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Mr. Malone: My hon. Friend is right. I have visited a number of total fundholding pilot projects, including one in Bath last week which will get under way on 1 April. They are exciting projects that must be evaluated, but remarkable achievements have already been recorded by projects that are under way. Progress to date has been extremely good.

Mrs. Beckett: Is the Minister aware that we receive literally dozens of letters from GPs protesting that, under instructions from Ministers, managers in their areas are attempting to browbeat them into becoming fundholders whether they wish to or not? That view is reflected in a survey in Pulse , which shows that 71 per cent. of GPs do not wish to become fundholders. Has the Minister seen the advertisement that has been placed in East Anglian newspapers by 32 GPs in Suffolk who are not fundholders? The advertisement states that the GPs are saving the Treasury more than £200,000 a year, and that not one penny of that money is available for patient care. Why is the Minister trying to force people to become fundholders when the practice is unproven, inequitable and very expensive?

Mr. Malone: That is marvellous, because the Leader of the Opposition is trying to force the right hon. Member for Derby, South (Mrs. Beckett) to support fundholding practices. We did not hear the right hon. Lady say today whether she agrees with the change in Labour party policy.

There is no question of forcing anybody to become a GP fundholder. Of course, GPs are encouraged to do so because it is the way forward in a primary care-led NHS. The vast majority of GPs who become fundholders-- sometimes, I concede to the right hon. Lady, reluctantly--usually end up being in the vanguard of those praising the system and the benefits it can bring, which include an extension of clinical expertise that GPs are able to deploy directly to patients. They are enthusiastic about it, but it is still a voluntary process. I still wish to see more people join the scheme.

Mr. Hayes: In my hon. Friend's busy day-- [Hon. Members:-- "Hear, hear."] I am grateful for the applause. Will my hon. Friend take time to be magnanimous and act as a mediator between the right hon. Member for Derby, South (Mrs. Beckett), the Leader of the Opposition and, I suspect, the deputy leader of the Labour party--

Madam Speaker: Order. The hon. Gentleman must ask a question that relates to ministerial responsibility.

Mr. Hayes: This is precisely to do with GP fundholders and NHS trusts, because the right hon. Lady wants to get rid of them while the Leader of the Opposition wants to keep them. Will my hon. Friend help the right hon. Lady out?

Mr. Malone: I am always prepared to be magnanimous, but I am afraid that I am not prepared to be quite as magnanimous as that.

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Performance-related Pay

13. Mr. Hoyle: To ask the Secretary of State for Health how performance-related pay will be calculated for NHS employees; and if she will make a statement.

Mr. Sackville: These are matters for local determination by national health service employers, having regard to the contributions made by staff to high-quality patient care.

Mr. Hoyle: Does the Minister realise that performance-related pay is totally inappropriate to the health service and that the practices of the supermarket and the office floor cannot be applied to doctors and nurses, whose jobs are to care for patients and to save lives? Whatever happened to the promise made by the then Minister of State on 23 November 1994 that the Government had no intention of introducing performance-related pay into the health service?

Mr. Sackville: The hon. Gentleman will know that there are plenty of precedents in the health service, such as merit awards for senior medical staff. It is absolutely right that local employers should have the maximum freedom in how they spend the larger part of their resources, which is for salaries. We have given trusts the freedom to make decisions. One of those decisions is on pay.

Rev. Martin Smyth: The Minister compares merit awards with performance-related pay. The former is based on comparison with peers and we can understand why it is done, but may we have some definitive, objective guidelines on how performance-related pay can operate in the health service? Will it mean that the more patients a trust gets through the door the more people will be paid? Is that

performance-related pay?

Mr. Sackville: It is up to each trust to make those decisions. I remind the hon. Gentleman that some 60 trusts have already published offers between 1.5 per cent. and 3 per cent., as recommended by the pay review body. The majority of offers are at the higher level. I expect that trend to continue.



Q1. Mrs. Liddell: To ask the Prime Minister if he will list his official engagements for Tuesday 14 March.

The Lord President of the Council and Leader of the House of Commons (Mr. Tony Newton): I have been asked to reply

My right hon. Friend the Prime Minister is currently on an official visit to Israel, the occupied territories and Jordan. He is accompanied by a large delegation of British business people.

Mrs. Liddell: The visit of the Prime Minister to the Gaza strip and the donation of equipment and aid are to be welcomed, but why have the Government chosen to donate police equipment when the entire community could have benefited from the excellence of British manufacturing facilities to provide clean water facilities, better health facilities and educational facilities?

Mr. Newton: The hon. Lady clearly was not listening. I said that a large delegation of British business people

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was with the Prime Minister precisely to see whether we can help with the kind of opportunities to which she refers.

Sir Anthony Grant: Does my right hon. Friend share my disgust at the blatant and continued misrepresentation by press and media of the case of the 10-year-old leukaemia sufferer? Is he aware that Cambridge health authority's decision to refuse treatment had nothing to do with money but was taken because the overwhelming number of doctors and specialists were not prepared to inflict further suffering on that poor little girl?

