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Mr. Forth: The Minister's analysis is very helpful to the House, not only today but when we consider the measures to be introduced in the future. Will he comment on clause 9, which puzzles me and, I suspect, might puzzle the Minister as well? Clause 9(1)(a) states that the director of a company must

in a way that

I wonder whether the phrase

has a particular legal meaning. Does it, in other words, mean the shareholders? Or does the term "members" encompass shareholders, employees, directors and anyone else we can think of? Language such as that strikes me as somewhat problematic in the drafting, if not in the philosophy behind the Bill.

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Mr. O'Brien: The right hon. Gentleman makes a reasonable point. We must be clear, when we are placing a duty on the directors of a company, precisely to whom they owe that duty. Clarity in the law is essential, because if directors have a duty in law that is only vaguely set out, they could well find themselves being challenged in court over the precise consultations and circumstances that they took into account when making a particular decision. We might think that that is very unlikely, but if a large number of jobs were at stake in a community, it would not be. In such circumstances, the directors of a company could well find that the trade unions would, in many ways justifiably, see an opportunity to protect the interests of their members or of the wider community.

It is therefore important that the wording of a Bill should be clear. Normally, the members of a company are regarded as the shareholders. That is the position in company law. The way in which the legislation is presumably set out here would therefore involve that definition, if it is using the normal description used by company lawyers. I cannot, however, see a separate definition of that term in the Bill. If I remember my company law well—it is now some years since I practised it—it is set out in the Companies Act 1948, but it could have been regularly superseded since then.

We need a view of the responsibilities of directors that shows that they have regard for enlightened shareholder value. That means that the basic goal for a director is to do what he judges to be in the best collective interest of the shareholders. Crucially, in deciding this, he must take into account all the material factors that he can practically identify in the particular circumstances of that decision. What are those material factors? Clearly, a director must take account of the relevant short and long-term consequences of any decision, but there is much more involved. A director must also take account of all the other factors that a person of care and skill would regard as relevant. Depending on the decision, this could, for example, include relationships with trade unions, employees, customers and suppliers, the company's reputation, and its social and environmental impact on the community and the working environment. That is presumably what clause 9(1)(a) and (b) are about.

My hon. Friend referred in his speech to the changes that he had made to our proposals. At first sight, the addition of subsection (1)(c) to clause 9 might appear a mere technicality. As I have just said, I agree with my hon. Friend that, wherever it is relevant, directors should take into account the impact of the company's operations on the communities that it affects and on the environment. Indeed, the House will see that that is set out in subsection (3)(b). Repeating it in subsection (1)(c), however, makes a fundamental change, making the duties pluralist. As I have explained, that is not the practical way forward. It may be only two dozen words, and they may appear a little technical—

Madam Deputy Speaker: Order.

Debate to be resumed on Friday 26 March.

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Remaining Private Members' Bills


Order for Second Reading read.—[Queen's Consent, on behalf of the Crown, signified.]

Hon. Members: Object.

Debate to be deferred till Friday 27 February.


Order for Second Reading read.—[Queen's Consent, on behalf of the Crown, signified.]

Hon. Members: Object.

Debate to be deferred till Friday 27 February.

30 Jan 2004 : Column 504

Bedwetting and Continence Services

Motion made, and Question proposed, That this House do now adjourn.—[Ms Prentice.]

2.31 pm

Dr. Jenny Tonge (Richmond Park) (LD): This may seem a strange topic on which to end the week, but I assure you, Madam Deputy Speaker, that it is important.

When I was preparing for the children's Bill in my former life, I read the Victoria Climbié inquiry report—Victoria Climbié was born in the Ivory Coast in 1991 and died in this country in 1998. It is harrowing reading, as I am sure the Minister knows. I was approached by a voluntary organisation called ERIC—the Enuresis Resource and Information Centre—which was concerned about the Victoria Climbié report, as I was, and wanted me to raise in this House the question of incontinence services. As I had some experience of the matter when I was in medical practice, I thought it appropriate to do so.

