House of Commons Hansard Debates for 9 Nov 1990

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evidence in other countries that have random testing shows that to be so. I am sure that the same will apply in areas of Britain that undertake random testing, even though there is no law to support such tests. Parliament has not laid down conditions in that respect, so random testing is now done at the discretion of individual chief constables. In other words, one might be stopped for a windscreen wiper offence and find, the policeman having smelled one's breath, that one is breathalysed.

Parliament should not have shied away from that problem, leaving it to chief constables, who know that they can save lives by increasing the deterrents. Apart from increased penalties, the greatest deterrent is the possibility of being caught. After all, one is more likely to get away with it if one happens to be in an area where the chief constable does not believe in random breath testing. The evidence in, for example, New South Wales, shows that when random breath testing is introduced, the public are overwhelmingly in favour of it. The same sentiment has been expressed in polls in this country. The evidence shows that random testing results in the number of deaths being reduced by a third. So if we add one third of the 1, 000 people killed as a result of drink driving to the other avoidable deaths of which we have been speaking, we see that about 50 per cent. of deaths could be avoided, if there were fewer accidents. I intend to give the House a chance to vote on the random testing issue. Although that will occur in a non-partisan way, I am pleased that my party has supported it, and it appears in our policy document. Allowing for all the civil liberties arguments that arise, we must now take the random testing argument further, as we did with compulsory seat belt wearing. That means Parliament laying down the conditions applying to random testing, with all the protections that may be necessary. We must lay down the how, why and wherefore of it all and thereby take a major step towards improving safety on the roads.

Mr. Peter Bottomley : It is worth noting that the proportion of dead drivers above the legal limit has dropped faster in this country than in New South Wales. Nobody discussing the issue next week should necessarily assume that the hon. Gentleman's proposal is the best.

Mr. Prescott : What the hon. Gentleman says is true and we welcome the figures, but much depends on the way in which the testing is implemented. As it is not a legal requirement on the police, we cannot say that it applies throughout the country. That is why I am anxious for us to lay down a standard and the necessary protections and to recognise that we can do something to reduce the number of deaths and accidents on our roads. That being so, Parliament should have the opportunity to act. We shall give the House that opportunity. Members in all parts of the House are united in wishing to reduce the accident rate. By implementing the simple measures to which I referred, we can make that reduction.

I have explained how we could take steps to improve the legislation that the Government propose. We want to see more resources made available to the transport system generally--for rail, buses and for safety--and we are glad that the Government are committed to finding extra resources.

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In conclusion, I shall ask the Secretary of State a question that I have asked him before and on which I have chased him with correspondence. To be fair, I wish to place the question publicly. Points have been made in the debate about Kuwait and the hostages. The House will recall that a British Airways plane landed in Kuwait on 2 August with 367 passengers on board. I have always wondered whether that plane could have been stopped and the hostages prevented from being delivered up. Relatives and crew members have told me that they are extremely concerned that the incident could have been prevented. There are rumours about whether Special Air Services staff from our own embassy were on the plane. All those rumours make the difficulties more contentious.

There has been correspondence between the Prime Minister and me on this matter, which is not open to argument. The plane landed at about 4 o'clock local time. We know that the takeover of the airport, the aeroplane and the crews occurred at about 4 o'clock. We know from other sources, particularly in America, that the invasion took place at 2 o'clock. As the Secretary of State in his letter, the Prime Minister and no one else will answer the question, will the Secretary of State now say when Britain first realised that troops had crossed the border? If that occurred at 2 o'clock, why did not we take essential action to prevent that plane landing and those people being delivered up as hostages? As my correspondence has failed to gain an answer, I ask the Secretary of State to answer the question in the public forum. Does he know when the invasion took place and was there a period in which the plane could have been prevented from landing? 2.7 pm

The Secretary of State for Transport (Mr. Cecil Parkinson) : Unlike anyone else in the world as far as I am aware, the hon. Member for Kingston upon Hull, East (Mr. Prescott) persists in ignoring the fact that Saddam Hussein made an unprovoked and unexpected attack on a helpless country. At that time, a British Airways plane was on its way to Kuwait. As has been explained to the hon. Gentleman, before the plane left London, the pilot checked with Kuwait airport, which checked with the ambassador, who said it was perfectly proper and sensible for the plane to leave.

