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Dr. Gibson: My right hon. Friend will be aware that, although there are indeed good news stories in our health service, we have much to do to raise the morale of workers in that service. Will he ensure that the national health service remains just thatnational; that it continues to deliver health care free at the point where it is needed; and that it is funded from our taxes and not according to ideas of private health insurance which have been described as aggressive and inequitable?
The Prime Minister: My hon. Friend is absolutely right to point out the many achievements in the national health service, not least the new, 953-bed Norfolk and Norwich hospital in his constituency, which is part of the largest hospital-building programme since the national health service began. He is also absolutely right to say that we want to get more resources into the national health service, and that we want to retain and not abandon the principle of the national health service being free at the point of usewhereas Conservative Members want to abandon it.
Mr. Iain Duncan Smith (Chingford and Woodford Green): The very serious claims made by the Parliamentary Commissioner for Standards are rightly matters for the House to investigate. As leader of the largest party in the House, will the Prime Minister back our call for a full inquiry?
The Prime Minister: Of course if named civil servants were alleged to have done something improper it would be the Government's responsibility, and of course I would look into it, but I am not aware of any such specific, named allegations. If the right hon. Gentleman is aware of named individuals who have, it is suggested, briefed against the Commissioner in some way, perhaps he will now state who they are.
Mr. Duncan Smith: The Prime Minister is just as aware as I am from the letter that I am sure he has also seen. He knows very well, just as much as I do, that we all in this House have a responsibility to ensure that our proceedings and the way we behave are above reproach. I simply ask the Prime Minister to ensure that he investigates those elements for which he is responsible. Will he undertake to do that?
The Prime Minister: I am not aware that the letter names individual people. If it does, I will certainly look at it, but I thought that it did not. It is difficult to investigate allegations against unnamed people. My understanding is that the matter is dealt with by the House of Commons Commission, and it should be dealt with by the House of Commons Commission, which has on it some people from the right hon. Gentleman's party. If there are issues they want to raise, they should be raised in that way, but this is a matter for the House and the House has the absolute power to do whatever it wishes in respect of it.
Q2.  Paddy Tipping (Sherwood): Will the Prime Minister welcome and give details of this lunchtime's agreement in Bonn, which paves the way for future stable government in Afghanistan? Will he also outline the further measures he intends to take to take the process forward?
The Prime Minister: It is a remarkable achievement in Bonn. When we think that a few weeks ago, when we embarked on the action in Afghanistan, people worried whether that action would be successful militarily and whether what would take the place of the Taliban regime would be worse, or indifferent to, for example, the appalling oppression of women in Afghanistan, it is clear that what has happened today is remarkable in the sense that people have come together from all ethnic groupings in Afghanistan, agreed to the provisional Government and to a process that will increase dramatically the democracy, justice and basic representation of the people in Afghanistan. I hope that those people who had doubts about the wisdom of the action that we are undertaking will look at what has been achieved and see that the future
Mr. Charles Kennedy (Ross, Skye and Inverness, West): To return to the issue of the national health service and the question that I raised with the Prime Minister this time last week, can he for once and all simply clarify for all of us whether it is the policy of his Government to raise NHS spending to the European Union average by 2005, or does that now become an aspiration in the broadest terms, as he sought to describe it on Sunday?
The Prime Minister: Not merely do we stand by that, but it is in our manifesto that we will raise spending to the EU average. With the greatest respect to the right hon. Gentleman, the real issue is whether the health service needs more money in it. We say yes. We also say that it should be provided to the NHS and I think that all other political parties that want to engage in this debate should now state what their position is.
Mr. Kennedy: The position is very clear and widely recognised by all parties. Of course, the health service requires more support, but how does the Prime Minister explain the evidence that the Chancellor's Treasury officials gave yesterday to the Treasury Select Committee? Since the Prime Minister is asking questions, I shall tell him what they said. First, they had no idea what the current level of health expenditure in the European Union is; secondly, they did not know what it would cost in 2005; and thirdly, they did not know how much it would cost to match it. If that is the case, should not the Prime Minister get the Chancellor and the Health Secretary together and give us a coherent policy to give the people the health service that they deserve, not a shambles?
The Prime Minister: First, the right hon. Gentleman is wrong. What cannot be predicted is what other countries spend on their health care system over the next few years; but what we do know is that the European Union average has remained roughly around 8 per cent. over the last decade. In fact, there is one major country in the world which is increasing public spending as a proportion of national income on both health and education, and that is Britain. We are able to do so because of the strength of our economy. If we had taken Liberal Democrat advice over the past few years on our spending plans, we would have interest rates through the roof, we would have national debt doubled again and the country would be in a mess.
