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Lord Thurlow: I too strongly support the intention behind the amendment. None of those who listened to the exposition of the noble Lord, Lord Alderdice, could fail to be moved by the urgency of taking the necessary steps where there is a risk of a young person finding himself in a ward with someone who might assault him.
I speak with some experience. One of my sons, as a youth and severely schizophrenic, was in and out of big hospitals. He had a great deal of excellent care and I cannot say, in retrospect, that in any of the hospitals he attended there seemed to be any danger of the risks we are discussing today. But that does not mean to say that conditions have not changed on account of the problems of concentration to which the noble Lord, Lord Alderdice, referred.
I do not see that there is any reason why the necessary action cannot be taken by the health authorities, with or without--I hope with--the necessary stimulus from the
Department of Health and without further primary legislation. Within the framework of the existing Act there is no reason why, if resources are available and if the will exists, this kind of segregation cannot be made when necessary. I repeat that I have some qualification about the generalisation. I know from experience that a young person can be in a secure ward without being in that sort of danger. However, I am sure that there are many situations where there is a crying need for rectification and for urgent action.
Baroness Ramsay of Cartvale: The Department of Health policy for child and adolescent mental health services is outlined in A handbook on child and adolescent mental health published in 1995. It stresses the importance of developing comprehensive services that span those within primary care through to specialist in-patient settings. A programme of work to implement policy is under way with the lead being taken by the regional offices of the National Health Service Executive.
The Government recommend that young people requiring in-patient mental health care should have access to facilities that are both age appropriate and able to meet their needs effectively. We do not underestimate the problems which the noble Lord, Lord Alderdice, so expertly put before us and which the noble Lord, Lord Thurlow, expressed from his unequalled personal experience. Young people with mental health needs are treated in a range of settings. It is recognised that, on occasions, particularly in the acute phases of illness, adult psychiatric wards are sometimes required for admission and this may not always be desirable. We would agree with what the noble Lord, Lord Alderdice, had to say on that subject. Young people, however, vary in maturity and degree of independence. The amendment is imprecise, leaving open the definition of "young". Sometimes it will be the psychiatric care required, rather than the chronological age, that will be the determining factor for where best a young person is treated. The amendment, which places a duty on health authorities, will limit flexibility. As the noble Lord, Lord Thurlow, so precisely said, in principle, if conditions are right--I do not want to paraphrase the noble Lord--there is nothing that could be objected to in what has been said by noble Lords. However, the amendment places a very precise duty on health authorities and would limit their flexibility.
In recognition of the genuine concern over access to in-patient facilities and the possible need for further guidance, the Department of Health is shortly to commission a national study. It will undertake a needs-based assessment of current in-patient provision, the alternatives that exist, the pathways of care for young people, and an analysis of current and future requirements. This will inform policy and service developments and enable planning into the next century to take place on a rational basis. I hope I am going some way to reassure the noble Lord, Lord Alderdice, and others that progress in this area does not depend on and hang entirely on legislation either being changed or being introduced.
The noble Lord, Lord Swinfen, asked a specific question about the Bill. I think that his question is more correctly addressed to the noble Lord, Lord Rowallan, whose Bill this is.
The amendment cannot be supported as to enshrine this duty in legislation will impose unrealistic burdens on health authorities in the immediate future, will reduce flexibility in service provision for young people, and may lead to inappropriate service developments. Those would be better planned after an assessment of the national situation has taken place. We cannot support the amendment.
Lord Alderdice: Before the noble Baroness sits down, perhaps I may welcome strongly the undertaking she has given and the nature of the study. When she speaks of a national study, may I have reassurance that that applies to England and Wales, Scotland and Northern Ireland--to the whole of the United Kingdom?
Baroness Ramsay of Cartvale: I shall tell the noble Lord what I think and then write to him if I have to correct myself. I would imagine that this applies to England and Wales. I cannot think that it would apply to Scotland or to Northern Ireland. However, if I am wrong about that, I shall certainly make that clear to all noble Lords.
Lord Alderdice: When we talk about a national health service we assume that it extends to the whole of the United Kingdom. However, the noble Baroness says that a national survey on a matter of this importance would apply only to England and Wales. I very much hope that the answer she has given is either not entirely correct or is one that can perhaps be reviewed.
Baroness Ramsay of Cartvale: As a Scot, I do not want to get into too much detail on this matter. As the noble Lord will know, at the present time health in Scotland is dealt with by the Scottish Office and in the very near future it will be dealt with by the Scottish parliament.
