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Disease Prevention

7. Chris Grayling (Epsom and Ewell): What actions she is taking to combat (a) HIV/AIDS, (b) TB and (c) malaria in the developing world. [37321]

The Secretary of State for International Development (Clare Short): Approximately half of infectious disease deaths in developing countries can be attributed to three diseases: HIV, TB and malaria, which cause more than 5 million deaths per year. My Department is working to strengthen developing countries' health systems and we have committed more than £1 billion to that purpose since 1997. The UK has also taken an active role in establishing the global fund to fight AIDS, TB and malaria, which is

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designed to improve provision of drugs and commodities to treat those diseases. I have pledged $200 million from my budget over five years for the fund.

Chris Grayling: I thank the Secretary of State for that answer. Does she share the view held by those on the Conservative Benches that the United Nations global health fund should be using some of its resources to ensure that AIDS and HIV sufferers in Africa have access to the drugs that they need?

Clare Short: I agree with the hon. Gentleman. The fund's purpose is to make drugs and commodities available. That includes, for example, HIV testing; most people with HIV do not even know that they have it and do not take action to protect themselves and to ensure that they do not infect others. Many people with HIV get TB, become unable to work and then become impoverished, and so on. The fund is meant to supply drugs and commodities, get the prices down by making big orders, ensure reliability of supply and exert leverage in developing countries to ensure that they have better systems to deliver. HIV/AIDS prevention is better than the use of anti-retrovirals to keep people alive, so that is our major focus, but lower priced anti-retrovirals are now available from pharmaceutical companies where delivery systems are in place.


The Prime Minister was asked—


Q1. [37345] Mr. Michael Jack (Fylde): If he will list his official engagements for Wednesday 6 March.

The Prime Minister (Mr. Tony Blair): This morning, I returned from the Commonwealth Heads of Government meeting. I shall make a statement on it later today, in addition to having further meetings.

Mr. Jack: The Labour-controlled Lancashire county council is proposing to close 37 of its elderly persons care homes and the associated day care centres. May I ask the Prime Minister on behalf of the vulnerable elderly in Lancashire if he can persuade the Department of Health to discuss this matter with Lancashire county council, with a view to withdrawing the proposal? All Lancashire's Conservative and Labour MPs oppose the proposal, which will do nothing for the quality of life of elderly people in the county and presents a threat to their homes.

The Prime Minister: I understand that Ministers in the Department have asked to be kept fully informed of the situation, and they will no doubt discuss it with the county council. However, I have to say to the right hon. Gentleman that, as he will know, under this Government, spending on social services has increased by about 20 per cent. Of course, throughout the country, councils are considering how best to care for elderly people. As a result of the extra investment that we will be putting in in the next three years, we will have an additional

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£1.4 billion going into care for the elderly. However, as I said, in respect of these particular plans, the Department will be in touch with the county council.

Q2. [37346] Mr. David Stewart (Inverness, East, Nairn and Lochaber): My right hon. Friend will be aware of the key economic role that is played by the British film industry. For example, my constituency has been the location for blockbusting films such as "Braveheart", "Rob Roy" and, more recently, "Harry Potter and the Philosopher's Stone". Does he share my view that the planned multi-million pound highland film studio will be vital in ensuring that the film industry in Britain can compete on the world stage?

The Prime Minister: I congratulate my hon. Friend and the Scottish film industry on the strength of Scottish film production. As he said, it is renowned throughout the world. It is true, of course, that as a result of measures introduced by the Chancellor, the British film industry as a whole has enjoyed considerable success in the past few years. I wish the proposal well. Obviously, it is an important matter for the Scottish Executive as well, but I understand that about £20 million of private sector money could also come in. I hope very much that his constituency will see the benefits.

Mr. Iain Duncan Smith (Chingford and Woodford Green): Given the wholly unacceptable decision of the United States to impose steel tariffs, will the Prime Minister stand by his statement of a few weeks ago, when he said of Mr. Mittal's firm, LNM:

The Prime Minister: Of course, the British Government stand by the policy that we have outlined, which is to oppose the tariffs introduced by the United States. They are unacceptable and wrong, and they affect not only Britain but the European Community and other countries throughout the world. In our view, the problems of the American steel industry are best solved by restructuring that industry, not by imposing arbitrary and unjustified tariffs.

