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Mr. Anthony Coombs : I recognise the importance of district health authorities' ensuring accountability in the provision of local health services. Does my right hon. Friend agree, however, that the primary impetus comes from GP fundholders, who now treat 88 per cent. of my constituents ? Will he ensure that the scope of reforms for GP fundholders is widened via the Bromsgrove project--which allows them to purchase accident and emergency services as well--and that single-hander GP fundholders will be allowed to operate ?
Dr. Mawhinney : My hon. Friend is right to point to the positive effect of GP fundholding in terms of the input of local people's views. I hope that he will be encouraged to learn that I have written to all GP fundholders in the country, asking them to suggest from their experience how we can best expand the scheme from April next year. We shall be holding a national conference on that very subject on Thursday this week.
Mr. Bowis : Our nutrition task force, which was set up in October 1992 under "The Health of the Nation" initiative, will be updating current guidance on nutrition for hospitals and health authorities.
Mrs. Fyfe : Is the Minister aware that a recent study of in-patients leaving hospital showed them to be less well nourished than they were when they entered hospital ? Will he discuss the matter-- [Interruption.]
Mrs. Fyfe : Is the Minister aware that a recent study of in-patients leaving hospitals shows them to be less well-nourished than when they entered hospital ? Will he discuss the matter with his ministerial colleagues in Scotland to ensure that patients do not rely on their visitors to bring them Chinese takeaways as well as the traditional bunches of grapes ?
Column 99which are a matter for my right hon. Friend the Secretary of State for Scotland. The report appeared in the British Medical Journal . The hon. Lady will also have seen that Dr. Pennington made it very clear that the main problem is loss of appetite associated with illness. Enteral and parenteral feeding is certainly necessary in some cases, but in most cases hospitals need to have good nutritional policy. That is why our task force is issuing guidance and a handbook and is training health professionals. I am sure that the next time the hon. Lady visits a hospital she will see the benefits.
Mr. Morgan : Does the Prime Minister agree with the words of the Home Secretary to the Institute of Directors convention this morning, when he said that the police, the courts and the prison services were having to pick up the pieces for the failures of others ? Does he agree that the word "others" may include those who have been governing this country for the last 15 years ?
The Prime Minister : I have not seen the text of what my right hon. and learned Friend said, but I am sure that he was seeking to convey that the causes of crime are many and varied ; that it is not possible to let all the aspects of crime simply be dealt with by the police and others ; and that everyone in authority, whatever that authority may be, may have to, and should be prepared to, take their share of responsibility.
Mr. Rathbone : Will the Prime Minister send a special message of encouragement to South Africa as the democratic elections continue there in order to welcome this final step away from apartheid ? Will he continue to bend his energy to bringing South Africa back into the Commonwealth ?
The Prime Minister : I think that people around the world welcome the elections that are taking place in South Africa and hope that they can be concluded without any more of the violence that has scarred events in the last few days. When the election is concluded and a new multi-racial government is formed, I very much hope that South Africa will decide to rejoin the Commonwealth. As far as this Government is concerned, it will be a very welcome entrant.
Mr. John Smith : How can the Prime Minister justify his Government's spending £500 million of taxpayers' money in fees to private consultants when, as is revealed in today's Financial Times , only £10 million was gained as a result ?
The Prime Minister : Let me set out some of the points related to that, because I think that the right hon. and learned Gentleman may tend to agree with much of what I have to say about it. The right hon. and learned Gentleman is asking questions that I myself asked, which
Column 100is the reason why the scrutiny was established in the first place. It was set up because of the growth in expenditure on consultants and in order to find out whether it is good value for money or whether better value for money can be obtained. If it confirms that the expenditure is producing good results, we will maintain it ; if not, we will make the changes required.
As far as savings are concerned, the spending is on specialist advice to support programmes. It is not a search to find savings especially.
Mr. John Smith : In other words, it is true : another grotesque waste of taxpayers' money has occurred. Is not the Prime Minister's game to delay this and any other bad news until after the local and European elections are over ? Why not tell the truth for once before an election ?
Madam Speaker : Order. I believe that I heard the right hon. and learned Gentleman correctly and found nothing unparliamentary in what he said, but would he care to repeat it so that it is clear to all of us ?
The Prime Minister : If there was an intention to hide anything, perhaps the right hon. and learned Gentleman could explain why we established the scrutiny in the first place--it is precisely to determine that the expenditure is conducted properly. However, since the right hon. and learned Gentleman wishes to judge without having seen the report, before the report is completed and without any understanding of the report or what is in it, let me give him a little more information. The examination of where the money is spent includes matters such as helping to design and evaluate weapons systems for the armed forces--not something that the civil service could do--and conducting feasibility studies on technical aspects of the road programme, which is not something that could be done without specialist advice. The right hon. and learned Gentleman should find out some facts before he smears.
Mr. John Smith : Does not the Prime Minister realise that families all over Britain--the real quiet majority--who are now paying huge tax increases imposed by his Government will bitterly resent this further example of the Government's now legendary incompetence ?
