House of Commons Hansard Debates for 23 May 1991

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Franco-British Relations

12.30 pm

Sir Anthony Meyer (Clwyd, North-West) : I must declare an interest as I am the chairman of the Franco-British parliamentary relations committee and deputy chairman of the British section of the Franco-British Council. I have never made and am unlikely to make a penny in profit out of those activities.

It is difficult to speak of Anglo-French relations without lapsing into well-meaning platitudes. I am pleased that so many people in Britain derive an agreeable impression of France from programmes like " 'Allo, 'Allo" and from the elegant jottings of Mr. Peter Mayall and the accounts of his life in Provence. I share his passion for that delectable region.

However, there is another France which is more a matter for our discourse. It is a France that has long since outstripped our living standards. It is the France of Peugeot Talbot, of the Compagnie Generale des Eaux, the Ecole Nationale d'Administration, and the great public works which ensure that all regions of France will have swift access by road and rail to the Channel tunnel without necessarily having to pass through Paris from the day that the tunnel is opened.

That other France is the country which has made up for its lack of natural energy resources by the most ambitious and successful nuclear energy programme in the world. It is a country which now has for the first time a woman as its head of Government, the formidable Madam Edith Cresson, who was well known in her previous ministerial capacity to several present and former Cabinet Ministers. She was well liked, but also somewhat awesomely respected.

It is that vibrant and sometimes over-thrustful France which is now one of our main partners in the European Community. The 600 years of enmity to the beginning of this century and the close alliance in two wars during the century are no longer what concern us now. We are now concerned with the future. Nor should we concern ourselves too much with purely bilateral Anglo-French relations as such.

I served for five years in the British embassy in Paris in the 1950s. I was lucky enough to serve under two great ambassadors. Oliver Harvey taught me to distinguish between the pays-le gale and the pays-re el and Gladwyn Jebb taught me to recognise and to urge the opportunities for Britain to get alongside France in the building of a united Europe. However, three of my five years had elapsed before I discovered that there was an official sitting somewhere in the depths of the Quay d'Orsay who dealt with Great Britain. He subsequently turned out to be the French Foreign Minister and then ambassador to the United Kingdom.

What really matters now is how our two countries work together or fail to do so in the European Community in the maintenance of world security and in promoting the development of poorer countries in the third world.

There are certain things which I and those who care about good relations between our two countries would like to see done to improve those relations further. The Franco-British Council, the body set up by the late President Pompidou and my right hon. Friend the Member for Old Bexley and Sidcup (Mr. Heath), set out to promote closer co-operation in matters outside the

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direct competence of Government. It is duly grateful to the Government for their generous moral support and the only slightly less generous financial support for the council's work. However, the fact remains that the support given by both the French and the British Governments for those activities pales into near invisibility beside the huge resources which have been poured into Franco-German co-operation since the understanding between General de Gaulle and President Adenauer and which provides for a massive programme of exchanges between young people and of language teaching.

Despite that huge governmental effort to develop Franco-German relations, there is a still larger latent support both in this country and in most parts of France for Anglo-French exchanges and for the learning of our two very dissimilar languages. It is quite right that industry on both sides of the channel, in particular firms that trade extensively in our two countries, should make the major contribution to exchanges from which it derives direct and tangible benefit. Those programmes of exchanges--I can vouch from the happy experience of my own constituency when such exchanges resulted in the twinning of Colwyn with Roissy en Brie--need priming by a judicious injection of funds at the right time and at the right level by Governments.

As I have said, direct Anglo-French relations are a less profitable matter to study than the role that our two countries play in partnership or in rivalry on the European or world stages. The recent Gulf crisis demonstrated that, despite some differences in assessment in the early stages--differences which, I am sorry to say, were deliberately magnified and distorted by a few in this House and by all too many in the popular press who imagine that they can win cheap popularity by jibes at the French --our two countries are clearly designated as the two leaders. I go so far as to say that they are the only two significant principals in any European activity outside the NATO area. It would be seemly for the British media to acknowledge rather more readily than they do the quite exceptional role that French relief agencies, notably Me decins sans Frontie res, are playing in that and similar emergencies.

The mention of NATO reminds me that one of the biggest obstacles to closer defence co-operation between Britain and France--the only two nuclear powers in Europe--namely, French non-participation in the NATO command structure, is beginning at long last to show some slight signs of weakening in practice if not yet in theory. Difficulties between our two countries-- sometimes painful difficulties--will continue. The agricultural policy of the European Community has long been and will continue for some years yet to be a fruitful source of quarrel.

Even though the protection of her domestic agriculture has ceased to be the all-dominating political issue in the now highly industrialised France, folk memories die hard. French public opinion did not reprove as sharply as it should have the actions of impoverished and enraged sheep farmers from the stony soil of the south-west who so brutally set fire to a lorryload of live sheep from the overstocked grassy hills of the Welsh countryside.

