Order for Second Reading read.
To be read a Second time tomorrow.
(No. 2) Bill-- Orders for Second Reading read.
To be read a Second time tomorrow.
Order for consideration, as amended, read.
To be considered tomorrow.
That, notwithstanding the provisions of Standing Order 121 (Quorum of committee on opposed bill), leave be given for the Committee on the King's Cross Railways Bill to proceed with a quorum of two.-- [The Chairman of Ways and Means.]
Hon. Members : Object.
To be considered on Thursday 8 February at Seven o'clock.
Order for consideration read.
To be considered tomorrow.
The Secretary of State for Scotland (Mr. Malcolm Rifkind) : In 1979 Health Service expenditure in Scotland was £205 per person. In 1989 it was £552 per person. That is a rise of 34 per cent. in real spending power.
Mr. Cran : Does my right hon. and learned Friend agree that by any objective examination of the facts, the Scottish Health Service is unquestionably second to none? That is illustrated by the fact that my father is receiving quite outstanding care at the Royal Infirmary in Aberdeen and the service at that hospital is open to anyone in that area. It is also shown in the quite astonishing building programme that has occurred since 1979 under this Government during which time there have been 54 major hospital building programmes with another 32 in train. If that is not enough, there has been a 32 per cent. increase in qualified nursing staff to look after the additional patients which the expansion has occasioned. Does not my right hon. and learned Friend agree-- [Interruption.]
Mr. Rifkind : While the National Health Service continues to have certain difficulties, it is right to draw attention to what has been achieved over the years. In Scotland, the number of in-patients has increased by more than 20 per cent. over the past 10 years while the number of out-patients has increased by 12 per cent. and the number of day cases treated by hospitals has increased by no less than 119 per cent. It is right that that side of the story should be emphasised.
Mr. Ernie Ross : Has the Secretary of State had time to study the press release issued by his junior Minister, the Under-Secretary of State for Scotland, about the ambulance dispute yesterday in which the Under- Secretary claimed that lives are put at risk? Given the amount of money that the Government are trying to claim that they have spent, exactly whose lives are put at risk? What is the Secretary of State doing about that?
Mr. Rifkind : The concern to which the Under-Secretary of State for Scotland, my hon. Friend the Member for Stirling (Mr. Forsyth) drew attention was that if there is not a proper response to 999 calls, and if ambulance officers do not accept the advice of their own unions in dealing with emergency cases, sadly there can be a risk to human life. I am sure that the hon. Member for Dundee, West (Mr. Ross) would join me in urging ambulance workers to respond to emergency calls in a proper and responsible fashion.
Mr. Sillars : Is not the pertinent measure the expenditure in relation to need at the present time? If that is the case and if the Secretary of State is so brilliant, why has the Greater Glasgow health board suffered a £12
Column 293million cut in its budget this year and faces a £16 million cut in its budget next year? Again if the Secretary of State is so brilliant, why have we managed to have a Health Service in which there are demoralised nurses, doctors, ambulance men and ancillary workers and a public who do not believe that the Health Service is any safer in the hands of the lady in Downing street than in the hands of the devil himself?
Mr. Rifkind : I do not accept for a moment the figures that the hon. Gentleman has been gratuitously introducing into the House. However, he may like to reflect on the fact that in his constituency, the health board in the city of Glasgow is, and continues to be, the best funded health board in the United Kingdom. Had the hon. Gentleman wanted to be fair, he might have prefaced his remarks by at least recognising and welcoming that point.
Sir Hector Monro : Does my right hon. and learned Friend agree that we cannot really judge patient care in terms of statistics? It must be true that we have far more doctors, nurses and specialist care in Scotland than were available in 1979. Does he agree that the Health Service is safe in our hands and will be developed effectively in years to come?
Mr. Rifkind : I do not question for a moment that there are still many things that the Health Service in Scotland would like to do but is unable to do even with the levels of funding that it has achieved. That goes without saying. The Health Service has continually been improving ever since it began in 1947. It is unfair that those who quite understandably call for even more improvements do not recognise the dramatic improvements that have taken place over the past 40 years or, indeed, over the past 10 years. Any fair debate on this subject should recognise that, as well as call for further improvements in the Health Service.
