What assessment he has made of the effect of the proposed consultants' contract on their productivity; and if he will make a statement. [67264]

May I say how pleased I am to see the hon. Member for Woodspring (Dr. Fox) in his place after the terrible and tragic events of the weekend? I am sure that all our thoughts are with him and all concerned.

May I put it to my right hon. Friend that, although there are many dedicated NHS consultants, the profession is notorious for its pursuit of self-interest and self-importance? What safeguards are in place to ensure that consultants deliver, and what will stop them pocketing the extra money and moving on seamlessly to their next demand?

A good start! I listen carefully to my hon. Friend in these and all other matters, but I have a slight difference of view with him on this issue. Most NHS consultants do a very good job of work for the NHS, and I should assure him that the new NHS consultants' contract is, in essence, a something-for-something deal. Obviously NHS consultants will get more, and we are prepared to pay them more, providing they are prepared to do more for NHS patients.

Is it not the case that the productivity of doctors in the hospital service will decline as shorter hours are introduced? Is it not also the case that costs will rise sharply as pay becomes more realistic? Can the Secretary of State give us some idea of how much of the extra money over the next three years will go in rising costs and lower productivity as shorter hours are introduced for all doctors?

I do not think that that is the case. In fact, as the right hon. Gentleman is aware from the public service agreement that we published yesterday, we expect a 2 per cent. increase each year in both efficiency and quality in the NHS as we expand it. It is certainly true that there are problems with productivity, particularly if the NHS does not expand. However, it is expanding precisely because of the choices that the Labour Government have made.

What other group of workers wield as much power as consultants? Their so-called trade unions, the royal colleges, dictate how many consultants can be trained each year, where they can be trained and which hospitals can carry out what operations. They decide how many hours consultants work for the NHS and they keep waiting lists high so that people fork out money to jump the queue that they have created. Will my right hon. Friend tackle this closed shop, which makes Bob Crow and the RMT look like a set of woolly liberals?

I think that that is what is known as a friendly question. As far as tackling the issue is concerned, my hon. Friend is aware of the terms of the framework agreement that we have reached with the BMA. Obviously that will now go out to consultation, and I presume that NHS consultants will have an opportunity to have a say on what they think about it. However, it will tackle many of the problems that he has outlined.

Does the Secretary of State agree that the merit award system is one of the root causes for consultants developing the characteristics so beautifully described by the hon. Member for Sunderland, South (Mr. Mullin)? What plans does he have for revising that system?

The merit, or distinction, award system needs to be reformed, and we are planning to do that, as the hon. Lady well knows. It is the next element of the reform programme and is under discussion. I want the merit awards to be precisely that: rewarding merit, especially those NHS consultants who do most for NHS patients. We trained them to do that and they are skilled experts. We have too few of them, but that will change. In the meantime, we need to ensure that we get more of their valuable time and skills for the benefit of more NHS patients.

If will make a statement on the provision of in-patient beds for mental health patients in urban areas. [67265]

Each mental health service user who is assessed as requiring a period of care away from their home should have timely access to an appropriate hospital bed or an alternative bed or place. In the NHS plan, we set down our commitment to create 500 extra secure beds and 320 extra 24-hour staffed beds. We have met this target.

I hope my hon. Friend will tell the House that mental health, always the Cinderella of the health service, will have a fair share of the huge increase in spending on the health service, because that is vital. On a specific problem, the number of patients in Manchester—the figure is typical of urban areas—who have been sectioned under the Mental Health Acts now accounts for 50 per cent. of the beds occupied compared with only 20 per cent. 10 years ago. The problem is that patients have to queue up for in-patient beds. Unless we provide more beds to get the balance right, people will be given a bed only when they have reached crisis point. Beds need to be available earlier, when it is cheaper and better for the patients.

My hon. Friend makes an important point about the priority previously afforded to mental health services. With the publication of the mental health national service framework and the NHS plan, the Government have made mental health one of the top three clinical priorities.

A month ago on 18 June I raised with the Secretary of State the crisis in the Avon and Wiltshire mental health partnership NHS trust. He said that it was all a matter of money. I wrote to the Minister on 29 April and she told me in a written answer that she would reply as soon as possible. Councillor Christine Reid, the Labour councillor who chairs that trust, has not replied to my correspondence. The matter is urgent. It is not party politics; it is process. In particular, it reflects a breakdown in the mental health system in south Wiltshire. If the Minister cannot answer, will she at least see me to explain why the trust has lost £60,000 for the alcohol and drug advisory service and how the Government expect the new trust to function with an initial deficit of £500,000?

