Lord McIntosh of Haringey: My Lords, Her Majesty's Customs and Excise is the department responsible for collecting and recording trade statistics on the movement of goods with other countries. The UK's export statistics are produced by Customs on the basis of the declared final country of destination and that approach is reflected in Customs forms at present.
Viscount Waverley: My Lords, the Government will wish to avoid distorted decision-making. Therefore, is the noble Lord aware that approximately 45 per cent of Britain's official figures are affected by the entrepot factor which affects our country league tables, our bilateral relations, direction of effort, general policy and resource decision-making in all government departments?
Lord McIntosh of Haringey: My Lords, the noble Viscount is not correct. He refers to entrepots, by which I assume he is referring to places such as Rotterdam and Antwerp and places outside the European Union. When goods are exported to a final destination via Rotterdam, Antwerp or any other entrepot, it is the final destination, not the entrepot, which is recorded on the forms. The export trade statistics are therefore correct.
Lord Saatchi: My Lords, is the Minister aware that the noble Viscount, Lord Waverley, touches on a key point and one which has involved the Government being criticised by a long list of complainants about the way in which the Government have used statistics, including in recent months the OECD, the Treasury Select Committee and only today the All-Party Agriculture Committee of another place? Will he reconsider the offer which I made him last week; namely, that that surely could be one area at least in which the parties could co-operate to ensure that government statistics are beyond the reach of those
Lord McIntosh of Haringey: My Lords, I am not sure whether or not the noble Lord is accusing the Government of distorting the statistics. He shied away somewhat from a final accusation. There is no reason to suppose that the government statistics are distorted in any direction. I appreciate that a number of people--notably, Mr Norris McWhirter--who think that because goods are first exported to European Union countries and then on to other destinations, the final destination is not properly recorded and that, therefore, the proportion of our export trade which is with the European Union is incorrect. There is no reason to suppose that that is the case. There is no reason why anybody should declare a wrong final destination unless, of course, those are goods which must be exported on licence. In that case, there is always the motivation for fraud. But if the noble Lord can show me any evidence that the Customs figures are distorted, I shall be pleased to discuss it with him.
Lord Campbell of Alloway: My Lords, I ask the noble Lord whether he accepts that for Customs declaration purposes, the distinction between final destination and transit destination is strictly relevant to all licensed goods and in particular armaments? I do not suggest improper usage of any forms, but if that is relevant for licensed goods such as armament exports, why should it not be relevant also to other goods?
Lord McIntosh of Haringey: My Lords, I do not want to rub salt into any Conservative wounds, but it is a fact that there have been occasions in the past when arms exports have been wrongly declared as going to Singapore rather than to their final destination of Iraq. Noble Lords opposite will be aware of that fact and of ministerial involvement in it. Those are the only occasions that I can think of where there is any motivation for declaring other than the true final destination. The port of export, the transit port, is not declared on European Community forms used by Customs and Excise.
Lord Pearson of Rannoch: My Lords, when one considers the re-export of materials and goods to the European Union, the goods which are exported to Rotterdam and Antwerp for onward transmission outside the European Union and the investments made through the Netherlands for tax reasons--the so-called Netherlands distortion--does the Minister accept that that takes us to a figure of only some 10 per cent of our gross domestic product or of our economy which is involved in trade with the European Union at all? If so, does the noble Lord accept that it makes a nonsense of the Prime Minister's often repeated claim that over 50 per cent of our trade lies with the European Union?
The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath): My Lords, the Government are concerned about the variation in caesarean rates between hospitals and have an active programme of work in hand to address that and the reasons for the rise in caesarean rates overall. We would expect a decision about whether to perform a caesarean section to be made on the basis of clinical need.
Baroness Cumberlege: My Lords, I thank the Minister for that Answer. I am interested that he feels that there is an issue about the varying rates in different hospitals. First, is he aware of two hospitals which are joining to form a trust, one of which has a caesarean rate of 12 per cent and the other of 20 per cent, and that not far away another hospital has a rate of 29 per cent? Will the Minister take this matter further and tell us how that discrepancy is to be monitored? What influence will he put on those hospitals which have a very high rate of caesarean sections?
Secondly, has the Minister seen the recent research which shows that where there is continuity of care by a midwife of a woman in labour, the intervention rate is low not only in relation to caesarean sections but also in relation to medical interventions? What is the Minister going to do about the appalling haemorrhage of midwives leaving the service?
Lord Hunt of Kings Heath: My Lords, the noble Baroness has asked a number of questions. The variations are considerable. The Audit Commission report of 1997 found variations of between 10 per cent and 18 per cent in the trusts surveyed. I understand that a 1998-99 survey by the English National Board for Nursing, Midwifery and Health Visiting (ENB) showed even higher variations.
Of course, some variations are explainable due to local factors. It is important that in establishing the variations and the reasons for them we take into account the factors that may arise. In its own guidelines, the WHO accepts that there can be
On the recruitment of midwives, the recruitment campaign which started at the beginning of the year is bearing fruit. Over 4,000 nurses and midwives are returning to the profession. We have every reason to believe that as we develop those campaigns more midwives will return.
Lord Clement-Jones: My Lords, can the Minister confirm or deny recent press reports of several cases concerning London hospitals, including the Chelsea and Westminster Hospital, where women who are about to go into labour have been turned away because of the shortage of midwives? Is it not time that the Government got to grips with the issue? Is it not time that the Government issued their long-awaited strategy on maternity services?
Lord Hunt of Kings Heath: My Lords, a limited number of units have been fully booked. In such a situation, women are encouraged to turn to a midwifery unit nearby. Overall, I believe that we are tackling issues in relation to midwife shortages. I have already said that the recruitment campaign which started at the beginning of the year has borne fruit. The recruitment survey for this year shows that for England as a whole we have a 2 per cent midwifery shortage on posts vacant for more than three months. Of course, one cannot be complacent. Our efforts are bearing fruit, but we should be aware of some of the alarmist reports that we have heard in this area.
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