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the European Union summit. If those are inconsequential, heaven help us from what the hon. Gentleman thinks would be consequential. On monetary union, I suggest that the hon. Gentleman compares some of the more recent speeches by European leaders with those of two years ago. He might, for example, look at Mr. Balladur's recent speech and at what President Mitterrand had to say at our joint press conference in Chartres. If he had done that, he would be better informed and would not have asked that question.

Sir Teddy Taylor (Southend, East): In view of the continued uncertainty in the fishing industry, would the Prime Minister care to clarify the statement by Mr. Gonzales in Madrid this morning that he was overjoyed at what he saw as a crucial breakthrough over fishing? Is it true that he forced this issue on to the agenda, that a crucial breakthrough was achieved, and that he got what he came for? Does the Prime Minister accept that, when such statements are made by foreign Prime Ministers, and particularly in the context of our fishing industry, it is helpful to have the issue clarified and a statement made so that the whole House knows what is going on, or whether a statement is a load of rubbish?

The Prime Minister: I have not seen that remark by Prime Minister Gonzales, but it is not entirely unknown for Prime Ministers abroad to make statements for domestic reasons-- [Interruption.] That does not, of course, apply to British Prime Ministers. It applies occasionally to Prime Ministers elsewhere who do not find themselves subject to the same rigorous questioning in their Parliaments as we do in ours. Indeed, I must say that some of my fellow Heads of Government could scarcely find their way to their Parliaments with a guide dog.

On the point about fishing, it has been agreed that the new rules must lead to no increase in effort, including for the Spanish fleet. There was no great breakthrough, no great change, and the issue will be debated in the House later this week.

Mr. Denis MacShane (Rotherham): That last insult to every Prime Minister in Europe really takes the biscuit. More seriously, if, as we know, the Prime Minister cannot speak for his party but claims that at least he speaks for his Cabinet, why is there not a single Europhobe Cabinet Minister sitting on the Front Bench with him today?

The Prime Minister: Dear, oh dear. I am not really sure why the hon. Gentleman bothered to ask that question and it certainly does not merit a reply.

Sir Wyn Roberts (Conwy): Does my right hon. Friend accept that the undoubted successes that he achieved at Essen, which were grudgingly welcomed by the Leader of the Opposition, will be warmly welcomed in many parts of the country? He should be congratulated on his part in achieving them.

On the economic front, is it not a fact that last week Mr. Delors described the policies pursued by my right hon. Friend and his predecessors as ultra- liberal economic policies which he was happy to thwart with socialism?

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Have not Conservative policies been well and truly vindicated as the only possible policies to be pursued in Europe to reduce unemployment and create jobs?

The Prime Minister: Not only do I believe that to be overwhelmingly the case, but I believe that that is the view of most of the people who attended the Essen summit.

Mr. Peter Mandelson (Hartlepool): As the Prime Minister is in candid mood today, will he tell us how he would pitch his enthusiasm for a strengthening of the EU's common foreign and security policy, in view of recent comments by the Foreign Secretary? What institutional changes within the EU would be required to allow such a strengthening?

The Prime Minister: A common foreign and security policy in the European Union is a relative novelty, following the Maastricht treaty. It is still in its infancy. We think that it can easily be further developed, but on the basis of co-operation, not qualified majority voting. Therefore, it would continue on an intergovernmental basis, but based on co-operation.

Mr. Jacques Arnold (Gravesham): I welcome the announcement on the trans-European projects, especially the funding for the channel tunnel rail link. Not least, it will fund some of the environmental improvements already agreed. May we have an assurance that European environmental funds will not be excluded from further environmental improvements in Kent?

The Prime Minister: I think that I can give my hon. Friend that assurance. Of course, I cannot guarantee that more funds will necessarily become available. I do not know whether they will or what priorities will emerge, but they will certainly not be artificially excluded.

Mr. Llew Smith (Blaenau Gwent): Has the Prime Minister read the report in The Times today, which states that the summit decided that job security and welfare benefits should be reduced to cut the queue of 17 million unemployed? If the report is true, why did he not mention it? Can he explain how cutting job security and welfare benefits will increase employment?

The Prime Minister: I do not know precisely what The Times is referring to--

Mr. Smith: Here it is.

