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Points of Order

3.31 pm

Mr. Paul Marland (Gloucestershire, West): On a point of order, Madam Speaker. I seek your guidance on what appears to have become a conspiracy to cover up an hon. Member's voting record. The question is whether or not the hon. Member for Edinburgh, East (Dr. Strang), Labour's Front-Bench spokesman on agriculture, voted for the export of live animals in 1975.

Hansard shows that, after the debate on 17 January 1975 following the O'Brien report, the hon. Member for Edinburgh, East, on a free vote, voted for the restoration of the export of live animals. Furthermore, on 17 April 1975 in an Adjournment debate-- [Hon. Members:-- "What is the point of order?"] The point of order is that it was not just in one free vote that the hon. Member for Edinburgh, East demonstrated his support for the export of live animals, but in his subsequent actions. In those circumstances, what can be done by the House to establish the truth and to expose what appears to be a conspiracy?

Madam Speaker: First, I take it that the hon. Gentleman informed the hon. Member for Edinburgh, East (Dr. Strang) that he intended to raise that matter today.

Mr. Marland indicated assent .

Madam Speaker: That is as it should be.

Dr. Gavin Strang (Edinburgh, East): Further to that point of order, Madam Speaker. This is an abuse of the time of the House. [Hon. Members: -- "Oh."] If Conservative Members have any doubt about that, they should read the remarks of the Minister of Agriculture, Fisheries and Food, who accepted the position. We reached agreement on what actually happened.

I will briefly state the facts. In 1973, I voted to stop the export of live animals, on a Labour motion. The Conservative Government, who opposed that motion, set up the O'Brien committee. By the time that a Labour Government were elected in 1975, of which I was a member, the O'Brien committee had recommended increased safeguards and resumption of the trade. I might add that the trade then was in cattle and pigs, and was small compared with now. I, as a member of the Labour

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Government, voted with those on the Conservative Front Bench and with the Labour Government for a resumption of the trade. It is nonsense to make such a meal of this. I have never sought to misrepresent the position. It is the hon. Member for Gloucestershire, West (Mr. Marland) who, at Prime Minister's questions a fortnight ago, misrepresented it.

Several hon. Members rose --

Madam Speaker: Order. I will hear no further points of order on that matter. Points of order on it are becoming far too frequent. It has now been cleared up once and for all.

Ms Glenda Jackson (Hampstead and Highgate): On a point of order, Madam Speaker. Last week, I tabled a series of questions for written answer regarding incidents of fire, crimes of violence, unannounced station closures and train cancellations on London Underground. Such questions had been answered in some detail in the Official Report in June 1994.

The reply that I received from the Minister for Transport in London on 27 January of this year was that these are operational matters for London Underground. Surely that constitutes an abdication not only of Government responsibility but of accountability to this House and to Londoners. I should be grateful for your advice on how to proceed in this matter.

Madam Speaker: As far as I am aware, there has been no change of policy. Ministers are responsible for the answers that they give. As far as I know, and as the hon. Lady has told the House, these are day-to-day matters of an operational nature. I am sure that she would want to find other ways of pursuing them, possibly with London Underground direct--or she may even try to get an Adjournment debate.


Motion made, and Question put forthwith pursuant to Standing Order No. 101(3) (Standing Committees on Statutory Instruments, &c.),

Sex Discrimination (Armed Forces)

That the Sex Discrimination Act 1975 (Application to Armed Forces etc.) Regulations 1994 (S.I., 1994, No. 3276) be referred to a Standing Committee on Statutory Instruments, &c.-- [Mr. Kirkhope.] Question agreed to.

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Motor Vehicle Insurance Certificate Display

3.36 pm

Mr. Bob Dunn (Dartford): I beg to move,

That leave be given to bring in a Bill to require all registered owners of motor vehicles to display prominently on each vehicle owned a valid certificate of insurance and for it to be an offence if no certificate is so displayed.

This is a straightforward Bill with a single aim: to reduce and eliminate the problems created by the uninsured motorist for the insured motorist-- problems of personal tragedy, financial difficulty and abuse of the law.

As the House knows, the law requires vehicles to be road-taxed, to undergo Ministry of Transport testing when of a certain age, and to be insured. On that last requirement, estimates vary, but it is reckoned that at least 1 million motorists currently drive without insurance. Other estimates whose accuracy I have no reason to doubt place the figure nearer 2 million or over 2 million.