Mr. Wilson : How many scarce resources belonging to the National Health Service in Scotland have now been used up in trying to defeat the ambulance men and women and in forcing them to give up their rightful claims by starving them into submission? Would the Secretary of State care to contemplate the newspaper headline that I am showing him as an acceptable face of the ambulance dispute? No matter how the soldiers and police try to perform the duties that have been thrust upon them, they are simply not able to do so because they lack the necessary equipment and training. Will the Secretary of State confirm that twice as much money has been spent on trying to defeat the ambulance men in Scotland, and elsewhere in the United Kingdom as would be required to settle their pay claim in full and give them the just settlement that every humane man, woman and child in Scotland wishes them to obtain?
Mr. Rifkind : No one questions for a moment that the police cannot provide the same quality of service as the ambulance officers. If that is a matter of concern to the hon. Gentleman, I hope that he will join me in calling on ambulance officers to return to normal work. The hon. Gentleman knows perfectly well that there are recognised negotiating structures. He knows also that the offer that has been made to ambulance officers is compatible with what the vast majority of other people who work in the National Health Service have already accepted. Therefore, he must appreciate that we must be fair to the National
Column 294Health Service as a whole. To give to ambulance workers, whose income has increased substantially over the past few years--
Mr. Rifkind : The hon. Gentleman says, "Rubbish." He should remember that an ambulance officer's income in 1979 was less than £3, 000. If ambulance workers accept the offer that has been made, the figure will be more than £11,000. Even taking inflation into account, that is a major increase.
By all means let these matters continue to be discussed and negotiated, but if the hon. Gentleman has patients' interests at heart, as I am sure that he has, he should urge ambulance workers to return to normal work so that the public should not suffer because ambulance workers have a pay disagreement with their employers.
The Parliamentary Under-Secretary of State for Scotland (Mr. Michael Forsyth) : Health boards have reported savings of £66 millio which have been used to recruit additional medical staff and improve facilities for the young, the elderly, the disabled and the mentally handicapped.
Mr. Hogg : The Minister's answer is consistent with previous answers. Is he aware that, of the contracts that have been awarded in the Greater Glasgow health board area, three companies--Initial Health Services, Mediguard and Hospital Hygiene Services--figure very strongly? Is the Minister further aware that those companies have a dubious record and have either withdrawn from or been sacked in Bradford, West Leeds, Northampton, Merton and Sutton, North Warwickshire, Norwich, Nottingham, Pontefract, South Tees, York, East Birmingham, Manchester, Bromley, Canterbury, Gateshead and Oxfordshire? Why must we put up with the same in the Greater Glasgow health board? How much money must be spent on redundancy payments for real Health Service staff who have lost their jobs because of those private companies?
Mr. Forsyth : In March last year, the saving available to improve patient care for the Health Service in Scotland as a result of competitive tendering was £5.5 million. The figure today is £66 million. The hon. Gentleman asked about redundancy payments. To date these amount to £5.2 million, compared with £66 million. Substantial additional resources are available for patient care.
The hon. Gentleman complains about particular companies. Three quarters of both the contracts and the savings have been obtained, not by private contractors, but the in-house work force carrying out the same task in a different way. He also complained about the quality of services. I am sure that he will have seen the parliamentary answer that I gave the other day. An independent survey of standards of provision where private contractors have been brought in showed that the standards were at least as good as, if not better than, those achieved by the in-house work force.
Mr. Allan Stewart : Does my hon. Friend agree that if Opposition Members were successful in campaigning against competitive tendering they would deprive patients of substantial additional resources for patient care? Will he confirm that every health board in Scotland has made savings and that in Greater Glasgow many extra staff have been made available? For example, is he aware that 74 extra staff for mental illness and handicap have been employed as a direct result of those savings?
Mr. Forsyth : My hon. Friend is absolutely right. Incidentally, I congratulate him on sporting the blue rose of Eastwood. He is right to draw attention to the substantial improvements in staffing and facilities in Greater Glasgow as a result of the competitive tendering programme. The public are entitled to ask why Opposition Members do everything possible to frustrate the Greater Glasgow health board in pursuing a policy that produces real, tangible and substantial benefits for patients, particularly those with mental handicap or illness.
Mr. Dewar : Is it not sad that staff of the health boards who have spent years in the service of the NHS have to give up hard-earned terms and conditions in order to save their jobs? Does the hon. Gentleman accept that the imposition of competitive tendering in areas that touch the core of the Health Service--such as diagnostic services, laboratories and radiography-- is damaging? Does not the Minister realise that there is no public support for policies that threaten to turn those services into opportunities for private profit? In view of the contrived changes in the rules on VAT and redundancy, is he satisfied that competition has not been rigged?