The Prime Minister: I am not quite that long-sighted. I did not read that report, but I suspect that it is an extrapolation of the argument that unless we are competitive we will lose jobs. That has been happening across the whole EU, where 18 million to 20 million people are unemployed. If the number continues to rise, it will be an extremely serious long-term problem for the EU. The number has been rising almost consistently since the 1950s as we have become progressively less competitive. I suspect that the article which the hon. Gentleman has in mind indicates the need to retain competitiveness across Europe to ensure that more people are put back into work.

Mr. Edward Garnier (Harborough): May I congratulate my right hon. Friend on what might be described as a dull and businesslike meeting at Essen?

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Will he confirm that quiet confidence at such meetings will achieve what this country needs: enlargement, competitiveness and subsidiarity?

The Prime Minister: I entirely agree with my hon. Friend about that.

Mr. David Winnick (Walsall, North): It was a difficult one, was it not?

The Prime Minister: I entirely agree with my hon. Friend's wise words on that subject, and he is right to stress them. The hon. Member for Walsall, North (Mr. Winnick) might have put it differently, but I prefer my hon. Friend's formulation.

Mr. Nigel Spearing (Newham, South): In his reply to my right hon. Friend the Member for Bethnal Green and Stepney (Mr. Shore), the Prime Minister suggested that the institutional conditions before enlargement were largely mathematical--matters such as seats. Has not the presidency, in the form of Chancellor Kohl and his friends, advocated increasing the powers of the European Parliament? Does the Prime Minister agree, therefore, that even if his Government do not believe in increasing those institutions' powers, other members of the reflections group at the 1996 conference probably will?

The Prime Minister: Yes, some of them will certainly want more powers, as the hon. Member for Hemsworth (Mr. Enright) said earlier, although I was not entirely sure whether he was in favour of or against them.

Mr. Enright: In favour.

The Prime Minister: He is in favour of them on this occasion--good. So some people will argue for that in 1996. The illustration that I gave the right hon. Member for Bethnal Green and Stepney (Mr. Shore) was just one example of the sort of matter that will be discussed in 1996. One could give others. I have no doubt that some will argue for changing the powers of the European Parliament. There will be a range of proposals, but whether they will be agreed is a separate matter.

Mr. David Harris (St. Ives): Will my right hon. Friend take the opportunity to refute completely the allegations and suggestions made by the Labour and Liberal Democratic parties that a backstage deal that will do down our fishing industry was stitched up at the summit? Will he assure the House that, at the Fisheries Council meeting next week, which is particularly vital to south-west England, we shall retain our position and robustly defend our fishermen's interests?

The Prime Minister: No backstage deal has been done. We have succeeded in setting aside the complex solution put forward by the Commission in September, which was not in the interests of British fishing. Instead, the Council agreed in its conclusions that a non-bureaucratic solution would need to be found. We shall continue to consult the fishing industry. Our objectives remain to ensure the following: that British fishing interests are protected; that only necessary

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measures are agreed; that fishing effort should not increase; and that the ability to take quotas is uninhibited.

Mr. Tony Banks (Newham, North-West): Before it develops into a story throughout Europe, would the Prime Minister care to rethink the gratuitously insulting words that he offered his colleague Prime Ministers on their inability to know where their Parliaments are, not to mention his insult to guide dogs? Other Prime Ministers may have their Parliaments under greater control than he has his own. Why does he object to the European Parliament having greater democratic powers? Why should it not be the democratic institution for Europe? After all, its members are elected as well, and national Parliaments seem incapable of getting democracy into the European Union.

The Prime Minister: I hope that the hon. Gentleman's words will gain wide currency. If he implies that he wants a significant movement of authority from this House to the European Parliament-- Mr. Tony Banks indicated assent .

The Prime Minister: I note that the hon. Gentleman is nodding. He therefore wants a significant movement of powers from this House to Europe.

Mr. Skinner: No.

The Prime Minister: There seems to be slight dissent from other Labour Members.

Mr. Skinner: We may disagree, but at least we all have the Labour Whip. [Interruption.]

The Prime Minister: Perhaps the difference is not so slight. There is a fundamental split between not just Opposition Members but left-wing Opposition Members, with Opposition Front-Bench Members no doubt sitting uneasily in the middle. Thank heavens that that sort of thing only happens there.

Mr. Michael Spicer (Worcestershire, South): I agree with the tone of much that my right hon. Friend said, particularly in respect of the European Commission, Parliament and Council. However, I believe that my right hon. Friend said that a single currency is unlikely to come about in the near future. Is not that difficult to square with the treaty, which states that a single currency must come about by 1 January 1999? Was my right hon. Friend implying that the treaty must be amended, so that the timetable will not be fixed?

