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Public Health Safety: Green Papers

Lord Morris of Manchester asked Her Majesty's Government:

Baroness Jay of Paddington: My right honourable friend the Secretary of State for Health launched the Green Paper Our Healthier Nation on 5 February. My right honourable friend the Secretary of State for Scotland published the Green Paper Working Together For a Healthier Scotland on the same day. Both Green Papers set out proposals for new strategies for health covering all age groups, and consultation on both documents ran until 30 April.

In England, we have received over 5,500 responses, in Scotland some 800, many of which commented on the Green Papers' implications of the proposals for the health of older people. We shall take all these comments into consideration as we develop the final version of the separate strategies which we plan to publish as White Papers later this year.

In both countries, working groups have been established to consider the setting of appropriate targets. That work would include the relevance of possible targets to older people.

My right honourable friend the Secretary of State for Wales published a consultation paper on a health strategy for Wales Better Health, Better Wales in May. Consultation will run until 31 July.

My right honourable friend the Secretary of State for Northern Ireland published the strategy for improving the health and social well-being of the people of Northern Ireland, Well Into 2000, in December 1997.

AIDS and Sexually Transmitted Diseases: NHS Costs

Lord Robertson of Oakridge asked Her Majesty's Government:

Baroness Jay of Paddington: The Government allocate funds to the National Health Service for the treatment and care of people with HIV and AIDS and in 1998-99 this budget totalled £228.1 million. These funds are not ring-fenced, but are separately identified. HIV/AIDS prevalence is unevenly distributed and funds are allocated to health authorities broadly on the basis of where treatment takes place.

Treatment costs for sexually transmitted diseases (STDs) are not identified separately. Most people with STDs, including many of those with HIV and AIDS, are likely to be treated in genitourinary medicine (GUM) clinics which provide free, open access, confidential

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services. The amount spent on the GUM specialty in 1996-97 in England was £118 million, which amounts to 0.5 per cent. of the total operating expenditure of NHS trusts.* Some of this sum will be provided from the HIV/AIDS treatment and care allocation. Accordingly the total NHS spend on treating HIV/AIDS and STDs will be less than the sum of the two figures provided. *Data from the annual financial returns and annual summarisation schedules of NHS trusts respectively.

Cancer: Minority Ethnic Groups

Lord Morris of Manchester asked Her Majesty's Government:

    What study the Department of Health has made of research findings in the United States that African Americans are at higher risk of developing breast cancer and cervical cancer and at much higher risk of developing prostate cancer; and what comparable information is available in the United Kingdom.[HL2767]

Baroness Jay of Paddington: No such studies have been done. The 1996 Cancer Research Campaign/Department of Health Symposium on cancer and minority ethnic groups in England and Wales concluded that cancer is a common and important cause of death in minority ethnic groups. Overall it is less common among Indian, Caribbean and African ethnic migrants than in the total population. However, Caribbean and African ethnic minorities have higher death rates from liver cancer and prostate cancer and there is a higher death rate from oral cancer amongst Asians. Death rates for breast and cervical cancer are not increased overall in ethnic minorities compared to the general population. The Cancer Research Campaign's fact sheet number 8 on cancer in ethnic minorities living in England and Wales is based on extracts from the report of the symposium, published in the British Journal of Cancer (BJC, Vol 74, Supplement XXIX (1996). Copies of the documents mentioned are available in the Library.

Human Fertilisation and Embryology Authority

Lord Hogg of Cumbernauld asked Her Majesty's Government:

    What plans they have to advertise for membership of the Human Fertilisation and Embryology Authority.[HL2968]

Baroness Jay of Paddington: There will be a number of vacancies in membership of the authority later this year. We are considering how best to ensure that applications for these vacancies are invited from as wide a field of suitable people as possible. This will include advertising in the national press shortly.We also intend to maintain a list of potential candidates for vacancies that arise in future years.

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Pensions: Contribution Records

Earl Russell asked Her Majesty's Government:

    How many pensioners receive less than the full state pension because of defective contribution records; what are the main reasons for the defective contribution records; and whether they are considering ways of ameliorating the situation of these pensioners.[HL2533]

The Parliamentary Under-Secretary of State, Department of Social Security (Baroness Hollis of Heigham): Of those receiving basic state retirement pension, 3,251,080 men and 867,440 women receive full pension based on their own contribution records. In addition to this, 59,040 1 men and 2,488,020 1 women receive full pension based on their spouse's contribution records.

However, 247,760 2 men and 3,024,820 2 women receive less than full state retirement pension based on their own contribution records or their spouse's contribution records.

There are three main reasons why women often receive less than a full pension. Married women in work may have elected to pay contributions at a reduced rate on the understanding that they would not be entitled to a pension in their own right. Alternatively, they may have stayed at home to care for children, or decided not to work at all.

For men the main reason for receiving less will be that for significant periods of their working life they neither worked nor claimed benefits in the UK. Alternatively they may have been self-employed and their profits were too small for them to be liable for contributions.

One of the Government's ten fundamental challenges in pensions is the need to narrow the pensions gap between men and women so as to give women more security in retirement.


