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Resource Allocation
10. Mr. Timms: To ask the Secretary of State for Health when and how he intends to implement the modified weighted capitation formula in allocating resources to health authorities. [33188]
Mr. Dorrell: The modified formula will be used as the basis of allocations to the new health authorities in 1996-97. Implementation will be gradual in order to safeguard continuity and stability of funding.
Mr. Timms: The Secretary of State will be aware that the York university report commissioned by the Government and published in October showed conclusively that inner-city areas such as mine do not receive an adequate share of health service resources. In the light of that information, is the right hon. Gentleman satisfied with the fact that it has taken so long to introduce the new formula, and is he as alarmed as I am by the fact that, this year, for the first time, 24 per cent. of the resources allocated to health authorities are being distributed without reference to deprivation criteria? What initiatives can he announce to the House to ensure that people living in areas such as mine receive a fair deal in the allocation of health service resources?
Mr. Dorrell: The hon. Gentleman asked what initiatives we have to ensure the fair allocation of resources throughout the health service. I entirely agree that fair allocation of resources is an important priority; that is why the York university work was done, at the Government's request, to ensure that the weighted capitation formula represented a fair way of distributing resources to purchaser health authorities. As for the hon. Gentleman's question about the 24 per cent., the York university work covered roughly 76 per cent. of health care--in-patient and day-patient care--but did not cover the assessment of need for community and other services. That element of health service care not covered by the York university work accounts for 24 per cent. of total resources. That is why that element is not covered by the formula.
Mr. Jenkin: Does my right hon. Friend agree that in areas such as my constituency of Colchester, North there has historically been a lack of funds because of the unfair distribution of resources? I welcome the new formulae. Does my right hon. Friend also agree that waiting lists in places such as north-east Essex reflect the problem of unequal funding rather than a lack of efficiency in hospitals?
Mr. Dorrell: My hon. Friend is right to say that the allocation of resources to his constituents needs updating. That is why we have changed the formula, and why the new formula will be used to distribute resources in future. [Interruption.] The right hon. Member for Sedgefield (Mr. Blair) has returned to us, and it would be wrong of me to let this moment pass without welcoming him back from his travels. Moses went to Mount Sinai and the right hon. Gentleman has been to Hayman Island. It is right for the whole House to welcome him on his return.
Mr. Bayley: The Secretary of State paid a fulsome tribute to the York university researchers who did the work on which his new NHS funding formula is based, but he did not answer the question asked by myhon. Friend the Member for Newham, North-East
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(Mr. Timms). Why has the Department entirely removed the needs weighting for the community health services part of the funding formula? When will the Government start increasing funding for underfunded health authorities in inner cities and in the north so that everybody in the country will get an equal and fair share of NHS funding?Mr. Dorrell: The answer is that the formula does not apply to the 24 per cent. to which the hon. Gentleman referred because it is not designed to apply to it. He asked when the process of change is to start, but the answer is that it has already started. This year, the regional health authority allocation to district health authorities is informed by the new formula, and we will ensure that future distributions are also informed by the formula.
Finchley Memorial Hospital
11. Mr. Booth: To ask the Secretary of State for Health if he will make a statement about the Finchley Memorial hospital. [33189]
Mr. Bowis: The Finchley Memorial hospital is an excellent example of a community hospital providing a range of services to local people including rehabilitation and respite care, out-patient clinics and therapy services.
Mr. Booth: My hon. Friend commends the Finchley Memorial hospital as a community hospital and for its excellent work. In launching the neighbouring community hospital in Edgware, will he hold up the Finchley Memorial hospital as an example of best practice, and so take the scare out of the scaremongering of Opposition Members?
Mr. Bowis: My hon. Friend is absolutely right. The hospital is part of a pattern for the modern health service in providing community services, and those services have been backed by a further £15 million of primary care from Barnet health authority. That should provide a pattern for the future of which my hon. Friend can be proud.
PRIME MINISTER
Engagements
Q1. Mr. Keith Hill: To ask the Prime Minister if he will list his official engagements for Tuesday 18 July. [33178]
The Prime Minister (Mr. John Major): This morning, I had meetings with ministerial colleagues and others. In addition to my duties in the House, I shall be having further meetings later today.
Mr. Hill: Does the Prime Minister share-- [Interruption.]
Madam Speaker: Order. I must hear the question. Hon. Members must stop shouting.
Mr. Hill: Does the Prime Minister share the public's concern about hon. Members who peddle political influence for private gain? If so, why is he rejecting Lord Nolan's plan that earnings from such activities should be declared? Where does he stand on the matter? Why, for once, does not he give a lead?