The Prime Minister: Originally, in 1972, there was agreement on a single currency by 1980. That patently did not happen because neither the economic circumstances nor the political will were right. It is certainly the case that the economic circumstances will not be right for 1997. It is extremely improbable that the right economic circumstances will be widespread in the Union in 1999--and they, too, are written into the Maastricht treaty as a necessary precondition for a single currency. That certainly applies to a European Union of 12, 15 or whatever number of states. It is conceivable, though no one yet knows, that a smaller group of member states might be ready by 1999. Even if that were the case, they would need to consider carefully the implications for the whole European Union

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if they adopted a single currency when the others--whether or not they wanted to go ahead--were not economically in a position to do the same.

Mr. Andrew F. Bennett (Denton and Reddish): The Prime Minister reported that the summit agreed to abandon the proposal for a carbon tax. Did the summit reaffirm commitment to the Rio targets? If so, how will the British Government meet their commitment?

The Prime Minister: A European Union conference on environmental matters will be held in Berlin in the near future. The summit touched on environmental matters only in general because it agreed that those matters and the Union's position at the Berlin conference should be discussed at the Environment Council next week.

Mr. George Kynoch (Kincardine and Deeside): I welcome my right hon. Friend's statement. Does not it demonstrate the United Kingdom's great influence on European affairs? Does my right hon. Friend agree that it would be disastrous for all parts of the United Kingdom if that single, strong voice were put at risk--as it surely would be under Labour's proposals for constitutional reform?

The Prime Minister: That is undoubtedly the case. I have forcefully expressed my views on that issue in the past. If the United Kingdom did not have a single, unified voice in the European Union, it would not have the same force of argument. That does not apply exclusively to the Union, because it would also be the case in the United Nations, G7 and every other international forum where Britain currently sits at the top table. A divided United Kingdom, perhaps leading to parts of it being separated, would not allow it to retain that position.

Mr. Barry Jones (Alyn and Deeside): Did the Prime Minister raise at the summit the difficulties confronting the British aerospace industry? Did France and Germany raise with him the need for the British Government to purchase the future large aircraft? I hope that they did. Is the right hon. Gentleman aware that my constituents,

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who manufacture the European Airbus, are terrified that the Government will buy Hercules and not place orders for the FLA?

The Prime Minister: No, the British aerospace industry was not discussed--although it is, of course, important. Much of the present Hercules fleet will need either substantial refurbishment or replacement. We must consider whether to go wholly or partly for refurbishment, buy new planes now, or buy some new planes now and develop the future large aircraft. Those matters are under active consideration and no conclusion has yet been reached.

Mr. Tim Smith (Beaconsfield): Is my right hon. Friend aware that there will be a warm welcome for the additional funds destined for Northern Ireland? Did not President Delors take a particular personal interest in the Northern Ireland peace process? Will my right hon. Friend confirm that the funds will genuinely be additional and directed at areas of greatest economic and social need?

The Prime Minister: My hon. Friend is entirely right. From the moment of the Downing street declaration, President Delors has been particularly helpful in regard to developments in Northern Ireland. I am very grateful to him for the personal effort that he has put in, and the personal part that he played in ensuring that this substantial package of extra assistance for Northern Ireland and the border counties of the Republic would be made available. It will be used for projects to promote reconciliation, encourage economic growth and expand job opportunities.

Mr. Harry Barnes (Derbyshire, North-East): Is it not disappointing that nothing was done at Essen to tackle the democratic deficit? Should not powers move to the European and national Parliaments, and away from secret bodies such as the Council of Ministers?

The Prime Minister: I am not sure that I would describe the Council of Ministers as a secret body. No one who attends its meetings would regard them as at all secret. Given that everyone holds press conferences immediately after the meetings, that conclusions are published, that some of the meetings are open nowadays and I will answer questions about them-- as, no doubt, will others--I do not think that they are terribly secret. I am not sure that the hon. Gentleman is on the strongest ground.

Several hon. Members rose --

Madam Speaker: Order. We shall now move on.

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Points of Order

4.30 pm

Mr. Frank Cook (Stockton, North): On a point of order, Madam Speaker. Last Thursday I reminded the House that the implementation order relating to local government reorganisation in the county of Cleveland was still before the courts. At that time, the Lord President of the Council effectively withdrew the assurance that he had given in June this year that progress on the order would await resolution in the courts. I submit that that in itself was a hindrance to proper procedure.