Mrs. Louise Ellman (Liverpool, Riverside): Will the Prime Minister review this country's relationship with Iran, following its continued material and financial support for Hamas, which carried out the mass murder of so many Israelis on Saturday and Sunday in Jerusalem and Haifa? Does he consider that having good relations with a terrorist state is an objective with which the Government should not be associated?
The Prime Minister: My hon. Friend is right to raise the issue of our relationship with countries such as Iran, and I shall tell her exactly what I think. I think it is important that we engage in a process of dialogue,
Q3.  Mr. Michael Fallon (Sevenoaks): Has the Prime Minister yet reviewed the ludicrous arrangement that means that nurses in the high-cost areas of Kent and Essex are not entitled to the cost-of-living supplement that applies in Hampshire or Wiltshire? As a result, our hospitals must meet the extra costs of paying for agency nurses and recruiting abroad. Is the right hon. Gentleman happy to have reduced the NHS to the point that hospitals have to fly nurses in, at exactly the same time as they are flying patients out?
The Prime Minister: Of course it is true that we have been able to introduce this new allowance only for people in certain areas. I well understand that people in other areas feel that they would like the same allowance, but I point out to the hon. Gentleman that, before this Government came to office, no additional financial help was available. It is true that we need to make more financial help available to nurses and others, but I am afraid that that once again returns us to the central difference between the Labour and Conservative parties. We believe in investing in the national health service, but the Conservative party's positionvery apparent in the debate earlier this weekis to take that money out.
Julie Morgan (Cardiff, North): Is my right hon. Friend aware of the Children's Society's decision to withdraw, without any consultation, from all its work in Wales, even though it is the largest provider of advocacy services for the most vulnerable children in Wales? Will he join me in condemning the society's action, and will he ask it to reconsider its decision?
The Prime Minister: I understand the concern raised by my hon. Friend. It is a disappointing decision, and I know that discussions are on-going about it. I hope that those discussions can reach a successful conclusion.
Q4.  Patrick Mercer (Newark): Violent crime in Newark and Retford has increased disproportionately recently. Will the Prime Minister explain, therefore, why the funding for Nottinghamshire constabulary is to be cut in real terms by £3.1 million?
The Prime Minister: I shall tell the hon. Gentleman exactly the situation with regard to funding, but my right hon. Friend the Home Secretary, who is sitting beside me, tells me that the situation described by the hon. Gentleman is not the case. No doubt there is a point there to be elucidated. In general terms, however, the Government have put substantial extra resources into police authorities up and down the country. I remind the hon. Gentleman that that was part of the last comprehensive spending
Mr. James Plaskitt (Warwick and Leamington): The latest league tables show that average performance in primary schools in my constituency has improved by 14 per cent. over the past three years. Will my right hon. Friend join me in congratulating staff and pupils on that achievement? Does he share my view that the £1.9 million allocated to Warwickshire solely for literacy and numeracy will enable those schools to continue that progress in the future?
The Prime Minister: There is massive additional investment going into education. Perhaps one of the most important reports of recent times was the Organisation for Economic Co-operation and Development report on educational standards and achievements across the world, which found British educational achievements to be among the highest anywhere in the world. The fact that we are very near the top of the table in areas such as literacy and numeracy is an enormous tribute to the hard work of teachers up and down the country. It also vindicates entirely the strategy of investment and reform in our education services. The Labour party will certainly continue that strategy in government.
Mr. Iain Duncan Smith (Chingford and Woodford Green): Last week, as the right hon. Member for Ross, Skye and Inverness, West (Mr. Kennedy) said, the Prime Minister said that he had a commitment to spend at the European average of health spending. Over the weekend[Interruption.]
Mr. Duncan Smith: On Sunday, the Prime Minister said that it was a broad aim; today he says that it is a commitment. If it is a commitment, he must know exactly how much it will cost. Will he please tell the House what the extra cost is?
The Prime Minister: It has come to something when the right hon. Gentleman has to recycle his questions from the Leader of the Liberal Democrat party. Yes, it is important that we meet the European average which, as I said a moment ago, over the past decade has remained at roughly 8 per cent. We are committed to raising our health service spending to that European average. I am committed to raising it to that European average which, as I have just said, has been about 8 per cent. over the past decade. Now perhaps the right hon. Gentleman will tell us whether he is committed to it.
Mr. Duncan Smith: People out there do not pay their tax as a percentage; they pay it in real money. Will the Prime Minister now tell the House[Interruption.] Well, it is clear that the Prime Minister makes it up as he goes along. It is a commitment today, a possibility tomorrow, now a percentage; but people on low earnings have to pay for it. Will the Prime Minister please tell us exactly how much this commitment really is, or does he not know?
