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Lord Warner: My Lords, over a number of years the noble Baroness has expressed a great deal of concern that homosexuality has considerable health hazards. Can she explain to the House how one can help people from the gay community to understand health hazards without making information widely available to them at an early age and through the teenage years?
Baroness Young: My Lords, I am only too happy to answer the noble Lord on that point. If I may read from the briefing on the Local Government Act--which I was about to do--as regards Section 28, it states:
- "It will not prevent the objective discussion of homosexuality in the classroom, nor the counselling of pupils concerned about their sexuality. Such activities will continue to be governed by Section 46 of the Education ... Act".
I would ask the noble Lord, Lord Warner, to consider this very serious point: is it right to put the teaching and proselytising of homosexuality in front of very young children? I do not believe for one moment that responsible parents want that. It would be a deplorable development.
The noble Lord, Lord Bassam, has challenged us to say what we would repeal when we come back to Government. That is the first thing that I would repeal--along with the lowering of the age of consent, should that come to pass. I can assure the noble Lord that this is not an issue that is likely to go away. As far as concerns the giving of money to homosexual organisations, we know that this is done extensively already by health authorities.
This is a very serious matter. I am not alone in this country in thinking that it is deplorable that children--who, after all, are obliged by law to go to school--should be taught about homosexuality as an equally acceptable life style to marriage. It undermines marriage; it undermines responsible good parents. I could say a great deal more.
When the Labour Government came into office, they talked a good deal about "cool Britannia", whatever that may mean. As we approach the millennium, far from cool Britannia, we are in danger of having a society reminiscent of the last days of the Roman empire.
5.5 p.m.
Baroness Ashton of Upholland: My Lords, it is with a real sense of privilege that I make the first of what I hope will be many contributions in your Lordships' House. In preparing to enter your Lordships' House,
I trawled the Internet--something I enjoy doing enormously--to look for other noble Lords' speeches on similar occasions. I was struck by the number of times that references were made to the kindness shown to newcomers in your Lordships' House. I confess that I thought perhaps that was merely good form. I will admit for the first and probably the final time in your Lordships' House to being completely wrong. I echo those sentiments and I add my heartfelt thanks for the kindness shown to me.I am pleased that I have the opportunity to speak to your Lordships and the opportunity to be brief. Your Lordships afford me the right to stand here and speak to you without interruption. I will respect the traditions of the House and speak in an uncontroversial manner.
I have spent 20 years of my life in economic and community development, on the fringes of education policy, and advising the Home Office on the relationship between government and the voluntary sector. By any stretch of the imagination, I am an "implementer". Most recently, I have become chairman of a health authority. In that capacity, I shall have much to say in future debates with the noble Earl, Lord Howe, and the noble Baroness, Lady Young.
I bring experience rather than expertise to your Lordships' House. It has been my joy, and occasionally my lot, to try to turn the policies, plans and strategies that emanate primarily from another place into practical action on the ground. Those of your Lordships who have also been practitioners will recognise a sense of frustration sometimes in trying to do precisely that and a desire perhaps to see the plans and practices on the ground turned into policies.
I can put it no better than an American president, who said:
- "We know what works in practice. The challenge is to make it work in theory".
I wish to commend three particular words in the gracious Speech on the subject of the health service. Those words are "10-year programme". As a practitioner, it has been my lot to be blighted by short-termism. We have academic years, calendar years, two-year funding cycles, three-year cycles and four to five-year electoral cycles. All of these mitigate against solving some of the deepest problems that we have, some of which go back to the Industrial Revolution and beyond.
In health in particular we are now looking to tackle some of the preventive issues and at ways in which we can ensure that people do not need the health service in the way that they traditionally have. But as we look at the prevention of heart disease, at teenage pregnancies, at drug abuse and at ensuring there are fewer accidents in the home, we know that we have to take a long-term view. I hope that the House will welcome with me the prospect of thinking in 10-year terms.
As we look at solving some of the health issues and at prevention rather than cure, we are also mindful of health inequalities. I am of the view that health inequalities go hand in hand with social and economic inequalities. They are joined-up problems, and joined-up problems need joined-up solutions. But joined-up solutions also need joined-up money.
I have spent 20 years inventing public, private and voluntary sector partnerships. In doing so, we have taken the best from each of the different sectors in our society and put them to work to try to address some of the underlying economic and social issues that our country faces. I think all will agree that some of these partnerships have been hugely successful. I was working on them in the early 1980s, when they were deeply unfashionable.
But we can go further. On Monday, I spent my day with the three party political leaders in Hertfordshire, where I live and where I do my day job as a health authority chairman. We met with the chief executive of the county council, with the director of social services and with colleagues from the health authorities. Our purpose was to look at how we could more successfully integrate the budgets between education, health and social services; to look at things from the perspective of the clients, the people we were trying to serve. We have therefore come up with a solution which looks at the adult population as one group and brings together education, the family and the child into another, focusing on the people rather than on the structures.
In Hertfordshire we know a great deal about working in an integrated way. In the health service we have a nursing home-at-home scheme which allows patients--particularly elderly patients--who need some kind of continuing care to leave hospital when they are ready to do so. They might have gone into residential care for a short time or, worse, they might have stayed in hospital. Instead, they can now go home and be cared for by social care staff and healthcare staff working together. The benefits to the health service of that are obvious. We take people away from beds which we need for other treatments. But, most importantly, the patient is able to do the one thing that all patients want to do, which is to go home.
We also have an assertive outreach programme in Hertford which works for those in our society who suffer from mental illness and whom we need to keep safe and whose communities we need to keep safe. Again, that work is shared by mental health staff and social care staff--again, a good strategy. As my noble friend Lord Bassam said, throughout my county the crime and disorder partnerships bring together many different agencies which work with an integrated approach. I long for pooled budgets, not simply integrated approaches. I hope that your Lordships will support me in wanting that.
If we can take away the ownership of a pot of money and give it for the purpose for which it was created, I believe that we can do even more. My noble friend Lord Hunt of Kings Heath will hear for the first, and probably the last, time from a health authority
chairman not a plea for more money but, indeed, a plea that we use the money differently in order to use it more creatively.I stray on to dangerous ground because I wish also to use the word "modernise". But I wish to use it in the context of a practitioner in the voluntary and public sector where it is a word that we use continuously. It is defined by me as meaning that we make sure that the processes we have--the organisations and institutions which we create--are fit for the purpose for which they are created. In the private sector we commend the modernisation that goes on; we commend the way in which companies learn to compete in a global market, painful though that can be at times. I simply make a plea that in our voluntary organisations, in our schools and in all our institutions, however simple and however grand, we follow that same rule.
As we move through the 28 Bills that will come to this House, I hope above everything that we will make sure that the processes of which those Bills are merely part are always subordinate to the goals and values that we hold.
5.12 p.m.
Lord Clement-Jones: My Lords, I am delighted to be the first to congratulate the noble Baroness, Lady Ashton of Upholland, on what I believed to be a very practical, thoughtful and yet challenging speech. Indeed, I should say that it was an inclusive speech, which was refreshing. I have known the noble Baroness for many years, particularly for her work with Business in the Community and the Prince's Trust. She is well known for her great ability to knit together the business sector, voluntary organisations and government. In the cause of tackling social exclusion and community development, with her great knowledge of social issues and her valuable experience in the NHS, I have always taken the precaution of taking her advice. I very much hope that after her excellent speech today the Government will do likewise.
I give a brief word of explanation for my speaking from these Benches. Quite simply, my party thought that this was the best form of retaliation in the light of the decision of the noble Lord, Lord Hunt, to make a pre-winding up speech on health.
Despite the fact that there is little in the gracious Speech on health and social care, nevertheless the Government have set themselves a formidable agenda of reform. But the jury is out on whether the Government have yet made any noticeable improvements to the health service. Delivery is yet to come. Despite all the Government's talk of modernisation, the public is beginning to be disillusioned. A recent survey showed that 11 per cent more voters than a year ago believe that the NHS is getting worse.
Health service managers, too, as shown by a recent survey carried out by the Health Service Journal, are sceptical. Three out of four do not expect to receive what they need to make the Government's programme work. They severely question the Government's
priorities, particularly waiting lists. Yet, those are the very people, along with medical staff, that Mr Milburn is telling to speed up the reforms. He certainly needs to start closing the credibility gap, and soon, if the NHS is to improve.However, on these Benches we welcome in principle the Government's proposals in the gracious Speech to introduce a care standards Bill to regulate residential, children's and nursing homes. We believe, however, that there should be a national regulator for those homes and that home healthcare and day care should be regulated in the same system as the King's Fund has recommended. What do the Government now propose in this respect?
We also welcome the commitment to regulate independent healthcare. However, we believe that there should be a single standard setting body, such as the Commission for Health Improvement for the NHS, and independent healthcare to ensure that standards are the same across both sectors. Will the Government reconsider on this matter?
The key question in this area, however, is when the Government will respond to the Royal Commission. A response is already long overdue. Will they use the care standards Bill to set up a national care commission, as recommended by the Royal Commission? It is also vital that they address the issue of the cost of personal care for those in long-term care. We need to deal with long-term care in a way that combines, in the words of the chairman of the Royal Commission, Sir Stewart Sutherland, "decency with self-interest".
On these Benches the logic of the majority report--that personal care should be funded by the state whether a person is within the NHS or in a residential or nursing home--seems to us to be persuasive, especially when the Chancellor can find at the drop of a hat £300 million for free television licences. Will the Government make a decision on this shortly?
On these Benches we also agree with the Royal Commission that it makes sense to place much more emphasis on more care at home so that older people can have as full and independent a life in familiar surroundings for as long as possible. Yet, now we see the very antithesis of joined-up government--the proposal to impose VAT on many home care services. Will the Government review their decision on this?
This leads to the major issue of age discrimination. It is still rife, as the recent Age Concern report, Turning Your Back on Us, has demonstrated. Is it NHS policy across the country to refuse heart transplants for patients over 60? Why is there no breast cancer screening for women over 65? Will the Department of Health carry out a full investigation into the extent of age discrimination, as Age Concern is calling for? On these Benches we pressed for a statutory equal opportunities clause in the Health Bill when it passed through this House. Will the Government now act to insert such a clause?
Another area where there is acute concern over discrimination is among those with mental illness. How will the Government respond to the extremely worrying findings of the MIND report, Creating Accepting Communities? At the time, on these Benches we welcomed the Government's initiative in asking Professor Graham Thorneycroft to draw up a new National Service Framework for Mental Health Services. But have the Government considered whether the £700 million extra they have allocated will be enough to comply with the standards set by the framework? Four out of five managers in this area said in a recent survey that they believed that promised resources would not be enough. A recent Sainsbury Centre report says exactly the same.
As regards reform of the Mental Health Act 1983, recent proposals by Professor Ginevra Richardson's committee for the introduction of a new compulsory treatment order are a matter on which we on these Benches have strong reservations.
In the area of mental health, we are also extremely concerned about recent official guidelines on the prescribing of Clozapine, the atypical drug which is so effective in the treatment of schizophrenia. Will the National Institute for Clinical Excellence--NICE--look at the impact of those guidelines as a matter of urgency?
This brings me to the question of the way that NICE will operate and the rationing question. Public concerns about postcode rationing are now overwhelming. Weekly, if not daily, there is a report in the press of a denial of treatment in one area which is available in another. Why is the pattern of the treatments that can be provided on the NHS so different? Aricept, Taxotere, Beta Endorphin and Clozapine are all problem areas. Nothing has improved since last year, with many patients being forced to pay up to £10,000 out of their own pockets for treatments which would be free just a few miles away in a different health authority.
On these Benches we welcomed the creation of NICE, but we are concerned about its current operation. In Committee on the Health Bill, Ministers made it clear that the question of affordability would remain the responsibility of government. Why does NICE's remit now include affordability as a criterion, contrary to those assurances, as mentioned in a speech by the new chairman of NICE? Is NICE now taking political decisions? On another connected matter, what is happening to Greg Dyke's recommendations following his report on the NHS charter and the consultations which followed?
I want to speak on a further four matters which are of great topicality: cancer treatment, midwifery, recruitment and resources. On these Benches we welcome the appointment of Professor Mike Richards as the new "cancer tsar". Clearly, in the first few months of his appointment he will be concentrating on cancer care services, ensuring that we have sufficient oncologists and ensuring that the long overdue Calman Hine reforms are fully implemented. But what new resources will he be given to tackle the issues?
At a recent conference, cancer specialists complained bitterly that they had to lie to patients about what treatments are available and compared Britain's cancer care to that in the third world. Already it is clear that hospital budgets for treatment are inadequate to meet the reduction targets of 15 per cent in deaths from cancer by 2010 and clearly inadequate compared to other EU countries. We need more money for treatment and more money to employ additional oncologists.
In terms of specific cancers, what are the Government doing in response to the prostate cancer campaign? It is true that, historically, this cancer has received inadequate attention, yet it is now the most common cancer in men. We have very poor outcomes for prostate cancer patients compared with France, Sweden and Germany. What resources do the Government plan to devote to fighting prostate cancer? It is high time they grasped the nettle.
Will the Government heed the words of Professor Gordon McVie, the director general of the Cancer Research Campaign, who said recently that the NHS cannot keep up with progress in cancer research. Yet that research itself is very haphazard. It relies in the main on charitable funding. It is high time that we had central co-ordination of cancer research. Professor Richards should look urgently at the question of forming a national cancer institute to undertake this task. Will he turn the current Cancer Research Funders' Forum into such an institute?
I could not let pass a topical reference to midwifery services. All of us will want to pass our best wishes to Cherie Blair. I can even recommend an excellent maternity ward and a superb midwifery team across the river at St Thomas', where my son Harry was born two years ago.
We need to recognise that, however good the services are in some hospitals, there are major shortages of midwives throughout the country. There are now 2,500 fewer midwives than there were four years ago. There have been many reports of women being turned away from hospitals such as the Chelsea and Westminster Hospital where they were due to give birth. This has also led to unduly high caesarean rates. As Lesley Page, Professor of Midwifery Practice at Thames Valley University and a member of the English National Board, recently said:
- "caesarean rates are becoming astronomical".
For a quality NHS so much depends on recruitment and retention of trained medical staff. A quarter of young doctors are leaving the NHS because their hours and pay are unacceptable. The Government have wholly failed to live up to their responsibilities under the working time directive to cut back doctors' hours. Junior doctors have had to rely on the European Parliament to take up their cause. Yet we have a shortage of 4,000 doctors. The noble Earl, Lord Howe, has referred to the failure of the NHS to agree special payments for the millennium. That is a disgrace. It has done so in Scotland. It will mean that
the junior doctors will not be available. They are at this moment making themselves available for the independent sector.Senior nurses, similarly, despite the Government's recruitment drive, are still leaving the NHS. We need another 15,000 nurses. Many hospitals in both the private and the independent sector are recruiting heavily from places such as the Philippines. That is not cost-effective, as foreign nurses do not stay long in post and in fact many are returning home for the millennium. We are essentially benefiting at the expense of third world countries which need these nursing skills. The only solution is better pay for nurses. Unless the Government recognise the need at least to give the senior nurses the 11 per cent rise received by junior nurses last year, the problem will continue. As the Royal College of Nursing recently pointed out, a reduction in staff turnover of 1 per cent could save the NHS £15 million. What will the Government do to ensure that more medical staff are retained and recruited?
There are many other issues that I could raise: the Government's inadequate strategy to tackle inequalities in public health; the Freedom of Information Bill, or the "secrecy of information Bill", as it has been called, which promises to bring little improvement in access to NHS information and approval of medicines; the NHS complaints system, which was the subject of a health committee report published this week; and the failure by the Government to give compensation to haemophiliacs infected with Hepatitis C by blood products. But the key area of debate in the coming months leading to the second comprehensive spending review next year must above all be that of resources. In the short term it appears that even before the winter there will be a deficit across the National Health Service this year of at least £300 to £400 million.
At the end of the day the simple conclusion about the NHS must be that more money is needed. It is clear from figures in recent months that the NHS in Britain is underfunded and yet our health is worse than in comparable European countries, as the Office of Health Economics has shown. Death rates from heart disease are more than twice those in comparable European countries; prostate, colon, lung and breast cancer outcomes are all worse than our principal western European neighbours. Total spending in 1998 in the UK was £56 billion, of which £8 billion was spent in the private sector. That represents 6.7 per cent of GDP against an OECD average of 7.7 per cent and an EU average of 7.9 per cent.
This is not a plea for a limitless purse. What we need is an approach centred on the needs of patients which recognises that health expenditure should be treated in many cases as an investment--where it keeps people within the community; keeps them at work; keeps them out of pain; and allows them to stay living independently within their own homes. We believe that is a positive approach to priorities and the use of resources. We now need to hear from health Ministers
what approach they will be taking in arguing for more resources under the next comprehensive spending review.5.26 p.m.
Lord Laird: My Lords, this is the first time that I have had the honour of addressing your Lordships' House so I stand here today with mixed emotions. As a new boy in this House, I join with my new colleagues in having to rely heavily on the many acts of kindness, thoughtfulness and support that I have received from noble Lords, the staff and the attendants. Their patience and thoughtfulness to a novice Member are a remarkable testimony to the institution that is your Lordships' House.
I arrive here with a record of which I feel I should inform your Lordships. I was a member of three political institutions for successively three years, two years and then 12 months. Each of those was done away with at the stroke of a pen by political diktat. With that track record, it is either an act of considerable faith or extreme folly that I should be appointed to the House at this stage. In any case, let me say that I am very honoured to be a Member of your Lordships' House and I hope that my contributions will be considered to be positive.
I should like to join with noble Lords in offering congratulations to the Royal Ulster Constabulary. As noble Lords may know, I am from Belfast. For the past 30 years we have looked to the Royal Ulster Constabulary as a brave and gallant police force to protect the ordinary law-abiding citizens of Northern Ireland. It is very fitting that the RUC has received this award from the Queen.
I should like to confine the rest of my remarks to healthcare, an area which, as we all know, has seen considerable changes over the past decades. In the 1980s Her Majesty's Government, with some justification in my view, sought to change the health service from a wasteful system of historic budget to one driven by consumer demand. The friendly but unreal concept of patients and administrators asking only for that which they required and nothing more has been abused over years. It created extreme differences in hospital sizes and services--even in some cases as a result of differing personalities.
Something had to give. The solution of the government of the time was the creation of an internal market and thus the total change of accounting practices. That policy, while it had the right intention, was too difficult to implement in the face of a massive health service bureaucracy.
The current Government's policy, as outlined in the gracious Speech, is for a 10-year programme of modernisation which will provide faster and more convenient services to help improve the health of the country. No one could disagree with that broad-brush approach: faster and more convenient services
to help improve the country's health. We need to look at the current policies in more detail. In my view, the replacement of the internal market with commissioning groups representing the needs of local populations provides an opportunity to find an acceptable way forward. However, while that is accompanied by a poor sense of direction, a major problem will still occur. To be fully successful, major policy decisions concerning the future of area hospitals must follow a central strategic plan.For example, in Northern Ireland there are four area boards in what is a relatively small area. The result is a lack of central planning which could lead to geographical gaps in the provision of hospital services. When a board is only focused on its own area, very strange inequalities can occur. The solution is for the centre to take back some power; namely, that of strategic planning for services. In the particular case of Northern Ireland, many argue that there is really no requirement for as many as four area boards. Perhaps this is a topic that will exercise the minds of the members of a new executive which I hope will be formed soon in my native province. With great respect to Her Majesty's Ministers in the Northern Ireland Office who have exercised decision-making powers in areas like health, I feel that the majority of people in Northern Ireland long for the day when control of many areas of policy is exercised locally. I trust that day will not be too far removed.
Perhaps I may turn my attention to primary healthcare. I should like to make a plea on behalf of general practitioners who, on an increasing scale, are being forced to provide new services backed up by considerable extra paperwork. I find that general practitioners are almost at breaking point. Levels of stress are high and morale is low. In my view, recruitment is now being affected. I ask the Government to consider the plight of primary healthcare professionals over the next few years and to try, where possible, to ease their burden and even to put more funding into this important front line of healthcare.
I also feel that a major and substantial campaign to re-educate the public about its expectations of the health service is vital. For too long local groups have fought to keep local services in local areas without any proper understanding and examination of the viable alternatives. Local services may not necessarily mean better services. In many cases, it is the reverse. However, progress can only be made following a re-education of the public on the main issues. Health is very much one of the topics that requires understanding and support. What you carry in your mind can affect your body.
To sum up, the important point that the Government must address in the next few years is the consideration of hospital and manpower provision at regional level. The larger the unit making the decision, the better the chance of producing a service
that is constant throughout the country and to a high standard. I believe that today the public expects an even and fair service throughout all parts of the country.5.34 p.m.
