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Mrs. Beckett: I realise that it is a gross dereliction of duty, but I was not aware of the views of the Italian
chairman of that federation. I know that that is a disgraceful confession, but I must be honest with the House. If he is speaking as an advocate of British beef, that is good. I know that Italy has been a good market for British beef and we hope that it will be again. I understand that the hon. Gentleman and his party are seeking what relics of advantage they can from the aftermath of the BSE crisis. However, in the long term, it would be to the advantage of British agriculture if the labelling of beef as British came to be seen as a mark of quality. Conservative Members should think more carefully about where our long-term interest lies before continuing to assert that such labelling will cause people not to buy British beef.
Mr. John Bercow (Buckingham): Will the Leader of the House reconsider her complacent replies to my hon. Friends the Members for New Forest, West (Mr. Swayne) and for Altrincham and Sale, West (Mr. Brady) and agree to a full day's debate in Government time next week on the role of the National Institute for Clinical Excellence and the policy on drug prescribing? Is she aware that the Department of Health previously assured Dr. John Chisholm of the British Medical Association that no one would be denied the investigations, drugs or treatments that he or she needed? Is she further aware that the Prime Minister's response to my hon. Friend the Member for Runnymede and Weybridge (Mr. Hammond) at Prime Minister's Question Time yesterday was markedly different from that earlier pledge? Will she accept from me, in my characteristically non-partisan spirit, that my constituent who suffers from relapsing remitting multiple sclerosis, Caroline Cripps of Westcott in the south of my patch, requires those matters to be urgently addressed? Can we have a full debate on the Floor to thrash them out once and for all without delay?
Mrs. Beckett: I would normally be surprised at the hon. Gentleman returning to a subject on which his hon. Friends have comprehensively lost since I pointed out that what is being said now is what was said and published in 1998. However, I understand that he wished to refer to the case of his constituent, and I recognise his interest and concern in doing so. He knows that NICE is urgently considering MS treatment. Not only is what was said in the past few days about the institute to be found in the consultation document in July, but the White Paper published in December 1997 said:
- "Efficiency and quality should go hand in hand . . . Patients suffer if resources are not used efficiently or to best effect."
-
It has long been clear that the Government, too, recognise the importance of cost-effectiveness.
Mrs. Beckett: No, I cannot confirm any such thing. As the hon. Gentleman says, the Bill has been published only recently; it will be debated in the House in the proper way, and will receive full and proper scrutiny. It is no good for the hon. Gentleman to say dismissively, "despite the pre-legislative scrutiny". Yes, the Bill did receive pre-legislative scrutiny of one of its most important parts. The Bill will be properly dealt with in accordance with the normal conventions of the House.
Sir Patrick Cormack (South Staffordshire): Would the right hon. Lady be kind enough to amplify the answer that she gave to her hon. Friend the Member for Walsall, North (Mr. Winnick) about the oath and affirmation that members have to take before assuming their seats in the House? Does she accept that the requirement to take the oath, or to affirm, cannot be altered save by legislation? Will she confirm that, although the House has very properly addressed the matter of Members and their consciences in the past, it has never sought to suspend the requirement for a Member to proclaim and acknowledge the sovereignty of the Queen as monarch?
Mrs. Beckett: I cannot amplify my remarks; the hon. Gentleman raises several important issues relating to conclusions that the House came to, presumably many decades ago, as to how we handle such matters. I can only repeat what I said to my hon. Friend the Member for Walsall, North (Mr. Winnick); the issue is important and I shall make inquiries into it. However, I am sorry that I cannot--on the hoof, so to speak--answer the question today.
Points of Order
Mr. Desmond Swayne (New Forest, West): On a point of order, Madam Speaker. The Official Report for Monday contains a list of the members of the Government. The hon. Member for Islwyn (Mr. Touhig) was omitted from that list. Is there any way that you, Madam Speaker, can confirm for the benefit of hon. Members whether the hon. Member for Islwyn is a member of the Government? Is this something that we should be told?
Madam Speaker: I think perhaps that it was a clear printers' error. However, I am sure that the hon. Member for Islwyn (Mr. Touhig) will be grateful for the oxygen of publicity that he has just received from the Conservative Benches acknowledging his appointment as a new Whip.
Mr. Oliver Heald (North-East Hertfordshire): On a point of order, Madam Speaker. When the Leader of the House discovers that there was a Committee sitting this morning in Room 9 that amended the terms and provisions of the National Institute for Clinical Excellence so that, henceforth, it will have to take account of available resources as defined by the Treasury, will she be able to correct the record of the remarks that she has just made suggesting that the Government have been consistent throughout? Will she be able to change the Official Report--to have it amended--or will she have to come to the House to make a statement because she was wrong?
