House of Commons Hansard Debates for 13 Mar 1990

Mr. Campbell-Savours : You, Mr. Speaker, have just ruled--

Mr. Speaker : Order. I have not ruled. I am saying that I do not know.

Mr. Campbell-Savours : The Register of Members' Interests shows the position. May I ask you, Mr. Speaker, to withdraw your statement that you have no idea?

Mr. Speaker : I take the hon. Gentleman's word for it. I have no responsibility for the personal declarations that are made in the register. That is not a matter for me. The hon. Gentleman has declared his interest.

Mr. Campbell-Savours : You are compounding the confusion, Mr. Speaker.

Mr. Speaker : Order. Will the hon. Gentleman please sit down so that we can get on with the debate?

New clause 74

Special Health Boards

In section 2 (Health Boards) of the 1978 Act--

(a) in subsection (1)--

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(i) after the words "Secretary of State" there shall be inserted the word "(a)" ; and

(ii) after the words "Health Boards" there shall be inserted-- "and

(b) Subject to subsections (1A) and (1C), may by order constitute boards, either for the whole of Scotland or for such parts of Scotland as he may so determine, for the purpose of exercising such of his functions under this Act as he may so determine ; and those boards shall, without prejudice to subsection (1B), be called Special Health Boards." ;

(b) after subsection (1) there shall be inserted the following subsections- -

"(1A) An order made under subsection (1)(b) may determine an area for a Special Health Board constituted under that subsection which is the same as the areas determined--

(a) for any other Special Health Board ; or

(b) for any Health Board or Health Boards constituted by an order or orders made under subsection (1)(a).

(1B) An order under subsection (1)(b) may specify the name by which a board constituted by the order shall be known.

(1C) The Secretary of State may by order provide that such of the provisions of this Act, or of any orders, regulations, schemes or directions made under or by virtue of this Act, as apply in relation to Health Boards shall, subject to such modifications and limitations as may be specified in the order, so apply in relation to any Special Health Board so specified." ; and

Brought up, and read the First time.

The Parliamentary Under-Secretary of State for Scotland (Mr. Michael Forsyth) : I beg to move, That the clause be read a Second time.

Mr. Speaker : With this it will be convenient to take Government amendments Nos. 266 to 268.

Mr. Forsyth : The new clause and the amendments are important as they allow the Secretary of State for Scotland to set up a special health board in Scotland. Those powers do not exist in Scotland, and I should explain to the House why my right hon. and learned Friend the Secretary of State would like to have them. This arises out of the review that we have undertaken of health education in Scotland--a review carried out on the Secretary of State's behalf by Touche Ross--and a report that has been produced on the incidence of coronary heart disease in Scotland.

Although in Scotland we spend about 25 per cent. more per head on health than is spent in England, we still have very high levels of coronary heart disease and lung cancer, and life expectancy is still lower in Scotland than it is south of the border. The Government have made health education and the promotion of good health part of their priorities for the Health Service in Scotland. Following the reports that have been made to the Government, it has become apparent that there is a need for a body in Scotland with the status and standing to ensure that our health promotion policies are given the centre-stage position that is required.

At present, health education is the responsibility of the Scottish Health Education Group, which is part of the Common Services Agency. The Secretary of State would

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very much like to create a new body that would be a special health board with responsibilities for health education and promotion throughout Scotland. That body would have as its purpose the implementation of a policy statement of priorities in health education and would be responsible for achieving the targets set by central Government. It would work closely with health boards. It is for those reasons that we are proposing the new clause and the amendments. It is our intention to establish the new body and to have it set up and working by 1 April 1991. It is essential that we move with speed. The Public Accounts Committee has drawn attention to the need to focus our health education programmes more effectively, and I accept the advice given and the criticism made in the past. Having said that, I believe that we have made great progress in health education. I make no criticism of those who have worked so hard to achieve that in the past.

I hope that the new clause and amendments will be welcomed on both sides of the House. This is a positive step forward. It is an attempt to meet the SHARPEN priorities, which we set out more than a year ago, in which health promotion and education were given a centre-stage position. I have considerable pleasure in commending the new clause and amendments to the House.