Lord Waddington: My Lords, I believe that I am very fortunate to rise immediately after the noble Lord, Lord Laird. It gives me the privilege of congratulating him on a really excellent maiden speech. At the beginning of his remarks the noble Lord said that he had been treated with kindness since he arrived here. I am very glad to hear that and not in the least surprised. I can assure the noble Lord that if he continues to make contributions of the kind that he has made this afternoon he will continue to receive kindness here. The noble Lord spoke with great authority and I congratulate him most warmly.
I found the Queen's Speech to be a great disappointment, for a number of reasons, but I have time only to dwell on one now. To some extent I shall echo the words of my noble friend Lady Young. The Prime Minister clearly gets great joy from his children, and the whole country rejoiced with him and his wife when they learned that the Blair family was about to be extended. However, there is a contradiction between Mr Blair the family man, who knows full well the importance of children being brought up in a stable family by a man and woman bound by their marriage vows to a lasting relationship, and Mr Blair the head of a government that seems bent on undermining the family. The Government's spokesmen often assert that the very word has to be redefined to suit changed social conditions.
I have to say that it is not only the Government that have been redefining the word "family" to mean something quite different from what the majority of people mean by the term. Recently the highest court in the land, the House of Lords sitting in its judicial capacity, decided that the homosexual partner of a tenant was a member of the tenant's family and could therefore succeed to the tenancy on his friend's death. The judges declared that their decision did not undermine the traditional concept of marriage. I hope that they are right, but I am afraid it is only a question of time before the decision will be cited as a precedent when further attempts are made to equate the rights of a homosexual couple with those of a man and wife.
Dame Elizabeth Butler-Sloss also said that she was not undermining the role of the traditional family when she made her notorious statement backing adoption by homosexual couples. But, if one thinks about it for one moment, clearly she was. She was certainly denying that a child has the right to be brought up in a proper family composed of a man and a woman so that he or she may learn from those traditional role models.
It cannot be denied that the traditional family has become very much weaker in recent years. Nor can it be denied that the social and financial cost of this weakening has been enormous. The catastrophic incidence of family breakdown, one of the highest
divorce rates in the western world, and the even more frequent break-up of cohabiting relationships have cost us dearly tax-wise and--far worse--it has meant that more and more children have been deprived of a stable upbringing. Thereafter, many of those children fail at school and at work and drift into crime.But far from buttressing the family, the Government's response has been on the one hand to attack the family tax-wise, and on the other, to attack traditional family values and traditional morality. In spite of their rebuff in this House last year, we have heard that the Government plan to go ahead with lowering the age of consent, apparently arguing--it was the only argument advanced by the noble Lord, Lord Bassam, this afternoon--that equality is the all-important consideration. Apparently equality is more important than the protection of young people's health, which is far more imperilled by homosexual rather than heterosexual activity. Equality is more important than the protection of young boys from sexual molestation, harassment and seduction, and, I would say, not just from people in authority.
Then there is the so-called Clause 28. It was introduced, I recall, at the demand of parents who were horrified that local government was using their money to teach children that there was no meaningful difference between a family headed by a man and woman and two homosexuals living together.
There is no evidence whatsoever that the activists responsible for causing all the trouble in the 1980s have seen the error of their ways. Since the passage of Clause 28, they have merely found other ways of pursuing the same agenda, as is obvious from the actions of the Lambeth, Southwark and Lewisham health authority in funding a guide to the etiquette of "cruising and cottaging". The fact that Section 28 has not been invoked is no possible argument for its repeal. And to assert that you cannot teach the facts of life and tolerance without actually promoting a gay lifestyle is just frivolous.
I simply cannot understand how the Government can countenance young people being taught that it is all right to indulge in homosexual activity, and promiscuous homosexual acts at that--because cottaging and the like seem to be part of the gay propagandist pitch--when they know perfectly well that if that lifestyle is adopted by those children it will mean at the very least an increased chance of HIV infection and a reduction in life expectancy.
I want to say a word or two about constitutional matters. I do not know why Mr Blair is so ashamed of his country's past, but, judging by his remarks at the Lord Mayor's Banquet, he certainly seems to be. When he says, "No one is interested in what we were", he totally fails to understand that what we were has made us what we are. And of course we are what we are not least because, for centuries now, Britain almost alone among the countries of Europe has enjoyed stability and security and escaped tyranny: and for that we have to thank not least the strength of our constitution--the institutions, laws and traditions that bind us together as a nation.
Labour, in its arrogance, has never understood that when we tamper with those institutions, which have stood us in such good stead, we do so at our peril. But tamper Labour has, and the consequences could be dire. Devolution could yet lead to the break-up of the United Kingdom. Emasculation of the second Chamber could mean, unless we are very careful, its subservience to a Government who have already set out in the most cynical fashion to weaken the authority of the House of Commons.
What Mr Blair revealed above all in his disgraceful "forces of conservatism" speech at the Labour Party Conference was his contempt for history and tradition. Mr Blair simply does not seem to appreciate the importance of pride in one's country and its past. He does not seem to appreciate the importance of children growing up to feel that being born British, not least because of Britain's history, is to win something like the first prize in the lottery of life--because it is that sort of pride, the shared pride of a people, which creates national unity. But Mr Blair, as he seeks to modernise at any price, as he destroys age-old institutions, has imperilled national unity.
Perhaps Mr Blair does not think that it matters. Perhaps in his mind the days of the nation state are over. But I have a dreadful feeling that if there comes a day when, in servile implementation of the wishes of the European Union, England has been divided up into regions which do not reflect any natural community of interest, when there is no focus for national pride in a place like England, that decent emotion of pride in the country will not be transferred to some government in Brussels, but will be replaced by much more nasty loyalties.
5.44 p.m.
Baroness Massey of Darwen: My Lords, I rise to give this maiden speech with some anxiety, inserted as I am between eloquent and experienced Members of your Lordships' House, both controversial and non-controversial. And I am somewhat distracted by the word "maiden", with its connotations of sport and pastoral idyll, both of which seem irrelevant at the moment. One of my children who is involved in the theatre advised me to "just speak up and avoid the furniture". I shall try my best to do both today.
Before I embark on the substance of my speech, which will be concerned with the health of young people, I must express the honour that I feel in joining this House and having the privilege of working in such distinguished company. I pledge myself to contribute whatever experience and enthusiasm I have to that work.
Since my introduction three weeks ago, I have been impressed by the high level of debate and commitment to causes in this Chamber. I have also been relieved to find a sense of good humour and, at times, levity. I should like to thank most sincerely Members on all sides of the House for their friendly and supportive welcome. It has been a warm and most gratifying experience. The staff and officials, too, have been exceptionally supportive.
In particular, I should like to thank my noble friend, and mentor, Lady Rendell, for unravelling to me the numerous mysteries of your Lordships' House. This she has done with her customary skill and drama.
I now come to the issue that I wish to discuss today--the health of young people. I refer to health in its broadest sense: physical, emotional and mental health as mutually supportive concepts.
There were references in the gracious Speech to health, children, young people, families, education, welfare and care. I shall attempt in the little time that I have today to synthesise some of those references into a context of concern for young people's health, and to place young people at the centre of systems which touch them. My concern stems from a background which is not a parliamentary one but that of a parent, teacher and health educator both in the UK and in developing countries. I am aware that access to systems of care and support for young people's health is sometimes difficult and limited, both in this country and abroad. Many of us are not as young as we were, but many of us on all sides of the House, I know, share an interest in the welfare of young people from a personal and professional perspective, as is demonstrated in your Lordships' debates, committees and all-party parliamentary groups.
I want to do two things today. The first is to describe some of the issues related to the health of young people, and then speak about some initiatives which I believe will benefit that particular group. Health status begins before birth and changes or modifies throughout life depending on circumstances. Patterns of health behaviour acquired when young may persist, for better or worse, into adult life. It is obvious, too, that the prevention of ill health is better, and less costly, than treatments. A recent report from Barnardo's discusses how the determinants of health interact in a complex way related to factors such as genetics, lifestyle, standards of living and inequality. The aim to abolish child poverty referred to in the gracious Speech should, when achieved, contribute ultimately to improvements in general health.
A report from the Trust for the Study of Adolescence (I declare an interest at a member of its board) makes the point that teenagers are usually seen as the healthiest group in society and that, therefore, less attention is paid to their health than to that of other groups. Yet it is clear from a number of studies that the health of young people requires attention, and that unfavourable influences are mitigating against healthy behaviour.
Death rates among young people aged 15 to 19, especially among young men, are particularly high due to injury, poisoning, suicide and transport accidents. Two girls in every thousand suffer from anorexia. The number of young people seeing their GP for depression and what might be broadly termed mental illness is worrying. Levels of smoking, alcohol consumption and the use of illegal drugs are major areas of concern. Risky sexual behaviour has resulted in high teenage pregnancy rates and increases in sexually transmitted infections such as chlamydia. The
All-Party Parliamentary Group on Population, Development and Reproductive Health and that on AIDS have both produced useful documentation on these areas. Nutritional deficiencies among young people are common due to missed breakfast and what is termed "grazing and snacking" on foods of little nutritional value.While risky behaviour is increasing, levels of physical exercise are decreasing. One 1997 study showed that sports among young people took up more time than homework or computing, but less time than TV watching. Some young people are particularly vulnerable. For example, 67 per cent of those in care are estimated to have mental health problems and 58 per cent of the homeless require medical attention when they turn up at Centrepoint. I refer also to young people with disabilities and some young people from ethnic groups, particularly where little English is spoken. Other vulnerable young people include those 19 per cent of children who are bullied at school and the 32,000 on child protection registers.
I have described the problems and given some statistics. But we have to use information and statistics to inform action. This is not about telling people what to do but about enabling and encouraging informed choices through public health policies and health promotion strategies at national and local level. New government initiatives seek to tackle these problems. Action to encourage healthy schools has been taken in relation to personal, social and health education in the curriculum and the promotion of healthy diet and exercise. A positive school ethos encouraged by personal, social and health education can have an impact on motivation and academic performance. The school of which I have been a governor for many years has in five years raised levels of academic achievement by over 20 per cent through a deliberate policy to foster young people's good health and levels of self-esteem.
The Health of the Young Nation strategy and the Young People's Health Network managed by the Health Education Authority are examples of positive intervention. The Social Exclusion Unit, the Teenage Pregnancy Unit and the sexual health and HIV strategy groups are working across government departments and consulting widely. A national family and parenting unit as described in today's Guardian has been set up. The fight against drug misuse has been advanced by the appointment of the Drugs Tsar and the encouragement of local drug action strategies. Long-term targets have been set to tackle killer diseases such as coronary heart disease. Initiatives exist to improve mental health and to tackle issues related to health and disability.
Many voluntary agencies work hard to give young people a better deal either through advocacy or service provision, and their role is crucial. Good practice at a community level is being documented--for example, peer support schemes, consultations with young people themselves and innovative approaches in primary healthcare. In Cornwall one GP has set up a unit in school. All these initiatives, strategies and practices are to be welcomed. Much work remains to be done, however, in monitoring their effectiveness
and ensuring that co-ordination between the initiatives takes place at national and local level and that good practice is shared.I thank noble Lords for their attention. I look forward to debates with your Lordships on the health of young people in a variety of fora and to keeping this most important issue high on the political agenda.
5.53 p.m.
Lord Ackner: My Lords, if one was asked to define the phrase embarras de richesse, it would be to find oneself on a list of speakers in your Lordships' House with a maiden speech both before and after one's contribution. It is a great privilege and pleasure to welcome the noble Baroness, Lady Massey, and to say how much we value her contribution bearing in mind that the health of the young is a particular problem today. The number of unwanted pregnancies among the very young is higher in this country than elsewhere. I have looked at the noble Baroness's entry in Who's Who. I congratulate her on her wide and stimulating interests which will doubtless raise the tone of debates in this House.
I gave an immense sigh of relief when the 28 Bills outlined in the gracious Speech did not include one directed at modernising the Crown Court. To explain myself I must briefly go back in time. Your Lordships may recall that the Crown Court, a superior court of criminal jurisdiction in which major trials take place, was created by statute by the Courts Act 1970 and represented one of the main proposals of the Beeching Commission which sat between 1966 and 1969. Its terms of reference obliged it to inquire into the then existing arrangements for the administration of justice at assizes and quarter sessions outside Greater London.
As was to be expected, the commission cut out the branch lines and concentrated on the main town centres. The Crown Court has thus been in existence for nearly 30 years. It would be surprising if there were not improvements which could and should be made with a view to speeding up the trial process, particularly at a time when such radical proposals are being made in regard to civil jurisdiction. In the days of assizes and quarter sessions the general administration of the courts was substantially in the hands of lawyers: clerks of assize and clerks of the peace. Beeching, however, proposed that the country should be divided into six circuits in each of which there should be an efficient administrative organisation. The administrative officers should exercise,
- "firm managerial control over all matters affecting the smooth running of the courts"--
- "other than those which have a direct bearing upon the discharge of judicial functions".
The report set out in some detail the main administrative functions of the presiding judge. They included the exercise of a broad measure of supervision over the running of the higher courts in his circuit area and ensuring that the administration service conducted the running of the lists at the different centres in an efficient and orderly way.
In 1976 I became a presiding judge on the Western Circuit. This was some five years after the system had been put into operation. At that stage relations between the administration and the judiciary were not at their best. There were no meetings between the 12 presiding judges as a whole with the six circuit administrators. At that stage there were not even meetings between the presiding judges themselves. In a genial letter of congratulation the late Mr Justice Melford Stevenson, a well known judicial wit, observed that the greatest compliment a presiding judge could hope to get from the administration on completion of his four-year stint was that,
- "he didn't cause us too much trouble".
Subsequently his successor, my noble and learned friend Lord Lane--I am delighted to see that he is still in the Chamber--quickly appreciated the value of this thin red line and appointed the first senior presiding judge to improve co-ordination. The first such judge was Lord Justice Tasker Watkins, VC. The current one is Lord Justice Igor Judge.
So much for the background. I now invite your Lordships' attention to a glossy consultation document issued only two months ago from the Court Service and entitled Transforming the Crown Court. Its status is of course significantly enhanced by a foreword from my noble and learned friend the Lord Chancellor. He tells us that the consultation document,
- "sets out important and radical new ways of working for the Crown Court. It expresses a vision of where the courts need to be as we enter the next Millennium and contains a range of ideas for achieving that vision ...levels of service and support to our customers which rival the best of any modern organisation, whether in the public or private sector".
My noble and learned friend, with characteristic wisdom and indeed insight, tells us that some of the proposals may be controversial. Some, he says,
- "may come to be seen ... not to be the right way forward".
- "judges should have planned work which begins at 9am and finishes not before 5pm".
- "This proposal not only runs counter to the wholly laudable idea that more emphasis should be placed on written submissions and on reading out of court but more seriously seems to show complete lack of understanding of the strain imposed on all of those who take part in a complicated trial. It also demonstrates an unawareness of the time at present spent by Judges outside court on reading and preparing reserved judgements as well as on such matters as applications by persons seeking leave to appeal from the Crown Court against convinction or sentence. We have all had the experience of sitting for an extra hour or so on particular occasions in order to complete a trial or to finish with a witness; it is our view that this extra time, though sometimes justified and necessary, is an added strain particularly for witnesses, and that it will do nothing to improve the quality of justice or the efficiency of the courts. It may sometimes be overlooked that the time spent in court during the average week by a High Court Judge is often a source of amazement to judges of other jurisdictions whose sittings are much shorter. It is a matter for regret that this proposal, which predictably attracted widespread public attention, should have been put forward without any prior discussion with the Judges".
Another hardy perennial related to stationing High Court judges permanently out on circuit. It suggested:
- "A more efficient system for meeting High Court criminal workload should be introduced. It might be more efficient to replace the itinerant system with one where a dedicated High Court Judge was permanently based in areas where there was sufficient work of the correct quality (perhaps in larger urban areas or on a Circuit basis)".
The Court of Appeal tersely observed in its observations:
- "We are strongly opposed to this suggestion which would have the inevitable effect of creating two types of High Court Judge--those who spend much of their time in London who would have the opportunity of doing a wide variety of work including some appellant work and those who live and mainly work on Circuit who would be cut off from the more specialised London work and from the constant exchange of ideas between colleagues which contribute so much to the strength and cohesiveness of the High Court Bench. The presence of 'local' High Court Judges would also interfere with the role of the Presiding Judges of the Circuit and their relationship with the Senior or resident or Circuit Judges who together have made a substantial contribution to the disposal of criminal cases".
I view it as a matter of some concern that a consultation document put out as expensively as this should not overlook but should suppress--because that is what it comes to--the fact that its proposals have been actively discussed and rejected, and accepted as appropriately rejected.
I have spoken to Lord Justice Rose, Vice President of the Court of Appeal, who is also the chairman of the Criminal Justice Consultative Council. He has kindly sent me a copy of his letter to the Court Service expressing his astonishment that the proposals in relation to the Criminal Justice Consultative Council and its area strategy committee have been made and circulated without any prior reference to him. He sets out in detail his comments on the proposals and concludes with the statement that the proposals in relation to the council and area committees are incompatible with judicial participation in these bodies and would destroy the character and usefulness of the council and committees as painstakingly established in recent years.
Finally, I understand that circuit judges in their responses have been highly critical of many of the proposals although accepting that there is merit in a judicial inquiry into possible ways of improving the Crown Court. I venture to suggest that that is the course which my noble and learned friend the Lord Chancellor should adopt.
6.10 p.m.
Baroness Gale: My Lords, before I was introduced to this House, I was told of the friendship and warmth I would receive when I arrived. In the few weeks I have been here, I now know that those claims were not exaggerated. In making my maiden speech, I should like to take this opportunity to thank Members and staff for the help, advice, and kindness shown to me.
Having lived in the Rhondda Valley all my life, an area well known for its friendship and community spirit, I can compare your Lordships' House with that feeling of community and friendship. Everyone has made me feel at home here in a short period of time. So much so that one member of staff exchanges a few words of Welsh with me every day, and in return I teach him one or two new words of Welsh each week. He greets me with "Bora Da", good morning; or "Prynhawn Da", good afternoon; and this week I have taught him "Noswaith Da", good evening. These gestures of friendship have been so helpful to me, and I thank you all once again.
I wish to concentrate my brief remarks today on the inclusion in the gracious Speech of the Bills to increase greater voter participation in elections, to establish an electoral commission, and to monitor the funding of political parties. I do so having been a full-time organiser for elections at all levels for many years.
The present arrangements for elections mean that electors can vote only on a weekday and only at certain times: 7 a.m. to 10 p.m.--a 15-hour period--or an even shorter period for local government elections from 8 a.m. to 9 p.m.--a 13-hour period. Not only do we restrict the period of time, but we also confine voting to a small geographic area; where the elector resides.
That may well have suited electors in the past. People often lived and worked in the same area, making it convenient to vote in that area. Today, we live in a different society. People often travel great distances to work. They are not always in their home environment during those hours of polling; or they may arrive home just an hour before close of poll and may decide that there are other things to do, rather than rushing out to vote.
The Government's proposals to allow local authorities to conduct pilot schemes are most welcome. These schemes allow local authorities to experiment with holding elections over a period of more than one day. That is an exciting innovation.
We now live in a 24-hour society. Many superstores stay open 24 hours a day, as do many other businesses. Why not 24-hour voting; or even 48-hour voting over a weekend? The aim should be to make it as easy as possible for people to vote, rather than continue the present restrictive procedures, although I appreciate that Sunday voting is still a controversial issue.
The Bill proposes that there will be the opportunity for voting in places away from the traditional polling stations, perhaps at places that people regularly visit, such as superstores, and leisure centres, or near bus or railway stations. Any new methods that increase voter participation must be welcomed and be seen as an improvement in our democratic procedures.
It is also absolutely clear that action has to be taken to improve the methods of compiling the electoral register. Non-registration is obviously a key factor in people's lack of participation in elections. Consequently, the introduction in the Bill of a "rolling register", to which names can be added during the year, means people will not miss the opportunity to vote in the area in which they live. This should mean greater participation at election time.
Also important is the right of homeless people to register, by a declaration of local connection giving an address for, or nearest to, a place where the person spends a substantial part of his or her time. Similarly, for the first time we will have legislation guaranteeing improved assistance for persons with disabilities. That must be welcomed by all.
The Government's proposal for an electoral commission is long overdue and has been advocated by my party for some considerable time. The electoral commission's role will not be purely one of enforcement. It will have a wide-ranging remit to review electoral law and practice, much of which dates back to the previous century.
It will be required to publish a report on the administration of all major elections, which should bring to light any features of electoral law and practice, including the operation of the new reporting requirements, which seem to deserve further attention. It will also have the crucial educational role in promoting public awareness of, and participation in, the democratic process.
That role will include the promotion of public awareness of electoral systems and systems of local and national government and the institutions of the European Union. In promoting this public awareness, the commission would obviously want to relate to the work being done by the Department for Education and Employment with schools in preparing young people for their role and responsibilities as active citizens and equipping them with the knowledge they require in preparing for the time when they, too, become electors.
