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NHS (Staff Statistics)

10. Mr. David Evans : To ask the Secretary of State for Health what is the present ratio of administrators and ancillary staff to doctors and nurses in the National Health Service ; and what was the ratio in 1979.

Mr. Mellor : In 1979, for every 100 administrators and ancillary staff there were 140 doctors and nurses. In 1987, for every 100 administrators and ancillary staff there were 190 doctors and nurses.

Mr. Evans : Does not my hon. and learned Friend's answer reiterate the Government's commitment to the Health Service and in particular to those at the sharp end? Does it not also illustrate that the Government are moving away from bureaucracy to patient care?

Mr. Mellor : It absolutely does, because that figure--which I am glad that the House has welcomed--shows not only the increase in medical staff but a very major change in administrative, clerical and ancillary staff : a sharp reduction in ancillary staff but an increase of over 63 per cent. in administrative and clerical staff working in clinically related posts. That is a major change and a fundamental reason why the NHS is serving patients better today than it ever did when the Labour party was in power.

Mr. Bell : Will the Minister note that there was nothing wrong with the ratio of administrators to doctors in Middlesbrough general hospital during the time of the child abuse crisis, when 121 children were taken into care and 98 were returned by the courts? Given that state of affairs, what does the Minister make of the doctors' statement at the weekend that 90 per cent. of the children were abused then and are abused now?

Mr. Mellor : I have every confidence in the Northern regional health authority and I support the decision it has taken to bring disciplinary action against Dr. Higgs. I cannot say more now, because the matter is sub judice. However, I can say that I read with considerable surprise the letter, signed by the 11 clinicians, that appeared in The Guardian. Neither I nor my Department can see any basis for the assertion that more than 90 per cent. of those children had been abused.

Sir Anthony Grant : Is my hon. and learned Friend aware that the Government are to be congratulated on their policy of encouraging ancillary services to be put out to tender, which has enabled millions of pounds throughout the Health Service to be applied to patient care and has put an end to the nasty NUPE and COHSE cartel?

Mr. Mellor : My hon. Friend is absolutely right. Competitive tendering has been a significant factor in enabling the National Health Service to treat a greatly expanded number of patients more efficiently. Once again, it is a sign of the double-talk of the Opposition that, although claiming to represent the interests of patients,

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they actually uphold the stranglehold of the cartel that NUPE and COHSE used to exercise over the NHS, but do no longer.

Working for Patients"

11. Mr. Beith : To ask the Secretary of State for Health how much has been spent on publicising the proposals in the recent health White Paper, Working for Patients'.

Mr. Kenneth Clarke : The sum of £1,250,000 has been allocated and spent on the launch of the White Paper.

Mr. Beith : Is that not an outrageous sum to have been diverted from patient care to give the Secretary of State greater publicity opportunities? Will that diversion of funds from patient care not be a characteristic of the reforms that he is setting out, not least if they involve a massive amount of invoicing, charging and recharging, all of which will add to the bureaucratic costs of the Health Service without helping patients?

Mr. Clarke : I regard it as a bargain at the price when one considers that we were explaining complicated proposals to a service that employs more than 1 million people and consumes £26 billion of taxpayers' money each year. In the past, the Health Service has not communicated well with its staff and, at times, has been reminiscent of the worst features of the car industry in the 1960s and 1970s, by its complete failure to communicate with its own staff. We embarked on a modest attempt to explain to people the implications of our proposals for their careers and their patients. The costs, incidentally, include things such as the popular leaflet and short communications pack, which I know that many in the House are using, let alone people outside.

Mr. Hayes : In welcoming the way in which my right hon. and learned Friend has taken time and effort to sell his policies and the way in which he has used money to do so, may I ask him to encourage some of his Cabinet colleagues to do the same?

Mr. Clarke : I know that at least one of my Cabinet colleagues has been interested in my experience of teleconferencing, and the same method will be used again. Given that the Government explain their policies in White Papers and other ways, it is absurd that we are not allowed to explain them to those mostly directly affected, using the most modern methods of communication. The cost is modest. The literature, videos and everything else contain no hint of party political material and we adhere extremely strictly to the conventions that surround these matters.

