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Mr. Mellor : None of that is right. Averaging will remove the principal point that the hon. Gentleman made. The BMA negotiators have agreed the contract. I appreciate that that means that the hon. Gentleman's fox has been shot--but there it is.
Rev. Martin Smyth : I welcome the Minister's reply, but will he confirm that, in practice, a two-doctor practice may be divided into three part-time practices, similar to one that we saw in Newcastle recently which wants to continue to give good service to its patients?
Mr. Mellor : I shall confirm that point in writing to the hon. Gentleman, but it sounds right to me.
Mr. Favell : Having heard what my hon. and learned Friend has to say, is it not now clear that the only doctor, whether man or woman, who has anything to fear from the new BMA contract is the bad or the idle?
Mr. Mellor : For the first time we have what many progressive doctors have been asking for for a long time--a performance-related contract that rewards initiative and those doctors who offer more services to their patients, not just those who are sick but those who need screening and better services to maintain themselves in good health. The capitation arrangement of 60 per cent. will ensure that there is a proper consumerist approach within the Health Service--and not before time.
Private Medicine
10. Mr. Worthington : To ask the Secretary of State for Health what research he has commissioned on the impact of private medicine on the National Health Service ; and what have been the findings.
Mr. Freeman : Three studies have been commissioned from Sheffield university. These studies have been published and I am arranging for copies to be placed in the Library. We welcome the private sector's contribution, which adds choice and flexibility in health care.
Mr. Worthington : The Minister did not say what the findings were. He is aware that adequate research has not been done into the impact of the private system on the National Health Service. Is he aware that we really must get away from assertions and have adequate research? Is
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he further aware that the findings of that research would be that the private health service badly affects the NHS? Would the Minister agree with that?Mr. Freeman : No, I would not agree. The research shows a very modest loss, of 0.3 per cent., of nurses each year from the Health Service to the private sector. The official Labour party policy, just published, is that Labour remains firmly opposed to the private sector. That is based on dogma. The private sector is complementary to the NHS. It offers choice and flexibility.
PRIME MINISTER
Engagements
Q1. Mr. Fatchett : To ask the Prime Minister if she will list her official engagements for Tuesday 23 May.
The Prime Minister (Mrs. Margaret Thatcher) : This morning I had a number of meetings. In addition to my duties in the House, I shall be having further meetings later today with ministerial colleagues and others.
Mr. Fatchett : Does the Prime Minister recall that three months ago she said that we were proceeding towards zero inflation? Will she take this opportunity to update the House on progress?
The Prime Minister : The steps that the Chancellor of the Exchequer has taken will deal with the problem-- [Interruption.] --and get inflation down and on a downward course again. I remind the hon. Gentleman that 8 per cent. was low for Labour. It is unacceptably high for us.
Q2. Mr. Holt : To ask the Prime Minister if she will list her official engagements for Tuesday 23 May.
The Prime Minister : I refer my hon. Friend to the reply that I gave some moments ago.
Mr. Holt : Following my right hon. Friend's successful visit to Teeside in November 1987, when she met the then unemployed Mr. Eric Fletcher, may I ask if she has seen last week's Middlesbrough Evening Gazette in which Mr. Fletcher is reported to be "doing smashing"? He is now buying his council house, has money in his bank and is grateful for the day he met the Prime Minister.
The Prime Minister : Yes. I understand that, on my advice, he took a good training course, that he did well on that course, that he has a job and that due to his own vigorous efforts, he has done well in that job. He is to be warmly congratulated. So should the Government, on having the right policies which enabled him to do that and which are bringing increasing prosperity to the north-east, among all other regions.
Mr. Kinnock : Does the Prime Minister recall saying last week that we picked up our inflationary tendency by trying to shadow the deutschmark? Will she say exactly who made the decision to shadow the deutschmark?
The Prime Minister : The policies are the policies of the Government -- [Interruption.] --as are all our policies, and they have been infinitely more successful on inflation than the 26 per cent. that was reached under Labour.
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Mr. Kinnock : So, the Prime Minister is saying that the reason we have 8 per cent. inflation and have picked up that tendency is that the Government, under her leadership, made a complete mess of it?
The Prime Minister : No. A complete mess would be the way to describe what Labour Members did when they were in office.
Mr. Onslow : As my right hon. Friend continues her commendable resistance to the threats of Socialist harmonisation by the bureaucrats in Brussels, may I ask her to seek also to promote some European initiatives to protect rain forests in Brazil and elephants in Africa?