But, most importantly, it will have a wide-ranging role in the control of party funding and election expenditure. There will have to be a declaration of all income and expenditure, the exclusion of foreign donations and the need for political parties to undertake any necessary inquiries about the bona fides of a donor. Recent reports only reinforce the need for this legislation.
For the first time a national limit was placed on spending by registered political parties. As the Labour Party's senior official in Wales, I was responsible for the election expenses of the list candidates and the expenses for the All-Wales campaign in the Welsh Assembly elections in May. As well as submitting returns for expenditure, all donations and income from all sources had to be declared. I am pleased to say that when I submitted my returns I was well within the limit of the £600,000 allowed.
I believe that having a spending limit for all parties can only be good for democracy. I am pleased to note that all elections will now come under these arrangements. No longer can any party outspend another. It creates a level playing field for all parties, however big or however small.
In conclusion, the measures set out clearly indicate the Government's intention of modernising the voting procedures, clarifying the campaign financing and spending at elections. That will bring about a much healthier approach and allow a greater degree of flexibility on polling day, creating greater voter participation and a healthier democracy for us all.
6.17 p.m.
Lord Dholakia: My Lords, I congratulate the noble Baroness, Lady Gale, on her excellent contribution. She makes much sense when she talks about the electoral reforms which are necessary. We look forward to many such contributions from her. The noble Baroness has done much to advance the cause of women in the Welsh Assembly and we will benefit from her knowledge of political parties. I look forward to her contributions on equality issues, particularly when women are so poorly represented in your Lordships' House.
There is another good reason why I am happy to hear her contribution. The noble and learned Lord the Attorney-General should realise that as regards Wales there is another voice in this House, and that is delightful.
As chairman of NACRO, I had the privilege to introduce our annual report on 15th November. I had this to say:
- "The links between social exclusion and crime are crystal clear from a glance at the characteristics of people in prison".
It is not denied that much of the Home Office's agenda is shaped by legislation on crime and criminality. From this side of the House, we have supported many of the Government's initiatives and equally have condemned those policies which verged on being oppressive. We often led debates and Questions, both in your Lordships' House and externally, about the supposed failure of the criminal law in dealing with problems of crime and disorder. There have also been worrying features of new offences created by previous legislation.
Only the other day, I was talking to a very senior civil servant--no need for a witch hunt, he has now retired--who told me that, when he was at the Home Office, his department tried to take a vigorous and principled view of the creation of new criminal offences--for example, on the ingredients of the offence, statutory defences, the avoidance of strict liability and the maximum penalty.
The proliferation of regulatory offences in the 1970s and onwards and the changed political circumstances of the 1990s have meant that the old standards are no longer applied today. They are probably not even remembered. Of course, these assumptions were never written down in any kind of memorandum or code, but I would advise the Government to revisit this area again to see if principles could be reconstructed from minutes on file before new criminal laws are contemplated.
There is a lack of adequate database as to how many criminal offences have been created in public legislation and also in private Acts. In a reply from the noble and learned Lord the Attorney-General when he was the Home Office Minister, I was informed that although the Home Office is responsible for scrutinising proposals for new offences in both public and private legislation, no comprehensive records are kept centrally of all new offences created in public legislation. Are we not entitled to ask why such information is not monitored on a regular basis? Would this not help us to examine the effectiveness of legislation passed by Parliament? Properly monitored information would certainly help us to identify whether claims made, for example, by Justice and the Consumers' Association for a middle system of law based on financial charges and enforcement or
reparation orders were more effective than criminal offences and penalties. Could this be the "third way" that we often talk about?The Government accept that the criminal justice system is a scarce resource and take the view that new offences should be created only when absolutely necessary. Again in a Written Answer from the noble and learned Lord, I am told therefore that the following are taken into account in considering whether new offences should be created: that the behaviour in question is sufficiently serious to warrant intervention by the criminal law; the mischief could be dealt with under existing legislation or using other remedies; the proposed offence is enforceable in practice; the proposed offence is tightly drawn and legally sound; the proposed penalty is commensurate with the seriousness of the offence. These are the bases on which the present policies are determined.
If these are objectives set by the Government, then we need to keep an effective record of all new offences and to analyse how effective they have been in meeting the Government's objectives. From what I gather, just taking into account Home Office measures since 1st May 1997, we have created 42 criminal offences and 81 in Private Bills. That is taking a considerable number of offences into account.
The reason why I express my concern is that today we are faced with nine Home Office and Lord Chancellor's Office Bills. The gracious Speech contains some very positive and constructive measures which will improve racial justice, the treatment of offenders and public safety alongside other measures which risk damaging the quality of justice and proving counter-productive in the fight against crime. For example, the modernisation of the welfare system will reinforce people's obligation to society by linking benefit entitlement to compliance with community sentences. Taking away the benefits of people with a recent criminal history will make them more likely to commit crimes, not less. What about the families of offenders? Will they have their benefits taken away? Does this break the European Convention on Human Rights? There are adequate measures for dealing with those who breach community service orders. The courts know how to deal with such offenders. For the Government to further supplement punishment smacks of double jeopardy. We shall certainly seek to amend this legislation at the appropriate time.
The Race Relations (Amendment) Bill is a welcome measure and we await the details of what it will contain. Equality measures deserve strong support from all sides of your Lordships' House. What is known of the Government's intention is that the Bill will extend the Race Relations Act to all public services and, in relation to the police, it will make chief police officers liable for acts of discrimination by police officers. The Bill is driven by the recommendation of the Stephen Lawrence inquiry, which showed that the extension of the Race Relations Act to operational policing was long overdue. At present, citizens can seek redress if someone's racist action deprives them of a house or a job, but not if a racist action of a police officer deprives
them of access to justice from the legal process. This is both anomalous and unjust and the Government's move to rectify the anomaly will receive our support.I have a deep concern that we are likely to miss the boat as regards the radical reform of the race relations legislation The last race relations legislation was introduced in 1976, some 24 years ago. The Commission for Racial Equality has expressed serious concern about the Government's proposals. The Race Relations Act places a duty on the CRE to review legislation and make recommendations to the Government. The CRE, for the first time in its history, has a black chairman whose distinguished service we should all acknowledge. Sir Herman Ouseley brought with him vast experience of local government and community service. He should be taken very seriously. Sir Herman has said that he was astonished that the proposals cover only direct discrimination and left out indirect racist actions and behaviour.
This legislation is driven by the recommendations of the Macpherson inquiry. It stated that the full force of the Race Relations Act should be fully implemented. The Government's proposals fail completely to address the challenge of institutional racism, which is the central plank of the report. The ethnic minority community will be sadly disappointed. The opportunity presented by the report for radical thinking and root-and-branch action has been totally missed. Significantly, the proposed Bill does not accompany the extension of the Act with an enforceable legal duty on all public bodies to combat racial discrimination and promote racial equality. The CRE had produced three separate reviews of the Race Relations Act. The previous government rejected nearly all the CRE's proposals. The present review was presented to the Home Secretary in April and it took into account legal and political changes such as the growing importance of EC law and the Human Rights Act.
Sir Herman has repeatedly stressed the need for a stronger and much clearer legal framework if we were serious about eradicating racism and discrimination and achieving racial equality. The Government should not be surprised if we continue to harass them to achieve those decent objectives. Our great disappointment is that the Government have failed to grasp the opportunity to tackle discrimination on any grounds, be it gender, race, disability, sexual orientation or religion.
There are many matters in the Bill which we certainly appreciate but I do not think this is the place, as time is running out fast, for me to expand on that. However, I started by quoting what I said to the annual meeting of NACRO only two weeks ago and I want to conclude by quoting Helen Edwards, the chief executive of NACRO, when she said,
- "Re-engaging people on the margins of society is not easy. Nor is it quick. Programmes and initiatives often struggle to reach and engage the most disaffected and disadvantaged. New intervention--however well researched and skilfully delivered--cannot instantly transform attitudes and behaviours moulded by years of failure, neglect and abuse. For all these reasons new
- opportunities will take time to materialise for many individuals. Let us ensure that legislation does not push them back into a position they have occupied for most of their lives".
6.29 p.m.
Lord Campbell of Alloway: My Lords, it is a privilege to follow the noble Lord, Lord Dholakia, who made a most constructive speech on matters which the Government have failed to address. As a prelude to debating the gracious Speech in a new House shorn of its successory entitlement, is it not appropriate to reassert the preservation of the symbolism of the ceremonial at the opening of Parliament; the trappings of pageantry associated with this place which serve to enhance the status and dignity of the Crown? Is it not further appropriate to canvass in the course of this debate some tentative propositions as to how the new House may discharge its functions--albeit that that is a matter for the ultimate decision of the House, as the noble Baroness the Leader of the House acknowledged in her Written Answer No. 95 on 5th November?
The amendment moved by my noble friend Lord Strathclyde is supported. The all but incredible omissions from the gracious Speech as regards agriculture were pointed out by my noble friend Lady Byford, the noble Lord, Lord Palmer, and other noble Lords. My noble and learned friend Lord Fraser asked about the implementation of the commitment in the gracious Speech,
- "to increase the effectiveness of the power to remove regulatory burdens".
The commitments in the gracious Speech, devoid of proposals for implementation, are incoherent and lacking in vision, as fairly described in the amendment. They are mere broad aspirations of inchoate intent--not even window dressing, for there are no goods in the window. It is proposed to give but two examples. My noble friend Lord Roberts of Conwy referred to the commitment to making devolution work and the process of decentralisation. How is that to be implemented? Is it not our obligation, at all events, to keep an ever-watchful guard against disintegration of this devolved Kingdom United at the behest of separatists, federalists or Republicans--notwithstanding the threat to invoke the Parliament Acts with a landslide majority in another place?
How is the reference in the gracious Speech to long-term reform of your Lordships' House to be interpreted? There is no commitment to implement any of the Royal Commission's recommendations; no commitment to implement any substantive redefinition or reform of the powers, functions or composition of either House; no security of tenure for any Member of your Lordships' House. Is it not wholly idle
speculation? We put out to sea, decks cleared for action, at the incalculable loss of invaluable expertise to which the noble Earl, Lord Listowel, referred.The efficacy of any action is dependent upon the endeavours at replacement to which my noble and learned friend Lord Fraser of Carmyllie also referred. The revision of extant convention was referred to in the tour d'horizon speech of my noble friend Lord Crickhowell. The setting up of an adequate independent manning selection process in accordance with the undertaking given by the noble Baroness the Leader of the House is for me the sole glimmer of light on our darkest day, with the skill of seamanship at the helm.
I turn now to conventions. As the concept is to achieve parity voting, should we not re-examine the Salisbury convention which was designed--and since implemented ad hoc--only to avoid disparity? As my noble friend Lord Crickhowell said on Monday:
- "Some of our practices will need to change. A number will fall away because the circumstances that caused them to be accepted no longer exist ... In today's circumstances new conventions are required and will have to be developed".--[Official Report, 22/11/99; col. 209]
I turn now to the selection process. The manner in which the appointments commission is set up and enjoined to discharge its functions is now, as a matter of urgency, of crucial consequence. The severely depleted stock of hereditary expertise on the Select Committees, which maintain also the singular standard of erudition in our debates, must be replaced, a point made--as I said before--by my noble and learned friend Lord Fraser of Carmyllie.
Pending the setting up of the appointments commission, or perhaps thereafter, the co-option of hereditary Peers with relevant expertise to serve as members of Select Committees, with the approval of the Committee of Selection, might be an answer. If so, perhaps some appropriate revision to standing orders, if requisite, could be devised.
May this House retain the respect and trust of the people for the old House and remain as guardian of the constitution, protector of minority interests unrecognised by government, and provide an effective curb on executive abuse of power.
There have been many speeches severely critical of the deficiencies in the gracious Speech. I apologise for exceeding the time by one minute, but I conclude that the amendment is well conceived as a timely protest. It is to be commended and supported by your Lordships.
6.40 p.m.
Lord Mackenzie of Framwellgate: My Lords, I rise to speak in support of some of the criminal justice issues outlined in the gracious Speech. The Prime Minister said last week that the Labour Party was despised in the 1980s on issues such as law and order. I was a police officer during those years and can remember that well. For obvious reasons, I was unable to take an active part in politics at that time. However, I can well remember the alienation felt by ordinary people from a party which appeared to be out of touch with the police, lent succour to the criminal and totally ignored the victim.
I can even remember when some left-wing local authorities refused to allow police officers to enter schools for the purpose of speaking about road safety and crime prevention. As the Prime Minister said, the party was unelectable. If evidence was needed of that fact, 18 years in the wilderness provides proof positive. How times change.
Why do I refer to that historical fact? When I saw the reaction of the various vested interests to the proposals in the Queen's Speech, it took me back to the days when I was a police officer and so saddened by the claptrap I used to hear then. I passionately believe in liberty and freedom: the liberty to walk the street without being attacked; the freedom to enjoy the comfort of your own home without being burgled; and the joy of bringing up a family without worrying about the threat of pornographers or paedophiles.
Perhaps, in the short time available, I can deal with a few areas. First, I refer to the crime and public protection Bill. This Bill will modernise and improve the effectiveness of the Probation Service. Probation is a necessary and useful part of the criminal justice system. But it is there for the purpose of crime prevention and the protection of the public; it is not a criminal welfare service. I am afraid that that is how it is sometimes seen by the great British public.
I have a great deal of respect for probation officers. However, I have to say that during my 35 years as a police officer, I knew one or two who had lost the plot. They had forgotten that their real purpose was the protection of the public. The Bill will improve the effectiveness of community penalties in the interests of everyone, including the criminal, but, most of all, ordinary people.
We all suffer from crime, even police officers. A colleague said to me last week that his wife had her credit card stolen. He told me that he had not reported it to the police because the thief was spending less than she was. That is rather a novel situation.
I argued strongly in my previous life, as President of the Police Superintendents' Association, for legislation to prevent people with a history of sex offending from applying for employment or positions which would bring them into contact with children. I can recall cases of paedophiles masquerading, for example, as music teachers and visiting children in their own homes. Having gained a foothold they abused their positions of trust. Those people are manipulators and schemers. I am therefore delighted to see that the new Bill has a provision to prevent sex offenders from working with children.
The attempts in the Bill to break the link between drugs and crime must be supported by all right-minded people who view drugs misuse as a major menace in society. An extension of mandatory drug testing in the criminal justice system is also to be welcomed.
Another Bill which has excited great interest is the Criminal Justice (Mode of Trial) Bill, which removes the right of defendants to elect for Crown Court trial in either way cases. The trade union barons were out in force when it was announced, both from the Bar Council and the Law Society. They condemned the abolition of this so-called "fundamental right" to be tried by a jury. There is no such fundamental right. It was brought in by statute about 150 years ago. What statute can create, it can also amend and abolish.
About 95 per cent of all criminal cases are dealt with in magistrates' courts. No such right applies in Scotland or, indeed, other Commonwealth countries, which in my experience value justice equally. Such a change was recommended by the Royal Commission on Criminal Justice in 1993 and the review of delay in the criminal justice system in 1997. So it has some powerful recommendations.
I can remember when, some five years ago, I proposed that a paedophile register be set up to monitor offenders in order to protect children. The usual suspects talked about the attack on civil liberties. Even some senior police officers said to me, "You'll never achieve it. It goes too far. You'll never get Parliament to agree that a person, having served his sentence, should report his change of address or change of identity to the police". I am pleased to say that as a result of our efforts we now have a Sex Offenders Act on the statute book providing additional safeguards to our youngsters.
Why do I mention that? There are vested interests in this country that are against change. A modern, vibrant government must continue to improve the provision of an efficient, fair and cost-effective criminal justice system. A jury trial costs on average £13,500 compared to £2,500 in a magistrates' court. The new Bill will reduce Crown Court trials by about 12,000 per year, saving the public purse over £100 million per annum. There we have the rub: public money which would otherwise be lining the pockets of lawyers.
In my judgment the provisions are perfectly reasonable and will close down an abuse whereby defendants have been electing trial simply to cause delay before the day of judgment, then quite often pleading guilty on legal aid at great public expense. I have seen it happen at first hand. It should not be
allowed to continue. It brings the criminal justice system into contempt. Justice demands that cases are dealt with quickly, with proper safeguards built in to take account of livelihood and reputation. With the provision of an appeal to the Crown Court, those provisions are eminently sensible and welcomed by the police and magistrates alike.I have heard it said that the provision to take account of the effect on reputation and livelihood would discriminate against working-class people. It is a gratuitous insult to suggest that middle and upper class citizens somehow have a higher reputation than people in the lower orders. A glance at recent events in the world of political sleaze gives the lie to that suggestion. As I have said, the Bill puts England and Wales on a par with Scotland.
Finally, perhaps I may briefly comment on the future Bill to reform policing in Northern Ireland. We all welcome the progress that is slowly being made in that troubled Province and wish all parties well in their deliberations. I speak with experience when I say that the Province has the most respected police service in the United Kingdom--the Royal Ulster Constabulary. I echo the words of the noble Baroness, Lady Harris of Richmond, in her excellent maiden speech in applauding the inspired award of the George Cross by Her Majesty.
I read recently that one in five officers leaving the force on non-medical grounds--I stress "non-medical grounds"--are in need of medical treatment. That such suffering should be heaped upon the fact of 302 officers murdered, 9,000 injured and 540 families intimidated out of their homes should give us all food for thought.
Those injustices did not happen because those police officers were members of a force called the RUC. They could have been called the Irish Metropolitan Police or the Six Counties Constabulary. No; they happened because they were doing a job of work upholding the rule of law on our behalf against those who know no rules.
Chris Patten produced a report containing many good features; the police would not quarrel with that. But what the Patten Commission did not appear to understand was that the force name and badge give officers a necessary sense of identity and comradeship--essential to high morale and providing the fibre to take on, as we know at great cost, the forces of terrorism--in much the same way as a regiment is fiercely proud of its identity, and as I am immensely proud to have been a member of Durham Constabulary.
I only hope that the new Secretary of State--an inspired appointment--has the skill and sensitivity to take those important points on board when, following the consultative process, he finally produces a package for policing Northern Ireland which accommodates the needs of all sides. I wish him well in his historic task.
6.51 p.m.
Lord Mackay of Drumadoon: My Lords, in view of the injunction we all received from the Chief Whip at the outset of this debate, I intend to confine my contribution to one topic and to speak very briefly upon it.
The topic I raise is the practical implications for the governance of our country of bringing into force during this parliamentary Session the bulk of the provisions of the Human Rights Act 1998. Noble Lords are of course familiar with the fact that when any Bill is now introduced by a government Minister, it carries with it an expression of opinion by the Minister that its provisions are compatible with convention rights. Increasingly, as we scrutinise legislation, convention rights issues are at the forefront of our minds. I suspect that that will be particularly so when we come to debate Bills such as the Armed Forces Discipline Bill and many of the nine Home Office Bills mentioned by the noble Lord, Lord Bassam, today.
It is not the convention rights issues of Bills that I seek to dwell on but the fact that, on 2nd October next year, the Government intend to bring into force the main provisions of the Human Rights Act throughout the United Kingdom. That is an important issue and one that should be before us in our debates throughout the current Session. In seeking to raise this matter, I stress that I do not intend to revisit either the principles that lie behind the Human Rights Act or the many lengthy and interesting debates we had on it when the Bill was before us. I fully accept that the Act is now part of our law. As a practising lawyer, I would be the first to acknowledge that convention rights are already throwing up many interesting legal issues which make life in the courts more challenging, more unpredictable and, I have to confess, more financially rewarding. What concerns me, however, is whether the courts and tribunals of the United Kingdom are so constituted that they will withstand scrutiny against convention rights when the Act is brought into full force.
What prompts me to raise this issue at this time is the recent ruling of the High Court of Justiciary in Scotland, which brought to a somewhat abrupt halt the use of temporary judges in Scotland. Prior to that case temporary sheriffs sat regularly throughout the sheriff courts in Scotland. They were appointed in the name of the Secretary of State for Scotland and held appointment for one year, their appointments normally being renewed automatically. Statutory provision existed for such appointments to be recalled, though it was rarely exercised. Some of those who sought and held appointment as temporary sheriffs saw it as a stepping stone to permanent appointment, whether as a sheriff or as a High Court judge.
The case to which I refer arose out of the summary prosecution of two accused men in Linlithgow sheriff court. Their trial began on 5th May before a temporary sheriff. It could not be completed on the first day of the case and was required to adjourn, due to pressure of court business, to a date in July. By that date the full provisions of the Scotland Act were in force. As your Lordships may be aware, the Scotland Act's provisions
include an obligation on all members of the Scottish Executive, including the Lord Advocate--the public prosecutor--to act in accordance with convention rights.When the case resumed, the issue was raised as to whether or not the temporary sheriff was an independent and impartial tribunal within the meaning of Article 6(1) of the convention. To cut a long story short, ultimately the High Court of Justiciary ruled that he was not. As a consequence the use of temporary sheriffs in the sheriff courts has come to an end. Some 129 temporary sheriffs lost their positions and in the High Court in Scotland the use of temporary judges has come to an end also.