I apologise if I have failed to respond to the hon. Gentleman's letter. I will ensure that he gets an answer. I have discussed issues to do with that trust with its chair and I am willing to discuss progress in his constituency with him. However, part of that discussion may well concern the difference in our approaches to investment in mental health services. The Government have made it clear that we are investing more in those services and will continue to do so; but the hon. Gentleman, and in particular his Front-Bench colleagues, have opposed that investment. That would have to be part of any conversation that we had about how to improve our mental health services.

Will my hon. Friend pay particular attention to in-service provision for children who present with serious psychiatric problems? All too often, they are inappropriately placed either on general paediatric wards or in adult mental health provision; they need their own specialist services, and I hope that my hon. Friend will consider the provision of such in-service beds.

My hon. Friend raises an important point. Mental health services for children and adolescents were perhaps treated even more poorly than adult services by the previous Government when it came to showing interest and making investment. The £105 million of investment in child and adolescent mental health services has begun to bring those services out of the shadows and enabled us to develop the specialist provision, including in-patient beds, for which my hon. Friend argues.

According to recent guidance from the National Institute for Clinical Excellence, the majority of studies show that the higher cost of purchasing atypical antipsychotics is more than offset by the reduction in in-patient stays. This morning, at a conference attended mainly by psychiatrists, more than two thirds of those present said that funding was a barrier to prescribing atypicals. How will the Minister ensure that adequate funding is provided to increase their prescription?

The hon. Lady rightly points out, as do the NICE guidelines, the potential benefits for the service as a whole and for individuals of being able to prescribe atypical antipsychotics in the appropriate circumstances. It was to secure those benefits that we set up NICE to develop such guidelines and to involve users, which is another important way in which we develop our services. We are investing in our mental health services, and we have earmarked extra investment for service delivery and the development of new services.

indicated dissent.

For Liberal Democrats the investment is never enough. The difference between sitting on the Opposition Benches and sitting on these Benches is that we make the decisions, we provide the investment and we set the priorities. We said that mental health was a priority; that is making a difference at a local level and I am confident that it will continue to do so.

Despite the excellent work that has already been done by the rough sleepers initiative, the condition of many mentally ill people in London is exacerbated by the fact that they are of no fixed abode. Given the peripatetic nature of their lives, it is not unusual for homeless people who are mentally ill to reach and pass the point of crisis and to find it impossible to gain any medical treatment. It is bad enough to be without a home, but surely to be denied access to the NHS is unacceptable. Will my hon. Friend please consult the Mayor's health commission to examine the additional needs for such services on a much broader than borough-by-borough basis?

My hon. Friend makes an important point about the needs of the homeless. As we develop our mental health policies—in particular, the new community teams which, in parts of London, have been able to reach out to people in the community, even people without homes who have previously been unable to access services or have not be able to access those services early enough—I am happy to talk to anyone to make sure that they deliver improvements for the most vulnerable people cited by my hon. Friend.

If he will make a statement about the number of people registered with NHS dentists in Gloucestershire. [67266]

One hundred and twenty-one thousand adults and 78,000 children were registered with a general dental services dentist in the former Gloucestershire health authority area on 31 May 2002. Thanks to the extra investment that the Government are making available, we are continuing to take measures to improve access to NHS dentistry in Gloucestershire. A new dental access centre in Gloucester, including a satellite clinic in the hon. Gentleman's constituency, has already treated 14,000 patients in the 12 months to May of this year. I am glad that funding has now been made available for a second dental access centre in the county.

I am grateful to the Minister for his considered response. He will be aware, however, that the number of people treated by NHS dentists in Gloucestershire has fallen in the past six years. I am not seeking to make a political point, as the issue is too serious for pensioners and the many other people who cannot afford dentists to make it political. Does the Minister see the future as one of private provision, or will the Government be able to ensure that there are sufficient NHS dentists for people in Gloucestershire who need that treatment?

The hon. Gentleman was wise not to try to make a party political point. He will not mind my pointing out that he is in a slightly difficult position, because the Government whom he supported presided over a major contraction in access to NHS dentistry. He and his right hon. and hon. Friends are now opposed to the extra investment that will put that right. He asked specifically whether we see the future as being one of private practice. The answer is clearly no—that is the policy adopted by him and his right hon. Friends.