The House will accept that this involves a cost, as all hon. Members will testify, knowing the cases of real hardship and personal anxiety that cross our desks from time to time. There is a cost to the insured, honest motorist, as recognised by the Association of British Insurers in a paper issued last year, which states, among other things:

"The cost of uninsured motoring has risen by an unacceptable extent over the last few years, and continues to rise."

Motorists who do insure are entitled to be protected against this cost. There is no reason why they should pay a surcharge on their premiums to meet the obligations of motorists who are not insured. But the honest motorist is paying a surcharge to pay for claims dealt with by the Motor Insurers Bureau, set up in 1946 by the industry with the aim of meeting judgments in respect of third party personal injury claims--and additionally, since 1989, of third party property damage claims.

In 1988, the Motor Insurance Bureau paid out £26 million in claims. But for 1994, the figure seems likely to be in excess of £100 million. The final figure for that year, including other categories, may well be in excess of £250 million. My hon. Friend the Member for Gloucester (Mr. French) pointed out, in an excellent trail-blazing speech last year:

"The failure to tackle the problem vigorously is expensive, because uninsured motorists give rise to claims bills of some £250 million a year. Thus, a £250 million subsidy is paid by honest motorists to dishonest motorists. The Motor Insurance Bureau is funded by a 2.5 per cent. levy on motor insurance policies, which is not much different from the insurance premium tax, on which so much objection has been expressed."

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My hon. Friend later pointed out a parallel with the vehicle excise duty, and said:

"Some important parallels can be drawn with vehicle excise duty, for which the display of valid cover is mandatory. There are 140,000 convictions a year for failing to display a road fund licence. They are not displayed because they have not been bought; but the chances of identifying 140,000 evaders without a requirement to display would be minimal."

He continued:

"So the need to display enhances compliance. I submit that, were not the tax disc required to be displayed, the level of evasion would be much higher. It therefore follows that, if an insurance disc were required to be displayed, the number of uninsured motorists would be likely to decrease or the number of evaders apprehended would increase."--[ Official Report , 19 December 1994; Vol. 251, c. 1446-48.]

We have international comparisons to draw on. In 1986, the Government of the Republic of Ireland went over to an insurance disc display system. Prior to that, 20 to 25 per cent. of Irish drivers were uninsured. Yet one year following the introduction of the display disc, the percentage of uninsured motorists fell to less than 10 per cent. Similar systems are in operation in France and the United States.

My interest in the matter first started in the days when my noble Friend the Baroness Chalker was Minister of State, Department of Transport. I raised the issue with her--I was treated kindly--but to no effect. Other colleagues in the House have raised the matter over the years, and it is time that something was done. To have between 1 million and 2 million uninsured motorists driving on our roads is unacceptable.

I believe that this simple measure, which requires the owner of a motor vehicle to display a valid insurance certificate on his or her windscreen or vehicle, in a prominent place, would ease the burden that I have described. There is a cost to the insurance industry and to the Treasury, but more importantly to the motorist and the road user.

Question put and agreed to.

Bill ordered to be brought in by Mr. Bob Dunn, Sir Jim Spicer, Mr. Jacques Arnold, Mr. Douglas French, Mr. Harry Greenway, Mrs. Gwyneth Dunwoody, Sir Anthony Grant, Mr. John Marshall and Mr. James Pawsey.

Motor Vehicle Insurance Certificate Display

Mr. Bob Dunn accordingly presented a Bill to require all registered owners of motor vehicles to display prominently on each vehicle owned a valid certificate of insurance and for it to be an offence if no certificate is so displayed: And the same was read the First time; and ordered to be read a Second time upon Friday 3 March, and to be printed. [Bill 41.]

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Opposition Day

[3rd Allotted Day]

National Health Service

Madam Speaker: I have selected the amendment in the name of the Prime Minister.

3.44 pm

Mrs. Margaret Beckett (Derby, South): I beg to move,

That this House views with alarm the growing evidence of dangerously inadequate patient care and of overstretched staff and facilities in the National Health Service; takes heed of the testimonies of those senior staff who are still free to speak, who say that the very existence of a nationwide service in health care is at risk; rejects the drive to replace it by local health businesses; and calls for a moratorium on bed closures in London, and on the Government to reassess their dogma-driven policy changes and to foster co-operation, not competition, between staff and institutions.

We move the motion today at a time when the Conservative party's "huge national experiment", as the chief executive of the NHS has described it, is turning health care into health chaos. Many of those who work in the health service would view with considerable irony the wording of the Government's amendment, since they think that the Government have already created chaos out of the health service as it is.