The Prime Minister: When the hon. Gentleman began, I thought that he was going to comment on the rail strike. The fact that he is sponsored by the National Union of
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Rail, Maritime and Transport Workers might explain why he did not. The House will have an opportunity to discuss the matter that the hon. Gentleman has in mind, and I look forward to that.Q2. Mr. Sumberg: To ask the Prime Minister if he will list his official engagements for Tuesday 18 July. [33179]
The Prime Minister: I refer my hon. Friend to the answer I gave some moments ago.
Mr. Sumberg: Now that we have seen the quite ridiculous spectacle of the Labour leader travelling around Australia passing himself off as Margaret Thatcher, is it not time that my right hon. Friend reminded the House that while he was actively working in support of Margaret Thatcher's policies of low taxation, a strong national defence and moderate trade unionism, that very same Labour leader was actively and consistently opposing every single one of those policies?
The Prime Minister: It seems to be the case that the Labour party in opposition today supports the policies that it opposed so vigorously in the 1980s. I have no doubt that the Labour party in opposition in the future will support the policies that it so vigorously opposes today.
Mr. Blair rose -- [Interruption.]
Mr. Blair: I would have slightly more respect for Conservative Members who say how shameful it is to have dealings with the Murdoch press if they had said that at the time of the 1992 general election.
I have given the Prime Minister notice of this question on Bosnia. After the appalling events in Srebrenica and Zepa, does the Prime Minister agree, first, that rather than talk of withdrawal, having designated safe areas and encouraged people to enter them, it is our duty to pursue all practical means to uphold the United Nations mandate and prevent further ethnic cleansing; secondly, that we should use UNPROFOR to open up the supply road to Sarajevo; thirdly, that we must impress on our American colleagues the absolute necessity of practical support for our actions rather than just rhetoric; and, finally, that, as threat after threat has been made to the Bosnian Serbs but not carried out, over the next few days we must work out our bottom line and this time stick to it, otherwise the consequences for the United Nations and for the resolution of conflicts everywhere will be lasting and disastrous?
The Prime Minister: The right hon. Gentleman and I spoke at length about Bosnia earlier this morning and I am grateful to him for saying at that time that he would raise the general question this afternoon.
Let me say to the House on the back of the right hon. Gentleman's question that there are, in reality, only three options for the future in Bosnia. The first is to see events escalate from the present circumstances into full-scale war, which would need a huge NATO force, including American ground troops, if that were remotely practical. The second option is to try to continue the United Nations humanitarian and peacekeeping work. That is becoming more dangerous and hazardous as day succeeds day, and carrying on that work does not guarantee prevention of the sort of attacks that we have seen at Srebrenica and are seeing at Zepa at the moment. Against that, however, the
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activities of the United Nations are still saving a great number of lives and the activities of British troops in central Bosnia in particular have brought peace to an area where we saw bloodshed and carnage on a massive scale only two years ago. The third option is to withdraw UNPROFOR and then lift the arms embargo. It is possible that events will head in that direction but I believe that, if that were to happen, it would be a course that we would regret, and that the Bosnians would come to regret as well.There are no magic answers. What is clear--we need to be entirely clear about it--is that it is not practical to mix war fighting with peacekeeping. Of those difficult options, I am sure that the right way is to go on trying to keep the peace, trying to provide help and trying to promote negotiations, until or unless that becomes impossible.
It is to deal with matters such as the specific points that the right hon. Gentleman raised that we have taken the lead this week in international efforts, including the meeting of chiefs of defence staff on Sunday, the visit of my right hon. Friend the Defence Secretary to Bosnia, the visit of my right hon. and learned Friend the Foreign Secretary to Washington, and the conference that we have called for Friday this week to try to deal specifically with questions such as those raised by the right hon. Gentleman and to determine a viable way forward for the protection forces and the diplomatic process. I hope that such a way can be found because, if it cannot, the alternatives for Bosnia and the whole region are potentially catastrophic.
Sir Ivan Lawrence: Is my right hon. Friend aware that, thanks to the Government, the police and the courts, crime has been falling throughout the country for the past two years? In Staffordshire, crime has fallen by 14.5 per cent. and in the City of London it has halved. Does that not show that we are the party of law and order? As my hon. Friend the Member for Welwyn Hatfield (Mr. Evans) would say, by opposing every toughening measure that we have introduced, that lot over there are nothing but wind and soundbites.
The Prime Minister: I am grateful to my hon. and learned Friend. I agree with his analysis and the accuracy of pointing out that the crime statistics are indeed falling and have been falling for some time. Neither the Government nor the police are complacent about the task that lies ahead and I commend a number of police constabularies for the innovative moves that they have made--Operation Bumblebee is but one example--to target particular types of crime. My right hon. and learned Friend the Home Secretary believes that it is important to continue in that fashion. We intend to do so, and to continue to give top priority to the battle against crime.
