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Rheumatoid Arthritis

6. Lady Hermon (North Down) (UUP): What steps he is taking to increase the availability of anti-TNF drug treatment for rheumatoid arthritis in Northern Ireland. [141219]

The Parliamentary Under-Secretary of State for Northern Ireland (Angela Smith): Extra recurrent funding has been provided, which has started the first phase of a three-phase project with a view to extending those therapies to 60 more arthritis sufferers by the end of the year. However, the decision on the appropriate therapy for an individual patient is a matter for the clinician concerned, in consultation with the patient.

Lady Hermon: I am grateful to the Minister for that reply, and I welcome it, but will she kindly clarify

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whether the Government have any plans to compensate rheumatoid arthritis sufferers in Northern Ireland for the Government's failure to extend the appropriate National Institute for Clinical Excellence guidelines to Northern Ireland at the same time as they are extended to England and Wales?

Angela Smith: It is important to ensure that the NICE guidelines apply to Northern Ireland. We are actively considering that and will make moves to do it as soon as is practical.


The Prime Minister was asked—


Q1. [141229] Dr. Andrew Murrison (Westbury) (Con): If he will list his official engagements for Wednesday 3 December.

The Prime Minister (Mr. Tony Blair): Before I list my engagements, I am sure that the whole House will join me in expressing our deep condolences to the Spanish and Japanese Governments and to the families of those who were killed in the attacks in Iraq at the weekend. Despite those attacks, both Governments are determined to continue helping the coalition to form a democratic and prosperous country for the Iraqi people, by the Iraqi people.

This morning I had meetings with ministerial colleagues and others. In addition to my duties in the House, I will have further such meetings later today.

Before the hon. Gentleman asks his question, I should say that I understand that he recently returned from duty in Iraq as a royal naval reservist. I thank him for the valuable contribution that he has made.

Dr. Murrison : I thank the Prime Minister for that, and I certainly join him in the condolences that he expressed.

The Prime Minister: I will certainly look into the specific point that the hon. Gentleman raises. Of course, it is important that our troops have all the protection that they need. I think that he would accept that, although the security situation in Iraq is extremely difficult, one thing is very clear: the coalition forces, particularly the British troops down in the south, are doing everything that they can to make life better for the Iraqi people. The irony of the situation is that despite the terrorist attacks, much that is valuable is being done in Iraq for the Iraqi people. That is why it is so important that we continue to fight the terrorists and to

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make progress for the Iraqi people, then to prepare for the handover of power to the Iraqi people, which will give Iraq democratic government for the first time.

Mrs. Lorna Fitzsimons (Rochdale) (Lab): Will my right hon. Friend join me in welcoming today's lobby with the National Union of Students? Speaking as an ex-president of that august body, will he take some gently given advice? The biggest barrier to access for people from my community is not debt but the absence of the aspiration to go into higher education, because even when we had the full grant, only 20 per cent. of people from the poorest communities went to university.

The Prime Minister: I am sure that my hon. Friend is right. The Government proposals are far more fair than the existing system or what went before, because they abolish the up-front fee altogether and make it a graduate repayment scheme. The point that my hon. Friend makes is absolutely right: we need to widen access to our universities and to fund the system fairly. It is important that we manage to do that without putting all the burden on to the general taxpayer, the vast majority of whom have not been to university.

Mr. Michael Howard (Folkestone and Hythe) (Con): Yet again, I join the Prime Minister in sending my condolences to the Governments and families of those who lost their lives in the most recent tragic incidents in Iraq.

The Prime Minister: Many people, including those in universities, believe that this is essential in order to widen access. This morning, we heard an interesting contribution to the big conversation from the right hon. and learned Gentleman's own spokesman on higher education, who said in respect of universities:

Now, if we both agree that universities are underfunded, how does the right hon. and learned Gentleman's proposal of scrapping fees and taking £500 million a year out of universities help either universities or students?

Hon. Members: Answer.

Mr. Speaker: Order. I do not want the Secretary of State for Education and Skills shouting at the Leader of the Opposition. It is difficult enough when Back Benchers, who are far away, do that but worse when the shouting is within earshot.

Mr. Howard: Let me remind the Prime Minister that it is my duty to ask questions on behalf of the country and his to answer questions on behalf of the Government. If he wants to swap places with me, I am happy to do that today, tomorrow, next week, next month—any time he likes. However, for the moment, it is his duty to answer the questions. He did not answer the first question, so let us try again.