Clearly, the common agricultural policy will remain for some time yet a source of potential difficulty rather than opportunity for closer co- operation between our two countries. I very much hope that our Minister of Agriculture, Fisheries and Food will not rest content with that state of affairs or curry favour in this House or

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elsewhere by playing up those differences. We need, can get, and to a large extent are getting the close co-operation of the French in the rapid and fundamental evolution of the European Community which is taking place.

Mr. Hugh Dykes (Harrow, East) : I pay tribute to the excellent work that my hon. Friend has done to foster Anglo-French relations. Does he agree that, in development of European political union and European monetary union negotiations, it is striking and interesting to note that the other great ancient nation, France, with its long history, does not appear to fear any loss of sovereignty, as some of our colleagues in the House and perhaps outside do? Those who fear it are a minority. The French believe that, by pursuing further integration in the Community, they will increase their real, practical sovereignty and retain all their powers of decision making.

Sir Anthony Meyer : My hon. Friend's comment prompts two observations. First, the French are realistic about these matters. They clearly understand that the trappings of sovereignty are relatively unimportant and that what matters is the extent to which a country can exercise real influence in the world. Therefore, the French are prepared to accept limitations which may not be far reaching in order to secure more effective co-operation within the European Community.

Secondly, it is welcome that the British Government have recovered and are reasserting freedom of manoeuvre on integration and are prepared, in order to secure vital British objectives, to pay lip service if necessary to ideals which are strongly held on the other side of the channel but which do not excite such support and enthusiasm here. Such ideals matter dearly to our continental partners. My hon. Friend the Member for Harrow, East (Mr. Dykes) and I have been struck by the way in which the Government are exerting that freedom of action.

There is a great deal of common ground between the British and the French about the structure of the European Community. We should build on that common ground. We are the two nations with the longest natural national histories and the most clearly defined identities. We are the only two nuclear powers in the Community. We are the only two permanent members of the Security Council. We are the two nations which have retained from our previous empires a continuing and well-informed interest in developments in every part of the globe. We two are as well-placed as any nation to strike the right balance between pursuing closer integration in Europe while holding open the door to the newly-free countries of eastern Europe.

France, alone in the EC, straddles the divide between the northern and southern halves of the European Community. Clearly it has a vital role to play in the immediate enlargement of the Community to include the European Free Trade Association countries. So vital is it to ensure that we maximise co-operation between France and Britain at this critical moment that on both sides of the channel we should bite off our tongues before giving vent to petty irritations. It is a stroke of good fortune that at this moment the two countries are represented by two diplomats--Sir Ewen Fergusson in Paris and M. Bernard Dorin in London--for whom better understanding between our two countries is a veritable passion.

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I also derive considerable comfort from the presence at the Dispatch Box of the Minister of State, Foreign and Commonwealth Office, my hon. Friend the Member for Watford (Mr. Garel- Jones), who will reply to the debate.

12.42 pm

The Minister of State, Foreign and Commonwealth Office (Mr. Tristan Garel-Jones) : A considerable time has passed since the House last discussed the important subject of Anglo-French relations, although there was a debate in another place on 18 June last year which coincided with the 50th anniversary of General de Gaulle's historic call to arms from Carlton gardens. I welcome this opportunity to take stock on the anniversary of the defence of Calais in 1940. I am especially pleased, and it is appropriate, that the debate was introduced by my hon. Friend the Member for Clwyd, North-West (Sir A. Meyer), who told us something about the history of his connection with France. Of course, he omitted to tell us that he served with distinction in the second world war and was wounded in northern France. He has spent the whole of his parliamentary career fostering Anglo- French relations through the Franco-British parliamentary group.

It often passes unobserved how many hon. Members on both sides of the House devote a considerable amount of their time and energies to fostering relations between Britain and various parts of the world in which they happen to take an interest, for either constituency or personal reasons. My hon. Friend the Member for Clwyd, North-West is a particularly fine example.

Anglo-French relations have gone from strength to strength in recent years. We have powerful shared interests as members of the United Nations Security Council, as nuclear powers and as members of all the multilateral institutions which affect our interests. There is hardly any subject on which Britain and France do not now consult closely at all levels. The annual summit has developed into a forum for in-depth discussion of issues of real importance, including our mutual defence interests. This year's summit in France will see a continuation of that trend : substance rather than form, the best characteristic of Britain's relationship with France in the 1990s. There are countless other contacts. My right hon. Friend the Prime Minister has had two warm and productive meetings with President Mitterrand since last November, and my right hon. Friend the Foreign Secretary sees his French counterpart almost as often as his own Cabinet colleagues. There are also many other long-standing historical links, such as those between veterans' associations, and cultural links, such as town twinning and youth exchanges. My hon. Friend referred to the town twinning that involves his constituency and he will be pleased to hear that my constituency, Watford, has an extremely successful town-twinning arrangement with Nanterre, which is just outside Paris. I agree with my hon. Friend that we must do everything that we can to build on these programmes and especially those that enable our young people to move freely between the two countries.