When the pilot was flying over Egypt, he passed another British Airways plane coming from Kuwait. He checked with its captain whether there were any difficulties in Kuwait and that captain said no. When the pilot reached Kuwait he radioed to the ground crew, who said that it was perfectly safe to land. He then circled the airport to check for himself whether the ground crew might be in some way constrained in giving him the right answer, but he saw that it was safe to land and did so. He handed over the plane to the outgoing pilot, who set about checking it. Unhindered, the incoming pilot caught a taxi into Kuwait City, went to bed and was woken up a couple of hours later by a telephone call from London saying that there had been an invasion. Every conceivable precaution had been taken and, having taken precautions, the captain landed the plane,

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satisfied that he was doing the right thing, which he was. There was no hindrance to him ; he was able to take a taxi with the rest of his crew and travel to Kuwait city.

I hope that the hon. Member for Kingston upon Hull, East, who clearly has a deep but rather strange interest in the subject, will drop it. It is clear that British Airways took what precautions it could, the ambassador gave his advice in the best possible faith, and the captain took extra precautions and was able to land the plane safely. The plane almost left, but was delayed by a few minutes and while it was being finally checked, the crew were told that the airport was closed. I regard the hon. Gentleman's action as a cheap stunt and I hope the House feels that I have now given him the facts, which I previously gave him in letters.

Mr. Tony Banks : I do not want too much time in every debate here to be spent on Saddam Hussein. However, my hon. Friend the Member for Kingston upon Hull, East asked the Secretary of State whether, when the plane landed, Iraqi troops had crossed the border into Kuwait. That is the important point. Had they already crossed into Kuwait when the plane landed? It is a simple question.

Mr. Parkinson : That point is not clear. What is clear is that the airport was open. The captain had taken every precaution and our embassy had given him the best advice that was available to it. Several hon. Members, including the hon. Member for Kingston upon Hull, East complained bitterly about our transport problems. The hon. Member for Dunfermline, East (Mr. Brown) asked whether Britain had had a decade of sustained growth and improved performance. But most of our traffic problems stem from precisely that fact. There are nearly 7 million more cars on the roads than there were when the Government came to power. Some 32 million more people are using our airports and going abroad from them. We have 80 million tonnes more freight going through our ports. All those facts are evidence of the increased prosperity and economic growth whose existence the hon. Member for Dumfermline, East questioned.

We enjoyed almost a decade of growth, improved productivity, increased production and exports and hugely increased investment. What brought that period to an end was the decision, made after the stock exchange crash in 1987 and referred to by my right hon. Friend the Secretary of State for Trade and Industry, to accept that, as the then Chancellor said, the prospect of depression and slump was less acceptable than the risk of increased inflation. The Government made the decision to give the economy a boost, which led to overheating and gave rise to our current inflation. It was a mistake and we are paying for it, but we will put matters right only by pursuing our present policies. I noted that when the hon. Member for Dunfermline, East was asked whether he knew of a way of reducing inflation that would not involve a slowdown in the economy, he studiously avoided answering the question, just as he avoided most of the major questions that my right hon. Friend put to him.

The reduction and control of inflation will lead to the renewal of growth, the controlled expansion of the economy and an increase in manufacturing and investment, all of which the hon. Member for Dunfermline, East says he wants. All that the hon. Gentleman proposed was a series of placebos, whereas we

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propose to tackle the problem at its roots. If we can get the economy growing on a sound basis and if we can get inflation under control, the Government will not need to give people incentives to invest. Investment grew without those incentives because the economy was growing. The proposals of the hon. Member for Dunfermline, East deal with the symptoms, whereas we are dealing with the root cause of the problem. The hon. Gentleman is supposed to be the bright young hopeful of the Labour party, but as I listened to him he seemed to be firmly rooted in the corporate state of the 1960s and 1970s--a concept that is utterly irrelevant to the problems of the 1990s.

