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1.23 pm
Mr. Clifford Forsythe (South Antrim): Northern Ireland's constitutional position has been regularly discussed in the House, and sadly the security situation also requires much attention from right hon. and hon. Members. The media in general prints many column inches and uses many feet of film and tape to cover both subjects.
While that is understandable in our sad situation in Northern Ireland, one of the casualties is the lack of attention given to the many social problems experienced every day by people of all shades of opinion in Northern Ireland. I am almost certain that my remarks on social affairs could be applied to many other parts of the kingdom, although each area has its particular slant on the subject.
I welcome the commitment in the Gracious Speech to treat the fight against drug misuse and trafficking as a priority. The problem has grown steadily in recent years. Unless resolute action is taken, the robberies and assaults--and, yes, the murders--associated with that evil trade will get out of all control and adversely effect the lives of all our citizens.
The same paragraph of the Gracious Speech states that priority will be given to action to protect and improve the environment. "Environment" can mean many things; it can mean the football field that I used to play on; it can mean the trees, the rivers or even the roads. I wish to mention another little part of the environment: the living space that surrounds our homes. In his remarks on the Gracious Speech, the Prime Minister mentioned with pride the number of people who had purchased their own homes. Most of us agree that it is good to have responsible home owners who take pride in their homes, but what about their surroundings?
Tenants were encouraged to purchase their homes from the local authorities. In Northern Ireland, it was from the Housing Executive. They may be paying less for a
mortgage than they used to pay for rent. So far, so good. They own their dwellings but their neighbours are often still tenants. They are good friends with their neighbours, especially their next-door neighbours. However, one day their good friends and neighbours next door move away and in come new tenants. Those people are not good tenants; indeed, they are outrageous. They play loud music at all hours of the night and in the early hours of the morning; their children pull down the fences; windows are broken; broken cars appear on their drives; and large dogs roam around, frightening people and creating mayhem.
Gradually, the people who are still tenants get transfers from the local authority or the Housing Executive, leaving the few home owners to cope with the bedlam. They have no escape because they cannot sell their homes. The police say that they must catch the culprits in the act. The local authorities say, "We are sorry but you are now home owners and you are not our responsibility." I hope that action will be taken on that environment. It is not a great advantage to own your own home in what rapidly becomes a rundown and hostile environment that other people avoid at all costs.
Of course a similar situation can arise for tenants and I have experience of how elderly tenants suffer from youths walking along their bungalows on the ridge tiles and looking through their bathroom and bedroom windows night and day. I hope that action will be taken to help people who live in that sort of environment.
The Gracious Speech promises consultation on measures to help people to make better provision for their long-term care. I am sure that that consultation will be closely followed by us all. However, most of us will be aware that many of those who need such care already feel that they made such provision by paying national insurance contributions over the years. They were given the impression that those contributions would provide for all their social needs, but we now know the truth: to provide all that would be desirable for people's needs requires someone to foot the bill. That bill can either be paid by us today through taxes, by our children and grandchildren tomorrow or, as some have suggested, through reducing the bill by reducing the provision of social services and benefits. Germany has had a taste of that in recent days.
The problem must be realistically faced by the House and not treated as a political football for short-term gain. Everybody and every hon. Member and political party will have to face that. As the total of social security payments rises, it becomes even more important to force fraud from the system so that available finance is targeted at those in greatest need. I strongly support the Secretary of State's proposed Bill to combat fraud and I support the other measures.
I am sure that all hon. Members could recount cases of fraud that have been reported to them over the years and I sincerely hope that we can expect action in this area as soon as possible in that part of the United Kingdom for which the Secretary of State for Social Security does not have responsibility--in Northern Ireland. I hope that the Social Security Agency there and the Department that is responsible now have a strategy in place: they did not have one in place when we took evidence from them almost a year ago.
It was illuminating that when checks were being carried out by Department of the Environment transport section inspectors on private hire taxis, 40 per cent. of those who were stopped and questioned had to be reported to the Social Security Agency for further investigation. That is a measure of the problem. Probably they were not all guilty. Nevertheless, 40 per cent. of those stopped were reported.
We all want eligible claimants to receive their entitlement but it is essential that those who defraud the system are detected and dealt with at an early stage. Nevertheless, all claimants should be treated courteously and hassled only when fraud becomes apparent.
There have been many recent changes to social security legislation and more problems have landed on my desk from constituents. The system for dealing with claims seems to have slowed down. I suspect that it is mostly due to the legislation's increasing complexity. Changes are difficult to absorb quickly and the system needs a chance to settle down before other changes are made.
At this stage, I take the opportunity roundly to condemn the cowardly and outrageous threat a few days ago to Benefits Agency staff by a telephone caller to the Falls road social security office. Such threats are disgraceful. I remind everyone that the staff merely implement, at the coal face, as it were, the legislation passed by the House. I am sure that the House will join me in congratulating all social security staff, but particularly those in Northern Ireland, who do an excellent job in difficult and sometimes, as I have illustrated, dangerous circumstances.
I have also been made aware of hold-ups in arranging tribunal appeals, so I checked the system in Northern Ireland and discovered that it was a bit similar to that of some of the quangos of which we in Northern Ireland are not particularly fond. I discovered that the president of the tribunals is appointed by the Lord Chancellor's Department and that the chairman is appointed by the Lord Chief Justice. Even though the "Public Bodies" book shows a president for each of the four appeal tribunals--the child support, disability, medical and social security appeal tribunals--I discovered that the president was the same person for each and that the chairman was the same person for each.
