House of Commons Hansard Debates for 14 Dec 1998 (pt 41)

Ms Jackson: I shall forgive the hon. Lady her audacity in asking for the protection of underground services, given that she represents a party that had 18 years in which to improve those services, significantly failed so to do, and would have been, had it been returned at the last general election, engaged in a process of running down those services so that they could be sold off. I shall forgive her on that level.

However, let me assure--indeed, reassure--the hon. Lady that our public-private partnership is a way of attracting into the underground vast amounts of money which could not possibly come from the public purse, to ensure that it is not only maintained, but modernised. I am speaking of the whole underground network. We have no plans--as, I believe, the Conservative party had in its previous Administration--to close a third of the lines before attempting to sell the underground.

The hon. Member for South Cambridgeshire (Mr. Lansley) made three points. He said that he did not perceive that London had any particular political identity. I am prepared to forgive him for that remark, which is insulting to Londoners. They are clear in their minds that London does have a political identity. For a long time, they have been arguing for their voice to be restored to them.

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The hon. Gentleman spoke of lack of clarity on planning. Given the failure of previous Administrations to do anything other than regard planning as a dirty word, and given the absurd, ad hoc nature of planning in London--Canary wharf is a prime example--I believe that what we are proposing, strategically, is precisely what London wants. I reassure the hon. Gentleman that the business community does welcome the GLA, not least to provide a strategic voice to sort out London's transport problems.

My hon. Friend the Member for Upminster spoke of the sense of being a Londoner. He too congratulated our right hon. Friend the Secretary of State. I was especially interested that he shared the Government's commitment to ensuring that the River Thames--that vast natural resource, which runs through this great capital city--is brought back to life and plays its proper part.

I mentioned the contribution by the hon. Member for Orpington, especially on the subject of crime and the police. We absolutely share his commitment to the idea of world squares.

My hon. Friend the Member for Ilford, South (Mr. Gapes) also welcomed the Bill. I tell him, and other hon. Members who were concerned about the proposed threshold, that the level of the threshold will be decided by a statutory instrument via an affirmative resolution. That is clearly something that must be discussed in detail, and that is what we are committed to doing.

My hon. Friend the Member for Hammersmith and Fulham (Mr. Coleman) spoke of the Transport Committee for London. I am sure that it was a slip of the tongue when he referred to the vulnerability of concessionary fares. There is no possibility of concessionary fares becoming vulnerable either before or after the creation of the GLA. My hon. Friend spoke of the importance of the London lorry ban. It was something for which Londoners had argued for a considerable time, which they eventually won.

My hon. Friend the Member for Brent, North (Mr. Gardiner) spoke of joined-up transport, which will undoubtedly be part of what the mayor will be approaching. We welcomed my hon. Friend's acknowledgement that our proposals for a police authority will introduce transparency and accountability into an area of London where they have not been present before. I have spoken of my hon. Friend the Member for Harrow, East underlining that the Bill is not the Greater London council mark II, that we are looking forward, that we are moving forward, that the Bill is modern and that it is a new concept of government.

In the main, it is true to say that what we have proposed and brought to the Floor of the House has been welcomed by everyone on the Government Benches and not welcomed at all by the official Opposition. In the main, the Liberal Democrats welcome the Bill and say that they will work with us.

Many issues have been raised tonight and we shall have an opportunity to address them all in Committee. I shall end as I began. I and my hon. Friends take great pride in keeping our promise to Londoners. This is another example of the Government keeping their promises. I commend the Bill to the House.

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Mr. Deputy Speaker: I now call the Government Whip to move--

Sir Sydney Chapman: On a point of order,Mr. Deputy Speaker. I apologise to the Government Whip. Is it not right to say that the debate can continue until midnight, and that if anyone wishes to seek to catch your eye, the debate can so continue? In the event of no one else wishing to speak, can a Member who has already spoken be regarded as having the right to speak again?

Mr. Deputy Speaker: The hon. Gentleman is debating the Question. I have caught the eye of the Government Whip and invited him to put a motion. It is for the House to decide whether it wishes to divide on the motion. If the motion were defeated, the debate could continue until midnight.

Debate adjourned.--[Mr. Hill.]

To be resumed tomorrow.

COMMITTEES

Mr. Deputy Speaker (Mr. Michael J. Martin): With permission, I shall put together motions 6 and 7.

Ordered,

Catering

That Helen Jones be discharged from the Catering Committee and Mr. Gerry Steinberg be added to the Committee.

Information

That Mr. Jon Owen Jones be discharged from the Information Committee and Mr. Ian Stewart be added to the Committee.--[Ms Karen Buck, on behalf of the Committee of Selection.]

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Strokes

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

11.53 pm

Mr. David Amess (Southend, West): Christmas is a particularly good time of year to consider the state of the nation's health, for obvious reasons. I suppose that I am looking to the Minister to show charity in redressing what I am sure was the unintentional omission of no longer having stroke as a national priority.