Dr. Reid : Will the right hon. Gentleman give way?

Mr. Parkinson : I was about to deal with the points made by the hon. Gentleman. He asked whether Cobden was now out of date. Cobden and the open trading system in which he believed have been the source of the growth in world prosperity since the war. There has been an explosion of trade in manufactures based on the very simple principle of lowering tariffs, removing barriers and encouraging trade. The renegotiation of the general agreement on tariffs and trade that is under way at present will extend to farming and services the rules that have proved so successful with goods. That is vital to the development of the world trading system. There is nothing more important to developed and developing countries than the removal of those barriers against goods and the establishment of the law of comparative advantage as the basis of our trading system.

Dr. Reid : The Secretary of State must not try to make truisms sound like profound revelations. I imagine that he is talking about the extensions of world trade in commodity production. That has been under way not since the war but since before the Napoleonic wars--since 1780. The hon. Gentleman mentioned inflation and said that he was getting to the root of the problem. If that is so why, after 11 years, is inflation higher now than it was in 1979?

Mr. Parkinson : If the hon. Gentleman had listened to my right hon. Friend this morning, he would have understood why. On that occasion we followed policies which his colleagues criticised because, in their view, they were not lax enough. We gave the economy a boost. Their criticism was that it was too little. As it emerged, the problem was that we gave the economy too much of a boost. The advice of the hon. Gentleman and his hon. Friends was totally and utterly wrong. We admit to an honest mistake and we are putting it right. The hon. Gentleman would have compounded that mistake. Indeed, the whole basis of the Labour party's policies when it was in government was consistently to go for growth, run the economy into the ground and hand over control for economic affairs to outside agencies such as the International Monetary Fund.

My hon. Friends the Members for Surbiton (Mr. Tracey) and for Streatham (Sir W. Shelton) raised detailed questions about their constituencies and I shall write to them personally within the next week.

Twice in the past two days the Government have given evidence of the high priority that they attach to transport and of the practical and purposeful way in which they are dealing with our transport problems. Those two occasions were in the Gracious Speech and in the autumn statement. On the first, the Government announced their plans for

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four major and worthwhile Bills. That is the largest number of Department of Transport Bills that have been in the programme for many years. On the second occasion, the Chancellor revealed spending plans under which the Department will preside over its biggest- ever investment programmes.

I shall give the House the scale of the figures. In the three years which ended in April 1990, £8 billion was invested. In the three years beginning in April, as a result of the agreement with the Treasury last year, the figure was increased to £14 billion. As a result of the latest round, in the three years beginning next April, £16 billion will be invested in programmes for which my Department is responsible. Those figures are made up of record investment programmes across the board on rail, underground, public transport, local and national roads and air traffic control. I might add that, at the same time as public programmes are under way, the private sector will invest in airports--which have been privatised as BAA--the second Dartford crossing, and in our railways, where privately owned assets which use our railways now total a staggering £3,000 million worth.

The legislative programme has three aims, the first of which is to improve road safety. I thank the hon. Member for Kingston upon Hull, East for supporting that part of our programme. I agree with him that the North report identifies some useful answers to a horrific problem. We have the safest roads in Europe, but even so, 100 people every week are killed and thousands more are injured. We have the equivalent of three Clapham train disasters on our roads every week. One of the most unfortunate aspects of that is that while our record is better than that of most other countries in every other respect, on child pedestrians we are among the worst. So we need to strengthen the law to deal with the dangerous and drunken driver. That is why our first Bill, which will implement North, will introduce tougher penalties for people who drive dangerously and drink. It will enable us to use modern technology to catch up with those who break the law and it should lead to better measures to tackle those who heedlessly kill and maim other people. I am glad that the House supports that measure.

