House of Commons Hansard Debates for 20 Feb 1990

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Trent Regional Health Authority

10. Mr. Duffy : To ask the Secretary of State for Health when he next expects to meet the chairman of the Trent regional health authority ; and what matters he expects to discuss.

Mrs. Virginia Bottomley : I have no plans for a special meeting with Sir Michael Carlisle at the moment, but I shall be meeting the chairmen of all the regional health authorities in March to discuss a range of issues.

Mr. Duffy : Given the recent allocation to the Trent authority for 1990-91 and the certainty that the increased distribution to its constituent health authorities will be absorbed by inflation, can the Minister assure me that the Sheffield health authority will not find that it has to retrench because of capital limits as well as cash revenue limits and that it will not be driven to restricting the services that it provides?

Mrs. Bottomley : In view of the increased resources to the Health Service generally, the hon. Gentleman will be aware that there are major opportunities to provide high quality care. With increasing expectations and changing demographic patterns, all health authorities must be sure that they use their resources to the best effect. The hon. Gentleman will be aware that the capital programme in Sheffield is the biggest in the Trent region, with improvements of the order of £38 million taking place at the Northern general hospital.

Mr. Michael Morris : May I draw my hon. Friend's attention to the National Audit Office report, "Financial Management in the National Health Service", which itemised the basic problem that the Treasury agreed a certain figure for pay and prices and the Department issued a different one? Can the chairman of the Trent health authority have confirmation from my hon. Friend that in the coming year pay that is agreed nationally will be fully funded nationally?

Mrs. Bottomley : The pay levels are very much what we anticipated and funded. It is clear that all regional and district health authority chairmen have to ensure that resources are used effectively and properly to take account of pay and of patients' needs.

Newham General Hospital

11. Mr. Leighton : To ask the Secretary of State for Health when stage 3 of the development of Newham general hospital will be complete.

Mr. Freeman : I understand that phase III of the Newham hospital is unlikely to start until after 1995. If further resources become available to the North East Thames regional health authority through an improvement in land sales income, the capital programme will be reviewed.

Mr. Leighton : Is the Minister aware that that reply will cause bitter disappointment and a sense of betrayal in the London borough of Newham, where phase III has been a central plank of Newham's future services since 1984 when the regional health authority gave its approval and put phase III into its capital programme? Is not it crazy and immoral that the National Health Service is funded partly by property deals, and now that high interest rates have

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knocked the bottom out of the market we shall not get our hospital? Is the Minister aware that it is doubtful that he will save much money because there will have to be extra capital and revenue spending at St. Andrew's hospital and that phase III is doubly necessary because of the expanded population caused by docklands development? In view of all that, will he receive a deputation of Newham Members of Parliament to discuss the matter?

Mr. Freeman : I should be glad to receive such a deputation. In answer to the main part of the hon. Gentleman's question, it is not incorrect that the National Health Service should receive something like 20 per cent. of the total capital funding programme from land sales income. That is appropriate. Some £1,000 million is provided by the taxpayer for the capital programme and a further £200 million to £250 million comes from land sales income. That is greatly to be welcomed.

Complementary Medicine

12. Mr. Tredinnick : To ask the Secretary of State for Health when he last met representatives of practitioners of complementary medicine ; what was discussed ; and if he will make a statement.

Mr. Freeman : On 29 November 1989 I met, at their request, representatives of the Council for Complementary and Alternative Medicine and of the General Council and Register of Osteopaths. It was agreed that a further meeting in a few months' time might be helpful.

12. Mr. Tredinnick : What arrangements is my hon. Friend making to safeguard the freedom of complementary medical practitioners after 1992? Is he aware that there is widespread concern among doctors in the faculty of homeopathy that they are being insufficiently consulted about the radical changes proposed by the EEC?

Mr. Freeman : There are two parts to that question. As regards the first part, because all the professions in complementary medicine are not registered and there are no statutory qualifications needed to practise, there will be no impact of 1992 upon those professions. In regard to homeopathy, because the medicines are natural there should be no effect upon homeopathy as result of EEC proposals on regulating the introduction of medicines.

District Health Authorities

13. Mr. Anthony Coombs : To ask the Secretary of State for Health what consequences he expects from the introduction of funding district health authorities by residents in 1991-92.

Mr. Freeman : Districts that send more patients for treatment outside their boundaries than they receive will have an increase in their funding in 1991-92 to enable them to pay, through contracting, for such services. In the first year, we expect that existing patterns of service will be broadly unaltered.

Mr. Coombs : In welcoming that important part of the Government's health proposals, may I ask my hon. Friend to confirm that they will benefit efficient districts such as Kidderminster, which attracts patients from outside, will next year give £90 million extra to the West Midlands

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regional health authority and, most importantly, will increase competition, efficiency and use of the Health Service for all those patients who most need it?

