. In other words, since Professor James's various verbal contributions to the consultation process—they were only verbal—he has already conceded that in the case of blood-related procedures the services are worthless: they will all have to go to Maidstone.

A few minutes ago I was on the telephone to Dr. Stewart Coltart to discuss this issue. He makes the point that the distinction that Professor James draws between blood cancers, in the case of which he has finally conceded that it will not be practical to follow his model in Canterbury, and the solid cancers does not exist: almost exactly the same problems apply to the solid cancer centre services as to the blood cancers. In other words, we face the loss of all the true cancer centre services from east Kent. It is true that on all three sites in east Kent it will be possible to continue to deliver the cancer out-patient unit services. However, to summarise in plain English what I have been saying for the last few minutes, if the proposals to reorganise the three acute hospitals in east Kent go ahead, the first cancer centre closure since the Government took office will take place: the cancer centre, as a centre, in Canterbury will close. I look forward to hearing the Minister's comments on that.

I pay tribute to my hon. Friend the Member for Romsey (Sandra Gidley) for securing the debate and setting out what she wished to say in such a clear and organised way. She draws our attention to key questions about diagnosis, the waiting time for diagnosis and, in a couple of examples, the quality of diagnosis, the waiting time for treatment, access to drug treatments, funding and the role of local cancer support services in the NHS and, particularly, the voluntary sector. I share her regret that more hon. Members from all parties are not present to hear her points of view, but what we lack in quantity the two previous contributions have made up for in quality.

Even in the south-east, cancer services are a large subject. I am sure that the Minister has come prepared to deal with a number of questions from Back Benchers and Front Benchers on all aspects. I concur with my hon. Friend that many of these issues are not only local and regional but national. I have a number of questions to which I hope that the Minister will be able to respond. To ensure that she has time to prepare her answers, I shall set them out at the start of my speech, before I mention each one individually. I should be grateful if she would respond to six questions.

Will the Minister first—she may have guessed that this was coming—set out the evidence base on which the two-week wait policy is predicated, to show that it will improve survival, compared with a policy of a maximum waiting time between presentation and treatment or diagnosis and treatment? She will accept that, at best, there is some controversy about the rational evidence base for improving survival for that target.

My second question, which my hon. Friend raised in passing, relates to the shortage of radiotherapists and the fact that the private sector has radiotherapists who may be available to the NHS. A separate question relates to the fact that the bulk of those radiotherapists will have been trained by the NHS, at its expense and that of the public sector, through our university system. Does the Minister think that it is reasonable for the private sector not to carry any overhead for the training of radiotherapists when it tenders for NHS contracts or any other business? Does she agree that there may be some rationale for asking the private sector to pay some form of levy for the time that it uses of NHS-trained radiotherapists and other professions allied to medicine, such as nurses and doctors? Otherwise, there will not be a level playing field in tenders for NHS contracts, which she wishes to open up to the private sector.

My third question relates to a point made by my hon. Friend. By focusing on specific aspects of waiting, the Government fail, by an act of omission, to pick up the overall waiting time between presentation and treatment everywhere in the country, although one can consider it on a regional basis. Can the Minister explain why the Government did not set up a mechanism to measure the time between presentation and treatment and, even more important, between diagnosis and treatment rather than between presentation and diagnosis of referrals, most of whom, fortunately, will not have cancer? The failure to collect such data and the failure to record other waiting times, such as those for MRI and other services, lead to the allegation that the Government seek to disguise long waiting times.

My fourth question is about NICE approval for drugs. Can the Minister tell us which drugs are not funded in order to find the money to pay for drugs and treatments that have been approved by NICE, which must now be used, following the regulation that NICE guidance must be implemented? If she cannot answer that, can she say what system she has set up to monitor the effect on drug treatments that have not been approved by NICE and, therefore, are not protected by the diktat that health authorities and primary care trusts—whoever has the funding—must fund them?

I should be grateful if the Minister would discuss the role of the lottery in local cancer support services. Perhaps the Government have changed their policy, but my understanding was that the lottery would not be used to pay for core services in the health service. We know that the proceeds of people's gambling on the lottery are used to pay for radiotherapy machines and linear accelerators to treat cancer. Is that because the Government's policy has changed or is it their view that such machines are not part of the core service that the NHS should provide? Everyone wants to see more machinery, but is that consistent with the Government's announced policy?

My final question is about the funding of hospice care, which is, I suppose, the end of the process. The Government made a series of announcements about additional funding for hospices, which have not really been part of the NHS. In my constituency and in the constituencies of other hon. Members, that important part of patient care has generally been left, at best, to a combination of voluntary organisations that have been fortunate and hard-working enough to raise funding, and small NHS or social services contributions. If hospice care and terminal care are part of core NHS treatment—I believe that they should be—they should be funded by the Government. I am not asking the Minister to repeat her previous announcement about the amounts of money, but I am asking her to clarify when hospices will receive the funds.

My local hospice certainly has not seen any additional funding. I refer to the children's hospice, Helen house, and its partner organisation, Douglas house, which is about to be established. I fear that, despite huge efforts, such hospices will be unable to continue to fund-raise sufficiently to maintain resources. Since there is not an adequate NHS for children and young adults, which is the area covered by the hospices, I should be grateful if the Minister would give a categorical assurance that the funding that she announced—it differed from a Library briefing that I was given—will reach front-line services.

My hon. Friend raised several important points about the two-week wait. Through her work, she showed that the implementation of that has been patchy, which is a source of concern even if it is a rational target. None of us wants our constituents to wait too long for a diagnosis of symptoms. There is a debate over whether people necessarily want a same-day or one-stop service, which has been previously advocated, or whether they want time for investigations, to see specialists, and to return in the near future for a discussion of the diagnosis. However, the trend towards conveniently accessed one-visit diagnoses and further investigations is important.

If there is no evidence of improved patient survival after a two-week, rather than a two-month, wait to see a specialist, one must balance the undoubted gain of speedy referral for some patients with the consequences of such a policy. The consequences do not appear to be improved survival for the patients referred; they appear to be a later referral time for those who are not fortunate enough to be referred under the two-week wait. That may apply to the people in the cases raised by my hon. Friend, who are not thought to have cancer symptoms and are referred by GPs in the normal process if they are referred at all. They must wait longer because resources have been taken from general out-patient services to meet the two-week wait.

Even when funding is available, if there is a fundamental shortage of staff one is simply rearranging queues. The Government have decided to prioritise people referred under the two-week wait, but they must recognise the consequences of that. Professor Michael Baum told me that he was concerned that in the breast cancer field patients who were not referred under the two-week wait would suffer. Many GPs recognise that, and refer as many people as possible for the two-week wait, which somewhat defeats the purpose. Can the Minister say whether any thought has gone into the implications of that policy?

I should like to reinforce the message of my hon. Friend on the state of recruitment among scientific officers, and on their remuneration. The problem is apparent not only in laboratory staff and medical laboratory scientific officers, but in cytology screeners, who are a crucial link in the diagnosis of cancer. They are among the worst paid graduates working in a technological area. The south-east has a general skill shortage and will find it more and more difficult to recruit newly qualified graduates. It may also become more difficult to recruit people into training for those subjects. As the former Member for Isle of Wight, Dr. Peter Brand, remarked, for scientific officers on the Isle of Wight to be paid less than chicken pluckers is an indictment of the way in which, over many years, the NHS has treated people with those qualifications.

There is a growing concern, although the problem has always existed, about the wait for radiotherapy treatment. In that case, outcome will be impacted by the time spent waiting for treatment. Many of the points made in the article in The Sunday Times need a response from the Government. In my constituency and other areas throughout the south-east, patients have great difficulty in gaining access to drug treatment. My hon. Friend drew attention to the difficulties for patients waiting for drug treatment when NICE has started its appraisal process because of what is commonly called "NICE blight" in which the take-up and prescription of a drug falls simply because the drug is going through the NICE process. My hon. Friend's questions about the speed at which NICE reaches its conclusions are pertinent and I look forward to the Minister's response.

A number of hon. Members in this debate and elsewhere have asked where the funding for cancer services has gone. My hon. Friend the Member for Twickenham (Dr. Cable) said at Prime Minister's questions that if funds are ring-fenced for cancer services, it is reasonable for people to ask what steps the Government are taking to ensure that that funding reaches its destination. There have been a number of claims that funding has been used to pay off debt or has gone to other areas. One can question whether it is reasonable, legitimate, ethical or distorting specifically to allocate some of the growth to centrally decided priorities, but if the Government do that they owe it to the audit process, if not to patients and staff whose expectations have been raised, to ensure that the funding reaches those priorities. The Science and Technology Committee report on research mentioned the matter and raised serious questions for hospitals not only in the south-east but throughout the country.

I again pay tribute to the hon. Member for Canterbury (Mr. Brazier), who perhaps has more detailed knowledge than anyone of the proposals for east Kent hospitals. He has been very active in the matter and I know from speaking to people in his area that he has worked hard on their behalf, no matter what their political views or whether they have any. The reorganisation of hospital services in east Kent, particularly cancer services, poses difficult problems for a Government with whom the buck eventually stops. His contribution reflected the widespread public concern about the future of cancer services as well as the drastic situation concerning acute services in those hospitals.

In conclusion, I join my hon. Friend in paying tribute to those who work in this area. They have to deal with a difficult condition. Cancer can strike at any age and is, by nature of its pathology, often relentless in its course. They must deal with a condition that receives a lot of political and media attention. Professional staff tell me that they know the risks of working with this condition and that they may be labelled negligent if one cancer is missed because the expectation is that screening will pick up every cancer and that early detection automatically and always means an increased likelihood of cure. The picture is more complex. Screening is high risk detection and is not foolproof. It is incumbent on the media and politicians to recognise that when cancer is missed. It was ever the case. We must improve diagnosis and our level of suspicion. We must also improve treatment in the health service, but it is dangerous to raise expectations to too high a level because it will simply put off hard-working staff who do their best.

Tribute should also be paid to the voluntary organisations that do so much to raise resources for cancer research and treatment. My hon. Friend referred to the tension between welcoming fund-raising of all kinds for cancer and the question whether that is a replacement for or an addition to Government funding for the health services. It is clear that without volunteers to offer counselling and raise funds for treatment and research, we would not have the cancer services that we do, and I join my hon. Friend in paying tribute to those people.

Like other hon. Members, I congratulate the hon. Member for Romsey (Sandra Gidley) on raising an important subject, although it is a great pity that its importance is not reflected in today's turnout. That said, the reason for the poor turnout may be that we hold debates almost every other week on some aspect of this issue, be it breast cancer, cancers in men or, as today, cancer services in the south-east. However, the low turnout gives the Minister an opportunity to provide a full and detailed response to the points that have been raised. Usually, Ministers must squash their replies into the final 10 minutes or so and are peremptorily cut off just as they get to the essential question that we want answered.