Madam Speaker: I have no comment to make on the political exchanges that take place in the House. I have no responsibility for the comments made either by Ministers or by Back Benchers. However, I note that the hon. Gentleman was in the Chamber while the Leader of the House was answering business questions. I should certainly have been willing to call him so that he could have put the question to her at that time and given her an opportunity to answer for herself. I am sure that that would have been the correct way to proceed.
BILL PRESENTED
Terrorism
Mr. Secretary Straw, supported by the Prime Minister, Mr. Secretary Prescott, Mr. Chancellor of the Exchequer, Mr. Secretary Cook, Mr. Secretary Reid, Mr. Secretary Murphy, Mr. Secretary Mandelson, Mr. Charles Clarke and Mr. Adam Ingram, presented a Bill to make provision about terrorism; and to make temporary provision for Northern Ireland about the prosecution and punishment of certain offences, the preservation of peace and the maintenance of order: And the same was read the First time; and ordered to be read a Second time tomorrow, and to be printed. Explanatory notes to be printed [Bill 10].
Long-term Care
[Relevant documents: With Respect to Old Age: A Report by the Royal Commission on Long-Term Care (Cm. 4192-I); Modernising Social Services (Cm. 4169); Long-Term Care: The Government's Response to the Health Committee's Report on Long-Term Care (Cm. 4414).]
Motion made, and Question proposed, That this House do now adjourn.--[Mr. Clelland.]
The Secretary of State for Health (Mr. Alan Milburn):
First, I apologise to the House for the fact that I shall not be here for the winding-up speeches due to a prior engagement. I have informed you, Madam Speaker, and the spokesmen of both the main Opposition parties.
We live in an ageing society. For too long, old age has been seen as a problem. People talk of the burden of an ageing population; some even say that changes in the ratio of working to retired households in our country are unsustainable. That is not the view of the Government. A growing elderly population is a success, not a failure; it should be celebrated, not denigrated. Older people are valuable in our society, not a burden on it. That is why we have taken action throughout Government to improve the health, well-being and security of older people: restoring free eye tests, introducing winter fuel payments, cutting VAT on fuel, the introduction of the minimum income guarantee for poorer pensioners, free TV licences for older pensioners--all of that a recognition of the importance of older people to our society.
Underlying each of these approaches is a recognition that, far from there being a demographic time bomb that will overwhelm society as we have known it, the rate of growth in the numbers of older people in the next 50 years will be about half that of the last 50 years. It is true, however, that there will be more very old people, aged 85 years or more, during the next few decades. That, too, is something to be celebrated, but it means that the way that we care for people in old age must change.
Today's debate gives the House the opportunity to consider these issues in what I hope will be a calm and considered fashion. The future of long-term care is an issue that concerns each of our constituents in each of our communities. Long-term care is not just about caring for older people. It is about younger, disabled people too. The need for changes to the system of long-term care is therefore not just the product of demographic change. Change is needed for other reasons. For too long, standards of care have been too variable. Standards of care have been a matter of local discretion. About 150 local authorities and about 100 health authorities regulate care homes, often to very differing standards. Some services, such as home-based care, are not currently regulated. The regulation system has not been properly independent.
There are very real concerns about the funding of long-term care. Although only one in five old people need long-term care, as they approach old age many more become anxious about how well they will be looked after, who will look after them, how much it will cost and who will pay. The current system has failed to be explicit about these issues, not least because it has developed in such an ad hoc way in recent decades. Under the previous Government alone, there were six major changes to the benefits and rules governing long-term care.
The current system of care is confused and confusing. It provides too many incentives to care for old people in care homes and too few incentives to care for them in their own homes. Arguably, the current system is premised upon the idea that older people do not want what most of the rest of us want--the chance to live a fulfilling life in as independent a way as possible. All the evidence suggests that, all things being equal, older people want to remain as independent as possible for as long as possible.
It is right, therefore, that we re-examine all the issues to do with long-term care in the round. In our election manifesto, we said that we would set up a royal commission to examine the funding issues. In December 1997, we established a royal commission chaired by Sir Stewart Sutherland. The commission took oral evidence, conducted public hearings and received more than 2,000 written submissions. We published its report in March 1999, and I want to place on the record my thanks to the royal commission for all its work.
When the report was published, my right hon. Friend the Member for Holborn and St. Pancras (Mr. Dobson) said that he hoped that it would stimulate debate to help find a way of ensuring that people could have access to high quality long-term care that was fair for individuals and the taxpayer. Indeed, the royal commission explicitly called for such a debate. Today the House has an opportunity to take part in that debate.
1.14 pm
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