House of Commons Hansard Debates for 2 Mar 1995

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because of problems with organising funding or if they cannot go private is acting like those who passed on the other side of the road to Jericho. It may make sound economic sense to the Conservative party, but it is morally indefensible for the Government of Britain to behave so at the end of the 20th century.

8.13 pm

Mr. Cynog Dafis (Ceredigion and Pembroke, North): I warmly welcome the hon. Member for Islwyn (Mr. Touhig) and thank him very much for his important speech and his critique of Government policy on the health service. I enjoyed my occasional stay in Islwyn during the campaign, saw something of the hon. Gentleman and appreciated the spirit in which the campaign was fought. My one regret is that, during his maiden speech, there were not more Conservative Members present to listen to what he said.

Mr. Ron Davies: There are too many.

Mr. Dafis: Indeed, but more should have been here to listen to the hon. Gentleman's speech.

I want to speak about the education service in Wales, especially about what is going on in Dyfed. Three weeks ago, I attended a packed meeting--so packed that some people had to be excluded--at Trinity college Carmarthen that was convened by the federations of school governors in Dyfed and the parent-teacher associations. It was attended by parents, teachers, school governors and councillors united--I emphasise--in anger at the crisis facing schools as a result of cuts in county funding.

The catalyst for the meeting was the Welsh Office's refusal to fund the teachers' pay rise of 2.7 per cent. The immediate objective of the meeting was to urge Dyfed county council to use some of its reserves to fund the shortfall. It was said that unless Dyfed dug into its reserves, about 150 teachers would be dismissed in September, there would be cuts in the schools' budgets of 2.8 per cent. despite an anticipated increase in pupil numbers and one third of Dyfed's schools would find themselves in budget deficit.

The immediate objective was achieved. The following day, Dyfed county council agreed to release £1.3 million from its £4 million reserves to fund the 2.7 per cent. pay award over what had been originally intended. The meeting recognised too that there was an underlying and severe funding problem that pre-dated the teachers' pay award of 2.7 per cent. Underlying that crisis, there was something much deeper.

Since 1993, Dyfed county council has found its budget squeezed in an intolerable fashion. In 1994-95, for example, the budget was increased by 1.75 per cent. in a year when inflation ran at more than 2 per cent. In 1995-96, the increase will be 0.4 per cent., when inflation is anticipated to be between 3 and 4 per cent. On top of inflation, of course, which is crucial, the county council in particular, along with other local authorities, has faced additional responsibilities and demands--many of them statutory. It has found itself facing the results of demographic changes--an increase in the number of elderly people and the associated cost--and an increase in the number of schoolchildren.

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I shall cite one example of the additional statutory requirements faced by a county such as Dyfed--indeed, by all counties in Wales in recent years. The Education Act 1993 created a statementing procedure for special educational needs that local authorities are obliged to implement. The increase in the amount of statements over recent years is worth noting and is very significant. The number of statements has increased from 646 in 1990 to 2,117 in 1995. In other words, it has more than trebled, which requires resources and involves costs. That constant increase has been driven, first, by parent demand--parents' awareness of what could be available to them and their awareness of their rights in that regard--and, of course, by statutory provision. In 1993-94, Dyfed budgeted £5.4 million for special educational needs. It actually spent in that year, because it was obliged to, nearer £6 million. In 1994-95, the budget was set at £6.167 million, but it is likely to be £6.76 million. The 1995-96 budget has meant that Dyfed has had to cut education spending by 3 per cent.--£4.5 million. That cut in education is the lowest proportional cut across the departments of the county council.

I want to give some examples of what is being cut. People have been perfectly justified in demanding additional resources for discretionary awards in further education. However, Dyfed is having to cut £150,000 in respect of discretionary awards. Over recent years, community education has increasingly been becoming a Cinderella. That is regrettable. However, Dyfed is having to cut £100,000 from its community education.

Dyfed is also having to cut the repair and maintenance of school buildings by £1.4 million. That is a hopeless approach to housekeeping. Dyfed is also having to cut £100,000 from in-service teacher training. In doing so, it loses the opportunity of GEST--grants for education support and training--funding from the Welsh Office of a further £150,000.

More important than any of that is the fact that there is no provision in Dyfed's budget this year for inflation in school budgets for non-pay items- -books, materials and equipment. At a time when we are talking about the need to raise education standards, the basic materials are now being cut because there is no provision for inflation.

