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Primary Care
16. Mr. Stinchcombe: What action he is taking to promote the development of primary care. [29330]
Mr. Dobson: The White Paper "The New NHS" sets out our approach to modernising the national health service and providing integrated primary and community health care services. It will be done through the establishment of primary care groups and ultimately primary care trusts. The establishment of the primary care groups will build on other policies that we have already implemented, such as the National Health Service (Primary Care) Act 1997, personal medical services pilots, the salaried doctors scheme and other local pilots. We shall introduce schemes only when they have been tried and tested.
Mr. Stinchcombe: Is my right hon. Friend aware that his policies are warmly welcomed by the doctors and nurses in my constituency, but that they also seek reassurances? In particular, they want a package of incentives to reward them adequately for the extra work that they will be asked to undertake.
Mr. Dobson: There will be such incentives. Knowing the professionalism of the doctors, nurses and other staff involved, the greatest incentive will be that the policies will lead to a better health service, for which they have all been hoping and working for years.
Rev. Martin Smyth: The Secretary of State will have heard the concerns that have been expressed about social care. Is he happy with the links between health professionals and social care workers in dealing with the scourge of child abuse? Are there enough social workers to deal with the problem?
Mr. Dobson: The Utting committee reported to me before Christmas with proposals to deal with the abuse of children living away from home. The record is disgraceful. We intend to change the arrangements to ensure that the situation improves. It is staggering that, although the number of young people in care--as it is fondly called--represents only a small proportion of the population, 22 per cent. of the prison population was previously in care. That does not say a lot for the care.
Mr. Lansley: When the Secretary of State comes to designate primary care commissioning pilots, will he ensure variety--not just geographical variety, but a variety of approaches to primary care commissioning? Will he also ensure that larger fundholding practices that feel capable of being primary care commissioning groups are offered opportunities to bid for pilot schemes? When will the Secretary of State seek a debate in the House on the NHS White Paper?
Mr. Dobson: The hon. Gentleman makes a reasonable point. The idea of the pilot schemes is to test different approaches. There is no point in having 30 identical pilot schemes. We want a variety of approaches, some of which include the enthusiastic involvement of fundholding doctors. We shall see what works and what does not. I shall say now so that no one can accuse me of not saying it in advance that some of the pilot schemes will almost certainly prove not to be successful. That is why we are having pilot schemes--to find out what works and what does not.
Community Hospitals
17. Mr. Prior: What proposals he has for community hospitals. [29331]
Mr. Boateng: As we said in our White Paper, we see an important role for community hospitals providing intermediate care close to where people live. The new arrangements that we are introducing will make it easier for hospital and primary care to work together to achieve that aim.
Mr. Prior: Is the Minister aware that hundreds of thousands of people, particularly in rural areas, regard their local community hospital as the most important part of the national health service? Will he give as much support and encouragement as he can to local health authorities that are doing their best to maintain as many such hospitals as possible?
Mr. Boateng: We recognise the vital role that many community hospitals play as a local resource. We want the best balance between them, acute hospitals and other community facilities to ensure the delivery of emergency, elective and rehabilitative care. Those three objectives, and a range of ways of delivering them, are at the heart of the new NHS.
Mr. Edwards: Will my hon. Friend join me in welcoming the announcement that building of the new community hospital for Chepstow will finally begin later this year? It will be the first hospital built in Wales under the private finance initiative.
Mr. Boateng: I am delighted to do so. That is another gain for new Labour.
Mr. Fabricant: Will not the quality of care depend on the number of people who can be employed in hospitals? Given that only a limited amount of money is available--albeit the Government claim that there will be an extra £1 billion--what representations has the Minister made to the Low Pay Commission on the minimum amount of money an hour that staff in hospitals should be paid?
Mr. Boateng: The hon. Gentleman is notoriously Whiggish on this and other points. Let us be very clear. We put our faith in NHS staff. NHS staff will be paid a proper wage. NHS staff deserve the very best. This new Labour Government will give it to them.