12. Mr. Andrew Smith : To ask the Secretary of State for Health what estimates he has made of the additional administrative costs of National Health Service hospital trusts, general practitioner budgets and other proposals in the White Paper, "Working for Patients".

Mr. Kenneth Clarke : No overall assessment of costs can be made in advance of decisions about the details and pace of implementation. I have no doubt that the NHS needs to invest in modern management methods.

Mr. Smith : It is not irresponsible of the Secretary of State to bring forward these proposals without having

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estimated the administrative costs? Does he not accept that his proposals will absorb, in the administration of wasteful competition, resources that should go into patient care? Will he give the House a straight answer to a straight question? Will administrative costs fall or rise? If the latter, who will pay?

Mr. Clarke : We made some provision for administrative costs in last year's autumn settlement when we allocated £2 billion. Money will certainly need to be put up front for investment in modern management techniques to achieve savings thereafter and to make better use of that money for patients.

As I said in my main reply, the Health Service needs to invest in that sort of modern management information. In any event, it is absurd that a huge service that spends £26,000 million each year cannot say with certainty where any individual sums of money go or what any facility costs or requires to be spent on it. All our investment in modern management techniques is essential to produce a stronger and better run National Health Service.


Civil Service

Q1. Mr. Dalyell : To ask the Prime Minister what arrangements exist to ensure that the Civil Service is not politicised in circumstances where a single party has been in power for a decade or more.

The Lord President of the Council and Leader of the House of Commons (Mr. John Wakeham) : I have been asked to reply The Civil Service is a non-political and professional career service, subject to a code of rules and disciplines. It is an express condition of that code that civil servants should discharge loyally the duties assigned to them by the Government of the day, whatever the political persuasion of that Government.

Mr. Dalyell : Pursuant to the Prime Minister's oral answer of 2 February, column 425, on the circumstances of Sir Leon Brittan's appointment, what is the House of Commons to think other than that Mr. Ingham and Mr. Powell have become so highly politicised that they connived at the Prime Minister's corrupt and-- [Interruption.]

Mr. Speaker : Order. The hon. Gentleman must withdraw the word "corrupt".

Mr. Skinner : Ted Heath said it.

Mr. Speaker : Order.

Mr. Dalyell : I borrow the word of the former Conservative Prime Minister.

Mr. Speaker : Order. The hon. Gentleman should resume his seat when I am on my feet. I do not care who else may have said that, but I ask the hon. Gentleman to withdraw that word.

Mr. Dalyell : Is there one rule for Back Benchers and another for former Prime Ministers?-- [Interruption.]

Mr. Speaker : Order. I have studied the Hansard of that exchange and it is my understanding that the former Prime

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Minister referred to the machinery at No. 10, not to the Prime Minister personally. I am asking the hon. Gentleman to withdraw the word "corrupt". I advise him that he will be taking time out of questions if he refuses to do so.

Mr. Dalyell : The last thing that I want to do is to get thrown out of the House of Commons. However, in view of column 657 on 27 January 1986, could we say specifically the Prime Minister's "misbehaviour"? Did they connive at that?

Mr. Speaker : Order. Will the hon. Gentleman please withdraw the word "corrupt"?

Mr. Dalyell : Is is an important day for the House and the last thing-- [Hon. Members :-- "Withdraw."] Mr. Speaker asked me to withdraw ; I will.

Mr. Wakeham : That was a long time acoming.

Whatever the hon. Gentleman's views, today's Civil Service is as impartial and professional as ever. If the hon. Gentleman wants any evidence of that, the Select Committee on the Treasury and Civil Service concluded in 1986 that it had received

"No convincing evidence that the British Civil Service is being politicised."

A working party of the Royal Institute of Public Administration has also recently concluded :

"There has not been an overt or systematic politicisation of the top ranks of the civil service."

I prefer their evidence to that of the hon. Gentleman.


Q2. Mr. French : To ask the Prime Minister if she will list her official engagements for Tuesday 21 February.

Mr. Wakeham : I have been asked to reply.

This morning my right hon. Friend the Prime Minister was in Germany for an Anglo-German summit. This afternoon she is attending the memorial service in Belfast for those who died in the air crash at Kegworth.