There are also extensive business links. A much more recent development, and one which we welcome, is the secondment of British and French diplomats to their sister ministries across the channel. I hope that the young diplomats who take part in the scheme do not have to wait for as long as my hon. Friend, when he was in Paris, to find

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a diplomat who looks after the interests of both Britain and France in the Quai d'Orsay and in our own Foreign Office.

The best-known non-governmental body that is active in the promotion of Anglo-French relations is the Franco-British Council. My hon. Friend is the deputy chairman of the British section. He is an active participant in the council's activities, which have made a significant contribution to Franco- British understanding since its inception in 1972. The Government support the council financially, with a grant of £74,500 in this financial year.

The council has an important role in bringing people together, in breaking down barriers and reducing stereotypes. A meeting last month to analyse the ways in which the British and French media have handled recent events was a good example of that useful activity. My hon. Friend left us in no doubt about the importance of the work carried out in that area. I sometimes think--I dare say that my hon. Friend may agree--that some people who live abroad take certain sections of the British press rather more seriously than we do. Nevertheless, problems can be created for us all.

It is more important than ever that Britain and France should understand each other and work closely together. I am confident that the Franco- British Council will continue its good work to this end which the Government support as a valuable complement to governmental activities.

As permanent members of the United Nations Security Council, Britain and France have a role in all major international and regional issues. Both countries contribute in full measure to the deliberations of the Security Council and played a central part in the unprecedented agreement in the international community on the steps needed to reverse Saddam Hussein's aggression against Kuwait. We both sent a swift and sizeable military contingent to the multinational coalition which was forced to carry out the task. We are again working closely each day to alleviate the suffering of the Kurds and others who have fled the savage repression in Iraq. Franco- British co-operation over the crisis has been exemplary. During the difficult weeks of the recent past I spoke on several occasions to my French counterparts, including the Minister with responsibility for overseas development, who was a founder of Me decins sans Frontie res. I think that we could claim that with the co-operation between France and Britain we led Europe and perhaps influenced the world in dealing with those matters.

A few more examples should suffice to demonstrate the breadth of Anglo- French relations nowadays. Britain and France both contributed substantially to the Paris charter for a new Europe adopted at the CSCE summit in Paris last November, which set the seal on the more co-operative international environment that has taken the place of the cold war. The newly inaugurated European Bank for Reconstruction and Development, with its London site and French president, is a further symbol of the close co- operation between our two countries. Britain and France both gladly gave up their rights and responsibilities as wartime allies following Germany's unification last year. We are both proud of our contribution to that historic event, which for both of us has cemented our partnership with Germany. The completion of the service tunnel across the channel and,

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yesterday, the first rail tunnel, gave Britain and France a physical link again, for the first time since the ice age. I look forward to the opening of the tunnel on 15 June 1993.

Trade relations between our two countries have shown a remarkable increase in recent years. Britain and France are each other's third-largest export market. Britain's exports to France reached £10.9 billion in 1990, an increase of 15 per cent. over the previous year. French exports to Britain have seen similar increases and the upward trend is continuing. Investment flows in both directions have increased noticeably. France is now by far the most important European investor in the British economy.

Defence and security, as my hon. Friend pointed out, are an important part of the relationship. Our positions, as the only European nuclear powers, and as permanent members of the United Nations Security Council, give us a special range of shared interests and responsibilities, in addition to those that we jointly exercise as members of NATO and the Western European Union. We both have global interests and a global outlook and we both maintain a broad spectrum of military capabilities. Our presence together in the Gulf as the major European ground forces co-operating with the United States symbolised how much common ground we share.

Britain and France co-operate at all levels and over a wide range of defence matters. The Government attach great importance to that close collaboration. We worked closely together in the conventional forces in Europe negotiations and share a similar approach to future conventional arms control.

In the nuclear field as well there is regular dialogue across a broad range of issues. We agree with France about the need for a more effective European contribution to our collective defence arrangements. Under the active French presidency of the WEU, which ends next month, we have made progress together in developing some ideas for a stronger European defence identity based on the WEU. Of course, we do not agree on everything. The United Kingdom and France have different attitudes to integration in NATO, although we hope that one outcome of the NATO review will be fuller participation by all the allies in the defence commitment to the alliance. However, we differ on the longer-term arrangements for European defence. We have urged that the debate in the inter-governmental conference on a common foreign and security policy should focus on substance, rather than mechanisms, but we and the French are at one in considering that the outcome of the various debates in progress this year should be both a reformed alliance and a stronger European pillar.

