Previous SectionIndexHome Page


Mr. Hoon: My hon. Friend is a distinguished former Whip, and has written about these matters. He understands how they work rather better than I do. I cannot give him any idea of a likely date for legislation, not least because we have embarked on an extensive programme of consultation, and we need to see the results before we can decide whether legislation is necessary.

Mr. John Greenway (Ryedale): A few years ago in the House, I successfully sponsored a change in the criminal procedure affecting those who are mentally disordered and who come before the courts. I welcome the Minister's statement about the need to extend that arrangement to deal with people with mental incapacity. Does he agree that it would be a tragedy if the reporting of his statement led to its being seen purely in terms of a statement about euthanasia?

Day after day, tens of thousands of people in this country--some voluntarily and some professionally--care for those with mental incapacity. The Minister is ensuring a proper code of practice, proper guidelines and a proper framework within which decisions about those people can be properly taken. Can he assure the House that if, as a result of his consultation, a change in the law is seen to be necessary, he will speedily introduce the necessary legislation?

Mr. Hoon: I am extremely grateful to the hon. Gentleman for his support and I pay tribute to his work in this area. I have taken great pains to distinguish the problems of mental incapacity from the issue of euthanasia and I am grateful to the hon. Gentleman for his forceful observation. I hope that the result of the

10 Dec 1997 : Column 1020

consultation will allow us to clarify the law in this area. Clearly, we must await responses to the wide variety of questions in the Green Paper.

Mr. Gerald Bermingham (St. Helens, South): The Minister's statement is welcome and covers a considerable number of fields. I suspect that Law Commission reports and other evidence that will result from the consultation will spawn not one Bill but a number of them to deal with separate areas. If that occurs and such legislation is needed, for example, for the protection of carers and people with mental incapacity problems, if I may put it that way, does he agree that such Bills ought to be dealt with by way of a Special Standing Committee whose examination would precede debate in the House?

Mr. Hoon: I am grateful to my hon. Friend for his suggestions, but, having said it is important to await the results of the consultation before deciding whether a single Bill is necessary, I am in no better position to suggest that a number of Bills might be necessary. My hon. Friend's final observation shows the importance of ensuring that whatever the Government's proposals, they have the widespread support of the House and the wider population. This is a hugely delicate and sensitive area and we shall move forward only when we feel that there is widespread confidence in our decisions.

Mr. Nicholas Winterton (Macclesfield): As a Member who is totally opposed to euthanasia in any situation, I am grateful to the Minister for his considered and detailed statement and for saying that the Government are totally opposed to euthanasia in any situation. However, he was less than frank about living wills or advance statements. Does he not accept that there are problems in this area, particularly when life-saving treatments may be developed after a person has made such an advance statement? He needs to look at that area with particular care, and so does the House.

Mr. Hoon: There is no need to repeat my and the Government's opposition to euthanasia. I share the hon. Gentleman's views. I recognise, and said as much in the statement, that there are difficulties about advance statements. That is why there is to be such extensive consultation. I specifically made the point about changes in medical technology. After all, such changes are responsible for many of these problems arising. Therefore, it is important to take account of the hon. Gentleman's point as we consult on these proposals.

Mr. David Hinchliffe (Wakefield): I welcome the Minister's statement, because the present law leaves many people wide open to exploitation and abuse. I hope that the steps that he has outlined will address that.

I should like to press the Minister on two issues. First, directly because of Government community care policy, a significant number of vulnerable people who live in the community may previously have been in various kinds of institutional care. Has the Minister, in conjunction with his colleagues in the Department of Health, looked at the possibility of updating the guardianship regulations, which date back to, I think, 1959, to bring them into line with the current situation? Secondly, bearing in mind the fact that, through the privatisation of community care, more and more vulnerable people are in the care of private

10 Dec 1997 : Column 1021

businesses, has he had the opportunity to look at supervising the financial circumstances of people who are in private care homes? I cast no aspersions on the many private care homes that offer very good care, but sometimes things have gone badly wrong.

Mr. Hoon: I am grateful to my hon. Friend for his considered observations. Guardianship regulations are not the direct responsibility of my Department, but my hon. Friend the Under-Secretary of State for Health, who is responsible for such matters, will have heard his comments, and I am sure that he will give them appropriate and careful consideration.

I realise that there are concerns about the circumstances in community homes, which must be investigated from time to time. The Green Paper contains a proposal to give social services enhanced powers to investigate the circumstances in which people, especially the elderly, are kept. I should be grateful if, in due course, my hon. Friend would write to the Department expressing his concerns in greater detail, so that his views can inform our decision making in this area.

Miss Ann Widdecombe (Maidstone and The Weald): I am grateful to the hon. Gentleman for his considered exposition of this matter and for his consultation document. The gratitude that I felt when he announced unequivocal opposition to euthanasia was somewhat attenuated when he announced an exploration of living wills and the extension of enduring power of attorney to cover health decisions. Those two measures added together make me uneasy.

The Minister made a comparison between people who are of sound mind, who make a decision whether they will accept medical treatment, and people who are not of sound mind and have made that decision in advance. There is a huge difference. People who decide to consent to or refuse treatment have a specific medical problem of which they are fully aware, and the specific medical treatment and possible outcomes have been explained to them--it is a very specific decision--whereas a living will, by definition, is vastly more general and cannot cover that.

What would happen if two people were in hospital beds side by side, one of whom had made a living will and one of whom had not? A different law would apply to each of them.

Mr. Hoon: I am grateful for the right hon. Member's support for the considered view that I set out. The nature of the problems makes it necessary to examine whether there is an argument for legislation on advance statements or for reforming existing powers of attorney. Examining the problem in a considered way allows us to discuss possible legislative solutions. I take on board her point about comparing specific indications with the more general instructions that may be contained in an advance statement. It is important for treatment to reflect the needs and concerns of the individual.

The right hon. Lady's example of two patients side by side in a hospital ward does not necessarily cause me any difficulty. It is right for the doctors or authorities to take account of the specific indications of one patient, whereas

10 Dec 1997 : Column 1022

the general intentions of the other patient are a matter of interpretation. That causes no difficulty, because a different approach can be taken according to an individual's particular circumstances. What runs through the Green Paper above all else is our absolute commitment to seeking to give effect to the intentions of an individual. I am sure that the right hon. Member and I agree on that.

Mr. Andrew Dismore (Hendon): I welcome my hon. Friend's comments. The Court of Protection has been doing a very good job with personal injury and accident victims, and I am pleased that we are considering extending its role. Equally, however, it does not come cheap, and there have been arguments in personal injury claims about who is responsible for Court of Protection costs. If there is to be a review, and if it is to go wider and potentially increase legal costs, will he assure the House that the costs of pursuing civil justice will be taken into account in the review, and, specifically, that costs will not be passed on to accident victims?

Mr. Hoon: I am aware of the concern about costs. Anxiety about extending the court's jurisdiction to cover issues of personal welfare, health, property and finance is addressed in the Green Paper. It is important that sufficient resources are available to ensure that decisions can be made in those more sensitive areas, and we are consulting on the matter. I am grateful for my hon. Friend's observations. I think that it is important, however, that we try to establish a single court jurisdiction, not only to cover questions of property and finance but to deal with the wider range of issues affecting particularly the elderly.


Next Section

IndexHome Page