Mr. Duncan Smith: Well, of course they are, but we have a problem here, because the company that the Prime Minister celebrated as a British company spent $600,000 on lobbying the United States Government to impose tariffs on steel imports. Those tariffs will, of course, affect the United Kingdom steel industry. As one chief executive put it this morning:

It took the Prime Minister 30 seconds to write a letter supporting a non-British company producing anti-British policies, yet it takes him months to write a letter to the US President to stand up for British interests. Will the Prime Minister now apologise to the British steel workers who may lose their jobs?

The Prime Minister: First, in relation to the British steel industry, let us take no lessons from a Conservative party that destroyed 100,000 British steel jobs while in government. Secondly, in relation to the American Administration, this matter was first raised by my right

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hon. Friend the Secretary of State for Trade and Industry last July, and it has been raised with the American Administration at every level of this Government. It is important that, together with other European countries, we now pursue the right remedies through the World Trade Organisation.

Mr. Duncan Smith: In case the Prime Minister has not noticed, he has been in power for almost five years, during which time nearly 400,000 manufacturing jobs have been lost. Ten thousand of those were steel jobs, so we do not need any lectures from him, either. When will he understand that his Government's misconduct affects people outside Westminster? What he arrogantly dismissed as "Garbagegate" some weeks ago will affect the lives and work of thousands of people who look to him for protection. It seems that the only mistake that the steelworkers and the steel industry made was not to give more money to the Labour party, because we now know that the Prime Minister always puts the interests of his friends before the interests of the British people.

The Prime Minister: First, let me repeat that this is a decision by the American Administration in respect not only of Britain but of imports into the United States from all countries. It is, therefore, absurd to suggest that it is somehow directed only against Britain. In respect of the decision, we have made representations at every level of Government and will continue to do so through the European Union. In respect of manufacturing and steel jobs, however, some people remember the two recessions under the last Conservative Government, and the millions of jobs that were lost when manufacturing output declined by somewhere in the region of 10 per cent. It is under the Labour Government that economic stability has been achieved, delivering—instead of 3 million unemployed—more than 1 million extra jobs in this country.

Mr. Mike Wood (Batley and Spen): I know that my right hon. Friend the Prime Minister will share the horror felt throughout the House at the sectarian violence in Gujerat, which has so far claimed the lives of at least 500 people, including my constituent Mohammed Aswat in an incident that also led to the disappearance of two more of my constituents—of whom nothing has been heard for five days—and the leaving for dead of another. Will my right hon. Friend agree to see a delegation of hon. Members, such as myself, who have constituents in Gujerat, where the violence persists, to discuss how those British nationals can safely and quickly be repatriated? Secondly, will he make every effort to have my two missing constituents, Sakim and Saeed Dawood, found, and to have those responsible for the attack on them, and for the death of Mr. Aswat, brought quickly to justice?

The Prime Minister: I understand that the Foreign Secretary is to meet my hon. Friend and other colleagues involved, and if they wish to meet me after that, I shall be happy to meet them. Secondly, we express our deep sympathy and condolences from all parts of the House to those who lost their lives in Gujerat. We are in close touch with the Indian authorities and will do everything that we can to assist them to bring this distressing violence to an end.

Mr. Charles Kennedy (Ross, Skye and Inverness, West): This time last week, the Prime Minister told me

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that the Secretary of State for Transport, Local Government and the Regions should be judged on his record. Since then, the Strategic Rail Authority has discovered a £8 billion hole in the Transport Secretary's proposed budget. Today City fund managers have signed a round-robin letter to the Chancellor in which they say that the way in which the Railtrack administration was handled will severely dent future investor confidence. What does that say about the Transport Secretary's record in the past week?

The Prime Minister: On the first point, something over £60 billion of public and private money will go into the railways. I should have thought that the right hon. Gentleman would welcome that. As for the decision to put the company into administration, I thought we had explained on many occasions—indeed, I thought this had some support from the Liberal Democrats—that the reason for its being put into administration was the huge losses that it had suffered. We simply could not continue with those losses.

As for the letter from the fund managers, these are fund managers who are also investors and shareholders in Railtrack. Therefore they are, as it were, in dispute with the Government in their role as shareholders. The best answer I can give them is that some £6 billion has already been committed as part of the private-sector investment in the railways, and we have no doubt that there will be more.

Mr. Kennedy: It is not just a question of the loss of confidence among City fund managers; it is a question of the loss of confidence among the travelling public, the loss of confidence in the Department, and—remember—the loss of confidence in the Labour-dominated Select Committee on Transport, Local Government and the Regions.

Let me return to the question that I asked this time last week. Just what does it take for the Prime Minister to lose confidence in his Transport Secretary?