The Prime Minister : The whole House will have noted that the right hon. and learned Gentleman was prepared to criticise, was wrong and was not prepared to apologise. I am glad at last that he is taking a closer interest in value for money and efficiency. I hope that he will apply the same test to Labour local authorities up and down the country--every single one he knows. If he were really concerned about tax, perhaps he would indicate what aspects of public expenditure restraint he would support. If he were concerned about local authority tax, perhaps he will explain why he and his party oppose compulsory competitive tendering despite the savings that it has made in councils up and down the country. Every single thing that he has said today is bogus.
Column 101Labour-Liberal coalition which runs Kent has decided to cut the police budget ? Will he comment on the amazing gap between the statements of the Front-Bench spokesmen of the two Opposition parties and what they do when they have office ?
The Prime Minister : My hon. Friend has made the point very clearly. I am not familiar with the particular illustration that he produced, but there are many similar illustrations of which the House is well aware.
Mr. Callaghan : Is the Prime Minister aware of the statistics that have just been produced by the North West health authority which show a 60 per cent. increase over three years in the number of youngsters aged 18 and under who have to attend hospital for treatment for drug abuse ? In view of those alarming figures and the fact that there is a connection between serious crime and drug abuse, as evidenced by the number of murders in our cities, will the Prime Minister tell the House exactly what he intends to do to combat the evils of drug abuse and serious crime ?
The Prime Minister : The hon. Gentleman touches on a very important matter and I am pleased to respond to him. The sum total of expenditure by the Government on drug-related programmes and other matters related to drugs now exceeds £500 million a year. I have asked my right hon. Friend the Lord President to bring together the expenditure all across Government to make sure that we can target it at the right Departments and at the right problems to begin to cope with the problem of drugs, which exists right across the world but which I think every hon. Member would wish us to tackle at the roots as speedily as possible.
Sir George Gardiner : In the course of his day, my right hon. Friend may have time to look at the final draft of the Conservative manifesto for the European elections. When he does, will he make doubly sure that it emphasises the crucial choice that faces our people in those elections-- between Conservative resistance to further moves towards Euro federalism, while we protect British jobs by staying out of the social chapter, and Labour and Liberal eagerness to sign up to anything, to hand over control to the Eurocrats in Brussels and to saddle us with employment costs that would hit directly at British jobs ?
The Prime Minister : My hon. Friend is entirely right. There is a sharp contrast between our policies on Europe and those of both the main Opposition parties, whose policies are almost indistinguishable. We believe in a free trade, deregulated, outward-looking Europe of independent nation states--unlike either of the Opposition parties, both of which want regulation, intervention and more high spending in a federal European state. That is not for us and I do not believe that it is the wish of the British nation either.
Ms Quin : Following the previous question, and as the Prime Minister feels that he has a lot in common with the four countries that hope to join the European Union next year, will he tell the House how many of them have supported his Government in requesting an opt-out from the social chapter ?
The Prime Minister : I think that one will find that across Europe-- [Interruption.] Across Europe, as the hon. Lady knows, countries are recognising that Britain is more competitive because we had the courage to stand up and say that destroying jobs in Europe was not a good idea. There are 19 million people unemployed in Europe ; only in this country is unemployment falling. Only this country is becoming more competitive, and that is because we were prepared to say no to policies that destroy jobs and yes to policies that create jobs.
Mr. Kynoch : Although controlling inflation is not an end in itself, does my right hon. Friend agree with me and the many business men in my constituency that it is, however, a precondition for falling unemployment, low interest rates and, ultimately, sound and stable economic growth ?
The Prime Minister : My hon. Friend is entirely right about that. The necessity to get inflation down is self-evident, as is the necessity to keep it down to have the economy growing steadily. As a result of the disinflationary policy that we have followed, we have now had growth for eight successive quarters, unemployment has fallen by a quarter of a million and we have a higher growth pattern than any other nation in the European Community. A CBI survey published this morning showed business optimism continuing to rise. That is a scenario which most other nations in Europe would be pleased to have.
Mr. Williams : On this historic day in South Africa, will the Prime Minister congratulate Nelson Mandela, the African National Congress and everyone else involved in the anti-apartheid movement for bringing democracy at last to South Africa ?
The Prime Minister : I am happy to extend my congratulations to Mr. Mandela, to President de Klerk and to everyone else who over the years has worked towards a non-racial South Africa. That will be welcomed by people across the world, and I hope that it will bring greater stability for South Africa in the future.
Mr. Jonathan Evans : Has my right hon. Friend noticed the recent extensive and co-ordinated press attention to concerns about the Government's proposals to deal with new age travellers ? Perhaps I can tell my right hon. Friend that the quiet majority in my constituency very much support the Government's plans as contained in the Criminal Justice and Public Order Bill, which will give them real protection from those unlawful activities.
The Prime Minister : My hon. Friend is entirely right. New age travellers have been an immense nuisance, not least, of course, in the west country over recent years. The legislation proposed by my right hon. and learned Friend the Home Secretary will give the police far more powers to
Column 104deal with them. In view of the difficulty that there has been in the west country, I am surprised that we have not had more support from the Liberal Democrats on that matter.
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