Mr. Freeman : I am grateful to my hon. Friend for those comments. An additional fact that represents a change from the earlier working papers on the Health Service reforms is that from 1991-92 the first step in weighted capitation will commence in relation to allocations by regions to districts.

PRIME MINISTER

Engagements

Q1. Mr. Patrick Thompson : To ask the Prime Minister if she will list her official engagements for Tuesday 20 February.

The Prime Minister (Mrs. Margaret Thatcher) : This morning I had meetings with ministerial colleagues and others. In addition to my duties in the House, I shall be having further meetings later today.

Mr. Thompson : Can my right hon. Friend confirm that the rebate system for the new community charge is considerably more generous than the old rate rebate system, particularly for those households in the lowest income band who should see, on average, a reduction of 26 per cent. in the proportion of their income that they pay to local government? Does my right hon. Friend agree that they will gain that benefit only if local authorities such as Norwich city council control their expenditure firmly and efficiently and resist the temptation to raise the level of charge?

The Prime Minister : Yes, I confirm that households in the lowest income band will see a lower proportion of their income paid to local authorities. That is because community charge benefits are more generous than rate rebates were and because many of the single adult households who will benefit from the change are pensioners and others on low incomes.

To answer the second part of my hon. Friend's supplementary question, I agree that local authorities should make strenuous efforts to keep their expenditure down. It is reported that some have nevertheless suggested a figure of £370 or more for community charge. If we had retained domestic rates instead of the present community charge, that would have led to an increase in domestic rates of 35 per cent., which is totally unacceptable.

Mr. Kinnock : When people live in a Tory district, in a Tory county, under a Tory Government, whom do they blame for their very high poll tax?

The Prime Minister : All local authorities, whatever their political complexion, should strain to keep down their public expenditure so that they can keep down their community charge. Far more Labour than Conservative local authorities are extravagant, with the highest community charges.

Mr. Kinnock : Why does the Prime Minister try to take refuge in fiction? Does she not realise that there are plenty of Conservative Members and others in her party who could tell her that the whole arrangement was a fairy story from the start, to use the words of her hon. Friend the Member for Spelthorne (Mr. Wilshire)? Is not that why

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only one authority in the whole country has been able to set its poll tax at or below the level specified by the Government?

The Prime Minister : Not all the community charges have been set. We are perfectly well aware, from the answer that I gave previously, that some authorities are taking refuge in the change to have higher expenditure. Therefore, it is our intention, when the community charge is finally set, to say precisely what the increase would have been in domestic rates had that taken the place of the community charge, so that local people can judge whether their authority has been wise or just plain extravagant. They will find that far more Labour authorities and those under no overall control will have far higher spending than most Conservative authorities.

Mr. Kinnock : Does not the Prime Minister yet understand that people will pay not what might have been but the much higher charges that will be inflicted on them by her and her Government?

The Prime Minister : No. The right hon. Gentleman knows that the majority of local authority spending is met by the taxpayer and by business ; the rest is met by the community charge payer. When councils load on extra expenditure, it is borne by the community charge payer. People will be able to see which are the most extravagant authorities. In any case, they will all prefer the community charge to Labour's roof tax.

Q2. Mr. Amos : To ask the Prime Minister if she will list her official engagements for Tuesday 20 February.

The Prime Minister : I refer my hon. Friend to the reply that I gave some moments ago.

Mr. Amos : Will my right hon. Friend persist in her determination to lift the voluntary ban on investment in South Africa, and will she confirm that other countries are investing there?

The Prime Minister: As my hon. Friend knows, President de Klerk has taken fundamental decisions which have gone further in the direction of ending apartheid than those taken by any previous Government. He is determined to end apartheid. In such circumstances, and given the actions that he has taken, we believe it right, step by step, to lift some of the sanctions, in particular the voluntary ones. With regard to the ban on investment, six other Community countries have a voluntary ban. We are not the only country to have a voluntary ban, and we are not suggesting the lifting of those sanctions which are enforced by order.

As my hon. Friend knows, it is not possible to do anything about profit from investment being reinvested in South Africa ; sometimes it has a compound nature within and without South Africa. My hon. Friend will be aware that BMW South Africa has just announced the latest £25 million instalment in a five-year investment programme which is worth £120 million. That means jobs, security and an improvement in living standards for the work force, and should be welcomed.

Q3. Mr. Michael : To ask the Prime Minister if she will list her official engagements for Tuesday 20 February.

The Prime Minister: I refer the hon. Gentleman to the reply that I gave some moments ago.

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Mr. Michael : What advice has the Prime Minister for the hon. Member for Winchester (Mr. Browne)?

The Prime Minister: The report of the Select Committee is serious and must be considered carefully. My hon. Friend the Member for Winchester (Mr. Browne) will want to consider what it says very carefully. In due course, and after consultation with others, my right hon. and learned Friend the Lord President will say when the report should be debated. I would think that it would be courteous to leave it at that.

Q4. Mr. Speller : To ask the Prime Minister if she will list her official engagements for Tuesday 20 February.

