Mrs. Bottomley : There is no doubt that the establishment of the new health authorities and trust boards has made opportunities for consideration of NHS matters far more effective and constructive. At the same time, the spirit of probity and accountablity is fundamental to the health service. The hon. Gentleman will for the first time be able to attend an annual meeting and to receive annual accounts and an annual report. There has been a transformation in the amount of information that is available about hospitals, the way in which they are run and the way in which they are funded.
Mr. Harry Greenway : Is my right hon. Friend aware that there has always been excellent practice at Hammersmith hospital ? The whole of west London welcomes her decision to keep that hospital in full order. Will she be similarly generous with the casualty department at Ealing hospital and confirm that its future is not in doubt ?
Mrs. Bottomley : I am pleased that my hon. Friend welcomes yesterday's announcement about the new Hammersmith Hospitals NHS Trust. It will be one of 143 trusts to be established on 1 April, making 419 in all. Again, that is a major step forward for the national health service. As for the other aspects, my hon. Friend will know that the precise configuration of services across London and more widely continues to be considered. We shall always need to be sure that there are high-quality accident and emergency services and, above all, to continue the great investment in ambulance services.
Column 130vagaries of the market ? When those trusts close great teaching and specialist hospitals in the capital, the Secretary of State washes her hands of the consequences and says that it is nothing to do with her. Is it not time that this nothing-to-do-with-us Government accepted responsibility for the health care of the British people ?
Mrs. Bottomley : It is because we accept that responsibility that we are prepared to face difficult and complex decisions. I note that the hon. Gentleman described yesterday's announcement of the Hammersmith Hospitals NHS Trust as a fudge. On other occasions when difficult decisions have to be made, he also washes his hands of those decisions, although he himself said that no change was no option in London. We recognise that if we want to increase the quality and quantity of patient treatment--we are treating 1 million more patients than before the reforms, waiting times have fallen from nine to five months and there has been a steady improvement--difficult decisions have to be delivered with care.
Dr Mawhinney : In the White Paper, "The Health of the Nation," we drew attention to the need to develop local programmes to review the prescription of all benzodiazepines, including Temazepam, and to replace them as necessary with other methods of treatment. Family health services authorities have been asked to work with general practitioners to agree local targets on the reduction of benzodiazepine prescribing.
Madam Speaker : Order. I can barely hear the hon. Lady from across the Chamber. I seek the co-operation of the House. I do not want to stop conversations, but let them be a little quieter so that I can hear hon. Members who are asking questions. Otherwise, it is a total waste of time.
Ms Quin : Thank you, Madam Speaker. Does the Minister agree that national action on reviewing this drug is urgently needed in view of the alarming number of crimes that have been committed by people high on Temazepam taken in combination with alcohol and other substances ? Does the Minister also agree with me that action is urgently needed to stop the alarming number of thefts of this drug from chemist shops ?
Dr. Mawhinney : I am aware of the problems of theft, particularly in the area that the hon. Lady represents. I know that that has been a matter of particular local concern. I am sure that we both agree that pharmacists need to take adequate precautions to try to ensure that drugs are stored safely on their premises.
The hon. Lady will be pleased to know that copies of the Mental Health Foundation publication entitled "Guidelines for the Prevention of Treatment of Benzodiazepine Dependence" were issued to all family health services authorities just last week.
Column 131thing to do be not to withdraw the whole drug, but just to withdraw the capsule which is being abused so horrendously ?
Dr. Mawhinney : My hon. Friend is absolutely right. The capsule form was changed to a gel form in 1989, I believe. That has caused difficulties for those who persist in using the drug illegally. It is a matter which is under review.
Mr. Connarty : Has anyone brought to the attention of the Prime Minister the 71.5 per cent. return in the Electoral Reform Society ballot on water services carried out for Strathclyde ? Does he agree with the 1,194,667 people who voted against the Government's proposals for quangoing the water services in Scotland ? Does he agree that this is a crushing humiliation, or could it be possible that the Prime Minister will see it as an opportunity to show that we have a listening Government and do the democratic thing and abandon his proposal immediately ?
The Prime Minister : Since Strathclyde wilfully misrepresented the Government's proposals, I see nothing surprising in the result. The Opposition have continued to link the proposals with privatisation, even though it is perfectly clear that we are setting up public water authorities. They persist in scaremongering about disconnections, although we have no proposals to legalise disconnecting domestic water supplies for non-payment of bills.
