House of Commons Hansard Debates for 14 Jul 1992

Community Care

12. Mr. Kevin Hughes : To ask the Secretary of State for Health if she will make a statement on the preparations of the national health service for its role in the provision of community care services after April 1993.

15. Mrs. Mahon : To ask the Secretary of State for Health if she will make a statement on the preparations the national health service has made for its role in the provision of community care services after April 1993.

Mr. Yeo : The national health service is working closely with local authorities to play its part in ensuring the successful introduction of the "Caring for People" reforms.

Mr. Hughes : Will the Minister tell the House who will pay for the extra community nurses who will be needed to care for the ill and frail elderly people who are being sent out of hospitals too soon by doctors who are under pressure from administrators who want to increase their bed- throughput to achieve the targets required by the Government's new market economy in health care?

Mr. Yeo : As an important plank in our community care reforms, we have made it clear that all health authorities must agree with social services departments robust arrangements for the discharge of patients and that a care plan in respect of each patient who is about to be discharged must be agreed. With regard to resourcing, as we have made clear on many occasions, there will not only be a transfer of resources from the Department of Social Security to increase resources available to local authorities, but continuing increases in the nearly £5 billion of personal social services expenditure available to local authorities every year.

Mrs. Mahon : Will the Minister take time to study the report by the Royal College of Nursing entitled "A Scandal Waiting to Happen"? Will he assure the House that he intends to act on some of that report's recommendations, not least in respect of the point made by my hon. Friend the Member for Doncaster, North (Mr. Hughes), about the inappropriate discharge of elderly people into a community which does not have the resources to care for them?

Mr. Yeo : We have studied the report to which the hon. Lady refers. I can assure her that we will certainly take into account the nursing needs of all elderly people in residential and nursing home care, when decisions about that care are made and when the local authorities enter into contracts for the arrangement of such care.

Mr. David Atkinson : Can my hon. Friend confirm that after 1 April next, every mentally ill patient and schizophrenia sufferer discharged from hospital can be guaranteed a package of care in the community best fitted to their needs? In that event, should we tolerate older hospitals for the mentally ill being kept open for a minute longer?

Mr. Yeo : I am aware of my hon. Friend's very close interest in mental illness and schizophrenia. I am glad to be able to inform him that from last April, under the care programme approach, all health authorities are required

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to initiate individually tailored care programmes on the basis of a full assessment for all in-patients about to be discharged from mental illness hospitals.

Information Disclosure

13. Mr. Fatchett : To ask the Secretary of State for Health what recent representations she has received about the employment protection of national health service staff who disclose information about internal affairs within the national health service, other than information related to patient confidentiality.

Mrs. Virginia Bottomley : Representations have been received recently from hon. Members, staff representative associations, and national health service employees. These have concerned both the general principles governing expression by NHS staff of professional concerns about health service issues, and the personal cases of some NHS employees.

Mr. Fatchett : Is the Secretary of State aware of the case [Interruption.] --

Madam Speaker : Order. I should be much obliged if the House would settle down. It is impossibly noisy and very hard work for hon. Members who are trying to ask questions and for Ministers who are trying to reply.

Mr. Fatchett : Is the Secretary of State aware of the case of Dr. Chris Chapman, a biochemist who faces redundancy tomorrow at the Leeds general infirmary? His only offence was to tell the truth about scientific fraud and financial irregularities. While Dr. Chapman is to be sacked, those who have committed the frauds and financial irregularities will remain in their jobs. They prosper and have been promoted. They include Mr. Stuart Ingham, the £90,000-a-year chief executive of the Leeds General Infirmary Trust. Will the Secretary of State now agree to set up a full public inquiry into Dr. Chapman's case? Or is she just happy to see a man of integrity lose his job, pension and livelihood while those responsible for his sacking remain in their posts and prosper?

Mrs. Bottomley : The matters to which the hon. Gentleman refers have, of course, been investigated by the independent auditors, and any new evidence has also been referred to them. It would be quite inappropriate for me to instigate an inquiry into an individual case where there are already statutory rights of appeal. Dr. Chapman has the right to take his case to an industrial tribunal. He has a right of appeal under the Employment Protection Act 1975, which I understand he has not yet exercised. Until he has done so, it certainly would not be appropriate to discuss the matter in the House.

Immunisation

16. Mrs. Gillan : To ask the Secretary of State for Health what progress has been made towards reaching national targets for immunisation against the major childhood diseases.

Mrs. Virginia Bottomley : I am pleased to say that the latest estimates show that we have passed the national immunisation coverage target of 90 per cent., which was set in 1985.

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Mrs. Gillan : Does my right hon. Friend agree that the GP contract which the Labour party opposed has been remarkably successful in improving the rate of child immunisation?

Mrs. Bottomley : It has been remarkably successful, and GPs are to be congratulated on 90 per cent. of them reaching targets and 70 per cent. reaching higher targets. This might be the last moment for the hon. Member for Livingston (Mr. Cook) at health questions to say that he was wrong when he said that those targets were too heroic. The GP contract has led to benefits in the services delivered by general practitioners. They have done excellently in immunisation ; they have done excellently in cancer screening and that bodes very well indeed for our strategy under "Health of the Nation".