Mr. Forsyth : The hon. Gentleman makes several points. His first was about people giving up hard-earned terms and conditions. For contracts that have been won in-house--that is the majority ; three quarters--the terms and conditions remain the same. They are Whitley terms and conditions. However, restrictive practices and the business of paying double time when it is not necessary have ended. That is how savings have been made. If the hon. Gentleman wishes to complain about the way in which savings have been made, he should address his remarks to the trade union officials who co- operated in the process in the interests of the Health Service and of obtaining the best deal for the patients.
The hon. Gentleman wrote about rigging to my right hon. and learned Friend the Secretary of State, who answered his question fully. I am surprised that he has raised the matter again. VAT is payable only where the cost of the outside contractor, inclusive of VAT, is less than the cost of the in- house service.
Sir Nicholas Fairbairn : Will my right hon. and learned Friend lose no opportunity to remind the people who live in Scotland, of whatever race, that they benefit to a greater extent than anyone else in the United Kingdom in all programmes of expenditure and that if they were to consider anything as foolish as a Socialist Government, a convention, an assembly or independence, they would be deprived of the level of living that we uniquely enjoy in western Europe.
Mr. Rifkind : I very much agree with the sentiments behind my hon. and learned Friend's question. However, he is not entirely correct, because the level of expenditure in Northern Ireland is higher than that in Scotland. My hon. and learned Friend is certainly correct that public expenditure in Scotland is considerably higher per capita than that in England and Wales, which is a benefit which Scotland derives from the present constitutional arrangements.
Mr. Robert Hughes : Does the Secretary of State recall that I wrote to him a couple of weeks ago to complain bitterly that while England and Wales has a substantial programme of cochlear implants, which are vital for deaf people, no announcement has been made in Scotland and we have no such programme of spending? When will the right hon. and learned Gentleman reply positively and make that money available to the health boards in Scotland so that deaf people in Scotland can benefit substantially?
Mr. Rifkind : I am afraid that the hon. Gentleman has not scrutinised his newspapers carefully because we made a comparable announcement that similar provisions are to be introduced in Scotland and we are working on the details at present.
Mr. Bill Walker : Does my right hon. and learned Friend agree that such expenditure programmes could not possibly be sustained in the event of any fraudulent proposals being brought forward for a Scottish Assembly in Edinburgh? Does he further agree that we could not enjoy the same number of Members of Parliament and that we certainly could not expect English Members of Parliament to support such programmes?
Mr. Rifkind : If a Scottish assembly were responsible for the matters that are currently the responsibility of the Scottish Office, and if it were required to raise funds for those matters from within Scotland, the present level of spending on education, health, housing and other measures could be maintained only by a dramatic increase in income tax which the people of Scotland, alone in the United Kingdom, would be required to pay.
Mr. Rifkind : It would depend on the spending policies of such a Scottish assembly as might be created. The point that I have just been making is that even if a Scottish assembly did not wish to increase expenditure, but simply to maintain the present level of expenditure from the taxes raised in Scotland, it would have to level additional income tax that would not be paid by people elsewhere in Britain. That is why such proposals would be very much against the interests of the Scottish economy, employment in Scotland and the general welfare of the people of Scotland.
Column 297Mr. Thurnham : Will my right hon. and learned Friend bear in mind the need to involve the private sector as much as possible in public expenditure programmes? Scottish civil engineers have a high reputation abroad, but need to have experience at home if they are to make the most of the worldwide opportunities.
Mr. Rifkind : That is the case, and that is why I am delighted that the recent surveys by the Fraser of Allander Institute and the Confederation of British Industry in Scotland have suggested that the Scottish economy will do even better than that of the rest of the United Kingdom over the next few years. They pointed particularly to manufacturing industry and exports. It is encouraging that only yesterday a prediction of increased exports from Scotland was made by Scotland's business men. I am sure that the whole House will be delighted to welcome that.
The Parliamentary Under-Secretary of State for Scotland (Lord James Douglas-Hamilton) : A number of representations have been received. The Government have agreed to defer the introduction of the new scheme for up to three months to allow the Convention of Scottish Local Authorities time to produce specific alternative proposals.
Mr. Campbell : Is the Minister aware that the Government's initial proposals have united councillors of all parties, and of none, in Scotland in opposition? Does he accept that no one becomes a councillor in Scotland because he or she wants to profit from the attendance allowance? Is he aware that the sum of £10, which was fixed in 1974, should be not less than £40 at today's prices? In the settlement that the Government will eventually reach, will he undertake to ensure that proper account is taken of the commitment and responsibilities of councillors throughout the length and breath of Scotland?