Mr. John Maxton (Glasgow, Cathcart) rose --

Mr. Barry Porter (Wirral, South) : Declare your interest.

Mr. Maxton : The hon. Member for Wirral, South (Mr. Porter) has asked me to declare my interest. I can tell the House that I am a member of the Management, Science and Finance union, but I receive no sponsorship for elections from that union and am not a sponsored member of it. I am not sponsored by any union except very indirectly, I suppose one might say, through the new clause, as the money for my expenses comes from the Labour club, and drinking and smoking provide a lot of its income. But that is another matter.

I think that everybody must welcome this new clause, but the problem that we have with it is that it makes no reference to health education. It is a broad, general clause dealing with special health boards in Scotland. It gives the Secretary of State powers considerably wider than those of health education. Opposition Members are suspicious that it is being done in this way, especially as the new clause was put down on Friday, which meant that the Opposition had no opportunity to table amendments to make it specific to health education. That arouses our suspicions about the Minister's intentions.

The Minister's problem in Scotland is that no one trusts him. He may have the best intentions in the world about this legislation and the new clause, but the people of Scotland, particularly when he takes such wide powers, simply do not believe him. They always look for ulterior motives and other things for which he intends to use such powers.

Increasingly, people in Scotland distrust not only the Minister's intentions, but his competence. One can only assume, as the Prime Minister stayed at the hon. Member's house for the night that she was in Scotland, that he was the person who advised her on her whole trip to Scotland. If he can create that sort of public relations disaster, we have every right to distrust his competence in anything at all, particularly since the Prime Minister went to Ibrox to make the draw for the Scottish Cup. If hon. Members

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wonder why this is relevant, I will tell them exactly why. Until last year the Scottish Health Education Group sponsored the Scottish Cup ; therefore the Prime Minister and the Minister had a direct interest at that time, although they have not now. To advise the Prime Minister to go to Ibrox in connection with the draw for a cup in which Rangers Football Club is no longer involved really takes a bit of beating and could cause considerable distress to many football supporters in Scotland. Her performance on television was appalling. That she should describe herself as a Scot by saying "we in Scotland" all the time takes a bit of believing.

Mr. Bill Walker (Tayside, North) : The hon. Gentleman, with his interesting ancestry, is trying to lay claim to a Scottish background and history. He should remember that some of us are real Scots.

Mr. Maxton : I do not know whether the hon. Member can make the claim that I can, that both his mother and his father were born in the constituency that he now represents. If that does not make me a Scot, I do not know what does.

The Minister's intentions and competence in this matter make us a bit suspicious and I think that we ought to ask him to explain why he is taking broad powers instead of specific powers. Why did not he simply table a clause to set up a new body in Scotland to deal with health education? What else will he use these powers for? The House is entitled to answers to those questions.

I still do not understand, even from what the Minister said, what exactly will be different in health education compared with what was done by the Scottish Health Education Group, for which I have a very high regard. I criticised it in an article that I wrote in The Runner magazine in Scotland because it did not sponsor enough running but sponsored football. However, a lot of its work in health education led the field not just in Scotland but in Britain, and in some cases in Europe ; it was very advanced.

Mr. Walker : I did not have the opportunity to read that article, but I am sure that it was interesting, because I have enjoyed reading other things that the hon. Gentleman has written. Does the hon. Gentleman believe that, when one writes articles and is paid for them, one should make a declaration in speeches in the Chamber, particularly if an article has been on Health Service matters?

Mr. Charles Kennedy (Ross, Cromarty and Skye) : No, definitely not.

Mr. Maxton : The hon. Member for Ross, Cromarty and Skye (Mr. Kennedy) may have an interest to declare. For myself, if the hon. Member for Tayside, North (Mr. Walker) knew anything about The Runner magazine in Scotland, he would know that it runs on a shoestring and does not pay contributors anything, so I did not get paid for the article.