The question that the hon. Gentleman should have asked is how Strathclyde will explain to its council taxpayers the waste of £750, 000.
Mr. Brandreth : Will my right hon. Friend consider adding to his list of engagements a visit to the uniquely beautiful city of Chester, where he will find inward investment at record levels, and unemployment 6 per cent. lower than a year ago and 26 per cent. lower than six years ago ? Does he agree that, in terms of inward investment to the European Community, the United Kingdom in general, and the city of Chester in particular, are now leading the way ?
The Prime Minister : I am certainly pleased to hear of the particular inward investment to Chester. There has been a dramatic amount of inward investment into every part of the United Kingdom over the last few years--Wales and Scotland have certainly received a great degree of inward investment. That is very largely connected with the
Column 132fact that we have a very flexible economy and a very effective business tax system, we do not have too many social on -costs, and investment here is welcome.
The Prime Minister : As the right hon. and learned Gentleman knows, it has long been the case that customers for a wide range of services can pay for them in advance. [Interruption.] There is nothing unusual about that. It has happened before every Budget that the right hon. and learned Gentleman can remember since he entered the House.
Mr. John Smith : The Prime Minister does not even begin to understand the problem here. Does he not understand that it is deeply unfair that those who are better off can avoid a tax obligation which millions of others have to shoulder because they do not have the money to exploit the loophole that the Government have permitted ?
The Prime Minister : It is not a loophole, as the right hon. and learned Gentleman says ; it is a position that has applied for very many years. As far as people who are less well off are concerned, as the right hon. and learned Gentleman knows, we have provided help for them worth £2.5 billion over three years--more to pensioners, more to disabled people and more to single parents. The right hon. and learned Gentleman did not mention that all those people will get the money before the bills arrive. That is a prepayment that the right hon. and learned Gentleman forgot to mention.
Mr. John Smith : Does the Prime Minister not understand that in those replies he has revealed the Tory attitude to tax in a nutshell-- loopholes for the better off, and everyone else has to pay in full ?
The Prime Minister : What has been revealed is that the right hon. and learned Gentleman is up to his old tricks yet again, telling other people how to spend their own money. It boils down to the fact that the right hon. and learned Gentleman is a meddler in everything--in private sector pay, in company decisions and in how people pay their own bills. What he does not mention is the fact that electricity companies, for example, have announced next year's prices and all of them have frozen the price or cut it. When did that ever happen under Labour Administrations ?
Dame Elaine Kellett-Bowman : Is my right hon. Friend aware that yesterday the Department of the Environment issued a section 13 notice, under the Local Government Act 1988, against the Lancashire county council for utterly failing efficiently to run its ground maintenance services under direct labour ? Is that not one more reason why the citizens of Lancashire wish the Lancashire county council to be abolished ?
Mr. Ashdown : Are not the policies of the Government and of the Labour party towards the provision of nursery education for all now revealed to be exactly the same--that it will not happen until resources allow ? Bearing in mind that it was the Prime Minister's predecessor, when she was Education Secretary nearly a quarter of a century ago, who
Column 133first formulated that policy, will the Prime Minister tell us when he thinks that that promise might be delivered--this year, next year, sometime or never ?
The Prime Minister : That was extremely well rehearsed, but, as the hon. Lady mentioned a second ago, if the right hon. Gentleman went to the Isle of Wight he would find no nursery education there, whereas if he went to Tory Westminster he would find universal nursery education.
Mr. Bill Walker : Does my right hon. Friend agree that, under every Labour Government since the war, before every Budget there was massive spending in the shops to avoid the tax increases that always followed Labour Chancellors' statements, especially during the period of purchase tax when that tax went up to 33 per cent?
The Prime Minister : My hon. Friend is entirely right about that. There has always been prepurchase of goods before Budgets, especially Labour Budgets, for precisely that reason, but the Opposition have been out of government so long that they have lost touch not only with government but with reality.
Mr. Winnick : Is the Prime Minister at all surprised at the way in which the President of the Board of Trade is now constantly being talked up as his successor as leader ? Should not the Prime Minister watch his back very carefully when the President of the Board of Trade says that he has no leadership ambition left ? If the Prime Minister believes that, he will believe anything.
Mr.Wilkinson : In view of the latest terrorist outrages at Heathrow airport and, more recently, the shooting down of an Army Lynx helicopter at Crossmaglen, is not my right hon. Friend the Member for Lagan Valley (Mr. Molyneaux) right to say that the Downing street declaration has run its course ? Is it not time to give primacy to the defeat of IRA terrorism, because political progress depends on progress on the security front ?