While the loss of such part-time employment may have been the cause of some inconvenience and a measure of disappointment for the holders of the posts, the much greater concern must be for the effective and efficient administration of justice. As a consequence of the withdrawal of the commissions of temporary sheriffs, certain criminal cases have required to be adjourned. In addition, both civil and criminal cases will be delayed. There is a certain irony in that the incorporation of the European Convention on Human Rights into our domestic law is leading to justice being delayed. As the noble Lord, Lord Bassam, reminded us earlier, "justice delayed is justice denied".
It is for the Scottish Executive and the Scottish Parliament to consider what should happen in Scotland as a consequence of this important case. I wish to make it clear that I do not seek to criticise what happened in Scotland, nor proffer any suggestions as to how the problems that exist might be resolved. That is for others in Scotland to consider. My concern is a wider one. It is that when the provisions of the Human Rights Act are brought into force in October next year, no similar problems should arise. Next week, a Question tabled by the noble Lord, Lord Goodhart, will be heard concerning the position of assistant recorders and recorders. I look forward with interest to the Answer that will be given to that Question.
However, the problem is much wider than the role of recorders and assistant recorders. Apart from the position of deputy High Court judges, who are widely used in England and Wales, there are many tribunals, with UK-wide jurisdictions, in which part-time members (both lawyers and non-lawyers) play a major role. VAT tribunals, the General Commissioners of Inland Revenue, employment tribunals and tribunals dealing with social security benefits, immigration, criminal injuries and compensation are examples that immediately spring to mind. If it proves impossible for part-time members to continue to sit in such judicial bodies and tribunals, there would be major consequences for the administration of justice and the timeous and effective carrying out of the procedures that exist for determining the civil rights and obligations of members of the public. In many instances, of course, such disputes are between members of the public on the one hand, and the state on the other. Likewise, if the procedures of such tribunals
cannot withstand scrutiny against convention rights, then the substantive rights of individual citizens will not receive the recognition and regulation they should.I trust therefore that the Government will acknowledge that it is essential that your Lordships' House should be kept fully informed over the coming months about the preparations being made for the implementation of the Human Rights Act. This House has a right to be informed of where the problem areas lie and what steps are being taken to deal with them. Those issues are just as important as many of the issues that will arise in the Bills mentioned in the gracious Speech.
I hope that the Government will make such work as they are doing available for public scrutiny by the preparation of reports lodged in the Library of the House and by the giving of detailed Written Answers to questions. If these matters are not debated in Parliament and resolved in this and another place to the satisfaction of the general public, the issues will be left to the courts. That will give the courts a greater role to play in the governance of our country, and some believe that that may weaken the role of your Lordships' House.
7 p.m.
Lord Patel: My Lords, it will not surprise noble Lords that my brief comments today will be related to health. However, before I begin, perhaps I may say a few words in relation to proposed legislation on racial discrimination, which I welcome. I hope that the legislation will be wide enough to include both direct and indirect racism in all of the public services, including the health service. I am sure that the Minister will be relieved to hear that, unlike other noble Lords, I am not going to make any suggestions as to where to get the best obstetric advice.
Comment was also made about the increasing rate of caesarean sections and how a reduction in that rate will lead to savings. I believe that the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives are currently involved in a study to address that issue. I agree though that the wider practice of evidence-based medicine will reduce costs--recently reported Medical Research Council funded trials on neural tube defects, the management of patients with diabetes Type II and criteria for surgery for hip replacement. If adopted, they will all lead to a reduction in costs.
I welcome the Government's intention to bring forward legislation to regulate private healthcare as part of their 10-year programme for the modernisation of the health service. I hope that this and other debates relating to health improvement will also be an opportunity to discuss whether the current structure of our healthcare provides the high quality of healthcare that we all seek.
I welcome the recognition of the need for more effective regulation of the private healthcare sector. I have alluded to this in your Lordships' House on a previous occasion. While much of the care provided in the private sector is of a high calibre, we need to ensure that it meets the same standards of patient care,
especially when things go wrong, as demanded in the NHS. Equally, the same mechanism of audit, clinical governance and inspection should apply to the private sector.The same regulatory mechanism should also apply to the private facilities within the NHS. It will be important to ensure that the regulatory framework includes not just the general provision of care and organisational standards but also specific treatments. How to, and who will, carry out independent external monitoring, whether this be by peer appraisal or audit, will require careful thought, particularly if it involves the hard-pressed workforce in the NHS carrying out such a task. Regulation leading to accreditation should not only apply to private hospitals but to any premises where invasive treatment is carried out.
Finally, as chairman of the Specialist Training Authority of the United Kingdom in Medicine, I hope that the legislation will address the issue of who is allowed to provide medical care in the private sector and what training the doctor has had. Currently, only those doctors who are on the specialist register of the UK are allowed to hold the position of consultant in the NHS. Similar regulation should apply to the independent health sector. In this context, there is an issue of what professional titles a doctor in the private sector can be allowed to use so that the public have confidence that the treatment received is from a fully trained medical specialist. I look forward to the proposals for legislation and taking part in the debate. I hope that the Minister will agree that these are important issues which need to be addressed.
7.4 p.m.
Lord Colwyn: My Lords, before I begin, perhaps I may point out that the smell of cooking is particularly obvious in the Chamber this evening. I should like to assure noble Lords, and place on the record, that it does not emanate from the House of Lords' kitchen but from the temporary arrangements for the other place which are situated not very far from here.
In the debate on the gracious Speech this time last year, I said that the dental profession had become disillusioned with the Government who had come to power with promises to reduce inequalities in health and to improve access to services. My profession were told that the Labour Government would address the problems of high decay rates in deprived areas and make NHS dentistry available to all patients who wanted it.
In my speech, I chided the Government for not presenting plans for a strategy for NHS dentistry which had been promised in the autumn of 1998. We are now one year further on and the strategy has still not been announced. However, I am happy to say that there have been two statements within the past four months which the profession welcomes. The White Paper Saving Lives: Our Healthier Nation announced an expert scientific review of the health benefits and safety of water fluoridation and made it quite clear that, subject to the outcome of the review, it is the Secretary of State's
intention to transfer the responsibility for public consultation on fluoridation proposals to local authorities and to change the law to oblige water companies to fluoridate where there is strong local support. My noble friend Lord Baldwin has now taken his seat. He will not agree with me, but fluoridation really does go a long way towards reducing oral health inequalities, where 80 per cent of the disease problems occur in 20 per cent of children--those in socially deprived areas both in inner-cities and rural places--and among minority ethnic communities.The Minister would become extremely popular if he could confirm that plans for fluoridation are proceeding as announced. He would be even more popular if he could announce a date for the dental strategy, and perhaps achieve cult status if he could confirm that the Government's intention is to make improvements in oral health, as specified in the Adult Dental Health Survey due to be published next month.
Speaking at the Labour Party Conference, the Prime Minister pledged:
- "Working with the British Dental Association, everyone within the next two years will be able to once again see an NHS dentist just by phoning NHS Direct".
- "one phone call to NHS Direct will result in the caller being directed to an NHS dentist who is within convenient travelling distance".
The department has announced a system of "phone and go" schemes across the country which will be set up following the personal dental services projects in Shropshire and Cornwall. I hope that the Minister can confirm that the seven more due to be opened this autumn are on time and that there will be no delay to the further 20 or 25 schemes that have been promised for next year.
There are many in the dental profession who are sceptical about this. The General Dental Practitioners Association has described the new initiatives as,
- "no more than window dressing".
- "unless the Government put their money where their mouth is, the Prime Minister's promise cannot be delivered".
On Monday, Mr Milburn announced a first step towards "generic" health workers, who would be paid according to the benefits that they gave patients rather
than their job title. Perhaps I could remind the Minister that the dental profession has been working under these arrangements for over 50 years.The Department of Health is being carefully monitored. It would be a rash Prime Minister and Ministers who, in what will be the run-up to the next general election, made promises to achieve something which they could not keep. They will be held accountable by the media and by Parliament if in two years' time there are still complaints about finding an NHS dentist at the end of 2001.
Last year I touched on the issue of tooth whitening. This is a dental technique which is used as an alternative to more destructive dental treatments and was banned this time last year because of an EU directive which states that bleaching is a cosmetic treatment rather than a medical treatment. What utter nonsense! The decision denies British dentists the legitimacy of significant scientific research on the safety of this concept and the successful, non-eventful clinical usage by millions of people over a decade. The technique has been accepted by the official dental organisations of major countries, including the United States, and it should not be in the domain of governmental agencies to control or dictate scientific or clinical policies beyond their realm of experience and education.
The DTI disagrees and, despite some minor changes, the EU is insisting on restrictions which seem to be enforced in the UK but not elsewhere in Europe. I hope that the Government will urge the DTI to continue to press the Commission for an early solution and an immediate application of any change in EU law.
Staying with Europe, I turn to complementary medicine and remind the House that the primary objective of the status of complementary medicine in Europe is,
- "To guarantee patients freedom of access to the treatment of their choice, whilst ensuring safety, and at the same time allowing practitioners freedom of establishment and freedom to provide services. However these must be accompanied by effective guarantees to protect patients".
Those working in the field of complementary medicine need to accept that there are challenges ahead that must be met to provide the public with the necessary assurances: a challenge to provide new evaluation criteria appropriate to the therapy and the products used; a challenge to practitioners to prove their knowledge and skill and to the manufacturers to provide good quality, safe products; and a challenge to the legislators and medical profession to widen the conceptual framework within which their scientific theories are constructed.
Despite the hundreds of millions of pounds spent on the NHS and similar amounts spent on the development of different drugs, we have not become
any more healthy. One in two of all adults takes a synthetic drug of some kind every day. Some 75 per cent. of all visits to general practitioners involve the prescription of a synthetic drug and something like 16 million adults take synthetic drugs on a regular basis. At any one time almost a third of the nation has a long-standing illness. The incidence of heart disease, cancer and respiratory diseases is increasing. I commend the department's determination to treat these diseases as absolute priority.The benefits of alternative and complementary medicines have been recognised by the public. There is an increasing demand for these treatments in the private sector and calls for wider availability through the NHS. It is up to the Government to respond with a respect for the individual's freedom of choice. I hope that the Government meet this demand with prompt and positive action.
There is also an increasing demand for health food products. The health food sector has an important role to play in helping the Government achieve their ambition of a healthier nation. Through the HFMA and other industry bodies the sector has put proposals for a new "third category" for the regulation of herbal products which allows them access to market in an appropriate legislative environment, classed neither as simply foodstuffs nor as pharmaceutical drugs, but accepting instead their special status and long-standing use.
Herbal remedies are also one of the most popular sectors of the health food trade, but misunderstandings about such products and antagonism towards them from the established orthodox scientific community has led to uncertainty in the regulatory environment. What is needed is a new affordable and achievable framework for herbal products which would allow them to be marketed with adequate information as to their nature and purpose while providing appropriate regulatory controls as to their safety, quality and efficacy.
In conclusion, I return to dentistry and finish with the identical final paragraph to my speech last year as not a lot has changed. I said then:
- "The dental profession looks to the Government to translate its ideas into action during this Session of Parliament. Dentists ... accept the need for modernisation, but such changes need a proper level of funding".--[Official Report, 2/12/1998; col. 569.]
From this side of the House we shall watch with interest.
7.14 p.m.
Baroness Linklater of Butterstone: My Lords, I should like to confine my comments on the gracious Speech to the implications of further remands in custody for those who have been mandatorily tested for drugs and found to be positive; those which relate to young people in trouble; and the urgent necessity for this Government actively to develop and expand alternatives to custody, particularly for children and young people but also for adult offenders.
The Government have expressed their intention to reduce crime and to improve public protection, a highly laudable aim particularly as regards drug related
offences as such a high proportion of offending is drug related. However, mandatory testing raises some important questions. First, if there is not a clear link between the reasons for the arrest and drug use, it will raise issues of civil liberty. We on these Benches would oppose such measures unless the link is clear. The police have already expressed reservations about the practicalities of mandatory testing because of the time and costs involved, and now it seems that any testing is likely to be left to their discretion. As the issue is so sensitive, this will require the police to be transparently objective and even-handed in how they conduct the tests.Finally, and importantly, it is likely that the Bill will result in more people being remanded in custody. That is highly undesirable. Our prisons are already unacceptably overcrowded and are themselves drug ridden, so those remanded will go from the frying pan into the fire. Far more effective will be measures to make advice, support and treatment a condition of bail. We would support wholeheartedly any plans to expand, for example, arrest referral schemes.
There continues to be a steady rise in the number of people in custody in this country. In particular there is a quite terrifying escalation in the number of young people being locked up in England and Wales, with the greatest increases among the youngest children. Without dazzling your Lordships with statistics, the population of 15 year-old boys imprisoned between 1993 and 1997 has more than doubled. The figure for 16 year-olds has risen by 130 per cent. The figure for 17 year-olds has risen by 73 per cent. In Scotland, by contrast, where no 15 year-olds are routinely imprisoned, and where the Children's Panel system can keep children out of the criminal justice system until they are 18, the figures have remained virtually static.
Most shocking of all, the Government embarked last year on a strategy in England of locking up 12 to 14 year-old persistent young offenders in a so-called "secure training centre". This was the subject of a most interesting debate in March of this year following a most damning report. The centre is now full again and I have just learnt that two more such centres have since opened in July and September. Such provision is inappropriate, ineffective and deeply shocking.
We now know that in many of our young offender institutions conditions prevail which have been condemned as being "nothing short of disgraceful" and "appalling" by the Chief Inspector of Prisons who asked whether the staff at a particular YOI and at headquarters would be happy for their sons, or the sons of their friends, to be on the receiving end of the treatment and conditions described in his report which, he said, "are unacceptable in a civilised country". This is a serious question. For however much these young people have offended in an unacceptable way--and all offending is unacceptable--we must never forget that these are also young people who require help as well as punishment, however awful their offences. They, like all prisoners, are sent away as a punishment, not for further punishment--something which is often forgotten.
Punishment should not only fit the crime, but also the criminal if it is to have a positive outcome. Regimes which intimidate, undermine any sense of self-worth, where bullying is part of the culture and nothing is done to address the offending behaviour of young people, will fail to prevent further offending in the future. The vast majority of young people in custody come from backgrounds which are poor in every sense of the word with, "disproportionate experiences of loss", as one report put it, characterised by instability, violence, abuse, poor education, or lack of it with life prospects which are at best very limited. If they are then put in conditions which neither fit the crime nor them as criminals, is it any wonder that 90 per cent of them re-offend, as they do?
Perhaps I may remind your Lordships of Article 37 of the UN Convention on the Rights of the Child, which states,
- "Every child, deprived of his or her liberty, shall be treated with humanity and respect for the inherent dignity of the human person, and in a manner which takes account of the needs of persons of their age".
So the question is: how are the interests of the public being served? Quite clearly measures which increase the prison population do not lead to a reduction in crime as intended in the Crime and Protection of the Public Bill--quite the reverse.
Putting people into overcrowded prisons in ever larger numbers does nothing to improve the protection of the public since, particularly among children and young offenders, it simply leads to more offending thus threatening public protection still further. All that is achieved is strictly limited protection while the offender is in custody, but he will be released in due course.
I passionately believe that the real way to protect the public is to develop those community penalties which have demonstrated how much more effective they are in terms of reducing re-offending--by up to 50 per cent and more--which cost a fraction of custody and keep the offender in the community thus not fracturing family ties, job and home. It costs the taxpayer £18,500 per annum to imprison a young offender, and a staggering £124,800 per annum in the secure training centres, with resulting 90 per cent to 100 per cent re-offending rates. Logic, reason and humanity, with the incredible disparity in costs and results, speak for themselves.
The Government have talked about being "tough on crime" and that seems to be invariably equated with locking people up. Alternatives are seen by the public, the sentencers, the media and the Home Office as a soft option, an easy way out. Indeed there is some evidence that Home Office Ministers have "talked down" community penalties, presumably because they are not seen to be tough enough. But that is not the case in reality. As well as being unpleasant and often negative, in some crucial ways it is custody which is the soft option since it represents an opting out of responsibility
to families and to the community which is so difficult to face up to for so many offenders. Those like myself who argue for the alternatives to custody do so not because we are soft on crime and criminals but because we want to see a system which really does reduce crime and protect the public.It is most welcome, therefore, that the extension of electronic tagging is being proposed, precisely because having already proved to be a very effective way of releasing short-term prisoners early without risk to the public, it could also potentially increase the numbers of long-term prisoners who can safely be granted parole by providing extra control over their movements.
These arguments do not however detract from the need to remove into custody those violent individuals who are a danger to their families and others in the community. Here prison has an important role. With fewer inmates, prisons could address this task much more effectively. Contrary to popular belief, violent offenders represent a small proportion of the total prison population (under one quarter). We must do what we can to help the prison services in this very difficult task. I know from my work with the Butler Trust what they can achieve in often impossible circumstances.
At present overcrowding, which is a national disgrace, makes it very difficult for custody to achieve anything but retribution. But what purpose does that serve unless accompanied by real deterrence and rehabilitation? Manageable numbers are essential if regimes are to be improved and sentences truly effective for those for whom custody is necessary and appropriate.
I welcome anything in the proposed legislation which will really achieve the objectives of crime reduction and public protection. But I urge the Government seriously to consider measures which will actively reduce the unacceptable numbers of people in prison; energetically to promote all possible alternatives to custody particularly where young people are concerned, and to remove from the criminal system children who simply should not be there. Without such initiatives we may succeed in satisfying the public need for retribution but we shall achieve little else.
7.25 p.m.
Baroness Rendell of Babergh: My Lords, a recent study has shown that people are happiest not in their middle years, but in youth and old age. Good health is a notable contributor to contentment and essential if vigour and an enthusiasm for life are to be maintained. Age is no longer a reliable indicator of a man or woman's abilities and aspirations. Today, older people can look forward to many more years of healthy, active life. They have complex needs that the National Health Service must address in partnership with others, particularly with local government. The Government's partnership agenda in the Health Act 1999 ensures that there are no barriers to joint working.
The noble Lord, Lord Clement-Jones, raised the question of age discrimination in the NHS on this issue. The National Health Service Framework for Older People will be established in April 2000 dedicated to reducing variations in the quality of health care.
Age Concern's report Turning your Back on Us cites examples of ageism in the National Health Service. Old people are told that treatment is unavailable to them because of their age or are given a low priority. Six months ago an Age Concern survey found that one in 20 people over the age of 65 in Britain had been refused treatment by the NHS. Areas of special concern are routine breast screening, cancer and coronary problems where there appears to have been positive discrimination.
The gracious Speech lays emphasis on the Government's aim to promote fairness and enterprise. In 1998 the Department of Health responded to public concern over the poor care of older people in hospital by commissioning the report Not Because They Are Old. The report found serious flaws in the standards of NHS care and instances of variability. The purpose of the National Health Service Framework for Older People is to address ageism and set national standards of care. It will set an agenda for the provision of services for coronary heart disease over the next 10 years which will aim to improve health, reduce inequalities and raise the quality of care, making explicit the need to ensure that services are made available to everyone who can benefit irrespective of their age or where they happen to live. It is considering areas of care that are of primary importance to older people. These include palliative care, transition from, to and within hospitals, models of assessment and care management, mental health, and physical and psychological injuries as a result of accidents and stroke.
Forty thousand hip operations were undertaken by the NHS last year. Most of them benefited older people, as does cataract surgery. The Government's guidance to the NHS stated:
- "Clinical priority must be the main determinant when patients are seen as out-patients or admitted as in-patients".
Over the next three years, the Department of Health will be expanding cataract services from the present 170,000 a year to 250,000, restoring eyesight to thousands of older people.
Older people must also learn to help themselves. My noble friend Lady Massey, in an excellent maiden speech, mentioned the importance of diet and exercise for young people; these are equally needful in the case of the elderly.
It is important to stress that in recent years the range of treatments available has greatly increased. Older patients can benefit from interventions that only a few years ago would have been regarded as too hazardous. Professionals and managers in the field must take account of the enhanced ability of older people to profit by active treatment. Above all, there must be no more cases such as that quoted by Age Concern, in its Turning Your Back on Us, where a woman of 65, with a possible 20 years of life ahead of her, was refused a heart transplant on account of her age. A positive drive against ageism will end injustice such as this.
I spoke earlier of old age and youth. The happiness a woman may expect to enjoy in her youth is severely impeded if she is a victim of female circumcision. This assault on female children is known and enshrined in the Act of Parliament of 1985 as "Female Circumcision", but those of us who know anything about it prefer to call it by the more accurate name of "Female Genital Mutilation". Circumcision suggests the harmless surgery carried out on Jewish male babies within a few days of birth. "FGM", as I shall refer to it, is not like that.
Here I must declare an interest as patron of the London Black Women's Health Action Project. The practice of FGM is a violation on a woman's profoundest sexual being, a gross mutilation of her genitalia and a deprivation for life of any kind of sexual pleasure or satisfaction in the process of giving birth. Far from being a quaint traditional practice carried out only in isolated areas, FGM is widespread across 30 countries. The World Health Organisation estimates that more than 126 million women have undergone it and a further 2 million undergo it each year. Today there is no practical, ethical or hygienic reason for its continuance; and, with neither the Bible nor the Koran endorsing it, no religious precedent.