Mr. Kennedy : The hon. Gentleman should bear in mind that that may be the story he was told when the magazine got his copy.

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5 pm

Mr. Maxton : That is always possible. However, I know the people who run the magazine and I think it fair to say that they do not have any money. That is taking us rather wide of the new clause. The Scottish Health Education Group has done good work in Scotland. In his brief speech, the Minister did not give us reasons why the group should disappear and a new body should be established. We need to know more about the relationship between a new health board and the other health boards in Scotland in regard to health promotion. I shall give one example from my area--the "Good Hearted Glasgow" campaign run by the Greater Glasgow health board. I do not know how effective it is, but it has done well in publicity. Whether it has stopped large numbers of people smoking or eating foods with high cholesterol is another matter. In that respect there is a question mark over health education. Certainly we need to know whether such a campaign would be taken over by the new health board or would remain with the Greater Glasgow health board. If it is taken over by the new health board, where is the division in responsibility? The "Good Hearted Glasgow" campaign is not just about advertising and education ; it is also about the provision of screening of blood pressure and so on, particularly of men of a certain age. Will the Greater Glasgow health board continue to do that while the new board takes over publicity? I hope that the Minister will give us more information on that.

When I first read the new clause, before the Minister kindly told me exactly what he intended, I wondered whether it had a relationship to the new Health Service executive which the Minister suddenly announced last week. Does he intend giving the new executive legislative standing by creating a special health board which would have power over all the other health boards in Scotland? That suspicion still remains. The Minister may set up such a body, but I am not sure that it would have great legislative standing under this legislation or under the National Health Service (Scotland) Act 1978. Does the Minister intend to use the new clause later to give that body powers?

The clause is broad enough to allow the Minister to explain to the House exactly who he intends to appoint to the new executive body, how much each will be paid for being a member, what contracts they will have, and the terms of the contract. We have grave suspicions about the body, as we have about Mr. Cruickshank, the chief executive of the Health Service in Scotland. We do not believe that the Health Service can be run as a private business like Virgin Records. It should be run for the benefit of the health of patients in Scotland. I hope that the Minister will say more about the health education side, how it links with the other health boards and how it will help education in Scotland to have the new body as opposed to the existing arrangement. Will he also say more about the new Health Service executive?

Mr. Bill Walker : I congratulate my hon. Friend the Under-Secretary on bringing forward the new clause. He will recollect that in Committee the hon. Member for Ross, Cromarty and Skye (Mr. Kennedy) and I tried to introduce amendments to the Bill. Because we were not as astute as my hon. Friend and his advisers, we were unable

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to come up with an amendment that was technically able to do the job. We put down an amendment which gave us the opportunity to speak--

Mr. Michael Forsyth : It was discourteous of me not to say, in introducing the new clause, that the hon. Member for Ross, Cromarty and Skye (Mr. Kennedy) and my hon. Friend the Member for Tayside, North (Mr. Walker) raised the matter in Committee, when I undertook to bring forward amendments. The genesis of the new clause and the other amendments was in that debate. I apologise for not having said that when I introduced them.

Mr. Walker : I thank my hon. Friend for his intervention. I gathered that that was the logic behind the new clause.

That brings me to the point behind the interesting contribution of the hon. Member for Glasgow, Cathcart (Mr. Maxton). He will have realised that the hon. Member for Ross, Cromarty and Skye and I had difficulty in Committee because, if we had made the amendment too narrow, it would have been out of order. We were grateful to the Clerk of the Committee for his assistance in framing an amendment to which we could speak.

I am pleased that the new board will be able to determine policy. Because of the special health problems in Scotland there should be a positive approach to the promotion of health care. I hope that the new clause will receive support on both sides of the House because we are all united on the prevention of health problems.

The meandering of the hon. Member for Cathcart through Ibrox was an interesting way to consider the promotion of good health care. We should encourage more anticipation in sport. The approach of the hon. Gentleman to health care is a splendid example ; I give him that.