The Prime Minister : Yes, and I am grateful to my right hon. Friend for those comments. We have policies to help protect rain forests in Brazil through our aid programme and through training people in Brazil and elsewhere to do precisely that. As for elephants and the worrying tendency to sell ivory, we agree with the international convention and we shall be raising the matter again at the next Environment Council. We believe that the sale of new ivory should be stopped altogether.
Q3. Mr. Wray : To ask the Prime Minister if she will list her official engagements for Tuesday 23 May.
The Prime Minister : I refer the hon. Gentleman to the reply that I gave some moments ago.
Mr. Wray : Does the Prime Minister realise that the British Medical Association, the Royal College of Nursing, the Confederation of Health Service Employees, the National Union of Public Employees, patients and staff are all finding it difficult to convince the Secretary of State for Health to scrap his White Paper "Working for Patients"? What plans does the Prime Minister have for recovering the £11 million of unpaid bills left by people who have abused the private facilities of the National Health Service?
The Prime Minister : The White Paper "Working for Patients" will improve the Health Service by giving hospitals more choice and more say in their own affairs, and by giving doctors more choice in running their own budgets. And there has been an enormous increase in resources from £8 billion to £25 billion per year, which has enabled doctors-- [Interruption.] If hon. Gentlemen cannot recognise correct accountancy, I am not in the least surprised. Perhaps they can raise the matter under the public expenditure survey, which shows that Labour spent £8 billion on the Health Service and that we are spending about between £24 billion and £25 billion now. That is the measure of the improvement to the Health Service.
Q4. Sir Hugh Rossi : To ask the Prime Minister if she will list her official engagements for Tuesday 23 May.
The Prime Minister : I refer my hon. Friend to the reply that I gave some moments ago.
Sir Hugh Rossi : Has my right hon. Friend seen the recent report concerning the low level of prosecutions and fines related to litter offences? Has she studied also the findings of several reports of the Select Committee on the Environment showing a similar situation in respect of very serious environmental offences? Does she agree that greater concern should be shown by the prosecuting authorities and by magistrates?
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The Prime Minister : Yes, I saw the report--and clearly the situation varies greatly from one part of the country to another. In areas where the local people, magistrates, the Tidy Britain group and the prosecuting authorities are greatly concerned to have a tidy Britain, there is much more success in achieving that than in other places. I agree with my hon. Friend that prosecuting authorities and magistrates should have regard to the need for a tidy Britain, and I hope that there will be a sufficient number of prosecutions and sufficiently severe sentences.
Mr. Ashdown : Is the Prime Minister aware that the whole nation will welcome yesterday's announcement by the Foreign Secretary that he had renegotiated his treaty with the Prime Minister, so that the decision on the European monetary system will be taken by the Government as a whole? Will the right hon. Lady tell the House whether that decision will be taken on the basis of a majority vote or will it be, as usual, subject to her personal veto?
The Prime Minister : I recognise that the right hon. Gentleman has no experience of government. Under collective responsibility, we are all responsible.
Q5. Mr. Wilshire : To ask the Prime Minister if she will list her official engagements for Tuesday 23 May.
The Prime Minister : I refer my hon. Friend to the reply that I gave some moments ago.
Mr. Wilshire : Can my right hon. Friend confirm that her Government have no plans to reintroduce secondary picketing, to renationalise British Telecom, or to give away our nuclear deterrent in exchange for today's equivalent of a piece of paper from Munich? Does she agree that such policies amount to a cynical attempt to trade beliefs for votes, and if implemented would spell disaster for this country?
The Prime Minister : I confirm that we have no plans to reintroduce secondary picketing, to re-nationalise British Telecom, or to get rid of the nuclear deterrent. All our policies are sound--sound at home and sound for the best defence of Britain--and there is not a cynical policy among them.
Sir Fergus Montgomery : Is my right hon. Friend aware of the warm welcome that will be given to the report in today's Daily Mail that she has joined the fight against the extinction of the African elephant? However, is my right hon. Friend aware that the all-important convention on international trade in endangered species is not due to take place until October and that many elephants may be killed before then? Will she use her influence to cut through the red tape and to secure immediate action on that very important issue?
The Prime Minister : As my noble Friend, the Minister for Housing, Environment and Countryside announced yesterday, having just returned from an official visit to Kenya, he will call for concerted European support for a total ban at the next Council meeting of Environment Ministers, which takes place in Luxembourg on 8 June, considerably before the international convention is due to meet.
Q6. Mr. Grocott : To ask the Prime Minister if she will list her official engagements for Tuesday 23 May.
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The Prime Minister : I refer the hon. Gentleman to the reply that I gave some moments ago.
Mr. Grocott : The whole House will appreciate the reason for the Prime Minister's total opposition to television viewers being able to see her performance at Question Time. Can she confirm that that reason is that this is one photo opportunity that she cannot stage-manage?