I do not want to disturb the unity of the Labour and Conservative parties, but the Minister will be aware that the number of people registered with a dentist in Gloucestershire has fallen from 44 per cent. to 36 per cent. under his Government, whereas under the Tories, the national figure did not fall by much more than 3 per cent—from 59 per cent. in 1992 to 54 per cent. in 1997. English coverage is now only 47 per cent. How, without more registrations, can holistic, preventive care be given to people with dental problems, rather than the emergency treatment-only provision which is the Government's one-club strategy?

Uncharacteristically, the hon. Gentleman failed to paint an accurate picture of what is happening. He likes facts and figures, so he will be interested to know that 1 million more courses of NHS-funded dental treatment are provided now than in 1997, and that nearly 2,000 more NHS dentists are providing services to NHS patients. I am not saying for a second that all the problems have been solved—clearly, they have not—but we are getting the investment in and easing the problems that we inherited. To continue doing so, we shall carry on making investment available and I hope that we have the support of the hon. Gentleman and his right hon. and hon. Friends for doing so.

If he will make a statement on the cost to the NHS of an average call to NHS Direct. [67267]

The average cost of a call to NHS Direct in 2001 to 2002 was about £17.92, although that is expected to fall significantly in the future as call volumes rise. The National Audit Office has found that half of callers are directed to forms of care that they would not have chosen, which tends to be care of a lower level and with a lower cost of intervention.

My hon. Friend may have seen press speculation that the cost of calling NHS Direct is higher than the cost of going to an NHS GP. However, the people who are raising those issues are missing the point. Is it not true that NHS Direct is expanding access, improving the service to patients and making sure that they get the right care? Will my hon. Friend assure the House that he will be looking not only at extending NHS Direct but at using other forms of new technology to make sure that we are always at the cutting edge of innovation around the world? In particular, will he look at the experiments in broadband technology which might assist the NHS in many different ways?

My hon. Friend is exactly right. NHS Direct is probably the best example in recent times of the use of information technology in Government. Yes, costs are higher than those of seeing a GP, but one would expect that with a new service. Costs are expected to fall over time. The important thing about NHS Direct is that satisfaction levels are between 90 and 97 per cent. One would have to look hard to find similar levels in private life, so to speak, and in other areas. Certainly, we will continue to look at ways of extending and expanding NHS Direct over the years ahead.

Can the Minister tell the House the number of house calls that GPs have made, particularly to the elderly infirm, since NHS Direct was introduced? Can he give me an assurance that NHS Direct will never ever become a substitute for house calls to the elderly and to those with particularly serious conditions?

No, it will not. I will write to the hon. Lady with the details in due course. The important thing is choice, diversity and access. NHS Direct, alongside GPs, increased use of paramedics, and reform in accident and emergency services, will bring about a reformed service. That is what we are working towards.

May I draw my hon. Friend's attention to a pilot seen by the Select Committee on Health at the West Yorkshire NHS Direct centre, where patients with chronic conditions are supplied with self-testing equipment and transmit data daily to the NHS Direct call centre, where the data are examined so that potential problems can be spotted? That service could have great benefit in an area such as mine, where there are high levels of chronic illness caused by industrial injury. If rolled out nationally, the service could unlock the full potential of NHS Direct.

I am grateful to my hon. Friend for drawing that to the attention of the House. It is excellent practice and is an expansion of NHS Direct. By 2004, hopefully, people will be able to ring up the NHS Direct number and make 999 calls from home without complication. We hope to extend the service for people with chronic illnesses to diabetes and asthma. NHS Direct can continue to support the ambulance service and help to reduce waiting times in A and E.

Given the current delays with NHS Direct, there is obviously much work to be done before emergency calls can be routed by it. What assessment has the Minister made of the impact on nurse vacancy levels in hospitals caused by the large number of experienced nurses who have transferred to NHS Direct from those hospitals—about 900 out of 1,150? Why, with all the cost—£110 million in the current year—does one in five callers still have to wait for 30 minutes to get a response from NHS Direct, and why is there precious little evidence of success in taking pressure off GPs, who cost half as much?