Mr. Maxton : Almost the only criticism I have of the Scottish Health Education Group is that for so many years it sponsored professional footballers in Scotland and did not put money into activity sports such as running and amateur football, as it should have done.

Mr. Walker : I do not disagree with the hon. Gentleman ; we should do more to assist amateurs in whatever activity they are involved. Like me, the hon. Gentleman is a great believer in the fact that we can prevent illness by looking after our own bodies, by exercise, and so on.

Because the hon. Gentleman wandered into Ibrox to talk about public relations exercises, perhaps I may refer to the best public relations flop last week when the leader of his party missed the boat to Dunoon. The chap who caught that boat was not the Leader of the Opposition but the vice- chairman of the Conservative party, myself. If it were a question of missing boats, I might draw the attention of the hon. Gentleman to the early-day motion about that, but I would probably be ruled out of order, so I will not refer to it. I am responding to the hon. Gentleman's meandering into Ibrox park. I would never have dreamt of going into Ibrox park until the hon. Gentleman did so. Because of that I had to respond.

This important debate was delayed because of points of order. The reaction of some Opposition Members to a fairly straightforward question, touching a fundamental aspect of the new clause, that when people earn money writing articles--

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Mr. Deputy Speaker (Mr. Harold Walker) : Order. The hon. Gentleman should address himself to the new clause about special health boards.

Mr. Walker : The new clause has been the subject of many interesting articles. I hope that you, Mr. Deputy Speaker, are not suggesting that it is wrong for me to refer to them. The hon. Member for Cathcart made his view clear about the support for professional football of the body that the special health boards will replace. If it was in order for him to do that, it must be in order for me to draw attention to the many articles that have appeared in the Scottish media on that matter. I cannot believe that you are suggesting that I am out of order in drawing attention to those articles.

Many of the authors of those articles are hon. Members and they have been commenting in those articles and have been paid for them. Perhaps the hon. Member for Cathcart would like to consider who is writing those articles. He should read the Glasgow Herald from time to time and he might recognise the names of the authors of articles in that paper. The new clause is very important because it will provide the machinery in Scotland to deal with important aspects of health care.

Mr. Robert Hughes (Aberdeen, North) : The only part of the Minister's speech with which I could possibly agree was the reference to the importance of health education. That is hardly surprising since my knowledge of health education was gained when I was convenor of the health and welfare committee of Aberdeen town council. The health officer at the time was the formidable Dr. I. A. G. MacQueen, who was one of the foremost protagonists of health education and the role of the health visitor.

I do not intend to discuss health education at length save to say that when the Health Service was reorganised in Scotland and we moved from the old regional hospital boards to the present health boards there was a great deal of concern that the removal of responsibility for health education from local authorities to the new health boards would lead to health education being subsumed under a huge area of responsibility. We were afraid that it would lose its importance and that the focal point would be lost.

I do not want to criticise the Scottish Health Education Group, but I suspect from the Minister's remarks that there is need for a higher profile, a greater focus and more attention to be given to health education. Over the years, health education has clearly not had the impact that we hoped it would have. The health of the nation is not determined simply by the hospital service or by general practitioners. It is certainly not determined by politicians. The health of our nation is determined by good social and housing conditions.

It is incongruous that we spend a great deal of money on unhealthy practices such as drinking and smoking. If we have to declare an interest in either of those pastimes, I must admit to partaking occasionally of the liquids that come from the vine and the rye and I occasionally indulge in tobacco. I hope that that does not prevent me from participating in the debate.

A good life style and good living habits should be encouraged at an early age and health education is extremely important. I would not quarrel with any of the Government's proposals to improve health education. However, I wonder why it is necessary to have such a portmanteau provision as new clause 74.

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As the Minister said, the new clause sets up special health boards. However, it states that the Secretary of State

"may by order constitute boards, either for the whole of Scotland or for such parts of Scotland as he may so determine, for the purpose of exercising such of his functions".

The Secretary of State is taking power here not just to set up special health boards to deal with health education or with HIV ; he can also set up boards in particular parts of Scotland.