The Anglo-French summit in May 1990 agreed that there should be "an enhanced programme of co-operation with particular emphasis on future security arrangements in Europe".

The Prime Minister and President Mitterrand pursued this further when they met in January this year. I am confident that that range of issues will again be on their agenda at this year's summit. We also keep in close touch with the French Government, as with other EC Governments, on progress in the two inter-governmental conferences, to which my hon. Friend referred.

On political union, we share a good deal of common ground. We both, for instance, are very wary of ceding control to the Community, and hence to the Commission,

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in areas where we feel it more appropriate for national Governments to operate, either alone or in co-operation with each other. We agree on the overall structure--the architecture--of the "union" that is now under discussion in the inter-governmental conferences. That is, we both see the "union" as something different from, but including, the Community. We are both keen to improve the efficiency and effectiveness of the Community within that broader European "union". There is also considerable common ground with the French Government in the inter- governmental conference on economic and monetary union. We are both agreed on the need to strengthen the ecu during the EMU process and on the need to establish some Community monetary institution with real tasks to perform in stage II. We also share the view that any European central bank should operate under political guidelines set by the Council. Even the United Kingdom reserve on participation in stage III--the single currency union-- is now accepted by partners, including France. Of course, there is still a great deal to negotiate, but both we and France are working to overcome our differences.

I feel, as I hope that my hon. Friends and other hon. Members feel, that there is a move in Europe, not just from Britain but towards Britain, to accommodate each other and to find common ground rather than emphasising and exacerbating differences. I hope that the British Government have played their part in bringing that about. I know that the French Government have also played a part.

We do not agree on everything, even under the broad heads of agreement. France, like the United Kingdom, is determined to protect her own national interests within the context of closer European co-operation. That is well understood and I am sure that when we are obliged to take a different line in the inter-governmental conference, for instance on questions of European social policy or the timing and content of economic monetary union stage II,

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differences of view and the reasons for them are well understood by both sides, because of the closer co-operation that we enjoy. We will continue to work constructively in the inter- governmental conference with the French and others for a satisfactory outcome acceptable to all.

We shall work for an outcome that enables the Community to take the necessary steps forward within the union. Those steps are necessary because the success that the Community has acheived through the single market, which the United Kingdom played such a prominent role in bringing about, has made the Community an important trading and economic bloc. Whatever our approach to it--our approach places an emphases on inter-governmental co- operation--we know that an economic bloc of such consequence must develop commensurate political and defence personalities. That is why my right hon. Friend has made proposals for an enhanced common security policy. That is why Britain and France are playing a leading role in discussing how the Western European Union, outside the union itself, can develop a European defence personality that will enable western Europe to defend its economic and strategic interests outside the NATO area.

Relations with France and Germany are at the heart of our European policy. As we move through the inter-governmental conference, the stakes are high but the prize, in terms of the future security, stability and prosperity of our continent, is also high. Productive relations with France and Germany are an important means to that end. Let no one be in any doubt that it is not only desirable but feasible to have good relations with both simultaneously. The vigorous pursuit of British interests does not require us to be permanently at odds with one or other of our partners. I am confident that, with Britain and France working together, we shall succeed in sustaining the objectives that I share with my hon. Friend the Member for Clwyd, North-West, with others of my hon. Friends and, I should like to think, with Opposition Members.

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Health and Social Services (Eastbourne)

12.59 pm

Mr. David Bellotti (Eastbourne) : I thank those who have enabled me to speak this morning. I thank also the Minister for the time that she is to give to responding to the debate.

As a Sussex Member of Parliament, and as a keen supporter of Brighton and Hove Albion, may I take one moment to express my good wishes to the team on its success last night in reaching the final of the play-offs. The team will appear at Wembley in June. I wish the management and the players well on that occasion.

This is a very serious debate. When one looks at the figures of those who are waiting for national health service operations in the Eastbourne area, one can only be very surprised indeed. Last September we had 3,938 people on the hospital waiting list, over 1, 000 of whom had been waiting for over a year. The position during the last six months--the most recent figures of all are those to March 1991--shows little or no improvement on those figures. Although the Government have encouraged health authorities, in Eastbourne in particular, to reduce the number of people who have been waiting for more than two years, that has been at the cost of those who have been waiting for up to two years. Today we still have 3,900 people on our hospital waiting list.