We move the motion at a time when those charged with responsibility for the public health of our nation are held in ever-rising contempt by lifelong Conservatives who are also distinguished consultants. The British Medical Association's "News" reported in October 1994 that half of consultants surveyed believed that the standard of care had declined in the last five years and 63 per cent. believed that the NHS as we know it will disintegrate. The Government are held in contempt by staff at every level of the health service, by journalists on newspapers that span the political spectrum, but, above all, by the wider British public.

There is today a threat to the sheer existence of the NHS that the Government and the Prime Minister claimed was safe in their hands. The threat shows in the evidence: in a growing catalogue of difficulties and problems--in the events. Problems can and do arise under any Government, but not on the scale, for the duration or with the consistency with which they are arising under this Government. The threat shows too in the testimony of staff of the health service--privately, for those in fear of the sack, publicly, for those who feel that they are still free to speak. The threat shows in the stark evidence that, whatever the Prime Minister said last October at his conference, the NHS is being privatised, by stealth, before our eyes and with intent, and the only people who are not supposed to be in on the secret are the people of Britain.

Let us begin with the evidence of decay. This debate is taking place after a week in which the corpse of a patient was found under piping in St. Thomas's hospital, parents in Truro found a hypodermic needle under their baby's skin, a woman in Sheffield's Royal Hallamshire hospital left her bed for five minutes, I believe to go to the loo, and returned to find that it had been taken away for use in another part of the hospital.

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Nor are those isolated incidents. There is other evidence too of decay and decline in the health service. The latest final figure of 1,071,000 is the highest published total of people on waiting lists since records of in-patients and day cases waiting have been available. When the provisional waiting list was published, Ministers boasted, and have gone on boasting, that their reforms have delivered shorter waiting lists, but when the corrected final figures showed a record high, Ministers were uncharacteristically silent. They did not even issue a press release.

The Secretary of State for Health (Mrs. Virginia Bottomley): I recognise that the right hon. Lady is relatively new to her job, but the Government have consistently talked about waiting times. Does the right hon. Lady recognise that the average length of time that an individual has been on a waiting list has just about halved since the reforms came in? What is more, does she recognise that the new patients charter, for the first time ever with a standard for out-patients, means that not only has a dramatic improvement in long waiters been achieved, but a limit has been set on out-patient waits?

Mrs. Beckett: The Secretary of State need not disturb herself. I propose to come later to the Government's waiting list figures, and to put them in context.

It is noticeable that on this as on so many other occasions, the right hon. Lady chose not to refer to the point that I made but to raise some other point entirely. That is a characteristic habit of hers, and one which does not contribute to the public's trust in her. As for the length of time that I have been in my post, indeed it has been very short. If I had been in the Secretary of State's post as long as she has, I would be ashamed of myself.

Mr. Terry Lewis (Worsley): Is my right hon. Friend aware that there is now a waiting list to get on to a waiting list? As I have pointed out twice before in the House, I waited 14 months to see a specialist before I was placed on a waiting list for treatment--and I needed that treatment. That is the position in the north-west, writ large.

Mrs. Beckett: My hon. Friend is entirely right. As I hope to show later, that is widely true in the country as a whole--which is why what the Secretary of State says so often seems irrelevant.

Mr. Kevin Hughes (Doncaster, North): In fact, there are now three waiting lists. There is a waiting list to get an appointment, followed by a waiting list to get a consultation; then, and only then, are patients put on a waiting list to obtain treatment.

Mrs. Beckett: That is quite true, and highlights what could be described as a question mark. I believe that it was in yesterday's Daily Telegraph that a journalist observed that the Secretary of State gives plenty of statistics, some of which are correct and some of which bear more than one interpretation.

Dr. John Marek (Wrexham): I hate to correct my hon. Friend the Member for Doncaster, North (Mr. Hughes), but there are not three but four waiting lists. Having eventually gone through three waiting lists at my local hospital, the daughter of one of my constituents was given an appointment for an operation and was then kept waiting for six hours. She was told to telephone at 7.30 the following day; there was no bed. She was told to

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telephone again at 8.30, then at 9.30, then at 10.30. At 11.30, she was told again that there was no bed for her. She is going back next March.

Mrs. Beckett: This has been an interesting exchange. The same thing is happening throughout Britain. Ministers, and the Secretary of State in particular, trot out statistics which, although not necessarily inaccurate- -they are inaccurate sometimes, however--are relatively meaningless. One hon. Member after another can rise to contradict them from his or her own experience.

