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Mr. Gareth R. Thomas (Harrow, West): I was pleased to hear my right hon. Friend announce a debate on the

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House of Lords. Does she agree that part of that debate should focus on the disgraceful decision by the other place to overturn key sections of our working families tax credit proposals? Is that not proof, if more proof were necessary, that the hereditary peers are completely out of touch with modern realities, especially concerning the child care needs of working families, and that sensible reform, long blocked by the Conservative party, is long overdue?

Mrs. Beckett: My hon. Friend is right to say that sensible reforms such as the working families tax credit are long overdue. It is part of the Government's multi-pronged approach to relieving the worst of the poverty for families in work which grew under the Conservative Government. Like my hon. Friend, I was astonished to learn that that was a matter in which the House of Lords thought fit to meddle. It is indeed a further example of the fact that that Chamber is now somewhat out of touch with modern realities and the modern world, and it shows that yet again it is acting on behalf of the few, rather than the many.

Mr. Peter Brooke (Cities of London and Westminster): Although the coincidence of timing between the Select Committee on Northern Ireland Affairs' visit to the United States and the Northern Ireland legislation next week, which I raised with the Leader of the House last week, has had some of the unfortunate consequences that I foresaw, I would still like to express my appreciation for the efforts that she made to find out whether anything could be changed.

I shall also ask a question supplementary to that asked by the hon. Member for Belfast, South (Rev. Martin Smyth), and say that one of the arguments in favour of a debate on smuggling across the Irish border is connected with a speech made by the Economic Secretary to the Treasury in Committee on the Finance Bill earlier this week. The hon. Lady said that the issue of a buffer zone such as that between Germany and Holland, which had been raised in the debate, was a matter for the Northern Ireland Office. However, Customs and Excise, for which she herself answers in the House, put that idea in a memorandum to the Select Committee. Is there not a sense in which the Treasury and the Northern Ireland Office both seek to avoid their particular responsibilities for dealing with that increasingly urgent question?

Mrs. Beckett: I thank the right hon. Gentleman for his kind remarks; I regret that that unfortunate clash has arisen. Nevertheless I hope that between us, with some good will, we can resolve it without too much difficulty.

I take the right hon. Gentleman's point about the concern expressed both by him and by the hon. Member for Belfast, South (Rev. Martin Smyth) about smuggling across the Irish border. The Government have provided resources for a substantial number of extra customs officers, so in that sense the Government are not ignoring the matter. The right hon. Gentleman is right to say that the Treasury answers for Customs and Excise in the House, and I shall draw his remarks to the attention of my right hon. Friend the Secretary of State for Northern Ireland and of Treasury Ministers, because it is important that we have the right liaison. I assure the right hon. Gentleman that all Departments are concerned about such matters.

Sir Sydney Chapman (Chipping Barnet): As Members are being elected to the Scottish Parliament today, does

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the right hon. Lady agree that the so-called West Lothian question now assumes immediate urgency? Will she join me in thanking my right hon. Friend the Member for North-West Hampshire (Sir G. Young), the shadow Leader of the House, for taking the initiative and arranging for the matter to be debated during the Opposition day debate on Welsh and Scottish devolution next Tuesday? Because of the vital importance of the issue within the United Kingdom constitution, will the right hon. Lady ask the Prime Minister to intervene in the debate and let us know exactly where the Government stand on this burning question?

Mrs. Beckett: Personally, I share the view expressed either by Sir Malcolm Rifkind or by Sir Alec Douglas-Home, or possibly by both, that the West Lothian question did not need to be answered but could readily be put on one side; devolution could continue without it. Both men were in key positions in the Conservative party when they said such things--but of course that was longer ago than last week.

The hon. Gentleman also asked for an early discussion to settle the matter with speed. I remind him that the hon. Member for Macclesfield, the Chairman of the Procedure Committee, is now carrying out an inquiry into precisely how devolution may affect this House. With respect, I must tell the hon. Member for Chipping Barnet (Sir S. Chapman) that no one who sensibly wants the House to develop effectively and efficiently wants to rush to judgment on such matters.

Miss Anne McIntosh (Vale of York): Will the Leader of the House agree to make time for an early debate on another European matter--the revision and amendment of the sixth VAT directive, which is now before the Council of Ministers? The amendment would, for the first time, allow church repairs to be exempt from VAT. I am sure that the whole House will support my campaign to allow that to happen, but the Paymaster General seems reluctant to apply for the exemption. It would apply to all labour-intensive industries, and would end the anomaly between the building of new churches, which is exempt from VAT, and the repair of existing churches, which is subject to VAT at 17.5 per cent. Can we make time for an early debate, before the matter is decided in the Council of Ministers?

Mrs. Beckett: I sympathise with the hon. Lady's concerns, and I am well aware that hon. Members seek

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to relieve all sorts of worthy causes from the imposition of VAT. Experience suggests that the boundaries are complicated and subject to much discussion. I shall draw her remarks to the attention of my Treasury colleagues, but I fear that I cannot undertake to find time for a special debate on the issue in the near future.