On 10 March, the Parliamentary Under-Secretary for the Environment assured the House that his Department would

"place in the Library a summary of all representations received by the Secretary of State about the Commission's final

recommendations"--[ Official Report , 15 March 1994; Vol. 239, c. 577 .]

when the Government laid the implementation order for Cleveland. He repeated that promise on 31 March. The order was laid last Thursday--nine months after that promise was made to the House, and 13 months after the Banham commission made its infamous recommendation. Despite repeated telephone calls from Library staff to the Department throughout Thursday, Friday and today, the summary of submissions has not yet been deposited in the Library.

Not only has the Secretary of State for the Environment treated the people of Cleveland with cynical non-concern by denying them a proper means of registering their preference; he has breached faith with the House by failing to keep his word, thus depriving hon. Members of information that could be crucial to the making of proper representations. May I ask you, Madam Speaker, to make the appropriate investigations of this disgraceful breach of faith?

Madam Speaker: From what the hon. Gentleman has said, the Department appears to have been very lethargic. Ministers will have heard that exchange, and I hope that they will report it to the appropriate Department without delay.

Ms Angela Eagle (Wallasey): On a point of order, Madam Speaker. A couple of hours ago, I heard that the North West gas board had introduced a £21 call-out charge for gas leaks. I am extremely concerned that that may lead to dangerous circumstances in the north-west. Will you advise me, Madam Speaker, on how I might raise the issue in the House as a matter of urgency?

Madam Speaker: Advice on procedure is not given across the Floor of the House, but I am sure that the hon. Lady--who is wily in the ways of getting things done in the House--will find methods of doing so before the House rises: indeed, in the next day or two.

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Orders of the Day

Health Authorities Bill

Order for Second Reading read .

Madam Speaker: Before I call the Secretary of State, I must inform the House that I have selected the amendment in the name of the Leader of the Opposition.

4.32 pm

The Secretary of State for Health (Mrs. Virginia Bottomley): I beg to move, That the Bill be now read a Second time.

The Bill represents the final steps in the programme of national health service reform that began with the National Health Service and Community Care Act 1990. When we embarked on those reforms, there was a clear consensus that the NHS needed to change. Despite the substantial extra funds that the Government had committed--increases unprecedented in its history--the service was still often inefficient, inflexible and unresponsive to the needs of patients.

Management was exercised through a cumbersome, command-and-control bureaucracy; staff were trapped in a system over which they had little or no control; the vested interests, whether they be the trade unions or the Sir Lancelot Spratts of this world, had too much power. The patient had little say, and even less choice.

The background to the Bill is four years in which--

Mr. William O'Brien (Normanton) rose --

Mrs. Bottomley: I am sure that the hon. Gentleman wants to share reminiscences with me, as someone who was a member of the Standing Committee that debated the National Health Service and Community Care Act 1990 five years ago. However, I must make progress.

The background to the Bill is four years in which the balance of power in the NHS has changed. We have effected a fundamental and irreversible shift in favour of the patient. Before I outline the detailed provisions of the Bill, let me remind the House of some of that progress.

We said that we would devolve power and responsibility to the local level, so that decisions would be taken as close to the patients as possible. We have done that by establishing NHS trusts, by creating a new and distinct role for local health authorities, and by giving family doctors more power through fundholding.

The hon. Member for Livingston (Mr. Cook), whose dodgy predictions we always enjoy on these occasions, foretold that the trust movement would be like a bicycle with a flat tyre. Well--some bicycle, some tyre. Not 30 per cent., not 50 per cent., not 70 per cent., but 96 per cent. of hospitals and community health services are now run locally as trusts.

I am delighted to be able to inform the House that I have approved a further 13 applications from hospitals and ambulance services wishing to become trusts from next April. That will mean that not 96 but 98 per cent. of services will be in trust hands.

Mr. O'Brien: Will the Secretary of State comment on the proposals for the Yorkshire and Northern regional

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health executive, which covers an area equal to that of Scotland but which will have fewer than 140 people to administer it and ensure fair treatment in hospitals? Will she consider allowing the existing Yorkshire regional health authority boundaries to remain in place, which would mean a better service for the people of the region?

Mrs. Bottomley: That is evidence of the Opposition's hypocrisy when they claim that they wish to reduce bureaucratic layers of management. We can achieve savings by reducing the number of regional health authorities and, what is more, because of the nature of the responsibilities devolved to the districts, we do not need the large command-and-control regional health authorities. The Opposition are always hankering after regional government, tiers of government and layers of officials. That is their idea of paradise, but it is not the right way forward for the health service today.