Female genital mutilation is a major health hazard. Immediate risks include shock, infection, tetanus, septicaemia and haemorrhage. Most women who have been subjected to Pharaonic circumcision are able to deliver their babies only by Caesarean section. In spite of the protection offered to women by the Prohibition of Female Circumcision Act 1985, all forms of FGM are carried out in this country. It is also not unusual for parents to take their small daughters home to the country of origin, ostensibly for a "holiday", and there have FGM performed. Sad to say that FGM is usually performed on children between the ages of four and 10.
Parents are unaware of wrongdoing. They believe that they are doing their moral duty and acting in their daughters' best interests. Without circumcision, many believe that their daughters will be unmarriageable or ridiculed and ostracised by the community in which they live.
In moving the humble Address in response to the gracious Speech, my noble friend Lady Pitkeathley made the "real world" the theme of her speech. The real world for these young women, particularly those who are the victims of infibulation or Pharaonic circumcision, is a place of pain, unpleasant hygiene procedures, chronic ill-health and often an inability to deliver their children normally. There is also a risk of infertility as a result of pelvic infections.
A surgical reversal of FGM is possible, but it is necessarily limited. However, although most women are willing to undergo this surgery, success depends on the severity of the original mutilation and not all are suitable candidates. Even at its most successful, this surgery cannot restore normal genitalia.
It is essential in a civilised society that the Act of 1985 and the Children Act 1989, which provides legal protection for girls, should be in place, but so far no prosecutions have been brought under the former. It would be encouraging to those who campaign for a more enthusiastic addressing of this problem if prosecutions were to be brought in the coming year. Unfortunately, a conspiracy of silence exists among parents of girls and those health professionals who can be induced to perform FGM.
The Department of Health provides core grant funding of £25,000 for 1999-2000 to FORWARD, a voluntary organisation on this issue, and has provided up to the year 2000 a project grant of £22,000 to produce a health education pack for professionals working in local health, education, social services and police authorities. This is excellent as far as it goes but more needs to be done on the lines of further funding through the ethnic minority access grant scheme. This has so far included the cost of a community training officer to FORWARD whose role is to liaise with ethnic communities to produce health and education literature in relevant languages. It also funds a project by the London School of Hygiene and Tropical Medicine and the London Black Women's Health Action Project to investigate the continuation of FGM among young Somalis in London. The report provides insight into the viewpoint on this subject of young Somalis who may contemplate circumcising their daughters. It appears that about 15,000 girls are at risk of FGM in the United Kingdom.
That is a very large number of vulnerable and largely defenceless victims. If this mutilation took the form of amputation of a hand or a foot, it would be viewed by the majority as an outrage. I believe that it is time for a nation-wide campaign to enlighten those--and they are many--who are ignorant of this procedure, the frequency with which it occurs, and its health and life-damaging results.
7.36 p.m.
Lord Mayhew of Twysden: My Lords, this is a fascinating debate and it is a privilege to be able to take part in it. The sad thing from my point of view--but, doubtless, not from your Lordships'--is that one is simply unable to pick up on the many speeches that have been made and to comment upon the excellent
points that they have contained. One thinks of course of the excellent maiden speeches that have been made today. I think in particular of the speech of my noble friend Lord Forsyth and of the noble Baroness, Lady Linklater of Butterstone; and I hope that the noble Baroness who has just sat down will forgive me but, for that reason, I am unable to follow her.I wish to detain your Lordships only briefly, with a thought or two about no more than a couple of the plentiful Home Office Bills that have been either announced or alluded to in the gracious Speech. The first of them I warmly welcome; that is, the Crown Prosecution Service Inspectorate Bill. The second, the Criminal Justice (Mode of Trial) Bill, I just as warmly deplore.
The Crown Prosecution Service has not been alluded to in the debate, but this gives me an opportunity to bang the drum for it. I have always greatly admired the standards of professionalism that in general--obviously not always--the service has attained from a standing start which was made in extremely adverse conditions. I am sorry to say that I feel rather guilty that conditions were as adverse as they were. I was the Solicitor-General at the time it had to be set up about 13 or more years ago. To be frank with your Lordships, I did not have the political clout to get the necessary resources out of the Treasury with which to get it off to a proper start. Accordingly, the Crown Prosecution Service started off with about 25 per cent fewer lawyers than it needed.
That was a misfortune that did not cause undue distress to a number of people with vested interests. People with vested interests were referred to by the noble Lord, Lord Mackenzie of Framwellgate, in what I thought was a most interesting speech, some of which I agreed with and some of which I disagreed with. At the time of the inception of the Crown Prosecution Service certainly there were present various people who were not at all happy to see it succeed. Therefore, I felt a little responsible and rather guilty about the fact that it rapidly acquired an unfair reputation for inefficiency.
At this stage in my speech, any Crown prosecutor would undoubtedly feel obliged to caution me. So I shall make only one further point on this subject before passing on to the mode of trial Bill. I wish to welcome the inception on a statutory basis of an inspectorate. I believe that it will be of great help both to the Crown Prosecution Service and to the Attorney-General, who answers for the service in Parliament. It will be of assistance to the service because it will provide reports that are free of any possible allegation of self-serving defensiveness by the professional head of that service. I do not believe that those allegations have ever been justified, but they have been there. An inspectorate will be of value to the Attorney because it will be an entirely independent report on the workings of the service for which he is responsible and for which he is responsible for obtaining the necessary resources from the Treasury. Therefore, I believe that that is a welcome inclusion in the Queen's Speech and in the legislative programme.
As to the second Bill, I have no feelings whatever of parenthood and, therefore, no feelings of concomitant guilt for it. Personally I have always resisted attempts to curtail the right to choose trial by jury. I do not feel stung by the assertion that those who feel as I do are motivated by considerations of pecuniary advantage. The reason why I do not feel stung is that I do not have any pecuniary advantage, and I do not believe that most people who have taken the line that I take on the matter, which I propose to mention briefly this evening, are motivated by that at all.
However, I have a considerable interest in fairness and, in particular, in the fairness of the justice system in England and Wales, including perceived fairness. I am well aware that on occasions the interests of fairness can conflict with the interests of Her Majesty's Treasury and of the Executive generally. I believe that this Bill illustrates that conflict. My belief is that the present dispensation about choosing jury trial--I agree that it goes back in statutory form only to 1857--is about right. I believe that it makes for fairness. It is used--some might say that it is resorted to--only in a very small proportion of the possible cases. That is a point that has already been made. But in each of those cases, the case is of particular importance to the accused person against whom, let it not be forgotten, there is a great imbalance of forces. The whole prosecuting arm of the state, with all its experience and expertise, is pitted against him or her.
If it were the case that the whole idea of jury trial was somehow now recognised to be outmoded in modern Britain, that would be one thing. Fortunately, it is not. We are being told that in a number of serious cases the type of trial should no longer be decided by the accused person exercising a right of choice but by the magistrates' court. Summary trial is highly practical and generally extremely fair. I have nothing but admiration for our unique system of lay magistracy, which deals with something in the order of 95 or 97 per cent of all criminal cases. I believe that it is an excellent and certainly a unique system.
However, there are cases in which the very width of the magistrates' experience can, in my belief, give rise to a risk of unfairness. In particular, I would instance shop lifting cases--or they can be perceived to give rise to the risk of unfairness. In a moment I shall venture to give an illustration. It is in order to meet circumstances of that kind that the present right to refuse consent to summary trial should be retained.
I put a scenario to your Lordships in the hope that it will be found to be a valid illustration of the point that I make. Perhaps your Lordships will imagine a young mother with four children. She is much harassed by domestic concerns and has a lot on her plate. She is behind time. She is shopping in a supermarket. She fills her trolley and, extraordinarily, she somehow wheels the trolley past the cash desk without paying. Her head is full of other things. She turns left on the pavement; she crosses one intersection; she crosses another intersection. It is then and only then that, to her horror, she realises what she has done or, more accurately, what
she has not done. In a panic she rushes back into the store and says, "I have not paid for these. Please let me pay".That is one scenario. In the minute or two remaining to me, perhaps I may suggest a variant; that is, that before the young mother has had a chance to pay, she has been tapped on the shoulder by a pursuing store detective. What is she likely to say? "Oh, my goodness! I forgot to pay. Do let me pay. I'll go back and pay". I suggest to your Lordships that, just as certainly, she would be arrested, charged and prosecuted. I hold a very strong belief, as I suspect do most of your Lordships, that she would have a far greater chance of being acquitted, innocent as she is, by a jury than by a magistrates' court, however conscientious the magistrates. If your Lordships believe that that scenario is altogether too far-fetched to have any persuasive value at all, perhaps I may say that that woman does exist; that it happened to her 25 years ago; that she was then my wife, and mercifully she still is.
I have never forgotten that episode as the whole justification for retaining the present right of choice. I hope that it will not be suggested that, if this Bill were enacted, it would all be all right because she would be able to avail herself of the provision in the Bill which says that the court must take account of whether her reputation would be seriously damaged. One is almost bereft of speech when one reads that provision. What kind of fair Britain is it that embodies in statutory form the notion that one person's reputation is more worthy of safeguarding than someone else's? One reads in the same Bill that the court may also take account of a previous conviction. That is wholly repugnant, too.
I know that it can be said that there are occasions when the right of choice has been abused. I know that it has. I know that it can be said that it does not exist in Scotland. Very well. We are talking about proposed changes for the people of England and Wales. For them, the provision will not be tough on crime; it will simply be tough on justice.
7.47 p.m.
Earl Baldwin of Bewdley: Back again to health, my Lords. In addressing the Government's health programme I rise with mixed feelings. That part of me which believes that we suffer from altogether too much legislation is relieved that a Government who are hyperactive in other directions can only state that they will,
- "provide faster, more convenient services to help improve the country's health".
First I should like to give some credit for some of the things that have happened since this time last year. The Health Act has put in place a mechanism for statutory regulation which will be a great deal more manageable for the complementary disciplines than what was there before. The Food Standards Act, while introduced by MAFF, has brought together health and nutrition in a way which has won the approval of many in complementary medicine who believe that nutrition is at the very core of health and disease.
The Department of Health has taken the initiative over herbal medicines, an initiative which is much appreciated by patients, practitioners and manu- facturers. Recognising the special circumstances of these medicines which cannot possibly bring in the revenue to fund the kind of clinical trials appropriate for more toxic pharmaceutical products, it is seeking to find a "third way" between full product licensing and food law which might commend itself to our European partners. I do hope the noble Lord, Lord Hunt, will be able to press on with the good work started by the noble Baroness, Lady Hayman. The Government have also to some extent opened up the procedures for appointment to expert scientific committees, which have always had a bias towards those from a conventional, industry-linked culture. I think we saw some of the drawbacks of this in the Vitamin B fiasco last summer.
Under pressure, the Government have set in train a systematic scientific review of the effectiveness and safety of water fluoridation. The noble Lord, Lord Colwyn, has already mentioned this. Sadly, he and I, in this but in not much else, find ourselves on opposite sides. It is extraordinary to think that it has taken 50 years, after the first enthusiastic fluoridation schemes in America, for a proper, unbiased, independent review to be conducted. It is to the credit of the Government that they have, albeit belatedly, put this in hand. As a member of the review's advisory panel, however, I was amazed to read a report in The Times of 16th November that the Government were going to press ahead with legislation on fluoridation. I sincerely hope that the noble Lord can confirm for me that no decisions will be taken until the review panel has reported. To do otherwise would be a nonsense and a waste of public money.
When I reread what I said about complementary medicine on the same occasion a year ago--here again I find myself in the same position as the noble Lord, Lord Colwyn--I found that most of it is still relevant today. We are talking about therapies which have been used by one in three of the population and by at least that proportion in other countries that have recently been surveyed such as the United States and Australia; therapies increasingly embraced by GPs, and increasingly taught in medical schools. The Parliamentary Group for Alternative and Complementary Medicine, which I chair, is having a presentation on this last topic in a committee room next Tuesday which any of your Lordships would be welcome to attend.
I think there are two main reasons for the upsurge in complementary medicine. By and large it works, as surveys of patient satisfaction show. And where side-effects exist, they are of a quite different order from conventional medicines. I will repeat what I quoted last year, from the Journal of the American Medical Association:
- "The incidence of serious and fatal adverse drug reactions in US hospitals was found to be extremely high".
- "Each year prescription drugs injure 1.5 million people so severely they require hospitalization and 100,000 die."
I spoke last year of the Commonwealth Health Ministers' recommendation that:
- "National policies for health need to give greater consideration and recognition to the existence of traditional and complementary medicine and their value to health development and health sector reform".
There are particular areas--and I have spoken about these before--where complementary medicine has a role to play. We have a new war on cancer. The noble Lord, Lord Clement-Jones, who I see is not in his place, referred to this. Let us hope it will not be the "qualified failure" of the last one--I take that phrase from an authoritative survey in the New England Journal of Medicine, which I think is a more reliable source than the cancer charities. We have hardly begun to look systematically at the potentially curative role of herbs, nutrition, healing, visualisation and the other approaches chronicled in a US Congress report nine years ago. I agree that delivery in cancer medicine in this country lags badly behind that of other countries, and it is good that the Government are addressing this. But what about prevention? We continue to produce carcinogenic chemicals which find their way via air, food, water or otherwise directly into the environment; but such is the commercial imperative that there is little impetus for funding research into most of them. Experts believe that the majority of cancers are environmentally caused, and thus essentially preventable.
I will pass over the Government's other priority areas and refer just to the antiviral and antimicrobial role of complementary medicine to which attention has been drawn in past debates. I will quote briefly from The Lancet of 7th August:
- "Whole-plant extracts may be more beneficial than single compounds ... [Two researchers] have used this approach to disable multi-resistant Staphylococcus aureus".
This is no small achievement in the present climate of worry about the declining effectiveness of mainstream drugs. Yet who follows this up and conducts the large-scale trials that could take this approach forward? Not the pharmaceutical companies, you may be sure. Who suffers meanwhile? The patients.
There is plenty of evidence for the benefits of complementary therapies. The fact that much of it is anecdotal should not stand in the way of further inquiry, and only the Government can realistically underwrite this. Let me give one final quotation:
- "while I must accept that virtually all the clinical evidence presented to us ... was anecdotal, nevertheless, we found it convincing".--[Official Report, 3/12/98; col. 691.]
It is a little early to say what the impact on complementary medicine will be of two new health bodies. Despite its acronym, NICE may work in an unfriendly way for the less well-researched therapies. To followers of traditional Chinese medicine, on the other hand, the new Commission for Health Improvement provides an altogether better acronym, as CHI describes the vital energy that keeps all bodies in being.
If I spoke of good examples of integrated healthcare, where conventional and non-conventional methods are used side by side for the benefit of the patient, I would go on too long today for your Lordships' patience. The same is true of the influence of primary care groups--referred to earlier by the noble Earl, Lord Howe--on the use of complementary therapies, where preliminary reports are worrying. A fuller picture of both may emerge in a year's time when, if I am still in your Lordships' House, I may be able to say more.
I want to end with a word about some of those who are no longer in your Lordships' House. The recent cull has gone hard for complementary medicine. In toasting absent friends I want to pay tribute to six who have been staunch and often vocal supporters: the noble Lord, Lord Thurlow, from these Benches; from the Conservatives the noble Viscount, Lord Addison, the noble Earls, Lord Clanwilliam and Lord Kitchener, and the noble Lord, Lord Rowallan; and from the Liberal Democrats the noble Lord, Lord McNair. Is it significant, I wonder, that no one from the Government Benches is on record as praising their acupuncturist or reflexologist? The case for complementary medicine will be the poorer without these voices, and I suppose that those of us who are lucky to stay here will, as in other spheres, just have to work harder. If the health of this country means anything, it is a cause worth working for.
7.57 p.m.
Lord Goodhart: My Lords, the present Government are the first since the Liberal Government elected in December 1910 to have come into office committed to a
far-reaching programme of constitutional reform. That programme is not the Government's alone. We Liberal Democrats have supported that programme, certainly in principle though not always in detail. We have more than supported the reform. We are co-authors of it through our membership of the Joint Cabinet Committee. Indeed, we are more than co-authors, because these are issues on which we have been campaigning for years, and we welcome new Labour as converts to the cause of constitutional reform.Much of the programme has already been achieved, but now is the time to take stock. We are more than half way through the life of the present Parliament. Indeed, the present Session is probably the last full Session we shall have before the next general election. We therefore need to ask ourselves what parts of this programme have been completed, what are incomplete and what have not yet been begun.
It is fair to say that the achievements on constitutional reform of the first Session were remarkable. We had devolution to Scotland and Wales; we have a framework for devolution to Northern Ireland, which we pray will become reality within the next few days; and we passed the Human Rights Act. That Act will have a great and beneficial effect on the rights of the people of the United Kingdom when it comes into force on 2nd October next year. The Human Rights Act leaves one item of unfinished business: that is its failure to establish a human rights commission. Without such a commission, individuals will find it extremely difficult to enforce their rights and indeed to find out whether they have rights that are capable of being enforced.
We regret that on this occasion the Government have not come forward with proposals to set up a human rights commission. The main constitutional business of the last Session was, of course, the House of Lords Act. That is plainly unfinished business and I shall return to the matter shortly.
I shall move on to the programme for the present Session which has been outlined in the gracious Speech. What is that programme in terms of constitutional reform? First and foremost it is, of course, the Freedom of Information Bill. The Bill is not as good as was proposed in the Green Paper of December 1997. On the other hand, it is not as bad as the draft Bill published in May of this year. The Government have listened and they have made some important and significant changes. However, a great deal remains to be done to make the Bill the measure that it ought to be. That is especially true as regards the Government's powers to withhold factual information which is relied upon for the formation of policy and in relation to the powers of the information commissioner.
We also welcome the proposals for controls on party funding and for greater flexibility for the electoral process in terms of the register and the place and time of voting. I do not wish to comment directly on the latest instalment of the Ashcroft saga, but the extent to which both the Labour Party and the Conservative Party have been funded by a small number of wealthy
individuals is extremely worrying. We believe that it is vital to encourage a much wider participation in politics and that we must attract more donations from ordinary people. For that reason I strongly support the views expressed earlier in this debate by the noble Lord, Lord Neill of Bladen, when he said that he regretted the Government's refusal to increase the value of small donations by allowing them to qualify for tax relief.However, at least as important as what is in the gracious Speech is what is not in it. That is especially so now because anything not included in this Speech is unlikely to be reached before the election. There is nothing in the gracious Speech about reform of the voting system. I accept that new systems are already in place for the Scottish and Welsh elections, and for the European elections. The top-up system used for the Scottish and Welsh elections seems to have worked well both in being acceptable to voters and in producing a parliament or assembly which is representative of a wider spread of political views than would have been possible under first-past-the-post. For that reason we very much regret that no proposals to put to the people for approval in a referendum a top-up system--as proposed in the report of the Jenkins committee--have been included in the gracious Speech.
Perhaps even more regrettable is the failure to introduce proportional representation for local government elections. Far too many local authorities have been, for far too long, single party states. That applies especially to the Labour strongholds in industrial areas. Like all one-party states, in some of those cases that has led to corruption and contempt for the democratic process. In some places, such as Liverpool, Sheffield and Islington for example, the Liberal Democrats have been able to mount an effective challenge and turn them into two-party states. But there are other areas such as Doncaster which remain single party states, with predictable results, as indeed we have seen.
Finally, I should like to turn to the unfinished constitutional business; that is, the future of your Lordships' House. No Bill is proposed for this Session. I think that that is inevitable. The enactment of stage two will be a matter for the next Parliament rather than this one. That is unavoidable. The Government say that they are looking forward to the recommendations of the Wakeham Royal Commission, as are we all. I believe that a great opportunity is available to the noble Lord, Lord Wakeham, and his commission. Opinion on what is the correct role and structure for your Lordships' House in the longer term is fluid and uncertain in all parties. If the noble Lord, Lord Wakeham, and his colleagues can produce sensible and well-argued proposals, there is a fair chance of adoption by consensus. On this occasion I shall not say what I think those proposals should be. However, I shall say that if those proposals bear much resemblance to the draft of the report leaked to the Sunday Telegraph a few weeks ago, there will be no consensus that will include these Benches.
In summary, the extent of constitutional reform that has already been achieved is impressive, but gaps such as the absence of a human rights commission need to be filled. In this Session we shall have a freedom of information Bill and we need to ensure that it is a good one. What has not been and will not be achieved in this Parliament is reform of the voting system and stage two of the reform of your Lordships' House. Both reforms are needed if this ambitious programme of reform is to be completed. Both these issues are matters on which we will campaign as strongly as we know how.
8.5 p.m.