The numbers are coming down. The hon. Gentleman should be aware of two important facts. First, NHS Direct employs about 1,500 nurses out of a work force of about 350,000, so he is speaking of a very small number. He should also be aware that many of those nurses are disabled or work injured; many of them work part time; many of them work for NHS Direct and in other parts of the NHS.

As the Minister will be aware, there is no 24-hour carers' helpline, so NHS Direct doubles up as that service. Are we monitoring how many carers are using NHS Direct; if not, does the Minister agree that we should?

More than 11 million people have used NHS Direct since it came into being, and more than 110,000 will use it this week alone. Two to 3 per cent. of those people become aware of the severity of their complaints through having rung NHS Direct, so it is saving lives. My hon. Friend is right to say that it is important, as the service expands, to examine ever more closely the profile of the people who call it, and to ensure that it is better integrated into the NHS as a whole. It represents the best example of the introduction of information technology in the NHS, and compares well with the failed Child Support Agency that Conservative Members introduced when they were in government.

If he will make a statement on his plans to increase resources going to cancer research. [67268]

In 2000–01, we invested £190 million in cancer research. By 2003, we will be investing an additional £20 million each year in the cancer research network and an extra £4 million in prostate cancer research. That new funding means that for the first time, Government—through the Department of Health, the Higher Education Funding Council and the research councils—will match the current investment of the voluntary sector.

I welcome the Minister's announcement of that investment. I was recently contacted by a constituent of mine, Robert Blunden, whose wife tragically died of cancer last year after a very long illness. Is the Minister aware that the oncologist who treated Mrs. Blunden, and 27 other cancer specialists, recently wrote to the press deploring the fact that the National Institute for Clinical Excellence had refused to permit the use of two new cancer drugs, despite the fact that there is no oncologist on the appraisal committee? We will never know whether those two drugs could have saved Mrs. Blunden's life or helped to alleviate her pain. However, given the Minister's and the Secretary of State's huge commitment to cancer care, does not she agree that there should be a cancer specialist on the appraisal committee; and why is she trusting her political judgment rather than the expertise of 27 specialists?

If the hon. Gentleman really understood how NICE works he would know that the NICE body includes a range of specialists, but not a representative from every single disease specialty. Members of NICE go out to consult clinicians working on the ground, health professionals and patients groups, exactly as they did in the case of those vital cancer drugs. They consulted all those bodies before they reached their decisions.

Does my hon. Friend accept that one of the key agencies for helping cancer research and caring for cancer patients is the hospice movement? Does she recognise that the hospice movement, including the children's hospice movement, faces a serious problem as regards resources, which are required immediately? Will she do all she can to ensure that those services can continue?

I am very aware of the excellent work that is done by the hospice movement and by children's hospices. We have made a commitment that, by 2004, an extra £50 million will be spent on specialist palliative care. We are world leaders in palliative care, mainly because of the excellent work that is done by the hospice movement. I know that concerns have been expressed about that money getting through to the front line, and I am looking forward to attending the all-party group on hospices tomorrow and having a good discussion with hon. Members in that forum. I can tell my hon. Friend that we can make the extra investment because we have made this vital area of palliative care a top priority for the Government.

Earlier this year, Professor Gordon McVie, the director of the Cancer Research Campaign, expressed his concern that the £570 million earmarked under the NHS cancer plan was running into the sand. What guarantee can the Minister give that the funds that she has just described will not similarly run into the sand?

As the hon. Gentleman knows, the Government have decided to make cancer a top priority. In 2001–02, we put in an extra £280 million; we shall put in an extra £407 million this year, and an extra £570 million next year. Part of those funds was centrally allocated to ensure that they would be directed to specific issues, but a large part of the extra money was put into baselines, so that people at local level could decide—quite properly, under the shift in the balance of power—where they needed to spend the money to make improvements in the cancer plan.

I welcome the Minister's comments on extra funding for palliative care. She may be aware of Derian House, and of St. Catherine's hospice, in Chorley—one a children's hospice, and the other a hospice for adults. They are experiencing severe problems in raising funds from the area and ensuring that the two hospices remain sustainable. I hope that she will give them some secure funding to ensure that both can continue to exist.

My hon. Friend is right to raise the excellent example of children's hospice care in his constituency. Children's hospices provide a relatively new form of care. Funding under the new opportunities scheme for those services is now open for bids, particularly from children's hospices, and I am sure that his local hospices will be preparing submissions to it. We have also increased carers grants and provision for respite care to provide breaks for families. The significant thing about children's hospice care is that it provides not only terminal care but respite care to enable children and the rest of their families—including their brothers and sisters—to have a break from what can be extremely trying circumstances.