I have never regarded The Daily Telegraph as a socialist rag, but, according to yesterday's edition, this is why the Secretary of State is so distrusted and disliked.

Mr. Jerry Hayes (Harlow) rose --

Mr. Gyles Brandreth (City of Chester) rose --

Mrs. Beckett: I advise the hon. Gentlemen, both of whom represent very marginal seats, to be wary of associating themselves with such perceived deceit of the country.

Mr. Hayes: Is there not a fifth waiting list--the longest of all? How long have we been waiting to hear the Labour party's health policies?

Mrs. Beckett rose --

Mr. Brandreth: The right hon. Lady spoke of decay. How does she square that with the increase of some 8,000 in the number of doctors and dentists over the past decade, and the fact that there are 3,000 more general practitioners? Most patients in my constituency are now looked after by fundholding GPs, and they seem to like the service they are getting.

Can the right hon. Lady tell us the cost and the implications of her proposals to abandon GP fundholding, which is working well in my constituency? My constituents believe that those proposals would increase bureaucracy and the number of local committees, and would reduce the amount of patient care, which has been improved by the introduction of fundholding. More doctors and better service: that is what we seem to be getting in Chester.

Mrs. Beckett: I am familiar with some of the claims that are made for the advantages of fundholding-- [Interruption.] There is no need for the hon. Member for Lancaster (Dame E. Kellett-Bowman) to scream at me; I can hear her quite clearly.

Patients are almost always happy with the service they receive from their GPs--and a very good thing, too--whether or not the practice involved is fundholding. Let me, however, say two things to the hon. Member for City of Chester (Mr. Brandreth). First, it is far from proven that the advantages to patients of fundholders are linked with the fundholding system itself. Secondly, let me recommend to the hon. Gentleman--who has talked of costs and bureaucracy--an article published, I believe, last week in the fundholders' own magazine. It suggested that the administrative and knock- on cost of each fundholding practice was some £80,000.

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I have been in the House, and studied the present Government, rather longer than the hon. Gentleman.

Dame Elaine Kellett-Bowman (Lancaster): Too long.

Mrs. Beckett: May I remind the hon. Lady that it is I who am making the speech? She says that I am speaking for too long, but I am making a speech and not an intervention.

Dame Elaine Kellett-Bowman: I said that the right hon. Lady had been in the House for too long.

Mrs. Beckett: The hon. Lady has succeeded: I have finally forgotten what I was going to say. I am sure I shall remember shortly.

The main point that I am making to the hon. Member for City of Chester is that the advantages that he claims to exist are not necessarily related to the system of fundholding. Many doctors who have taken it up do not actually support the system as it now exists, but believe that they are wise to take advantage of the money while it is there.

I have now remembered what I was going to say to the hon. Gentleman. Long scrutiny of the Government's policies tells me as clear as day that, once the costs of fundholding become apparent, GPs who hold funds will be squeezed and squeezed and squeezed. They have been bribed into the system, as they are aware, by the use of public money. I assure the hon. Gentleman that it will not last. The more of them there are, the less generous the Government will be to them. I have been diverted from my speech, and I had better return to it.

Mr. Jacques Arnold (Gravesham) rose --

Mrs. Beckett: The hon. Gentleman will forgive me if I do not give way. I am sure that he will have an opportunity later. I know that he is one of the Government's avant-garde when it comes to interventions. [Interruption.] I hope that I am not complimenting the hon. Gentleman too much.

A survey of English regional health authorities showed today that more than 10,000 operations were cancelled on the day of or after admission to hospital, and that about 10 per cent. of the people involved were not readmitted within a month. The number of hospital complaints has risen 300 per cent. in the past 10 years. That is a good example of how different interpretations can be put on the evidence.

In The Daily Telegraph yesterday, the Secretary of State said that the 300 per cent. increase in hospital complaints was evidence of how well the system was working, because it was easier for people to make complaints. The Daily Telegraph reporter asked her, if she judged such an increase in complaints as evidence of success, by what measure she would judge failure- -a pertinent point, and one that I have yet to hear the Secretary of State deal with. I am sure that she will come to that matter in her speech.

Hospital and ward closures are continuing. The NHS lost more than 10,000 beds in 1993.

Dame Elaine Kellett-Bowman: There have been increases in day cases.

Mrs. Beckett: The hon. Lady is right. The number of hospital beds has decreased partly as a result of day case

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treatment, and partly because of the advantages of medical technology. Will she explain, however, why, side by side with reductions in the number of beds in the public sector, the number of beds in the private sector has increased? It is clear to us that what is happening is a matter not simply of medical advance, but of changing direction in the provision of health care in Britain. That is especially striking when it comes to psychiatric beds, where the position is even more crystal clear.

