The Lord Chancellor (Lord Mackay of Clashfern): My Lords, before the commencement of business, I take the opportunity to inform the House that I am to formally open the magistrates' court at Bromley on Friday, 1st March. Accordingly, I trust that the House will agree to grant me leave of absence for Friday, 1st March.
The Minister of State, Home Office (Baroness Blatch): My Lords, the report of the inter-departmental group of officials has been received by Ministers and is at present under consideration by my right honourable friend the Home Secretary and his colleagues. The issues are complex, but we hope that it will now be possible to reach final decisions and announce the conclusions of the review as soon as possible.
Lord Ackner: My Lords, I thank the noble Baroness for her Answer, though not quite with the degree of intense gratitude that I had anticipated. Will the noble Baroness confirm--perhaps I should have said "re-confirm" because she confirmed it on 24th October when I last raised the matter--first, that the inquiry was set up as a result of the unease experienced by the public in regard to the verdict of murder brought in against Trooper Clegg; secondly, the purpose of the inquiry was to decide on the merits of reducing from murder to manslaughter in those cases where excessive force was used in self-defence or in upholding the law; thirdly, recommendations that that should occur had been provided by the Criminal Law Revision Committee 16 years ago, by your Lordships' own Select Committee seven years ago, by the Law Commissioner in adopting it in the draft code six years ago, by the Court of Appeal
Baroness Blatch: My Lords, I have given one reason and I believe that the noble and learned Lord hints at it; namely, that it is a complex and sensitive issue about which there are different opinions. The noble and learned Lord was absolutely right when he stated the reason for setting up the review. The review itself relates to the use of lethal force in self-defence or in the prevention of crime. The review focuses on the use of lethal force in the maintenance of law and order, including the use of the yellow card. I believe that the noble and learned Lord knows that the regulations about the yellow card are also being reviewed as part of this exercise. I can also say that the review did not consider the mandatory life sentence or the law of provocation. All the references made by the noble and learned Lord are being taken into account in coming to a conclusion.
Baroness Blatch: My Lords, I cannot give an absolute guarantee about that at the moment. What I can say is that the Government will come to Parliament with their conclusions and they may include the report or a summary of the report. I note the noble Lord's concern.
Lord Campbell of Alloway: My Lords, I was a member of the Select Committee. Whether or not the conclusions are published--I suppose that they will have to be--can my noble friend say that they will be considered in this House before any decision is taken to implement them?
Lord Harris of Greenwich: My Lords, we have already been waiting for a substantial period for the report of this review. Why cannot the noble Baroness tell the House that it will at least be published? The Government constantly say that they are in favour of open government. Why cannot they give some demonstration of their enthusiasm for that by publishing this review?
Baroness Blatch: My Lords, I am in a difficulty to say what information my right honourable friend will bring forward when he comes to his conclusions. It is highly likely that the information that he received and what he took into account in coming to a conclusion will in fact be made available to the House, but I am not able to say at this moment what form that will take.
The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege): My Lords, my right honourable friend the Secretary of State for Health has met a number of individuals and groups in recent months and has listened carefully to their views and concerns about the future of St. Bartholomew's Hospital. He has made clear that he will not be re-opening decisions, announced in April 1995, on the provision of hospital services in east London.
Lord Molloy: My Lords, I thank the Minister for that Answer. Has a response been submitted to the report of the King's Fund Institute, which stated, "Keep Bart's open"? It also stated that, in addition, two smaller specialist units should be created near that great hospital which would be for the benefit not merely of Londoners but all the citizens of our country.
Baroness Cumberlege: My Lords, the Secretary of State has met a number of groups recently. All have drawn his attention to the recommendations of the King's Fund Report on the future of the Bart's site. We have serious reservations about the report. It does not look at the wider context of population needs in east London. It starts from the premise, "Here we have a site. What can we put on it?". It does not take into account the other services which are provided at University College Hospital, London, the Royal London and the Guy's and St. Thomas's sites. It does not even take into account the fact that medical schools have merged. The report itself states that it has not fully costed all the options. Indeed, it endorses many of the conclusions of the Royal Hospitals Trust's own business case for change.
Lord Boyd-Carpenter: My Lords, is my noble friend aware that many of us would regard it as tragic if this famous ancient and historic hospital were to be closed and can see no justification whatever for doing so? Will the Government reconsider the matter?
Baroness Cumberlege: My Lords, it is people, rather than buildings, who contribute towards the special ethos mentioned by my noble friend. For years and years--indeed for centuries--people have looked at the health needs of Londoners. We know that they are not being met by the present state of the hospitals; by the way that they were planned haphazardly--indeed, hardly planned at all. Therefore, there is no question of revisiting these decisions. I am absolutely convinced that by bringing together the two great hospitals--the Royal London and St. Bartholomew's--we shall have a much stronger
Baroness Gardner of Parkes: My Lords, will my noble friend comment on the plan to open an 8 a.m. to 8 p.m. service at the hospital, which will cover the period when most commuters might require medical attention in the City of London?
Baroness Cumberlege: My Lords, a minor injuries unit has already been established at St. Bartholomew's Hospital. I visited it on Friday and saw that it was being very well used. It is meeting the need that we thought it would. Of course, there are accident and emergency departments within a two-mile radius of the previous catchment area.
Baroness Jeger: My Lords, why does the Minister refer to local needs as regards Bart's, as though it were a village cottage hospital? Is she not aware that when one visits Bart's one finds patients not only from all over this country but from other countries too and that it has a representation far beyond Shoreditch and Mile End? Has that been taken into sufficient account?
Baroness Cumberlege: My Lords, yes, it has. No capital in the world can sustain 11 teaching hospitals within a six-mile radius. We have been most anxious that the United Kingdom should retain its reputation as a centre of excellence in medical education, treatment and services. We know that if one fractures the services and has specialties in so many different places-- 13 cancer units, 14 cardiac units and so forth--one cannot retain the essential excellence that is required and is achieved by bringing the various specialties together. It is because we care about the leading position that this country has in the world, and because we care about the people of London, that we have had to take some very hard decisions.
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