I echo the six questions raised by the hon. Member for Oxford, West and Abingdon (Dr. Harris), which I, too, have raised at various times in the past, not least in this Hall. I want to take up two of the hon. Gentleman's points. First, the two-week policy has been a cornerstone of the Government's approach to cancer treatment, but I have seen evidence that it distorts treatment times following the front-end loading of consultation times, which have been speeded up only through the massive concentration of a finite quantity of resources.

Secondly, I echo the hon. Gentleman's final question, which related to hospice care and to which I hope the Minister will reply. Hospices are finding the going tough, and that will be particularly true following the national insurance increases in the Chancellor's recent Budget. They will receive none of the additional funding that is intended to make up for the £250 million national insurance bill that will fall to the NHS. The vast majority of hospice funding will have to come from additional voluntary contributions and charitable fundraising which we see throughout the country. That is true not least of St. Barnabas hospice in my constituency, of which I am honoured to be a patron. St. Barnabas is conducting its massive chestnut tree appeal to build a hospice for children in my area, and it needs to raise £5 million in capital alone. The running costs involved in staffing the new hospice will be that much higher than elsewhere given that it is in the most expensive corner of the country and that it is particularly difficult to recruit medical staff. The Government must consider the issue more favourably than they have done. The Conservative party promised a big increase in funding for hospices, particularly for children, and I would like guarantees along those lines from the Government.

The initial point raised by the hon. Member for Romsey was that our comments about cancer services in this debate and elsewhere are not a criticism of the dedicated and long-suffering staff in this highly stressed area of the NHS. From all the examples that I have seen, I know that, without exception, they do their jobs with enormous dedication and professionalism, even if the results do not reflect their input in many cases.

Cancer treatment remains one of the cornerstones of new Labour's promises to modernise the NHS, but we still hear far too many horror stories and excuses as to why services are taking so long to improve and will need much more investment. The national cancer plan stated:

"The ability of the NHS to modernise and reform its cancer services is a litmus test for the health of the NHS as a whole."

The Government therefore have an awful lot more to do.

Over recent months, we have heard stories that suggest that things are not going as well as they should, not least the stories in the recent Science and Technology Committee report about the siphoning off of cancer funds, revealing that money promised to improve cancer care appears to have been siphoned off by NHS trusts to pay for other priorities.

In their cancer plan, the Government pledged to increase spending on cancer care by £570 million a year by 2003–04, but cancer specialists told the Select Committee that part of the first round of funding—about £280 million for 2000–01—may have been diverted by NHS into paying off debts or meeting administration costs. The report stated:

"The increase in cancer care funding, often quoted over recent months, may not be reaching those who are relying on it to deliver the cancer plan … We are seriously concerned at the apparent ease with which trusts can re-deploy such funds if they choose."

The Committee thought it "dissembling" of the Government to allocate funds to cancer care with great publicity, without taking even the "simplest precautions" to ensure that the money reached the intended areas. I am sure that all hon. Members will echo the sentiments expressed in that frank, detailed and welcome report.

As other hon. Members have said, there are continuing problems over spending on chemotherapy drugs. Spending in this country is still way out of proportion to what is spent in other countries. Spending per head of population is £6.24 in Germany, £3.31 in Italy and a derisory 95p in the United Kingdom. That puts it in context.

Conservative Members welcome the Government's cancer plan—it will allow preventive work to reduce the risk, earlier detection and improved community support for sufferers—but the proof of the pudding will be in the output, not in the amount of literature produced to identify the problem and to try to convince us that something is being done.

As we have heard, waiting times are still far too high. In a recent Adjournment debate, my hon. Friend the Member for Bexhill and Battle (Mr. Barker) spoke of the alarming problems caused by the time that breast cancer patients have to wait for treatment in his constituency in East Sussex. In an article entitled "Not the waiting list" in The Sunday Times this weekend, we read of further examples of treatment not happening in the south-east. For instance, Joy Barthorpe of Battle was diagnosed with breast cancer last October and had her operation on 28 December. She has now been told that her radiotherapy will not start until 24 June.

Another patient from Sussex was attending the Kent oncology centre in Maidstone. She was diagnosed last autumn as having breast cancer, and she underwent surgery on 21 November. Following the operation, she was told that it would be a requisite part of the treatment that she should start radiotherapy between four and six weeks later. She was told that she would receive written confirmation that radiotherapy would begin in early January, but she heard nothing for seven weeks. On telephoning Maidstone and Tunbridge Wells NHS trust in early January, she was told that her treatment could not begin until 25 March. In practical terms it means that treatment that was recommended to begin four to six weeks after the operation will not now take place until at least 16 weeks later.

Perhaps the most unfortunate aspect of the case is that the hospital made no attempt to get in touch with the patient and tell her that she would have to wait another two and a half months to begin radiotherapy. By its own admission, current waiting times at the Maidstone and Tunbridge Wells NHS trust are not unusual; they are an accurate reflection of the situation across the NHS. The comments of my hon. Friend the Member for Canterbury (Mr. Brazier) show how the centralisation of those services may push waiting times out even further.

I am most grateful to my hon. Friend for giving way, but he has just made exactly the point that I was about to make. We already have completely unacceptable waiting times at Maidstone. Waiting times at Canterbury are currently shorter; however, if Canterbury is run down and everyone is expected to be treated at Maidstone, what can we possibly expect to happen to waiting times?

My hon. Friend makes his point well. As we know, Kent has a particular problem. Speed is of the essence in treating these cancers. Six weeks is approximately the time that it takes for many tumours to double in size, and introducing an additional delay of four or more weeks between planning and starting radiotherapy must prejudice outcomes.

It is not all the bed of roses in the south-east that many Ministers seem to think. It is the largest region in the country, with 8,100,000 people, which is 13.5 per cent. of the population of the United Kingdom. It is the most densely populated part of the country and the one with the greatest number of older people, as I know from my experience of Worthing. That brings with it problems for the NHS, such as additional costs of treatment for the elderly, bed blocking and long waiting times for hip and knee replacements. What measures have been taken to utilise spare capacity elsewhere in the United Kingdom? Those in the south-east face disproportionately long waits.

The pressures on finance are especially acute in the south-east. One recalls the leaked memo from Ruth Carnell, the chief executive of the NHS in the south-east region, which came to light just before Christmas. The memo showed that NHS trusts in the region would overspend in the financial year 2001–02 by £60 million. The Worthing and Southlands Hospitals NHS trust, in my constituency, is some £2.7 million in deficit.

Jo Yardley, the general manager of Kent oncology centre in Maidstone, in my hon. Friend's area, said:

"We asked for in excess of £1 million for this financial year. It was reduced to £650,000 and has now been reduced yet again. The waits cause immense anxiety yet I have never reported on any performance programme. It's something that we have been crying out for years."

Hilary Thomas, professor of oncology at Royal Surrey County hospital, said:

"When the money comes in, the chief executives want to put the money into achieving the targets over which they will get sacked. The public should know that one patient might be getting their varicose veins surgery done to meet some silly target in a manifesto and another"—

someone who does not appear on the waiting list—

"might not get radical treatment for cancer that may make a difference to whether they live to old age or not."

Those quotes are from this weekend's edition of The Sunday Times.

In the south-east, the additional pressures of staff shortages at all levels are causing problems. There is a particular shortage of radiographers, as has been mentioned by hon. Members. The figures for radiographer shortages in the south-east are alarming: the number of whole-time equivalent radiographers per 100,000 for the whole of England is 21. In the south-east, that figure is just 17 and in West Sussex, in my area, it is just 12, which compares with a figure of 25 in the northwest and 65 in Manchester. Those are big differences.

The vacancy rates also reflect the differences between regions. Against a national average of 8 per cent. of vacancies for therapeutic radiographers, in the southeast the average is 13.1 per cent. and in East Sussex and Brighton and Hove, next to my constituency, it is 19.2 per cent. Those are enormous differences. When I tabled questions about radiographer vacancies, we were told that information regarding the number of radiographers joining and leaving the NHS was not collected centrally. One might suggest that it should be collected centrally, because urgent central attention is required.

The Government may tell us that the number of qualified radiographers has increased by 8 per cent. since 1997—that is a head-count figure, not a whole-time equivalent. However, the Government have placed extra burdens on radiographers, with the enormous numbers of people who now, rightly, have breast screening. That extra capacity has been used up in dealing with the extra breast screening alone.

The breast screening centre in Worthing hospital has one consultant radiographer, Dr. Linda Rockall. Goodness knows what problems we would have in that hospital if she fell under a bus. The hospital desperately needs more recruits. People at the hospital say that they would be delighted to offer breast screening to older women, but that they cannot do so because they are struggling to cope with the work load as it is, without taking on a new raft of clients. Breast screening for older people would be a fair promise to make, but it is a worthless promise unless the resources and qualified radiographers exist. Especially in our corner of the world, there is an enormous shortage of those people.

I want to mention breast care services in Brighton and Hove. The central Sussex partnership has proposed the establishment of a single breast care service at the Princess Royal hospital at Haywards Heath, which will mean the closure of the breast care unit at the Royal Sussex County hospital in Brighton. That is a big issue locally. Just last week, a couple of Brighton and Hove councillors, Brian Oxley and Ann Norman, came to see me to try to focus yet more attention on what is a serious issue. A petition on the subject attracted some 30,000 signatures in just 11 days and a unanimous vote by every councillor of every political persuasion on Brighton and Hove council.

The city of Brighton and Hove has a population of just over 250,000, plus another 50,000 people living in the surrounding areas and 750,000 in West Sussex and my constituency, from where many people go to Brighton hospital for treatment. Many hundreds of women who live locally put their lives at risk each year by failing to keep hospital appointments, mainly due to fear of diagnosis. Certainly, as the hon. Member for Romsey said, we need to encourage women to walk into centres and get treatment at an early stage. It is felt that the number who fail to keep appointments will rise if patients have to undertake a difficult journey, often alone by public transport—in this case, to Haywards Heath.

The journey by public transport from Brighton to Haywards Heath and back to Brighton would take approximately four hours to complete, as the Princess Royal hospital is situated on the outskirts of Haywards Heath. The journey will be even more difficult for people who are elderly, disabled or infirm. The hon. Member for Romsey mentioned paying the travel costs of people who have operations on the continent, but it is a real problem at home. By contrast, buses travelling from all parts of Brighton and Hove stop at four-minute intervals outside the Royal Sussex County hospital in Brighton.

Even if the breast care service should be relocated to Haywards Heath, the accredited pathology service and treatment for patients needing chemotherapy or radiotherapy would be available only at the Royal Sussex County hospital in Brighton, and it is felt that separating services could lead to a lack of continuity in care. Two thirds of patients who attend breast care facilities at the Royal Sussex County hospital come from the Brighton and Hove area, where, on average, 2,700 patients a year attend 7,700 appointments.

My point is that the centralisation of cancer facilities—in this case, breast cancer facilities—is not doing anyone any good. Virtually the whole of the population of Sussex will have to use one centre or go across the border to Maidstone, and my hon. Friend the Member for Canterbury has mentioned the problems there. Such services should be far more widely available, and far greater cognisance should be taken of the transport difficulties that people, especially those who come from deprived areas, encounter in trying to reach those facilities. That is not happening in Brighton and Hove.