The Prime Minister: I entirely support the decision to put Railtrack into administration. As I said, I thought the Liberal Democrats understood the reasons for that very well. I suspect that we are witnessing something of a piece of opportunism in their turning round afterwards and saying that it was not right—[Interruption.] I agree, of course, that that would be highly unusual in the case of the Liberal Democrats.

The plain fact is that, as I pointed out, the fund managers who wrote today are the fund managers who are investors and shareholders in Railtrack. They are therefore currently negotiating with the Government over the amount of compensation. The best answer I can give is that the private-sector investment is coming in. As I said, £6 billion has already been allocated. Between July last year and March this year, some 44 different private finance initiative and public-private partnership contracts had been agreed. There is no shortage of private-sector involvement in these projects.

Mr. Gwyn Prosser (Dover): My right hon. Friend will be aware that today is the 15th anniversary of the sinking of the Herald of Free Enterprise, in which 193 crew and passengers perished. He will also know that this morning

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we held our annual memorial service at the port of Dover. Will he join me in extending sympathy to the friends and families of those who were lost, and in paying tribute to the bravery of those who gave their lives that others might live? Will he also ensure that the United Kingdom Government continue to take the lead in promoting higher international standards of safety at sea, so that the effects of an appalling 140 losses of ships at sea every year do not continue?

The Prime Minister: On the anniversary of a tragic event that I think all Members will remember, let me express our sympathy to the family and friends of those concerned, and also pay tribute to their bravery and to the selfless courage exercised by many of the victims in helping those in distress at the time of the accident. As for improving the safety standards of ro-ro ferries, my hon. Friend may know that we are pursuing that in the International Maritime Organisation, and also urging the European Union to take it up. I agree that the level of accidents is currently unacceptable, but we are working in every possible forum to bring it down.

Q3. [37347] Dr. Vincent Cable (Twickenham): Has the Prime Minister had a chance to look at the report of the Royal College of Radiologists, which explains why many of our constituents who have been diagnosed with cancer are now having to wait at least two to three months for radiotherapy? As the national health service is the Prime Minister's top priority, and as cancer is the top priority within that top priority, can he explain why the Government have been so slow to address the issue of retention and recruitment of key staff, and why the situation is still deteriorating?

The Prime Minister: We are, of course, training more staff. One reason why there have been longer waits for radiotherapy is precisely because of the additional consultants, additional investment in machines and other investment in the health service and cancer services. More and more people are being referred for radiotherapy, but the numbers in radiotherapy are increasing. The hon. Gentleman will know that the audit was carried out some time ago, and I think that he will find that we are managing to improve the situation for radiotherapy services across the country.

Q4. [37348] Mr. Bob Blizzard (Waveney): Is my right hon. Friend aware that it is costing the taxpayer £400 million a year to clear up the millions of tons of litter dropped on our streets and in our open spaces? Although we have litter laws, only a few hundred prosecutions are made a year. As my private Member's Bill seems unlikely to find parliamentary time—[Hon. Members: "Aah!"]—will he introduce legislation to allow councils to keep the money raised through fixed penalty fines, so that they can employ people to enforce the litter laws? That way, we can clear up this country and make the polluter pay.

The Prime Minister: I am aware of my hon. Friend's ten-minute Bill. The Government in principle support the proposal to allow local authorities to spend the money that they get from fines on improving the litter situation in their area. As one part of that, we have recently increased—indeed, doubled—the penalties for litter, and

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it is important that we continue to make every effort that we can to deal with a problem that may seem trivial, but which is very important for people in their local communities.

Mr. David Trimble (Upper Bann): Does the Prime Minister remember assuring the public during the campaign for a "yes" vote, following the Belfast agreement, that the early release scheme would not be an amnesty? In particular does he recall the following statement, issued by the Northern Ireland Information Service:

Indeed, the word "amnesty" was underlined. That was part of the basis on which people voted for the agreement. Does the Prime Minister realise that for a lot of good people who have stuck with the agreement through thick and thin, and who have had to put up with quite a lot recently, the Government's going back on their word and breaking faith with them will be the last straw?

The Prime Minister: First, it is of course right that people released under the early release scheme as prisoners be released on licence. Should they breach the terms of that licence, they can be readmitted to prison. Secondly, we made it clear at Weston Park that this was an issue to be dealt with. We will deal with it, but how we do so is open to discussion.

Q5. [37349] Valerie Davey (Bristol, West): Fair trade fortnight encourages all of us to support producers of tea, coffee and cocoa, yet the processors of those products in the developed world are still getting the greatest profit. What can the Government further do to develop fair trade and to open the common European Union markets to processed goods from developing countries?

