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Mrs. Liddell: The Minister has the support of the Opposition in the stance that she has taken. The new clause would create a substantial loophole and would cause considerable difficulty by giving a blanket exemption to dealers. Those who will be able legitimately to hold higher-calibre weapons will be very small in number and there will be no real need for a wide network of dealers, which could only leave an opportunity for those with dishonourable purposes to gain access to premises where they knew such firearms could be held. I commend the Minister for the common sense of her position.

Sir Jerry Wiggin: I beg to ask leave to withdraw the motion.

Motion and clause, by leave, withdrawn

Mr. Dalyell: On a point of order, Madam Deputy Speaker. About three-quarters of an hour ago, anticipating that the House of Commons was likely to rise on a Tuesday at an unprecedented early hour, I inquired about the possibility of a second Adjournment debate on the position of Brigadier Thompson's reconnaissance team, which is coming back from Zaire. The information that I received from the Table Office was that in all circumstances post-Jopling there is no possibility of a second Adjournment debate even when it is anticipated at a very early stage that the sitting could collapse.

The Adjournment debate of the hon. Gentleman from mid-Wales, the hon. Member for Ceredigion and Pembroke, North (Mr. Dafis), could not possibly be extended from hospitals in mid-Wales to other matters. Given the pressure on parliamentary time, it is a crying

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shame and totally unsatisfactory that we should be about to begin the Adjournment debate at 12 minutes past 6. This is prime time, and many hon. Members have subjects on which they wish to raise questions--the commitment of the British Army in Zaire is just one. Can this matter be brought to the attention of the Procedure Committee because what it has done is, in effect, deeply unsatisfactory?

Madam Deputy Speaker (Dame Janet-Fookes): The hon. Gentleman is correct in his understanding of the present practice. I would suggest that if he is unhappy he should go directly to the Procedure Committee to raise the issue. However, I must point out that, technically, we have not quite reached the Adjournment.

Bill reported, with amendments, pursuant to Order [18 November].

Bill, as amended, ordered to lie upon the Table.

Ordered,


Mr. Dalyell: Further to that point of order, Madam Deputy Speaker. You have said that the current situation regarding a second Adjournment debate is "the present practice". Frankly, a lot of my colleagues did not know that. Is it "practice", which can be defied, or a resolution of the House which cannot?

Madam Deputy Speaker: I understand that the present situation is a result of the agreement following the Jopling reforms and that these are the orders under which we now work. I said "the present practice" because one cannot anticipate what changes might be made in the future.

Mr. Alex Salmond (Banff and Buchan): Further to that point of order, Madam Deputy Speaker. I do not wish to detain the House, although my hon. Friend from Wales, the hon. Member for Ceredigion and Pembroke, North (Mr. Dafis), could go on for some time with his Adjournment debate. I have considerable sympathy for the hon. Member for Linlithgow (Mr. Dalyell). I remember the Jopling reforms, but I do not recall that such an eventuality as this was considered. Many people would argue that there should perhaps be a reserve list of Adjournment debates for just such an eventuality. I hope that you, Madam Deputy Speaker, will use your good offices to make that view clear, as the hon. Member for Linlithgow--as he so very often does--has put his finger on an important point.

Madam Deputy Speaker: I do not think that I can add to what I have said, but it is open to any hon. Member to make such recommendations as he feels suitable to the Procedure Committee, which exists for the purpose.

Mr. Dalyell: I do not want to put you on the spot, Madam Deputy Speaker, but could a statement be made at some point on precisely where the orders have been agreed that there should not be a second Adjournment debate? The Clerk may have some knowledge of this.

Madam Deputy Speaker: I will ensure that a member of the Clerk's Department provides chapter and verse for the hon. Gentleman.

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Ceredigion and Mid-Wales Hospital Trust

Motion made, and Question proposed, That this House do now adjourn.--[Mrs. Lait.]

6.15 pm

Mr. Cynog Dafis (Ceredigion and Pembroke, North): I have been accorded a status this evening to which I would not dare aspire. I have been described as the hon. Member for mid-Wales, and even as the hon. Member for Wales. There may be a sense in which my party represents Wales, but I claim only to be the hon. Member for Ceredigion and Pembroke, North. However, what I have to say tonight applies and is relevant to a large part of mid-Wales.

I am grateful to the Under-Secretary of State for Wales, the hon. Member for Cardiff, North (Mr. Jones), for being here tonight to respond to this important debate, and for the courteous hearing that he has given me in the past on this subject. I am also grateful to him for the letter that I received today in response to my most recent one to him--although it did not give me much comfort, except in one detail.