I want to add one point to the powerful case that my hon. Friend is putting on the issue of staffing. Part of the capacity problem results from staff shortages, yet people who are told that they must move to jobs in other specialties do not always go. I have seen a considerable number of resignations result from people being told that they must move from working on cancer.

My hon. Friend is absolutely right. It is a question not just of getting patients to the new facility but of getting professionals there to treat them. As the Minister knows, Sussex is a notoriously bad county to travel around, especially going from east to west. We need to take such considerations into account, instead of adopting the approach that big is good and centralising is inevitable. That is crucial in relation to breast cancer services, so I ask the Minister to reconsider. I am not saying that all services should be kept at Brighton or go to Mid Sussex, but we need much greater provision, which is more accessible to everyone in that area, although I do not believe that the example is atypical. I shall not refer to my second example because I want to leave the Minister adequate time to address the serious and important questions that have been raised. I hope that she will use the remaining 22 minutes to do so.

I congratulate the hon. Member for Romsey (Sandra Gidley) on securing this morning's debate and choosing such an important issue to discuss. The issue of cancer services clearly has immense resonance and importance to people throughout the country, including the many people who have in their family someone suffering from cancer and those whose relatives have died of cancer. Of course, people are anxious that, should they suffer from cancer, they will get the treatment and support that they need.

In introducing the debate, the hon. Lady spoke about the south-east, although she recognised that these were national issues. Other hon. Members also raised national issues, so I will talk about local issues, but I shall need to address many of the national questions that have been raised and put them in the national context.

The Government drew up a national cancer strategy, the NHS cancer plan, in September 2000. It is a 10-year strategy, part of the NHS 10-year plan. It is the first time that there has been a national strategy that covers cancer all the way from prevention, through diagnosis and treatment, to palliative care and research. Although hon. Members have concentrated primarily on cancer treatment, I shall make a couple of points later about prevention and research. It is important to look at the overall picture, not to segment the approach to cancer, as happened too often in the past and led to many of the problems that we face.

We should be clear that, throughout the country, NHS patients receive excellent cancer care. Hon. Members have mentioned the gratitude felt by individuals towards those who treat them; many people feel that they receive excellent care. However, it is also true that many patients wait too long for their treatment, and that there are too many variations in care across the country. Before the National Institute for Clinical Excellence and the cancer plan, we had too little in the way of national standards.

Considerable progress has been made, particularly in the areas that have piloted some of the most innovative reforms, but we still have a long way to go. The Government have made substantial extra investment available for cancer—with tangible results in terms of both cancer consultants and extra equipment. We had 560 more cancer consultants in September 2001 than we did in September 1997, including 360 more since the national cancer plan was set out, and we have 29 new MRI scanners, 81 new computerised tomography scanners, 41 new linear accelerators and hundreds of extra pieces of breast cancer equipment.

In the south-east, staff recruitment and retention pose additional problems, although considerable work is under way and good progress is being made with the cancer plan initiatives to recruit and train more cancer staff. We must consider not simply recruiting further members of staff—given the time that it takes to train many health professionals, that could still leave us with an interim concern—but changing the mix of skills and the work that different health professionals do, in order to expand capacity. For example, we have made £2.5 million available to train additional staff in endoscopy and I shall say more about radiotherapy.

Capacity is not the only issue; there is also a matter of reforming the way in which care is provided in order to speed up treatment. In that respect, I pay tribute to the excellent work being done by the cancer collaboratives, including those in the south-east, some of which have demonstrated the most innovative reform in the NHS. For example, the cancer collaborative in north Hampshire has cut the length of time for which a patient has to wait between an out-patient appointment and a CT scan from an average of 20 days to an average of two days, and the one in west London has cut the diagnosis time for prostate cancer from 20 weeks to 14 days simply by changing the way in which it provides the service. On average, since the cancer collaboratives were introduced, waiting times for treatment have dropped by two and a half weeks. The NHS has also made substantial progress in meeting the two-week target for waiting to see a specialist. Between October and December 2001, over 95 per cent. of patients nationally referred urgently with all suspected cancers were seen within two weeks. That figure rose to 97.1 per cent. in the case of breast cancer in the south-east.

The hon. Lady mentioned variations in meeting those targets and referred to Hastings and Rother meeting the two-week target in only 58 per cent. of cases. The latest figure there is 97 per cent. I am advised that in order to meet that target, the health authority developed a one stop breast clinic. It was a question of reforming the way in which it provided the services in order to speed up the time that patients had to wait to see consultants.

Hon. Members raised concerns about other factors not being measured and said that the whole cancer pathway from referral to treatment or from referral to diagnosis should be considered. That is right and that is exactly what we are doing. We have set out a series of targets that will come into force during the next few years. Already, from last December, a maximum one-month wait between urgent referral and treatment has been established for children with cancer, patients with acute leukaemia and those with testicular cancer. A similar one-month target has been established for the length of time between diagnosis and treatment for women with breast cancer. By 2005, there will a maximum one-month wait from diagnosis to treatment for all cancers and a maximum two-month wait from urgent referral to treatment for all cancers.

The two-week wait is just the first step. It is an important step and an important part of the patient pathway, but we must also take action to bring down the waiting times for diagnosis and for treatment. To do that, we need to measure waiting times differently and follow the patient in a different way. The cancer collaboratives are already doing that and we need to do it across the NHS to ensure that cancer patients are getting the best possible care. Work is already in hand to introduce those targets and ensure that they are met across the country.

Hon. Members raised issues surrounding radiotherapy. We have been very open about the problems in that area. The number of therapy radiographers needs to increase and we need to improve facilities. The problems are exacerbated by the fact that the number of patients being referred for radiotherapy has increased considerably during the past few years, following the establishment of specialist cancer teams. The increase in referrals is a positive development because there was unmet need before, but that increase means that considerable work needs to be done. Progress has already been made. The number of therapy radiographers increased by 9 per cent. between 1997 and 2001 and training places for therapy radiographers at university have increased by 62 per cent. since 1997. By 2003–04, the projected increase is 120 per cent.

The numbers are increasing, but we need to go further. We need to consider a different skill mix. Different skill-mix programmes are already being piloted, including the creation of a new grade of assistant practitioner. Pilots are continuing in 10 centres and early indications are positive. Huge additional investment is being made in radiotherapy facilities, but there is much to do and we need to go further.

Hon. Members asked questions about funding. We have made substantial extra sums available to support the implementation of the cancer plan. We are monitoring the extra investment and will continue to do so to ensure that improvements are being made. In the end, the key issue will be the output from improvements in care.

Hon. Members also raised the question of palliative care. We have made available an extra £50 million to support investment in such care by 2004. It will be a matter for local cancer networks to decide how that extra money needs to be spent. They will consider hospices, investment in the community and the issues surrounding palliative care in hospitals. It is important that that is done as part of a strategic approach. For the first time this year, local areas have had to draw together palliative care strategies, which are now being assessed. In some areas, it is the first time that hospices have got round the table properly with the NHS to consider strategically the community's palliative care needs. In other areas, good working relationships have been built on and in others there is considerably more to be done.

It is important for the NHS to pay sensible contribution costs. We need to inform that process through guidance produced by the National Institute for Clinical Excellence on palliative care, which is due to be published this summer. However, it should be recognised that extra investment is reaching hospices. The Help the Hospices survey showed an increase in funding to hospices during the past two years of 14 per cent., although I say that from memory and not from my briefing. Extra resources are reaching the hospices, but they must be part of a broader, more strategic approach to palliative care across the country.

The Minister is making quick progress through the points that we raised, but I want to return her to my first two questions. The first related to her attitude to the private sector employing NHS-trained radiotherapists, whether there is any compensation for the NHS and, more important, whether one can ask it to reflect the cost of that training in its tenders. The second related to the evidence base for improved survival resulting from concentrating first on a two-week wait to see a specialist rather than giving priority to the waiting time for treatment for patients already diagnosed with cancer.

When it comes to the relationship between the NHS and the private sector, the Government have clearly said that we must ensure that the NHS obtains value for money. There are many different ways to achieve that. The relationship will evolve over time to ensure that that value for money is sustained. However, we must use whatever extra capacity there is and must not disadvantage patients by avoiding doing so, as long as extra capacity can provide value for money without undermining the long-term sustainability of the health service.

The two-week wait must be seen as one part of the patient's journey. There is considerable evidence of the anxiety felt by patients at that important time when they first raise concerns and are referred by a GP, but have not been seen by a specialist: they have not even entered the first stage of the process of being seen by the specialist and sent off for the appropriate tests or possibly being reassured by the specialist. Therefore, we must speed up every stage of the patient's journey. The point is not to separate out the different stages and consider the comparative evidence base, but to start at the beginning and see how quickly patients can get through the whole process once they are referred by their GP. The cancer plan approach is to consider the whole journey, and that is what the collaboratives have done. Their success has come from following the patient from beginning to end instead of looking at the way in which isolated cancer services perform and do their job. That is the right approach, but the improvements take time to put in place, because they involve different ways of working as well as changes taking place across the NHS and additional capacity, and the information must be monitored. It is right to make a start with the two-week wait, but we must also speed up the process across the board, particularly by rolling out the cancer collaboratives.

The hon. Member for Canterbury (Mr. Brazier) referred to the cancer services and issues in his area and in relation to the Canterbury hospital. As hon. Members will know, after a public consultation on proposals issued last year the East Kent health authority has made its conclusions known. The new health authority considered those proposals recently, and two community health councils have now registered their objections to some of them. Ministers will have to decide what action to take, and a decision will be needed from the Secretary of State. The hon. Gentleman has raised those issues before and will understand that I can add no more to my earlier comments. It is not a decision that Ministers will take lightly; they will have to consider all the issues. The Under-Secretary of State for Health, my hon. Friend the Member for Salford (Ms Blears), will visit the East Kent health authority area in advance of any decision to see the situation for herself. I simply underline the fact that decisions on reconfiguration in East Kent must be taken in the best interests of all the residents, who must have access to the best quality treatment. The cancer services and their configuration in the area must reflect those principles.

I am most grateful to the Minister for giving way. Would she accept that the problem is that cancer was not included in that consultation? The trust responsible for delivering cancer care in Maidstone and Canterbury, the Maidstone and Tunbridge Wells NHS trust, was not a signatory to the consultation document.

I know that the hon. Gentleman has made those points. My hon. Friend the Under-Secretary is very much alive to them, and will certainly take them into consideration. Although I cannot comment, the hon. Gentleman made various detailed remarks about the views of different consultants, and I will ensure that my hon. Friend is aware of the points made during today's debate.

On the issue of cancer services in Brighton, I understand that the recommendation for the central Sussex partnership programme has yet to be considered in full by the new health authority. Because that is the case, and because of the possibility that Ministers will have to take a decision on that issue in future, I am sure that hon. Members will understand that it would be inappropriate for me to comment at this stage.