Mr. Newton: It certainly has been made clear by the health authority that funds would have been available if the view of the doctors responsible had been that treatment would have been in the best interests of the child. It is first and foremost a matter of clinical judgment. I think that, however sad, that should be acknowledged. The other thing that should be said is that the whole House will want to wish the girl well in the treatment that she is undertaking today.

Mr. Prescott rose --

Hon. Members: Hear, hear.

Madam Speaker: Order. That is a warm enough welcome.

Mr. Prescott: Can the Leader of the House confirm the leaks that are emerging from the Prime Minister's tour of the middle east that the Greenbury committee proposes to recommend absolutely nothing to curb the greed of the bosses in the privatised utilities?

Mr. Newton: What I can confirm is that the Prime Minister and, indeed, all my right hon. Friends have made it clear that they attach importance to the work of the Greenbury committee and that they will want to study its conclusions with care and then consider whether it would be appropriate to make any legislative change.

Mr. Prescott: Whatever the right hon. Gentleman may say, is not the Prime Minister's support for legislation against pay excesses a sham? Only yesterday the President of the Board of Trade once again defended boardroom greed. When will the Government realise that people in Britain want a fundamental shift so that power, wealth and opportunity are in the hands of the many and not the few?

Mr. Newton: It sounds to me as though the right hon. Gentleman will need to undertake another rewrite of clause IV before the ink on this one is dry.

Mr. Wilshire: Last December, our right hon. Friend the Prime Minister stated that Ministers would not talk to Sinn Fein-IRA before huge amounts of weapons were surrendered. This morning, I received a letter from our right hon. and learned Friend the Secretary of State for Northern Ireland stating that talks would take place with Sinn Fein-IRA before weapons were handed in. Which is current Government policy?

Mr. Newton: My hon. Friend has indeed received a letter from my right hon. and learned Friend today. I have a copy of it before me. It makes it absolutely clear that, before Ministers will engage in talks in the way that Sinn Fein currently seeks, there must be a clear and reliable assurance from Sinn Fein that constructive discussion,

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especially in achieving substantial progress on decommissioning arms, would be facilitated and accelerated by Ministers joining that dialogue. No such assurance has been received, and I think that what is being said and done is entirely consistent with what my right hon. Friend the Prime Minister and my right hon. and learned Friend the Secretary of State have said before and, indeed, with what is sensible and practicable in seeking a way forward in Northern Ireland.

Q2. Ms Eagle: To ask the Prime Minister if he will list his official engagements for Tuesday 14 March.

Mr. Newton: I have been asked to reply.

I refer the hon. Lady to the reply I gave some moments ago.

Ms Eagle: On executive pay, will the Leader of the House admit that the public know that the Greenbury committee is a con, because it is full of the very fat cats who are earning millions of pounds, who are protecting their own pay and positions? Does he not realise that asking that bunch to legislate to curb excesses of executive pay is like asking Dracula to guard the blood bank?

Mr. Newton: The answers to the hon. Lady's questions are no, no and no, in that order.

Mr. Elletson: Would my right hon. Friend care to speculate on the possible reasons why the historic commitment to full employment, endorsed by generations of Labour party members, has now been abandoned by the right hon. Member for Sedgefield (Mr. Blair)?

Mr. Newton: It is perhaps not for me to speculate about the causes of Opposition policy changes, but, if I were driven to do so, I would venture the opinion that the penny has finally dropped that their commitment to a minimum wage, a social chapter and a further renewal of trade union powers is incompatible with full employment.

Q3. Mr. Callaghan: To ask the Prime Minister if he will list his official engagements for Tuesday 14 March.

Mr. Newton: I have been asked to reply.

I refer the hon. Gentleman to the reply I gave some moments ago.

Mr. Callaghan: Will the Minister note that the former and the present Secretary of State for National Heritage have not replied to the Select Committee on National Heritage report, "Privacy and Media Intrusion"? As it is now exactly two years since the Select Committee presented its report, why have the Government have failed to respond to it? What is he afraid of, and will he apologise to the House for the delay?

Mr. Newton: I have no doubt that my right hon. Friend the Secretary of State for National Heritage will seek to reply as soon as the very difficult issues involved have been thoroughly considered and studied.

Mrs. Lait: Does my right hon. Friend agree with the hon. Member for Hackney, North and Stoke Newington (Ms Abbott) that the rewritten clause IV is 400 words of waffle-- [Interruption.]

Madam Speaker: Order. I have been very tolerant today, but I remind hon. Members that we holding the Executive to account for their policies, not for the policies

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or the activities of any other party. If the hon. Lady can rephrase that question, I will give her an opportunity to do so, but she must seek to bring the Government to account.

Mrs. Lait: Does my right hon. Friend agree that, if we were ever to have a clause IV, it would not contain 400 words of waffle?

Mr. Newton: I am afraid that my hon. Friend's question was slightly lost in Opposition Members' baying. I am certainly aware that the hon. Member for Hackney, North and Stoke Newington (Ms Abbott) has described the new clause IV as 400 hundred words of waffle. It is absolutely clear that it takes us no nearer to what we really need: some clarification of Labour's policies.