The lack of provision for inflation means that schools will have to fund a significant part of the teachers' pay rise from their own budgets. They will have to find that money from their reserves--some schools have reserves, but others have deficits and no reserves--or from a further cut in the funding for books, materials and so on. The euphemism used in that regard is efficiency savings.

When the basic provisions in schools are cut, the situation becomes critical. At the very best it means that a school's parents and supporters will have to raise funds to make up the shortfall. They are raising funds now, not for additional luxuries that one might think it reasonable for parents to contribute to, but for the fundamental necessities of education in schools. That is entirely unacceptable because it is an unfair burden. Parents find that they must contribute constantly to all kinds of causes. It is also pernicious because it is inequitable. Parents in some areas are clearly better able to make up the shortfall than parents in other areas. Inequity is increasingly becoming a feature of the school scene.

That state of affairs has led governors in Dyfed, not councillors, to ask for a meeting with the Secretary of State for Wales. I do not know whether he has received

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the request yet. If not, he will receive it soon and I hope that he will agree to the meeting. Tomorrow, representatives of people in Dyfed will hand in 2,000 letters to the Welsh Office in Cardiff and a petition will be presented in the near future.

People are very angry. I have rarely felt such anger among people in respect of the implementation of policy. There is deep anger, resentment and hostility towards the Government. People now understand perfectly what is happening. They understand what is afoot. They understand the hidden agenda, which has been exposed to all and sundry. The agenda is to undermine and remove local authority responsibility for schools. The intention is that that should be achieved by a combination of Government- imposed financial constraint and privation and the promotion of grant- maintained status, complete with inducements. These are the pincers the Government are using in order to bring their aim to fruition.

Part of the process involves obliging local authorities to dip into their reserves to reduce those reserves to perilously low levels. That weakens the position of local government in the process of reorganisation.

The Government are zealous in their promotion of grant-maintained status. Last July, the former Minister of State, the right hon. Member for Conwy (Sir W. Roberts) announced new measures in relation to GM status that meant that governors were obliged to consider the issue annually; the issue had to appear on the agenda every year. There was always an increased aid package for schools considering becoming grant-maintained.

The former Minister of State's successor, the hon. Member for Clwyd, North- West (Mr. Richards), the hammer of local government, is even more fanatical in his zeal for GM status. In September, he announced that information packs were to be sent to schools--and these are his words; I would not use them--

"outlining the advantages and opportunities offered by grant-maintained status."

Those information packs include significant inducements. Special purpose grants, capital grants and transitional grants are on offer. Those grants are significantly more generous than anything that could be available from a local education authority. For example, an 80-pupil school would, if it opted for and obtained GM status, receive a total of £53,400 in its first year. That is quite an inducement and it is difficult to resist.

Dyfed county council has calculated the difference between what the Welsh Office would provide in that way and what the local education authority would be able to provide. If all schools in Dyfed were to become grant- maintained, the difference between what the Welsh Office is offering as an inducement and what Dyfed can offer would be £14, 936,000. That is a nice sum which Dyfed could use to combat its shortfall.

An extrapolation of that concept on an all-Wales basis shows that the Government are offering £124 million if all the schools in Wales were to choose GM status and the Welsh Office agreed to that. It is worth asking what would happen if that occurred. Would the Welsh Office be prepared to foot such a bill?

Significant inducements are on offer and all that is happening at the same time as local government reorganisation. Local authorities will soon have to prepare and present their service delivery plans for the new

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unitary authorities. Those plans are the descriptions of how they are going to deliver services, and that includes education. How can local authorities possibly decide how to deliver education services? How can they decide the size of the establishment which will be available or which they will have to recruit? How can they decide how best to collaborate with adjoining local authorities to arrange the delivery of services if they cannot even be sure how many schools they will have to service?

It is quite clear that it is the Government's intention--I believe this; it is not just rhetoric--to achieve their aim of making GM status the norm and having all schools in Wales grant-maintained by creating disorder in the existing system. When the Conservative party presents itself as the advocate of social order and the orderly implementation of policies, it is astonishing to find a Conservative Government employing tactics of the worst kind of anarchism to achieve their aim. They believe that if they undermine the present system, they will be able to create their new Jerusalem according to their own values and model. The greatest deceit is that that is done in the name of choice and diversity.