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The Prime Minister: Of course we will always listen to what people say. However, they are saying that we need to fund lifelong education, which includes pre-school, adult skills and higher education. I want to enter into a conversation with the right hon. and learned Gentleman because people have a choice: our proposals, which mean that graduates pay back something that is linked to ability to pay, or his proposals. A day or two ago, the head of Universities UK said about the Conservative proposals:

The right hon. and learned Gentleman wants a conversation, so let us have one. Does his policy stand?

Mr. Howard: Let me make it clear: this grammar school boy will take no lessons from that public school boy on the importance of children from less privileged backgrounds gaining access to university. If the case for top-up fees is so overwhelming, why, only two years ago, did the Prime Minister promise in his manifesto not to impose them? He appears to have forgotten that, at the last election, we both stood on manifestos that promised not to impose top-up fees on students. The difference between us is that I am honouring our manifesto pledge and he is breaking his.

The Prime Minister: I have said that of course we will listen to people, but we must deal with the facts. The right hon. and learned Gentleman remarked that he was a grammar school boy and I am a public school boy. Many people went neither to grammar schools nor to public schools. Let us consider their interests. Surely it is in their interests to be able to go to university and for university places to be available. He wants to debate policy. Here is the policy choice: if we want to increase the number of people going to university and—[Interruption.] Conservative Members say, "What's the point?" I shall tell them: the point is to offer educational opportunity to all not a few. If the right hon. and learned Gentleman admits that, as his spokesman says, universities are currently underfunded, where does the extra money come from: general taxation or graduate repayment? Let us have a straight answer from him in this big conversation.

Mr. Howard: The question was about hospitals. Three questions have been asked and none answered. Let us try again. People are interested in the conversation; they want to know where the Prime Minister stands. If, in the big conversation, people make it clear that they want a say on the European constitution, will the Prime Minister give them a referendum?

The Prime Minister: We have not got the European constitution yet. As the right hon. and learned

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Gentleman may have noticed, it happens at the end of this month. If he wants me to deal with hospitals, let us deal with hospitals. [Interruption.] Oh yes, we will deal with hospitals. [Interruption] He wanted me to deal with it, now suddenly he does not. That is because he does not want to deal with the choices on the NHS either, so let us go to the NHS and the choices. We have a report this morning on the national health service saying that, as a result of the extra investment, we have more nurses, more doctors and more people being treated and treated more quickly. Now, we are in favour of that extra investment going in. Here is another point in the big conversation: is he in favour of it or not?

Mr. Howard: It really does not bode well for the big conversation if in this quite small conversation the Prime Minister is not prepared to answer the questions. If he is not prepared to listen to the answers that he gets on top-up fees or on foundation hospitals or on the European constitution, what on earth is the point of this ludicrous exercise? Does not he realise quite how ridiculous he is beginning to look? If he will not listen to the people, why on earth should anyone listen to him?

The Prime Minister: But we do listen to people. We listen to them—[Interruption.] Oh yes. Let me tell the right hon. and learned Gentleman how we have listened to people. We listened to people after 18 years of Conservative government and let me tell him what they told us. They said they wanted an end to boom and bust economics, and we provided it. They said they wanted an end to mass unemployment, and we provided it. We are talking about the future—things for which we have answers and he has none. We have talked to people about the national health service. They say they want that extra investment going into the health service. We have a report this morning showing that people are getting better treatment as a result. Now, in this conversation—small, I admit, between me and him, and rather closed on his part—is he prepared to commit the Conservative party to matching our NHS spending?

Jim Sheridan (West Renfrewshire) (Lab): My right hon. Friend may be aware of yesterday's major lobby by construction workers from the oil industry, expressing concern about the importation and exploitation of cheap foreign labour in this country. Will he take seriously the concerns expressed? In my view, regardless of what gear he may be in, if we do not take seriously the concerns expressed by the workers, some of us on this side of the House may be looking out our old working gear.

The Prime Minister: My hon. Friend is right to draw attention to the issues in manufacturing industry. Of course, one of the main issues there is to ensure that we have modern apprenticeships where we can get the skilled work force of the future. That is why it is important that the Government are increasing those to about 200,000 modern apprenticeships a year. The other thing for industry is to ensure that we have stability in our economic conditions. The reason we have that stability is low interest rates, low inflation and low unemployment.

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The one thing that I would say to my hon. Friend, however, is that I do not think it right to promise people that we can stop jobs changing in this modern economy. What we can do is help people to get new jobs.

Mr. Charles Kennedy (Ross, Skye and Inverness, West) (LD): Given that the Prime Minister and Downing street have made it clear on top-up fees that he is prepared to go to the wire, that he is putting his job on the line and that there is no turning back, can he clarify for Parliament whether that means that whenever this vote comes he will regard it as a vote of confidence in his Government?