The second aim of the legislative programme is to get better use out of our existing roads. This is tackled in two of the Bills ; one on traffic and the other on new roads and street works. The road traffic Bill will introduce the red route scheme whereby 300 miles of arterial roads in London will become red routes, effectively parking-free or tightly controlled parking areas. The hon. Member for Newham, North-West (Mr. Banks) spoke about the problem of Islington and the arterial route there. As he probably knows, Islington is our agent in handling the roads in its borough. It was asked to resurface this stretch of road in the spring of this year. It has only just come forward with its proposals, despite a lot of pressure. It is effrontery of a high order for it, having failed to carry out its duty, then to criticise us, because the fact that it is nearly a year late doing its job means that there will be a delay on the red routes. A period of decent silence, rather than using this as an excuse to attack the Government, would not have come amiss. That is a good argument for not continuing to use Islington as our agent. The Bill will have a proposal for a traffic director for London who will manage and control the red routes and advise about parking. Part of the plan is to transfer to the borough responsibility for legitimate parking--meters and

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so on--leaving traffic wardens and police free to enforce the rules on criminal parking, particularly on the red routes. We intend, having made more capacity on those 300 miles of roads, to ensure that buses get their fair share of that extra capacity because we recognise that buses are our only underused transport facility. The new roads and street works Bill will, we hope, command wide support. I was glad that the hon. Member for Newham, North-West mentioned it. Better co- ordination of the digging up of our roads, making sure that they are reinstated properly and promptly to a high standard, avoiding unneccessary works and penalising the utilities that are dilatory and inefficient will enable us to get better use of our existing system.

Our third aim in the legislative programme is to increase the scope for private sector investment in the transport system. In the roads and street works Bill, we shall have proposals to enable the private sector to finance, build and operate new roads and to charge tolls. There is a place in the system for such investment, but one important point needs to be made. The Government have made it clear from day one that any funds attracted into the road system in this way will be in addition to, not a substitution for, our public sector programme. They will bring extra resources into an area where we need them badly.

Mr. Tony Banks : Will the Bill make provision for allowing existing roads to be privatised along the lines of the system in the United States? Could people in Hampstead get together and have their road declared a private road and then operate it as a private road?

Mr. Parkinson : That is not part of our plans, but we may need to link public roads to the proposed private roads. This will happen only as part of the process of linking privately financed roads into the road network, not as part of implementing any general principle. The Bill will enable us to attract more private money into the financing of improvements to our road system. For example, we plan to attract more private money into the financing of the Severn bridge. The scheme has been let and the new Severn bridge will get under way when the House approves the Bill that the Government will introduce. As part of the aim of improving private sector investment, we plan to produce a Bill to enable trust ports to come forward with schemes for their privatisation.

We believe that that is a vital part of improving our port structure. I think that the entire House recognises now that getting rid of the dock work labour scheme led to a major improvement in our transport system. The trust ports are now hampered, however, by their own almost mediaeval structure. It is difficult for them to enter into joint ventures and to raise the money that they need to develop themselves. It is as part of the process of modernising our ports and improving them that we are coming forward with a trust ports Bill. Within our legislative programme will be the planning and compensation Bill, which will be introduced by my right hon. Friend the Secretary of State for the Environment. It will enable additional compensation to be paid to those whose homes are blighted as a result of road or rail schemes. I believe that the Bill will be welcomed generally, and especially by my hon. Friend the Member

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for Wanstead and Woodford (Mr. Arbuthnot) and my right hon. Friend the Member for Worthing (Mr. Higgins), both of whom have campaigned hard for such a measure for some time. I hope that they are pleased that the Government will be recognising the rightness of their case by introducing the measure.

That is only part of the story. Yesterday my right hon. Friend the Chancellor of the Exchequer revealed the Government's public expenditure programmes for the next three years. As I have said, we plan to spend £16 billion over that period. For the benefit of the hon. Member for Kingston upon Hull, East, who spends most of is time living in a dream land and making imaginary investments with non-existent money, I repeat that £16,000 million will be invested over the next three years. That is an all-time record for my Department. It will see an improvement across the spectrum of transport investment. The hon. Gentleman is always wrong when he talks about figures. Last year's investment programme for British Rail was the highest for 25 years. We have had continually growing investment programmes in transport as the economy has strengthened. We have now made a step change and we are moving forward into a huge investment programme across the spectrum.