I was very disappointed to hear the leader of the Labour party recently defend the grant-maintained sector as providing a welcome element of choice. Of course, we know that choice exists for those who can afford it and for those who are themselves chosen. Grant-maintained status and its development are really about selection. That is what it will inevitably lead to, and that is implicit in the Education Act. The reintroduction of selection at 11-plus is its intention. In part, grant-maintained status is a vehicle for that. The statement of the Labour leader clearly shows the need for distinctive Welsh policies and for the power to legislate in Wales, whatever party is in power in London. Hardly any aspect of policy demonstrates more clearly the need for Welsh self-government than education. The so-called reforms of the past decade have been designed in a way that, at best, is inappropriate for Wales and they are certainly incompatible with our values and aspirations. That is true of the encouragement of competition between schools, the design of the curriculum, which is inappropriate to the Welsh situation, and the setting up of two parallel systems of public sector schools and then letting them fight it out to the death. That is what the Government are imposing.

Mr. Richards: The hon. Gentleman said that the design of the national curriculum for Wales was inappropriate. Does he mean, therefore, that making Welsh a core subject in the national curriculum was inappropriate for Wales?

Mr. Dafis: The hon. Gentleman would be surprised if I answered yes. I am referring not to that but to the structure of the curriculum and the fact that the curriculum has not been designed on the basis of the knowledge that pupils in Wales should receive. I am referring, too, to one very simple fact: that the design of the curriculum, which is uniform across England and Wales, ignores the fact that we have an additional subject in Wales, to use rather old-fashioned language, which takes up four to five

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lessons a week, yet the content of all the other subjects is designed for a curriculum that does not include that additional subject. That is a perfectly good example.

Mr. Richards: The hon. Gentleman must know that the orders for the national curriculum in Wales are designed for Wales and are different from those for England--in Welsh subjects.

Mr. Dafis: I anticipated that that would be said. Of course, we have some variation in the orders in some subjects. We have what is called a Curriculum Cymreig. It is totally inadequate. What we need in Wales is a curriculum based on Welsh values and Welsh ideas and the knowledge that is appropriate to our needs. We need something much more radical than the present curriculum. By the way, we also need to strengthen the powers of ACAC--the Curriculum Assessment Authority for Wales--which is little more than a subsidiary of the London-based body, the Schools Curriculum Assessment Authority. I think that I have made my point about what the Government's agenda is. The good news is that the Government's agenda is now well understood. The Government have been rumbled good and proper. The people of Wales are enraged by the combination of subterfuge and bullying that now occurs. Matters have reached the stage at which, as the hon. Member for Caerphilly (Mr. Davies) mentioned, the Welsh Office was actually afraid--I use that word advisedly--to send a Minister to an important BBC television debate on the state of the nation, which was broadcast on Tuesday. That is an extraordinary state of affairs--the Government were not prepared to be represented in such a debate.

It is infuriating that the situation in Wales is being driven by a Secretary of State who has the democratic mandate of the people of Wokingham only, who, within the Cabinet, has led the drive for public expenditure cuts, and who is now leading the drive for tax cuts before the next election. The Secretary of State is the arch-proponent of competition as a motive force of public sector services, including education. The Secretary of State, of course, has been overwhelmingly rejected by the Welsh electorate.

While that mayhem is occurring, the real education issues in Wales that should be occupying our minds are largely unaddressed. We should debate how to raise school standards in Wales--standards need to be raised--without recourse to the irrelevant market mechanisms that the Government regard as their only instrument. What examination and assessment system is likely to contribute to raising standards in Wales? We need to look carefully at the ideas that have been put forward by the Institute of Welsh Affairs in its recent document on the Welsh education system.

How best can we deliver education for 16 to 18-year-olds within an integrated framework instead of the present mish-mash in which education for that age group is funded from two different sources and in which we have the ridiculous competition between further education colleges and school sixth forms and so on? What structure should there be for a truly Welsh national curriculum? How can we best expand the advantages of Welsh- medium education and knowledge of the Welsh language so that they become available to all?

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Those are the real issues. They remain undiscussed because we do not have a democratic forum in which to debate them. Those issues will remain unattended until we have a self-governing Wales that sets its own priorities and is charged with the task of building our own national future. The achievement of a self-governing Wales is now being assisted daily by the Government's opposition to it. Every time they open their mouths, they strengthen the case for Welsh self-government, but the achievement of it must be the central theme of Welsh politics.

8.35 pm

Mr. Llew Smith (Blaenau Gwent): I congratulate my hon. Friend the Member for Islwyn (Mr. Touhig) on a remarkable contribution, which I would have expected from him. He represents a constituency with a fine tradition and a fine past. If things go well in the next couple of years, he will also represent a constituency with a fine future. We all look forward to that day.

