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Sainsbury, Hon Tim

Sayeed, Jonathan

Shaw, David (Dover)

Shaw, Sir Giles (Pudsey)

Shaw, Sir Michael (Scarb')

Shephard, Mrs G. (Norfolk SW)

Shepherd, Richard (Aldridge)

Shersby, Michael

Sims, Roger

Smith, Tim (Beaconsfield)

Soames, Hon Nicholas

Spicer, Sir Jim (Dorset W)

Squire, Robin

Stanbrook, Ivor

Stanley, Rt Hon Sir John

Stern, Michael

Stevens, Lewis

Stewart, Allan (Eastwood)

Stewart, Andy (Sherwood)

Stradling Thomas, Sir John

Summerson, Hugo

Tapsell, Sir Peter

Taylor, Ian (Esher)

Taylor, John M (Solihull)

Tebbit, Rt Hon Norman

Temple-Morris, Peter

Thompson, D. (Calder Valley)

Thompson, Patrick (Norwich N)

Thornton, Malcolm

Thurnham, Peter

Townend, John (Bridlington)

Townsend, Cyril D. (B'heath)

Tracey, Richard

Tredinnick, David

Trippier, David

Twinn, Dr Ian

Vaughan, Sir Gerard

Viggers, Peter

Waddington, Rt Hon David

Wakeham, Rt Hon John

Waldegrave, Hon William

Walden, George

Walker, Bill (T'side North)

Waller, Gary

Ward, John

Wardle, Charles (Bexhill)

Warren, Kenneth

Watts, John

Wells, Bowen

Wheeler, John

Whitney, Ray

Widdecombe, Ann

Wiggin, Jerry

Wilshire, David

Winterton, Mrs Ann

Winterton, Nicholas

Wolfson, Mark

Wood, Timothy

Woodcock, Mike

Young, Sir George (Acton)

Tellers for the Noes :

Mr. Stephen Dorrell and

Mr. Sydney Chapman.

Question accordingly negatived .

Main Question put and agreed to .

Resolved ,

That this House welcomes the thorough and comprehensive report by Mr. Desmond Fennell QC on the investigation into the King's Cross Underground fire ; endorses the Government's commitment to invest in the improvement and modernisation of the Underground and its decision to provide £266 m over the next three years for the implementation of the report's recommendations ; notes London Regional Transport's constructive response to the report ; and looks forward to continuing vigorous action by London Underground to implement its

recommendations.

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National Health Service (Charges)

10.14 pm

Mr. Robin Cook (Livingston) : I beg to move,

That an humble Address be presented to Her Majesty, praying that the National Health Service (Optical Charges and Payments) Regulations 1989 (S.I., 1989, No. 396), dated 8th March 1989, a copy of which was laid before this House on 10th March, be annulled.

Mr. Speaker : With this it will be convenient also to discuss the 11 other National Health Service prayers :

That an humble Address be presented to Her Majesty, praying that the National Health Service (Optical Charges and Payments) (Scotland) Regulations 1989 (S.I., 1989, No. 392), dated 9th March 1989, a copy of which was laid before this House on 10th March, be annulled. That an humble Address be presented to Her Majesty, praying that the National Health Service (Dental Charges) Regulations 1989 (S.I., 1989, No. 394), dated 8th March 1989, a copy of which was laid before this House on 10th March, be annulled.

That an humble Address be presented to Her Majesty, praying that the National Health Service (Dental Charges) (Scotland) Regulations 1989 (S.I., 1989, No. 363), dated 7th March 1989, a copy of which was laid before this House on 10th March, be annulled.

That an humble Address be presented to Her Majesty, praying that the National Health Service (Charges for Drugs and Appliances) Regulations 1989 (S.I., 1989, No. 419), dated 9th March 1989, a copy of which was laid before this House on 10th March, be annulled. That an humble Address be presented to Her Majesty, praying that the National Health Service (Charges for Drugs and Appliances) (Scotland) Regulations 1989 (S.I., 1989, No. 326), dated 3rd March 1989, a copy of which was laid before this House on 10th March, be annulled.

That an humble Address be presented to Her Majesty, praying that the National Health Service (General Ophthalmic Services) Amendment Regulations 1989 (S.I., 1989, No. 395), dated 8th March 1989, a copy of which was laid before this House on 10th March, be annulled. That an humble Address be presented to Her Majesty, praying that the National Health Service (General Ophthalmic Service) (Scotland) Amendment Regulations 1989 (S.I., 1989, No. 387), dated 8th March 1989, a copy of which was laid before this House on 10th March, be annulled.

That an humble Address be presented to Her Majesty, praying that the National Health Service (Travelling Expenses and Remission of Charges) Amendment Regulations 1989 (S.I., 1989, No. 517) dated 20th March 1989, a copy of which was laid before this House on 20th March, be annulled.

That an humble Address be presented to Her Majesty, praying that the National Health Service (Travelling Expenses and Remission of Charges) (Scotland) Amendment Regulations 1989 (S.I., 1989, No. 393), dated 9th March 1989, a copy of which was laid before this House on 10th March, be annulled.

That an humble Address be presented to Her Majesty, praying that the National Health Service (Travelling Expenses and Remission of Charges) Amendment (No. 2) Regulations 1989 (S.I., 1989, No. 614), dated 6th April 1989, a copy of which was laid before this House on 7th April, be annulled.