Several hon. Members have raised the issue of cancer drugs and the role of NICE. It is important to remember why we set up NICE. We did so specifically to end the lottery of postcode prescribing. For the first time, we have national guidelines on treatment and drugs, particularly for cancer. It is important that the national guidance is right and that the process that NICE goes through involves opportunities for interested parties to submit evidence and comment on draft conclusions. Directions have been issued obliging health authorities and primary care trusts to provide appropriate funding for the treatments recommended by NICE.

The hon. Member for Oxford, West and Abingdon (Dr. Harris) asked what the implications were for other drugs. We have made the extra investment available for cancer services. It is clear that that was to cover recommendations made by NICE. We have also made overall investment available for the NHS, which is increasing by more than 7 per cent. and includes a substantial increase in the drugs bill. Local areas clearly have to take their own decisions about prescribing, but the allocations available for them and the investment in drug treatments is increasing substantially right across the board.

There are other areas of progress worth pointing out, including the increase in the number of women receiving breast cancer screening as a result of the extension of the age range up to 70. A total of 87,000 more women were screened last year, and that figure will eventually reach 400,000. There has also been an increase in the numbers of people receiving support to give up smoking. We should not forget that we shall save far more lives from cancer by preventing people from getting it in the first place than purely by improving the care that people receive.

There have been some common themes in the debate, interestingly including, from both the Opposition spokespersons, a concern about more investment and more money for cancer care. They want more money for drugs, treatment, palliative care, staff pay, and consultants. I agree that we do need more investment in cancer treatment, and that cancer services need more funding. They are already getting an increase in funding, but they need to continue to receive that increase during the next few years. That is why the Government set out an overall increase in funding of over 7 per cent. a year in real terms-double the historical increase that the NHS had during the last 30 or 40 years-and we have said that that money will come from national insurance contributions.

The Conservative Opposition, with respect, have opposed the increase in national insurance contributions, but have also said that there should be more money for palliative care and other areas of cancer. I have no inkling of where on earth they think that that money will come from. Frankly, the idea that people should pay extra for cancer care to provide, for example, their own cancer drugs is not something that we would expect to see realised in the NHS, and no one, whatever their background, is likely to be able to afford it easily, given the cost of some of the new treatments that are coming on line. It is right and fair that cancer care should be provided for everyone on the NHS, not simply for those who can afford to pay. We need greater investment but also greater reform.

Opposition Members need to recognise our extra investment, and if they want further investment they need to set out where it should come from. We have set out where it should come from and where it should go—

Order.

I am grateful to have this opportunity to raise the standing spending assessment for Bury. This may not be the best-attended debate of the Session, but the issue is of enormous importance both to my constituents and to the local authority that encompasses my constituency. My hon. Friend the Member for Bury, South (Mr. Lewis) and I have campaigned consistently on behalf of our constituents over the past five years, and it is only his ministerial responsibilities that prevent him from participating in today's debate.

The timing of the debate is interesting as it is almost three years to the day since I raised the issue of SSA in Bury in an Adjournment debate that I secured on 19 May 1999 on primary schools in Bury. The particular component of SSA that is most controversial from Bury's point of view is, of course, the education SSA, to which I shall return later.

Bury metropolitan district council is one of the smallest of the 36 metropolitan districts, with a population of 182,000. It has a mixed population and is not easily categorised. It contains areas of great deprivation and of great prosperity. It is an urban local authority with a rural hinterland and significant expanses of suburban areas. The local authority has historically suffered from its small size because, by definition, it cannot enjoy the economies of scale open to bigger metropolitan districts and shire counties. Historically, it has been underfunded, originally because of many years of control by a Conservative group, which did not build up the asset base in Bury, and over the past decade by the impact of the SSA, which has always worked against Bury and many other small metropolitan districts.

The authority has recently been categorised as one of the 20 most improved authorities in the country. It is well regarded by most ratepayers in Bury, as evidenced by the results of the local elections last Thursday, in which the Labour majority on the council was increased by two. The authority does most things well, some things excellently, and where it has weaknesses is working hard to remedy them. Its financial difficulties are enhanced by the large majority of properties being in council tax bands A, B and C, which limits the scope of revenue from that source.

The history of Bury over the past 10 years is interesting. In the early 1990s, it was subjected to continuous financial pressures that led to an absolute crisis in the 1997 budget. Several million pounds of cuts were made, particularly to the education budget. That caused widespread controversy and disruption throughout schools in the borough. The council had historically protected its education service—it has to be said that that was at the expense of other services such as highways and social services—by spending approximately 10 per cent. more than SSA throughout the early 1990s. By 1997, that was no longer possible, and the bullet had to be bitten. The local authority bit the bullet by cutting its education spending to the SSA level.

In Bury, we are extremely grateful for the gradual increase in SSA that the local authority has experienced in the past three years. For example, in 1998–99, it increased by 7.99 per cent. against a national average of 5.19 per cent.; in 1999–2000, it increased by 5 per cent. against a national average of 4.84 per cent.; and in 2000–01, it increased by 4.74 per cent. against a national average of 4.37 per cent. We are grateful for the year-on-year improvements in investments in our services. Despite that, the difference between Bury's education spending and the national average has widened in the past three years, as has the difference between Bury's education SSA and that of the best-funded authorities.

We would never expect to be one of the best-funded local authorities, but we are hugely aggrieved that we consistently find ourselves in the bottom quarter of the education SSA. The Government's index of local deprivation suggests that Bury is in the worst third of local authorities on most deprivation indicators, so we think that our SSA settlement should reflect that. I should like to quote briefly a debate here on 19 May 1999. I am reluctant to quote myself, but it is a timely way to start. I said:

"On finance, Bury local authority has suffered historically from a low standard spending assessment…The aggregated schools budget per capita spend is £100 below the national average for primary schools and £150 below the national average for secondary schools."

Those differentials have increased over the past three years. I also said:

"I know that Ministers at the Department of the Environment, Transport and the Regions are highly conscious of the inequities of the SSA system. I know also that a considerable amount of work was done on that last year and that a change to the children's social services criteria was introduced which benefited some of the poorly funded authorities such as Bury. However, I again draw attention to the fact that we must wait a further three years for the next review of SSAs. The contentious issues of the area cost adjustment and the additional educational needs criteria remain to be resolved. In those three years, Bury and other small local authorities will continue to he funded by a system that is widely regarded as being unjustified and methodologically unsound."—[Official Report, 19 May 1999; Vol. 331, c. 1023.]

So it has proved over the past three years. We look forward to the promised Government reforms of 1 April 2003.

Just before the 1997 general election, my right hon. Friend the Member for Holborn and St. Pancras (Mr. Dobson), the then shadow Secretary of State for the Environment, came to Bury, pledged that there would be a full reform of the SSA system, and accepted that Bury's case for improvement was overwhelming. Two years later, the present Secretary of State for Transport, Local Government and the Regions came to Bury in his former capacity and recognised the inequity in funding, particularly in education; he pledged that the system would be reformed. In each of the past five years, the local authority has written to the Department in response to the settlement and has made arguments for change and improvement. My hon. Friend the Minister will be aware of recent correspondence, and I am grateful for his reply acknowledging the council's points.

In a letter that I sent to the Department on 24 January this year which summarises my views I said:

"I am writing to support the Council's response in its entirety; to reiterate the urgent need for a transformation of the current arcane SSA system to one that is not only fairer in application but more transparent in methodology and less subject to dubious forms of manipulation; and to draw attention to the fact that the discrepancy between Bury's SSA and that of both the best funded authorities and those with average levels of funding would appear to have significantly widened during the last four years."

We welcome the overall improvements to local government finance, the approximately 5 per cent. a year increase in SSA, and the introduction of new funding streams, particularly for education, from which we have benefited. However, I come back to the fact that the basic methodology that currently applies is unacceptable.

In a letter to the Department for Transport, Local Government and the Regions, the finance spokesman of a local authority criticised the area cost adjustment component of the SSA:

"The operation of what is the most perverse element of the SSA system has now reached the point of farce and the late amendments made to the data used in the provisional Settlement has brought the absurdity of the situation directly to the attention of our residents, schools, partners and service users.

Bury continues to acknowledge that the costs of providing local authority services in London and the South East are, to some extent, higher than in other areas of the country. However we have always believed that the current ACA methodology considerably overstates the differential in costs and we have campaigned, along with our colleagues in SIGOMA, for a distribution system that reflects actual, measurable variations in local authority costs.

The late data changes have severely damaged the expectations of service providers and users, and they will hit our schools particularly hard. Local politicians and officials will find it well nigh impossible to justify to Governors, teachers and parents why it is that the pay increases given to 350 `City' workers should rob Bury schools of around £400,000 of much needed resources."

That was a reference to the late changes to the data used in the settlement for this year. We want a system that is based on transparency and on measurable costs that have been agreed and that everyone can understand.

May I give an example of the differentials that currently apply between Bury and other authorities? The gap that I referred to in the 1999 debate on Bury's primary schools was of the order of £100 between the primary SSA for Bury and the national average, and £150 between the secondary SSA for Bury and the national average. In the past three years, the gap has increased: the gap between Bury and the English average is now £201 for the primary SSA and £254 for the secondary SSA. The differentials between the Bury primary and secondary SSAs and those of some of the best-funded authorities have increased by far more than that. The primary SSA for Tower Hamlets has increased by £443 in the past three years, against an increase of £223 in Bury. Its secondary SSA has increased by £521 against an increase of £281 in Bury. I know that Tower Hamlets has many problems to grapple with, and everyone in Bury would accept that the problems in Tower Hamlets are of a different order from those in Bury. However, my constituents, my local authority and I cannot and do not accept that that is an argument for increasing the differential in SSA year after year.

I am focusing on the area cost adjustment element in education because it is most controversial. We have particular problems this year. For example, the need to provide local authority matched funding for the standards fund resulted in the call of an extra £900,000 on the local authority. Had the local authority not attempted to draw down its full allocation of the standards fund, it would rightly have been subject to criticism by head teachers and governors and by the auditors. The only way it could find that additional £900,000 was by working with the schools and getting their agreement to pool their surpluses to achieve the matched funding.

The teachers' pay award this year put additional stress on SSA funding. The cost of statementing children with special needs has increased dramatically in recent years. Like many other areas, the area faces the problem of declining numbers in primary schools, an issue with which the authority is currently dealing through a consultation programme on proposals for mergers of primary schools to reduce surplus places.

The pressures on education budgets remain intense, but it is not just education that feels such pressures. The local authority was particularly aggrieved this year at the way in which the implied promises£I choose my words carefully£of increases to highways SSA because of the use of geographical information system data did not materialise. Apparently, that was because of a very late decision to change the application of GIS data so that the data applied only to principal roles. That change resulted in the loss of several hundreds of thousands of pounds for Bury's highways SSA.

In social services, we have a legacy of overspend, with which the local authority is dealing effectively. However, pressures on social services, particularly because of the interface with the health trust, are putting significant pressures, in turn, on the local authority. I draw attention to a further issue: the pressure on the local authority to meet performance indicators on the movement of elderly people from residential care and on the increase in domiciliary care is in conflict with the pressure on primary care trusts to deal with bed-blocking by getting more people out of hospital as soon as they are ready to leave and into residential care. Ministers in the DTLR and the Department of Health could usefully discuss, and to try to resolve, that issue. At the moment, the local authority's performance indicators are in direct conflict with the performance indicators by which primary care trusts have to abide.