5.15 pm

I hope that the Minister does not believe that the new clause will weaken the comprehensive role of the existing health boards. There has been much discussion and argument about the functions of the new health boards. It was decided that they should cover the widest possible spectrum covering primary health care, secondary health care and community care.

We know that community care is to be removed. Will there be a special health board to deal with community care once it disappears to local government? That would seem to be inconsistent, but it might be a possibility. Will there be special health boards in local areas? Will there be special health boards in local areas to deal with specific functions? Does the Minister believe that if a particular health board is recalcitrant about privatisation--and I regret to say that Grampian health board is enthusiastic about privatisation-- Mr. Michael Forsyth indicated assent.

Mr. Hughes : I can see the Minister nodding and smiling, but we will return to that point later.

For the purposes of this new clause, if a health board decided that it would not pursue privatisation for particular services, does the Minister have the power under the new clause to establish a special health board to deal with those areas that he wants to privatise? He must give us a clear answer on why he needs special local health boards. He gave no reasons in his opening remarks. It is not good enough to table such broad sweeping new clauses without providing a clear explanation of their meaning.

I want now to consider the Health Service executive. I assume that the Minister has legislative authority over that, although he is not taking such powers in the new clause. What is the legislative purpose of the new Health Service executive? Will it be a special health board under new clause 74?

We need to know how much the executive staff will be paid. I have seen estimates that they may be paid as much as £50,000 a year. What binding contracts will be provided? Anyone thinking of taking up such a contract must be aware that if he is appointed arbitrarily with an arbitrary contract, he will be subject to arbitrary dismissal if there is a change of Government.

The Minister cannot provide five-year or 10-year contracts believing that they will tie staff down, because there will have to be compensation if the executive is disbanded if there is a change of Government. I hope that no one will take such a job under the illusion that he has a fat, juicy contract with £50,000 a year and that he will get compensation if we decide that the executive will not exist after the next general election.

The new clause looks innocuous and it would appear to be a reasonable tidying-up measure. Most uncharacteristically, the Minister introduced it in such a modest and

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moderate way that it is hardly surprising if we wonder what is going on in his little mind behind his smiling, bland little face. We need more explanation before we accept the new clause, although I emphasise that we support entirely the idea of giving health education a much higher profile and more new money.

Mrs. Maria Fyfe (Glasgow, Maryhill) : I begin by declaring an interest in that I am sponsored by the Transport and General Workers Union, although not a penny of that money enters my pockets. It is spent campaigning against Conservative policies in Maryhill--and that is an easy job.

I want more information from the Minister on the proposals for special health boards and health education than he has so far troubled to give us. The Minister has not said anything about how the membership will be decided. We must remember the way in which the composition of the local health boards has been changed over the years, so that more and more people of Conservative persuasion seem to serve on them while fewer and fewer of Labour persuasion are chosen. That makes me wonder how these boards will be chosen. Might trade unionists who are involved in health education find a place or two on them?

What are the Minister's plans for choosing women to serve on the boards? Very few women serve on the public bodies in Scotland--boards of various types--over which the Minister has some influence or control. The proportion is tiny. Women chair only one or two. Generally speaking, those in which women participate in any great extent relate directly to things that are seen as women oriented. I also wonder about the resources that the new health education board will have--

Mr. Michael Forsyth : I may have misheard the hon. Lady, but is she suggesting that very few health boards are chaired by women? If so, she could not be more incorrect. If the hon. Lady checks, she will see that a number of health boards are chaired by women, for example, Lanarkshire and Forth Valley. The most recent appointment that we made--in Forth Valley-- was bitterly criticised by the Labour party, but it was another example of another woman being appointed to a health board. Others, such as in Fife and the Western Isles, are also chaired by women.

Mrs. Fyfe : If the Minister had been listening to what I had been saying, he would have heard me refer to public bodies in general, across the whole spectrum. Few women serve on or chair such bodies. Of course, I do not simply want there to be more women--I want more women of progressive views to be involved, who will want to do something for their communities. Clearly, not all women fall into that category--as is only too obvious in this place.