If the Government had been in office for only the past 15 months, I could understand their refusal to accept responsibility for many of the problems that we face in communities throughout Wales, but they have not been in office for 15 months--they have been in office for 15 years. Because of that, they must accept responsibility not only for the problems but for the devastation that they have inflicted upon our communities.

That devastation shows itself in many ways. It shows itself, for example, in poverty levels in communities such as mine in Blaenau Gwent. I am continually reminded of that devastation. Indeed, I was reminded of it at a meeting last year with the local authority, the Welsh Development Agency, the training and enterprise councils and the Department of Employment. In response to a question that I asked about the wage levels for all job vacancies on one day in Blaenau Gwent, the Department of Employment replied that the average hourly wage rate was just over £3. How would the Minister advise people in that situation on bringing up their families in decency and dignity, with that money? I go one further: I ask him to visit my community in Blaenau Gwent and to tell those people how to bring up their children when faced with hourly wage rates of £3.

That problem is not peculiar to my community; it is happening in working- class communities throughout the United Kingdom. I am sure that all hon. Members could give many examples of wage levels below £3 an hour. My hon. Friend the Member for Merthyr Tydfil and Rhymney (Mr. Rowlands) gave such an example some weeks ago, when he referred to a vacancy that was advertised in the local jobcentre. It was for a security guard, who was to be paid the grand sum of £1.80 an hour, and who was advised to bring his own guard dog. That is not an isolated example. Such jobs crop up in Blaenau Gwent and in the communities that my hon. Friends represent.

We can see how bad the situation is, but for the unemployed it is even worse. May I allow some of those unemployed people to speak, and try to explain to the House the feelings and frustrations that they experience every day of their lives? I shall do that through a document which some of us produced a year ago, and which contains what some of the families facing the problems of unemployment say.

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First we hear from an unemployed couple with one child at home. Father, aged 49, is on invalidity benefit, suffers from spondylitis arthritis and has not worked for 11 years. He said:

"The Hoover's broken, it'll cost about £70 to repair so we'll just have to go without. We don't go on holiday--just day trips. We don't go out, we don't drink . . . We have got into debt, but we learnt from that. If we want something now we sit down and talk about it. You've got to watch every penny . . . I think we go from day to day. We feel a bit depressed. It affects your whole life--it's monotonous. Some days we get up thinking if only something was different."

Next comes a single parent aged 23, with three children, living on £90.60 a week. She said:

"It's a struggle to live. I don't manage on the money. I've got a lot of debt but I get help from my mam and aunties. We never go on holiday."

The next family consists of an unemployed couple with a son who is also unemployed. Father, aged 62, had been unemployed for 10 years. He worked on the buildings for 30 years, often on low pay, and he said:

"People like us will get into debt. The social will only give you a loan and then you have to fight for it. We put in for a £70 loan for a cooker and they wanted £8 a week back off us. Well we didn't bother-- we couldn't afford to pay that . . . We went on holiday once--we paid for a caravan--that's in more than 30 years of marriage . . . I came from Manchester and people who did well gave back to the community. They built the library and created parks but people don't do that now . . . I'm not optimistic for me, nor for my grandchildren. The chosen few will be getting all the resources and all the others will get left out."

In many ways, that sums up the frustrations felt by the people who face the problems of unemployment and the linked problems of poverty.

We are all aware that we cannot measure unemployment by the statistics provided by the Department of Employment, because it has been proved time after time in the House that those statistics have been fiddled on a regular basis for the past 15 years.

I was interested to read the results of a survey sponsored by the Government, on unemployment in the former coal mining areas of south Wales. The survey said that male adult unemployment stood at 33 per cent. When I put the figures to the Secretary of State some weeks ago, he did not deny them, and agreed that there were still pockets of unemployment. The south Wales coalfield is not a pocket; it is a vast area experiencing vast problems.

Perhaps the Minister would like to comment on one pocket of unemployment in my constituency. In our study of poverty, we interviewed families in one street, and the results were staggering. The survey said:

"Of the 58 households, we were able to interview 54, making a total of 91 adults and 86 children. Of those 91 adults, 22 people were working, 60 people were out of work, of whom 13 were single parents, five were retired and four classed themselves as housewives. At least 16 people were suffering from some kind of disability or illness. Of the 86 children, 57 came from homes where no one was working.

In 40 of the homes at least one person was without work, in 32 homes all the adults were out of work, including single parents, and in 15 of the homes at least one member was working."