PRIME MINISTER

Engagements

Q1. Mr. Bowis : To ask the Prime Minister if he will list his official engagements for Tuesday 14 July.

The Prime Minister (Mr. John Major) : This morning I presided at a meeting of the Cabinet and had meetings with ministerial colleagues and others. In addition to my duties in the House, I shall be having further meetings later today.

Mr. Bowis : Does my right hon. Friend agree that some people have still not learnt the lesson that real and lasting growth can come only with an economy that is based on low taxation and low inflation? Is not that the reason why last week's figures were so good? Will my right hon. Friend keep at it and ensure that his election pledge to lick inflation is fulfilled?

The Prime Minister : My hon. Friend is entirely right about that. I want to ensure that our record on inflation in the 1990s exceeds that of the 1980s, that we get inflation down to the lowest possible level and that we keep it there. Economic policy is geared to that end.

Mr. Kinnock : Does the Prime Minister recall his promise in the election that a Tory victory would provide the spark to ignite recovery? Will the Prime Minister now admit that no such ignition has taken place and that there will be no real recovery as long as he continues with the policies that have already brought us two full years of recession?

The Prime Minister : I shall turn to the right hon. Gentleman's point in a moment, if I may, for this is the last occasion that we will be able to exchange comments over the Dispatch Box in this fashion. We have done so on many occasions in the past 20 months. We have often disagreed, sometimes we have agreed, but I should like to thank the right hon. Gentleman--[ Hon. Members :-- He's going to resign."] That is quite wrong ; I am staying.

I should like to thank the right hon. Gentleman for his support at times of crisis, for his strong support throughout the Gulf war and for the support that he has given us throughout the difficulties in Yugoslavia. On many occasions when he and I have had to deal privately with matters, without exception he has respected the

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confidences of those occasions. I am very pleased to have the opportunity to thank him for that and to do so publicly and with warmth.

In direct response to the right hon. Gentleman's question, he will know the view of the OECD and of the London business school, both of whose latest surveys forecast that recovery will be under way from the second quarter of this year. We share that view.

Mr. Kinnock : I am grateful to the Prime Minister for his kind remarks. I consider it a great honour to have been able to serve my country in the way that I could. I know that he shares that vocation, and I hope that the country and its people can achieve greater success in the future.

I put it to the Prime Minister that his strategy of perpetuating recession, combined with high unemployment, in an attempt to suppress inflation, has all the features of the slump of the 1930s. For the sake of our country, I put it to him that he should now recognise that continuation of those policies will not achieve durable or sustainable recovery, and will certainly not put our country at ease with itself.

The Prime Minister : I respect the view that the right hon. Gentleman expresses, but I say in all sincerity that I cannot agree with him. The recovery--the jobs, the prosperity and the security--that everyone in this House wants for all our citizens can be based only on sustainable growth and low inflation. Unless we have low inflation as a base, we shall not get a form of growth that is sustainable. I realise that it is not easy, that it is uncomfortable and that it is frustrating when growth does not appear immediately, but I know of no other way to ensure the medium and long-term growth and prosperity of the nation, and I am determined to stick to the policies that I believe to be in our medium and long-term interests.

Mr. Kinnock : May I say to the Prime Minister, with equal sincerity, that, after two years of recession, there is a very great danger that continuation of the present policies will risk driving the economy down so far as to make the prospect of recovery recede by years. I hope that the Prime Minister will use this summer to think again about the course of that policy and will adopt different policies that can give this country and its people the chance of jobs, growth and success, which we have not enjoyed in the immediate past.

The Prime Minister : The Leader of the Opposition and I agree about what the objective is, but I regret that we do not agree about the basis that is necessary to achieve it. One needs to look at what is happening. The volume of exports was at a record level in May ; our volume share of world trade has recovered, after being in decline for many years ; car sales are increasing ; producer price inflation is at a very low level indeed. The ingredients are there. I return to the independent view of both the OECD and the London business school that recovery will be under way in the second half of this year. And it will be recovery based on a rate of inflation that is far lower than anyone in this House predicted 18 months ago. It is from that base that we shall get the growth that we all wish to see.

Sir Michael Marshall : In a week that marks the 75th birthday of the British space pioneer Arthur C. Clarke and his visit to the House of Commons will my right hon. Friend take this opportunity of assuring the House that during our presidency of the EC Her Majesty's

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Government will make every effort to take initiatives in the space field to improve the quality of life and assist British industry?

The Prime Minister : I think I can give my hon. Friend the assurance that he seeks. I welcome the visit of Mr. Clarke to the House. We shall continue to take initiatives, within Europe, internationally and in other forums, in pursuit of space priorities. We are particularly interested in the development of Earth observation systems for the monitoring of the environment and of climate change.

Q2. Mr. John D. Taylor : To ask the Prime Minister if he will list his official engagements for Tuesday 14 July.

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

Mr. Taylor : May I take this opportunity to register the thanks of the Ulster Unionist party to the Leader of the main Opposition party for the leadership he has given to Her Majesty's Opposition. It has been a privilege to work with him in recent years.