Lord Rowallan: Existing child and adolescent services cater for elective planned admissions and cannot cater for emergency admissions. Every acute psychiatric admission unit is periodically required to admit children because there is no alternative for them. On a ward at Homerton Hospital, which I recently visited, a 13 year-old girl was admitted, mute but aggressive, following a serious sexual assault by her step-father, which I am afraid happens all too often. Nowhere else could or would take her. During her admission she was given illicit drugs by other patients and was herself subjected to sexual harassment and assault. That is disgraceful and should not be allowed to happen. It is small wonder that the professionals involved do not wish to carry on maintaining and working in such a service if we allow that sort of thing to happen. We cannot sit back and allow this to go on. How many more 13 year-olds or 14 year-olds have to be seriously harassed and abused in mental health hospitals, where they are supposed to be receiving treatment, before we do something? I beg to move.
On Question, amendment agreed to.
Clause 2, as amended, agreed to.
House resumed: Bill reported with amendments.
Government of Wales Bill
Brought from the Commons; read a first time, and to be printed.
Business Improvement Districts Bill [H.L.]
11.59 a.m.
Clause 1 [Business Improvement District (Election) Orders]:
Lord Jenkin of Roding moved Amendment No. 1:
The noble Lord said: My Lords, in moving this amendment it may be for the convenience of the House if I speak to Amendment No. 23. I hope that the House will bear with me for a moment if I follow the example of the noble Baroness, Lady Farrington, at Committee stage when she craved the indulgence of the House to make a general point near the beginning of that stage (Hansard, 27/2/98; col. 886.). After some introductory remarks, she made two specific points and I wish to refer to one of them. At col. 887 she said,
At the time I questioned that statement. Since then I have had the advantage of advice from some financial experts in this country. I have been able to study the European system of accounts to which the noble Baroness referred on that occasion. But perhaps most important, I have had the advantage of a meeting with the noble Baroness, for which I am immensely grateful. She was accompanied by a formidable group of officials not only from the DTI, but from the Treasury and from the Office of National Statistics.
I believe that it would be fair to say that we did not attempt to resolve the issue as to whether a charge under this Bill is a tax and the spending of it would count as public expenditure. But I believe that we reached an understanding that, first, it would be right to proceed with the remaining stages of the Bill in this House (and we are here today to deal with the Report stage), secondly, that it would be for another place to take account of the argument perhaps by requiring a privilege Motion to be moved in the ordinary way; thirdly, that if expenditure by a BID company is indeed public expenditure that still leaves open the question as to whether it should be treated as part of what is called in the jargon "the control total"; and, fourthly, and perhaps most important of all, the Government's forthcoming consultation paper on the local government financial system, which we were told will include options for business rates, will certainly be germane and may well be directly relevant to the issue. So I do not intend to say any more about it at this stage, but to follow the understanding that the noble Baroness and I reached that we should proceed with the Bill.
I move straightaway to Amendment No. 1. A number of points were raised during Committee stage, many of which we have tried to meet with the amendments which I have tabled. The purpose of this amendment is to ensure that a local authority may make an election order where the area concerned is within its boundaries or outside those boundaries; where the authority is acting on behalf of another local authority; or--and this is the substantive change made by the amendment--where the authorities are acting jointly through, for example, a joint committee. That arrangement may be appropriate in some cases where, for example, there is a substantial area in two or more local authority areas and none of them wish to release the task of processing the business improvement district's application to the other. The amendment is intended to cater for the joint arrangements in such cases.
The new subsection retains the requirement that the applicant for an election order must be a ratepayer of the hereditament in the area in which the BID is being proposed. Since Committee stage I have had the advantage of visiting one or two areas which I was told would be wholly applicable to this Bill. I have heard of others. I believe that at Second Reading I mentioned the Park Royal estate in West London which is within the area of three different local authorities. So the amendment is intended to deal with a point that was raised. I beg to move.
Page 1, line 10, leave out subsection (2) and insert--
("(2) Subject to subsection (3) below, a local authority may make an election order for any area--
(a) which is wholly comprised within the area of the authority, and constitutes the whole or part of the area in which the establishment of a business improvement district is proposed; or
(b) in relation to which the authority are discharging the functions of another local authority as respects the establishment of a business improvement district.
(3) The applicant for an election order must be a ratepayer in respect of a hereditament within the area for which the election order is proposed.").
"It is clear that under the provisions of the Bill, businesses in an area will have to pay a certain amount if there has been a local vote to that effect. Although individual businesses will have the opportunity to vote, they will not have a choice on payment of the charge if the decision is taken to implement the draft scheme. As I am sure the Committee will recognise, this is exactly analogous to the taxation system in any democratic country. We can influence the level of income tax via the ballot, but there is no choice on whether or not to pay. This is, by definition, a tax and spending of the income received would count as public expenditure".
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