The rail investment programme will rise to more than £4 billion, the highest for more than 30 years. It will be 58 per cent. higher in real terms than the programme for the previous three years. Of the £4 billion, £1.4 billion is to enable British Rail to prepare for the Channel tunnel, including £330 million of investment in freight facilities. The balance of £2.6 billion will be spent on improving the existing railway. That includes the completion of the east coast main line electrification programme to Edinburgh, massive investment in the regional network and the gradual introduction of new trains so that by 1993-94 virtually every train in the provincial fleet will be modern diesel or electric multiple units.

In network SouthEast we have a massive investment programme. The bad news for the hon. Member for Kingston upon Hull, East is that new trains will be delivered in increasing numbers, starting very early in 1991. Modern trains will be running over huge areas of the rail network in 1991 and 1992

The programme for the underground system has been expanded to over £3 billion. The hon. Member for Kingston upon Hull, East goes on and on about the public service obligation grant reduction of £80 million for Network SouthEast. Alongside the £80 million we shall be investing £1,200 million in modern stations, new trains and greater capacity so that Network SouthEast will be able to attract more customers. It will be able to reduce its costs beause it will be operating modern trains. That is how a gap can be bridged without increasing fares unduly. The hon. Member for Kingston upon Hull East can think only of subsidy. When the Labour Government were in power and subsidy was at its highest, British Rail's investment programme was at an all-time low. We should prefer the money to be invested in improving the system and attracting customers, rather than in bribing the customer and subsidising fares. More than £3 billion will be spent on the underground over the next three years. There will be two new lines. The docklands light railway will be extended and there will be a huge investment in the existing network to increase its capacity by about 20 per cent.

Both national and local roads will have increased

programmes--national roads of £6 billion and local roads

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of £2.4 billion. We watched with interest the manoeuvrings of the Labour party. The hon. Member for Dagenham (Mr. Gould) began by saying that he would abandon the programme. He then said that it would be reviewed. The hon. Member for Kingston upon Hull, East then intervened. The Leader of the Opposition has made a sensible decision--he has put the hon. Member for Dewsbury (Mrs. Taylor) in charge of knocking their heads together and trying to get them both to talk sense.

It being half-past Two o'clock, the debate stood adjourned. Debate to be resumed on Monday 12 November.

LOCAL GOVERNMENT FINANCE

Ordered,

That the provisions of paragraph (2) of Standing Order No. 84 (Constitution of standing committees), paragraph (1) of Standing Order No. 86 (Nomination of standing committees) and Standing Order No. 101 (Standing Committees on Statutory Instruments, &c.) shall apply to the draft Code of Audit Practice for England and Wales as if it were a draft statutory instrument ; and that the said draft Code be referred to a Standing Committee on Statutory Instruments, &c.-- [Mr. Wood.]

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St. Christopher's Hospice, Sydenham

Motion made, and Question proposed , That this House do now adjourn.-- [Mr. Wood.]

2.30 pm

Sir Philip Goodhart (Beckenham) : At the beginning of each parliamentary Session, it is customary for the two hon. Members who have been chosen to open the debate on the Address to describe their constituencies in some detail. In a similar position, I should have referred to the benefits that have flowed to the sick from two establishments in my constituency--the Wellcome research laboratory and St. Christopher's hospice. The research workers at the Wellcome laboratory have a remarkable record for producing drugs that combat disease and suffering, while St. Christopher's hospice has become an inspiration and an example to the rapidly growing hospice movement, both in this country and overseas.

I am especially grateful that, so early in the Session, I have been given the opportunity to discuss once again the financial problems facing St. Christopher's, a hospice in which I know that you, Mr. Speaker, take a great interest. For the first 23 years of its life, the driving force behind St. Christopher's has been Dame Cecily Saunders, the only saint I know who was educated at Roedean. For those 23 years, it has been her energy, humour and faith that has inspired St. Christopher's. Like Florence Nightingale, she holds the Order of Merit ; and like Florence Nightingale, I expect that her reputation will survive for generations.

When I first raised the subject of St. Christopher's in June 1988, the hospice faced a financial crisis following the last major increase in nurses' pay. Those problems have not gone away ; in fact, they have grown. However, I am happy to say that the hospice movement as a whole has grown.