May I remind the hon. Lady of the unsurpassed work of the Gray cancer institute at Mount Vernon hospital in my constituency? May I urge her to get the Secretary of State to reply to the letters that he has received from Professor Wardman, the director of the institute, who is, rightly, deeply concerned that the hospital's cancer centre might move away from Mount Vernon and thereby prejudice the close co-operation that exists between researchers at the Gray cancer institute and those who work at the cancer centre? Will the Minister address those serious problems, which concern my constituents and the many thousands who are admirably served by the cancer centre at Mount Vernon?

I cannot comment on the particular issue that the hon. Gentleman raised, but I shall certainly look into replying to the correspondence to which he referred. I would say, however, that the Government have set up translational cancer centres, which address exactly the issue that he raised: how we translate scientific research into clinical research that can make a difference to patients. We have now set up eight centres of excellence that are involved in the national translational cancer research network—NTRAC—process. They are bringing the benefits of scientific research to the clinical trials that matter for patients. It is because the Government have set up the cancer research networks that we are now seeing the benefit of the investment in that vital research.

What assessment he has made of the effectiveness of newly formed primary care trusts. [67269]

Three hundred and three primary care trusts have been established and are now operational. The trusts will be accountable to the new strategic health authorities, which will assess their performance. In addition, the Commission for Health Improvement will undertake routine assessments in every NHS trust, strategic health authority and primary care trust.

Does my right hon. Friend agree that our primary care trusts will be judged on how well they work with other organisations in the community to improve people's health and well-being? Does he welcome plans such as those of Crawley PCT to commission partnership posts jointly with social services and the local borough council, to get the very best out of the jobs and ensure that people understand that there is now a cohesive health system in our communities and that the power has gone back right to where it belongs, with our GPs?

Yes, I agree strongly. One of the key jobs of the new primary care trusts will be to bring about the closer integration between health and social care that my hon. Friend described. Most of our constituents see health and social care as one system, and they want them better integrated. We will do all that we can in the Department to encourage that. We have already changed the legislation and we are putting in the investment to ensure that we get that closer integration. I had the good fortune of visiting my hon. Friend's constituency recently and had the chance to discuss this and other developments with the leaders of her primary care trust. They are doing a brilliant job, and so is she.

I have no doubt that the Minister will wish to pay the same tribute to me.

In his own way, the hon. Gentleman does do a brilliant job. He has a long association with Crawley, too, but let us not dwell on that. I agree with him strongly about the important role that primary care trusts will play—actively, we hope—in supporting voluntary organisations and helping to improve the delivery of front-line services. There may be some disagreement on this point. He and many others may make the argument for devolution to the front line, which is absolutely right, but then ask us to issue guidance on how the functions should be delivered. There is a balance to be struck. There are key responsibilities for primary care trusts on which it is perfectly appropriate for Ministers to issue guidance—commissioning and a range of other important services—but we trust PCTs to make the right decisions. Their resources are growing substantially, with a 10 per cent. cash increase this year alone. That will also benefit him and his constituents. We want to leave the PCTs free to make their own decisions.

Under the previous health authority, my constituency was one of the most underfunded in the entire country. Now that we have the Bolton primary care trust, and following the Chancellor's excellent announcement yesterday, will my right hon. Friend assure my constituents that he will look again at the most underfunded areas in the country and bring them up to target faster than hitherto?

My hon. Friend will be aware that my right hon. Friend the Secretary of State is currently reviewing the funding formula and the method of allocating resources across the NHS. I hope that we will be able to make appropriate announcements on that in the near future. Many hon. Members of all parties have raised this important issue with me. We must set ourselves the important objective of improving the health of the poorest members of our community at the fastest possible rate. That is the challenge for this Labour Government. We welcome that, and we will take it on—in stark contrast to the Conservative party, which could not even bring itself to mention health inequalities in the 18 years for which it had the stewardship of the national health service.

First, I thank the Secretary of State for his comments, the sympathy expressed to the family of the road traffic accident victim, and for his support in the past few days. It is a pity that the friendship and courtesy that typifies the way we do business in this place most of the time is not the face that the public see.

