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Mr. Gordon Prentice (Pendle) (Lab): Can we have a debate when we return on the implications for the structure of the NHS of the Government's choice agenda? Does my right hon. Friend understand my despair at the possibility of another restructuring in the NHS? Does he agree that the Government's reluctance to let changes bed down before uprooting them and starting again is positively Maoist?

Mr. Hoon: I am fully confident that my right hon. Friend the Secretary of State for Health and her Ministers are well aware of the significant amount of change experienced by those who work so hard on our behalf in the health service. I recognise my hon. Friend's concern that the NHS should not be in a state of perpetual revolution. It is important that those hard-working people have the opportunity to deal with recent changes and to continue to serve our communities so well.

Mrs. Iris Robinson (Strangford) (DUP): When we return, will the Leader of the House find time for a debate on industrial derating in Northern Ireland? Thousands of jobs will be lost if the Government maintain their present position. Understandably, there is massive concern, especially among small and medium-sized businesses.

Mr. Hoon: I appreciate that this is an important and significant issue for Northern Ireland. I thank the hon. Lady for raising it and I shall ensure that my right hon. Friend the Secretary of State for Northern Ireland writes to her on this subject.

Mr. Ian Austin (Dudley, North) (Lab): Will my right hon. Friend arrange a debate on what is being done to tackle health inequalities? Although increased expenditure in the NHS has produced improvements such as shorter waiting times and better treatment for many illnesses, it has been reported this week that people in my constituency of Dudley, North die an average of eight years earlier than their neighbours in the south of the borough. Such a debate would enable us
 
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to examine the causes in detail and to look at the work being done to tackle such inequalities. We would also be able to determine whether resources are being properly targeted to give my constituents the same quality and length of life as those living elsewhere.

Mr. Hoon: My hon. Friend raises a very important issue and one that is central to the way that the Government are tackling health care across the country. The problem of inequality is precisely why we are spending so much money on the NHS. When we came to office, NHS spending amounted to some £34.7 billion. It has risen to £69.7 billion now, and on present plans is estimated to rise to about £92 billion. That money is specifically designed to ensure that the same standards are achieved across the country. We look hard at best practice in different areas to ensure that that is spread across the whole population. We now have the resources available to make sure that that happens.

Mr. Peter Bone (Wellingborough) (Con): The Government have a formula for funding police authorities around the country, but the funding for Northamptonshire has been £5 million short over the past three years. That has denied the people of the county at least 50 full-time police officers. Will the Leader of the House find time for a debate on that obvious anomaly?

Mr. Hoon: If the hon. Gentleman had been here in 1997 and seen the poor support given to the police and police authorities by the previous Government, it is possible that he would not be making that observation today. I know that there are more police officers in Northamptonshire today than was the case in 1997.

Mr. Bone: That is not the point.

Mr. Hoon: The point is that we have substantially increased police funding and police numbers across the country, including in Northamptonshire. The hon. Gentleman should give the Government credit instead of making carping criticisms.

Tony Lloyd (Manchester, Central) (Lab): My right hon. Friend will have noted the mocking laughter from Opposition Members when my hon. Friend the Member for Walsall, North (Mr. Winnick) raised the question of the House of Commons cleaners—[Interruption.] They are laughing again. However, there is considerable support among Labour Members for a proper, fair and just settlement for the cleaners. What is intolerable is that there is a differential between the conditions for permanently employed House staff and those for contract cleaners. There is no logic in that, and it is outrageous that a person can work here for nine years and yet at no point be offered any pension entitlement. That is what has happened to one of the cleaners I spoke to yesterday, and it is not acceptable in modern Britain.

Mr. Hoon: As I understand it, staff directly employed by the House work in a different capacity and do rather different jobs. Leaving that aside, however, I made it clear in my earlier answer that it is important for the
 
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employer and the relevant trade union to negotiate and reach a proper settlement. I certainly encourage them to do so.

Dr. Julian Lewis (New Forest, East) (Con): I want to make it clear that no Conservative Member was mocking the very worthy cause of the contract cleaners. However, we were somewhat amused by the mock heroic efforts of the hon. Member for Walsall, North (Mr. Winnick) to join the picket lines, in a throw-back to the 1970s—

Derek Wyatt (Sittingbourne and Sheppey) (Lab): Shame!

Mr. Speaker: Order.

Dr. Lewis: I think the Leader of the House will be sympathetic to my request for a statement when the House returns. It is about the 8,500 multiple sclerosis suffers who are desperately waiting for the validation of a drug called AIMSPRO, which has been trialled for the last few years. Changes in medical guidelines have resulted in its withdrawal and as a result, those who have witnessed great improvements in their condition now feel all the symptoms returning. Will the Leader of the House do all that he can to look into this matter before the House returns? It is obviously very cruel when those whose condition has improved greatly see their one chance of such improvements becoming permanent being put into reverse.

Mr. Hoon: Every Member of this House is well aware of the suffering that this appalling disease causes—often to friends and family—and of the importance of appropriate treatment. But the hon. Gentleman and other Members know that the availability of prescribed drugs is determined wholly independently by the National Institute for Health and Clinical Excellence, which is independent of Government and makes appropriate clinical judgments in the light of the appropriate medical evidence. It is right that that independent approach to this difficult and often sensitive issue should continue.

Mr. Neil Gerrard (Walthamstow) (Lab): May I return to the forthcoming change whereby those with refugee status will no longer be given leave to remain in the country? I draw the Leader of the House's attention to early-day motion 569, which is in my name.

[That this House is concerned at the proposal in the Government's five year strategy for asylum and immigration to end the practice of granting indefinite leave to remain in the UK to people who are given refugee status and to replace this by up to five years' temporary leave to remain; believes that while this may not be legally incompatible with the provisions of the 1951 Geneva Convention, it is a retrograde step since it reverses the policy of granting indefinite leave introduced by the Government in 1998 without any evidence either that problems have arisen as a result of the current policy or that other countries which grant only temporary leave benefit as a result; is further concerned that the uncertain position this will put refugees in is totally inconsistent with other Government policies to assist the integration of refugees in the UK; further believes that this will
 
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inevitably lead to inhumane decisions when refugee families with children are threatened with removal after living in the UK for several years and establishing family life, leading in turn to further pressure on the immigration appeals system, and the caseload of honourable Members; and urges the Government to abandon this unnecessary change.]

That significant policy change, which will affect a lot of people, was announced in a written statement on Tuesday but it will come into effect on 30 August, so it will be impossible to discuss it in this House before it takes effect. Will the Leader of the House ensure that we discuss it as soon as we return from the recess? It is not satisfactory for such a change to be implemented in the middle of the recess.

Mr. Hoon: I understand my hon. Friend's concern. I have noted the importance of this issue to families, and I know that my right hon. Friend the Home Secretary will want to write to him about it.


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