I shall put the matter in perspective. In June 1988, there were 124 hospices in the United Kingdom, with 2,000 beds ; by June 1990, there were 145 hospices, with 2,600 beds. They are supported by 277 home care teams and 115 day care units. More than 30 further projects are planned. The National Health Service provides, on average, rather more than one third of the funding. Of course, the demand for hospice care for terminally ill patients is growing rapidly. In St. Christopher's, the work load has grown by 10 per cent. during the past year.

Even greater than the growth of in-patient care has been the demand for home care. In 1986, St. Christopher's looked after 50 patients in their own homes at any one time. In October 1990, the number receiving home care exceeded 100 for the first time, and in January 1991, the hospice will expand its work in south Croydon, bringing a further increase of 25 per cent. in home care work.

The hospice also hopes to open a new day centre by Christmas, which will look after between 15 and 20 patients each day, not only providing essential therapy but giving families at home a much-needed break and an opportunity to recharge their batteries.

Ten years ago, in 1980, St. Christopher's received 50 per cent. support from the National Health Service and needed to raise £250,000 in donations to break even. In 1990, even after the hospice received its share of the extra £8 million for hospices announced by my hon. Friend the Minister for Health on 15 December 1989, National Health Service support will meet only 38 per cent. of St.

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Christopher's expenditure, and donations of £2.5 million are needed. St. Christopher's is by far our largest local

charity--virtually every club, pub and organisation in the community raises funds for it--but the cost of the services provided by St. Christopher's next year will push expenditure close to £5 million. Looking at hospices other than St. Christopher's, I note that, even with the extra £8 million announced by my hon. Friend the Minister, it seems inevitable that there will be some bed closures and cut in services unless the Government provide further funding. St. Oswald's in Newcastle, St. Michael's in Hastings, and Butterwick hospice in Cleveland face particular problems, while Michael Sobell house in Oxford, in which I also have a personal interest, has closed four beds, with further cuts threatened.

With the introduction of health service reforms, hospices will be required to negotiate contracts with individual authorities. St. Christopher's is notably well administered, but that new arrangement is bound to increase its administrative problems, as it will have to agree contracts with no fewer than 10 separate district health authorities.

In the debate on 23 June 1988, I called for 50 per cent. support from the National Health Service for St. Christopher's and all hospices. I was delighted when, on 7 October 1989, my hon. Friend the Minister with responsibility for health matters in Scotland announced that that would happen in Scotland, and that the Government would match pound for pound public support for Scotland's 13 hospices. He said :

"Hospices are a splendid example of partnership in health care. The movement is well-established and has been recognised for many years as providing an integral part of the care for cancer patients. I cannot stress strongly enough the importance I attach to supporting hospices and ensuring that they are equipped to face the challenges of the future, confident in the belief that they will be able to maintain and further improve upon the already high standards of patient care that they offer.

We must acknowledge the expertise that hospices have in the care of the terminally ill and assist the hospice movement to improve and develop its services and encourage the growth of locally based services.

Therefore, I intend making funding available to match, pound for pound the support given by the public. This will result in a substantial increase in the amount of public funding provided to hospices.

Working for patients is the watchword. The terminally ill and their families deserve as much care and support as we can possibly give them. The hospice movement has proved its worth, and in this very worthy area of service, and I am very pleased to be able to share in carrying their burden."

That was a splendid announcement. In implementing this 50:50 funding scheme, there have been some problems, as one would expect, but in the seven months that the scheme has been in operation, I note that individual donations have increased. As one might expect, the reality of the Government doubling gifts has encouraged benefactors. I was also encouraged by the Minister of Health's statement on 15 December last year, when she said :

"The Government's objective is to work towards a position in which the contribution from public funds available to voluntary hospices and similar organisations matches that of voluntary giving. This will provide a clear basis on which to plan ahead."--[ Official Report, 15 December 1989 ; Vol. 163, c. 847. ]

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Yesterday, the Chancellor of the Exchequer was able to announce another massive increase in funding for the national health service. As the Secretary of State for Health said yesterday :

"Next year the NHS in the United Kingdom will get the biggest ever year on year increase in resources. The service will have £3.2 billion more to spend than this year. This is an increase of 11.6 per cent. or 5.3 per cent. after allowing for inflation."