The local authority has put a budget together this year that resulted in a council tax rise of a little more than 6 per cent.—;higher than we would have wished. It has allowed some modest growth in education and one or two other services, but there have been serious reductions in some services. The local authority continues to support the work of the special interest group of municipal authorities, which has campaigned consistently for the abolition of the area cost adjustment. It is also a member of the F40 group of local education authorities—the 40 worst-funded LEAs. Bury has a very strong interest in the campaign that F40 runs for a national minimum per capita level of investment in primary and secondary education.

I know that the Government have pledged to reform the system by 1 April 2003 and I understand that there will shortly be a consultation document. We look forward to that with enormous interest. We hope that there will be a genuine consultation, 'with ample opportunity for all local authorities to state their views. In his reply, I hope that the Minister can say whether he accepts the case that Bury has consistently argued over the years—that the current system discriminates against Bury.

Can the Minister confirm that the reforms promised by the Government, whatever shape they prove to have, will be in place by 1 April 2003? Can he tell us when the consultation document is likely to be published and how long the consultation period will be? Will the proposals put out for consultation include the idea of a flat-rate entitlement in respect of the education SSA? Given my earlier comments about the discrepancy in the way in which Bury is treated for SSA and categorised in the index of local deprivation, will the index of local deprivation be used as a factor in the new methodology?

Finally, the Minister is very welcome to visit my constituency and I invite to him to do so at his earliest convenience.

I congratulate my hon. Friend the Member for Bury, North (Mr. Chaytor) on securing this debate on Bury's standard spending assessment. I drove through his constituency the other day, but did not stop in Bury. I should be delighted to visit his constituency and Bury metropolitan district council in the not too distant future. Not only has my hon. Friend secured this debate on Bury's SSA, but the evidence of his contribution suggests that he is in danger of becoming one of the five people in the country who, allegedly, fully understand the SSA system.

The 2002–03 local government finance settlement has come and gone. Parliament approved it, councils have set their budgets and are getting on with the difficult tasks they face this year. Finance directors of most councils are turning to the distribution of grant next year. We want a fair and transparent distribution of Government grant between authorities. My hon. Friend's letter of 19 January was prescient in that regard. That is precisely what we are trying to achieve in our review of how SSA, or its successor, is determined.

My hon. Friend focused on the changes he would like to be made to the distribution formula. We are working hard to develop proposals with local government and will consult councils, probably during the summer, on the options. I confirm that the new distribution formula will be in place for the next financial year, but I do not underestimate the magnitude of that task. All authorities want to be winners, but that, of course, is not possible. I can assure my hon. Friend that changes will be made only in the interests of ensuring that the money that is available as a result of the current spending review finds its way to the right areas.

I must set the scene for what has happened in Bury in recent years. It could make a case that it has not done as well as it might in terms of grant increases, but we have been able to provide good increases for Bury metropolitan district council in recent years. However, I recognise that it has not done as well as many authorities.

The overall settlement for 2002–03 was a good one for local government and provided an increase of £1.9 billion in general grant on a like-for-like basis. Those good increases in grant enabled us to set a floor grant increase to ensure that all authorities received increases in general grant at least in line with inflation. All authorities with education and personal social services functions, such as Bury, received an increase of at least 4 per cent. Bury's settlement was just above that floor with an increase of 4.2 per cent. or £4.6 million. However, Bury remains close to the floor because it received a lower than average increase in SSA: 4.3 per cent. this year compared with a national average increase of 5.4 per cent.

That was due mainly to a small population decrease compared with a national average increase and also to a below-average increase in the number of pupils aged 11 to 15 compared with a national average increase of 1.2 per cent. However, as my hon. Friend said, compared with the increases in SSA before 1997, Bury, like many authorities, has done well. In the four years before then, Bury received an average SSA increase of 2.6 per cent. each year and since then it has received an average annual increase of 4.6 per cent.

My hon. Friend also mentioned the pressures facing social services departments from bed-blocking and the care of elderly people. He will be aware that Bury benefits from the increase in ring-fenced grant to tackle bed blocking and receives £500,000 from the new fund. We recognise, however, that there remain substantial pressures on social services departments in that regard.

My hon. Friend makes the case for a different distribution of grant, which would benefit Bury. As I mentioned, we want a fairer and more transparent system for distributing grant between councils, and we are working with local government to develop options to achieve that. Fairness is, however, often in the eye of the beholder, and while we hope to achieve consensus, we shall inevitably be unable to please everyone.

I cannot provide details about the possible options today, but the debate has given us a valuable opportunity to understand more about the issues from Bury's perspective. As I said, we will consult on options for the new grant distribution system over the summer. Colleagues from across Government and I will continue to discuss these difficult issues with hon. Members, local government representatives and others with an interest in what the grant system delivers.

As my hon. Friend said, Bury wants to close the gap between SSA and spend. We know that most authorities spend more than the grant allocation system assumes when standard spending assessments are calculated, and we are considering particular pressures in the spending review. Among other things, that will effectively spell the end of the standard spending assessment as we know it. We certainly intend to remove from the system elements of roll-forward from historic assumptions, which have caused some of the problems that my hon. Friend mentioned.

My hon. Friend will also want to know that, alongside the changes that I have outlined to the SSA system, the Government are committed to ensuring that ring-fenced funding as a proportion of total revenue spend will go down over future years.

It is for local authorities to take decisions on council tax levels and on whether to spend above the level that we assume in the formulae. The son or daughter of the SSA system is likely to involve a decision about how much spending the Government are prepared to support, and grant will be allocated on that basis. However, we want local authorities that are in the process of making such decisions to continue engaging with their communities about priorities and their implications for council tax.

My hon. Friend mentioned the possible allocation of a fixed sum to reflect population. He said that Bury was a small authority and could not find the same efficiencies of scale as larger authorities. My officials are examining the proposal from many smaller authorities that an element of grant be distributed on a fixed-cost basis. Authorities should, however, be able to think innovatively about making themselves more efficient and providing better services.

My hon. Friend mentioned the area cost adjustment and underlined his concern about the late change in this year's figures. The area cost adjustment turned out to be different from initial indications. A late change in the data that the Office for National Statistics supplied to us led to a change in the area cost adjustment just before the provisional settlement announcement. We certainly want to avoid a repeat of that. We know that the ACA is possibly the most controversial element of the formula system, and we want to reform it.

My hon. Friend talked about the education standard spending assessment formula. I am very much aware of the strength of feeling about the current education funding formula in Bury. As he will know, we are working on a new system, which includes education. Our aim in introducing that system is to make funding not only fairer, but clearer, and that is particularly true of education. For the first time, we will separately identify the funding that we want to reach schools, which we cannot do under the current system. Of course, any funding formula will need an element for deprivation and an enhancement for areas where schools must pay more to recruit and to retain staff. However, we want the level of those enhancements to be decided using more up-to-date evidence, not by building on past expenditure, as in the current system.

We still have work to do on the new system, and my hon. Friend will understand that until the new formula has been developed and detailed figures have been obtained we cannot say how individual authorities' share of overall funding will be decided. We shall be consulting on proposals for the new funding formula in the summer.

I accept that there are declining pupil numbers in Bury. Interestingly, however, a lag in data tends to protect local authorities in that regard. The problem faced by authorities with increasing pupil numbers is of equal concern.

Order. We move to the debate on the state of the Scottish whisky industry.

I am pleased to have the opportunity to initiate a debate on the Scotch whisky industry, which is responsible for much of the country's exports. It is a significant employer and provides hundreds of millions, if not billions, of pounds of taxation revenue to the London Treasury.

I should begin with a declaration of interest, which is not confined to a personal, though moderate, recreational tasting interest. My first job was at the Scotch Whisky Heritage Centre on Edinburgh's Royal Mile. That has been superseded by my responsibilities in representing Moray, the constituency that contains more than 50 per cent. of Scotland's malt whisky distilleries. I am also vice-chairman of the all-party group on Scotch whisky, and I pay tribute to Margaret Ewing, my predecessor in that post and in the House. She was a doughty fighter on whisky issues in the House and continues to be so in the Scottish Parliament.

Maintaining a close interest in all Moray's whisky producers is not always easy, especially at election time, when it is necessary to tour the region's fine distilleries. Of course, it would be rude not to sample the product—in moderation, I hasten to add. Discipline is called for, given the number of distilleries. One can at least rely on the knowledge of numerous genuine experts in Moray, such as Peter Brown of Craigallaichie hotel, whose encyclopaedic knowledge covers all 436 single malts, a large selection of blends and the vatted malts at the Keeper of the Quaich bar.

The whisky industry in Moray is vital, owing to the considerable direct and indirect employment that it provides in the constituency, from the stillmen, the coopers, peat cutters, farmers, hauliers, tour guides, managers and office staff. Moray is home to world-renowned bottlers, retail outlets and experts, such as Gordon & McPhail, the whisky shop in Duffton, and Malcolm Greenwood, the celebrated writer. For those who would like to know more, I recommend the new Scotch whisky course offered by Moray college.

One cannot accurately measure the importance of the whisky industry to local business and tourism, as it is immense. Yesterday, the highly successful Spirit of Speyside whisky festival ended. At the beginning of the festival, on Friday, I was delighted to be able to join hundreds of locals and tourists at the Coothie Doo Two ceilidh in Craigallaichie. That was a fantastic event, featuring a fly-over by Flight Lieutenants Colin McGregor and Andi McColl of the Tornado GR4 display team based at RAF Lossiemouth, in their aptly named fast jet Spirit of Speyside. It was a great example of the local partnership between the whisky industry and charitable and community causes. In this case, moneys were raised for the Children's Hospice Association of Scotland, Rachel house. I am sure that hon. Members will wish the appeal all the best.

The whisky industry is significant throughout Scotland. It is the second largest export industry in Scotland and the fifth largest in the United Kingdom. The industry directly employs more than 11,000 in Scotland and a further 30.000 are employed in related sectors. It is among the United Kingdom's top five export earners, generating more than £2 billion from sales a year, in 200 markets. The industry uses about 25 per cent. of Scotland's barley crop, and 70 per cent. of all Scottish grain is used in grain distilleries. It supports one in every 54 Scottish jobs, accounting for 5 per cent. of all manufacturing jobs, and spends £1 billion a year buying goods and services from local suppliers.

In 1999, the Fraser of Allander Institute produced a report for Allied Domecq. ft identified that the Scotch whisky industry was twice as important as computer-related manufacturing, a third bigger than the oil and gas industries, 12 per cent. greater than banking, insurance and finance, 30 per cent. greater than mechanical engineering, and a third larger than the chemical industry. All those statistics underline the key importance of the Scotch whisky industry, and stress the need for the Government to provide the optimal conditions for it to flourish.