If the hon. Gentleman looks at the progress that has been made in recruiting new GP registrars, for example, he will see that a substantial number of GPs—nearly 7,000—are in training. From that figure, I think that we can meet our target of recruiting a minimum of 2,000 GPs by 2004. Key to that aim is the investment that we are putting into the national health service. The hon. Gentleman expresses concern about the rate of progress in recruiting GPs, but I should point out in the politest way that I can that we will take him and his colleagues seriously when they are prepared to match the investment that we are putting in.

Doctors should be recruited into general practice because it is a career that they want, not bought from a GP supermarket. In the past two quarters, there has been a huge increase in emergency admissions through accident and emergency, totalling almost 100,000 above trend. To what does the right hon. Gentleman attribute that increase, and what does it say about the current interaction between general practice and the acute sector, and particularly the burden on GPs?

We are investing significantly in improving our accident and emergency departments, but is it clear that the hon. Gentleman cannot match that investment. I remind him of what I said a moment ago about the number of GPs who are already entering GP training. That is the cohort from which we will meet our target of recruiting additional GPs for the national health service. Across the various areas that he has drawn attention to, we are making progress.

Those answers smack more than a little of complacency. PCTs have staff shortages, they have failed to reach their IT targets, they must repay their deficits this year, and thus they say that little or no money will be available for primary care development. They also have to shoulder the inappropriate role of public health, and on top of that, they are concerned about the Government's plans to push ahead with foundation hospitals. How will the relationship between PCTs and foundation hospitals differ from current relationships?

Basically, the hon. Gentleman is criticising the Government's reform agenda for the national health service—our attempts to improve its efficiency, productivity and effectiveness. I repeat that we will take his concerns seriously when he can outline for us his reform agenda. Until he does so, most Government Members will be forced to reach the only rational conclusion: the bogus rhetoric of the Conservatives is a smokescreen for what we all know will happen if we ever have the misfortune to experience a Tory Government again. It will be cuts, cuts and cuts again.

As my right hon. Friend is aware, the primary care trust that serves Barnsley is the biggest in the country. Unfortunately, it started life in April 3 per cent. short of its funding target. That shortfall, which equates to about £6 million, has been compounded by a further £1.5 million debt, and by the shortage of GPs, which costs us money. Will he look again at Barnsley PCT's funding?

I am afraid that I can only repeat what I said to my hon. Friend the Member for Bolton, South-East (Dr. Iddon). I am aware of the issue to which my hon. Friend draws attention, and my right hon. Friend the Secretary of State and all Ministers in the Department of Health are fully committed to addressing it. However, it is worth pointing out that, despite the problems to which my hon. Friend rightly draws attention, Barnsley PCT received a very significant increase in its resources this year. Our challenge and responsibility is to keep that investment coming through, and I can confirm that that is what this Government will always do.

If he will make a statement on the future availability of food supplements and traditional herbal medicinal products to consumers. [67270]

Our intention is to ensure continuing availability of a wide range of food supplements and traditional herbal remedies, within the European legislative framework. We aim to achieve that by active participation in the work required to follow up the recent food supplements directive, and through the continuing negotiations on the proposed directives on traditional herbal medicinal products, and on the review of medicines legislation.

I am grateful for that reply. The traditional herbal medicinal products directive threatens the availability of 70 per cent. of safe herbal products in the UK. The food supplements directive, to which the Minister referred, would ban 300 safe nutrients and many safe higher potency vitamins. I have considerable regard and affection for the Minister—[Interruption.] Will she listen to Consumers for Health Choice, the National Association of Health Stores and the Health Food Manufacturers Association? They speak positively and accurately for the industry and its many thousands of consumers.

I will take the matter more slowly, and I urge the hon. Gentleman to do the same. There are proper and genuine concerns in this regard, which the Government take very seriously. Just last week, Lord Hunt and I met representatives from the industry as a whole. We talked particularly about the traditional herbal medicines directive. Some industry representatives welcome the quality and safety standards being applied to manufacturing, but people from the health food sector are worried about some of the products. We have extended the consultation period to the end of July, and are looking for areas of over-regulation or for instances of items that might be excluded.

May I commend the Government's increasingly measured approach on this matter? Some hon. Members were critical of the haste with which the Government supported proposed European regulation in this area. I remind my hon. Friend of the important prize at the end of the process—a single European framework for the consumption of these products. That will be valuable to companies such as Peter Black and Surepharm in my constituency.