Fifty : fifty funding for hospices in the United Kingdom will cost approximately £15 million. Yesterday afternoon we were talking of sums in excess of £3 billion. I hope that today, or in the near future, the Minister will be able to come to the Dispatch Box and say that he can take extra steps towards 50 : 50 funding, which we are all agreed is a sensible objective.

2.43 pm

The Parliamentary Under-Secretary of State for Health (Mr. Stephen Dorrell) : I congratulate my hon. Friend the Member for Beckenham (Sir P. Goodhart) on the fact that, for the third time in four years, he has drawn the attention of the House to the history of St. Christopher's hospice in his constituency and to the fact that it is a shining example that not only should be, but has been, followed on many occasions and by many people who are interested in the subject in different parts of the country and of the world.

My hon. Friend may remember that on both previous occasions he had the good fortune to start his debate before the time for the introduction of such business and therefore got more than his half hour. On this occasion he was limited to 15 minutes, but used his share of time with the grace and skill of an accomplished and experienced parliamentarian.

In his introductory remarks my hon. Friend drew attention to your own interest in this subject, Mr. Speaker. It was also drawn to my attention by my Department, and if my hon. Friend had looked behind him, he could have drawn attention to the interest of my hon. Friend the Member for Chislehurst (Mr. Sims) ; he and I were able to discuss the matter briefly before the debate.

I echo the tributes paid--not only by my hon. Friend the Member for Beckenham, but by my two predecessors who answered the two earlier debates- -to St. Christopher's and all that has been done there since its establishment. As my hon. Friend said, the enormous progress that has been made in the development of palliative care is, in a very real sense, attributable to the example of St. Christopher's, and especially to the guiding light of that institution, Dame Cicely Saunders. Her work there, and the institution that she established, have come to represent an international beacon of excellence in palliative care. The lessons learnt there have been widely applied, both in the voluntary hospice movement and in wider thinking about palliative terminal care in our own health service and in other health care systems around the world.

Dame Cicely's efforts, and those of the dedicated staff who have worked at St. Christopher's since its establishment, have brought a sense of peace and well-being to thousands of dying people, and--perhaps equaly important- -to their relatives and friends. They have established new standards of excellence in palliative care. Her work has been founded on the principle that, although a doctor may tell a patient, with rational and

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clinical detachment, "I am sorry, there is no more that I can do for you", that should not be the end of health care and the caring professions. People who are concerned for the well-being of patients and their families want to ensure that dying people--and their relatives and friends--have the best possible support and quality of life.

One of the major benefits of this concept has been a much greater openness in the discussion of death, and of the conditions and support that can be provided to people as they approach it. The support that we give can reduce the natural dread of dying that we all feel, and encourage us to think less about dying from cancer and more about finding a way of living with it in the days that are left to us.

Since the launch of St. Christopher's in 1967, the hospice movement has mushroomed nationally and internationally. The lessons not merely learnt but demonstrated at St. Christopher's have been applied in similar institutions elsewhere in the world. It is an enormous tribute to those who have been involved in that endeavour from the beginning that their ideas are now so widely applied--and, indeed, regarded as the norm in the care of terminally ill patients. Having demonstrated the Government's recognition of the importance of the work done at St. Christopher's, I should like to trace the history of the Government's thinking about the development of terminal care. Since 1980, as we can show, official thinking has developed- -perhaps not as fast as Dame Cicely Saunders's might have, but we have progressed in our own pedestrian and official way. In 1980, one of my predecessors set up a working group under Professor Eric Wilkes to examine this subject and to report on the development of care of the terminally ill.

The working group's report stated :

"Terminal care is not a matter of new buildings or expensive equipment. It depends primarily on enlightened professional attitudes. Our objective now should be to ensure that every dying patient has access to professional staff who can provide the appropriate care."

