Baroness Masham of Ilton: My Lords, I thank the Minister for that reply. However, is she aware of the great concern arising from the fact that regional health authorities are shortly to go? Is she further aware that districts feel that some of the prisoners are from far and wide and not from their own districts? Will she please look at Onley young offenders' institution which has had its HIV and AIDS programme cut in the middle because of this development?
Baroness Cumberlege: My Lords, if a service has already been discontinued, that has nothing to do with the re-organisation because that has not yet taken place and is subject to legislation, not least in your Lordships' House. With regard to the future arrangements, I anticipate that when regions go health authorities will form consortia, or at least appoint a lead authority to act for the others.
Lord Ennals: My Lords, does the Minister agree that the noble Baroness has raised a very important question? Will she confirm that for many prisoners the only allocated resources for HIV prevention work are the ring-fenced moneys to which she has referred? Is she aware that in many cases health authorities have not made allocations to prisons, that prisons have not sought the funding available, and that therefore the HIV prevention work is not being undertaken in some prisons?
Baroness Cumberlege: My Lords, HIV prevention co-ordinators work with the prison and probation service. That is a good arrangement because prisoners, it is to be hoped, leave prison and therefore need continuing advice and in some cases care and treatment. The Directorate of Health Care, which used to be the Prison Medical Service, does on occasions also get involved when it feels that it is necessary.
Baroness David: My Lords, does the education service in prisons have no input into this area, as indeed it did in schools through its science programmes? I am rather mystified that the education service should not be involved in any way.
Baroness Cumberlege: My Lords, the education service is involved. Schools, too, still have instruction and advice, not particularly in the science curriculum but in the general values and moral context.
Baroness Hilton of Eggardon: My Lords, I am also mystified that the Prison Medical Service is involved only occasionally in this matter. Surely it is a matter in which it should be taking a lead and advising prison governors. Is the Minister content with the rather limited role played by the Prison Medical Service in this respect?
Baroness Cumberlege: My Lords, HIV prevention co-ordinators are specifically trained for this task and have great expertise in the field. It is appropriate that they should be involved. But as I said, where the Directorate of Health Carethe former Prison Medical Servicewants to be involved, there is nothing to stop it.
Earl Jellicoe: My Lords, perhaps I may assure my noble friend the Minister that this matter is of general concern, and not only of concern to one party in your Lordships' House. The incidence and prevention of HIV infection in prisons is a very serious matter indeed, as I know from a good deal of experience. I therefore ask my noble friend to keep a very close eye on this matter.
Baroness Cumberlege: My Lords, I pay tribute to my noble friend Lord Jellicoe for the interest he has taken in this specific subject, especially with regard to the insurance industry. The Department of Health keeps a very close eye on AIDS and HIV countrywide.
Baroness Mallalieu: My Lords, given that in many, if not most, prisons drugs seem to be almost as freely available as they are in many of our big towns and cities, which I believe the Minister recognises, is any joint approach planned between the Home Office and the Ministry of Health about giving guidance to prison governors? Does the Minister agree that they may wish to see the distribution of clean needles and some means permitted of sterilising them within their prisons rather
Baroness Cumberlege: My Lords, it is essential that all the professions involved should work closely together. We encourage that. In February we issued guidance to ensure that that happens. As regards prisons specifically, we have undertaken a survey of three London prisons to see what the prevalence is and also to discover what action is being taken. We are expecting the results of that survey early in 1995.
Baroness Jay of Paddington: My Lords, is the Minister aware, following the questions of my noble friends and the support given by the noble Earl, that there is considerable confusion about precisely who is responsible for this work in prisons? I have spoken recently to the governor of one of the major London prisons who is undertaking a great deal of work in this area. He is concerned that when the regional health authorities go difficulty will arise about who should support him. He is also concerned that the lowering of grants to some of the voluntary agencies has reduced their ability to help with work in prisons on this very important subject.
Baroness Cumberlege: My Lords, we are increasing funds for local authorities and health authorities for prevention work on HIV and AIDS. I am concerned if there is confusion in the prison service. That is not the information which I had. I have been told that in Trent, Yorkshire, South Thames, Leicestershire, Staffordshire, Avon and the West Midlands, there are some very good examples of the excellent work which is taking place, not least by the chaplain at Parkhurst. Chaplains have a crucial part to play in this matter.
Baroness Jay of Paddington: My Lords, I would not want the Minister to believe that the work being undertaken in the prison which I mentioned is in any way under par; the work is very good. I was simply repeating the expressed confusion of the governor about where and how he will be able to draw resources for this work in future.
Baroness Cumberlege: My Lords, as I said in response to the noble Baroness, Lady Masham, this matter will arise when we are considering the Bill that will come before this House. However, there are clearly ways forward, including a consortia of health authorities taking on the responsibility for others.
Baroness Masham of Ilton: My Lords, when the Minister is looking into these new procedures will she see that all governors throughout the country receive clear guidelines, because this matter is so important? Will the Minister also ensure that the governors know that money is available? This Government have been generous as regards HIV and AIDS prevention and we want that to continue.
The Parliamentary Under-Secretary of State, Department of Transport (Viscount Goschen): My Lords, the concerns expressed by the British Air Line Pilots Association were passed on to the Civil Aviation Authority who is responsible for aviation safety in the UK. The Joint Aviation Authorities and the UK CAA consulted widely on the draft proposal and the views of pilots and operators have been taken into account. There will be no reduction in safety standards.
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