The Prime Minister : The hon. Gentleman talks his customary poppycock.
Mr. Wigley : In view of the indication by the Secretary of State for Wales of his preference for a different emphasis in economic regional policies, will the Prime Minister confirm that the entire reason for the existence of the Welsh Office--and of the Scottish Office--is to enable a different policy to be pursued where circumstances dictate it? Will she tell the House whether she has full confidence in the Secretary of State for Wales?
The Prime Minister : Yes, I have. The policies that are being pursued and are bringing such prosperity to Wales are Conservative Government policies, and I hope that everyone is very grateful and thankful for them.
Mr. Neil Hamilton : Does my right hon. Friend agree that the mendacious and inaccurate campaign being waged by the British Medical Association suggests some deficiency in diagnostic ability on the part of the doctors who are contributing to it? If their medical judgment is as bad as their political judgment, would not patients be well advised to find another doctor, and quickly?
The Prime Minister : I believe that my right hon. and learned Friends the Secretaries of State for Health and for Scotland have negotiated a very good contract with the doctors, and I hope that they will in general accept it. Among other things, the White Paper suggested that people who were not satisfied with their general practitioner could move from one to another more easily. Under Conservative Governments there have been more general practitioners, so the number of each list has gone down by about 300, giving doctors more time to spend with each patient.
Child Sexual Abuse
Q7. Mr. Allen : To ask the Prime Minister if she has any plans to increase the amount of money being spent by Her Majesty's Government's Departments into research into the sexual abuse of children ; and if she will make a statement.
The Prime Minister : We will continue to support research into child sex abuse. We have already increased our expenditure, and further research proposals will be considered in the light of the knowledge gained from existing studies.
Mr. Allen : Is not the Prime Minister ashamed that in 10 years her Government, through the Department of Health, has put just £1 million into this difficult and sensitive subject? Will she consider establishing a national institute for the study of the sexual abuse of children, as has been done in Canada, Australia, America and many other countries? The victims need help and the perpetrators need to be prevented. For a very small
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amount of money the Prime Minister could do a great deal of good. Will she take that suggestion away and consider it?The Prime Minister : I do not think that it is a question of finding extra money. Well over £800 million is provided for basic research. It would be quite easy to put into that sphere and perhaps take a little away from others, but we must decide our priorities. The real difficulty, as I should have thought that the hon. Gentleman would know, is that of designing and conducting research and obtaining incontrovertible results. We need to ensure that projects are considered properly before they are commissioned.
Mr. Burt : Is my right hon. Friend aware that Bury district health authority will shortly be appointing two additional consultants, thus bringing to 16 the number of such consultants appointed in the area in the past five years? Will she welcome that contribution to the Health Service?
Mr. Speaker : Order. Are these consultants concerned with the sexual abuse of children?
Q8. Mr. Macdonald : To ask the Prime Minister if she will list her official engagements for Tuesday 23 May.
The Prime Minister : I refer the hon. Gentleman to the reply that I gave some moments ago.
Mr. Macdonald : Can I ask the Prime Minister to state her complete confidence in the prediction made by the Chancellor as recently as two months ago that inflation this year would peak at 8 per cent. and not go higher?
The Prime Minister : I have nothing further to add to what my right hon. and learned Friend the Chancellor said. I can assure the hon. Gentleman that our efforts to attack inflation will be infinitely more successful than those of the last Labour Government. The Labour party was the party of inflation and when it had got inflation up to 25 per cent. had not even the resources to inflation-proof pensioners' pensions.
Q12. Mr. Mullin : To ask the Prime Minister if she will list her official engagements for Tuesday 23 May.
The Prime Minister : I refer the hon. Gentleman to the reply that I gave some moments ago.
Mr. Mullin : Has the Prime Minister noticed that the people of Afghanistan managed to see off the Red Army without the need for nuclear weapons?
The Prime Minister : Yes, Sir ; with a good deal of help from other people.
BILL PRESENTED
Riders of Equine Animals
Mr. Harry Greenway, supported by Sir Bernard Braine, Mr. Iain Mills, Mr. Stuart Randall, Miss Ann
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Widdecombe, Mr. Ronnie Fearn, Mr. Michael Colvin, Mr. Robin Cook, Mr. Henry Bellingham, Mr. John Carlisle, Mr. Terence L. Higgins and Mr. Gerald Bermingham, presented a Bill to make provision for the wearing of protective headgear by under-eighteen year old riders of equine animals ; and for connected purposes : And the same was read the First time ; and ordered to be read a Second time on Friday 9 June and to be printed. [Bill 145.]
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