The Prime Minister: I agree with my hon. Friend that this is a very important and serious issue. It is being raised in the context of the World Trade Organisation negotiations, which began at Doha last year. Of course, she is absolutely right to say that, for many of the poorest countries in the world, what is more important even than aid is access to western markets. I very much hope that—as part of the partnership agreement with Africa, which we hope to conclude at this year's G8 summit, in Canada—the developed world will give a clear steer and sense of direction that we are prepared to ensure that our markets are indeed open, not just to goods that are raw materials, but to processed goods.

Mr. Iain Duncan Smith (Chingford and Woodford Green): I do not want to frighten the Prime Minister, but I agree with him on one thing: although the Liberal Democrats supported his programme to take over Railtrack, they did not support the minority report of the Committee. They are probably the only people in history to try to jump on a bandwagon, only to roll under it. Perhaps he can answer the real question: will raising private investment in public services prove more or less expensive as a result of the actions of his Secretary of State?

The Prime Minister: As regards the investment that we can get into the railways, the only decision that we could possibly have taken was to secure additional private

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investment by putting Railtrack into administration, then bringing it out in a restructured form. There was no way in which we as a Government could have carried on pouring billions of pounds into a failed company. That would have affected our ability to raise the money.

Therefore the answer to the right hon. Gentleman's question is no, I do not believe that it is more expensive. We will only ever get proper investment into our railways by halting privatisation, which did so much damage, restructuring the company and relaunching it on a proper footing.

Mr. Duncan Smith: The Prime Minister is wrong. It is now well known that under the 10-year plan he expects to raise £35 billion, but the Government's credit rating has been so downgraded that it is calculated that it will cost at least £1 billion extra to raise that money. The group of investors who wrote today in The Times,

were absolutely spot on. Must not the Prime Minister now make a clear choice between getting private sector investment into his railway programme or getting rid of his Transport Secretary?

The Prime Minister: No, Mr. Speaker. As I pointed out a moment ago, we have already committed £6 billion. Indeed, there was a recent commitment for extra private sector investment in the Chiltern line.

The difference between us and the right hon. Gentleman is that he would have carried on with Railtrack as it was—a privatised company siphoning off billions of pounds from the Treasury. We believe that it should have been put into administration; he would want us to pay £1 billion in compensation to the shareholders, including the 20 fund managers who wrote to The Times. That money should be going into our railways, but the right hon. Gentleman would give it to the shareholders. That is the difference between us.

Mr. Duncan Smith: The one thing that is absolutely certain about us is that we would not have such a Transport Secretary, who, according to the letter and to every single commentator, has lost the trust of business and of the civil service, and is now going to make the public pay through more delays and extra costs in raising the money for public services. The real price of the Prime Minister's weak—I repeat, weak—refusal to sack the Transport Secretary is that the public will have to pay more tax for less service.

The Prime Minister: Of course, Mr. Speaker, the Conservative Government had a Transport Secretary who privatised Railtrack in the first place and left us in this situation. Not only was that botched privatisation allowed to take place, but—according to the Public Administration Committee when it was headed by the right hon. Member who is now chairman of the Conservative party—the way in which it was sold meant that the public lost billions of pounds on the sale. The Conservatives were responsible not only for that botched privatisation, but for losing public money on it.

The plain fact of the matter is that we have set aside public money for extra investment in the railways. That will result in billions of pounds going in over the next few years, along with money from the private sector.

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We support that investment and the right hon. Gentleman opposes it. That is the true test of commitment to Britain's railways.

Ms Diane Abbott (Hackney, North and Stoke Newington): Is the Prime Minister aware of the growing concern in the country that we may be moving by degrees towards war with Iraq? Does he accept that in the event that British troops are sent into action, there should be a debate and a vote on the Floor of the House?

The Prime Minister: Of course, were we ever to take action in respect of Iraq there should be an opportunity for the House to express its view, as indeed it has in respect of Afghanistan. However, I have to say to my hon. Friend that no decisions have yet been taken about any possible action in respect of Iraq.

I remind my hon. Friend that two days after 11 September I made a statement in the House in which I said that the issue of weapons of mass destruction was an important issue that we would have to tackle; and we do have to tackle it. Iraq is plainly in breach of the United Nations Security Council resolutions on the accumulation of weapons, and we must deal with that. How we do so is a matter for discussion and consultation.