In the UK, about 750,000 children over the age of five wet or soil themselves. It causes great distress to children and parents alike, yet some children simply cannot grow out of it. They need proper, sympathetic treatment to avoid child abuse, in some cases, and bullying at school. Bedwetting—or nocturnal enuresis, to use the medical term—affects half a million children between five and 16 years old—yes, as old as 16. Daytime wetting affects a smaller number—120,000 children—and more than 100,000 children in the same age group, five to 16, experience soiling problems. The cause is often physical. It can be caused by a lack of control between the bladder and the brain—an overactive bladder, as it is commonly described—or can be due to a lack of a hormone called vasopressin, which suppresses urine production at night. It can also be due to serious or minor kidney and bladder disease, which is often undiagnosed. Soiling is often due to constipation, which is itself caused by poor diet. We have heard a lot about poor diets in recent weeks, and low fluid intake in many children is an increasing worry.

Children who have had disturbing events in their lives, such as bereavements, removal from home or school trauma can also develop these problems, and any further trauma or punishment makes matters worse, so it becomes a vicious circle. It causes acute embarrassment and stress; those affected feel isolated, different and guilty, terrified of being found out by other children, and they become socially excluded and terrified of the usual childhood treats, which my children all enjoyed, such as school trips or sleepovers in their friends' houses.

The consequences for family life and for the child affected can be dire. Most parents and carers are patient and concerned, but others—especially if they have social or partner problems, or live in very cramped accommodation—punish their children, thus starting the vicious circle of increased stress, more bedwetting and worse punishment. It can lead to child abuse.

That was what led me to bring the problem to the attention of the House. When reading the Victoria Climbié inquiry report, I tried and tried to understand why that tragic little girl had died such an agonising death after months of torture, in this country. She had been given no attention, no love, no affection.

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A major trigger in Victoria's terrible abuse and death was bedwetting. It started, presumably, when she was given to an aunt to be brought to Europe and start a better life, far from her family on the Cote d'Ivoire. I want to refer to the inquiry, because I feel that this child should be remembered.

Victoria was bedwetting, which was a great nuisance to her aunt and her aunt's boy friend. She was taken to a local church. The priest was told about her incontinence, and

and she was made to spend her nights in the bathroom of the couple's flat. This child was seven years old.

When Victoria was in the bathroom,


so she lay

in the cold. Her hands were "bound with masking tape", and she was

by her aunt and her aunt's boy friend.

I am sorry to have subjected the House to that, but it started with bedwetting, which is why I wanted Members to concentrate on the subject, if only for half an hour. If only someone had intervened and saved Victoria. That is why the subject is so important.

I have tried to quantify the costs to family and society. A bedwetting child probably costs a family more than £1,000 a year in extra washing, bedding, nightclothes and disposable nappies. A child who soils is even more of a problem. A child with both problems—and perhaps other special needs, for children with special needs often suffer from these problems—costs parents far more than that. Sadly, many parents are still not taken seriously by some doctors, who are much too busy to investigate further, and simply say "Do not worry, they will grow out of it". However, parents of a child living in an area with a proper incontinence service will receive full advice, guidance, treatment and follow-up enabling them to manage the problem. There are many products on the market that can help, apart from advice.

I know of only one voluntary organisation that gives advice and guidance, and that is ERIC, the aforementioned Enuresis Resource and Information Centre. It has its own website and a telephone advice centre. It knows which primary care trusts have catered for the problem, but it is of course chronically underfunded.

There are 814 primary care NHS treatment centres for the problem in the UK, with 50 per cent. treating bedwetting and daytime wetting and a lower percentage dealing with soiling; and 63 per cent. of the clinics are nurse led, as they should be. The cost of treatment is

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minimal and the impact on families and children could save huge sums of money for the NHS in the longer term.

We can also use existing personnel to set up an effective paediatric continence service. That is perfectly feasible; I have seen it done in my professional life. Before the Minister tells me that the Liberal Democrats are calling for yet another spending commitment, I am not. Existing staff can do it at no extra cost. I can assure him of that and, if he wants to see it done, I shall take him somewhere and show him.

Links can be forged with schools and other professions allied to medicine, which would hugely help to develop the whole network that we want to build up to prevent child abuse. It would mean a broader network, with more people talking and looking after one child. All primary care trusts should surely be asked to provide that service for GPs in the area. If health visitors are being devolved to GP surgeries, there is no reason why one of them should not train for and run a continence clinic for several practices in the trust.

The children's national service framework should surely include clear standards for paediatric continence and urge every primary care trust to provide access for a proper integrated paediatric continence service. I plead with the Minister to consider the issue very seriously in order to prevent the suffering—and often the tragedy—that the problem can cause.

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