The Minister has not spelt out whether the new boards will have more or fewer resources than the present health education body. I hate to suggest this to the hon. Gentleman in case I am putting ideas in his mind, but has he any thoughts about the bodies being funded by the commercial interests that would benefit from increased health education, such as Outspan and Jaffa? Who knows, perhaps this is the first time that that has entered the Minister's head. I hope that I have not given him a new idea.

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I do not see the point of leaving it up to the new boards to determine their priorities and targets. I should have thought that medical advice on the major problems confronting us would be the best way in which they could decide their priorities.

We have enormous health problems in Scotland. Indeed, the Minister identified the problems of heart disease and bronchitis from which we know that Scotland suffers especially. There is not much point in advising people that their housing conditions are unhealthy when they can do precious little about it. Will the Minister run a course in health education for his hon. Friend the Minister for Housing and Planning so that they can do something about achieving the major improvement in people's health that would result if they were removed from the damp-ridden housing that is wrecking their health? Problems such as drug abuse are widespread in parts of Glasgow. I know that useful work had been done on that, but I should like to know whether special funding will be provided for it. Quite apart from the horrific impact on people's lives if they themselves are abusing drugs and on those of their families, drug abuse creates extremely unpleasant living conditions for their neighbours and those who live in the vicinity. Children in parts of my constituency find needles lying in untended grass on wasteland.

Many health education issues need our attention. I am arguing for women to be involved in the boards not simply on the grounds of sexual equality, but because many health matters affect women especially. Women tend to be greater users of the Health Service, both in their own right and because they bring their children to the surgeries. It would be a pity if we did not ensure that women are involved in those bodies in appropriate numbers, and not only in the tiny minority that is the case now in most of the different boards that operate in Scotland. Obviously, I want women of progressive views to be involved, and not too many Conservative women.

Mr. Archy Kirkwood (Roxburgh and Berwickshire) : I welcome this important new clause. Any idea that was cobbled together by my hon. Friend the Member for Ross, Cromarty and Skye (Mr. Kennedy) and the hon. Member for Tayside, North (Mr. Walker)--an unholy alliance if ever I saw one--must be worth supporting, but perhaps that is going too far.

Since being elected to the House, I have tried to take a particular interest in preventive medicine in its broadest sense because I believe that moving health care in general in the direction of prevention is an entirely good and proper thing, and health education is an important element in that.

The only reason why I am dragged to my feet now is to ask about the independence that the new body will enjoy. I do so because some worrying parallels could be drawn with the situation that arose in 1986 when the right hon. Member for Sutton Coldfield (Sir N. Fowler), the then Secretary of State for Social Services, abolished the health body that was then independent of the Government and established a new Health Education Authority. That provides a parallel with the contents of the new clause. I do not need to remind the House that real misgivings were voiced at that time. When the right hon. Gentleman introduced that change in 1986, he said that he was doing so to deal with the special problems of AIDS. Everyone

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supported the move for that reason. However, it subsequently became clear that the Government were using undue influence and bringing to bear departmental methods of working and priorities in a way that was not possible before, when the previous English and Welsh body had more independence from Government Departments.

There is a great deal of value in any health education body having an element of independence. If such a body is to be successful, it must operate in areas that are difficult for any Government because they embrace, for example, dietary provision and nutrition. That immediately involves a confrontation with the direct commercial interests of the food industry. I fully accept the difficulties of that. We have had arguments about sugar and about cholesterol-free diets around which many commercial interests have been built up. Similarly, we must confront the difficult area of alcohol abuse in terms of, on the one hand, what is good for the population's health, and, on the other, what is good for the industry that is supplying liquor of all sorts. There are also similar problems with the tobacco industry, about which I have been concerned for some time. Any health education body worth that description will have to look closely at the impact of the produce and the products that such commercial enterprises are purveying to the public. If that body is under direct Government guidance and control, that puts the Government in a difficult position. I hope that that matter has been properly addressed and that the things that went so badly wrong in 1986 when the Department in England took over the previous health education body for England and Wales are corrected for Scotland in the future.