A study, which I think was carried out by the Royal College of Psychiatrists, suggests that many units, especially those in London, have a so-called bed occupancy rate of more than 100 per cent. The study states that some units in inner London have a bed occupancy rate of 120 per cent. because of the disappearance of long-stay beds. The number of people needing care far exceeds the number of beds in which to treat them.

Mr. Jacques Arnold: The right hon. Lady referred to anecdotes from her colleagues. She might like to hear the anecdote of a constituent of mine who rang up to say how pleased he was with the treatment that he had received in our local NHS--a treatment that was not available on the NHS only a few years ago, and especially not under the Labour Government. The only reason that he is receiving the treatment is the more than 50 per cent. real terms increase in the Government's spending on the health service.

Mrs. Beckett: As I said in our previous debate--I do not think that the hon. Gentleman was here on that occasion--in all honesty, people in the NHS and the British public find few things more offensive than Conservative Members taking the credit for medical advances, for the work of health service staff, or for anything else that has gone right in the health service, especially when they so patently refuse to take the blame for anything that has gone wrong. I am delighted to hear that his constituent--

Mr. Arnold: That will not wash.

Mrs. Beckett: Public reaction suggests that that is exactly what the British people believe, and they are right to believe it.

Mr. Peter L. Pike (Burnley): All too often, because of financial restraints and financial considerations, patients are discharged from hospital far too quickly, purely on financial, rather than medical, grounds. Is not that one of the ways in which the Government reduce the number of beds, and one of the factors that lead to complaints? Even worse, on some occasions those patients do not even have the back-up so that they can be looked after when they get home.

Mrs. Beckett: My hon. Friend is right. Real concern exists about whether we respond adequately to the changes with discharge procedures, and about whether we are considering readmissions and other matters. We continually press the Government on that matter.

Mr. Alex Carlile (Montgomery): The right hon. Lady focused on psychiatric care, a subject in which the Secretary of State has some professional expertise. Does the right hon. Lady agree that it is not only the shortage of psychiatric beds in London that is a scandal but the

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fact that some patients are being shunted 100 or 200 miles from their homes although their families are an essential element in their psychiatric treatment?

Mrs. Beckett: The hon. and learned Gentleman is entirely right. It is especially worrying that this most vulnerable group of people are being treated in that way. No one who knows the position is at all happy or satisfied with the level of care that it implies. A survey carried out by the Royal College--

Mr. Toby Jessel (Twickenham): Will the right hon. Lady give way?

Mrs. Beckett: No, I am sorry, but I had better get on. I have given way a great deal already; I may give way later if I have time. A survey carried out by the Royal College of Radiologists was cited in a Which? survey of the Government's health care changes--I know that the Government always approve of consumer surveys. The Which? report states:

"A survey carried out by the Royal College of Radiologists in 1993 found that 14 out of 29 cancer units reported waiting times for radiotherapy of four weeks or longer. In some cases the delay is seven or eight weeks"--

which no one can think desirable in terms of health care. The Evening Standard has done a great deal of work on health care, and it is noticeable --this pattern occurs not only in London but across Britain--that it has more health stories that worry reporters, editors and readers than it can readily print. On 25 January, the Evening Standard stated:

"This winter, there have been several occasions when not a single intensive -care bed has been available anywhere in the capital for either an adult or a child."

Despite that fact, seven of London's 48 intensive care units are said to face closure.

I refer now to the Secretary of State's use of statistics. Which? states:

"It simply isn't true"--

as the Secretary of State said yesterday--

"to say that no one is waiting more than two years. The figures published by the Government under the Patient's Charter"-- which I regard as a cone hot line for the health service-- "reflect"--

they should do so, but they do not--

"the experience of people".

The article draws attention to the fact that the top priority in the NHS since the Government's so-called reforms has been to reduce waiting times and how much money the Government have put into it, but it also states that the targets and proposals represent only half the story. It finishes by saying:

"The only national figures"

for waiting times

"that are currently published are compiled by the

independently-funded College of Health. These show that some patients wait well over a year or more to see a specialist, who then decides whether or not to put them on a waiting list."

It goes on to state that some of the longest waits are of three years for general surgery and more than two years for orthopaedic care.

I am struck by the fact that the Secretary of State used to imply--I do not want to misrepresent her, but it may even be that she used to say--that the issue to which my

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