Mr. John Bercow (Buckingham): May we have an early debate in Government time on the problems of small businesses? Given that businesses with fewer than 100 employees constitute 99.6 per cent. of British enterprises, employ 50 per cent. of the private sector work force and produce two fifths of national output, but that there has been a massive rise of 32 per cent. in small business bankruptcies compared with the same period last year, such a debate would give the Secretary of State for Trade and Industry a chance to expand on his recent statement that

He could explain to the House and the country how and when he intends to reverse the damaging increase in regulation that his Government have spawned, and how they will create a climate in which the seedcorn of this country's prosperity can survive and flourish.

Mrs. Beckett: I am well aware of the importance of small and medium-sized businesses and have long been so. We are all mindful of the importance of trying to reduce the burden of regulation, whether on small or other businesses, but I accept that it impinges especially on small businesses. I was a little surprised that the hon. Gentleman mentioned bankruptcies. Whatever recent difficulties have arisen, there is no doubt that bankruptcy levels under this Government pale into insignificance beside the record of the Conservative Government whom he supported. We strongly believe that it is important to try to get the burden of regulation lifted as much as possible and, indeed, we hope to reverse the Conservatives' record of talking about reducing the burden of regulation but actually increasing it out of sight.

On the Government's general record, I remind the hon. Gentleman that it was only recently that small business commentators were moved to say when my hon. Friend the Member for Hornsey and Wood Green (Mrs. Roche) left the Department of Trade and Industry that she was the best Small Business Minister there had been for years.

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London's Health Service

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

1.3 pm

The Secretary of State for Health (Mr. Frank Dobson): I cannot possibly start this debate on the modernisation of London's health services other than by paying tribute to the emergency services, and in particular the staff working for the NHS in London, for their swift, effective and highly professional response to the bomb outrages in Brixton, Brick lane and Soho. The staff involved all did an amazingly good job. Like the victims, the staff who tended to them were black, white, Asian, men and women, straight and gay, all united in that singular humanitarian ethic that towers above all others--the commitment to help our fellow humans when they are in desperate need.

In Brixton, 15 ambulances and three motor cycle paramedics went to the scene. The first ambulance was on the scene in eight minutes. By the time it arrived at King's College hospital with the first of the wounded, emergency plans had already swung into action. Staff already on duty had made all the necessary preparations. Other staff had been called back in. Yet others had rushed in of their own volition just in case they could help. The same was happening at St. George's hospital and at St. Thomas's hospital.

After the Brick lane explosion, five ambulances were dispatched to the scene. The first arrived within seven minutes, and was followed by emergency teams from University College hospital, helicopter emergency services, and the immediate care doctors. The Royal London hospital and other nearby hospitals were fully prepared to receive the victims. All displayed the same state of readiness and commitment that were evident in south London the week before.

Last Friday, 21 ambulances were dispatched to the scene in Soho. The first arrived in four minutes. Emergency teams from UCH were there shortly after, and once again the nearest hospitals--University College, St. Thomas's, Guy's, the Royal London and St. Mary's--all responded just as the others had in east London a week before and in south London two weeks before. All performed magnificently. The UCH Middlesex hospital did so despite operating with emergency services in Gower street and some in-patient services at the Middlesex site following the closure of the main UCH building in 1993.

This brilliant performance by London's NHS was partly because of the commitment and skill of the staff concerned and partly because of the painstaking contingency planning involving clinical and non-clinical staff, and management. One young nurse whom I met at the UCH accident and emergency department last Saturday evening explained to me that it was the first major incident she had been involved in. She had expected it to be chaotic, but it was not. She said everybody knew what they were supposed to be doing and got on with it.

I had gone there 24 hours after the bomb, partly in my role as the local Member or Parliament, to thank her and her colleagues. Some of the staff had not really had a rest since the night before, but when I met them they were involved in four main tasks. Some were still looking after

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badly injured bomb victims. Others were dealing with the "run-of-the-mill" patients turning up or being brought into their busy accident and emergency department that Saturday evening. All were considering what lessons could be learned, so they could do even better when the next major incident occurred, whether as a result of accident or terrorism. One senior member of the nursing was laboriously sorting out all the special kits that they use for major incidents, replenishing stocks of dressings and drugs, so that they would be ready if there was another major incident that night.

Far too often, all that is taken for granted, as if such a highly organised response to disasters was natural and spontaneous--something that just happens. But it does not just happen: it depends on professionalism and commitment, planning and accumulated experience.

That organised response is delivered by a public service, by people who do not just talk of the public service ethic, but who live by it. As my right hon. Friend the Prime Minister said at the charter mark awards ceremony last year,

The NHS staff who looked after people after the bombs in Brixton, Brick lane and Soho look a bit embarrassed when one praises them to their faces. They say that they were only doing their jobs. They chose to work in the NHS because of the people they are. They are not motivated by share options or by windfalls from stock market flotations. They do it because they work for the national health service, which is committed to trying to provide the best health services for everybody--the best for all, on the basis of quality and equality, and that is what they deliver.

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