Perhaps even worse is the position of the notional time that it would take to clear that number of people. If there were no new people requiring hospital surgery and therefore hospital admission, it would take one year and 14 weeks for that number of people to be treated. Of the 191 district health authorities, Eastbourne is the fifteenth worst. We are in the bottom 8 per cent. for performance and for high waiting lists. I understand that the position in the south-east Thames area is the worst in the country. It has six of the worst 16 district health authorities out of the total of 191. We have also suffered a massive loss of beds. Since 1983 there has been a 36.2 per cent. reduction in the number of beds available in the Eastbourne health authority. That has to be set against a south-east Thames average reduction of 30 per cent. and an all-England average of 21.2 per cent. We have lost a much larger number of beds than other district health authorities. During the October by-election that saw my election to this House, the Conservative candidate tried to claim--and did claim in writing- -that we had 200 beds at St. Mary's hospital which, when visited, he could see had been demolished.

Since that occasion in October I have had referred to me a fairly large number of cases, to a few of which I wish to refer. I shall make the full details available to the Minister, but I am sure that she will understand if I refer to them as cases. The first case is Mr. A. Mr. A had been waiting to go into our district general hospital for major surgery for an aneurysm of the aorta--quite a dangerous condition that requires intensive care. Twice he was given a date for admission and twice it was cancelled. One can imagine the stress. On the third occasion he was admitted. He was prepared for surgery but he then had to be sent home, after preparation for surgery, because another emergency required the bed space. One can also imagine the stress on that occasion. The pressure on bed space in the district general hospital is just one of the problems that we face.

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The outpatient services, though, fare little better. There have been considerable cuts in joint funding, available with local authorities. The example that I want to give is that of Master Craig. He is a Down's syndrome child. The county has recognised that he has special speech therapy needs, but unfortunately that therapy has had to cease. He was obtaining 30 minutes of therapy each month--itself thought to be inadequate, but at least a help--but that has now been terminated. A letter from the district speech therapy manager of the district's community health services says that speech therapy will no longer be available in this case

"until our funding and staffing levels are increased."

A similar letter from the same speech therapy manager sent to all schools showed that speech therapists would no longer be available to visit schools to assess children. In other words, they would have to be known to have a need or be referred to a clinic by someone else, but it is not clear who.

On a further case I am pleased to say that my late predecessor obtained success during his time as Member of Parliament for Eastbourne. In March 1989 Master W experienced a problem obtaining a replacement for a national health service bone conductor hearing aid. After some months his mother went to the late Ian Gow who managed to secure that replacement by July 1989. At the time, a promise was given that a spare bone conductor hearing aid would be kept at Brighton or Eastbourne. In October 1990 the hearing aid went wrong again and Master W went to Princess Alice hospital in Eastbourne and was told that a replacement would be obtained as soon as possible. There were many telephone calls and many visits and, eventually, early this year, they visited me. By 3 February, some four months after the need arose, Master W received the bone conductor hearing aid that he needed. His mother commented that it came in a very nice case which will never be used and which was a waste of NHS funds. The answer to those problems and many others that I could have listed is that we need more resources. We need to reduce waiting lists, increase beds and provide a better out-patient service. The response that we are being offered to those problems is an application for trust status. A year ago the majority of consultants, doctors, nurses and other professionals concerned said that they did not want trust status, so the health authority put the application back in the drawer. It has now been brought out again. The health authority consists of a group of unelected people with no mandate. It is claiming that it could increase staff and decrease waiting lists. However, the Minister and I know, because we read and check our facts, that that has not been happening in other parts of the country. We know of the cuts in staffing at Bradford and Guys and we know of the budget-holding general practitioners in Watford who seem to be able to demand a better service than GPs who do not have budget-holding status. Only yesterday I saw in the newspaper that a lady wrote that in her area of Oldham the waiting time for an appointment has increased from two weeks to three months.

The people of Eastbourne want to know whether the future will be better than the present. They want answers to various questions. For example, will trust status enable unelected people with no mandate to sell buildings? Could one of our hospitals be sold and work concentrated on another? Could unlimited private work be accepted? I met the chairman of the group making the trust application

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and he told me that he thought that it could take in extra laundry from Eastbourne to make a profit. Should that be happening, and will it be possible as it would would divert people from their proper tasks? Will those unelected people be able to hire and fire staff without reference to elected bodies or to Government? Will they be able to take people from abroad who can pay more rather than the people in Eastbourne who have great need?

Those questions are in the minds of my constituents now. I have asked the chair of the group making the trust applications whether he will hold a community referendum. He said no. Therefore, I intend to hold such a referendum. I shall be circulating to every household in my constituency the details of the proposals and inviting them to say whether they support them. I shall do that in June so that the results can be made available to the Minister when the application is considered in mid-August. Does the Minister believe that she should abide by the result of the referendum, so that the people of Eastbourne can have a major say in the provision of health services? The service is far too big to be made a political football ; we should listen to local people.