Lord James Douglas-Hamilton : The answer to the hon. Gentleman's last point is yes, but I must stress that even under the consultative proposals that have been put forward, the sums available to councillors in Scotland would have been at least 80 per cent. more than those for councillors south of the border and up to 125 per cent. more for district councillors. Strong representations were made about distribution and we have recognised that some authorities have a much larger workload and larger electorates than others. We were conscious of those facts and responded to COSLA's recommendations to defer those matters. We look to COSLA to come back to us with what we hope will be a much fairer and more consistent approach. I should stress that the sums available to councillors next year will be no less than those available this year--the sum for Britain as a whole being increased from £37 million to £42 million.
Mr. Michael J. Martin : Will the Minister bear in mind that the vast majority of councillors do the job voluntarily? Often their home is inundated with people with serious problems and the family cannot enjoy a decent meal at night because of the phone calls that have to be attended
Column 298to immediately. This being the case, should not there be decent compensation for councillors who do a hard-working job?
Lord James Douglas-Hamilton : I stress that I have been a councillor, so I am acutely conscious of the point that the hon. Gentleman has made. Council membership is based on the principle of voluntary public service and is not regarded as a salaried appointment. However, it is in the public interest that councillors should not suffer financial loss because of the public service that they perform.
Mr. John Marshall : Does my hon. Friend accept that many people believe that local government, in Scotland and elsewhere, was better when councillors such as myself were unpaid volunteers, rather than, as under the present system, some at least being semi-salaried?
Lord James Douglas-Hamilton : I am aware of the activities of my hon. Friend, but I stress that chairmen and convenors sometimes have to give almost full-time service and the special responsibility allowance is appropriate in their cases, and will be forthcoming.
The Minister of State, Scottish Office (Mr. Ian Lang) : Since September 1988 when employment training first started in Scotland, my right hon. and learned Friend has received 190 representations about the operation of employment training in Scotland, and 66 were parliamentary questions.
Mr. Wallace : The Minister will be aware that, under the employment training regulations, it is possible to give to single parents an allowance for child care while they are in training. How does he explain the selective approach to my constituents who are the wives of fishermen and who, when their husbands are at sea, are to all intents and purposes single -parent mothers and who wish to undertake training? Will the new local enterprise companies that are to be set up in Scotland and will have a training remit have the flexibility to allow payment to be made to such wives?
Mr. Lang : It is part of our purpose that local enterprise companies should have as much flexibility as possible in the development and administration of training schemes. That is one of the important reasons why we are setting them up. At the same time, the existing arrangements take account of problems in different parts of the country. The hon. Gentleman will know that in the administration of employment training in Orkney and Shetland, consideration is being given to awarding skill shortage status to that area, which will be of advantage to it.
Mr. Worthington : Is the Minister aware of the report that has just been published by the Scottish Council for Voluntary Organisations showing what the consequences for community care were of the transition from the community programme to the disastrous employment training scheme? That report has shown that over £17 million has been lost to community care, and that 50 per cent. of the care for the elderly and 62 per cent. of the care
Column 299for the disabled have been lost. The voluntary organisations warned the Minister that this would happen, but he could not have cared less. Will he now show some regret for the distress caused by the withdrawal of these services?
Mr. Lang : One of the reasons for the loss of places was the lack of co-operation--indeed, the positive hostility--of many authorities. The Scottish Council for Voluntary Organisations is heavily funded by the Government and it does a good job. However, it is important that it should realise that employment training is not another form of social care--which is already fully provided--but essentially an employment training scheme to help unemployed people into jobs. In that, it is doing much better than the community programme did, as it is now helping 59 per cent. of leavers into jobs or further training and education, compared with 42 per cent. on the community programme. We should encourage that trend.
Mr. Lester : When my hon. Friend has the opportunity to make representations to the Chancellor of the Exchequer, will he draw his attention to the following anomaly? Under the employment training scheme we quite properly support single mothers by allowing them to claim the costs of child care, but when they are trained and seeking a job there is no provision for looking after their children--a heavy premium for anyone seeking employment. Might there be an opportunity in the next Budget to do something about that?
Mr. Lang : I understand that there are certain advantages at salaries of up to £8,500 a year, but I shall pass on my hon. Friend's comments to my right hon. Friend the Chancellor. My hon. Friend would not expect me to comment on what might be in the Budget.
Sir David Steel : Do not the figures released yesterday show an average increase over Scotland of 9.1 per cent., with many authorities showing increases of more than 15 per cent? In the light of that, how will the Government maintain the fiction to pensioners, ambulance men and others that the rise in the cost of living is 6.5 per cent?