Mr. French : Will my right hon. Friend find time to consider the greater degree of choice that the Government's housing policies afford to council tenants? Does he agree that allowing tenants to choose their landlord is the best way of raising standards? Is he aware that Gloucester city council is providing such a choice by offering its tenants the opportunity to opt for one of the best housing associations?

Mr. Wakeham : I wholeheartedly agree with my hon. Friend that the best way of raising council tenants' standards is to give them a choice of landlord. The Housing Act 1988 achieves that through the tenants' choice provisions and I am sure that council tenants will welcome those new rights. I am also aware of Gloucester city council's proposals for transferring its housing, but I must resist the temptation to comment on them, because the council may wish to apply to my right hon. Friend the Secretary of State for the Environment for a consent to dispose of that housing and I would not want to prejudice his consideration of the application.

Mr. Kinnock : May I inform the right hon. Gentleman--[ Hon. Members :-- "Question."] Mr. Speaker, may I inform-- [Interruption.]

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Mr. Speaker : Order. Come on, please.

Mr. Kinnock : May I inform the right hon. Gentleman that the Opposition fully support the firmest international action against the threats that have been made on Salman Rushdie's life? The great majority of Moslems, although devout in their faith and offended by what they have been told that Mr. Rushdie has written, are nevertheless law-abiding citizens who are opposed to any illegal act. I also repeat my conviction that Mr. Rushdie is free, under the law of this free country, to publish, and no power has the right to menace or oppress his liberty to do so.

Mr. Wakeham : I am grateful to the right hon. Gentleman and I am sure that his sentiments are shared by all hon. Members. I am sure that he will also be grateful that my right hon. and learned Friend the Secretary of State for Foreign and Commonwealth Affairs will make a statement at the end of Question Time.

Q3. Mr. Boswell : To ask the Prime Minister if she will list her official engagements for Tuesday 21 February.

Mr. Wakeham : I refer my hon. Friend to the reply that I gave some moments ago.

Mr. Boswell : Will my right hon. Friend find time to look into the compensation arrangements that follow compulsory purchase? Does he accept that they are often felt to be unfair and resentment of them contributes to further delays in infrastructure projects?

Mr. Wakeham : My hon. Friend knows that we keep these matters under review and he will be pleased that we have substantially increased home loss payments to a minimum of £1,200.

Q4. Mr. Blunkett : To ask the Prime Minister if she will list her official engagements for Tuesday 21 February.

Mr. Wakeham : I refer the hon. Gentleman to the reply that I gave some moments ago.

Mr. Blunkett : In view of yesterday's events at Shrewsbury, does the Leader of the House first accept that Opposition Members do not wish yesterday's events to be seen as a way of resolving the problems of a unified Ireland?

Secondly, does the right hon. Gentleman accept that very grave concern is felt by those who use service camps about the way in which privatisation has resulted in a plethora of contractors not using proper screening methods? When I recently visited accommodation outside Catterick camp I was informed that, although service and Civil Service personnel were vetted and supplied with proper passes, contractors' employees who provide catering and other services were not. Will he investigate that matter?

Mr. Wakeham : I know of no evidence to support what the hon. Gentleman has said, but I shall take note of it and see that it is examined by the appropriate authorities. The attack on Clive barracks was another callous attempt to kill and maim soliders as they lay asleep. It was thwarted by the vigilance of the guards, and their courage and presence of mind prevented a serious loss of life. I am sure the hon. Gentleman would not expect me to comment on security arrangements or any details of them.

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Mr. Conway : Notwithstanding the supplementary question, which was a far from accurate reflection on the state of security on British forces bases, will my right hon. Friend take time during his busy day to ensure that the Secretary of State for Defence communicates to the commanding officer of the 2nd Parachute battalion the congratulations of the House on the vigilance of that battalion in having secured a large base? Will he also commend the courage of Private Norris, who fought off the attackers?

Will my right hon. Friend ensure that a review is carried out into whether sentries guarding military bases should have their weapons loaded? The fact that they were not on this occasion is not the fault of the individual private or of his commanding officer--it is current MOD policy.

Mr. Wakeham : I shall certainly pass on what my hon. Friend says. I am sure the whole House would want to pay a warm tribute to the young men who, asleep or on duty, are at grave risk for our safety. With regard to the safety arrangements at the camp, the appropriate measures are taken in the light of the changing threats. Measures are constantly reviewed. At Clive barracks the soliders were armed with weapons and had immediate access to ammunition. I would not want to comment on any other speculation.