Q4. Mr. Wilson: To ask the Prime Minister if he will list his official engagements for Tuesday 14 March.

Mr. Newton: I have been asked to reply.

I refer the hon. Gentleman to the reply I gave some moments ago.

Mr. Wilson: We can understand the reluctance of the Leader of the House to answer questions about executive pay and share options, so perhaps we can move the debate forward a little. Do the Government intend to devolve other areas of Government policy to sub-committees of millionaires appointed by the CBI? Will the recommendations of those committees be final and, if so, is that what is meant by the "smack of firm leadership" from the Government?

Mr. Newton: I do not think that I have shown any reluctance to answer the questions--it is just that Opposition Members do not like my answers. As the main thrust of the question refers to a matter that is principally for shareholders to decide, it seems entirely correct to consult and to take the views of such a committee.

Mr. Peter Ainsworth: Will my right hon. Friend join me in welcoming the news that prizes from the national lottery now amount to almost £500 million? Is it not excellent news that a substantial amount of money has been allocated to the good causes supported by the lottery?

Mr. Newton: Indeed it is very good news. The national lottery is certainly giving pleasure to many people and it is yielding both large prizes for the winners and large amounts of additional money for the arts, sport, heritage, charities and the Millennium Commission. It has been a huge success, which is very much to the credit of my right hon. Friend the Prime Minister, and I think that that success will continue and will grow.

Q5. Mr. Fisher: To ask the Prime Minister if he will list his official engagements for Tuesday 14 March.

Mr. Newton: I have been asked to reply.

I refer the hon. Gentleman to the reply I gave some moments ago.

Mr. Fisher: On executive pay, will the Leader of the House answer the question of my right hon. Friend the Member for Kingston upon Hull, East (Mr. Prescott) and explain what the Government intend to do about it? What sort of Prime Minister says that he finds something distasteful but then says that he does not have the first

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idea of what he wants to do about it and simply leaves it to the CBI to tell him what Government policy should be? What sort of Government do that?

Mr. Newton: What the Government are going to do is what I have said at least twice this afternoon and what my right hon. Friend the Prime Minister has said on many other occasions: we will study the recommendations of the Greenbury committee with care and we will then decide what action to take, including the possibility of legislation if that seems appropriate.

Mr. Couchman: Does my right hon. Friend agree that President Clinton's decision to meet Mr. Adams on Thursday and to allow Mr. Adams to raise funds on behalf of Sinn Fein-IRA is a grave blow to the United States' special relationship with this country, and indeed to the cherished links with the Republic of Ireland and the majority of the Irish people who are opposed to Mr. Adams's violence and terrorism?

Mr. Newton: My hon. Friend will know that my right hon. Friend the Prime Minister has made his views very clear to the President. The United States Administration are in no doubt about our views. I hope that everyone will now acknowledge that it is important to maintain pressure on Sinn Fein from all sides to engage in substantive constructive discussions along the lines that my right hon. and learned Friend the Secretary of State for Northern Ireland has indicated. I hope that the need for Mr. Adams to engage in such constructive and substantive discussions will be emphasised firmly and vigorously in any meetings with the United States Administration.

Q6. Mr. MacShane: To ask the Prime Minister if he will list his official engagements for Tuesday 14 March.

Mr. Newton: I have been asked to reply.

I refer the hon. Gentleman to the reply I gave some moments ago.

Mr. MacShane: In view of the fact that most independent jurists do not consider the courts of Singapore to be independent of the Executive and in view

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of the desire for a full judicial spotlight on the Barings affair in London, will the Leader of the House assure us that every effort is being made to extradite Mr. Nick Leeson from Germany so that he can stand trial in London?

Mr. Newton: The House will understand that I do not think it right to get drawn into commenting from the Dispatch Box on the legal position in other Commonwealth countries. The Government are determined to make every effort to ensure that the Barings events are properly and thoroughly investigated and that appropriate action is taken in the appropriate courts.

Q7. Mr. David Atkinson: To ask the Prime Minister if he will list his official engagements for Tuesday 14 March.

Mr. Newton: I have been asked to reply.

I refer my hon. Friend to the reply I gave some moments ago.

Mr. Atkinson: Is my right hon. Friend aware of a letter of appreciation that I recently received from an Anglican clergyman in my constituency, who does not often support the Government's policies but who greatly appreciates the education that his daughter has received as a result of the assisted places scheme? He knows of many other low-income families in his parish whose children have benefited in the same way. How shall I respond to my constituent's request to learn whether the assisted places scheme has a future and whether it is safe?

Mr. Newton: I am sure that my hon. Friend is right that not only his constituent but many thousands of other parents throughout the country welcome the assisted places scheme, which has provided an excellent education in independent schools to many able pupils from low-income families. It has been outstandingly successful. The assurance I can give my hon. Friend and his constituent is that the assisted places scheme is safe under us. It is certainly not safe under the Opposition.

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