Q6. [37350] Mr. David Heath (Somerton and Frome): When the Prime Minister next returns from overseas, will he forget the official car and instead take the train into Paddington? As he does so, will he reflect that we still do not know whether 41 recommendations from Lord Cullen on safety after the Paddington rail crash have yet been implemented, despite the deadline being three months ago? The Prime Minister says that his priority is rail safety. Can he guarantee that those safety improvements are now finished? If not, why on earth does he have confidence in his Transport Secretary?

The Prime Minister: We are taking forward the proposals on safety recommended by Cullen, but if the hon. Gentleman looks at the safety record of the British rail industry overall, he will see that it is not declining, but improving. I would have thought that he recognised that. He will know that, according to the recent figures, the degree to which there have been incidents involving a lack of safety has declined and not increased. I agree that much more needs to be done, but Lord Cullen made many proposals. We are taking them forward in consultation with the industry, which is the best way to do it.

Margaret Moran (Luton, South): Is the Prime Minister aware that, over the last few years, 15 children have been murdered as a result of courts granting contact to violent parents? Is he also aware that courts are continuing to grant unsupervised contact to schedule 1 offenders, resulting in violence and sometimes death to children? Will he ensure that we hold inquiries into such circumstances where there are domestic violence murders? Will he do everything he can to ensure that there is an amendment to the Children Act 1989 to protect our children from this kind of violence in future?

The Prime Minister: First, on the specific point about the amendment to the legislation, we will give serious consideration to the point that my hon. Friend makes. Secondly, I should say that there is an interdepartmental

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ministerial group specifically to look at how we co-ordinate work in this area and she will be aware that the Government have tightened legislation in recent years.

Q7. [37351] Mr. Julian Brazier (Canterbury): The Government's solution to the desperate overcrowding in east Kent hospitals is a £200 million investment programme. Does the Prime Minister understand that 15,000 people have marched against the proposed plan, that consultants are saying that it is medically unsafe and that the Royal College of Nursing has come out against it? Will he give us some extra beds for patients now, or will he engage in this ridiculous and extravagant exercise in empire-building; the kind of empire on which the sun never shines?

The Prime Minister: The decisions on the reconfiguration of the service in east Kent, which were taken by the health authority board, will be referred to Ministers after proper consultation. The points that the hon. Gentleman makes will be taken in account. In relation to the service as a whole, we recognise that there have been real and specific problems in east Kent but, as he has just implied, we are putting millions of additional investment into the services. It will take some time for that investment to go through, but in terms of accident and emergency, the numbers of beds and cancer services in east Kent, we are making additional investment available. As for the reconfiguration of those services, that is a decision by the health authority board and Ministers will consider it after due consultation.

Q8. [37352] Dr. Stephen Ladyman (South Thanet): When the hon. Member for Canterbury (Mr. Brazier) asked his question, he forgot to remind my right hon. Friend of the tens of millions of pounds already spent on modernising east Kent hospitals, the £2 million accident and emergency modernisation programme at Margate that is just completed and the £180 million that is about to be spent? Does my right hon. Friend agree that still much more needs to be done in the NHS? Does he share my concerns about waiting times for heart patients? What does he intend to do about that?

The Prime Minister: My hon. Friend is right that there is a great deal more to do, but the answer to the problems of waiting times or the additional numbers of consultants and nurses needed in the health service cannot be to cut the investment going to the health service, which is the position of the Conservative party.

On cardiac services, as a result of the additional funding that the Secretary of State for Health has announced today, we will be able to cut substantially cardiac waiting times. That is in addition to increasing by 45 or 50 per cent. the number of cardiologists within the NHS. These are important changes and investments, and the Government will carry on making necessary investments in the NHS. The single biggest dividing line in the House lies between Labour, which wants investment in public service, and the Conservatives, who are against it.

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Mr. John Randall (Uxbridge): The Prime Minister will doubtless recall the promise made in the 1997 Labour party manifesto to end waiting for cancer treatment. When will he fulfil that promise?

The Prime Minister: The latest figures indicate that referrals for cancer treatment within two weeks have risen from just over 60 per cent. when we came to power to more than 90 per cent. now. As a result of additional

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investment, not only in increasing the number of cancer specialists but in extra cancer equipment throughout the NHS, there is no doubt that cancer services have been enabled to improve.

The hon. Gentleman's question brings us back to what I have already said. [Interruption.] If Conservative Members do not accept that, they do not accept the reality of their position. After years of cuts in beds, cuts in training places and cuts in the number of nurses, the Government are investing in the national health service.

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