That an humble Address be presented to Her Majesty, praying that the National Health Service (Travelling Expenses and Remission of Charges) (Scotland) Amendment (No. 2) Regulations 1989 (S.I., 1989, No. 616), dated 6th April 1989, a copy of which was laid before this House on 7th April, be annulled.

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Mr. Cook : Twelve prayers relating to the Health Service are before the House tonight and all relate to charges for drugs and appliances. I trust that the House will forgive me if I do not divide my time equally between the 12 prayers. Several matters of substance are raised in the regulations, but I must confess that Opposition Members do not hold strong views about the price of wigs prescribed on the National Health Service. Although I know that the price of wigs is on the way up, I am greatly relieved to note--

Mr. Frank Dobson (Holborn and St. Pancras) : Is there a special concession for wigs for members of the legal profession?

Mr. Cook : I think that on this occasion I can give my hon. Friend an assurance on behalf of the Government that wigs for the legal profession are not under discussion.

I am relieved to note that, whatever the rate of inflation for human hair wigs, it is at least not as high as the rate of inflation which appears to be affecting the budget for advertising--

Mr. Bowen Wells (Hertford and Stortford) rose --

Mr. Cook : How could I resist giving way to the hon. Gentleman?

Mr. Wells : Does the hon. Gentleman agree that the question relating to wigs should be taken separately?

Mr. Cook : The hon. Gentleman raises an interesting point which, of course, has been a matter of discussion between the Front Benches. I must advise the hon. Gentleman that our difficulty is that prayers, unfortu- nately, do not get the same protection in terms of time before the House that orders get. If the hon. Gentleman would like to join us in pressing for the same amount of time for debate on prayers as the House provides for debate on orders, I should be happy to ensure that there were separate rounds of debate. I am sure that the hon. Gentleman will have adequate time to deploy his point and if he chooses to seek to divide the House on the basis that the charge for wigs is an unreasonable imposition, I shall give favourable consideration to advising my colleagues to join him in the Division Lobby.

I am relieved that the rate of inflation in the charges in the regulations on wigs, other appliances and drugs is at least not as high as the rate of inflation that the Department of Health has just applied to its own advertising budget, because it has been discovered that the rate of inflation for that for the current year is no less than 87 per cent. Opposition Members urge the Department of Health to apply that uprating to its expenditure on patient care rather than on its expenditure on advertising it.

I do not propose to delay the House further on such matters because the matter of substance to which I wish to draw the attention of the House and to which I shall be directing the remainder of my remarks is the instrument providing for the exemption from the charges for eye tests. That is something of real substance which touches on a matter of great public policy. It has been an issue of considerable controversy in the House, both between the different parties in the House and among Conservative Members.

The particular issue for debate tonight is why the regulations providing for exemption from charges do not provide for exemption from the charges for pensioners.

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After all, pensioners make up the majority of those coming forward for eye tests. Indeed, pensioners represent 60 per cent. of the people who go to opticians for eye tests. Pensioners are not automatically exempt under the provisions. Tonight I wish to challenge whether, in the light of the evidence that is now available to us about the charges for eye tests, it is right to continue to exclude pensioners from exemption from the charges.

I recall that we last debated this matter on 1 November, when the Secretary of State for Health, whom I am delighted to see has been able to free himself from other engagements to join us on this occasion, made the central point that the charges for eye tests would be so low that it was not necessary to worry about those groups that were not exempt. If I may say so, he was characteristically robust in stating his view. In the course of the debate he asserted that it was his strong opinion that competition would drive down charges for the eye test.

I shall share with the House a couple of quotations from the Secretary of State's speech. He said :

"I do not believe that all opticians will maintain a charge for a sight test which is equivalent to the present NHS fee".

Later he said :

"even in rural areas, I cannot believe that opticians will be too far away from other opticians for such pressures not to exist. Although they may have a slightly protected market, they will not sustain their position if it is clear to their rural customers that in nearby towns such as Leeds or Hull there are no charges for a test."--[ Official Report, 1 November 1988 ; Vol. 139, cc. 928, 930.]

That was a clear statement of faith that a number of opticians would charge less than the NHS fee, including, for a curious reason not immediately clear to me, particularly opticians in Leeds and Hull. The NHS fee was then £9.75.

The right hon. and learned Gentleman's second statement of faith was that not only would some opticians charge less than the NHS fee, but a number-- at times in this passage of his speech he appeared to think that it would be the norm--would make no charge at all. It was on that basis that he invited the House to approve the charge for eye tests. On that basis the House approved the charge, without agreeing to an exemption for pensioners and in the full knowledge that the regulations before us now would be laid without providing such an exemption.

Last week, my office carried out a survey of opticians in a couple of dozen towns throughout Britain, from Aberdeen to Falmouth, covering twice as many opticians. Nowhere among the 50 opticians whom we sampled did we find a single optometrist offering an eye test free. Nowhere among the ones that we sampled did we find anyone offering a test for less than £10.40. Boots, which caters for 26 per cent. of the market, is charging an eye test fee of £10.50. Dollond and Aitchison, the next market leader, charges £10.40. Between them, those two firms have 40 per cent. of the market, so those are not untypical figures which we specially searched out. They represent the market leaders.

Among the independents, we identified opticians who were charging between £10.50 and £12.50 as a norm. Quite a number of the optometrists that we sampled were charging £15. We even found one optometrist who was charging £17.50. Ironically, I am bound to say that was the optometrist nearest the Department of Health, from whom the Department could most readily have sought advice.

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