Over the years, commentators have established that the taxation regime at home and abroad is one of the most significant factors that determines whether whisky sells as much as possible. In recent decades, Scotch whisky has made great strides in markets such as Spain, Italy, the United States and the far east. Those areas generally have more benign tax regimes than the United Kingdom. Sadly, some of the worst taxation excesses are to be found in the UK, the state that benefits from massive revenues from the industry.

Currently, 66 per cent. of the price of a bottle of whisky is tax. Since 1973, the price of a bottle of whisky, including the excise duty, has been subject to value added tax, which is levied on the duty-paid price. That means that the price of a bottle of Scotch whisky is increased by and subject to a tax on a tax. On 10 occasions in 18 years of government, the Conservatives took the opportunity to raise the burden on the whisky industry. Perhaps that sad record is why no Conservative Member of Parliament is present today. The discrimination under the Conservatives has continued under the Labour Government, and duty on whisky is currently one and a half times higher than that on other competing beverages.

Although there has been some recent narrowing of tax discrimination against spirits, the discrimination remains and was continued in this year's Budget by a Chancellor who, of course, represents a Scottish constituency. Like the Scotch Whisky Association, the Scottish National party has been in favour of a 4 per cent. cut in whisky duty. Experts believe that such a measure would be revenue neutral, creating a higher demand for whisky and thereby maintaining duty and taxation income for the Treasury.

Most distilleries are based in rural areas such as Moray, and the distillery is often the lifeblood of the community. A duty cut for Scotch would have helped to end the competitive disadvantage that discriminates against Scotland's farmers and rural communities. Perhaps the Minister, in his summing up, will outline how long we must wait for an equalisation of duty under the Government's current policy.

I hope that the Minister will take the opportunity to clarify the recent and welcome U-turn by the Treasury, in which it dumped its controversial proposal to bring in strip stamps. The Government have consulted on introducing the costly anti-fraud strips on the top of bottles, despite evidence from other countries that they do not work. Luckily, a vigorous campaign by the Scotch Whisky Association, the Scottish National party and others made the Government see sense. However, Ministers still have to answer why they thought about introducing the daft scheme in the first place.

I thank the hon. Gentleman for raising the issue. Like him, I enjoy a tipple or two now and again, and frequent the usual areas. Unfortunately, there are no distilleries in Midlothian, although East Lothian has the only lowland distillery.

Does the hon. Gentleman not give credit where credit is due? The Government are listening. They listened to Back-Bench Members who approached them, and to the whisky organisations, about the strip duty. It was a bad idea, but the Government had to consider it. He should give them credit for having withdrawn it.

Midlothian has the largest plant that produces labels for the Scotch whisky industry, so the hon. Gentleman has a direct and pressing interest in it.

I am grateful to the hon. Gentleman for mentioning other parties' opposition to strip stamps. Early-day motion 842 was tabled by my hon. Friend the Member for Perth (Annabelle Ewing), and we were grateful to receive the support of English Labour and Liberal Democrat MPs. However, I note with interest that not one Scottish Labour or Scottish Liberal Democrat MP chose to oppose strip stamps publicly. I am therefore grateful that the hon. Gentleman has, perhaps belatedly, joined the opposition to what I described as a daft idea. I welcome that greatly, and would be grateful for his support on similar campaigns while they are ongoing rather than over.

Why did the Government think about introducing strip stamps? That measure would have cost the Scotch whisky industry £250 million extra. The Government had no idea how much revenue strip stamps would raise, but application machines would have cost producers millions of pounds, forcing smaller businesses under.

In a recent debate on the subject in the Scottish Parliament, justifiable concerns about tax fraud were raised. Despite efforts by Labour Members of the Scottish Parliament such as Brian Fitzpatrick to support the case for tax stamps, more thoughtful contributions were made on the problem of inward diversion, which is tax fraud connected with whisky coming from the European Union to the United Kingdom. Of course, the primary difficulty is that excise duty in the UK is much higher than in other EU states. That creates an automatic incentive to fraudsters who want to avoid paying the higher rates of excise duty in the UK. Government efforts to deal with fraudsters should start with that point, rather than measures that penalise the whisky industry.

The key matter of minimum duty rates applied by the European Union also affects the Scotch whisky industry. The EU Commission has said that spirits, including whisky, are disadvantaged and that there is distortion in the market. With a new draft proposal by the Commission on the table, I would be grateful if the Minister clarified what efforts the UK Government are making to secure the best deal for the whisky industry and everyone who works for it, directly and indirectly.

It would be useful to find out what consultations have been held with the Scottish Executive, whose Ministers miss 90 per cent. of meetings of the Council of Ministers. That is a great example of the case for direct Scottish representation in Europe. Today's edition of The Herald suggests that the Scottish Executive and Scottish Parliament do not receive all relevant EU documentation from UK Departments, including the Department for Environment, Food and Rural Affairs.

Before today's debate, I took time to speak to many local people in Moray involved directly in the whisky industry. I tried to find out what problems they face, in the hope that the Government would listen to those concerns and do something about them. Next to the matters of taxation that I have outlined—that is the overwhelming issue for them—red tape concerned them most. Despite the excellent safety and environmental record of the industry, regulations and compliance issues with regard to the control of major accident hazards have mushroomed. Those include the climate change levy, the waste water directive, the fresh water fisheries directive and the possible consequences of the Rogues report. What assurances can the Government give that they will stop forcing the industry to prove negatives, that public agencies will act as facilitators rather than barriers to success, and that red tape will be reduced?

The Scotch whisky industry is vital to the Scottish economy and the UK Treasury. The taxation imposed on whisky by successive UK Governments has disadvantaged Scotch in the home market, where whisky is taxed at higher levels than wine or beer. That discrimination has allowed other countries to seek to justify their own discriminatory tax regimes by reference to those implemented in the UK by a Labour Government and previously by a Conservative Government.

The Government will be aware of a joint document published by the Scottish Executive and the Scotch Whisky Association, aptly if optimistically entitled "A Toast to the Future: working together for Scotch whisky". The Scottish Executive support the industry's case for a review of the UK tax regime, with the aim of achieving a fair outcome for the Scotch whisky industry. Will the Minister indicate whether the Government will accede to that moderate demand, or do they oppose the Labour-Liberal Scottish Executive?

I welcome the Government's U-turn on a tax stamp system, which would have constituted a barrier to trade and been inefficient and ineffective. Finally, it is high time for all powers relating to the regulation and taxation of the whisky industry to be transferred to the Scottish Parliament. That should not be left to the whim of successive Westminster Governments, who do little to help it.

I congratulate the hon. Member for Moray (Angus Robertson) on securing this debate and on making a strong case for an important industry. It is important for employment in many areas—not only rural areas but urban areas. As my hon. Friend the Member for Midlothian (David Hamilton) pointed out, the Scotch whisky industry is important to his constituency and the surrounding area.

The whisky industry, however, is also much involved with the tourist industry. I speak as someone who has enjoyed the whisky trail, visiting the distilleries in Speyside—a good time was had by all—and I understand the popularity of whisky tasting. The hon. Member for Moray may like to know that, when the United Kingdom had the presidency of the European Union and the president of the Agriculture Council was my right hon. Friend the Member for Copeland (Dr. Cunningham), one of the most popular informal meetings was the whisky tasting event. Indeed, Franz Fischler was intrigued by it, and it was difficult to get him out of the room at the end. The event was a huge success for Britain and for the Scottish whisky industry.

I was intrigued to learn that the hon. Gentleman once worked at the Scotch Whisky Heritage Centre. I should have thought that the attraction of being a Member of Parliament for the SNP did not compare to working in the whisky heritage centre: the hon. Gentleman seems to have given up a very good job. I echo his comments on the Tornado GR4 display team. It is good to see such community involvement. I congratulate all those concerned in that fund-raising exercise and wish them every success.

I turn to the details raised by the hon. Gentleman. We concede the whisky industry's importance to the UK. We also recognise its tremendous success in promoting exports. He was right to state that Scotch whisky is the UK's fifth largest export earning industry. Fourteen per cent. of exports go to the United States of America, and 40 per cent. go to the EU. Indeed, wherever one travels, Scotch whisky is effectively promoted. The brand image and the industry's promotion campaigns are a lesson to other industries on how to succeed in export markets.

The hon. Gentleman raised the issue of tax parity and the duty on whisky. We know that it is of considerable interest to the sector. There has been a lot of dialogue between the industry and the Government. I emphasise that, since the Scotch Whisky Association wrote its report on duty, my right hon. Friend the Chancellor of the Exchequer has frozen the spirits duty rate for a fifth successive year. That will doubtless feature in the association's report for 2002. It demonstrates that the Government are prepared to listen to a good case and to respond. That five-year freeze is significant.

The hon. Gentleman will not be surprised to hear me say that future taxation and parity are matters for the Chancellor, not the Department for Environment, Food and Rural Affairs. Decisions on spirits duty and other taxes are made Budget by Budget, and account is taken of a wide range of factors, including the views and the state of the industry concerned. I am sure that the Scotch Whisky Association is well capable of making its case. Indeed, it has done so, and I am sure that it will be pleased with the results.

On EU minimum duty rates, the UK has consistently argued that member states should be allowed to maintain fiscal sovereignty, but that it should be underpinned by a regime of sensible and realistic minimum rates. The Government hope that the European Commission will carry out a meaningful review of EU minimum rates, and we look forward to receiving its long-overdue proposals.

The Scotch whisky industry's strength lies in its export markets, so it is not surprising that much of its long-term success will depend on fair access to world markets. The Government recognise the importance of access in Europe and further afield, and we seek to assist the industry wherever possible. That was highlighted in the Scotch Whisky Association's 2001 annual report, which said:

"the single most important trade issue confronting the industry in world markets is to secure acceptable access to India 's enormous domestic spirits market".

We recognise how important that is to the industry. We have worked hard on its behalf to persuade the Indian Government to remove trade barriers that are causing concern, and Ministers have repeatedly pressed the industry's case with their Indian counterparts. On 28 February, the Indian Government's Finance Minister announced budget proposals to reduce the relevant import duty in line with India's World Trade Organisation schedule. That is a positive step, which we welcome.

The hon. Gentleman mentioned tax stamps. Antifraud strips were certainly worth considering, and I was a bit surprised that he dismissed them. I understand, as the Treasury did, that they would have had significant financial consequences for the industry, but it is unreasonable to dismiss them as daft. The Treasury was examining how to prevent fraud that costs the country about £450 million, which is a significant amount. It is not, therefore, unreasonable that the Treasury should consider a range of anti-fraud measures. It consulted on the options and listened to the industry's case, which many of my hon. Friends, including my hon. Friend the Member for Midlothian, supported. The Treasury accepted that the industry's case was reasonable, and did not go ahead with its proposal. That demonstrates that the Government respond positively to a fair and good case.

Why have not the Government pursued an active policy of reducing duty on Scotch whisky? Such a policy would remove the incentive to use fraudulent measures, because the cost of whisky here would be equalised with that in EU countries, where fraud is a particular problem. Will he also say whether the Government are happy to accede to the Scottish Executive's proposal for a review of taxation on Scotch whisky?