    1 Includes category B and category AB pensions.

    2 Includes all categories of the basic state pension.


    5 per cent. sample of the pensions strategy computer system, at September 1997.

Child Support Agency: Leaks

Lord Higgins asked Her Majesty's Government:

    Whether they will hold an official inquiry into the leaking of the proposals and the recent statement on the Child Support Agency in advance of their presentation to Parliament.[HL2740]

Baroness Hollis of Heigham: The information which found its way into the press could have been derived from a number of sources as official announcement drew near. The prospects of demonstrating successfully the source of the information is poor and, though we deplore any leak of government proposals in advance of their announcement to Parliament, we concluded that a full formal enquiry would not be justified.

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Disability Rights Commission

Lord Graham of Edmonton asked Her Majesty's Government:

    What plans they have to announce their proposals for a disability rights commission.[HL2923]

The Minister of State, Department for Education and Employment (Baroness Blackstone): The Government today published a White Paper entitled Promoting Disabled People's Rights: Creating a Disability Rights Commission fit for the 21st Century, setting out their proposals on the role and functions of a disability rights commission. This has been laid before the House and copies have been placed in the Printed Paper Office.

In our manifesto we stated our support for "comprehensive and enforceable civil rights for disabled people". Accordingly, in October 1997 we announced that we would:

    set up a Task Force to report to the Government on how best to secure those rights;

    implement the remaining provisions of the Disability Discrimination Act; and

    establish a disability rights commission.

The Disability Rights Task Force was set up in December 1997. The Government are very grateful to all the members of the task force, whose recommendations on a disability rights commission form the basis of this White Paper.

In June we announced that we would be bringing in the provisions within the Disability Discrimination Act which will require service providers to make reasonable adjustments to make their services accessible to disabled customers in two main stages, in 1999 and 2004.

Our move to establish a disability rights commission is another major step towards fulfilment of our commitment to comprehensive and enforceable civil rights for disabled people.

We envisage that the role and functions of the disability rights commission will be broadly similar to those of the Equal Opportunities Commission and the Commission for Racial Equality. Our proposals aim to take account of over twenty years of experience gained by equality commissions here and abroad in combating discrimination. We want to create a disability rights commission fit for the 21st century.

The commission will make a large contribution to ending discrimination against disabled people and enabling them to play a full part in society. Discrimination against disabled people remains all too extensive and is totally unacceptable. The commission will provide disabled people with support to sustain the rights which the law creates for them. It will promote conciliation and, where necessary, enforcement. But its role will also be to promote good practice and educate, and it will provide a central source of information and advice to employers and service providers to assist them in meeting their duties.

We emphasise that we expect that the commission should not work in an adversarial or oppressive way.

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There need be no tension between the interests of disabled people and the interests of employers and service providers. The commission should be seen as supportive of both disabled people and businesses alike. We are proposing that there should be a single commission in Great Britain but with offices in Scotland and Wales. The commission will comprise between 10 and 15 commissioners. Their appointment will comply with the guidance issued by the Office of the Commissioner of Public Appointments.

The commission must be credible with all stakeholders. The body of commissioners between them will need to have sufficient diversity of experience to be able to take account of the interests of all disabled people and to reflect the interests of all key stakeholders, including those of small businesses. We intend that at all times a majority of the commissioners should be disabled.

The commission will be an independent executive non-departmental public body, subject to the formal management and reporting arrangements and accountabilities laid on such bodies.

The commission's main duties will be to:

    work towards the elimination of discrimination against disabled people;

    promote the equalisation of opportunities for disabled people with those of non-disabled people;

    promote good practice; and

    advise the Government on the operation of the Disability Discrimination Act and other relevant existing legislation, and any future legislation dealing with discrimination against disabled people, and whether changes need to be made to it.

We will expect the commission to work in partnership with other organisations and networks which have expertise relating to disability discrimination.

Within this framework of general duties, the commission's specific functions will be to:

    provide a central source of information and advice, particularly to disabled people, business, and the public and voluntary sectors;

    assist individuals in securing their rights under the Disability Discrimination Act and other relevant domestic legislation, under any legislation resulting from the implementation of relevant European Union directives and under Article 14 of the European Convention on Human Rights which makes it unlawful to discriminate against disabled people in the enjoyment of their rights under the convention;

    prepare and review statutory codes of practice containing practical guidance on what is necessary to comply with legislation. The commission will have a duty to publish a draft of any codes which it prepares for consultation;

    arrange for the provision of an independent conciliation service in respect of access to goods, facilities, services and premises and monitor the performance of that service. The Advisory, Conciliation and Arbitration Service (ACAS) will

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    continue to provide conciliation on employment issues.

The commission will have also the power to undertake formal investigations. Such investigations would normally be reserved for serious and complex situations or issues. There will be adequate safeguards in place to ensure that the rights of those under investigation are not transgressed.

Finally, the commission will be able to carry out research about issues that fall within its purview.

We believe that a disability rights commission is essential in tackling discrimination against disabled people and to promote an inclusive and just society. We invite comments on our White Paper by October 16 and will introduce legislation to establish the commission as soon as the parliamentary timetable allows.

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