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Baroness Symons of Vernham Dean: My Lords, if my noble friend is suggesting that we should relax sanctions against Iraq, I cannot agree with him. Relaxing those sanctions without Iraq having met its obligations would be a serious mistake. It would reward the obstinacy of a brutal dictator, it would leave him free to build up a military threat against others in the region and it would signal that the international community had lost the will to enforce its demands as put forward in the United Nations Security Council resolutions. I remind my noble friend that the latest reports of the UN special rapporteur, Max van der Stoel, hold Iraq primarily responsible for the precarious food and health situation in that country. My noble friend made reference to the review of the sanctions policy which my right honourable friend announced earlier this week. It is true that the Government have been looking at ways of targeting sanctions more against regimes than against some of the innocent people in those countries. But in putting forward those plans my right honourable friend also made clear that he did not believe that it would be possible to have that kind of specific targeting in the case of Iraq.

Lord Blaker: My Lords, what is the Government's assessment of the state of President Saddam Hussein's programme for developing weapons of mass destruction?

Baroness Symons of Vernham Dean: My Lords, the noble Lord asks an extremely important question. It was in order to try to assess what is happening over the programme of weapons of mass destruction that, on 30th January, the Security Council set up three panels. One is looking into what has happened to Kuwaiti prisoners; another is examining the humanitarian aspects; the third is looking at weapons of mass destruction and the way in which the Security Council resolutions can still be carried forward. We hope that

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the results of the work being undertaken by the United Nations will be put forward shortly, possibly in a couple of months' time.

Lord Steel of Aikwood: My Lords, is it not the case that allied policy has perforce had to change to more military containment of Iraq, which hurts the regime there directly? In that context, is it not reasonable to ask that the discussions that are starting should see some lifting of the sanctions, which hurt the people of Iraq directly?

Baroness Symons of Vernham Dean: My Lords, there has been some military activity. I assume the activity to which the noble Lord refers is that which we have seen in the no fly zones, notably on 28th February and 1st March. I assure the noble Lord and the House that the action of the allies has been defensive action, strictly limited to proportional responses against Iraq's weapons and facilities which pose a threat to the coalition forces. The Security Council is presently discussing ways in which to make the oil-for-food programme more effective in meeting the needs of the Iraqi people. One of our proposals is to lift the ceiling on the oil-for-food programme. That would mean that there would be no limit to the amount of oil that Iraq could export to fund oil-for-food. That said, the key to all of this must be the willingness of the Iraqi regime to ensure that food reaches hungry people and that medical supplies get to where they are needed.

Lord Gisborough: My Lords, in view of the enormous amount of censorship, how much information is beamed into Iraq so that people there know that the food is being stored?

Baroness Symons of Vernham Dean: My Lords, as I mentioned in answer to my noble friend Lord Judd, we have the report of the special rapporteur. We know that the latest Iraqi plans on the distribution of food involve a reduction in the calorific value of the daily food ration. We know that Iraq has allocated 25 million dollars to the purchase of banknote counting machines and 100 million dollars to the purchase of telecommunications equipment--all of this while Iraq is holding 275 million dollars' worth of medical supplies and distributing only 15 per cent. of medical equipment. Iraq is also attempting to sell food to its neighbours--for example, to Syria and it has attempted to do so to Jordan.

Lord Kennet: My Lords, in view of the adoption of five new principles which should govern sanctions and which were announced on Monday by my noble friend in a Written Answer to my noble friend Lady David, and in view of the fact that the current sanctions on Iraq breach at least three of those five principles, can my noble friend give any idea as to when she hopes to lift them?

Baroness Symons of Vernham Dean: My Lords, as I indicated, the Government have been doing a

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great deal of work on sanctions policy. We are examining whether policies can be improved so that they punish the regimes of the countries concerned rather than innocent people in those countries. When my right honourable friend published the outcome of the review, he made clear that there would be rare occasions when comprehensive sanctions should be imposed where the behaviour of the target regime justifies the toughest measures. My right honourable friend said that Iraq is one such place.

NHS Hospitals: Private Finance Initiatives

2.54 p.m.

Lord Clement-Jones asked Her Majesty's Government:

    What action they are taking in response to the recent UNISON report Downsizing for the 21st Century which analyses plans for the North Durham Acute Hospitals Trust private finance initiative development.

The Parliamentary Under-Secretary of State, Department of Health (Baroness Hayman): My Lords, we have carefully considered the report to which the noble Lord refers. It contains a number of inaccuracies and misunderstandings and we intend to issue a formal response shortly. A copy of that response will be placed in the Library.

Lord Clement-Jones: My Lords, I thank the Minister for that reply. Instead of that report, I could easily have cited a report by St. George's Hospital medical school in relation to seven other PFI contracts which demonstrate that PFI schemes do not deliver either the quality or the amount of service that publicly funded schemes deliver, and that they offer less value to the public. Is it not time that the Minister's department woke up to the problems associated with the PFI? Will the department join the BMA, the NHS Confederation, UNISON and the Health Select Committee in their reservations? Is it not time that the department instituted an urgent review of the PFI schemes in order to ensure that they secure value for money and much-needed beds?

Baroness Hayman: My Lords, of course we must ensure that PFI schemes, and indeed publicly funded schemes, provide value for money. I need not remind the House that there have been problems in the past, in terms of both time and cost overrun, in relation to hospital building in the public sector. Equally, we must ensure that the number of beds and the range of services provided in new schemes, whatever the means of procurement, are adequate for the health needs of the population. That is the reason that we are undertaking a national bed survey. However, where PFI schemes such as the one in North Durham (as the report to which the noble Lord draws attention makes clear) offer value for money against strict and accepted criteria, when they deliver a hospital in one phase in three-and-a-half years

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instead of in two phases in seven years, and to a better design specification, and when more cash is coming back into the NHS through land sales, I do not believe that we should say for ideological reasons that that method of procurement is not right.

Earl Howe: My Lords, does the Minister agree with the UNISON report that, under the PFI, North Durham will be spending more for a reduced level of service than would have been the case under the public sector option? If that was the result of the capital investment appraisal, was there therefore a ministerial direction to the Department of Health accounting officer to proceed with the PFI option--and if not, why not?

Baroness Hayman: My Lords, it would be difficult for the House to go into the textual analysis of a report that it has not seen. However, I assure the noble Earl that the economic appraisal showed the Durham scheme as providing better value for money than its public sector comparator over the 60-year period against which the Green Book states that investment decisions should be assessed. There is no question of not providing value for money. That is one of the misunderstandings in the report to which I referred. We shall make that clear in our response. As the noble Earl will be aware, new hospitals initially cost more than the old, outdated facilities that they replace. But the step changes in the standards of care which the modern NHS needs to deliver can best be achieved by building new hospitals, whether under the private finance initiative or from public funding.

Lord McNair: My Lords, does the Minister have any idea how many beds are available in the private health care sector which could be used when there is a shortage of beds in the National Health Service?

Baroness Hayman: My Lords, I do not have the figures available for the number of beds across the private sector as a whole. I will write to the noble Lord. The assumption that such beds could be made available when they were needed involves many hypothetical issues. I am not sure that a definite decision could be arrived at. Our aim is to provide within the NHS adequate facilities for treating NHS patients. As I said, the national bed survey will look closely at whether, over the past two decades, we have reduced bed numbers too sharply in this country.

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