The Prime Minister: I answered that question yesterday. Of course it is important for the Government; all these votes are important for the Government. The important thing between now and the vote is an argument about the alternatives. We have had the alternatives from the Conservative party. It would be terribly unfair and regressive to cut the number of people able to go to university. What is the right hon. Gentleman's alternative? His alternative is to raise the top rate of tax to 50 per cent. That is completely unfair, because there is no way—[Interruption.] Yes it is unfair, because there is no way that he can fund all the commitments that he has out of that top rate of 50 per cent.

Mr. Kennedy: The Prime Minister has confirmed the fundamental importance of that vote, when it comes. Therefore he is saying that he is prepared to force his MPs through the Lobby on a confidence vote to introduce a policy in direct contravention of what his party said in its manifesto. Is that the action of a Prime Minister who is a strong leader or, in fact, an increasingly desperate one?

The Prime Minister: What is interesting about both sets of exchanges is that neither Opposition leader has wanted to argue about the merits of the policy for the simple reason that the longer this argument goes on, the clearer it will be what the alternatives are. We have exposed the Conservative alternative, so let me expose the Liberal Democrat alternative.

I have recently had an opportunity to examine the Liberal Democrats' spending proposals. They say that they will finance everything they do for students out of a 50 per cent. top rate of tax. Seven of their spending proposals alone—ending prescription charges; free personal care for the elderly; extra pay for doctors and nurses; and commitments on pensions, small businesses and villages halls—amount to more than £12 billion, and that is before we get to their proposals on student finance. They are telling students that, with the money collected from the top rate taxpayer, they will fully restore all grants, abolish all fees, and provide big rises in university salaries. They even have a commitment to pay benefits to students during the summer holidays so that they do not have to take summer jobs. Taken together, those commitments amount to more than £15 billion. It is wholly dishonest to pretend to people that

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they will get £15 billion from top rate taxpayers. Until the right hon. Gentleman has a serious alternative to put forward, he will not have a serious party.

Mr. Peter Pike (Burnley) (Lab): My right hon. Friend will know that yesterday Philips LG announced that it was to close the glass factory at Simonstone, at which I used to work before I became a Member of Parliament. The factory is in the Ribble Valley constituency, but most of the workers reside in mine. Does my right hon. Friend accept that, while we must fight to save that factory, because of the new deal and what the Labour Government have done, those workers now have a better chance of getting a job when the factory closes next year than they would have had under the Tories 20 years ago?

The Prime Minister: My hon. Friend makes an important point. In any economy, from time to time people will lose their jobs. What is important is that the Employment Service and the new deal provide additional hope for those people, so that if they lose their job, they can at least have some hope of moving on to fresh employment. The solution offered by the Conservative party, which is to scrap the new deal that has helped 800,000 people, would return us to precisely the days when the right hon. and learned Gentleman was Employment Secretary and unemployment was more than 3 million.

Q2. [141230] Bob Russell (Colchester) (LD): Will there be legislation to ban hunting in this parliamentary Session?

The Prime Minister: As I said when I was asked this question during the Queen's Speech debate, we have said that we will resolve the issue in this Parliament, and we will resolve it in this Parliament.

Llew Smith (Blaenau Gwent) (Lab): If no weapons of mass destruction are found in Iraq, would this Parliament be right to expect resignations to follow at the highest level of Government?

The Prime Minister: The reason that we took the action in Iraq was that, as the United Nations itself stipulated last November, it was clear that Saddam Hussein was a threat. It is also absolutely clear to me that weapons of mass destruction are a real issue, not just in Iraq but in the wider world. I believe entirely in the information that was given to us at the time. We will carry on the search for those weapons through the Iraq survey group, which should be allowed to complete its work before anyone makes up their mind.

Q3. [141231] Mr. Richard Bacon (South Norfolk) (Con): Given the need to protect investors and encourage personal saving, does the Prime Minister agree that when banks like Abbey National expose customers, such as my constituents Roger and Mary Mayhew, to inexperienced and poorly trained staff who give bad advice and then leave the company, there is a

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special responsibility on financial institutions to protect their customers and uphold the clear verbal commitments that have been given?

The Prime Minister: I am sorry that the hon. Gentleman's constituents have had that experience. In general terms, he is right that there is such a duty. We have tried to put in place a robust regulatory regime for investment advice through the Financial Services and Markets Act 2000, which gives the Financial Services Authority a clear remit to regulate the financial industry. If individuals are dissatisfied with the advice that they receive, or feel that they have had advice from people who are not properly qualified to give it, they can refer their complaint to the independent financial ombudsman service to help to resolve the dispute. I am sure that if that is done they will at least have a process through which to gain redress.