When I see so many people unemployed, it always serves as a reminder of how crazy the system is. For example, we are going through one of the worst housing crises for decades, yet we have hundreds of thousands of building workers on the dole. Our national health service has been devastated and has long waiting lists, yet there are nurses and other people with tremendous skills on the dole. That is just crazy.

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When the right hon. Member for Conwy (Sir W. Roberts) was talking about the coal industry, he said that it had been necessary to respond to the problems of overmanning. The response was novel. I have never known anyone else who has responded to the problems of overmanning in an industry by totally wiping out that industry. When we discuss poverty, we are not talking about unemployment and low wages alone. We are also talking about bad housing, poor health and an environment that is often savage. For example, the 1991 census revealed that 41 per cent. of all households in my constituency have a member suffering from long-term sickness or disability. That compares with a proportion of about 33 per cent. for the rest of Wales. Blaenau Gwent has one of the highest levels in England and Wales.

A Gwent health survey for the years 1985-89 confirms that the most deprived parts of the county experience the worst health. Again that is true of Blaenau Gwent, where deaths from lung cancer, respiratory disease and heart disease are all above the national average, and even the county average.

In the face of such problems, one would have thought that the area health authority for Gwent would be composed of people who had devoted their lives to the health service and knew what was required to make it better and to respond to the health needs of the people in my community. But that is not so. The area health authority is made up of building specialists, roofing experts, former gas purchasing officers and even fruit farmers. But where are the people who have devoted their lives to the national health service? Would not that service have been far better managed over the past decade or more if nurses, ancillary workers, doctors and consumers had had a greater say in its running and the business people out to make quick money had had less of a say?

While I am talking about health, may I ask the Minister when he sums up to explain why student nurses attending the purpose-built centre at Caerleon have had to move to Llandaff hospital, where the facilities are inferior, in order to continue their studies? The costs and the travel time for nurses in my constituency are now much greater, and their examinations are only a couple of months away. That is another loss for Gwent and another disincentive for people contemplating nursing as a career. Will the Minister also explain why those nurses had only five days' notice of the move?

Another way of measuring poverty in an area is to examine its housing stock. The 1991 census shows that housing conditions in the borough of Blaenau Gwent have improved, but remain poor. For example, 2.6 per cent. of pensioner households do not have their own bathroom or inside toilet. More than 40 per cent. of housing was built before 1990, almost all by the private sector, and much of it is in poor repair.

Much of the public housing also has its problems, for two main reasons. First, there is a high percentage of prefabricated concrete council housing. Secondly, most council estates are on hillsides, where the conditions make homes hard to heat and where homes need regular maintenance. Government policies and low income among owner-occupiers have made it increasingly difficult to maintain or improve the quality of the existing housing in the borough. At the same time, homelessness and the demand for homes are growing.

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I have heard many Ministers extolling the virtues of a dynamic market economy. If it is a dynamic market economy, why are we faced with the problems that exist in my constituency? Why are millions of people unemployed throughout the United Kingdom? Why are we experiencing the worst housing crisis for decades? Why are the differences in wealth and income growing? Finally, if the economy is so dynamic and successful, why is it that the Government will soon be dumped from office?

8.49 pm

Mr. Ted Rowlands (Merthyr Tydfil and Rhymney): I would have loved to chase at greater length aspects of the Secretary of State's speech, which, in some ways, was extremely revealing. Where did he turn to for his economic and social models? The United States. That was a very interesting choice.

The shape and character of the communities for which the right hon. Gentleman now claims to speak are based on anything but American styles of society. The economic and industrial experience shaped social cohesion and it was often the battle against capitalism which gave the distinctive character to the communities that I and my hon. Friends represent. We are now told that the economic, and presumably social, model to follow is one that has led to a huge and growing underclass and a largely alienated population who are turning more to guns and drugs than to any form of social values. Is that the model that the Secretary of State wants us to follow?

I want to make health the focus of my remarks. It is to the American-style model that the Government have turned to find a health model. We have in the purchaser-contractor-provider system a half-baked version of the American health system. One of the characteristics of the American system is that it is extremely expensive in administrative terms. Everything that I have read suggests that 15 per cent. of the costs in the United States go on the contracting, accounting and administration of the health service.

The NHS has always been inexpensive in administrative terms, with only 3 per cent. to 4 per cent. of costs going on administration. But the figure is now rising progressively. We should be worried that the right hon. Gentleman is seeking to apply American models to our services, and in particular to the health service.