Mr. Duncan Smith: We do not need any lectures from the Prime Minister. He is the leader of a party that introduced charging into the health service and he still has charging in the health service. The reality is that the Prime Minister and his Chancellor have spent their time rowing about this over the past week, and the Prime Minister does not have a clue. The Chancellor attacks the Secretary of State for Health when he calls for a hypothecated taxthe Chancellor says that it should not happen. Where does the Prime Minister stand? What is the Prime Minister's view? Will he tell us whether tax will go up, whether spending will go up and by precisely how much?
Of course we want extra money spent on the health service. The ludicrous thing about the right hon. Gentleman is that he says that he wants to look at other health care systems. He listed a whole lot of other health care systems in the article he wrote today[Interruption.] This is directly on spending. He listed systems in the Netherlands, France, Germany, Sweden, Australia and New Zealand, all of which he was going to look at. They all have something in commonthey make more public spending provision than this country. So if the right hon. Gentleman says that this is his vision of the future, presumably he agrees with us, but we know that he does not. We know that from the article in The Times today, written by the Conservative party think tankadvisers to the Conservative party. On the board of that think tank are the shadow Home Secretary, the shadow Secretary of State for Work and Pensions and, yes, the shadow Chancellor. The article is entitled "Abandon the NHS"; they conclude that it will not work. As someone might say, "Ask a Tory question, get a Tory answer".
Phil Hope (Corby): My right hon. Friend will be aware that crime in Corby is coming down, but that the fear of crimeespecially among older people and young peopleis still too high. Although we are looking forward to measures for police reform and to extra cash
The Prime Minister: I agree with my hon. Friend. I think that the new crime and disorder partnerships that were introduced by the Government have made a big difference to fighting crime on the ground, but they need to be taken further. In my view, we also need further measuresespecially against antisocial behaviour, which is probably the biggest problem in many of our constituencies up and down the country. For that reason, my right hon. Friend the Home Secretary will be introducing measures in the criminal justice Bill that will allow us to fight those problems much more effectively in the future.
Q5.  Mr. Laurence Robertson (Tewkesbury): If the Prime Minister wants to increase funding for health, does he agree with his right hon. Friend the Member for Hartlepool (Mr. Mandelson) that social insurance schemes should be considered, or does he agree with his Chancellor that they should not?
The Prime Minister: That is very simple. I agree with exactly what the Chancellor said: we want the moneydone through general taxation. It is not merely me or the Government who have said that; it is also, for example, the British Medical Association in a report published in February this year, which stated specifically that, on grounds of equity and efficiency, we should have a national health service. With the greatest respect, I do not think the questions need be asked of this side as to where we stand: we stand for extra funding coming into the national health service, allied to reformfundamental reform. We believe in a national health service free at the point of use. The hon. Gentleman does not need to preface his question by asking me if I am in favour of extra health service spendingI am. The question is: is he?
Vernon Coaker (Gedling): The Prime Minister will know that one of the great concerns that we all share is the low level of participation, especially of our young people, in our democratic process. At the last election, just four in 10 of our 18 to 25-year-olds voted. Will my right hon. Friend make that a priority and will he look at imaginative steps that we can take to try to re-engage our young people in the formal political process?
The Prime Minister: One of the reasons for the establishment of the Electoral Commission was precisely to try to look at how we can widen participation. This is an issue not just for this country, but for other countries. I also think that we need to make it easier for people to participate, but perhaps we all need to go out and explain to peopleno matter how they votethat politics is important and how political decisions affect their lives. We only need look around to see howafter the events of 11 Septemberpolitical decisions taken by Governments around the world have had a dramatic impact on the lives of people in this country and elsewhere.
Q7.  Mr. Neil Gerrard (Walthamstow): Our Government played a very important part in setting up the global AIDS and health fund. Is the Prime Minister aware that so far only £1.5 billion has been pledged to that fund, compared with the £7 billion to £10 billion that Kofi Annan said was needed annually; and that some poor countries, such as Uganda, have actually made bigger contributions, relative to their wealth, than many richer countries? Will the Prime Minister consider, first, increasing our contribution; secondly, doing what he can to encourage other western Governments to contribute more; and, finally, encouraging major British companies to contribute in the same way that some big American companies have done?
The Prime Minister: We certainly want to encourage greater private sector influence and commitment; indeed, I have held meetings with private sector companies on this issue. We are committedas Britainto about $200 million for that global health fund. The overall fund is $1.8 billion. Obviously, it is true that at the moment we have not spent all that, but that is probably for good reasons as well as badin part to ensure that any money we spend actually goes to the people who need it and that it is properly used. I can assure my hon. Friend that our commitment is absolute; we have shown that, by havingin a senseled the argument over the past few years. If we can do more, we will
Q8.  Miss Ann Widdecombe (Maidstone and The Weald): I am aware that the Prime Minister has been asked this before, but there was so much noise that I did not happen to get the answer. How much will it cost him to achieve his ambition of reaching the European average on health expenditure by 2005? The question is how much, and the answer is . . . ?
