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House of Lords

Tuesday, 21st April 1998.

The House met at half-past two of the clock: The LORD CHANCELLOR on the Woolsack.

Prayers--Read by the Lord Bishop of Bath and Wells.

Baltic States: Democratic Institutions

The Earl of Carlisle asked Her Majesty's Government:

    What measures they are taking, following the President of Estonia's visit to the United Kingdom in February, to strengthen the democratic institutions of the Republics of Estonia, Latvia and Lithuania.

The Parliamentary Under-Secretary of State, Foreign and Commonwealth Office (Baroness Symons of Vernham Dean): My Lords, the United Kingdom has been a strong supporter of the Baltic states' democratic development since they regained their independence in 1991. Democratic institutions are well-established in all three countries. All three enjoy free and fair elections and free media. Public administration, policing and the administration of justice are improving. The UK's continuing work in this field includes advice on improvements in the quality of public administration, collaboration between Strathclyde police and local police forces on community policing techniques, and, in Lithuania, a new project on citizens' advice bureaux.

The Earl of Carlisle: My Lords, I thank the Minister for her most promising reply. However, does the noble Baroness not view with concern the Russian Federation's recent statement that it would take economic measures against the independent Republic of Latvia if it did not amend its citizenship laws? Do Her Majesty's Government believe that, during the next two months of the presidency of the EU, they could do a little more to assist the Republic of Latvia to improve its processes in order to expedite the applications of the minorities for full citizenship?

Baroness Symons of Vernham Dean: My Lords, the OSCE, the Council of Europe and other international observers have judged Russian claims of human rights abuses in the Baltic states to be unfounded. The UK supports the work of the OSCE monitoring missions in Estonia and Latvia. Along with EU partners, the UK encourages the integration of Russian-speaking minorities in Estonia and Latvia. However, in Latvia, non-citizens are not allowed to vote in either local or national elections. We are encouraging the Latvian Government, and, indeed, the Estonian Government, who also do not allow non-citizens to vote in national elections, to address this issue as part of the process of integration of non-citizens in those countries.

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Lord Moynihan: My Lords, given the fact that the Foreign Secretary has said that the main concern of the British presidency will be to get the negotiations on the enlargement of Europe off to a flying start, what lead are the Government taking to ensure that other European Union member states are equally committed to the enlargement process as well as providing the financial assistance necessary to the Baltic states, especially in view of Spain's threat to block the whole process if its special grants from the Cohesion Fund are stopped to help applicant countries?

Baroness Symons of Vernham Dean: My Lords, the accession negotiations with the applicant countries--Estonia, Poland, the Czech Republic, Hungary, Slovenia and Cyprus--have already begun. The Commission's assessment about Latvia and Lithuania is that there is still a great deal more progress to be made on those fronts. The noble Lord may know that when his noble friend asked a similar question a few weeks ago I said that the UK Government were indeed leading by example in the provision of the Know-How Fund, which is providing training and negotiation courses for civil servants, judges and others, and have given a great deal of money to that process--some £85 million in the past year or so. Therefore, we are leading by example and encouraging our European partners to follow that example.

Lord Avebury: My Lords, in her first Answer, the Minister made no reference to the high commissioner for national minorities. However, has he not played a significant role in trying to solve the problem of Russian minorities in the Baltic states and should he not be given due credit in that respect? Further, does the Minister agree that the work of the high commissioner for national minorities does not receive the priority that it should be given? Therefore, during our presidency, should we not work to ensure that that work is highlighted by all OSCE states?

Baroness Symons of Vernham Dean: My Lords, as I believe I indicated earlier, there is a difference of opinion about the real nature of the problem of Russian minorities, especially in Latvia. Perhaps I may reiterate to the noble Lord that the fact is that the OSCE, the Council of Europe and, indeed, other international observers think that some of the Russian claims about human rights abuses in the Baltic states are unfounded. There are undoubtedly some problems in relation to voting which I have outlined to the House. The EU has begun a dialogue with the Estonian and Latvian authorities to discuss practical means of overcoming those problems.

Muscular Dystrophy

2.41 p.m.

Lord Hunt of Kings Heath asked Her Majesty's Government:

    What advice they give to health authorities on the funding of support services for those suffering from muscular dystrophy.

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Baroness Ramsay of Cartvale: My Lords, we are committed to providing patients with a modern and dependable NHS. Quality of care to patients is the first priority. The changes which we put in place will support that principle. Integrated care, based on partnerships, will replace the internal market and provide a more holistic approach to care for patients with neurological conditions such as muscular dystrophy. The White Paper, The New NHS, promised that new arrangements for commissioning specialised services would be in place by April 1999. A draft guidance document, covering both what the new arrangements should look like and which services should be covered, was issued in the week beginning 6th April, with a deadline for responses by 1st June.

Lord Hunt of Kings Heath: My Lords, I thank my noble friend for her encouraging response. Does she agree that with the introduction of primary care groups there may be a problem with those groups providing sufficient support to the charities concerned because of the relatively small number of patients with which each primary care group will be involved? Will the Government consider offering guidance in this area?

Baroness Ramsay of Cartvale: My Lords, we intend to move from annual contracts to longer term agreements. These agreements, which will reflect dialogue between clinicians and will focus on health improvement and quality objectives, will increase the emphasis on programmes of care that cross traditional boundaries to meet patients' needs best. Health authorities will have lead responsibility for drawing up health improvement programmes which will bring together the NHS, local authorities and other important actors to secure improvements in health and healthcare. Primary care groups will be involved in both the development of health improvement programmes for their local population and, in the future, in commissioning services from local providers in line with these programmes. Guidance on the establishment of primary care groups was issued in April and further guidance on the development of commissioning by primary care groups will be issued in due course.

Lord Campbell of Croy: My Lords, as a vital support service for muscular dystrophy is an efficient wheelchair system, do the Government consider that needs are being met satisfactorily all over the country; and if not, will they encourage co-ordination and the dissemination of good practice within the more than 150 different wheelchair services that now exist?

Baroness Ramsay of Cartvale: My Lords, I know that the noble Lord will be well aware that the Muscular Dystrophy Group was a leading participant in the effective campaign, "Batteries not Included". I understand that the noble Lord, Lord McColl of Dulwich, among others, was a participant in that campaign. As a result of that, the NHS executive introduced electrically powered, indoor, outdoor wheelchairs (EPIOCs) to the NHS at a cost of £27 million over four years. In December 1996 guidance was issued to health authorities, trusts and wheelchair services

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setting out how the initiative should be implemented. The provision of EPIOCs is accelerating but the funding is incremental. With regard to the thrust of the noble Lord's question, not all needs or expectations can be satisfied immediately. We can only do our best.

Baroness Gardner of Parkes: My Lords, I do not know whether the rest of the House is as amazed as I am, but it appears to me that the responses we are being given by the Minister do not apply to the Question on the Order Paper. I must ask the noble Baroness to answer the Question on the Order Paper which states,

    "To ask Her Majesty's Government what advice they give to health authorities on the funding of support services for those suffering from muscular dystrophy".
If the answer is that they give no advice but leave the matter entirely to local health authorities, the Minister should at least say that.

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