Following that train of thought one step further, I hope that the voluntary sector will be able to interface closely with the new body that the Minister is setting up. I also hope that funds will be made available so that it can undertake work in some of the sensitive areas with which the Government find it difficult to cope, such as AIDS. I pay tribute to what has been done north of the border in that area. An awful lot more needs to be done. It is valuable to establish a health education authority to look at the specific Scottish aspects of the development of the disease. I am grateful that the Minister is nodding his assent.

I fully understand that for any Government advertising campaigns are necessary to confront the problem adequately. It is difficult for Government Departments to do so. There is a value in having pressure groups and voluntary groups that can work alongside AIDS sufferers and HIV positive patients in a way that Ministers, officials and civil servants never could. That is no criticism of them ; it is simply recognising reality. I hope that the new body will have a wide scope, flexibility and independence and will be free from the influence of the Minister's Department. If not, he will be wasting his time and the body will not succeed.

It would be helpful if we could be given a steer about the amounts of money and the resources that might be available to the authority. Is it likely that there will be new money or will budgets have to be trimmed to give the new health education authority an acceptable budget with which to work? I hope that the Minister will consult widely--I mean widely, to the extent of consulting the voluntary sector--before he puts together the membership of the new body. That, too, is crucial. I agree with the hon. Member for Glasgow, Maryhill (Mrs. Fyfe) that we must have more

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women on all such bodies. We must have a spread of membership to embrace all the difficult matters that must be dealt with if the body is to succeed.

I welcome the initiative. The body has great potential for confronting some of the difficulties that are peculiar to north of the border, such as coronary heart disease and short life expectancy, to which the Minister referred. The body can do so only if it is genuinely free of day-to-day Government interference and control. 5.30 pm

Mrs. Margaret Ewing (Moray) : I shall be brief because many of the points that I should have made have been touched upon by other hon. Members. The Minister has shown an administrative commitment to the establishment of the boards and we are asking for details to flesh out the ideas behind them. A great deal of importance should be attached to who the members of the boards will be and what budget will be available to them.

We all recognise the great importance of health education. One point that has not been touched upon by other hon. Members is how the boards will interface with our education system. We all recognise that a great deal of health education work has been undertaken in our primary and secondary schools. We owe a great debt to many teachers, particularly physical education teachers, who, through their classes, have made youngsters aware of the implications of diet and habits for their health. Many parents have told me that they have stopped smoking because such an impact has been made on their children during lessons at school that the parents feel guilty and give up the habit. Perhaps I should have some children who could come home and give me that lesson because, like the hon. Member for Aberdeen, North (Mr. Hughes), I admit to particular vices.

It is important to know how the health boards will tie in with our education system, and use the expertise that is already present in our schools and the information that the Scottish Health Education Group so readily supplies to them. We want that to continue and to be expanded. It will be interesting to hear what interface the Minister has in mind.

Mr. Kennedy : As the Minister was either generous enough or grotesque enough to give me joint B-film scripting accreditation on the new clause with the hon. Member for Tayside, North (Mr. Walker), it seems appropriate for me to say a few words. My hon. Friend the Member for Roxburgh and Berwickshire (Mr. Kirkwood) described that partnership as an unholy alliance. I hope that the House understands that on these Benches we can speak about that term with particular insight.

I echo the question put to the Minister on the structure that he has chosen. The hon. Member for Aberdeen, North (Mr. Hughes) said that, like so much else in the Bill, the new clause opens up fairly wide-ranging powers. Under various clauses, we have heard time and again that the Secretary of State is taking powers unto himself. More often than not, we are told, "Don't worry because he does not intend to exercise them." Some of us fear that from time to time those powers will be exercised. We should never ascribe to this Health Minister some of the mean motives that might be in the hearts or minds of other Health Ministers, but the successors to his office may want to use those powers in a different way. What safeguards are there?

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