The Prime Minister: The answer is as I gave a moment or two ago[Interruption.] Yes, I am afraid it is. We will meet the European average, and we will do so because we believe in putting extra resources into the national health service. As I said, when the comprehensive spending review is published, the right hon. Lady will see that the Government are committed to putting more money into the health service, and it will be obvious that, whatever sums of money we put in, she and the Conservative party are committed to taking them out.
Mr. Chris Bryant (Rhondda): Is my right hon. Friend aware that there are 22,700 pensioners in my constituency, many of whom have small occupational pensions and will be delighted with last week's announcement that their attempts to save throughout their lives will be rewarded rather than harmed; but will he and his colleagues make every effort to ensure that every
The Prime Minister: My hon. Friend is right to draw attention to the fact that pension measures the minimum income guarantee, for example, helps the poorest pensionersare there for all pensioners: the guarantees that were given by the Chancellor in his statement last week, the free TV licences for the over-75s and the winter allowance, which, of course, the Conservatives refused to introduce and still oppose. In respect of all those measures, we will help all pensioners and those who are poorest. The pension credit allows us also to help people who have modest savings but who often find that those savings do not actually help them to gain a proper income in retirement. It will allow us to do that and will benefit something like 5.5 million pensioners.
Q9.  Mr. Elfyn Llwyd (Meirionnydd Nant Conwy): The Prime Minister will know that, since February of this year, the Strategic Rail Authority was instructed to put on hold the choosing of a franchisee for Welsh railways. We have had 10 months of damaging delay and services going down10 months of damaging economic anxiety. Will the right hon. Gentleman please have a word with the Secretary of State for Transport, Local Government and the Regions; otherwise he will have to find somewhere else to bury some bad news?
The Prime Minister: Of course it is important that the decision is taken. I will certainly ensure that my right hon. Friend is aware of what the hon. Gentleman has said, but I cannot give him the date now.
Geraint Davies (Croydon, Central): How easy, in the Prime Minister's view, will it be for Yasser Arafat to hunt down and hand over the terrorists responsible for the 25 brutal murders in Israel when he and his security infrastructure are being bombed by the Israelis, and the Americans are failing actively to call for restraint?
The Prime Minister: First, I should express sympathyI know on behalf of the whole Housefor the savage acts of terrorism that killed so many innocent Israelis just a short time ago. It is important in my view that the Palestinian Authority does everything it possibly can to ensure that those in the organisations responsible for those attacks are rounded up and put under proper lock and key. That is the very minimum that the international community needs to see from the Palestinian Authority. Although there may be difficulties in certain areas in the authority acting in that way, it is necessary that it does so, and it must show that it is doing everything possible to
Q10.  Mr. Henry Bellingham (North-West Norfolk): Does the Prime Minister recall that when he came to our local hospital during the recent election he made two predictions? First, he predicted that Labour would hold North-West Norfolk. Secondly, he predicted that, if Labour won, the health service would get better. Is he aware that that latter prediction has a very hollow ring for my constituent Mr. Andrew Gray of Ringstead, who, having waited in pain for 16 months for a hernia operation, has had it cancelled not once, not twice, but four times? Does not he owe an answer to Mr. Gray? Will he answer also the question posed by my right hon. Friend the Member for Maidstone and The Weald (Miss Widdecombe)?
The Prime Minister: Of course it is wrong that the hon. Gentleman's constituent should have had his operation cancelled. It is correct, however, that 19 out of 20 operations are actually done within the time that they are supposed to be done. What is more, now some 70 per cent. are done within three months. I do not know the exact circumstances of the hon. Gentleman's constituent, but I know that that constituent could not possibly be placed in a better position as a result of the Conservative party's proposals, which are to force people to pay for their operations.
I have to say to Conservative Members that this debate about the national health service and how it is funded will go on from now until the next general election. The truth is that the money going into the health service has actually improved it. We need to do much more and we will do much more. Every single change that we have made on extra resources has been opposed by them. If they were given the chance to run our health service again, people would be forced to pay for their operations. That will never happen under this Government and this party.
Q11.  Tony Wright (Cannock Chase): Does the Prime Minister know of any public institution apart from this one where the people who are regulated have the ability to choose and dismiss the person who regulates them?
The Prime Minister: It is for this House to decide how the Commissioner is appointed, who that Commissioner is and the terms of that appointment. I have to say to my hon. Friend and to some Opposition Members that, if the House wishes to change the rules, the measures lie with the House itself. A House of Commons Commission was established with Members of all political parties on it, including the Conservative party's Chief Whip. If people want to change the rules, they are perfectly entitled to do so. However, just because my hon. Friend thinks it is right to change them, that does not mean to say that it is. It is for the House as a whole to decide.