Q5. Mr. George Howarth : To ask the Prime Minister if she will list her official engagements for Tuesday 21 February.

Mr. Wakeham : I refer the hon. Gentleman to the reply that I gave some moments ago.

Mr. Howarth : Is the Leader of the House aware of recent reports that have suggested that contact with certain bleached paper products, particularly women's sanitary wear and children's nappies, could lead to the users being infected with dioxin? Does he agree that the manufacturers' response to that has been inadequate and in some respects patronising, and what will he do about that?

Mr. Wakeham : The hon. Gentleman is correct to say that there has been some trouble in this area, but it is of small proportions. It is being examined to check what can be done to relieve the problem.

Mr. Raffan : Does my right hon. Friend agree that the valleys initiative, together with the 67 per cent. increase in this year's urban programme allocation, shows the Government's determination that all areas should benefit from the economic transformation that is taking place? Does he also agree that the Opposition's clear embarrassment by the initiative is simply because this Government are doing for their traditional heartland what they lamentably failed to do when in office?

Mr. Wakeham : My hon. Friend is right. I was present in the Chamber yesterday when the Opposition gave a great deal of publicity to the speech made by my right hon. Friend the Secretary of State for Wales this morning, in which he pointed out that in 1988 there was new inward investment in the valleys every two weeks, and more than half those projects were for more than £1 million. In total those investments will provide

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several thousand new jobs, and unemployment in the Welsh valleys has fallen by 38 per cent. over the past three years.

Mr. Steel : Will the Lord President make it clear to the Prime Minister that not even the best efforts of her publicity machine will persuade us that the German Government are out of step in NATO on the issue of premature modernisation of short-range nucler weapons ? A fortnight ago she told the House that Norway was a loyal NATO ally. The Lord President may know that Norway and Denmark have joined the Germans in resisting this move. Does he accept that we believe that this country should spend the next two years seeking further reductions in nuclear and conventional weaponry on the Warsaw pact side, and that it is the British Government who are out of step ?

Mr. Wakeham : My right hon. Friend had a successful meeting in Germany with the Chancellor. I believe that they had good discussions, and I hope that our positions are coming closer together.

Mr. John Marshall : During his busy day will my right hon. Friend consider the results of the ballots held under the Education Reform Act 1988? Does he agree that they show that the parents of this country prefer Conservative choice to a Socialist straitjacket?

Mr. Wakeham : My hon. Friend makes his point well ; I certainly shall.

Q6. Mr. Rooker : To ask the Prime Minister if she will list her official engagements for Thursday 21 February.

Mr. Wakeham : I refer the hon. Gentleman to the reply that I gave some moments ago.

Mr. Rooker : When the Leader of the House considers with the Prime Minister, as he must do from time to time, the legislative programme of the House, will they take on board the supreme difficulty, indeed the impossibility, of a British jury deciding on blasphemy in respect of Christianity, let alone other religions, and accept the reality of life in this country, that in effect our national religion is one of freedom, and take the considered report of the Law Commission and bring forward legislation to abolish the law on blasphemy and replace it with public order offences?

Mr. Wakeham : I will certainly take the first part of the hon. Gentleman's question and discuss it with my right hon. Friend, but the hon. Gentleman would not expect me to answer him here now.

Q7. Mr. Key : To ask the Prime Minister if she will list her official engagements for Thursday 21 February.

Mr. Wakeham : I refer my hon. Friend to the reply that I gave some moments ago.

Mr. Key : Many hon. Members and all Conservative Members will welcome the downward trend in long-term unemployment. Will my right hon. Friend accept the congratulations of the House on that and also express the thanks of the House to all those, often lowly paid, civil servants in jobcentres who made this trend come about?

Mr. Wakeham : My hon. Friend is absolutely right to draw the attention of the House to the excellent figures

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released today, showing that long-term unemployment is down by about 280,000. It has fallen in all regions, which is excellent news, and total employment is at its highest ever.

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Mr. Dalyell : On a point of order right now, Mr. Speaker.

Mr. Speaker : No. Statement by the Foreign Secretary, Sir Geoffrey Howe.

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