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Lord Filkin: My Lords, as the House may well know, the draft legislation is available to be inspected. It was deposited in draft form at the end of June, allowing a three-month consultation period. No doubt parliamentarians will contribute to that as much as ever. With regard to dual-scrutiny, the position is that if someone commits in, say, France, an offence which is covered by one of the 32 generic headings—for example, terrorism, trafficking in human beings, laundering the proceeds of crime, kidnapping, rape or murder—it will be possible to apply for his extradition from this country to France. That will be a quicker process. It will bring to justice sooner people who have committed crimes. By reverse, it will make possible people facing justice in this country who have fled justice by going abroad. It is in the interests of British society that they should be held to account in British courts rather than being able to avoid justice—for many years in some cases.
Lord Pearson of Rannoch: My Lords, does the Minister agree that the lifting of a scrutiny reserve by the Select Committee of both Houses is not the same as full agreement in debate in both Houses? Secondly, when he says that the arrest warrant was not agreed by the Government until the scrutiny reserve had been lifted, does he agree that the British Government gave provisional agreement to the arrest warrant a long time before the scrutiny reserve was lifted? Can he clarify what is the legal source of provisional agreement in the European Union?
Lord Filkin: My Lords, provisional contracts, like draft contracts in that sense, have no force at all. They
are an indication that the British Government thought that the framework agreement was moving in the right direction. They were seeking to achieve objectives that were in the interests of British people. The reserve is put down, as the noble Lord, Lord Pearson, well knows, to preserve the position of scrutiny so that proper scrutiny can take place. Scrutiny can influence the final shaping of such documents, as I believe it happened in respect of the framework agreement on the arrest warrant. Therefore, the scrutiny processes in this House had a positive effect on the final document.
Lord Monson: My Lords, can the Minister say what would happen if someone in the Channel Islands were accused of uttering a xenophobic remark, say, about Belgians or Greeks? The Channel Islands are not part of the United Kingdom; nor are they part of the EU. However, the United Kingdom is responsible for their external relations. Could an arrest warrant be issued in such a case?
Lord Filkin: My Lords, it is one of my many failings that I am not an expert on Channel Islands law. If someone made xenophobic remarks in the United Kingdom about another country he could not be extradited under the framework agreement. We are firm that if anyone undertakes an act which is not an offence in this country he cannot be extradited.
Lord Cope of Berkeley: My Lords, am I right in thinking that, if the Government had wished, on 13th June they could have placed a full parliamentary reserve on the matter, saying that they would wait until Parliament had had the opportunity to approve the legislation? On reflection, would that not have been a better approach?
Lord Filkin: No, my Lords, I do not think so, unless one thinks that there is absolutely no benefit to this country from the processes of collective working and co-operation in the European Union. We think that there are significant benefits to Britain from the European arrest warrant. Having negotiated what we felt was an improvement to it, and having allowed both Houses of Parliament to scrutinise it thoroughly, we lifted our reserve. I repeat: it is still open to Parliament, if it so wishes, not to incorporate the framework agreement into domestic legislation.
Violence in the NHS
2.51 p.m.
Lord Clement-Jones asked Her Majesty's Government:
- Whether they are taking sufficient action to tackle violence in the National Health Service.
The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath): My Lords, action has been taken to tackle the problem of violence as part of the NHS zero-tolerance zone
campaign. For the first time ever, that includes central funding to support a large number of local initiatives being introduced to protect staff.
Lord Clement-Jones: My Lords, I thank the Minister for that reply. The Government have talked tough on violence in the NHS for years now, but the latest survey from the Department of Health shows a rise from 65,000 to 85,000 violent incidents during the past two years. How will the department reduce violent incidents by 30 per cent during the next year, as its target states? Is it not time to ensure that violent patients are banned from National Health Service treatment and prosecuted?
Lord Hunt of Kings Heath: My Lords, prosecutions have taken place. There are many examples of good practice. We have a policy on withholding treatment. I cite the example of Bart's and The London NHS Trust, which produced a policy on withdrawal of treatment from violent patients in September 2000. That has been an effective deterrent.
As for the baseline survey, of course the number increased. The original survey was incomplete because it lacked robust data requirements. The baseline figure of 85,000 reported incidents is for 2000-01. We are now beginning to measure the most recent financial year; we shall continue to measure. The target of 30 per cent is for financial year 2003-04.
Baroness Sharples: My Lords, can the Minister tell us how many charges have been brought against those violent people?
Lord Hunt of Kings Heath: No, my Lords, that information is not held centrally, nor is it held by the Crown Prosecution Service. But there are recent examples of prosecutions. For instance, in the East Anglian Ambulance NHS Trust area, a man was sent to prison for four months for threatening paramedics with a crossbow and a replica gun. There are other examples of successful prosecutions. The key is getting across the message that we shall not tolerate violent action against our staff.
Baroness Masham of Ilton: My Lords, does the Minister agree that not only staff but patients need protection? There have been several cases of rape. Does he agree that it may be worth considering breathalysing disruptive and disorderly people on National Health Service premises for drugs and alcohol?
Lord Hunt of Kings Heath: My Lords, I am not sure about breathalysing, but I certainly agree with the noble Baroness that members of the public—patients—have been the victims of violent assaults on NHS premises. That makes it important that the NHS has effective policies in place at local level to protect patients. Many of the measures that are being taken, including the introduction of closed-circuit television and the use of swipe cards in selected areas will have a protective effect for both patients and staff. At the
same time, we are stepping up staff training so that they can deal with those difficult situations and, we hope, defuse what can otherwise become extremely nasty incidents.
Lord Walton of Detchant: My Lords, can the Minister tell us what proportion of those violent offences occur at weekends compared to other parts of the week? Anecdotally, it appears that many of those are alcohol-related incidents on Friday, Saturday and Sunday evenings. Would it not be wise for the Government to recommend that a higher number of security guards be available at times when those incidents are likely to take place?
Lord Hunt of Kings Heath: My Lords, clearly, the experience of each individual NHS trust is different, but I certainly agree with the noble Lord that many accident and emergency departments face especial problems in the late hours of the weekends and the early hours of Saturday and Sunday mornings. As for the use of security officers, I agree that a proper security policy in each trust would consider the number of incidents and match the presence of security personnel and other staff to ensure that sufficient people are present to deal with such incidents. My impression is that from almost a standing position several years ago, the NHS has become much more fully geared-up to deal with those issues.
Viscount Falkland: My Lords, were not the previous two supplementary questions an attempt to get the Minister to remark on alcohol and other substances? Is it not unusual for people in this country to become violent unless they are mentally unstable, have been taking either alcohol or other drugs or, possibly, have just got out of their motor car? If we removed all such cases from the incidence of violence in hospitals, would there be any violence left?
Lord Hunt of Kings Heath: My Lords, I am afraid that the extensive research that I have undertaken—which is of course available—does not help to answer that question. We do not know the causes of each of those 85,000 recorded incidents of violence. The noble Viscount is absolutely right: substance misuse and alcohol are a cause of many incidents. Sometimes, where there has been a violent incident in the community—whether or not caused by drink—the trouble can follow injured people into the casualty department and NHS staff have to pick up the pieces.
In common with many other sectors of society, members of the public in hospitals are less patient than they used to be. Staff often have to deal with incidents of rage. We need to give out a clear message to the public that we will not tolerate such incidents in future. The zero-tolerance campaign is beginning to work. The example of Bart's and other hospitals, which have withheld treatment, shows that we are taking the matter seriously.
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