I shall pay the Secretary of State, who is a curious mixture of a man, a compliment. The right hon. Gentleman did something that few Secretaries of State would have done. He came up to see a hospital that was under threat of closure, and talked to the people involved. That was much appreciated. The meeting on that occasion was revealing and illustrative in many ways. The Secretary of State was greeted by the chairman and chief executive of the area health authority and by the accountant unit manager of the district. They were on one side. On the other side were the people whom I wanted the right hon. Gentleman to see and who represented the views that I was expressing. They included the nurses at Mardy hospital, the people interested in maintaining the fabric of the building, the carers and the patients. The

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Secretary of State was hearing two separate voices, and he will have to make up his mind on which he wishes to listen to. One of the growing consequences of the right hon. Gentleman's reforms-- he cannot wash his hands of it--is the increase in the number of men in grey suits. The growing need for accountants, negotiators and contractors is a consequence of the purchaser-provider model that the right hon. Gentleman is trying to impose on the NHS.

I am pragmatic in most respects. I have heard all the arguments, claims and counter-claims about expenditure, and about the huge amounts that the Government claim to have spent on the health service. Like the Secretary of State, I have talked to the people who are trying to deliver the service. In one way, half of what I have been told proves the Government's case. Those involved in the service have said that they never thought about costs, or about the way in which they ought to have utilised their resources in the most efficient manner.

That is certainly a factor in the matter. But while we might accept the diagnosis, the Government's prescription is equally senseless. Top specialists now spend more of their time accounting for the service than delivering it, and more time administrating than administering the service. The hon. Member for Ceredigion and Pembroke, North (Mr. Dafis) referred to a similar situation in education. In that area also, the prescription is half-baked. The purchaser-contractor-provider concept is now a problem rather than a solution. While that is bad enough--it is absorbing energies and costs that ought to be delivering front-line services--it is now also distorting clinical judgments and affecting the delivery of the service.

I shall illustrate that in a couple of ways. First, an elderly person who was suffering from advanced lung cancer was admitted to a district hospital, although it was not a hospital that I represent or, indeed, even in Wales. Her family were told that she was terminally ill but not acutely ill, so she should be discharged from the hospital. The semantics of that are interesting.

I can just about understand something like that happening, because the prognosis was that the person did not need the acute facilities of a major district general hospital. But the family were told that they should make arrangements to send the patient to a private nursing home, which would cost about £300 or £400 a week, because she was terminally ill and not acutely ill. Those are the distinctions which are creeping in and which have grown in the service. We are counting costs more than thinking about the quality of service to patients.

This week the Department issued a revealing document as a result of some health ombudsman cases in Leeds. Let me read out what it was necessary to tell the health districts and authorities not to do. The document that the Secretary of State has just published states: "In addition patients who have finished acute treatment or inpatient palliative health care in a hospital or hospice, but whose prognosis is that they are likely to die in the very near future should be able to choose to remain in NHS funded accommodation". I support that. The very fact that such advice has had to be issued shows that it cannot have been happening.

Terminally ill people, as in the case that I have just described, have been pushed out of hospital. Why? Because of the cost argument and the implications for beds in district general hospitals as opposed to elsewhere.

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Fancy having to issue such a document in 1995, and having to tell the people providing the service that that is the guideline that they should follow. It is a powerful illustration of the corrosive influence of contracting and purchasing and of the way in which they are affecting our service.

My hon. Friend the Member for Islwyn (Mr. Touhig) made a powerful speech. It was almost the speech that I would have liked to make on health.

I shall give the Secretary of State another illustration. Let us turn from the Mardy to the Prince Charles hospital. We are trying to save money. Opposition Members understand the need for minding costs and being efficient. We also understand the need for new technology. One of the consequences of new technology in eye surgery is that everyone can be treated on a daily basis. Patients do not need to stay in a hospital, which sounds ideal. But in practice, 80-year-old patients are having to get up at 5 am or 6 am to turn up at the hospital by 8 am for day surgery. They are discharged by lunchtime or early afternoon and told to put drops in their eyes. I am 55 and my hands are shaky enough--I could not put drops in my eyes--so imagine telling 80-year-olds to put drops in their own eyes and to come back the following day and the day after for new dressings. That is the other side of the coin of driving through this contracting and purchasing model, and everyone is conscious of it. Service and the concept of care are becoming less important than cost. We need to strike a balance, but at the moment it is being struck the wrong way.