Baroness Seccombe: My Lords, I also looked at last year's Official Report and found that during my contribution to the debate on the gracious Speech I referred to the use of the words "modern", "modernisation" and so forth which occurred 11 times in the gracious Speech. The Government's obsession continues. This year, the same words appear 10 times, and in addition reference is made to a 10-year modernisation plan. The spin doctors have had a field day, whirling themselves into such a crescendo that there is now talk of modernising Europe and even the United Nations. In my book, modernisation means change. I hope that over the past year everyone has learnt at least one lesson. It is that for change to be acceptable it must be change for the better and it must be absolutely clear and transparent what the replacement will be.
I was very distressed to hear of the reintroduction of the Bill to equalise the age of consent. I hope most sincerely that the Government do not see this matter as merely another item in their catalogue of modernisation. It is far too important to be trivialised in that way. I was deeply moved by the speech of the noble Baroness, Lady Rendell of Babergh, about the horror that some girls have to face. I wish to refer to another horror that some girls may have to face.
One aspect of the Bill gives me particular concern; namely, the effect on girls who have been drawn unwittingly into this debate. It is not understood by the vast majority of people in this country that girls would be affected in any way. In fact, I have not come across even one person who realised that the Bill would legalise the consensual buggery of girls aged between 16 and 18.
I have raised this issue twice during the year. The first time I established that women's organisations had not been consulted on this specific issue, and on the second I was informed that there had been 12 regional meetings of the Women's National Commission and the matter was not raised by anyone. The noble Baroness the Lord Privy Seal said that it was made clear in the Explanatory Notes to the Bill that there was a distinction between homosexual acts and buggery. But how many people outside Parliament read the Explanatory Notes? Indeed, who would want to on this highly sensitive subject?
I have carried out some research. I have found that the 15th Report of the Criminal Law Revision Committee was presented in April 1984. It reported
that most of the committee were of the opinion that girls did not need the protection of the criminal law against anal intercourse once they had reached the age of 16. However, paragraph 6.6 stated:
- "Some of our Members, however, consider that girls should be protected by the criminal law up to the age of 18 in relation to anal intercourse. The differing opinions as to whether the age should be 16 or 18 expressed in the comments on our Working Paper are taken by these Members to demonstrate that this is a sensitive issue on which the law would do well not to move too far in advance of public feeling. To introduce an age of consent of 16 would, in the opinion of these Members, be to risk losing public support, which might well be forthcoming if a more modest recommendation for a reduction to 18 were made".
During the passage of the 1994 Act, Tony Blair, who at that time was shadow Home Secretary, said that the debate was not about age but about equality. But how can that be so when male and female bodies are different? Serious study has been undertaken on the risks of anal intercourse. There is increasing vulnerability to HIV and other infections, and consensual intercourse carries particular risks of physical damage to the receptive partner. I shall not go into further details other than to say that no condom provides adequate protection for that type of activity. It grieves me that schoolgirls discuss this unnatural way of life as being acceptable, and I was absolutely astounded when one of your Lordships told me that his 12 year-old granddaughter announced that she had been told that anal sex was safer than vaginal sex as you would not become pregnant that way.
I was reluctant to raise this matter. However, I believe that we have a duty to start a nation-wide debate. I hope that the Women's National Commission, under the chairmanship of the noble Baroness, Lady Crawley, will consult on this specific item, and I hope that the media will also debate the issue.
Should the Bill reach the statute book, I wonder whether the noble Baroness the Lord Privy Seal would include the measure as a triumph in a future edition of the Labour Party propaganda publication, Voices.
I referred earlier to spin doctors, those highly paid people who believe that it is their job to deliver messages to the population. What a message an Act of that nature would give to young girls, boys and, yes, even predatory older men. It is saying, "It is up to you how you enjoy sex. Have a go and see which you prefer. Either way is all right by us." It would be a disaster to give such encouragement to young people. I fear that there would be many 16 and 17 year-old girls left too traumatised and physically damaged to make the stable and loving relationships that are the cornerstone of a decent society.
8.13 p.m.
Lord Ahmed: My Lords, few would disagree that in terms of its scope and emphasis the gracious Speech was, in most of its parts, indeed historic, the kind of document that was needed to usher us confidently into the 21st century. I wish the Government well in this Session with most of their proposed legislation.
However, I have to admit that, as a British Muslim, I found part of the speech disappointing, for it was a clear case of an opportunity lost in terms of reflecting and acting on the complexities of a modern multi-cultural, multi-religious and multi-racial Britain.
I shall concentrate on just three of the 28 proposed new measures: the extension of the Race Relations Act 1976; the prevention of terrorism Bill; and the Criminal Justice (Mode of Trial) Bill. The Government's proposals on the Race Relations Act 1976 are not enough. They fail to initiate moves so that the law is reformed so that all sectors of our community are protected. They lack both the courage and the vision that are needed to contribute effectively towards the evolvement of a harmonious society in Britain, a society guided by the principles of fairness, equality and justice; a society the Prime Minister has described as a,
- "beacon of multi-culturalism to the world".
My second concern relates to a missed opportunity; namely, religious discrimination is excluded from the proposals. The Runnymede Trust report, Islamophobia: a challenge for us all, launched in September 1997, highlighted the issue of anti-Muslim discrimination in modern Britain. According to the report, Islamophobia is a,
- "real and growing phenomenon--an ugly word for an ugly reality".
During the past two decades or so, British Muslims have not only had to contend with racism and Islamophobia but also insensitive anti-racist strategies
to address discrimination which have reduced the Muslims, the largest minority in Britain, to a deprived and disadvantaged community, almost in a state of siege.The anti-racist solutions provided under the aegis of the Race Relations Act 1976 as it stands now have just not worked for Muslims. All they have done is to disguise the Muslim experience of discrimination. Islamophobia is not only a grotesque reality but a deforming one, providing the oxygen for extremism and marginalisation.
The recognition of Islamophobia and its effects are a matter of grave concern and of vital importance to Muslims. After all, Muslims are--literally--dying because to it. Twelve of the 26 victims of racist murders inside the Metropolitan area since 1991 have been Muslims.
But it should also be of importance to the Government, because if the authorities fail to take action now, it will set in motion consequences which will detrimentally affect not only the Muslims but community relations in general into the next millennium.
I urge Her Majesty's Government to show courage and political will in championing the reforming of the law so that it protects all members of society from discrimination, including faith communities, whether Hindu, Christian, Muslim or Buddhist. Incorporating a law against religious discrimination would modernise our legal system, making it reflective of our society. More importantly, it would make our legal system compatible with other major international agreements such as the European Convention on Human Rights and the UN Declaration on Freedom of Worship.
My second point regarding the gracious Speech relates to the proposed prevention of terrorism Bill which will include conspiracy and incitement clauses with wide-ranging effects. The proposals will include funding and financing of "terrorist organisations".
Early this year, an imam from Oldham was refused a visa to remain in the United Kingdom because it was alleged that he was involved with the recruitment of young people and collecting funds for an organisation that was helping freedom fighters in Indian occupied Kashmir. The case was highly publicised, and during the court case it was alleged by the imam that the Secret Services tried to recruit him to spy on his congregation. When he refused, he was served with a notice to leave the UK. It was the courts that allowed the imam to remain in the United Kingdom.
I condemn terrorism of all kinds perpetrated by an individual, a group or a state. However, my concerns relate to the definition of terrorism. For example, would the former Prime Minister of Israel, Mr Begin, President Mandela, Archbishop Makarios of Cyprus or President Arafat be classed as freedom fighters or terrorists? Would Members of Parliament, including myself, who attend charity dinners for the Kashmiri victims of genocide be classed as conspirators or financiers of the freedom struggle in Kashmir? Would our support for the KLA be classed as incitement to terrorism in Kosovo? Who determines which freedom
struggle or right to self-determination campaign we can support? I am very clear about the prevention of terrorism within the United Kingdom or British territories. I support the Government's proposals in relation to that. But what needs to be made clear is how far one can support a genuine freedom struggle like that in East Timor, Tibet and Kashmir.My last point is concerned with the mode of trial. My concern is that often a great percentage of black people elect jury trial. Under the Government's proposals they would lose out. Have the Government conducted any research or study into the reasons why black people prefer a jury trial rather than magistrates? How will Her Majesty's Government ensure that justice is not only done but seen to be done? I shall follow the passage of the legislation with great interest and hope that Her Majesty's Government will ensure that our concerns are considered and examined properly at the drafting stage.
8.21 p.m.
The Earl of Onslow: My Lords, I rise to speak after the noble Lord, Lord Ahmed. As a Kashmiri I realise how strongly he feels about the behaviour of the Indian Government over Kashmir. It was a disgrace. However, I believe that it is also reasonable to say that India and Pakistan have been independent since 15th August 1947 and it is none of our business. I also draw to the noble Lord's attention the wonderful words of Edward Gibbon in describing how the great Charles Martel beat the Muslims outside Poitiers. He said that had victory gone the other way the towers of the Oxford colleges would have re-echoed to the cries of the muezzins. I believe that he wrote that only to irritate the Christian Church and the dons of Oxford, and in both respects he succeeded beyond his wildest dreams. We have had three and a half maiden speeches today, and it is not for me to comment on how good they have been. I am sure that they have had all their due compliments.
I have serious doubts about this Government's attachment either to Parliament or to individual liberties. That was perfectly exemplified by the Leader of the House when she said, following the passing of the House of Lords Act, that she was now going to go back to women's issues. For heaven's sake, one asks her to get a sense of proportion. Which is more important? We have been considering the constitution of one of the greatest political institutions that the world has ever seen. That institution has ensured that there are no French hussars in Moscow, no German Waffen SS in Paris, that the world's system of free trade exists and that America has developed in peace and quiet. It is not a bad record for a small island separated from the Continent by what Black Adder refers to as 22 miles of wet blue wobbly stuff.
The Queen's Speech is full of illiberalities. At luncheon today a judge said to me that the duties of Parliament and the powers of government are those that they can do and no more, but that the rights and liberties of an individual are everything that they may do except that which is proscribed by law.
At the end of the last Session the Government passed an order in council which allowed the Secretary of State to appoint anybody whom he liked to enter premises without warrant. Was this to do with drugs, murder, arson or paedophilia? No. It was to do with lead pellets in a duck's breast. This is the habit of tyranny. What happened in the last Session was a demonstration of the law of unintended political consequences. My peerage was originally that given to one of my forebears by the great Sir Robert Walpole. For perfectly decent and corrupt reasons it was later uprated by the great William Pitt the younger. Now my peerage, not for any corrupt reason or anything like that, has been confirmed and re-justified by Mr Anthony Blair. Therefore, like your Lordships' House, I have an authority that I did not have in the previous Session.
It follows from that that Salisbury and Addison have gone out of the window. Therefore, I hope that your Lordships' House will, with very great care, consider whether orders in council and delegated legislation are sloppily drafted. I concede that my own side has been just as guilty of this as noble Lords opposite. However, noble Lords opposite claim that they are a better and more efficient government. Therefore, they will do it rather more efficiently and frequently and introduce delegated and regulatory powers of which we have far too many. I sincerely hope that we shall sling them out. It follows from that that if it is known that this House will sling them out, the Government will be much more careful about what they introduce. That will have justified the new peerage given to me by Mr Blair.
Further, it means that if we do not like an Act of Parliament we can say so. The hereditary Peers have now gone. All those hordes of Marquesses and Earls dragged in by the noble Lord, Lord Denham, with his normal skill are not here any more. We have been reformed. I am now elected. I absolutely love it. This is an experience that the noble Baroness, Lady Jay, has never had. I accept that the electorate is arcane, even unique. However, this House now has greater legitimacy. I sincerely hope that we shall use it and take great care about rights of entry.
We are all aware that the noble Lord, Lord Bassam, knows about the right of entry without warrant. He used to do it when he was a young man in Brighton. But we should take seriously our duties as guardians of the liberties of the subject. The more seriously we take them the more seriously will the Government take them. There are enough illiberal measures in this Queen's Speech, from fox hunting to fur farming to the removal of the right of trial by jury to the stopping of individuals and automatic drug testing. It is our new and reformed duty to make it very difficult for these illiberal and anti-libertarian measures to find their way onto the statute book.
8.29 p.m.
Baroness Masham of Ilton: My Lords, I must apologise to some of the maiden speakers for having missed their speeches. I had to attend the All-Party
Group on Drug Misuse. We had a government Minister attending, and the room was booked in my name. I shall read their speeches.I quote from the gracious Speech:
- "My Government's ten year programme of modernisation for health and social care will provide faster, more convenient services to help improve the country's health".
It has been proved time and again that patients who go to a spinal unit within 48 hours have far fewer complications and get back home and to work far more quickly than those who are not transferred to a specialised unit.
The spinal unit at Stoke Mandeville Hospital has had its funds hijacked for use in other parts of the hospital, thus damaging some of the rehabilitation facilities. We are not asking for modernisation. We are asking for protection of existing services which have led the world for years in this field of medicine. We do not want to go backwards to the terrible days before the National Health Service.
I hope that the Minister will visit the unit for himself and meet the patients. There is nothing like seeing the real thing. If the King of Spain can visit the 250 bed unit in Spain, as he did a short time ago, surely the Minister here can get out into the real world of specialised medicine and learn for himself about these issues to which I have alerted your Lordships.
Who will monitor the infection control in hospitals and nursing homes? Will it be NICE (the National Institute for Clinical Excellence)? The Government have said that they will provide a faster, more convenient health service. The spread of the so-called superbug, methicillin resistant staphylococcus aureus (MRSA), is causing great concern to many people. Patients go into hospital for one procedure and can become more seriously ill or die when infected with MRSA. It is even becoming resistant to Vancomycin. Infections delay healing and hold up discharge of patients, causing hospitals extra work and expense and extra stress and inconvenience to patients.
Unless the Government make the control of infectious diseases a priority, how can they hope to provide a faster service? Is it not time that MRSA became notifiable? Is it also not time that the results of tests for infections of all kinds were produced faster? Many patients in the community become ill and are given an unsuitable antibiotic, thereby increasing the risk of resistance developing. A fast track in testing would give increased efficiency. If the Government
really want to provide a faster, more convenient service, they will put those matters high on the health agenda.With the pressure on hospital beds, mattresses often are not cleaned between patients, and nurses and doctors do not always wash their hands between touching patients. If the bugs win, the Government will not be able to deliver their pledge. Perhaps it would be wise in the next 10 years to plan hospitals with more isolation rooms and more basins in wards and corridors so that staff can wash their hands when moving from place to place.
Last week I met a man who is totally blind, has diabetes and a heart condition which affects his breathing. He lives alone. He told me that the social services had offered to help give him a bath, which he could manage himself, but he could not get the assistance he desperately needed to clean his house. How can the Government pledge a more convenient service if they are so inflexible? Disabled people do not fit into neat official boxes. That blind man could be living among cockroaches and other pests and not know it. I wish the Queen's Speech had included the word "flexibility". If it had I might have thought that the Government were trying to understand and help severely disabled people.
I have been contacted by several agencies providing home care for severely disabled and elderly people, and a consultant in spinal injuries from Scotland, concerning the effect that the regulation of the private recruitment industry will have on home carers. The consultant said that most of his patients with tetraplegia (paralysis from the neck down) are discharged from hospital to home where the vast majority of them lead rewarding and fulfilling lives despite their disabilities. Many patients with very little movement in their arms have returned to work as lawyers, business people, and in many other occupations. This is only possible because they are often attended 24 hours a day by carers who can attend to them. A significant increase in the cost of those carers would mean that many patients would not be able to afford to return home. Instead young, intelligent people would be discharged to nursing homes with no prospect of their integration into society.
If VAT has to be paid on these carers' services, it will mean that the increased cost of care would be a tax from the disabled people which would be a retrograde step for any government to take. The extra costs which will be placed on the agencies will be off-loaded on to the clients. It is no good the Government naively thinking that the agencies will absorb the costs. They should understand the real world and the needs of severely disabled people before it is too late. Many severely disabled people are VAT exempt. If they buy equipment they just sign a form. I cannot believe that that cannot be organised also for their care.
I should like to ask the Government a question relating to people living with HIV/AIDS and their health workers. The noble Lord, Lord Hunt of Kings Heath, and I sat on the panel for the parliamentary
hearings of the All-Party Group on AIDS. We heard important evidence about what needs to be done. The report was published in October 1998. The Government also held a strategy conference that month. But what has happened since then? When will the strategy be published?The previous government took HIV very seriously and put in place funding and a number of good measures. It was a key part of their Health of the Nation strategy. This Government took HIV out of the White Paper, Our Healthier Nation, and promised instead a separate HIV/AIDS strategy. We are still waiting.
There is a worrying misconception that HIV is "going away" or is now curable. Last year there was the highest ever number of new infections in this country. With the rising number of people receiving treatment, paying for those expensive drugs will soon become a problem. If the Government are going to provide a faster, more convenient service to help improve the country's health, they need to put up front the funds to train high quality staff so that they have the experience that is needed, to provide good health facilities and the correct drugs for patients' many different needs. There are many people waiting with high expectations for action rather than just words.
8.40 p.m.
Lord Carlile of Berriew: My Lords, much of the focus of the debate, including some excellent maiden speeches, has been on the criminal justice system. All I want to say about that system tonight, before I turn to the health issues upon which I really want to speak, is this. The gracious Speech would have been far more impressive if it had focused not on meddling around with the mode of trial system, but rather on changes in the substantive law which have been needed for years. Perhaps I may cite one example and perhaps the Government will explain why they are not acting on it. For years, the Law Commission's recommendations on reform of the Offences against the Person Act 1861 have been gathering dust, despite apparently having the imprimatur of government approval. Why have they not included such measures and other dusty Law Commission Bills in the gracious Speech rather than looking for political issues, for that is what the mode of trial proposals are?
I welcome the attention given in the gracious Speech to health and care standards. I spent 10 years as a lay member of the General Medical Council until earlier this year. Like the noble Lord, Lord Patel, in that capacity I enjoyed a particular form of insight into some of the strengths, and not a few of the weaknesses, of the piecemeal regime that exists to promote and ensure proper standards in the provision of clinical treatment.
For most of my childhood, my father was a general practitioner in a Lancashire cotton town. In the 1950s, like many medical families, we lived in the surgery premises. My father became doctor, confessor and adviser to a large population huddled and crowded into a strong community in terraced streets, then generally described as slums.
In those days, primary medical provision was as much a caring service as a curing service. Consultant referrals were made only after deliberation and very rarely on demand. Patients accepted more and demanded less. Today, greater knowledge and information has produced a more demanding public to whom at least in health terms outcome is everything.
As a result, the medical world has changed since the years of my childhood. Many people who have no medical condition whatever, let alone an illness, use clinicians as a resort of choice. Larger people try to be slighter and slighter people try to be larger. Face-lifts are given as birthday presents. Chins and noses are reshaped, often those which need it least. Many are "clients", not "patients", and they expect and are entitled to top quality standards. When they buy a new nose or a new chin, just as when they buy a new car or refrigerator, they are entitled to demand what we recognise as the rights of the consumer.
With these developments have arrived squadrons of sometimes self-appointed experts, presenting their private clinics as the gateway to a new self. In many cases, medically unqualified so-called consultants trade on the medical connotations of that word when in reality they are no more and no less than good sales people. However honest they may be as sales people, often they have neither the ability nor any potential as scrutinizers of the quality of the service they are providing. Most private clinics are very, very good. But, unfortunately, a minority range from the undistinguished to the fraudulent. That minority drags down the reputation of the majority.
In another place on 10th December 1998, Alan Milburn, then Minister of State at the Department of Health, said [col. 693] that the Government want self-regulation to work but that it must become more modern, more open and more accountable. I agree with that and with the Government's view that if self-regulation is to be the bedrock of high clinical standards in future, it cannot operate in isolation. It must form part of an integrated framework of new mechanisms that embrace the clinical professions--all of them--the regulatory machinery, the educational bodies and, of course, the NHS. Providers of private medical facilities and procedures must not be excluded from the regulation and it is to be hoped that there will be room in this Session's legislation to tackle these issues.
The General Medical Council has done much to face up to the future. Its lay membership has increased significantly, though perhaps not yet enough. It has reduced the size of conduct panels so that it can deal with its burgeoning and alarming caseload with greater efficiency. The new procedure of performance review is now functioning to deal with conduct falling short of serious professional misconduct. The need for regular revalidation of a doctor's competence has been accepted, and the GMC is now considering how to administer what will be a huge new responsibility.
However, the role of the GMC in this context is limited to the registration of individual doctors. It is not a licensing body for clinics. It is not a body with
powers of inspection. It is necessarily demand-led, empowered to respond only to information placed before it. It is often the whipping boy for much journalistic bile that could be better directed elsewhere.Like the Royal College of Nursing, the Royal College of Midwives, the British Medical Association and, I believe, the General Medical Council, I welcome the Government's recognition of the need for better and more effective regulation of the private and voluntary healthcare sectors. I know that the Minister replying on health tonight has deep knowledge of the healthcare system; he was a distinguished manager in it for a number of years. I hope that with that knowledge, the noble Lord will confirm tonight that the Government's proposals will include an independent, quality regulatory framework that will include all premises providing clinical facilities of whatever kind and that there will be an inspection and licensing system--whether nationally or regionally organised does not matter--to underpin regulation.