In general terms, I agree with the hon. Gentleman. I understand that new guidance on this subject will be issued in the not-too-distant future.

Kali Mountford (Colne Valley) (Lab): May I thank my right hon. Friend for listening to the all-party group on domestic violence and for bringing forward a Bill on domestic violence, which many of us waited decades for? Will he ensure that the systems are robust and will spearhead other legislation so that when victims bring complaints, they feel secure that they will be taken seriously, and that systems are in place to support them through going to court and afterwards, so that they are safe in their own homes?

The Prime Minister: It is an important measure and I hope that it will gain support from all parts of the House. It amounts to the biggest overhaul of domestic violence legislation for somewhere in the region of 30 years. We are putting nearly £20 million this year into building new refuge places and over £50 million into refuge provision through the supporting people programme. It is worth pointing out that this is one of the key areas of violent crime in the country and that about two women every week lose their lives through domestic violence, so tougher measures together with support is the right way to go. As I say, I hope that recommends itself to the whole House.

Q4. [141232] Mr. Alan Duncan (Rutland and Melton) (Con): Given what the Prime Minister said in response to the leader of the Liberal Democrats, does he believe that his own party now believes that the vote on top-up fees is a vote of confidence in him?

The Prime Minister: I am afraid that I have nothing to add to what I said earlier. Of course, it is an important vote. I hope that people make up their minds on the merits, but let us have a debate then about the merits of the respective proposals. What is very interesting in this debate is that it seems to me that I am the only one who actually wants to talk about the disciplines imposed by facing up to the future challenges that this country faces. If we are going to finance higher education in a fair way, it cannot be right that the ordinary taxpayer has to do it all. A system that abolishes up-front fees and allows

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people to make a modest contribution, a fair amount, once they are graduates, seems to me a fair way to go. If there are alternatives, let us hear them.

Mr. Brian H. Donohoe (Cunninghame, South) (Lab): What more does the Prime Minister intend to do about the scourge of AIDS in the world, given that the statistics in Africa are now reaching epidemic proportions? We need to put more effort into that campaign.

The Prime Minister: It is important that we first recognise the scale of the problem. Some 20 million people have already died. A further 3 million people will die this year of HIV/AIDS. It is a true crisis of international proportions. Not merely are we doubling our funding to UNAIDS but we are the second biggest bilateral donor after the United States on HIV/AIDS and our funding has increased sevenfold over the past three years. It is almost £300 million in this financial year. We have to do everything we possibly can to ensure that we put the support in but also reduce the price of the drugs to treat people in some of the poorest countries in the world. We are working with the drug companies to do that, because with the right combination of measures on prevention and treatment, there is no doubt that we can make a significant difference to the problem.

Q5. [141233] Mr. John Taylor (Solihull) (Con): Does the Prime Minister recall that, in the previous Parliament, I introduced a Bill on nuisance high hedges, which his Government have now adopted? Can we look forward to his accepting further initiatives from Conservative Members?

The Prime Minister: It has to be said that the hon. Gentleman is a remarkably prescient and sensible Conservative Back Bencher and I am delighted that we have done what he suggested a few years ago. That only goes to show that, on the rare occasions when Conservative party people say sensible things, we listen.

Geraint Davies (Croydon, Central) (Lab): Does my right hon. Friend agree that, in cases of domestic violence, which, as he said, claims the lives of two women a week, it should be the man who is placed in the refuge pending a decision by the court on who should occupy the family home? It should not be the battered woman and screaming children who have to flee the family home away from social networks. When will the criminal justice system put the interests of the victims—the children and the mother—ahead of the interests of violent men and ensure that abusive and criminal men pay the full cost of their action?

The Prime Minister: The Domestic Violence, Crime and Victims Bill will allow the man to be evicted from the home in circumstances of domestic violence but also to be put under greater restraint in terms of his ability to get near either his female partner or the children. It is important to recognise also that the Bill will impose far

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stricter penalties for breaches of non-molestation orders. It is the combination of the additional money and the stronger penalties that will do the trick.

Q6. [141234] Mr. Edward Leigh (Gainsborough) (Con): The armed forces are doing a difficult and dangerous job, acquitting themselves with great skill, professionalism and courage. Is the Prime Minister satisfied that the equipment that they need to do their job properly is being brought into service without the unnecessary slippages and shortcomings highlighted regularly by the Public Accounts Committee?