The Under-Secretary will know that I have been expressing concern about the future of the hospital service in my constituency since June 1995, in correspondence and in questions in the Chamber. He will also know that, all along, I have avoided alarmism in this discussion.

Those who attended the well-attended public meeting that I convened in Aberystwyth on 27 September--which led to the formation of the Ceredigion hospital services working group--will confirm that it would have been perfectly possible to create a mood of alarm, but that I avoided doing so. However, I must say that I am becoming alarmed at the direction of events and the likely consequences of the funding crisis--that is no overstatement--that is now affecting the Ceredigion and Mid-Wales hospital trust.

Before I come to discuss the crisis, can I first emphasise the excellence of the service provided by the trust? I wish to emphasise the district general hospital at Bronglais, Aberystwyth, and the three community hospitals at Aberaeron, Cardigan and Tregaron.

Bronglais provides a wide range of services, led by its own consultants, to a very high standard--of that there can be no doubt. The quality of service is matched by its efficiency, as its position in the NHS Wales performance tables on waiting times clearly shows. It has met its patients charter requirements successfully, and won the Healthy Hospitals competition in 1995. It is now preparing for King's Fund accreditation and the Investors in People award in 1996-97, and it has every confidence of success. It has set itself an impressive list of targets for the next financial year.

It is worth asking what lies behind that success. The trust's new chairperson, Eleri Ebenezer, who came to the job at the beginning of this financial year, identifies a number of factors in her foreword to last year's annual report. She says:


Such things are often said, and they sound like cliches, but I think that there is truth in what is said about the hospital and the trust.

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The foreword continues:


The three community hospitals in turn are cherished by the localities they serve, by virtue of the same dedication and quality of care. However, the service, in terms of both quality and, crucially, range, is in danger.

Until a week or so ago, the Ceredigion and Mid-Wales trust, alone among the trusts in the Dyfed Powys health authority, had failed to agree a contract with it, arguing that the authority's offer was £400,000 short of what was needed. Knowing that, if conciliation found in the trust's favour, the authority would go to pendulum arbitration, which could result--that being the nature of such arbitration--in its getting nothing, the trust accepted an improvement of only £150,000 on the offer.

The additional sum of £150,000 that was agreed 10 days ago is in the form of a loan, and £320,000 of this year's health authority contract is what is known as brokerage--a loan that must be repaid. The implications of the settlement will be grave.

The health authority faces serious difficulties. It is responsible for, among other places, the constituency of the hon. Member for Brecon and Radnor (Mr. Evans), who is here today; I am sure that he is interested in the matter.

For various reasons, the health authority will have to find a total spending reduction of between £9 million and £10 million by the end of the decade; that is partly because Powys health authority, the predecessor authority, accumulated a deficit of, I believe, £2 million up to the end of last year. There is some feeling in the Dyfed part of the new authority that it should not have to carry the consequences of that deficit, but I do not want to be divisive and pursue that matter tonight.

Because of the need to pull back £9 million-plus, there will be year-on-year cuts until the end of the century, with little if any scope for efficiency savings to be made without reducing service quality. What I said about the efficiency level of Bronglais is relevant to that, and I emphasise that Bronglais has among the lowest management costs in Wales. It is small wonder that the health authority says:


Within that dismal picture, Bronglais district general hospital--I want that term to mean what it says--as a small hospital, serving a sparsely populated rural area, has its own specific problems, operating as it must in the competitive environment of the national health service market. Specifically, it is required to service any capital development to the extent of 6 per cent. and to provide a 6 per cent. return not only on new capital development but on asset value.

Unless there is a recognition of those specific problems--there should and can be such a recognition--and unless provision is made, as it must be, to cope with them, Bronglais will find it increasingly difficult to maintain a sufficient capital programme to replace equipment and keep abreast of new developments in technology and other facilities. The effect on staff

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recruitment and the marketability--we have to use that terminology--of the hospital's services could be to set up a spiral of decline. I have described to the Minister in the past how that could occur.

The strategy document of Ceredigion and Mid-Wales trust, "Ceredigion 2000", contains a SWOT--strengths, weaknesses, opportunities, threats--analysis. Among the threats, it identifies the fact that fundholders now have far greater discretion in purchasing decisions and that they--and especially those at the outer periphery of the area--might be tempted to purchase services elsewhere.

On capital development, lest anyone should mention the private finance initiative, let me express my total scepticism as to its relevance to the health service in general and to a small hospital in rural Wales in particular.


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