Mr. Beith: If there is not to be a total and irreversible humiliation of the United Nations and all that it stands for in this desperate situation, do not clear and achievable objectives have to be identified and followed through? Would not one of those objectives be the maintenance and defence of a clear humanitarian route over Mount Igman to Sarajevo to relieve and supply that city?
The Prime Minister: The right hon. Gentleman may be right about that. It is one of the matters that is being examined at the moment with the commanders on the ground. A route over Mount Igman would be suitable in the summer but perhaps less suitable in the winter. What
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is necessary for Sarajevo is an access and egress route in both summer and winter, but I do not deny the importance of having proper access and egress over Mount Igman.The right hon. Gentleman and others should appreciate that it is necessary to look at the wider question as well as individual snippets of policy, such as the proposed route, in order to get a proper view of what is practicable and what it is possible to ask the forces to do and to maintain. I repeat that one cannot mix war fighting with peacekeeping. It is important for the safety of our troops and protection forces for that to be recognised. There is an element of action that can be taken, but we must leave it to the commanders on the ground to determine precisely where that line is drawn, unless the western democracies are prepared to cross that line entirely towards a war-fighting role. I see no indication that those powers are prepared to do that.
Sir Malcolm Thornton: Will my right hon. Friend join me in congratulating the Royal Liverpool Philharmonic orchestra and its management on the completion of a highly successful summer pops concert programme that has given pleasure and enjoyment to 25,000 people? Will my right hon. Friend also reflect on the fact that it was held in the Merseyside development corporation area, which represents a continuing commitment to the Government's wish to regenerate the inner-city areas?
The Prime Minister: I am happy to congratulate everyone concerned on what was clearly an attractive and worthwhile event. My hon. Friend is right to point out the proposals that we have carried out for some years to regenerate the inner-city areas. There is a good deal more to come, and I believe that people up and down the country will welcome it.
Q3. Mr. Winnick: To ask the Prime Minister if he will list his official engagements for Tuesday 18 July. [33180]
The Prime Minister: I refer the hon. Member to the answer I gave some moments ago.
Mr. Winnick: Do the Prime Minister and the leaders of other western democracies understand how deeply betrayed the people of Bosnia feel? They live, or did live, in so-called safe areas, but they have been given no protection in the face of Serbian aggression. If it was right, as I believe that it was, for the House to pass legislation about alleged Nazi war criminals living in Britain, what are we and the international community going to do about those war criminals in Bosnia today who are ethnic cleansing, mass murdering, raping and committing other such war crimes? Will any action be taken to bring those war criminals to justice?
The Prime Minister: The hon. Gentleman knows the answer to that because it has been given in the House on a number of occasions--he knows that the answer is yes. I know that the hon. Gentleman feels deeply about this matter, but he should not underestimate the work done by the aid agencies and United Nations troops, who have aided those agencies to carry out work that otherwise would have been impossible to complete. Many people are alive today who would not have been but for that action, which was largely led by this country and British troops.
Mr. Churchill: I fully appreciate the difficulties confronting my right hon. Friend in the decisions that he
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must take with his fellow national leaders over Bosnia. Is he aware, however, that the honour of Britain is engaged in the defence of the safe haven of Gorazde, which the Government established, and which is guarded by 200 Royal Welch Fusiliers? Is it not now incumbent on us to ensure the safety of those tens of thousands of the civilian population who have flocked there? Will he make sure that we and our allies, together with the United States, do all in our power to ensure that Gorazde does not fall?The Prime Minister: I am conscious of that, but my hon. Friend would be the first to realise that it would not be appropriate for me to expand on that matter.
Q4. Mr. Illsley: To ask the Prime Minister if he will list his official engagements for Tuesday 18 July. [33181]
The Prime Minister: I refer the hon. Gentleman to the reply I gave some moments ago.
Mr. Illsley: Does the Prime Minister realise that the recommendations of the Greenbury committee will do nothing to curb the obscene pay rises that have been
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awarded to the directors and chief executives of privatised utilities? Does he further realise that the announcement yesterday about taxation will affect the half a million ordinary employees who have share options? Is it not time that the Prime Minister took action to curb excessive pay awards in major companies rather than increasing the tax burden on ordinary employees?The Prime Minister: I know that it is coming to the end of term, but that is pretty rich from the hon. Gentleman. The Labour party has been calling for share options to be taxed as income for some time. Just as some Members now appear to be calling for a 50 per cent. tax rate on earnings, here is the hon. Gentleman talking about reducing taxes. There seems to be a lack of conjunction between the Front Bench and the Back Bench.
As far as other matters are concerned, I believe that the right hon. Member for Sedgefield (Mr. Blair) said yesterday, some way away,
"There is, believe it or not, still prejudice against success". Well, there sits the prejudice--right along the Labour Benches.
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