I cannot finish with the subject of trusts without offering the right hon. Member for Derby, South (Mrs. Beckett) one last opportunity to clarify her party's policy on NHS trusts. Would they stay or would they go under Labour? Will she say yes or will she say no? She recently had breakfast with David Frost, and she made a proper meal of it. I have the transcript of the programme here. The right hon. Lady was asked whether she would keep the trusts, and she replied:

"You can't simply tear the plan up and start again".

That seems perfectly clear, but, two pages further on in the transcript, she has changed her mind--

"By the way"--

she added as an afterthought--

"we're not talking about keeping the Trust hospitals". She is after all thinking of tearing up the plan and starting again.

I know that, in her defence, the right hon. Lady will say that she is consulting. She told Mr. Frost that a Labour Government's first dramatic act in respect of trusts would be to do even more consulting. To be fair to her, she also said that she would "consult fast", but that is not good enough. Labour has a third health spokesman, but the party is still consulting.

I doubt that the right hon. Lady could tell us the day of the week without gathering views from the length and breadth of the Labour movement and issuing a discussion document. It has to be said that the right hon. Lady is the author of the biggest waiting time scandal in the national health service--the length of time that the public have been kept waiting for the Labour party's health policy. I was referring to the progress made in implementing the Government's health reforms which form the backdrop to the Bill. As part of the reforms, we promised more consultants to reduce waiting times, to improve the quality of services and to cut long hours. In those three years, more than 1,000 new consultant posts were created. Thirteen thousand on-call rotas of 83 hours for junior doctors were eliminated, and in the past six months there has been a 46 per cent. reduction in the number of on-call rotas of more than 72 hours. That is real progress, which will lead to benefits for patients as well as staff.

Mrs. Jane Kennedy (Liverpool, Broadgreen): Is one of the 13 national health service trusts that the Secretary of State is announcing today the proposed new trust which

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is a merger between the Broadgreen hospital trust and the Royal Liverpool university hospital trust? The two NHS trusts are struggling financially, but the proposed merger offers no solution to their financial problems.

The people of Liverpool have waited a long time for a decision. They have been "consulted"--according to the Secretary of State's understanding of the word--and we are now waiting for her announcement. Will she clarify the situation?

Mrs. Bottomley: I confirm that that trust is one to which I have been able to give approval today. It will join the other trusts in providing excellent quality of care for patients. The hon. Member is particularly fortunate to live in a part of the country which, under the leadership of Sir Donald Wilson, has delivered waiting time achievements which are the envy of the country. Most of my hon. Friends think that the people of Mersey are extremely fortunate to have their health care controlled by the health service rather than by political appointments and local councils which have not had the same achievements or praise. But I do not intend to provoke Labour Members, as I have to make a great deal of progress, and I know that they want to make their own speeches.

We said that general practitioner practices would be allowed to manage their own budgets. Fundholding has proved to be one of the biggest reform success stories. Fundholders are expanding services and shaping the services that others provide in order to respond to patients' needs. They are cutting waiting times, improving the quality of services and showing others the way.

The House does not need to take only my word, or that of my hon. Friends, for it: hon. Members should consult the report released last week by the National Audit Office. It states:

"There is evidence that the direct involvement of general practitioners in health care purchasing has led to improvements in the services provided for their patients and made fundholders more aware of the cost implications of their spending decisions." By being good stewards of available resources, GPs have been able to make the resources go further and work harder for the benefit of all patients.

The report, like the independent evaluation of fundholding by Howard Glennerster before it, is further evidence that fundholding works. The report recommends that the benefits of GP involvement in purchasing should be extended to all patients. That is our policy, and it is why I recently announced a radical extension of fundholding.

Mr. Nicholas Brown (Newcastle upon Tyne, East): Is there not a problem with the right hon. Lady's argument? The National Audit Office report also says that, at the time of the field work, none of the regions it visited was able to compare directly the funds allocated to fundholders and the resources available to districts to purchase equivalent services for the patients of non-fundholders. In other words, the NAO says that direct comparison is not possible.

Mrs. Bottomley: It is quite clear that the methodology behind setting budgets and the details of the reforms' implementation are improving all the time.

Mr. Rhodri Morgan (Cardiff, West): Compare like with like.

Mrs. Bottomley: It is comparing like with like. The report says that there is scope for improving the

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