The working group's recommendation was this :

"The way forward is to encourage the dissemination of the principles of terminal care throughout the health service and to develop an integrated system of care with emphasis on co-ordination between the primary care sector, the hospital sector and the hospice movement."

That was the basis on which we began to develop our official thinking.

As a consequence of the report, the Department convened a conference in December 1985 which was opened by His Royal Highness the Prince of Wales. My right hon. and learned Friend the Member for Rushcliffe (Mr. Clarke), who until a week ago was my boss in the Department of Health, delivered a speech in which he said : "I would like to see every health authority drawing up comprehensive plans for providing services for those facing death. This means looking carefully at the range and type of specialist care which is needed in their district and, where possible, working with local and national voluntary groups to provide the necessary services."

It was the first time that a Minister made explicit the Government's wish that the NHS should work with the voluntary sector and apply the lessons learnt by the hospice movement.

Thinking has moved on further since then. In January 1987, the National Association of Health Authorities in England and Wales published a guide that it distributed to its members on the practice of care for the dying. In

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February 1987, the Department of Health issued a circular that set out the Department's official thinking on terminal care. It contained the important statement, for the first time, that

"where a voluntary group provides a service that represents an essential element in a health authority's overall plans for terminal care, the health authority should agree with them a contribution to the costs of that service."

By 1987, therefore, official thinking had moved to the point where it wanted to apply the lessons learnt from the hospice movement. Moreover, the Department's official policy, set out in that circular to health authorities, was that where NHS patients ended their days in a hospice the NHS should make a contribution towards the cost of hospice care. That was a clear policy statement by the Department. Our thinking has developed even further. In December 1989, my hon. Friend the Minister for Health announced for the first time a special grant of NHS funds to health authorities specifically to support care in hospices. My hon. Friend the Member for Beckenham referred to the £8 million grant that was announced on that occasion. It represented the first explicit direction of central Government funds to hospice care and reflected the Government's view that it was important to make further progress towards reaching the objective that has been set out in the press release that was quoted by my hon. Friend the Member for Beckenham : to ensure that official funds matched the funds flowing into the hospice movement from the voluntary sector. The sum of £8 million was made available because we recognised that we must make progress towards achieving that objective. It represented significant progress towards ensuring that official funds matched those raised by the voluntary sector from non-public resources.

Progress has been made in the development of official thinking, from regarding the hospice movement as an inspired voluntary movement somewhat separate from the health service to it being an important part of the health care package on which the health service has come to rely and which therefore, quite properly, expects a contribution from the health service.

My hon. Friend the Member for Beckenham recognised that and quoted extensively from the utterances of my hon. Friend the Minister of State, Scottish Office, who has blazed a trail towards achieving the objective of official funds matching those raised by the private sector. I hope that my hon. Friend will not misunderstand me when I say that it is an attractive characteristic of the Scots that they regularly pioneer new ideas and approaches. My hon. Friend the Member for Stirling (Mr. Forsyth) will particularly appreciate it when I say that the Scots, from Adam Smith onwards, have had a particularly pioneering approach to the development of new ideas.

We share the Scottish Office's commitment to matching the funds raised from the voluntary sector, but we must recognise that in the competition for resources within the health service in England, the pace that we have been able to set in achieving the objective has been somewhat less ambitious than the pace that the Scots have been able to achieve.

I congratulate my hon. Friend the Member for Beckenham on his impeccable sense of timing. This is only the second Adjournment debate since my right hon. Friend the Chancellor announced the increases in public expenditure for the financial year 1991-92. I congratulate

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my hon. Friend on making the first bid for the hospice movement in the internal redistribution process within the health service. We shall consider seriously what he has said and shall consider ways, if not in 1991-92, in future years, of delivering for the hospice movement the objective of ensuring sufficient official funds to match the funds raised by the voluntary sector.

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I cannot give a commitment that we shall achieve that in 1991-92, but I assure my hon. Friend that his bid is the first in the hat and that it will be seriously considered. If we do not achieve it in the financial year 1991-92, the commitment still stands and we shall continue to seek ways of achieving the objective that we share with him.

Question put and agreed to.

Adjourned accordingly at three minutes to Three o'clock.

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