Mr. Rifkind : I noticed that the right hon. Gentleman did not mention that the two district councils in his constituency have reduced the community charge, or that the regional council has had a zero increase-- perhaps it should have reduced its charge, too, given the grantt that it received. The increases in the community charge were less than the local authorities were predicting, and would have been much less if Labour- controlled authorities had not substantially increased the community charge by going for higher spending. It has been significant that a number of Labour local authorities receiving large increases in grant have used the money to increase spending rather than to reduce the charge.
Sir Nicholas Fairbairn : Leaving aside the concept of averages or of the middle ground which is so favoured by the right hon. Member for Tweeddale, Ettrick and Lauderdale (Sir D. Steel)-- [Interruption.]
Sir Nicholas Fairbairn : Leaving aside the average concept or the middle ground so favoured by the right hon. Gentleman, may I ask my right hon. and learned Friend to lose no occasion to remind the people of Scotland and the people of England that if they want to have the money that they earn spent by Socialist authorities, they should vote Socialist? If they do not want that, they should vote Conservative.
Mr. Rifkind : There is no doubt that Labour authorities appear incapable of maintaining services without huge increases in local taxation, while non-Socialist authorities appear more able to maintain the same level of services by means of better management and better value for money. The public clearly and rightly take that factor into account.
Mr. Canavan : How can the Secretary of State possibly justify the Tory Government imposing this crippling tax system on the people of Scotland? In some areas the full poll tax will be more than £400, and even on maximum rebate people who depend on social security benefits and students who possibly have no grant will be expected to find more than £100 for the poll tax. Is it any wonder that at least half a million people throughout Scotland are refusing to pay the tax, or that many will continue their resistance until the Government come to their senses and abolish this iniquitous tax?
Mr. Rifkind : The hon. Gentleman's rather unimpressive sympathy for people on low incomes would be slightly more persuasive if he, with a substantial income, were prepared to pay the tax that Parliament expects his constituents to pay. With his large income, the hon. Gentleman does not set an example of a sense of social responsibility and he cannot expect the House to treat his views with other than contempt.
Mr. Lang : The business community in Scotland has warmly welcomed the Enterprise and New Towns (Scotland) Bill and is enthusiastically participating in the groups bidding to become local enterprise companies throughout Scotland.
Column 301myself the economic success created by this Conservative Government. Does not my hon. Friend agree that Scottish Enterprise will build on this development?
Mr. Lang : My hon. Friend is absolutely right. It is because of the success of the Scottish economy in recent years that we are able to contemplate Scottish Enterprise, and it is because of the needs of the years ahead that we are now bringing it forward, combining the training role of the Training Agency with the economic development role of the Scottish Development Agency, and devolving it to local companies around Scotland. The enthusiastic involvement of the business community--we have now received 22 bids from groups of business men seeking to form local consortia--is very encouraging for the future of the Scottish economy.
Mrs. Fyfe : How is the Minister responding to the views expressed by employment training trainees who have experienced grossly inadequate and irrelevant training schemes and schemes in which they have been treated as cheap labour?
Mr. Lang : We always investigate such complaints. The hon. Lady will know that we have investigated such allegations as have come to our notice. The vast majority of such allegations have turned out to be ill founded, but where any minor deficiencies are discovered they will be dealt with in the appropriate way.
Mr. Knox : Can my hon. Friend say how much, on average, the agency has spent each year since the present Government came into office, and how that compares with the average amount spent under the previous Government each year?
Mr. Lang : Perhaps I can best illustrate the figures by telling my hon. Friend that the budget for next year, at £180 million, is the largest that the agency has ever had--15 per cent. higher in real terms than in the last year of the last Labour Government.
Mr. McKelvey : The Minister will be aware that precious little of that money ever went to Kilmarnock. For that matter, I should like to know how much went towards improving the environment. Will the Minister undertake, on his next journey up north, to put on his hiking boots and march from Tummel, through Loch Rannoch, by Lochaber? He can go along heather tracks with heaven in their wiles. Some of us might think that there was a braggart in his step amidst all that beauty. Will he stop and reconsider the fact that if he does not give local authorities enough money to neutralise the billions of tons of rubbish and poison being poured into our coastal waters, neither he nor any of us, will ever
"smell the tangle o' the Isles".
Mr. Lang : I know that this is the season of Burns--we have just had the Kilmarnock edition. The hon. Gentleman mentioned the importance of environmental renewal. He is absolutely right. This year the agency is