The Prime Minister: I am as satisfied as I can be of this: we have made it clear to the military that there should be no cost constraint on making sure that our forces are properly equipped for the dangerous work that they are doing in Iraq. Obviously, issues of logistics—what equipment is purchased and how it gets out there—are left to the military, but prompter action is taken on some of these issues than is sometimes suggested. When issues are raised, we look at them carefully.

Q7. [141235] Alan Simpson (Nottingham, South): I know that the Prime Minister will be well aware of the musical works of Paul Simon. I am not asking for a rendering of "Fifty Ways to Leave Your Lover", but will he publish the 40 ways that the Department of Education and Skills has identified as possible means of funding the expansion of higher education? If the big conversation is to have meaning, it has to be an informed conversation with the public. By publishing those 40 ways and giving the public a chance to scrutinise and decide for themselves, we might find that they were able to offer us their version of a "Bridge over Troubled Water."

The Prime Minister: First, I congratulate my hon. Friend on his extensive knowledge of Paul Simon's repertoire. Secondly, it is of course important that we have the debate on the basis of the fullest possible information. We are happy to make available the information that we have, but the choice is simple. If we want to expand the numbers going to university and if we believe that universities are underfunded—apparently, that is now the consensus among Labour, Conservative and Liberal Democrat Members—there are only two ways of paying for that. It either comes out of some form of contribution from students, as well as the additional investment from the state, or it comes from general taxation. [Interruption.] It is perfectly fair to say that it can come from general taxation. But is it fair to ask the majority of the population, who have not been to university—some of whom are on low incomes—to pay even more taxes so that others can go to university? I do not think so, but let us have the debate based on the real policy options and not on some imaginary hypothesis where everyone can get everything for free and there is no difficulty for everyone else.

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Q8. [141236] Miss Anne McIntosh (Vale of York): What is more important to the Prime Minister: developing relations with Commonwealth leaders in Nigeria or coming home early to have his picture taken with Jonny Wilkinson?

The Prime Minister: As a matter of fact, I am coming home early not for the rugby reception, but for a private appointment of a different nature altogether.

Q9. [141237] Tony Cunningham (Workington): A few years ago, I suggested that if we were not careful with sport in this country, we would end up like the United States, which has a small number of highly professional sportsmen and women while everyone else simply watches sport. With the success of the Rugby Union world cup, the European championships in Portugal and the Olympic bid, we have a huge opportunity to promote participation in sport. Will the Government seize that opportunity?

The Prime Minister: I pay tribute to the work of my hon. Friend on the Tackle Learning initiative, which aims to engage a series of partnerships involving rugby union, rugby league and effective working and learning for young people. Some 80 centres are involved, 90,000 pupils have gained and there is a target of opening at least 100 centres. As he knows, we are spending about £1 billion on school sport. I can assure him that we will do everything we can to encourage youngsters in sport, but also to make sure that sport is not the preserve of a few

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well-paid athletes and is for ordinary people in our communities. Some will be excellent, some will not, but all enjoy sport.

Q10. [141238] Mr. Peter Lilley (Hitchin and Harpenden) (Con): Is the Prime Minister aware that, according to the National Audit Office, between 5,000 and 20,000 people die from infections caught in NHS hospitals, and that according to the European Commission, the problem is worse in this country, and getting worse at a faster rate, than anywhere else in Europe? Will he therefore turn his attention back from the search for elusive biological threats in the middle east to the real biological warfare that is being fought and lost in dirty wards, and through unclean hands, in our under-managed and demoralised health service?

The Prime Minister: First, it is not sensible to set the serious issue that the right hon. Gentleman raises against fighting terrorism in the middle east; both issues are important, and they obviously have to be tackled in different ways. Secondly, the question of infections in hospitals is not new, and we are taking action to try to limit this. Thirdly, yes, there are hospitals in which we obviously need to make further changes and to raise standards, but I hope that he and the vast majority of people will accept—I am not sure that many Conservative Members do accept this—that on the whole, those in the health service do a fantastic job in looking after patients. The vast majority of people get excellent treatment within the national health service, and I do wish that occasionally, particularly on a day when the progress of the health service is being laid before people and is so obvious, he would congratulate it on making progress, rather than continually drawing attention to the defects.

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Human Tissue

Mr. Secretary Reid, supported by the Prime Minister, Mr. Secretary Blunkett, Mr. Secretary Murphy, Secretary Tessa Jowell, Mr. Paul Boateng, Mr. Peter Hain and Ms Rosie Winterton presented a Bill to make provision with respect to activities involving human tissue; to make provision about the transfer of human remains from certain museum collections; and for connected purposes: And the same was read the First time; and ordered to be read a Second time tomorrow, and to be printed. [Bill 9].

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