We can all quote cases. On Saturday, a chap whose shoulder was destroyed in an accident came to see me. It means that he cannot work. He went to the hospital in Newport--not to the Prince Charles in my constituency--and was told that he would have to wait six months for an operation. He cannot go back to work and will become a dependant of the state. He was also told, however, that he could meet the same surgeon and have the same operation within a few days, if he paid his £1,000 or £2,000. That is an illustration of the corrosive influence of the growing queues--people are profiting from protracted pain.

I do not think that the Secretary of State wants that sort of national health service. I have had extensive correspondence with him, his predecessor and with junior Ministers who have dealt with health, including the Under-Secretary of State. I have seen them about more than one patient and told them about my worries and concerns and about the corrosive influence of this evil business of private patient care and the national health service beginning to mix--the so-called green book guidelines and all the rest, and the fact that people can drive a coach and horses through them. That is the sort of worry that we have over a major area of public service and care. Frankly, there is an alternative model. The Secretary of State has tried to produce one and now I shall. Whether in education or health, in hospitals or schools, unlike Wokingham, London and other suburban areas, we do not have the choice in my constituency. The services are near monopolies. There are only one or two general practitioners whom we can go to and only one hospital. Our children are likely to go to one primary or secondary school. The Government try to use the concept of competition, contracts and that type of model to attack the concept of the monopoly. I understand why, if there is a

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monopoly, one must make it very accountable, both in terms of cost and sensitivity to the public, but the Government have got their model wrong. They are trying to graft a competition model on to what, for the vast majority of people, is a monopoly service, whether it be the health service or schools.

Instead of contractors and providers and all these competition models, we should try to adopt another system. I have a couple of recommendations for health. Let us pack up the nonsense of purchaser-contractor-provider. By all means have a powerful, lean and hungry bunch of people, who can act as health auditors. The Government have taught us the power of regulation in gas and electricity, which has delivered power to consumers. I must admit that we were poor supporters of consumers in many curious ways. The regulator is an interesting model to follow. The concept of regulation can be used in both health and education as an alternative to the purchaser- provider model and the pretence of competition, which exists in neither health nor education in most of our communities.

We could also borrow from local management of schools, which has worked in education, devolving responsibility downwards, by putting sisters and matrons back in charge of hospitals. I now meet chief nursing officers whom I have never seen in uniform as they no longer work on hospital wards. I come from a family of sisters and matrons and know that, when sisters and matrons were responsible for the accounts, they were the best and meanest at them. We need neither accountants nor trusts at the top, but responsibility should be devolved back to where it belongs.

Above all, for philosophical reasons we must change the language. Let us talk about a public service and engage people who want to serve. I do not want my health service or hospital run by a chief executive who demands a car, performance-related pay, share options or some kind of bonus in order to activate him into being committed to the show. Patients should not be referred to as clients or customers. Let us put the concept of service back where it belongs--in the service, whether it is education or health. We must get away from the ethos of contracts, money and commercialism driving the system, but by all means retain a tough regime in terms of cost. That is the model which my hon. Friends must promote as a distinct and clear alternative to commercial values, competition and the corrosive influences that the Secretary of State and others have brought into our health and education services.

9.6 pm

Mr. Donald Anderson (Swansea, East): I suspect that the Secretary of State shares many of the values which my hon. Friend the Member for Merthyr Tydfil and Rhymney (Mr. Rowlands) has just set out in terms of community and service. Our argument against the Secretary of State is that his ideological impulses push him in the opposite direction and lead to results which are wholly contrary to the values that I believe he espouses.

I join my hon. Friends the Members for Merthyr Tydfil and Rhymney and for Blaenau Gwent (Mr. Smith), and the hon. Member for Ceredigion and Pembroke, North (Mr. Dafis), in paying fulsome tribute to the maiden speech of my hon. Friend the Member for Islwyn (Mr. Touhig). He comes from the valleys and brings with him

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much of the breath of the valleys. The examples that he gave show that he will represent powerfully the constituency of Islwyn. St. David's day is our annual Welsh day and this is the only opportunity that we have to review the state of the nation. In my brief contribution I shall try to sermonise on two headlines in yesterday's Western Mail . The first may be a little partisan. It says:

"Tories in Wales face wipe-out at elections".

The second is a charming little headline which reads:

"John Redwood wants the dragon to roar".

With regard to the first headline, the current 12 per cent. support for the Conservative party in Wales illustrates a fundamental contradiction in Welsh politics: although the Labour party has consistently had about half the popular support, for the past 16 years the Conservative party has ruled Wales. Are the Government and Conservative representatives in Wales not embarrassed by that? Have they sought to combat the inevitable frustration and potential alienation of the Welsh people? Are they aware of the sensitivities of Wales? Have they tried to promote community and a sense of Welsh identity? The record is patchy.