The Prime Minister : Two things run in parallel : first, the Downing street declaration ; and, secondly, the continuing efforts to defeat terrorism and engage in the talks process. Security co-operation has improved and continues to improve. The welcome recent successes on both sides of the border are evidence of the intensive efforts by the security forces in both jurisdictions to combat terrorism. Both Governments are committed to close co-operation, which is currently at an all-time high. I assure my hon. Friend that we propose to build on that security co- operation in both the short and the long term. There should be room nowhere in the United Kingdom for terrorism, and we are determined to maintain our battle against it.
The Prime Minister : As the hon. Gentleman knows, and as I have conceded before, it has been necessary to increase taxes. I invite him also to condemn the large and unjustifiable council tax increases imposed by Labour councils.
Mr. Thurnham : Does my hon. Friend agree that many people with disabilities make excellent employees ? Will he ensure that the public sector plays its full part in employing the disabled and thus leads all other employers by example ?
The Prime Minister : I entirely agree with my hon. Friend. The civil service is steadily increasing the number of registered disabled people whom it employs. I am delighted that, as a proportion of its work force, it now employs slightly more than the percentage of registered disabled people in the work force as a whole. A number of Departments and agencies do significantly better than that. I share my hon. Friend's desire to see progress made, but it is encouraging that the public sector is now doing better than the private sector.
The Prime Minister : The hon. Gentleman states a choice which, had he ever negotiated in Europe, he would not have stated in that fashion. He is blind to both the short and long-term consequences of change to the qualified majority vote system. We are determined to negotiate in Brussels, and to fight Britain's corner just as hard as every other nation would fight for itself. We will not be moved by phoney threats to delay enlargement. There is ample time to complete the enlargement process ; if there is delay, it will be because certain other member states--two in particular--have taken an inflexible and doctrinaire line. We shall not do what the Labour party do, which is to say yes to everything that comes out of Europe, with no critical examination whatever. The Opposition would sign away our votes, our competitiveness and our money. The right hon. and learned Member for Monklands, East (Mr. Smith) is the man who likes to say yes in Europe--Monsieur Oui, the poodle of Brussels.
Column 135creating jobs. Since 1985 the Northern Development Corporation has secured 36,000 jobs for the region. By piling on costs to business, the social chapter would destroy jobs in the northern region, as it would across the country.
Mr. Bates : Is my right hon. Friend aware of the decision by Black and Decker to close its production plant in Limburg in Germany and move to Spennymoor in county Durham because of the excessive level of non-wage labour costs in Germany ? Does that not clearly demonstrate that the best way to keep manufacturing jobs in the north-east is to keep Britain out of the social chapter ?
The Prime Minister : I entirely agree. What is clear when one looks across Europe is that the social on-costs of every country other than the United Kingdom are rendering those countries progressively uncompetitive with Japan, the United States and the Pacific basin. What the social chapter would mean is the loss of jobs in the United Kingdom. I very much welcome the news for the people of Spennymoor. The Durham plant has a very high and very well-deserved reputation for quality. Black and Decker knows that high costs destroy jobs and that, for that reason, Britain is the best place in the European Community in which to do business and in which to invest.
Mr. Home Robertson : As the Prime Minister once dismissed Strathclyde as a monstrosity, I welcome his conversion and the fact that the Government have now decided to keep the Strathclyde passenger transport authority so as to safeguard comprehensive concessionary travel for pensioners in Strathclyde. Why are not pensioners in other parts of Scotland being allowed the same safeguards ? I appeal to the Prime Minister to consider that point and to ensure that pensioners in all parts of Scotland, including the east, are given equal rights.
The Prime Minister : It is extremely unlikely that the hon. Gentleman would appeal to me in any circumstances. The view of Strathclyde that I hold is unaltered, as I indicated earlier with regard to the referendum, which was an expensive stunt. As to the second point, that is a matter for my right hon. Friend the Secretary of State for Scotland.
Mr. Skinner : On a point of order, Madam Speaker. You will have heard the Prime Minister, in responding to one of my hon. Friends on the question of tax increases, say that we should condemn the council tax increases also. This means that the right hon. Gentleman was admitting that the tax increases, too, should be condemned. Will you, Madam Speaker, ensure that Hansard is not altered ?
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