Iraq
18. Mr. Dalyell: What recent representations he has made to the World Health Organisation in relation to Iraq. [29332]
Mr. Dobson: We have made no representations recently to the World Health Organisation about Iraq. We welcome and support the humanitarian work that the World Health Organisation is carrying out in Iraq. It is worth noting that, since 1991, the United Kingdom has contributed more than £94 million in humanitarian and medical aid through bilateral and multilateral sources to Iraq, especially northern Iraq, where Saddam Hussein deployed chemical weapons against his own people.
Mr. Dalyell: Is not now the time to help the children of Iraq, particularly in relation to waterborne diseases?
Mr. Dobson: The British Government have taken the lead in trying to double the amount of oil that the Iraqis can sell to raise money to provide medicine and medical treatment for their people. It is worth remembering that, although the first United Nations resolution went through in 1995, it was December 1996 before the present Government of Iraq were even willing to go ahead with that resolution, which was intended to make food, medical equipment and pharmaceuticals available to the people of Iraq. If anyone is to blame for those materials and that food not getting through, it is the Government of Iraq, not the Government of Britain or the World Health Organisation.
Iraq
3.31 pm
The Prime Minister (Mr. Tony Blair): With permission, Madam Speaker, I will make a statement on the recent crisis over weapons inspections in Iraq, and the agreement signed by the United Nations Secretary-General and the Deputy Prime Minister of Iraq in Baghdad yesterday. Since the text of the agreement is now in the public domain, I am arranging for copies to be placed in the Library of the House.
It is worth recalling again the origins of the crisis. One of the main conditions of the Gulf war ceasefire in 1991 was that Iraq's weapons of mass destruction should be destroyed or rendered harmless by inspectors working for the United Nations. That was embodied in Security Council resolution 687. Since then, the UN weapons inspectors have done a tremendous job in finding and destroying those weapons. The full details have been given to the House before, but they include horrific amounts of chemical and biological weapons. The inspectors achieved that despite systematic obstruction, deceit and concealment by Saddam Hussein, which caused repeated confrontation between the UN Security Council and Iraq.
There was a crisis in November about the composition of UNSCOM teams, which was resolved by Saddam Hussein agreeing to allow the inspectors back in, following a diplomatic agreement brokered by the Russians. Crucially, however, that was not written down or followed by a fresh Security Council resolution. He almost immediately went back on the agreement, plunging us into the most recent crisis about access to presidential compounds, some of them large and containing hundreds of buildings, and presidential palaces. This has not been an artificial argument about some theoretical threat, but a reflection of real alarm on the part of UN inspectors about the use of those sites to conceal both evidence and actual weapons. The Security Council cannot accept that any areas remain off limits.
Saddam began by saying that there could be no access to the sites. Then, under intense pressure, not least from the start of the build-up of forces in the Gulf, he eventually agreed that they could be visited once. That was clearly unacceptable, but he refused to move further. Meanwhile, we and the Americans, together with our other allies, continued to make it clear that, if he did not back down, we saw no alternative in the end to the use of force. We made preparations to ensure that we were ready to use force, if absolutely necessary.
Under that renewed pressure, Saddam Hussein began to show readiness to move further. On the basis of a text drafted by Britain, the five permanent members of the Security Council agreed last week that the UN Secretary-General should go to Baghdad to make it clear to Saddam Hussein that he had to comply fully and unconditionally with the relevant Security Council resolutions, and to negotiate a written agreement on those lines. It was clear to all that if Saddam was not prepared to agree, force might have to be used, albeit with the greatest reluctance.
I am delighted that Kofi Annan, for whom I have the greatest respect and admiration, has succeeded in his mission and has brought back a signed agreement,
the details of which have now become public. He will report to the Security Council this afternoon on his discussions with the Iraqi Government.
The key provisions of the agreement are as follows: Iraq reconfirms its acceptance of the relevant Security Council resolutions, including 687, and its readiness to co-operate fully with UNSCOM and the International Atomic Energy Agency; Iraq undertakes to accord immediate, unconditional and unrestricted access to UNSCOM and the IAEA; a special group will be established to inspect eight clearly defined presidential sites. It will be composed of UNSCOM and IAEA experts, together with diplomats appointed by the Secretary-General, and headed by a commissioner, also appointed by the Secretary-General. The group will operate under the established procedures of UNSCOM and the IAEA, but with some extra specific procedures related to the nature of the sites.