On language, the Government have a pretty good record. Here I pay tribute to the right hon. Member for Conwy (Sir W. Roberts): on the whole, he handled with great sensitivity an issue which could have been explosive in Wales. The package, which continues to evolve, will--for a time, at least-- meet the general consensus in Wales. Overall, however, the Government's record is not good. They have sought in many ways to emasculate the local elected representatives by means of increasingly severe financial constraints and have also sought to attack their personal competence for the work. The Secretary of State well knows the record of the Under- Secretary of State, the hon. Member for Clwyd, North-West (Mr. Richards), in that respect and I shall not repeat what is well known to Members of the House. The Government have also sought to bypass the elected representatives by creating and encouraging a series of quangos, which are a form of outdoor relief for friends and relations of members of the Conservative party and create disillusion and frustration in Wales.

Nationally, the political maturity of the people of Wales is attacked by the Government by injecting into the argument about devolution--I well understand that there are cogent arguments on both sides--the suggestion that an elected assembly in Cardiff would inevitably, as night follows day, lead to the break-up of the United Kingdom. Surely Wales is more sophisticated than that.

Mr. Rowlands: They used that argument against appointing a Secretary of State for Wales.

Mr. Anderson: Indeed. The right hon. Member for Conwy will shortly visit Catalonia. Does the fact that Catalonia has an elected assembly, which encourages the language there, of itself inevitably entail the break- up of Spain? Has not every one of the motor regions with which Wales is linked--Lombardy, Baden-Wu rttemberg, Rho ne-Alpes, and so on--at least some focus at regional-national level where people can feel that their problems are tackled more sensitively than at the overall national level? Why must the Conservative party try to

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frighten people with a Domesday scenario, saying that the heavens will fall, the Rhine will overflow and the United Kingdom will break up if we, like every other country in Europe, have an elected regional assembly? Surely the argument can be conducted on a more elevated level.

On the theme of Welsh identity, Government policies have eroded the sense of Welsh identity of institutions in Wales in many ways. Let us take the privatised utilities. Some, like Welsh Water, encourage Welsh identity, but others are moving their centres of operation increasingly away from Wales; one thinks of the gas industry in that respect. British Rail, which remains a nationalised undertaking, is moving increasingly away from Wales.

I wish to mention to the Secretary of State one further institution--the traffic commissioners. I hope that the Secretary of State will, in his usual courteous way, seek to inquire into that problem and perhaps respond to me. The Secretary of State may be aware that, five years ago, we fought successfully against the threat to move the traffic commissioners away from Cardiff. I understand that that threat has now reappeared, and I hope that the Secretary of State will try to fight for their retention. Will the Secretary of State inquire into the matter and try to provide an assurance that south Wales will continue to have its own licensing authority and traffic commissioner, notwithstanding what may or may not appear in the review of traffic area offices currently being carried out? Large and small institutions are moving away from Wales. I welcome the arrival of the Chemical bank and other groups in Cardiff, but they do not underpin the financial structure. Such moves are relatively shallow and fragile. I hope that we will seek to develop institutions--both private and public--as a focus of Welsh identity in Cardiff rather than stand by and watch as they are increasingly dragged away from Wales.

Having described the erosion of many institutions, I thought that there had been a great change when I read the headline,

"John Redwood wants the dragon to roar".

Had there been a Damascus conversion? Was the Secretary of State donning the cloak of Wales and seeking to promote Welshness? Alas, no--he was making a rather petty attempt at parading his anti-European feelings.The Secretary of State has many virtues. He is intellectually rigorous. As my hon. Friend the Member for Merthyr Tydfil and Rhymney said, he will look at things in person and he has an open-door policy. However, he must recognise that his political views are those of an English nationalist and that his ideology is not consonant with the interests of the Welsh people. It is no wonder that the polls show only 12 per cent. support for the Conservative party in Wales.

The Welsh people sometimes feel like the African leaders of the 1950s who pleaded, "Please, let us make our own mistakes." The Secretary of State is out of touch with our radical traditions and the forces which have helped Wales to develop its own sense of identity. He will always put market-based solutions first, even if they are against the interests of the Welsh people.

One example is the likely announcement about a cardiac unit at Morriston hospital. The Secretary of State will be aware that there are strong suspicions that he has been pushing for the BUPA solution, which constitutes a vote of no confidence in the in-house bid from Morriston hospital. I shall be delighted if the Secretary of State will

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