In partnership with the mechanisms available through the contracting bodies and ultimately through the profession, such a framework should drive the cowboys out of the market and ensure greater public confidence in the services that they receive. New measures must include a better match between the various players on the complaints field, which is often far from level and allows too many googlies to be bowled at those least able to protect themselves; the consumers.
The private sector should be encouraged in its current efforts to develop an acceptable complaints handling system; but one should not lose sight of the fact that a voluntary system will be insufficient to protect the public from the least scrupulous. And they will be the people who will often abuse terms such as "doctor", "consultant" and "therapy"; terms which perhaps deserve some legislative definition and examination.
I trust that the Government will be prepared to meet some of the cost of a new framework. Of course, the providers themselves can meet much of the cost, especially in the private sector. I suggest that public cost will be offset by savings which stronger regulation would provide in that there would be fewer pieces of negligence and incompetence to pick up if we had a sound regulatory system.
I hope and believe that all genuine and responsible clinicians will welcome firm measures designed to improve public confidence in the important work of their professions and that they will recognise that stronger regulation is essential in this age of wider choice and increasing self-diagnosis.
8.50 p.m.
Baroness Kennedy of The Shaws: My Lords, I add my voice in welcoming so many of the positive reforms and innovations in the Queen's Speech. For those of us involved with children's organisations, the reform of the Child Support Agency and the assistance to young
people in their transition from public care into independent adulthood are particularly welcome. I am also delighted to see that there will now be proper regulation of children's homes under the care standards Bill. However, I can only express dismay that the Freedom of Information Bill is such an anaemic version of what was originally envisaged.When the Government were elected, one of the most powerful and vibrant parts of their manifesto was the commitment to constitutional change. That programme of constitutional reform was long overdue and it has been heartening to see so much of the programme take life--the Human Rights Act, devolution, reform of this House. It took vision to embark on such change. However, at the centre of any truly modern democracy must be a bold Freedom of Information Act, not a tepid, timid attempt. Information is crucial to active citizenship and a confident executive, as this executive surely must be, should have no worries about creating truly open government. This Bill regretfully can only receive the comment, "Surely we can do better than this." I therefore urge boldness on the Secretary of State. His original instinct was to be bold and I hope he will be persuaded, in the interests of good governance, to go back to his first thoughts.
I now turn to the heart of my sadness concerning the gracious Speech. I keep thinking there must be some mistake when I hear that a Labour Government are set upon reducing the right to jury trial. Trial by jury is undoubtedly the best way of determining the guilt or innocence of an accused. Like most people who have cause to be in the courts, I am a believer in the jury. The great success of the jury is that it is a display of active citizenship, of drawing the public into the process of deciding the culpability of a fellow citizen. It is therefore more, as Lord Devlin said, than an instrument of justice.
The majority of people who ever participate as jurors will tell you how impressed they have been and the extent to which the people with whom they participated took the role seriously, becoming more than the sum of their parts. Jurors rise invariably to the occasion and command the respect of all who watch them undertake their function. You can be sure, just as the noble and learned Lord, Lord Mayhew, said, that if any one of us had the misfortune to be accused or if any one of our children were accused, we would want trial by jury for them if they were saying, "I did not do this." The truth is that we would get it. We noble Peers would get it. We would get our trial by jury. You have to ask yourselves who would not get it. The people the magistrates think are guilty; they will not get jury trial. Surely, you may ask, deciding whether a person is guilty before he has actually had his trial is not what magistrates are supposed to do. And, of course, you would be right.
To change the law so that magistrates or, on appeal, a Crown Court judge can determine whether you should be allowed such a trial will inevitably introduce unfairness, as the noble and learned Lord, Lord Mayhew, said. I am afraid that there is already stereotyping and discrimination in our courts, and I
say that as a practitioner. Indeed, Home Office studies have shown that there are differentials between sentences passed on black defendants and their white counterparts. They are shown differentials in the granting of bail between different racial groupings. Do we really think, despite all the efforts devoted to training, which are all to a good end, but one still to be reached, that similar differentials will not take place in the granting of jury trial? Do we really not think that perhaps there will be those who get it and those who just will not?The black community is understandably alarmed; so too are civil liberties organisations. Indeed, anyone who really cares about justice is alarmed. I even hear people say behind their hand how much they regret that the proposal has found its way into the Queen's Speech. It is regrettable that it has been suggested that when lawyers express concern, they only do so out of self-interest. It is a scandalous perception and I can only think that it was said in the heat of press conference rather than with real seriousness because it would be unworthy if that were truly the view of the Secretary of State.
To suggest that we should be going down this road because it is done in Scotland is really sleight of hand. The Scottish legal system, as we all know, is a different legal system and those who make decisions about the form of trial are not lay magistrates. When we have sought to advocate changes such as exist within the Scottish system we have often in the past heard it said to us that it is inappropriate to look to that system when it is so distinct from our own here in England and Wales.
To suggest that large numbers of people elect trial and plead guilty at the door of the Crown Court is not supported by evidence. The number of people electing trial is half that at the time of the Royal Commission on Criminal Justice in 1993. The reason is that judges are taking into account concern expressed about people delaying and pleading guilty at the door of the court. Lawyers are advising their clients, "If you are only using this as a delaying tactic, you will lose credit with the court." The effect has been quite remarkable. The research available on who elects trial by jury is 10 years out of date. It covers only convicted defendants and takes no account of those who elect trial and are acquitted. If you were to ask, the Home Office would admit that there are no current statistics on those who elect trial and plead guilty. So where the figures being brought forth in the press come from, one can only guess.
Jury trial is one of the things which make Britain great. It should be a source of pride and it should be protected with urgency and vigilance because it is so precious. All I can say to the Home Secretary is, "Please think again".
8.58 p.m.
Baroness Hanham: My Lords, as part of its legislative programme for the coming year outlined in the gracious Speech, the Government are committed to introducing a Bill to reform the structures of local
government, ostensibly to make it more innovative and accountable. I have very real concerns that the measures will succeed only in shifting power into the hands of a few well-paid councillors, and standards of accountability, transparency and service will not improve. Where, before the legislation has been passed, the cabinet system has been introduced, there are already sharp voices being raised by councillors and the public that this has indeed been the effect.The Bill legitimises a cabinet system, one which is widely used already, but also enables that small number of members to take decisions in secret and to act upon them in secret, something which is explicitly forbidden in the current local government legislation.
I hope to be able to contribute to the debate as the measures come before us, but my reason for mentioning them now is that part of the Government's rationale for the local government organisation and standards Bill was that the changes would generate such public enthusiasm that it would help to counteract the falling percentage of the electorate taking part in, in this case local, elections.
Much the same claim has been made by the Government to justify the changes made to our traditional first-past-the-post electoral system. Elections involving a form of proportional representation for the Scottish Parliament and the Welsh Assembly, the European Parliament and, shortly, the Greater London Authority, have replaced our simple and democratic regime of first past the post. To date, claims that proportional representation would increase turnout would not be able to be proved and could not lead us confidently to the conclusion that this major upheaval to overturn our traditional practices will have the desired effect.
The gracious Speech states that the Government will now try again to raise electoral enthusiasm by bringing forward measures to reform the electoral procedures. Pilots--which may be carried out only at elections and may therefore delay somewhat any conclusions that may be drawn from them--will be carried out into voting at supermarkets and other similar venues. They will include changing the day of polling, early voting--I hope not early and often--out-of-area voting, all postal ballots and electronic voting. Of course, we must try such innovations, but with caution. As polling moves away from the local polling station, care must be taken that impersonation, multiple voting and other misuses of the democratic system do not increase and that safeguards are built into those systems to prevent such abuses from occurring.
The one measure which I welcome without reservation is the proposal for a rolling register. While it may not be easy to maintain, an effort to do so is surely desirable where, as in my borough, there is an annual turnover of 33 per cent of the population. Arrangements to enable the homeless, prisoners on remand and those detained long term under the Mental Health Act to participate in elections are also properly democratic. However, those still disenfranchised will include some of your Lordships' colleagues who were somewhat unceremoniously
jettisoned from this House so recently. As a result, some 200 former Members of this House are unable to vote in the by-election currently taking place in the borough of Kensington and Chelsea.Clearly, innovative systems are justified. In Europe the turnout at elections is somewhere in the region of 79 to 80 per cent. However, structures are not necessarily the answer to the problem of low voting numbers--although poor registration does not help. A lack of commitment to take part in the democratic process must lie far deeper than the structural deficiencies. The malaise with and cynicism of government; a disinterest in the effect that government has on people's lives; and the denial of a right and duty to participate are more fundamental than all the superficial efforts now being made.
I have neither the time nor the inclination to probe those problems tonight. However, while I believe the Government to be well-intentioned in the measures that they are taking, I believe also that they must propose measures which more than merely scratch the surface of this problem.
9.3 p.m.
Lord Monson: My Lords, it might be argued that the first element in the gracious Speech upon which I want to touch should have been raised in the mainly agricultural debate two days ago. However, as it involves the creation of yet another new criminal offence, it seemed to me on balance to be a Home Office matter. I trust that the Minister will concur, especially as the issue has scarcely been mentioned so far apart from an extremely brief reference made by the noble Earl, Lord Onslow, half an hour ago.
I refer of course to the deplorable proposal to outlaw the hitherto legal practice of fur farming which will throw scores of people out of work and leave the field clear to our competitors in Scandinavia--where, I remind your Lordships, concern for the welfare of animals is generally similar to our own. In yesterday's Daily Telegraph, Mr Elliot Morley, the Minister for Fisheries and the Countryside, who is in charge of the Bill, declared that,
- "the keeping and slaughter of animals for their fur can no longer be justified",
With the exception of medicines, all of those could be described as luxuries, in so far as human beings can perfectly well survive without them. In that respect they are on all fours with animal fur. No doubt the "intensive
rearing" argument will be trotted out in response, but chickens and turkeys, among others, are also intensively reared. However, we learn from a letter in today's Daily Telegraph from the well-known writer on agricultural matters, Mr Robin Page, that Mr Morley, to whom he spoke, would oppose violently the banning of broiler units because that would cause considerable unemployment in his constituency.The upshot is that when many votes are at stake, principle flies out of the window, but it is all right to clobber a small group of hard-working individuals who lack electoral clout in order to garner votes from the readers of the more downmarket tabloids, who tend to emote rather than to think. I have heard rumours that the Opposition--if they can still be so described--do not intend to oppose this illiberal measure. I trust that those rumours will turn out to be slanderous.
I turn now to the lowering of the age of male homosexual consent which is returning to haunt us. Leafing through the Official Report of our debate of 11th April this year, I was struck by the way in which some noble Lords, including my noble friend Lord Bledisloe and the noble Lord, Lord Wallace of Saltaire, on the Liberal Democrat Benches, argued that lowering the age of consent to 16 was a libertarian imperative. With respect, as someone who has knowledge of these matters, I disagree. Libertarian considerations should be paramount where consenting adults are concerned. I have argued this for 35 years, long before such an advocacy became conventional or even respectable. But most people would agree, including, significantly, a number of responsible adult homosexuals, that where minors are concerned other considerations come into play which may necessitate certain legal restrictions on the under-18s in sexual matters, just as in matters of access to alcohol, tobacco, motor cars, powerful motorcycles and so on.
That is underlined by the United Nations Convention on the Rights of the Child which was extolled, rightly, in the gracious Speech, a section of which specifically aims to prevent under-18s from sexual exploitation or sexual abuse. In any case, an absolutist libertarian approach would have to entail lowering the age of consent to 12 or 13, among other things. But I do not believe that the Government are motivated by libertarian principles, absolutist or otherwise. Indeed, they are effectively saying to boys aged 15 and three quarters, "No matter how powerful your urges, you have to wait three months in England, Scotland and Wales, or fully 15 months in Northern Ireland, before you can legally satisfy those urges, at least with other people".
No; the Government are inspired, it would seem, by the sacred mantra of sexual equality at all costs. As the noble Baroness, Lady Seccombe, so powerfully reminded us a little while ago, the trouble is that they are not comparing like with like, at least where intercourse is concerned--the aspect which, legitimately, most concerns parents and grandparents.
It is not the moment at this hour to revisit the statistics or to point out all the grave dangers to young people, psychological or physical, which are involved.
Obviously this matter is not going to go away. I would urge a compromise based on the admirable suggestion which emanated from the Bench of Bishops. In this context it is worth reminding your Lordships that despite, I would guess, their broad support for this Government in general, the Bishops voted by a massive majority--75 per cent to 25 per cent--against lowering the age of consent seven-and-a-half months ago, as did the noble Lord, Lord Jakobovits, who is sadly no longer with us, and the noble Lord, Lord Ahmed, who almost certainly represent the majority opinion in the Jewish and Muslim communities respectively.I do not speak from a doctrinal standpoint. I never have and I never would. Nevertheless, the fact is that nearly all the world's great religions, including Buddhists, as I know from my travels in South-East Asia, are in broad agreement on this matter. That cannot lightly be disregarded. The particular Episcopal contribution I commend--I have raised this before--is the article by the right reverend Prelate the Bishop of Ripon in the Parliamentary Monitor dated November 1998 in which he urged that anal sex should continue to be illegal for the under-18s even if other genital activity is reluctantly to be permitted. I suggest simplifying and slightly liberalising that proposal by making it illegal for anyone over 18, not just schoolmasters, vicars, scoutmasters, employers and so on, as the Government propose, to have anal intercourse with anyone under 18, be they boys or girls.
In other words, any alleged discrimination would not be against one gender, as we now have to call it, but purely against one dangerous, albeit optional, sexual practice, regardless of the gender of the young victims. Such a compromise would avoid a ping-pong battle between the two Houses of Parliament, with all the attendant bad press publicity for the Government that would result, while surely going far enough to satisfy both new Labour and the European Court.
9.12 p.m.
Baroness Crawley: My Lords, I hesitate to begin my speech as I realise that I am being followed by the noble Lord, Lord Norton of Louth. He has told us in the House Magazine that he is having a personal war against cliche. I hope that my contribution will live up to his high standards and avoid being cliche-ridden.
In the debate on the gracious Speech tonight, perhaps I may concentrate for a few moments on home affairs. In particular, I very much welcome the proposal to introduce the first ever Freedom of Information Act. This Bill is an essential part of the Government's aim to build strong foundations for modern, accessible government administration that responds effectively to its citizens at all levels.
It was a privilege for me to be one of the members of the Select Committee, under the excellent chairmanship of my noble and learned friend Lord Archer of Sandwell, that examined the draft Freedom of Information Bill in June and July of this year. This Bill has had more inspections in its various draft forms over the past few years than Britain's livestock population. While the Select Committee was certainly
not without its criticism of aspects of the draft Bill, it also agreed strongly that actually having a Bill in front of us was to be welcomed and was long overdue.I felt it was uncharacteristically dismissive of the noble Earl, Lord Howe, to refer to the Freedom of Information Bill in his opening of the debate today in the way that he did, especially given the fact that the Conservative campaign guide for 1997 stated that there was "no need for a freedom of information Act" and that the only group in Britain who are seriously interested in a freedom of information Act are inquisitive, left-wing busybodies. Many people in this country who would not consider themselves, on reflection, to be busybodies, will welcome the Bill's duty to publish information proactively, as well as the requirement to consider the disclosure of information in the public interest, even where an exemption applies. They will welcome also the establishment of an independent information commissioner and a new information tribunal with wide powers to enforce the rights created.
Even the Campaign for Freedom of Information, which was less than ecstatic about one or two parts of the Bill, pointed out that it covers a large number of public bodies, that the statutory right of access is to be welcomed and that the charging provisions within the Bill are fair. I believe that the Government have been listening to the many voices raised in the continuing debate on openness over the past two years. I welcome the number of changes they have made since we last met as a Select Committee this summer. No doubt in the course of the Bill's progress through your Lordships' House in the coming year, outstanding issues which were reflected in the committee's recommendations will be raised and debated--the most obvious being the powers of the information commissioner in regard to a public interest override. And no doubt there will be heated discussion as to whether or not background information can be distinct and separable from policy advice, and therefore be taken out of the class exemption for policy advice.
But those are the problems of the success of a government determined to drive forward legislation in this important area of citizens' rights and end the culture of secrecy, and a government that will take no lessons from noble Lords opposite who presided over an era of unprecedented government secrecy and neglect of citizens' rights. Who will forget the secrecy surrounding the BSE scandal, the arms for Iraq affair and the continual resistance to opening up party political funding?
In conclusion, I add my congratulations to those of other noble Lords to the seven maiden speakers on their contributions. They should give us all heart that this House will go from strength to strength through the quality of their advocacy.
9.17 p.m.
Lord Norton of Louth: My Lords, I am conscious of the hour and the need to be brief. However, I was a little surprised earlier in the day when the Government Chief Whip announced that the noble Lord, Lord
Hunt of Kings Heath, would be speaking, as he put it, "after every Back-Bencher". Had the noble Lord spoken after every Back-Bencher we would still be here tomorrow and the noble Lord himself would probably be in need of the health service.As has been variously mentioned during the debate, the Queen's Speech was notable both for what it includes and for what it excludes. Given that, I should like to put two questions to the Government, one derived from what is in the gracious Speech and the other from what is not. The first question is straightforward. What is the philosophy, the particular world view, that underpins what the Government seek to achieve? On the basis of the measures envisaged in the gracious Speech, there is no apparent philosophy underpinning them at all.
Today we are considering home affairs. During the course of this Session the noble Lord, Lord Bassam of Brighton, will on one or two occasions be donning a liberal hat; on other occasions he will be donning a seemingly illiberal or what might be described as his "Straw" hat. The range of measures promised in the Queen's Speech follows no clear logic or structure. There is no apparent underlying set of beliefs to what we are offered. This point is not specific to the measures embodied in this gracious Speech; it is a criticism that can be levelled at the gracious Speeches of the past two Sessions. It is a criticism that I levelled at the House of Lords Bill in the previous Session. I wanted to know then what intellectually coherent approach to constitutional change motivated the measure. The answer to that question is that there was no coherent intellectual approach: there was not one then and, as far as I can see, there is no such approach motivating the measures that we are debating today. If there is, what is it?
It is clear from what I have just said that we need to know where the Government are coming from. But we also need to know where they are going; that is, in terms of the effects of the measures that they propose. That prompts my second question. What thought have the Government given, or rather what study has been undertaken or commissioned by them, as to the likely consequences of each of these measures?
We need to think through the likely effects of each Bill. All too often, there is a temptation to legislate in haste and repent at leisure. Parliament has variously approved well-meaning measures designed to address perceptible problems but measures that have had less than desirable consequences. Parliament has also approved measures which some of us would regard as less than well meaning and which have not been properly thought through.
We need to ensure that a Bill incorporates the most effective means of addressing a problem and that the provisions of the Bill are not likely to cause problems of their own. We certainly need to ensure that a Bill will not create a situation that is worse than the one it seeks to correct.
The need to think through the likely consequences of a measure applies to all Bills placed before your Lordships' House. It certainly applies in the context of
those measures of constitutional significance which fall within the remit of the Home Office and the Lord Chancellor's Department. Nowhere is this better demonstrated than by the passage of the Human Rights Act. We are now in a situation where the appointment of temporary sheriffs in Scotland by the Lord Advocate has been held, in anticipation of the Act taking effect, to be unlawful and where magistrates in Scotland who also serve as councillors have, as a precautionary measure, been suspended from serving on the bench until January.The Government make much of joined-up government, but what this demonstrates is a lack of joined-up thinking, of not thinking through the consequences of one Bill of constitutional significance for another. Why did not the Government, in drawing up the Scotland Bill, anticipate the consequences of the proposed incorporation of the European convention?
In terms of anticipating the consequences of measures, the experience to date has not been encouraging. The sheer number of Bills included in the Queen's Speech also raises doubts about the extent to which the Government are concerned to think through what they are proposing. Consideration of consequences should precede the introduction of a Bill, not succeed it. I very much welcome the move towards the publication of Bills in draft, but there is still a long way to go before we get the process right. The gracious Speech makes reference to three Bills to be published in draft. That is welcome, but why only three?
I therefore invite the House to shift the focus, or rather the balance, of debate. Of course we must address the problems that motivate the introduction of the Bills. We must satisfy ourselves that there are genuine problems to be addressed. That is necessary, absolutely necessary, but it is not sufficient. We must also satisfy ourselves as to the likely consequences of those Bills. We must satisfy ourselves that the Government have thought through the consequences of those Bills. That may mean looking at the way we consider legislation in Parliament.
The procedures available to this House, and to the other place, are not necessarily well geared to investigating the likely effects of a measure. We need to spend more time seeking advice and data from those bodies that have expertise and experience in the field. The other place has provision for the appointment of Special Standing Committees which can take evidence. Despite the entreaties of successive Procedure Committees and the Modernisation Committee, such committees have not been employed on a regular basis.
