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Lord Bruce of Donington: My Lords, it is always easy to be wise after the event. After having listened to Her Majesty's Opposition on this matter, I cannot help but question the depth or otherwise of its wisdom after presiding over the health service for some 18 years, during which so little that was constructive was done.

It is already quite clear--and was made clear by a Government report published only a few weeks ago--that there are gross disparities in the health of people depending upon their own individual circumstances. By and large, the poor, the unemployed, the homeless and those that are badly housed are more susceptible to bad health than other sections of the community. And yet, over the past few years, the Opposition has said exactly the opposite and pooh-poohed any suggestions of that kind.

Does my noble friend agree that, on taking office, the difficulty is to make some assessment of the resources that will be required to restore matters to a degree of normality? Does she agree that perhaps we overestimated the savings that could be made by the administrative actions necessary to take this wretched internal competition out of the health service? Perhaps we should have estimated that it would cost a lot more and that it would probably restrict the Government's ability financially to deal with the matter. Does she also agree that, far from being a matter for the Department of Health alone, health is a matter for the whole Government--for the Cabinet and every department that has any impact at all on the health of the nation?

Baroness Hayman: My Lords, I particularly agree with the last point made by my noble friend. It is certainly important that we take a view across government about improving people's health. That should be done as much by policies in connection with public transport, pollution reduction and those sorts of issues as by the direct provision of health care.

We also have to recognise the time frame in which investment starts giving a return. Although we are putting money into nurse training now, we shall not get new nurses trained and through for three years. The money that we are putting into supporting smoking cessation now will be tremendously advantageous, but not immediately. We have to deal with a long legacy of ill health. That is why it is important that we look across the board and that, while we focus today on immediate pressures, we do not lose sight of the long term.

Baroness Emerton: My Lords, perhaps I may ask the Minister about the timing of the review as regards the increase in acute beds. I am the chairman of an NHS acute trust. Last week we had to cancel the admission of 109 elective patients. We do not have flu down in our part of the world, but the admission of those elective patients, some of whom are suffering from cancer, had to be cancelled. I am pleased to know that the

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Government have acknowledged the pressure as regards acute beds. However, it would be helpful to know when the review will come to fruition. Can the Minister give us some information in that respect?

I should also like to make an observation about the training of nurses. In the Statement the Secretary of State said that reform was necessary. Would it be possible for us to have some idea of when such reform will take place? I say that because correlation of theory and practice is certainly something which we need to see; and, indeed, we do need to see change. It would be most helpful to the profession itself, as well as to higher education and the trusts (where the clinical placements are), if the education programme could be changed.

Baroness Hayman: My Lords, as regards nurse education, there are very major structural issues to be addressed. However, there are perhaps less controversial issues on which many parties are agreed; for example, the importance of introducing practical experience early in the curriculum. Progress could then be made through the local educational consortia in the short term. I would not like to think that we were ruling that out but that we are in fact supporting those sorts of agreed changes. I believe that we need to look at what can be done in the short term as well as in the medium and the long term.

As far as concerns the review of beds, I cannot give a specific date. As I said when repeating the Statement, preliminary work has shown a need for more beds. We are trying to ensure that the investment which will take place over the next three years will enable us to respond rapidly when the final report becomes available.

Broadcasting (Restrictions on the Holding of Licences) (Amendment) Order 1998

5.32 p.m.

Lord McIntosh of Haringey rose to move, That the draft order laid before the House on 11th November be approved [48th Report from the Joint Committee, Session 1997-98].

The noble Lord said: My Lords, the order will lift the restrictions in broadcasting legislation which prevent British Telecom and other public telecommunications operators, which I shall henceforth call PTOs, from providing broadcast television through their telecommunications network. At present, any PTO which wants to deliver such entertainment services has to create a subsidiary company to compete in the auction of cable franchises run by the Independent Television Commission. If it were successful--as was the case for the Milton Keynes and Westminster franchises--the PTO had to build a new cable network separate from its existing telecommunications network. This order will enable PTOs to hold such broadcasting licences directly.

We published in April last year a policy paper, Broadband Britain--A Fresh Look at the Broadband Entertainment Restrictions, setting out how the Government intended to deliver our manifesto commitment to end the entertainment restrictions on

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PTOs. In that policy statement we made clear that PTOs, cable operators and others should immediately have the option to compete in the provision of broadcast entertainment to the 17 per cent. of UK homes currently outside any cable franchise area. We also announced our intention that PTOs and cable operators should be allowed to compete in the provision of television services by wire throughout the whole country from 1st January 2001. This will bring to an end the previous licensing practice of awarding exclusive cable franchises to the highest cash bidder.

The order before your Lordships' House this evening is the only change to broadcasting legislation that is required to implement Broadband Britain. It may be helpful if I briefly explain what steps have been or will be taken by the Independent Television Commission to deliver, by administrative means, the commitments in Broadband Britain. The Department of Trade and Industry is currently considering in close consultation with DCMS, the ITC and Oftel, how best to take forward the necessary changes to telecommunications licensing arising from Broadband Britain.

The Independent Television Commission has already implemented the Government's commitment to enable open competition in the provision of broadband services to those areas currently not covered by cable franchises. On 2nd November, the ITC published its invitation to apply for local delivery service licences to cover the 4 million UK homes currently outside cable franchise areas. These licences--in accordance with the ITC's revised policy reflecting Broadband Britain--will be non-exclusive. So, PTOs, cable operators and others can already compete openly in the delivery of services to both businesses and consumers in the currently unfranchised areas.

In April the ITC announced that existing cable franchisees could apply to the commission to replace their existing exclusive licences, which contain terms set to reflect that exclusivity, with new non-exclusive licences containing revised terms. To date, licensees in 10 franchise areas have replaced their existing licences with new non-exclusive ones.

Finally, the ITC intends to invite applications in mid-2000 for further licences in areas which are currently exclusive to be effective from 1st January 2001. This will complete the delivery of the principal broadcasting objectives of Broadband Britain--which, incidentally, is impossible to say--ending the exclusive nature of cable franchises and opening up competition between different cable operators, public telecommunications operators and others in the provision of broadband entertainment services.

The phased introduction of the Government's approach to the licensing of cable franchises balances the need of existing cable operators to finance the remainder of their network provision against the needs of all service providers to plan and finance their strategies for digital services with confidence. The introduction of truly open competition from 1st January 2001 will benefit the industry and the consumer.

The implementation of the new broadcasting licensing regime, which was set out in Broadband Britain, is an example of the Government's evolutionary

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approach to tackling the implications of convergence. We have used administrative measures to deliver the practical results that the industry wants and needs rather than rushing in with stop-gap revision to the statutory regime. Assessment of changes to that statutory regime can be made in a more considered manner, taking advantage of responses to our Green Paper, Regulating Communications, which we are now considering. So any changes will be more fully thought through, and we will avoid regulatory uncertainty at a critical time for the broadcasting industry as it invests in the new digital technology.

The order before us today is one step in achieving this Government's broadcasting objectives, and the lifting of the current entertainment restrictions on public telecommunications operators is one, I hope, we can all agree is necessary. I commend the order to the House. I beg to move.

Moved, That the draft order laid before the House on 11th November be approved [48th Report from the Joint Committee, Session 1997-98].--(Lord McIntosh of Haringey.)

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