We await clarification of the details of the special group, but three things are essential. First, the commissioner in charge of the group must be properly qualified for the task. Secondly, the details of the inspection regime must preserve in full the professional and technical nature of the inspections and the inspectors. Thirdly, there can be no question of negotiating with Saddam Hussein over the integrity of the weapons inspection process. I am confident from our contacts with the Secretary-General that he understands those points.
I welcome the agreement, and pay tribute to Secretary-General Kofi Annan's achievement in securing it. It has been an important demonstration of the value of the United Nations and its absolutely vital role in the world. We should never forget that, if we do not stop Saddam Hussein acting in breach of his agreement on weapons of mass destruction, the losers will be not just those threatened by him, but the authority and standing of the UN itself.
The agreement refers to the desire of the Iraqi Government for the lifting of sanctions. No timetable is set for this. The sanctions have always been there for a reason: to ensure full compliance of Iraq with the relevant Security Council resolutions. Once that is achieved, the issue of lifting sanctions can be properly addressed.
Let me also deal with one false assertion often made by the Iraqi regime. It has never been our intention to undermine Iraq's territorial integrity, or its security, or the dignity of the Iraqi people. The issue has always been to ensure that there are no weapons of mass destruction left in Saddam Hussein's arsenal. The agreement repeats that and makes it clear.
However, while the agreement signed in Baghdad is welcome, it is not in itself enough. A piece of paper signed by the Iraqi regime plainly cannot be enough. The Saddam Hussein we face today is the same Saddam Hussein we faced yesterday. He has not changed. He remains an evil, brutal dictator. The only thing that has changed is that he has changed his mind in the face of effective diplomacy and firm willingness to use force. Nothing else would or could have brought about this success. Nothing else will ensure that it is followed up by satisfactory implementation on the ground and the total elimination of his capacity to obtain or produce weapons of mass destruction.
We will not tolerate any repetition of the Iraqi behaviour that has led to this agreement. We are not going to play more elaborate diplomatic games that allow Saddam Hussein to thwart the inspections regime that has now been agreed.
That is why there are now two essential requirements in the coming days. First, we need to embody the agreement in a new Security Council resolution. This must make it clear that any further prevarication or obstruction by Saddam Hussein of the smooth operation of the inspections, in accordance with previous Security Council resolutions and the latest agreement, will not be accepted by any member of the Security Council and will inescapably be followed by the most severe consequences for the Iraqi regime.
Secondly, the implementation of the agreement must be tested soon. That will require inspections by UNSCOM without any Iraqi obstruction, whenever and wherever it wishes to inspect. There will be no immediate change in the readiness of British or US armed forces in the Gulf until that is clear.
Throughout the dispute, our aim has been a peaceful, diplomatic settlement. There was no desire on either side of the Atlantic to use force, but it was also clear to us throughout that Saddam Hussein only understands and respects force. Those who have criticised us and the Americans for our willingness to use force in the last resort have to explain how such an attitude could have recovered Kuwait in 1990, or could ensure Saddam's compliance now. I do not believe that they can convincingly do so. As Kofi Annan said in Baghdad:
Our task now is to do everything we can to ensure that the agreement reached by Kofi Annan is smoothly, effectively and rapidly implemented. We played a key diplomatic role in the negotiations leading up to his mission and we will continue to play the same role in the follow-up. I have already discussed this with Presidents Clinton, Yeltsin and Chirac in the past 24 hours, and my right hon. Friend the Foreign Secretary is in close touch with his counterparts. We are all agreed on the need for a rapid and clear Security Council resolution to ensure that we cannot find ourselves in the same position again in the future. That will be the main focus of our immediate efforts.
I have made it clear that when Saddam Hussein has complied fully with the Security Council resolutions, the UN inspectors have completed the disarmament stage of their work and the threat from his weapons of mass destruction has gone, we can consider the lifting of sanctions. Indeed, if Saddam had not blocked the implementation of UNSCOM's work so systematically, that could have happened long ago. The long-suffering Iraqi people deserve our sympathy and our help--our quarrel was never, and is not, with them.
"You can achieve much by diplomacy, but you can achieve a lot more when diplomacy is backed by firmness and force".
I would put it this way: with Saddam, diplomacy plus force equals success.
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