Now that the inter-party talks on Northern Ireland have advanced to strands 2 and 3, in which Her Majesty's Government are no longer in the chair but are equal partners with the other participants, may I ask the Prime Minister whether he recognises that progress towards real understanding, recognition and mutual respect in the island of Ireland depends upon the removal of articles 2 and 3 from the constitution of the southern Irish republic? Will Her Majesty's Government take the opportunity available to them in strands 2 and 3 to request the Dublin Government to remove their constitutional claim over that part of the United Kingdom known as Northern Ireland?

The Prime Minister : The hon. Gentleman is right in saying that articles 2 and 3 are important ingredients in the progress that has to be made. I welcome the talks at Lancaster House last week and I look forward to further substantive talks in Belfast later this week. This is an historic opportunity. I have made that clear to the Taoiseach. I think that he shares that view. He was generous enough to do so in a joint message just a few days ago. It would not be helpful for anyone to say a great deal about the talks while they continue, not least because the participants have agreed on the vital importance of confidentiality. But the talks have gone further than many imagined. The position is more hopeful than it has been for many years. We must all hope that the talks can make further progress.

Q3. Mr. Patrick Thompson : To ask the Prime Minister if he will list his official engagements for Tuesday 14 July.

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

Mr. Thompson : In the light of the harrowing plight of the children of Sarajevo, is there any immediate prospect of medical assistance being sent or provided to help with the terrible suffering which is occurring there?

The Prime Minister : Some progress has beeen made this morning. I am pleased to be able to tell my hon. Friend that a team of eight doctors and nurses from the South Manchester accident and rescue team is assembling its emergency supplies. Subject to the necessary clearance from the United Nations, which we expect to receive shortly, the team will fly out to Zagreb later today or

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tomorrow. It will link up with the United Nations and United Kingdom medical teams already in the area. It will be there both to offer immediate medical assistance as required and to report back to me with an on-the-spot assessment of the best way in which we can help those tragic children.

Mr. Ashdown : In view of the Prime Minister's previous statements, can he deny that unemployment will be at or through 3 million by Christmas?

The Prime Minister : As the right hon. Gentleman knows, no Minister of any Government has made projections of unemployment. I do not intend to start. We shall have some more figures later this week. The right hon. Gentleman will be able to make his own assessment.

Mr. Alan Howarth : Does my right hon. Friend recall the words of the former leader of the Labour party that

"inflation is the father and mother of unemployment"?

Does he agree that inflation is a social as well as economic evil that has dogged this country for a generation? Does he accept that he has wide support in the country in his determination to seize the opportunity that we have now to defeat inflation decisively?

The Prime Minister : I believe that my hon. Friend is right. I well recall the quotation that he uses. We have the headline rate of inflation down to 3.9 per cent. and the underlying rate of inflation effectively down to 4.8 per cent. Both are falling. That is very welcome news indeed.

Q4. Mr. Cummings : To ask the Prime Minister if he will list his official engagements for Tuesday 14 July.

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

Mr. Cummings : Is the Prime Minister aware that tens of thousands of chronically sick and disabled people are awaiting the determination of their application for disability living allowance? Is he further aware that, following a period of 10 months, the family of a late constituent of mine received a determination two days after the lady died? What does the Prime Minister intend to do about that disgraceful state of affairs?

The Prime Minister : We seek to process such applications as speedily as possible. The Benefits Agency is examining the difficulty and putting in staff to address it as speedily as possible.

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Q5. Mr. Devlin : To ask the Prime Minister if he will list his official engagements for Tuesday 14 July.

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

Mr. Devlin : Is my right hon. Friend aware of the great pride in the north-east of England that Britain is shortly to become once again a net exporter of cars? Is not that a tribute to both the motor industry in general, which has restructured in the past few years, and to the Government's success in attracting inward investment to Britain?

The Prime Minister : Yes, I believe that the attraction of inward investment is very important. Among other things, it relies on very low inflation and stable economic policies which do not change and are well understood. There is no doubt that the British car industry has made excellent progress in improving competitiveness and significantly reducing the balance of payments deficit on trade in the automotive industry. In welcoming that, I agree with my hon. Friend about the importance of inward investment, most notably, in that instance, in the motor car industry from Japan.

Mr. Turner : Is the Prime Minister aware that his notion of the freedom to choose is an empty gesture to millions of people in this country? When they have paid their electric, water and gas bills, they find that they have nothing left for the simple pleasures of life. When will he do something to help those people, instead of helping the better off whom his Government have always helped?

The Prime Minister : I am not sure that that is the invariable view of people who would call themselves better off. Of course we are concerned to help people who find themselves in such difficulties, and our policies have done so consistently during the past 12 years. What the hon. Gentleman and his right hon. and hon. Friends do not like is choice itself. That is why they did not want to sell council houses, why they did not want people to choose what schools they have, and why they do not like choice in health. The truth is that when people choose, they choose conservatism and not socialism.

Madam Speaker : I should be obliged if those hon. Members who are leaving the Chamber would do so quietly or resume their seats, as we have a statement.

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