On the latter point, I assure the hon. Gentleman that the Government regularly discuss such issues with the Scottish Executive, to whom we listen carefully.

I understand the hon. Gentleman's point about equalising duty as part of an anti-fraud measure. The problem, of course, is that equalising duty in European markets is no guarantee that people will stop illegally avoiding duty if they think that profits can be made by doing so. Although I understand the case for equalisation, that is a matter for the Treasury. The hon. Gentleman would be making a mistake if he thought that equalisation would prevent fraud. There is no indication that it would, although I accept that that is not his argument.

We are ensuring that Customs works with the industry on a joint strategy to identify and track illicit consignments of spirits, radically increasing the exchange of information and making fraud easier to detect through the development of product testing kits, enhanced barcode data and a range of other measures. We recognise that there are several ways to tackle fraud, and I am gratified that we have received so much cooperation from the industry.

We have also made additional funding available to Customs this year to allow it to up the volume of intelligence-based checks on inward freight consignments of duty-suspended spirits, which includes making full use of the national network of X-ray scanners; to increase disruption of the criminal gangs engaged in spirits fraud; and to strengthen control on UK excise warehouses.

We take the issue of fraud very seriously. We are looking at several ways of tackling fraud; barcoding the bottles was just one. However, we accept that the disadvantages to the industry would have outweighed the benefits. We are committed to supporting the industry in the drive for export markets. I can update the hon. Gentleman. As recently as last week, we intervened in a case in the European Court of Justice brought by the Commission against Greece, because preferential duty rates for ouzo were acting against the interests of competing products such as Scotch. I know that our intervention in that case was warmly welcomed by the Scotch Whisky Association. We are committed to the long-term sustainability of the Scottish whisky industry, and we are working to foster conditions abroad that will achieve that.

On the hon. Gentleman's final point about the cost to the industry of red tape, the problem is not confined to the Scotch whisky industry. The matter is raised with the Government by all industries, which are, reasonably, concerned about the additional cost burdens inherent in a range of policies—some are national, such as the climate change levy; others result from European Union directives, such as environmental pollution controls; and others relate to health and safety measures designed to protect those who work in the industries.

We recognise those costs to the industries, but whatever measure we implement, we always carry out a financial impact assessment to give us some idea of its implications for the industry concerned. We seek to minimise costs and streamline the burdens placed on industries. I am sure that the hon. Gentleman will agree that environmental controls, pollution controls and health and safety are important issues, which we should not ignore.

We are trying to strike a balance between the necessary protections, controls and regulations, with which all industries must comply—in the case of EU directives, to ensure that, within the European single market, no industry has to bear an unfair burden and the costs and bureaucracy that fall on the sector. We regularly review those issues, which are also considered by taskforce groups, and we talk to people in the various sectors of the industry about how to reduce the burdens. Indeed, where there is a case for self-regulation, we will consider that, too.

In conclusion, the Scotch whisky industry is a great success story for our country. It is important for us economically, and in terms of our export markets. We have done a lot for the industry and we are working closely with it. We have listened carefully to the representations that we have received. I believe that the industry has a great future. We will recognise its needs and support it.

May I say in advance that I will not accept interventions from any party because I am already sharing time with one of my hon. Friends?

In a recent debate on the Government of Wales Act 1998, the hon. Member for Meirionnydd Nant Conwy (Mr. Llwyd) angrily intervened on my contribution, accused me of ranting and wanted the Deputy Speaker to call me to order. I assumed that the hon. Gentleman and his fellow nationalists were not happy about me trying to iron out some of the contradictions that are obvious in their policies. In retrospect, I have to admit that I was probably wrong, and that deep down the nationalists, and the hon. Gentleman, appreciate all the good work that I am doing in trying to resolve those contradictions. Their support for my good work has been recognised during the past few days when I received a letter from their party headquarters inviting me to the leaving party for their chief executive, Karl Davies. I am sure that that was not a computer error, or the result of someone pressing the wrong button, but a genuine attempt on behalf of the nationalists to show their appreciation and thank me for all my good work in recent months in highlighting their policies. I hope that the nationalists who attend the bash will give my apologies and appreciate the necessity for me to be here in Parliament to continue all of the good work.

My father and his family were born in England in the early part of the last century and they came to Wales. My father proceeded, from the grand old age of 13, to work in the local colliery as a face worker. He died not just with cancer, but like many of his generation in that employment, with pneumoconiosis as well. His brother, at a very young age, died as a result of a tragic accident in the same local colliery. Although my dad was English, he did not feel, as nationalists have described them, that he was part of an

"alien culture within our nation".

Like other people who came to Wales from England, my dad built many of the good things that we are proud of in communities such as those in south Wales. He never learned the Welsh language, but that did not make him any less a part of Wales. Contrary to what nationalists such as Saunders Lewis argue, he did not

"completely submerge and destroy all of Welsh national tradition."

Indeed, he and his generation helped to build on many things in that tradition, which we are justifiably proud of in working-class communities. If he had a criticism of Wales, which I share, it was that we lost too many times on the football field. He often made the plea for the occasional victory, which he thought would be much appreciated.

The nationalists have always seen conspiracies everywhere to destroy the Welsh tradition and nation, and almost invariably they are the fault of the English. I well remember reading an account of the decision of Neath town council in the 1930s to invite the Bath and West Southern Counties show to the town. The nationalists protested at the time, claiming that the invitation was

"proof of the diseased individualism of Welsh local authorities"

and

"a basic challenge to our principles as a party.

That attitude to the English can also be seen in their opposition to English children coming to Wales during the second world war to avoid the Nazi bombing of their homes. For the nationalists, that movement of population was one of the most horrible threats to the continuation and life of the Welsh nation in history. How could anyone have such a warped sense of priorities, seeing as the enemy not Nazi Germany, which was bombing the homes of people in London, but English children, who were coming to Wales as evacuees?

Will the hon. Gentleman give way?

No.

It was not just the Bath and West Southern Counties show and English children coming to Wales that caused concern. The Welsh nationalist party at the time described the building of the Severn bridge as a suicidal policy; I have never heard any retractions from modern-day nationalists. I assume that their main interest was breaking all links with England, and that that was far more important than creating jobs.

Some hon. Members may argue that those examples are from some years ago and that Welsh nationalists have seen the light and learned to love the English. Sadly, that is not so. Gwilym ap Ioan referred to the English in Wales as an alien culture within the nation.

Will the hon. Gentleman give way?

Order. The hon. Member for Blaenau Gwent (Llew Smith) has said that he is not giving way.

Gwilym ap Ioan said that Wales would soon be so full of foreigners that the Welsh voice would be drowned out, and Simeon Glyn referred to retired people moving to Wales as a drain on the resources. Time does not allow me to quote the many other examples of similar expressions put forward by leading nationalists. When is the leader of the Welsh nationalist party, Ieuan Wyn Jones, going to insist that such people be kicked out of the party if they continue to make racist demands?

Not only nationalist members but fellow travellers such as John Elfed Jones use the race card. He compared the effect of English migration to foot and mouth disease. Who made the greater contribution to Wales, my English father and his generation, or John Elfed Jones, who made a killing on the backs of Welsh workers and consumers, among others, through the privatisation of Welsh Water?

The BBC has joined in. It was recently found guilty in the courts of sacking one of its senior journalists because his accent was not Welsh enough. The Arts Council of Wales continues to subsidise Barn, although it says that it will review the output. However, anyone who knows anything about the Arts Council of Wales knows that very little will happen.

My hon. Friend the Member for Conwy (Mrs. Williams) referred in the Welsh Grand Committee to a visit by my hon. Friend the Member for Foyle (Mr. Hume) to north Wales. In referring to his lecture, my hon. Friend the Member for Conwy said that he recalled that,

"as a child—of about 10 years old, I think—he attended an outdoor parliamentary meeting with his father. He felt himself caught up with the passions aroused by patriotic flag-waving. His father brought him down to earth by reminding him, 'You can't eat a flag."'

My hon. Friend the Member for Conwy said:

"That comment is relevant in Wales today, and I would add that the people of Wales cannot eat the graffiti, 'Cymru i'r Cymry. English go home.—[0fficial Report, Welsh Grand Committee, 24 April 2002; c. 60.]

Today, John Humphreys of the Welsh Independence party calls for a national act of defiance to halt the influx of incomers to the Welsh heartlands. He states:

"Those of us of a bloody minded disposition will not be passive observers to the obliteration of our heritage",

which, he goes on to say,

"must be fought for over and over again."

I do not want to give the impression that the Welsh nationalist party hates the English to the extent of taking a principled stand against taking English taxpayers' money. Hardly a day goes by without their demanding a change to the Barnett formula so that Wales can have a bigger slice of the cake. When cash is concerned, the principles of the nationalists go out of the window. It is not surprising that English Members of Parliament are increasingly demanding to know why the nationalists and their sympathisers, who demand independence, are not willing to accept the financial responsibility that goes with it. The nationalists are willing to take money from the enemy, the English, although they took a somewhat different and, in some ways, more principled position in the 1930s when they argued for refusing the blood money from the English, whom they so despised.

That is sad. It is damaging when nationalists and their fellow travellers judge others not by their character but by their nationality. We are a tiny island and if we cannot live together as brothers and sisters, there is little hope for us. Linked to that, there is little hope for the Welsh language if nationalists use it as a political philosophy and a measuring rod of Welshness. I say that as someone who spent a considerable part of 15 years developing the Welsh language in Gwent.

Nationalists in Wales demand that we dump the geography that we share with the rest of the United Kingdom, our common struggles and the philosophy of international socialism, replacing those with a narrow nationalism based on bigotry and prejudice, in which the problem lies with the so-called English or London government, not with the economic system. Is that the kind of philosophy that we want our children to inherit? I suspect not. That is why we are having this debate.

I congratulate my hon. Friend the Member for Blaenau Gwent (Llew Smith) on his forthright contribution. The strong strand of racism and xenophobia in Plaid Cymru's history is well tabulated. We have only to look at some of the writings of Saunders Lewis, the founder of Plaid Cymru, to recognise the truth of that. He believed that he could embrace the corporatist ideas of Mussolini, with whom he was enamoured. He certainly had plenty of time for the racist remarks of various fascist elements arising in Europe in the 1920s and 1930s. Let me make it clear that he was an anti-Semite. We can see that time and again in his writings—it runs through them from start to finish.

Saunders Lewis had sympathies for Mussolini, Franco and Hitler. Other elements in Plaid Cymru had sympathies—[Interruption.] Opposition Members should not betray some of their pedigree by interrupting in the way in which they are. If they stopped to listen for a moment, they might learn something. That goes for Scottish as well as Welsh nationalists.

Will the hon. Gentleman give way?

My time is short and I have a number of points to make. I will not give way.

It was not only Saunders Lewis who was enamoured with fascist elements in Europe. On one occasion in the 1930s, when Welsh miners were going to Spain to fight for liberty and democracy, Welsh nationalist academics stood up in Cardiff university and toasted Franco as an honourable Christian gentleman. That is in the nationalists' history, and they cannot get away from it, even if they do not like it.