Yes. I am conscious that the regulations have been welcomed in some respects because, if they provide a more secure regulatory framework, products such as herbal medicines will gain more respect in the market place and consumers will be able to rely on their quality. We must not take our eye off the ball: there is a prize to be won at the end, and that is getting the best deal for manufacturers and consumers, while at the same time protecting public health and safety. We are determined to be very active in the negotiations to achieve that.

The Minister will recall that, when we debated this matter in European Standing Committee C, I queried the directive's loose wording. The Minister assured the Committee that no legal foodstuff products would be barred as a result of the directive. However, Lord Hunt admitted on 27 June that several products would be excluded. Will the Minister take this opportunity to correct the statement that she made to the Committee before it divided on the matter?

Yes. I told the Committee that certain combination products were unlawful at present, and would remain so after the directive was implemented. The directive itself will not make those products unlawful. Some of those combination products are not covered by regulation, and we are looking at that. The hon. Gentleman is right that some ingredients are not on the permitted list, but that is a separate matter. The Government are pressing to get as many dossiers as possible approved for food supplements and traditional herbal medicines so that the list of permitted ingredients can be extended. I repeat, however, that some combination products are illegal now and will remain so after the implementation of the directive. That will not be a result of the directive, but we must be conscious of the need for a regulatory home for those products.

I thank my hon. Friend for her answers so far. As a Member of the European Scrutiny Committee that referred the matter for debate in the Standing Committee, may I point out that some of us still have concerns that it should not be dealt with at European level? Questions of subsidiarity and where we deal with such matters are for debate in the Convention on the Future of Europe. I hope that the Government of the United Kingdom will think seriously before allowing Europe to make decisions on matters that should really be between consumers and health authorities in the UK. The prime directive should be to give good advice and then to let the consumer decide what they want to use.

Again, that is about finding the correct balance. Matters relating to medicines are regulated at European level because there are pharmaceutical safety issues. We are talking not merely about herbal products but herbal medicines that have a physiological effect and thus fall within a regulatory framework. It is important to get the safety issues absolutely right. The matter is not one of unaccountable European decision making: the directive is subject to co-decision and consideration and has been subjected to scrutiny in the House. However, it is important to recognise that, in the case of medicines, the regulatory framework is extremely important for the safety of consumers.

Will the Minister accept that there is considerable disquiet among users of these products about what is going on? Will she also accept that they can see no justification for interference in the exercise of their decision and their freedom to pick and choose? Will she give serious consideration to abandoning what is going on? Can she justify the Government persisting with something that is both unwanted and unpopular with the people most directly affected by their actions?

The hon. Gentleman must be careful; it is a matter of finding the right balance. I hope that he is aware of some of the ingredients of traditional medicines, such as aristolochia, which is found in some traditional Chinese medicines and has caused two cases of kidney failure in the UK. There is a question over kava kava which has caused three deaths abroad. There have also been interactions between St. John's wort and contraceptives where that medicine caused considerable harm.

What his policy is on reducing the incidence of suicide among women. [67271]

We published the national suicide prevention strategy for England for public consultation on 26 April 2002. It is a comprehensive, evidence-based strategy to prevent suicide. The strategy describes key actions already taken, and proposes further actions to be taken, to help meet the target set out in the White Paper, "Saving Lives: Our Healthier Nation". In addition, the Department is producing a strategy for women's mental health that will ensure that reformed mental health services meet the needs of women.

I thank the Minister for that answer. Is she aware that suicide is the main and rising cause of death among pregnant and perinatal women and new mothers? Different forms of suicide are occurring; there are many more violent methods and they are gender-specific. What is being done to increase awareness among health professionals of the risk to that particular group of women?

I think that the hon. Lady refers to information in the confidential inquiry into maternal deaths. It is worth putting the deaths from suicide among that group of women into context: the report highlighted 28 deaths due to suicide in more than 2 million maternities. However, she is right—any suicide is serious. The confidential inquiry made several recommendations for the management of women who are at risk of serious mental illness following delivery. In May, the Department produced a supplement insert for the GP magazine PrimaryCare, which included the key issues from the inquiry, to help to raise awareness of the factors that can contribute to maternal deaths. We also produced a separate midwifery summary of the confidential inquiry, and the findings will of course feed into the development of the maternity module of the children's national service framework.