Since it was announced that we would have the debate this evening, I have been contacted by a number of hon. Members. I know that the hon. Member for Crosby (Mrs. Curtis-Thomas) wanted to be in her place and that for various reasons, she is unable to be present. She is very interested in the subject. I am delighted to see the hon. Member for North-East Derbyshire (Mr. Barnes) in his place. He is a regular attender in the Chamber and I had not realised that he was the victim of a stroke this summer. Having read the newspaper cuttings, I pay tribute to him on the remarkable recovery that he has made. He is in a good position to speak about the Government's decision not to continue with stroke as a national priority.

Mr. Harry Barnes (North-East Derbyshire): I compliment the hon. Gentleman on raising this subject. I also thank you, Mr. Deputy Speaker, for assisting me when I had a stroke, which happened on the Bench in front of me. My hon. Friend the Member for Bolsover (Mr. Skinner) and an Attendant serving the House also assisted. The events were of great personal importance and give me some insight into this issue. I am keen that the Government should pay proper attention to the interests of bodies such as the Stroke Association.

Mr. Amess: I am glad that the hon. Gentleman has made that point. Although it may be slightly embarrassing that you are in the Chair at the moment, Mr. Deputy Speaker, there is no doubt that had it not been for your good self and others, the hon. Gentleman might not be with us today.

I note that the hon. Member for Southwark, North and Bermondsey (Mr. Hughes) is in his place and I am delighted that my right hon. Friend the Member for Maidstone and The Weald (Miss Widdecombe) is also here. She knows how important the subject is. I am even more delighted that the Under-Secretary of State for Health, the hon. Member for Barrow and Furness (Mr. Hutton) is to reply to the debate. He is a product of Westcliff grammar school in my constituency. We are proud that a product of a local selective secondary school has become a Minister. I am not so delighted about his politics, but I do not think that it is churlish to hope that in the coming year when we debate the future of grammar schools, he will bear in mind the great debt that he owes to Westcliff high school for boys. It is barmy to deny future generations the opportunity of the education that he had without putting something better in its place.

I regret the removal of stroke as a priority. The Conservatives' "The Health of the Nation" White Paper set two targets for stroke: one for those under 65 and another for those between 65 and 74. For whatever

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reason--no doubt the Minister will enlighten me--there is now just one target for heart disease and stroke combined for the under-65s only. I regret that.

Each year, more than 100,000 people in England and Wales have a first stroke. It is a little like Members of Parliament saying that they are experts because they are a father or a mother, but my father died following a number of strokes. He was a good age and his strokes went on over five years. He liked the occasional drink. The first time that it happened, as I remember only too well, my mother thought that he might have had a little bit too much to drink. We realised that something had happened to him--my nephew was present at the time--when he lost his speech. I have not had the same experience as the hon. Member for North-East Derbyshire, but I have seen my mother, who was nearly 80, caring for my father for five years. She kept him alive, but he lost a great deal of his dignity. He went to a speech therapist, but he never really regained his speech. I have witnessed at close quarters what stroke means for many people.

There are more than 60,000 deaths each year due to stroke. It is the third most common cause of death, after heart problems and cancer. Stroke is the largest single cause of severe disability in England and Wales. The estimated cost to the national health service is £2.3 billion a year. The cost of stroke care will rise in real terms by about 30 per cent. by 2023. As we all know, stroke is blockage of the supply of blood to the brain. The effects of stroke can be mild or severe. Who is at risk? There seems to be a misunderstanding that only elderly people are at risk, but young people can suffer from strokes. It has been estimated that about 40 per cent. of strokes could be prevented by regular blood pressure checks.

I pay tribute to the Stroke Association, which has been quite magnificent in briefing me closely. It is a national charity which provides practical support to people who have had strokes, their families and carers. I was privileged to be present, by sheer coincidence, at my local stroke Christmas dinner on Saturday evening and I spoke to a number of people who have suffered strokes and their carers.

I am delighted that stroke services in Southend are first class. I have no complaints about our local services and we have an excellent unit at the hospital, which takes patients in the acute phase and works through the rehabilitation process with them. After discharge, essential follow-up rehabilitation is provided by community-based speech and language therapists. Neuro-physiotherapists and occupational therapists also help, and funding is provided for a Stroke Association dysphasia support officer who, together with a team of volunteers, provides continuing support for those who have communication problems after strokes.

The service in Southend is first class, but, without being dishonourable to the Minister, I want to articulate and share with him my concerns and tackle the ministerial responses, which I do not accept. "Modernising Health and Social Services: National Priorities Guidance 1999/00-2001/02" has at page 10--for all to see, so I am not imagining it--waiting list times, primary care, coronary care, heart disease and cancer, but there is no mention of stroke.

At page 20, although the Minister will argue that it is included under coronary heart disease, it is not at all clear that stroke is accepted as a priority. That important

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document will direct the work of health and social services for three years from April next year, which is why I am very concerned. Stroke is the single largest cause of disability.