More recently, we have seen spasmodic examples of intolerance coming to the fore from the Welsh nationalist party, such as the comments of Simeon Glyn.

Will my hon. Friend give way?

My time is short, and I must continue.

We have seen the racist remarks of Simeon Glyn and the comments of Simon Brooks. What unites their views is an intolerance of English people and those who speak the English language. There was a report in The Western Mail yesterday about a new play written by a Welsh playwright by the name of Dic Edwards, about Welsh extremism and the Free Wales Army. Two of his performances have been disrupted by Welsh nationalist elements. He spoke forthrightly and sadly to The Western Mail, which reported:

"Born and brought up in Cardiff, Mr Edwards said he encountered racist attitudes towards immigrant communities in areas of the city and now sees similar racism towards English-speaking incomers in rural areas."

Will the hon. Gentleman give way on that point?

The report quoted Mr. Edwards:

"'I come from a racist culture in Cardiff and now that I live in Aberaeron and work in Lampeter I know children who are discriminated against because they are English,' he said. He said his son Nick, brought up fluent in Welsh, was so disgusted with the attitudes he found among Welsh speakers towards English that now, at the age of 30, he wants nothing to do with the Welsh language."

That is extremely sad. I want the Welsh language saved and I want it to flourish. I call upon the Welsh nationalist party today to unite the communities of Wales—to unite the Welsh speakers and the English speakers, so that we have one Welsh nation.

Will the hon. Gentleman give way?

I call upon the leadership of Plaid Cymru, once and for all, to renounce unequivocally the racism and xenophobia inherent in the party. Now, here is a chance for Plaid Cymru to renounce those elements. Let it do so.

My hon. Friends the Members for Blaenau Gwent (Llew Smith) and for Caerphilly (Mr. David) have made some serious points in their usual trenchant way, and have given examples of when, in our history in Wales, race has been used as a political weapon. Words are as powerful as arty weapon, particularly if spoken by those who hold political responsibility, as we do. Words can be used to inspire great actions, but they can also be used to inspire base actions. All of us who hold political office in Wales have a responsibility to choose our words carefully. They must not give offence in a racial way.

Does the Minister agree that it is important that one should not take a partisan approach to such a serious issue? He says that words are important, but will he put on record his opposition to Ministers using words such as "swamping" and to Back-Bench Labour Members using words such as "floodgates" when talking about asylum seekers and their children? Will he disassociate himself from the Government's efforts to build a special relationship with a Government who include neo-fascists, and perhaps reflect on the fact that the Labour party, through the Socialist International, condoned the first occasion that the Freedom party got into government in Austria?

Yes, we should all be careful about the words that we use, because it is possible to give offence in a racial way. I have made that point clear. That applies in Wales as much as in any other part of the United Kingdom.

Our great cultural heritage, which includes the Welsh language, should be used to unite the people of Wales, not to divide them. Wales is a bilingual country. As the hon. Member for Caernarfon (Hywel Williams) said in last week's debate in the House on Wales in the world, we must remember that English is a Welsh language, too. Those who seek to use the Welsh language to emphasise their separateness from the rest of the peoples in these islands do no service to the Welsh language or to the Welsh people.

The Minister will accept that I was born in Wales and lived there for 33 years of my life. I am proud to be Welsh but proud to be British as well. Part of the problem between reality and perception is that, when politicians say things that are narrow, nasty and evidently abusive to our neighbours in England, it does enormous damage, even though they are only a small minority. The English will feel equally hurt when people who should know better have a go at the Welsh.

I accept the hon. Gentleman's point and I shall touch on it as I progress.

No artificial wall, whether it is a wall of rhetoric or one put there by the law, will protect Welsh-speaking communities from a lack of jobs and economic opportunity. Indeed, we will not help the Welsh language by shutting out non-Welsh speakers. We will help it only by ensuring that people can stay in their local communities in rural Wales: they will stay if there are jobs, affordable housing and good public services.

The future of the Welsh language will be secured through a strong economy. We have already made good progress by cutting unemployment in Wales to a 27-year low, but we know that there is much more to do. To secure economic prosperity, we must take tough decisions. That applies to all parties, both Government and Opposition parties. We must radically reform the current system of agricultural subsidies and tackle the culture of long-term reliance on benefits, which is a blight in many parts of Wales: we must help people to move from welfare to work. We must also tackle the problem of providing affordable housing in rural communities, an issue we should be cautious about. Some restrictive policies in relation to new houses have had the opposite effect from that intended. The market being what it is, house prices are often driven up in rural Wales as a consequence of the actions of some, and the problem remains.

I have referred to measures to reform agricultural subsidies and welfare to work, but vociferous members of the Welsh nationalist party, who are here in the Chamber this afternoon, have opposed them. They have been negative and backward looking when we have sought to raise those issues and to take that agenda forward.

Will the Minister give way?

Will the Minister give way?

They have that attitude because they have no serious policy issues.

On a point of order, Mr. Griffiths. The subject of the debate is racism in Welsh politics. The Minister has not mentioned that in his speech. Is he trying to disassociate himself from the inflammatory and ill-informed speeches by his hon. Friends?

That is not a point of order, but it was a nice try.

My hon. Friend the Member for Newport, West (Paul Flynn) must not have heard what I said at the beginning of the debate about race being used as a political weapon in Wales. He should bear that in mind. I am seeking to develop an argument that language is being used destructively as a racial political weapon in Wales.

Plaid Cymru has no serious policies on the issues that I have raised. It has no political leadership about which it is worth talking. In fact, it will not take responsibility for facing up to the problems in Wales. Political leadership must be based on a set of beliefs and a set of principles. On no issue is Plaid Cymru's lack of leadership more evident than on that of whether language extremists have introduced race into the political debate in Wales. Language extremists want to restrict the movement of English speakers, whether or not those English speakers are Welsh-born.

Does the Minister share my great disappointment that, in an Adjournment debate on racism in Wales, we have heard not one word about racially motivated crime in Gwent, which is higher than that in London, not one word about asylum seekers' problems in Wales and not one word about the difficulties faced by young Asian people, who are less likely to find jobs in Wales than people of other races? Does he agree that this debate is disgraceful? Nasim Babur of the Welsh Asian Council said:

"There is no problem with Plaid Cymru and Welsh nationalists who just want to control their own country, which anyone would want to do".

I agree with the Welsh Asian Council. Does the Minister?

The hon. Gentleman must recognise that it is our country as well as the nationalists' country. The subject of the debate to which I have been asked to respond is racism in Welsh politics, and I am seeking to develop my argument on that subject. Every intemperate attack on so-called outsiders and every word of hatred expressed can only worsen the prospects of Welsh-speaking communities getting the investment that they desperately need to secure their future. Recent headlines in the press such as

"Anti-English graffiti daubed over village"

and

"Town daubed with racist graffiti"

damage Wales, rural Wales and its economy, because tourism is important for that part of the country.

In a recent debate, my hon. Friend the Member for Conwy (Mrs. Williams) made some good points, to which my hon. Friend the Member for Blaenau Gwent referred. She represents an area that depends strongly on tourism. She made it clear in the Welsh Grand Committee how damaging such headlines are to our efforts to encourage people to take their holidays in Wales. We had a debate in the House last week on Wales in the world. It is extremely harmful to Wales, its people and its economy when lunatics put up posters and splash walls with graffiti that says, "English go home".

In last week's debate, my hon. Friend the Member for Vale of Clwyd (Chris Rua ne) made those points and pointed out the lack of leadership in the Welsh nationalist party. When he made those points, hon. Members representing Plaid Cymru said, "This is our leader," and pointed to the hon. Member for Meirionnydd Nant Conwy (Mr. Llwyd). Perhaps there will be a challenge somewhere down the line. He would be a leader of some stature. A vacuum presently exists in Plaid Cymru.

We must remember that if we want to secure and improve use of the Welsh language, we must underpin that with a strong economy in rural areas. All we hear from the nationalists, apart from a constant demand for English taxpayers to stump up more money for their separatist nightmares, is a demand to tax English people who settle in Wales. Nowhere is that more clearly shown than in Plaid Cymru's hypocritical approach in dealing with Cymuned and Simon Brooks.

Cymuned is a deadly enemy of the Welsh language, and those involved in Cymuned are harming the Welsh language. Their tactics, which are simple—this goes to the heart of the debate about racism—are to intimidate English speakers, whether Welsh or English born, out of what they see as their communities. It is our community, whether we speak Welsh or not. They want a monoculture: a throwback to a Wales that I doubt ever existed. I know that some members of Plaid Cymru are as disgusted with that approach as Labour Members, but they dare not say so because at the core of Plaid Cymru is a right-wing, hard-core group of language extremists who drive forward their policies. They have been successfully excluded from positions of real power in Parliament and the Welsh Assembly, but it remains the case that everyone in the nationalist party who wants to succeed must bend a knee before those who preach language intolerance.

Simon Brooks is the grinder of the organ and Ieuan Wyn Jones plays his monkey. They do not offer leadership; they offer an opportunity for those who hold the extreme view that people who do not speak our language and come from outside Wales have no place in Wales. It is a sad reflection on Wales in the 21st century that people who hold the views expressed by leaders of the nationalist party 30 or 40 years ago—

On a point of order, Mr. Griffiths. As we have been unable to debate the real causes of racism against black and ethnic minority people in Wales, will it be in order to apply for such a debate? The title for this debate was misleading.

That is a matter for Back Benchers, not for me.

I regret that the hon. Member for Ceredigion (Mr. Thomas), for whom I have great respect, is again following his party's leadership and ducking the issue by not condemning the racist extremists in his own party. Why do people such as Mr. Brooks remain on its candidates' list for election to the Assembly? Strong leadership would have tackled that and said that such people have no place in the party or in politics in Wales. It is important that we all unite in saying that it is wrong.

I sensed a degree of unity when the matter was touched on during the debate on Wales in the world in the House last week, but there is no such unity in the Chamber this morning for partisan reasons. Interventions this morning have dodged the issue. Hon. Members have said that they will oppose such views, condemn people who hold them and remove them from their party. That is the true fact of the problem.

We will not build a harmonious and strong Wales if we allow people who preach intolerance to be seen to be speaking for the people of Wales. They do not. The people of Wales treat such people with abhorrence. The language should not divide us; it should unite us. English is a Welsh language, as the hon. Member for Caernarfon said during the debate last week.

It is important to take opportunities such as this to flush out extremism in society. We have seen it grow in other parts of Europe and we have seen the resulting danger to a healthy, free, open and democratic society. Our challenge to everyone in politics in Wales should be to stand up and say we will not tolerate such division in our society, or racism. It is a pity that the so-called Opposition party in the Assembly—the so-called party of Wales—is so lacking in leadership that it is unwilling and unable to stand up to people who are divisive and destructive. It is for those on the Labour Benches to bring such matters into the open, and to make it clear that we shall fight them tooth and nail.