I want to deal now with related health matters, some of which come under the social services department. There are more people over 75 in east Sussex than in any other social service provider in England. Eastbourne has a large proportion of over 75s, and indeed of over 85s. There is a great need for residential care, especially nursing homes. In Eastbourne, the number of private nursing home beds increased from 1,065 in 1984 to 1,411 in 1990. That is a cause for much concern, unless Government grants enable those places to be maintained. Fears were expressed only this week to the Select Committee on Social Security that funds might not be made available to support those people.

There are many mentally handicapped people in Eastbourne, because it is a nice place to live and the quality of life is high. I recently visited an excellently run private home for mentally handicapped people, the Heatherdene. It is concerned about funding for individuals in its care.

Linden Court in Eastbourne is a training centre for mentally handicapped people, but cuts in social security benefit have led to concern about not only residential places but the buying power of people in contributing to that establishment.

A deaf mentally handicapped child has attended Hazel Court school in Eastbourne for the past four years, having moved from Hackney. He is now becoming an adult but wishes to continue with the adult training that is available at Linden Court. The county council has said that Hackney must pay his costs of £200 per week and £35 a week for a taxi. He having lived in east Sussex for four years, one would have thought that the council could meet the bill. His mother described the decision as heartless and uncaring and asked how can we expect Hackney to contribute.

Just before Christmas, I tried to raise with East Sussex county council the saga of a residential home called Milton Court. In late September, county councillors were promised that a report on care in that home would be made on 11 October. In early October, I met a man who had been transferred from a day centre at the residential home to another day centre, having been told that it was

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to close. No report was tabled at the social services meeting on 11 October, but staff had been sent a letter saying that their jobs would cease and asking whether they would transfer elsewhere. There was no matching joint finance from the district health authority for the future intentions for that home.

The county council has much responsibility in this matter. Councillors were not told the truth. They were told that investigations with a local housing association might be brought forward. Unfortunately for the county council, the previous day I had attended a meeting with the housing association, which had told me it had only just received a letter asking whether that might be possible, and of course it was not. The funding from the district health authority was not going to be sufficient to carry out that project. The county councillors were not told what would happen in Milton Court and, in the meantime, the staff were given letters of dismissal. The staff were also told by the director of social services not to speak to councillors. That does not seem the way to plan for care in the community.

There were also proposals earlier this year to close eight residential homes in east Sussex. The number of beds in the county is to decrease from 1,212 to 772, a loss of 440. In the editorial in our local Evening Argus the editor summed up the position well when he said :

"East Sussex has one of the highest percentages of old people in the country and the numbers of those aged 85 plus are rising. The suspicion is that there simply may not be enough homes for those who cannot cope by the mid 1990s."

Into that scenario the county council recently announced the closure of another residential home in Eastbourne, St. Anthony's Court. To save just £138,000 a year the council plans to close an absolutely wonderful home. The home has a friends' organisation to raise money for extras. I recently attended a fun day at which two local primary schools sang and provided entertainment for those who live there. The staff are superb and the buildings are perfect, yet the county council wishes to sell the home.

The pressures on Eastbourne will not decrease because homes in adjacent towns such as Hastings and Peacehaven will also be sold. The reduction of 440 residential care places is to fund an additional 179 day care places. The equation does not add up. Our care in the community strategy, which we want to put in place for 1993, will require more day care and respite care places and the loss of residential care places will scupper that policy.

The management of social services in east Sussex has not been good, but recently it has become chronic. Last year it overspent by £1.6 million without telling any of the councillors. It is closing many homes and has appointed at high level many additional top managers but very few grass- roots social workers. The Minister should investigate the social services department in east Sussex and especially the actions of the chairman of the social services committee, Councillor Pat Wright, and the director, Mr. Nicholas Holbrook. If she does not, the strategy for community care will be scuppered.

There have been no Government funds to plan community care. The threat now faced by local authorities, which will have community care responsibility devolved to them in 1993 and which will also have the possibility--no, the probability--of massive local government reorganisation in 1994, is a recipe for chaos, for

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confusion and for poor standards. Local government needs to know where it is going and it needs to have the resources.

Some essential services will fall between stools. Will the Government give some assurances about authorities, such as East Sussex, that want to plan over a five or 10-year period on "in" and "out" packages ? The promises made today must hold for the future. An example of a service that will fall between stools because the planning is not there for it is the drug misuse service. In Eastbourne, there are three voluntary organisations--the Libra Trust, the Seaside Centre, run by the Young Men's Christian Association, and Open Door. They provide, with grant aid, support for young people who have a drugs problem. Will the trust that is proposed for Eastbourne district general hospital and the community care plan which will come into force for the county council in 1993 take on board the need for grants for those bodies ? I fear that they may not.