We have provision in this House to make use of investigative procedures during the passage of a Bill. I am thinking, in particular, of the provision for the appointment of a Select Committee to consider a Bill. This is not the only procedure available, but I think that it is the most appropriate in this context. This provision has rarely been used and, when it has been, it has usually been for Private Members' Bills. I believe that there is a case for making greater use of Select Committee scrutiny prior to normal consideration in
Committee of the Whole House. Such scrutiny will allow the House to explore more fully the likely consequences of a Bill. That would be to the benefit of the House in considering the Bill. It should also be to the benefit of government enabling them to ensure that a Bill is workable and that it avoids having unintended consequences.By publishing some Bills in draft the Government are in effect conceding that measures may be improved by consultation and by discussion with relevant bodies. What I propose is consistent with what the Government have conceded. If the Government are confident that what they are proposing in the gracious Speech is both desirable and workable, they should have no objections to it being subject to proper scrutiny by your Lordships' House.
9.25 p.m.
The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath): My Lords, I welcome the opportunity to speak tonight about the Department of Health's legislative programme. I start by thanking the House for its tolerance in allowing me to speak tonight.
When the National Health Service was created by the Labour government in 1948 it was the ambition of all those building the new service that Britain should have a system of health and social services that would be the envy of the world. That is why we have embarked upon a 10-year programme of modernising the health and social services. I say to the noble Lord, Lord Clement-Jones, that that programme of modernisation has already begun to bear fruit.
Many in the Opposition believe this to be impossible. Indeed one had only to listen to the noble Earl, Lord Howe, in an uncharacteristic guise as a prophet of doom and gloom when he spoke earlier, to realise that. We on this side of the House are confident about the National Health Service. Since coming to office in May 1997 we have kept our manifesto commitment to abolish the wasteful and divisive internal market and to put an end to the short-termism so appropriately described by my noble friend Lady Ashton. We have replaced it with a system of integrated care based on partnership and driven by performance.
The noble Earl, Lord Howe, talked about resources. We have kept our commitment to allocate more resources to the NHS. The NHS will receive continuous, substantial extra funding over the remainder of this Parliament as a result of the comprehensive spending review. We have launched the biggest hospital building programme in the history of the NHS with 37 hospitals under way, or shortly to be under way.
We have tackled the issues raised by the noble Baroness, Lady Williams, who I see is not present, by creating a new pay structure for nurses with a top salary of £42,000, and awarded all nurses the biggest real terms pay increase for 10 years, paid in full with no staging. Over 2,000 nurses have returned to the profession as a result of our campaign with another
2,000 in training and shortly to return. We have arranged for 1,000 extra training places for doctors to be put in place by the year 2005. We are committed to an increase of 7,000 in the number of doctors.We have set up NHS Direct, a 24-hour advice line staffed by nurses, to provide the public with immediate advice and help in contacting other services. It has been an enormous success and it is being watched with great interest by other countries. We have taken action to reduce waiting lists from the record number we inherited. The total number on the list is now 73,000 below that which we inherited and we are on course to achieve our target of 100,000 below that inherited. In relation to waiting times I say to the noble Earl, Lord Howe, that it was the government he served that had an 18-month target. But they failed to deliver it. We have achieved the 18-month target.
We have placed major emphasis on quality, consistency and high standards of patient care. How much I agree with the noble Lords, Lord Carlile and Lord Patel, on the issue of quality in evidence based medicine. That is why we have established the National Institute for Clinical Excellence and the Commission for Health Improvement. It is why we have established clinical governance at local level.
In a notable, uncontroversial maiden speech, the noble Lord, Lord Forsyth, spoke about the postcode lottery of care. Where did that come from? It came from the introduction of the internal market. The purpose of establishing the National Institute for Clinical Excellence is to ensure that we have cost-effective medical interventions in the future and that there will be much greater consistency throughout the country with those interventions.
I agree very much with the noble Lord, Lord Patel, as regards private sector regulation. We have consulted on that matter and are now considering the responses. We hope to announce the outcome shortly. The noble Lord, Lord Colwyn, invited me to take on cult status in reassuring the dental profession. I am not sure that I can really ascribe to that. The dental strategy has not yet been published. It is later than we envisaged. That is because the scope of the strategy has widened considerably. If the scientific review of evidence on fluoridation of water confirms benefits to dental health and no risk to overall health, we shall then consider legislative changes to put water companies under an obligation to fluoridate areas where the majority of significant populations are in favour. That should reassure the noble Earl, Lord Baldwin.
I turn to complementary therapies. I welcome the constructive speech of the noble Earl, Lord Baldwin. I am not afraid to acknowledge that I use such medicines. He seemed to be looking for some users on this side of the House. As regards herbal medicines, I assure him that I wish to continue the good work of my noble friend Lady Hayman.
The noble Baroness, Lady Masham, asked about the HIV/AIDS strategy. I can assure her that our strategy on sexual health published in March encompasses that strategy. Working groups are taking
forward details of the strategy. The noble Baroness also raised the extremely important issue of hospital-acquired infection. Noble Lords have debated this issue in the past year. It is a matter of great concern. We are discussing with the professional organisations most concerned how to develop a strategy for a much more structured surveillance of hospital-acquired infection.The noble Earl, Lord Howe, accused the Government of being inactive over the rise in the cost of generic drugs. I refute that suggestion. We have moved to make Category D entry more difficult and to allow drugs to come out of the category more quickly than has been the case in the past. We have referred the issue to the Office of Fair Trading. We have announced a fundamental review of the generics supply industry.
The noble Lord, Lord Clement-Jones, referred to the £700 million over three years in order to help us deliver the safe, sound and supportive mental health services that we need. That has to be taken together with the mainline resources that are already spent in the mental health field. We believe that this will provide the resources to begin implementing the national service framework.
The noble Lord, Lord Laird, spoke of issues in relation to Northern Ireland and particularly about the reorganisation of the acute services. We have enough challenges here without my becoming embroiled in such issues. But I take this opportunity, as a frequent visitor to the Northern Ireland Health Service, to acknowledge the excellence of so much of what is provided there.
The noble Lord, Lord Clement-Jones, and my noble friend Lady Rendell raised the issue of healthcare for older people and the suggestion that discrimination is exercised against them. I reiterate that discrimination of any kind has no place within the NHS. We are committed to a fundamental rule that the NHS is there to provide services for everybody irrespective of age, race or gender. Decisions regarding treatment rest with individual doctors in individual cases. Such decisions can be complex in the care of older people. All the clinical factors need to be taken into account, including other physical illnesses and current medication. But the national service framework as regards older people will be able to pick up and address some of those issues.
My noble friend Lady Rendell raised concerns about female genital mutilation. I have a great deal of sympathy with the points she raised. I will be happy to meet with her to see if there is more that we can do.
The noble Lord, Lord Clement-Jones, and other noble Lords, asked about the date of the announcement of our response to the Royal Commission on long-term care. We hope to make an announcement before Christmas. We are giving the Commission's report the very careful attention it undoubtedly deserves. We have begun work in some of the areas highlighted by the report; for instance, improving services for carers.
The noble Baroness, Lady Masham, asked about the spinal injuries centre at Stoke Mandeville. She has almost tempted me to visit the centre. I am satisfied that the local trust recognises the importance of the centre. Equally, we should recognise that the trust provides invaluable services to the centre.
The noble Baroness, Lady Massey of Darwen, spoke about the health of young people and the priority we have to give to that. How much I agree with her. More generally, she was right to focus on public health and Our Healthier Nation strategy.
As far as concerns our 10-year programme to modernise the health services, we are already delivering more and better healthcare. We have set ourselves tough targets to show that this will continue. That is exactly our goal for social care services as well. Those matters will be the focus of our two Bills this Session. The Children (Leaving Care) Bill has been introduced into the House already and the care standards Bill will be published shortly.
The care standards Bill will establish a new independent regulation system to inspect care homes, children's homes and other care services. There will be national standards and tough new powers to protect vulnerable people, including the power to close down a home if it is not up to standard. The Bill will establish a level playing field between the public and private sectors; and it will set up tough new arrangements for inspecting private hospitals and clinics to ensure that people get the protection they deserve. I very much agree with the noble Lord, Lord Carlile on that. The Bill will establish a general social care council to raise professional and training standards for the million-strong social care work force.
So the Bill will ensure that children in care are protected from abuse and neglect; that elderly and disabled people who rely on care services get decent standards of care and the protection they deserve; and that private hospitals and clinics operate to proper, modern standards of healthcare. The Bill is very important. I have no doubt that we shall debate it at some considerable length and subject it to considerable scrutiny.
But there is also the tragic situation of young people who leave care and are left to make their way in the world, all too often with sad results. There is little doubt that the present system has failed too many young people. Many have ended up unemployed, homeless and socially excluded. Increasing numbers of young people leave care at just 16; one in four of the girls are pregnant; three-quarters have no qualifications; and 50 per cent are unemployed. I agree with and reiterate the comments of the noble Earl, Lord Howe, and the noble Lord, Lord Warner, as regards the problems that we have to tackle. The situation is clearly unacceptable. The system needs reform, and this we will do with the Children (Leaving Care) Bill, which was introduced in the House last Thursday.
The Bill will reverse the current trend of children leaving care too early and make sure that they leave care only when they are ready and willing to do so and
with proper support. The Bill will give the responsible local authorities a new duty to assess and meet the care and support needs of eligible young people aged 16 and 17, whether they choose to remain in care or not. It will give all eligible young people a pathway plan from their 16th birthday to map their route to independence. It will provide all eligible young people with a young person's adviser, who will keep in touch with them, oversee the pathway plan and ensure that they have the help that they need.Finally, the Bill will put a duty on local authorities to assist care leavers to benefit from higher education by providing them with accommodation during vacations where needed. They may provide help with the costs of education and training up to the age of 24, whenever the course starts.
In conclusion, perhaps I may say to the noble Lord, Lord Norton of Louth, that, just as we are determined to raise standards of social care services, so we are determined to raise standards in the NHS. That is the purpose of the Bills which we put forward today. We are taking ideals from Aneurin Bevan which hold as good today as they did in 1948. We are taking those ideals and making the NHS fit for the 21st century, raising the quality of our health and social care standards to the best that the world can offer--supported by all, used by all, fast, accessible, consistent and first-class.
9.40 p.m.
Lord McNally: My Lords, it is my honour and duty to wind up the Queen's Speech debate on behalf of these Benches.
I believe that your Lordships would all agree that, not just today but throughout the debate on the gracious Speech, we have had a succession of awesomely effective maiden speeches. It would be invidious to name names in such circumstances. However, I believe that one maiden speech stands out; that is, the speech of the noble Lord, Lord Forsyth. As exclusively predicted by my noble friend Lord Rodgers of Quarry Bank, his application for the leadership of the Conservative Party in this House was delivered on time and on schedule. But I believe that there may have been some mistiming: perhaps he should have waited for the outcome of the Kensington & Chelsea by-election. If the Conservatives were to be successful there, he could have mounted a joint putsch with Mr Michael Portillo. There we would have it: Portillo and Forsyth--the Burke and Hare of British politics--running off with the body of the Conservative Party.
My prime responsibility on these Benches is to speak on Home Office matters, and it is to those that I shall devote my remarks this evening. I noted that the noble Lord, Lord Bassam, predicted that he will appear regularly at the Dispatch Box during the coming year. I must confess that I am still trying to get the measure of the noble Lord, Lord Bassam. Apart from his waistcoats, he is the least flamboyant of the Government Front Bench. I must also confess that I miss his predecessor--now the Attorney-General. The
noble and learned Lord always came to the Dispatch Box with an air of wounded self-righteousness. Sometimes it almost qualified him for these Benches.The difficulty for Home Office Ministers is exemplified by the gracious Speech. Over a quarter of the Bills in the Speech will be the responsibility of the Home Office or the legal departments. In addition, we shall undoubtedly have emergency legislation, responding to some as yet unforeseen crisis within the Home Office ambit. I once described the Home Office as "the Ministry of one darned thing after another". The noble Lord, Lord Callaghan, put it better in his memoirs. He said this about the Home Office:
- "Its work is concerned with holding the balance between the state and the citizen, between law and justice and liberty and order".
- "His work is the stuff of newspaper headlines, the human story that will appear on the front pages: drugs, football hooligans, gambling, pornography, prison escapes, demonstrations, police behaviour, the treatment of immigrants. They are not abstract concepts like the Treasury's monetarism, or the Public Sector Borrowing Requirement; but are subjects about which every man knows that the opinion of the Home Secretary is no better than his own".
There is no doubt that those responsibilities for freedom and security often chafe one against another. The good Home Secretary gets the balance right. I have known the present Home Secretary since our student days over 30 years ago and I know that he has many of the personal qualities to become a great Home Secretary. There are, however, genuine doubts about him which I think are reflected in the Bills contained in the gracious Speech. I would not go so far as to say that there is something of the night about Jack Straw; it is more of the twilight zone. The distinguished political commentator, Philip Stephens, of the Financial Times, made the point last Friday that too many of the Bills in the gracious Speech,
- "spoke to the populist illiberalism which is the Government's least attractive trait".
If fiddling the figures over police numbers shows the populism of the Home Secretary's twilight zone, freedom of information shows his illiberalism. Like the noble Baroness, Lady Crawley, I was a member of the Select Committee under the chairmanship of the noble and learned Lord, Lord Archer. I remain optimistic that there are still sufficient people on the Benches opposite, like the noble Baroness, Lady Kennedy, who know the importance of a truly radical and wide-ranging Freedom of Information Act. We must change the culture of secrecy which pervades British government at all levels. To ensure that, the Bill now before the Commons must be dramatically amended and improved in this House.
Having waited 30 years for a Freedom of Information Act, I would rather throw out a Bill or challenge the Government to invoke the Parliament Act than acquiesce in an ineffective and illiberal measure going on to the statute book.
So I say to the one in four Members of this House who have been sent here by the present Prime Minister, do not just leave it to Jack Ashley or Alf Morris--have the courage of your convictions. Let the Chief Whip know that this Bill will just not do. You will feel a whole lot better for it.
Then, of course, we have the Criminal Justice (Mode of Trial) Bill, which will be coming to this House next week. I have to say that when the whole legal profession unites in hostility to an idea my first reaction is that the proposal must have some merit. Yet, as my noble friend Lady Williams made clear, there can be no more deeply embedded right in our national psyche than the right to trial by jury. My honourable friend Mr Simon Hughes has warned in another place that these proposals will face a "battle royal" from the Liberal Democrats.
In contrast, there is good news about the creation of a unified probation service. That will receive our support. The change will put the probation service in a better position to persuade courts and the public that community supervision is rigorous and effective in cutting crime. It will also ensure a clearer voice for the probation service, achieving public understanding of the value of its work.
Most of the other measures contained in the crime and public protection Bill are also welcome. In particular, the proposals to create a new system to prevent unsuitable people from working with children will have the support not only of the organisations working with children but also of those working to rehabilitate sex offenders and divert them from further offending.
As my noble friend Lord Dholakia indicated, the race relations proposals in the gracious Speech will not satisfy many among the ethnic minorities who saw the Lawrence Report as a launch pad for far more radical reforms. We are fortunate in this House in having a number of Members of experience who are well informed about the opinions of the ethnic minorities. We have heard today from both my noble friend Lord
Dholakia and the noble Lord, Lord Ahmed. I hope that we will listen carefully to them again when the legislation comes before us.The counter-terrorism legislation comes at a time when, it is hoped, one kind of terrorism may be on the wane as the political process takes root in Northern Ireland. However, on these Benches we are determined that permanent legislation is open to the same level of scrutiny as the present temporary legislation. We will keep an eagle eye open for the erosion of any civil liberties masquerading as anti-terrorism measures.
In that context, there is nothing in the gracious Speech about the accountability of the security services. I believe this is a nettle which should be grasped and not simply left to the next cock-up, revelation or defection to produce panic measures. Ministers should risk the wrath of the noble Baroness, Lady Park, and bring forward well-considered proposals for scrutiny and accountability by Parliament, as recommended by the Home Affairs Select Committee.
I would like to see a properly accountable security service both at home and abroad given a specific mandate to make war on the drug barons. However, I think that such a policy must go hand in hand with a fundamental reappraisal of our drug laws. When my own party conference suggested a Royal Commission to look at the matter a few years ago, we were immediately branded as soft on drugs. When Charles Kennedy renewed that call as one of his first acts as our new party leader, he ran into similar flak. Yet we have to ask ourselves if the tough words on drugs contained in the gracious Speech match up to everyday reality.
Mr John Humphrys, writing in the Sunday Times last Sunday, wrote in a way that suggested that the climate of thinking may be changing. He wrote about the legislation:
- "What I do know, as does every other citizen of this country from the prime minister down, is that the present approach is not working. Every single parent I have ever spoken to is terrified of the shady figure lurking in the shadows of the school playground. What I also know is that it must be right to have a sensible debate on the subject and wrong to be scared off by the threat of a newspaper campaign".
Likewise, on party funding I remain personally convinced that the measures being proposed will prove inadequate to the task of cutting out the cancer of influence buying from our political system. I believe that only a system of transparent state funding of political parties will do. The present proposals will allow the big two parties to raise £20 million each for the next general election. I do not think that that addresses the problem. That is big money which will not be raised from members' subscriptions and jumble sales. So we will stumble on until the next political scandal hits us or we move towards the American-type dollar democracy referred to by the noble Lord, Lord Neill.
There are Bills and parts of Bills in the gracious Speech that we will support. As in the last Session, we will seek for our opposition to be constructive and we will not shirk from supporting the Government when the forces of conservatism and reaction threaten, as they do this evening. That means that we shall vote with the Government. Yet we do have doubts about the populism and illiberalism identified by Philip Stephens. The liberty of individuals, their empowerment via access to knowledge of the decision-making processes of government, together with the security that comes from the police and legal system, which are instruments of the people's will and not of an authoritarian or overly powerful state, are the benchmarks against which Liberal Democrats will examine the contents of the gracious Speech. And they will determine our support or our opposition to the government measures as they come before us in the year ahead.
9.54 p.m.
Lord Mackay of Ardbrecknish: My Lords, perhaps I may say first to the noble Lord, Lord McNally, on the stunning news that his party will vote with the Government: some things never change. I did not actually have to grab my pillbox in order to recover from the shock of that particular news. The shock will come on the day when the Liberal Democrats do not vote with the Government. I sometimes wonder why they do not change places with the Cross-Benchers on the other side of the Chamber so as to be nearer to their friends. Maybe they want to see their faces.
On each day of this debate we have heard a galaxy of maiden speakers. Today was no exception. We heard the noble Baronesses, Lady Stern, Lady Ashton of Upholland, Lady Harris of Richmond, Lady Massey of Darwen, and Lady Gale, and the noble Lord, Lord Laird. In addition, we heard my noble friend Lord Forsyth of Drumlean, who, not surprisingly for me, rather redefined what was meant by a non-controversial maiden speech. After these four days of maiden speakers, the rest of us will have to look to our laurels in the months ahead.
The noble Lord, Lord McNally, mentioned the Minister's taste in waistcoats. Indeed, I agree with him--although today's is not quite so dramatic as yesterday's, which I thought rather resembled a tartan. I was not entirely sure whether it was the Bassam tartan or the Brighton tartan. Whichever it was, it was a pretty unconvincing one. I would certainly advise the Minister not to wear it next Tuesday, St Andrew's Day, if he is invited to any Scottish party. The result might be a little like Wembley last week.
It is not only the Minister's waistcoats that are sometimes--as yesterday--a bit of a mish-mash. It is also the programme, not only of the Home Office, but of the whole gracious Speech. In its critique of the gracious Speech, the Economist posed the question:
- "Is Tony Blair a pro-enterprise Liberal or an interfering authoritarian?".
- "His new programme presents mixed evidence".
Put differently, and in the words of the amendment moved by my noble friend Lord Strathclyde, the measures show,
- "incoherence and lack of vision".
In regard to the Home Office programme, we have no problem with the idea of mandatory drug testing and the refusal of bail to those testing positive. My only concern would be to ask whether the resources are available in prisons to cope with the people who will be refused bail. Furthermore, will there be offers of help for them to come off the drugs which are probably the cause of their turning to crime, as many noble Lords suggested during the course of the debate.
As regards the removal of the right to a jury trial, surely the reforms introduced by the previous government--which I will call in shorthand our "plea before venue"--should have been allowed to run a good deal longer. My understanding is that they were already proving successful in reducing delays. As a mere layman in these matters, I find it difficult to square the Government's new policy with the words written in The Times when these proposals were first aired in 1993 by none other than my normal sparring partner, now the Attorney-General, the noble and learned Lord, Lord Williams of Mostyn, who said this about the proposal not to have jury trials:
- "This would be madness ... I hope Parliament will refuse to countenance legislation of this kind".
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