The Prime Minister: I refer my hon. Friend to the reply that I gave some moments ago.

Mr. Speller : What has gone wrong with the arithmetic relating to the community charge in England? Why are low-spending,

low-rateable-value authorities such as North Devon and Mid Devon, which previously levied less than £190 per adult, having to levy more than £300? Is that the fault of those who are levying the charge locally or those who organised it?

The Prime Minister : The figure which my hon. Friend mentions of £300 for the community charge in North Devon and Mid Devon is based on an increase of more than 19 per cent. in spending by the county council and 21 and 15 per cent. increases for North Devon and Mid Devon respectively. If the authorities continue their present pattern of spending, the community charge will be £210 in North Devon and £220 in Mid Devon. I hope that Conservative authorities will maintain their present tradition of prudent budgeting and well-managed services.

Mr. Ashdown : Is inflation still to be the judge and jury of the Prime Minister's Government? If so, how does she explain the fact that Britain's inflation has been higher than the European average for eight out of her 11 years, higher than the Organisation for Economic Co-operation and Development average for nine out of her 11 years and higher than that of any of our industrial competitors for 11 out of her 11 years? Does she realise that if inflation is to be the judge and mortgage misery the charge, with that record there is only one verdict--guilty, guilty and guilty?

The Prime Minister : The present inflation rate, based on the retail prices index, at 7.7 per cent. would have been low for the Labour Government, whom the right hon. Gentleman's Bench chose to support year after year. For us, it is high, and to bring it down remains our priority. I must point out to the right hon. Gentleman that this country's record on increasing jobs and on creating jobs has produced a low level of unemployment of 5.7 per cent., which is lower than that in almost any other country in the Community.

Q5. Mr. Jack : To ask the Prime Minister if she will list her official engagements for Tuesday 20 February.

The Prime Minister : I refer my hon. Friend to the reply that I gave some moments ago.

Mr. Jack : Can my right hon. Friend confirm that her Government would never countenance following policies that would impose a 59.5 per cent. tax rate on wage and salary earners? Has she had a chance to see recent

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newspaper reports suggesting that a tax rate of 59.5 per cent. is precisely the policy being pursued by the Opposition?

The Prime Minister : I confirm that we should never think of putting up a tax rate of 59.5 per cent. and that we shall continue the policy of lower taxation, which has brought about extra enterprise, more jobs and a higher standard of living for this country than it has ever known before. I refer my hon. Friend and Opposition Members to the report, "Social Trends", and I must point out that under our policies the top 10 per cent. of taxpayers contributed not only a larger amount to the Exchequer, but 40 per cent. to the yield of income tax. That is on a policy of reducing taxation which gives incentives. Q6. Mr. Clelland : To ask the Prime Minister if she will list her official engagements for Tuesday 20 February.

The Prime Minister : I refer the hon. Gentleman to the reply that I gave some moments ago.

Mr. Clelland : Does the Prime Minister believe that there is any connection between the fact that homelessness increased by 45 per cent. between the end of 1986 and the end of 1988 and the fact that under her Government council house building has fallen from 111,000 per year in the 1970s to only 21,000 per year in the 1980s? Does not that show that the Government lack any concern for the needs of people at the lower end of the income scale?

The Prime Minister : It has been our policy to encourage home ownership, and it has increased from 11.5 million homes in owner occupation to 15 million. Many people have had a chance under our Government that they would never have had under a Labour Government. On homelessness, the Government announced an extra £250 million to help provide homes for the homeless and an

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increase in money from the Housing Corporation for housing associations, rising from about £800 million at present to £1,700 million in the next two to three years. That is a large allocation of taxpayers' money for alleviating homelessness.

Q7. Mr. Butler : To ask the Prime Minister if she will list her official engagements for Tuesday 20 February.

The Prime Minister : I refer my hon. Friend to the reply that I gave some moments ago.

Mr. Butler : Is my right hon. Friend shocked that ILEA can produce only 137 A-level students in French throughout London? Does not that indicate that years of big spending and comprehensive schools do not necessarily produce the goods?

The Prime Minister : I agree with my hon. Friend. Big spending does not necessarily produce the best education results and ILEA is proof positive of that. I hope that when ILEA is disbanded very soon the separate district education authorities will have a much better record and a lower level of expenditure than ILEA managed.

Mr. Graham : Is the Prime Minister aware that more than 500,000 people in Scotland cannot pay the poll tax, yet Tory councils are going to put a huge poll tax burden on the people they represent? How many people in the Tory shires will not be able to pay the poll tax and how much of that is due to increased inflation? The Prime Minister : Bearing in mind that the community charge in Scotland meets only 14 per cent. of the expenditure of local authorities, and that Scotland's earnings are about the fourth highest in the United Kingdom, I believe it is not that people cannot pay their community charge ; it may be that some have been led not to pay it on wrong advice of others.

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