Eastbourne has unique challenges. We need answers and action, not ideas which are not welcome and which do not inspire local confidence. The health and well-being of our community is at stake. The people whom I represent need and deserve to know what the Government intend to do to help them.

1.19 pm

The Minister for Health (Mrs. Virginia Bottomley) : I congratulate the hon. Member for Eastbourne (Mr. Bellotti) on seeking this opportunity to discuss the health and welfare needs of his constituency. However, I was disappointed by his biased and lopsided account because, before coming to this debate, I studied the situation in his area. In his discussion of health and welfare, he singularly failed to draw attention to a group that is doing outstandingly well in Eastbourne--the general practitioners. I am pleased to report to the hon. Gentleman that 88 per cent. of his general practitioners reached the higher target--the 90 per cent. target--for child immunisation and that 70 per cent. of them reached the higher target--the 90 per cent. target--for cervical cytology. That is one of many examples.

In East Sussex, there has been a substantial drop in the number of patients whom each GP has to look after. There has been a big increase in the number of practice staff. On the basis of the new GP contract, GPs are clearly providing an excellent service for patients.

I began by mentioning the family practitioner services because they are often the basic building blocks of not only our hospital services but our social services. I was enormously impressed on 12 February when I asked Councillor Pat Wright, the chairman of the social services committee, who seemed to me to have done an excellent job, together with the first-rate director of East Sussex social services, Nicholas Holbrook, and a councillor from Eastbourne borough council to speak to me and to take me through the practical steps that they were already taking to implement care in the community. In many respects, they are ahead of others, especially in their work to co-ordinate their proposals with housing authorities and in integrating their plan with health authorities.

The hon. Gentleman began with the question of waiting lists. It is a fortuitous circumstance that his debate should coincide with today's report by the Select Committee on Health on waiting lists. The hon. Gentleman is one of the

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first to learn that, today, we are able to announce the most dramatic improvement in the number of patients who have been waiting an unacceptable length of time. There has been a 38 per cent. fall in the number waiting over two years and a 19 per cent. fall in the number of patients waiting over a year. The hon. Gentleman and I will both agree that it is unacceptable for patients to wait for such long periods. However, I must make it clear that one patient in two is admitted immediately. The judgment on hospital admission is based on clinical priority. The average for patients who are not admitted immediately is five weeks. The hon. Gentleman is right to identify the need for further progress in his health authority, as in others, on cutting down the number of those waiting.

In Eastbourne health authority, there has been an excellent advance in cutting down. There has been a 61 per cent. decrease in the two-year waiters. We want there to be more progress, and to help this year, as well as the increase of funding for the health authority of over £12 million in one year alone--going from £59 million to over £71 million in 1991-92 to spend on the health care of people in Eastbourne-- there is additional funding from the region of £186,000 which is intended to help especially with the waiting lists for ear, nose and throat treatment, oral surgery, urology and gynaecology, which are important areas of progress and activity.

This year, we are spending about £60 million through the regions. We are making it clear that we must bring down the number of patients who wait for unacceptable periods. Today's excellent news on the progress made over the past year is a heartening first step. The hon. Gentleman fell into the trap, as so many other hon. Members have done, of referring to the number of beds as an indicator of care. That is a naive approach, whether applied to care in the community or to hospitals. Increasing numbers of us can now receive support on a domiciliary basis in the community or day care. Reports from authoritative sources constantly stress the importance of moving towards more day care. I am pleased that the hospitals in the hon. Gentleman's area have been able to increase the number of patients treated- -even at a time when they were rationalising bed use. The hon. Gentleman went on to discuss the concept of the Eastbourne hospitals trust. I have already seen, and am most impressed by, the prospectus that has been produced. Over the next three months, it will be the subject of consultation with the people of Eastbourne because it is important that they should know and understand. The hon. Gentleman talked about the strengths and weaknesses of ballots and referendums. The key point is that these are complex issues on which people need to have an informed and reasoned discussion. Scaremongering and doom and gloom can play no part. When the Secretary of State decides whether to approve the Eastbourne hospitals trust, in his mind will be purely and simply the question whether that is a better way of managing the health service to improve the care of patients--national health service patients. That is the aim, objective and pride of our national health service. The hon. Gentleman asked whether the trust would be free to undertake private work. We have no vendetta against the private sector. Many people wish to spend their resources on private health care. But the aim, objective and commitment of national health service Ministers, the management executive and the national health service trusts is to pioneer, develop and improve the quality of

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national health service work. The hospitals may admit private patients or patients from overseas. We have no objection to that. But our criterion, aim and objective is that it should be done to improve the care of national health service patients.

The hon. Gentleman asked about income generation--whether the trust could use the plant in the hospital to provide laundry services. That is a matter for the trust to consider. But its goal, its mission, its purpose in being, is to provide national health service work. That is the key to the national health service trusts.

