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The Countess of Mar: My Lords, I thank the noble Baroness for that full Answer. Is she aware that there is a growing list of children diagnosed as suffering from ME who are being placed by social services on the at risk register? Is she aware of the enormous trauma this causes in families, which is not good for children suffering from ME, and the fact that some of the children are being forced into psychiatric hospitals for treatment which many practitioners agree is not the right treatment for ME?
In the light of the decision by the High Court Queen's Bench Division on 15th October 1998 that referrals by community physicians to social services are illegal; that the use of Section 47 of the Children Act in these cases is also unlawful; and that parents should have the right to choose treatment for their children, will the Minister now instruct social services and all those physicians dealing with these children in the current state of the law and enable parents once more to exercise their right to consent? Will she also consider whether it is appropriate to lift the restrictions imposed by the court on the Olie family?
Baroness Hayman: My Lords, as regards the final point, the House will understand if I do not comment on a particular case, especially where the child in question is a ward of court. It would not be appropriate so to do.
The noble Countess referred to a number of cases. I am aware that there has been controversy around the treatment of certain children and young adults suffering from ME/chronic fatigue syndrome. This is an area where treatment is a matter of controversy. The working
Regarding the High Court judgment, to which the noble Countess referred, it would be for colleagues at the department which has responsibility in these areas to examine the judgment carefully to see whether it is appropriate to offer advice to social services departments.
Lord Clement-Jones: My Lords, I welcome the Minister's reply to the Question. Clearly, the issue of consent gives rise to a number of difficulties in many cases. Will the Minister comment on whether she believes that the balance of law was correct in the case of the St. George's Healthcare Trust involving a caesarean section where a mother was entitled to refuse a caesarean even at risk to the life of her unborn child? Will she say whether or not, in the light of that case, the Department of Health plans to amend its guidance on consent?
Baroness Hayman: My Lords, I shall avoid giving my views on the correctness of the judgment. In the past there has been controversy over compulsory caesarean treatment. Courts have recently clarified the position in a number of cases. It has been made absolutely clear that mentally competent women in labour have the same right in common law to give or refuse consent to treatment as any other patient. In such cases the court does not have jurisdiction to declare medical intervention lawful and the question of best interest does not arise. In such cases, if a woman refuses consent to a caesarean section, a declaration of the High Court is required to decide whether or not it is lawful to carry out such treatment. The department issued guidance summarising court rulings in these areas and the principles were expanded earlier this year. We shall be conveying those expanded principles to the NHS.
Earl Baldwin of Bewdley: My Lords, does the Minister agree that ME/chronic fatigue syndrome is not a psychiatric condition as such but is more usually multi-factorial, and that psychiatric symptoms can have physical causes just as physical symptoms can have psychiatric causes?
Baroness Hayman: My Lords, just as I do not pretend to be a lawyer, nor shall I pretend to be a doctor. Certainly, the issues referred to by the noble Earl are of deep concern to patients and to carers of those suffering very distressing conditions. It is important that their views are well understood. That is why, in the membership of the working groups on ME in both adults and children, we have taken great care to reflect a broad range of professional and patient opinion.
The Lord Privy Seal (Baroness Jay of Paddington): My Lords, before my noble friend replies to the noble Lord's Question, perhaps I may remind your Lordships that the House in its judicial capacity is hearing an appeal in the matter of the requested extradition of Senator Pinochet. The matter is therefore sub judice and under the rules of the House no reference should be made to the case.
The Parliamentary Under-Secretary of State, Foreign and Commonwealth Office (Baroness Symons of Vernham Dean): My Lords, I refer noble Lords to the Answer that I gave to the House on 28th October. We are continuing to work hard to make sure that the detention of Senator Pinochet does not affect our healthy relationship. We have long, historical ties and a strong trade and investment relationship with Chile. UK exports to Chile reached a record high of £210 million in 1997. The Chilean Foreign Minister, Senor Insulza, visited London in October 1997. My noble friend Lord Clinton-Davis, then Trade Minister, and my honourable friend Tony Lloyd, the Minister of State, have both recently made successful visits to Chile. Our relations with Chile are cordial. They are based on dialogue and co-operation on a wide range of political, economic and other issues of mutual interest.
Lord Moynihan: My Lords, adhering strictly to a "nil by mouth" policy on matters that are sub judice, will the Minister tell the House in what way the comments of the Minister of State for Trade and Industry, Peter Mandelson, during the BBC "Breakfast with Frost" programme on 18th October represent government policy? Furthermore, what is the Minister's reaction to the criticism by the Chilean Deputy Foreign Affairs Minister that the Government's updated advice on travel to Chile is not the best way to avoid a political escalation of the situation and that it paves the way for the interpretation that the advice further damages Anglo-Chilean relations?
Baroness Symons of Vernham Dean: My Lords, my right honourable friend Mr. Mandelson expressed a personal opinion, as I understand have many Members of the Opposition. I recall that in this House last week the right reverend Prelate the Bishop of Oxford reminded us of some of the difficulties in regard to what has happened in Chile in the past. That must not be confused with the important point that this process is in the hands of the judicial authorities, and has been from the start. The issue is one that will be dealt with by the legal process, not political processes.
Baroness Williams of Crosby: My Lords, does the Minister agree that Chile has made a remarkable transition to democracy, a transition in which that country has consistently upheld the rule of law within the country, and that it has brought about a remarkable diminution in levels of poverty? Does Chile not deserve our applause for that remarkable achievement over the past few years?
Baroness Symons of Vernham Dean: My Lords, yes. I can agree wholeheartedly with the noble Baroness's remarks. The United Kingdom and Chile see eye to eye on many issues, including those around social justice and the free market. Chile is a valued partner on the world stage. I believe that those sentiments have been reflected in the discussions held recently by my honourable friend Mr. Lloyd with Senor Fernandez. Indeed, the discussions that my noble friend Lord Williams had with a number of Chilean senators only last week were of a constructive and helpful nature. I believe that during those discussions United Kingdom Ministers were able to explain to Chilean counterparts the position regarding the legal process in this country, and that has been fully understood.
Lord Clinton-Davis: My Lords, is the Minister aware that during the visit that I made to Chile to which she referred a number of Ministers in the Chilean Government expressed their great appreciation of the help and sustenance that were offered to refugees and people in exile during the dark days in Chile by the Labour Party? They felt that that was a great help in enhancing what has been a very good trading relationship between our two countries since the Labour Government took office.
Baroness Symons of Vernham Dean: My Lords, I am sure that the warm approach which is fundamental to the way in which Her Majesty's Government and Chile normally carry on their relations is a characteristic that will inform our general relationship.
On the issue of commercial relationships, our position in regard to Chile is strong. Our exports last year were at a record high. Chile is the UK's third largest market in South America, after Brazil and Argentina. We hope that that trading position will continue to improve.
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