In a smaller part of the United Kingdom such as Northern Ireland, that is perhaps understandable. Do we want to appoint all those presidents or chairmen? I then discovered, however, that all the tribunal members are appointed by the president, so the president appoints 52 male and 38 female tribunal members.With that number of members, why do appeals take so long to be heard, and if the president and chairman cover all four bodies, do any of the members serve on more than one tribunal? I shall investigate further and perhaps have the opportunity to report to the House on another occasion. Perhaps it would help if the names of the people who serve on such bodies could be included in the 1996 edition of "Public Bodies".
The Government's programme up to the general election is before us. In saying that, I understand that two extra important items have been added. My party will examine carefully the fine detail of all those measures and will play its part by supporting or opposing them as appropriate for the general good of the country and of Northern Ireland in particular.
Mr. Tom Cox (Tooting):
I listened with great interest to the Secretary of State for Health. Few right hon. and hon. Members, to whichever party they belong, disagree about the importance of primary health care and family doctor services, which we all want to see developed. However, we did not hear in the right hon. Gentleman's lengthy speech any explanation of how his proposals fit in with the current situation in the health service and of the source of their funding. Who will pay for the kind of developments mentioned this morning?
St. George's in Tooting, in my constituency, is one of the largest hospitals in the United Kingdom. I spoke in two debates last year of the problems that afflict that hospital, which were also the subject of an entire "World in Action" programme. Subsequently, I received a large number of letters from not only my constituents but people throughout the country. They wrote, "The remarks that you made about the hospital in Tooting are the same that we would make. We have an excellent hospital with superb, dedicated staff, but it is being pushed to the limit by Government policies."
The situation was bad enough last year, but Merton, Sutton and Wandsworth health authority--which covers a large number of parliamentary constituencies--is now confronting a major crisis in respect of St. George's, which faces a deficit next year of more than £14 million. Last year, I spoke of the conditions in that hospital's accident and emergency unit, where seriously ill people were left lying on trolleys in corridors for hours because there were no hospital beds for them. Wards were closed because the health authority did not have the money to open them or to employ the necessary staff. Sadly, the situation has not improved over the past 12 months.
I heard the Secretary of State's comments today about the new proposals on primary health care, but I must ask how the proposals will help to deal with the problems that we have faced in my health authority for such a long time. In recent weeks, we have heard of the total closure of treatment waiting lists for some medical conditions. No more names will be added to lists for hip replacements, cataract operations or for the treatment of varicose veins. At a meeting in the House a few days ago, we were told by senior health representatives that, because of financial problems, they envisage that they will be permitted to perform only about 25 per cent. of the operations in the next year that they have been able to perform in past years.
I am sure that all hon. Members hold advice services at which they meet people from all types of backgrounds. A couple of weeks ago, I met a lady at my advice service who told me that she was 50 years old and suffered appallingly from varicose veins. She has a very sympathetic doctor, who has helped as much as he can, but she said--this was backed up by her doctor--that the tablets that he prescribes for her no longer provide any benefit. She said that her health problem is not life threatening, but that her quality of life is continually
declining. She is not able to pay for a private operation. She told me that, unless someone makes some medical provision for her, someone else will soon have to provide her with other services, because she will no longer be able to perform the tasks that she has been able to perform for so much of her life. I am sure that all hon. Members can speak of similar cases.
In the past few days, all hon. Members should have received a letter from the British Medical Association. If ever there was a damning indictment of what is happening to health services in the United Kingdom, this is it. The letter states:
The list attached to the BMA's statement shows how many areas of the United Kingdom suffer from the same problems: Oxfordshire, Lancashire, Devon, Cornwall, North and South Thames, Derbyshire, the midlands, Scotland, Wales--across the United Kingdom. The BMA has provided documentation about the scope of the crisis that we are facing.
Earlier in this debate, some hon. Members mentioned accident and emergency services. I have already mentioned A and E services at St. George's. The Evening Standard of 23 October 1993 contains a full-page article entitled "One woman's diary of her struggle in a London accident ward". My only quote from that article is that it
Another matter is causing great concern in my constituency and at St. George's. We have a hydrotherapy pool that is in constant use. All hon. Members will agree that the use of a hydrotherapy pool to treat certain medical conditions is, without doubt, of enormous benefit to sufferers. The pool is currently open because a Hong Kong business woman made a £350,000 donation--it costs about £70,000 a year to run. We have been told by the health authority that the pool will be closed next year because of a lack of money. When hon. Members consider that it is estimated that the area will have a deficit of £14 million next year, the case presented by me and by other Members of Parliament for the area looks hopeless. One has to be realistic and ask whether we have any real chance of keeping the pool open in the face of such an enormous deficit.
That brings us back to the theme of the debate--primary health care. We are losing the essential day-to-day health services that are so crucial. Against the background related by hon. Members today, one has to ask where the Government's targets are now. We have heard a great deal about targets for the patients charter and waiting lists, but, when set against the enormous
problems, one has to wonder what relevance they will have. I cannot believe that the public will see them as credible.
"The BMA held a press conference today to highlight the concerns expressed by doctors throughout the country about the implications for patient care due to chronic underfunding of the NHS. There are massive health authority deficits, rising waiting lists, and non-emergency procedures will virtually cease in many parts of the country. Patients who are not emergencies but who genuinely need treatment are waiting in pain and distress, and their diagnoses are being delayed. From doctors' reports, it appears that the crisis is more widespread and deeper than in previous years with doctors facing these problems only halfway in the financial year."
That statement is a description of what is happening in my constituency.
"is a startling picture of the treatment Londoners are receiving."
That clearly shows the enormous problems faced not only by the people of London--other London Members of Parliament have touched on that subject today--but by people throughout the country.
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