The sort of policy objectives that we are considering are already taking off in Eastbourne. I have looked at some of the criteria established in the contracts between the purchaser authority, the commissioner, the Eastbourne health authority and the existing provider units. The criteria state that residents who are mentally handicapped shall be consulted in all aspects of their health or welfare. They state that acute patients must have an individual care plan with specific aims for care and at least a daily comment on their progress. They state that, on discharge, the general practitioners should be informed within one week of the recommendations for the patient. Those are the quality objectives to which we are committed and which our national health service reforms are already achieving.

The hon. Gentleman referred to care in the community. He spoke about resources in relation to drawing up preparations for the care in the community provisions. I urge him to consider the evidence. The increase in the social service spending that we have recognised this year is of the order of 23.5 per cent. That is the largest single increase in social service spending for 15 years.

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The hon. Gentleman referred to specific aspects of care in the community. For the first time, we are to have a drug and alcohol specific grant allowing spending to the order of £2 million for voluntary organisations--precisely the organisations to which the hon. Gentleman referred. What about the new work for the mentally ill? The specific grant, allowing £30 million worth of spending, will result in East Sussex receiving £330,000 towards its work for the mentally ill--a very important group. What about the money specifically for training for community care? This year, we substantially increased the amount that goes towards training those in social services for this important and popular development.

East Sussex has received £220,000 towards training social service staff so that they are properly and effectively prepared for the implementation of this important policy. The authority is working hard to ensure that the needs of the frail and vulnerable--those who are entitled to an effective quality of care in the community--are met. That will take time and detailed planning. Next year's plan, which is subject to consultation, will be a further and important springboard for progress.

The hon. Member for Eastbourne should have no doubt about the commitment and concern of those involved in social services and health care. If the hon. Gentleman is tempted to suggest that his party has reservations about national health service trusts, he should contact Councillor Marian Border. She is a Liberal Democrat councillor and a non-executive member of the Freeman Group of Hospitals NHS trust in Newcastle. We believe that that is a way of using the resources more effectively and powerfully to provide better patient care. It will be subject to consultation and detailed consideration before the final plans are announced in Eastbourne. I have been impressed by and warmly congratulate those people who have pioneered service improvements for the people of Eastbourne.

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Deep-mine Coal Industry (Lothian)

1.30 pm

Mr. Gavin Strang (Edinburgh, East) : The Government have a responsibility to ensure that this country has an energy industry which meets our short-term needs and ensures that in the long run we will not have to depend on imported energy. For those and other reasons, I believe that Energy Ministers should be concerned about Monktonhall colliery in Lothian.

Scotland is an energy-rich country. We have nuclear and hydro-electric power, offshore oil and gas and the coal industry. However, it must be accepted that we will depend on our coal industry long after the oil and gas have run dry. There is therefore an important strategic reason why we should protect the long-term future of our deep-mine coal industry in Scotland--an industry which has been reduced to the single Longannet complex.

We were reminded today of the severity of the balance of payments deficit. At the bottom of the recession, it was announced today that there was a balance of payments deficit in March of more than £300 million. Surely the Government accept that it is only common sense to take decisions intended to reduce our balance of payments deficit in the long term rather than to exacerbate them.

It is worth recalling that, while we are now struggling to break even in our energy balance of payments, as recently as 1985 we had a surplus of more than £6 billion on our energy balance of payments. I hope that that gives some idea of the huge potential of our energy industry and, in particular, our coal industry for the balance of payments if the Government are prepared to accept some responsibility for ensuring that the right decisions are taken.

It is not just those important strategic questions that affect the economy and the coal industry. The decision to reopen Monktonhall colliery is crucial to the Scottish economy. We now have only the Longannet pit, which is operating very efficiently, as no doubt the Minister will confirm later. Output in the Scottish economy fell last year by 9 per cent. Unemployment was high and is now rising significantly. Against that background, and during a recession, there must be a strong case for encouraging a nationalised industry such as British Coal to invest in the Scottish economy. A decision to invest in Monktonhall would give a very important boost to the local economy in Lothian. A boost in investment--although not a huge investment--is required to bring the pit back into production. There would be a boost also in terms of the creation of direct jobs in the mine and also indirect jobs and in terms of the additional local purchasing power that would be generated in the local economy as a result of those jobs. That project is very important for the Lothian economy. The Secretary of State for Scotland himself has acknowledged that the Government have a responsibility and that it stems partly from the concern that any Government should have for the future of the Scottish economy. So that there is no misunderstanding, I shall quote from a letter dated 8 May 1991 from the Secretary of State to the general secretary of the Scottish Trades Union Congress. He stated : "I am well aware of the strength of feeling surrounding the possible redevelopment of these mines, particularly Monktonhall. Indeed, a number of independent proposals to

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