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Lord Saatchi: My Lords, when was the last time the Chancellor of the Exchequer used the phrase, "the end of boom and bust"?

Lord Davies of Oldham: My Lords, I do not follow every word that the Chancellor says, although no doubt the noble Lord does and is therefore rather better informed than I am. What the Chancellor often identifies is the extraordinary levels of inflation and house mortgage failures in the 1990s that reflected a very significant bust at that time. He is in a position to assure and guarantee the nation that we do not get a repetition of that.

Lord Higgins: My Lords, does the Minister deny that the savings ratio has virtually halved since the Government came into office? Is that not very worrying?

Lord Davies of Oldham: My Lords, there are aspects of the savings ratio that we would like to see improved. That goes without saying. The noble Lord will also recognise that the fact that a very substantial proportion of the wealth of British people is held in their houses, against a background in which their homes are being significantly enhanced in value by the rises of recent years, means that people are able to look at matters with more confidence than they otherwise would.

Animal Rights Protests

3.1 p.m.

Lord Taverne asked Her Majesty's Government:

The Parliamentary Under-Secretary of State, Home Office (Lord Filkin): My Lords, the Government are totally committed to protecting those working on, or otherwise connected with, legitimate scientific research on animals.

The police have a range of powers under existing criminal law and public order legislation to deal with intimidatory protests by animal extremists. We have made legislative changes in the Criminal Justice and Police Act 2001, which provides a new power to move protestors away from homes where such protests may cause harassment, alarm or distress. We have also

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strengthened the provisions on sending malicious communications with the intent to cause distress or anxiety. However, the effectiveness of existing laws is continuously monitored and proposals to strengthen existing legislation will be brought forward if found necessary.

Lord Taverne: My Lords, the Government are concerned about the threat of terrorism. The animal rights extremists are real-live terrorists who terrorise employees, children, babysitters, old ladies who hold shares—anyone who is remotely connected with a target company. They use megaphones in the middle of the night, break windows, burn cars and beat people up. Surely that is a systematic campaign of intimidation. Are the Government satisfied, with more than 700 such cases in the last quarter of last year, that the police are properly enforcing laws against such intimidation? Surely it is a form of terrorism that must be dealt with more effectively and rooted out.

Lord Filkin: My Lords, I share the noble Lord's repugnance for some of the actions of animal rights activists. I agree that, at the extreme end of the spectrum, such repulsive behaviour can be classified as terrorist activities. The Government have worked closely with ACPO to try to ensure that all police forces have in place adequate procedures for monitoring and acting against extremists when they carry out harassment of employees or directors of companies undertaking legitimate scientific research and business activities. A number of people—I think four or five—are currently in prison for having committed and been found guilty of criminal acts of such a nature against such firms or their employees.

The police will not hesitate, and are encouraged by the Government, to use fully the powers that the legislation gives them. In addition, the Crown Prosecution Service is looking to try to ensure that its actions are as co-ordinated and to a similar high standard so that any possible cases, where there are good grounds for prosecution, are brought.

Lord Mason of Barnsley: My Lords, there is an animal rights group called PETA, the People for the Ethical Treatment of Animals. It is also an anti-angling organisation, which concerns me particularly. Have any intimidation cases involving PETA been brought to the Minister's notice? Have any charges been made against the organisation?

Lord Filkin: My Lords, I am aware of PETA, as is the Home Office. To date, it appears to be small and mainly focused on anti-angling campaigns. We have not so far noticed any acts of harassment, but all such groups are actively monitored, both by the Home Office and by the police.

Lord Campbell of Croy: My Lords, does the noble Lord recall the serious threat of extreme violence and the physical attacks a few years ago against people working in laboratories who were carrying out humane experiments aimed at saving the lives of human beings? Does he agree that that was misguided?

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Lord Filkin: My Lords, I recall it and I agree that it was misguided. To many of us, it demonstrates the utter extremism of some such actions. We have had, since the 1986 Act was passed, what I think is the tightest system of regulation in the world. There is a very strong system for authorisation and inspection of people, premises and facilities and projects before animals can be used. Animals are not used flippantly or lightly, but for medical, veterinary or fundamental scientific research that benefits us all.

Lord Clinton-Davis: My Lords, will my noble friend indicate the incidence of prosecution in 2000, 2001 and 2002 of the animal rights groups?

Lord Filkin: My Lords, as I suspect my noble friend would expect, I do not have those figures exactly at my fingertips. I shall be very pleased to write to him with them and place a copy in the Library.

Lord Turnberg: My Lords, is my noble friend aware of the impact of animal rights activists on the pharmaceutical industry? Many companies are considering moving their operations to other countries, particularly the United States, where there is a much more favourable atmosphere.

Lord Filkin: My Lords, we are also aware of the experience of the Huntingdon Life Sciences Company, which moved its shares on to the American stock exchange from the British one because it gave greater shareholder protection and anonymity. The Government work closely with the pharmaceutical industry in respect of the matter. The industry is one of the gems of British industry and British research. It is fundamental to the health of our economy. We view with extreme concern any worries on its part that our environment may be hostile to its highly successful businesses and highly necessary scientific research.

Lord Jenkin of Roding: My Lords, there was recently an event in the House for the BioIndustry Association, which has since written to me on the issue. Some of its members would find it difficult to reconcile their own experiences with the account of the action taken against the terrorists that we have heard today. Will the noble Lord accept that much more needs to be done? If there is to be a proper distinction between persuasion, on the one hand, and intimidation, to use the word of the noble Lord, Lord Taverne, on the other, that intimidation should be effectively proscribed.

Lord Filkin: My Lords, I agree that we wish to prevent and outlaw any acts of intimidation that inhibit or deter legitimate business or scientific research. In respect of the examples that the noble Lord did not fully give, if he would let me have that evidence I would be pleased to place it before my honourable friend the Minister in another place who deals with the matter. I am sure that he would be pleased to consider it to ensure that we do all that we should as a government on the matter.

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Licensing Bill [HL]

3.9 p.m.

The Minister of State, Department for Culture, Media and Sport (Baroness Blackstone): My Lords, I beg to move the Motion standing in my name on the Order Paper.

Moved, That the amendments for the Report stage be marshalled and considered in the following order:

Clause 1,

Schedules 1 and 2,

Clauses 2 to 4,

Clause 177,

Clauses 5 to 8,

Schedule 3,

Clauses 9 to 111,

Schedule 4,

Clauses 112 to 176,

Schedule 5,

Clauses 178 to 196,

Schedules 6 to 8.—(Baroness Blackstone.)

On Question, Motion agreed to.

Community Care (Delayed Discharges etc.) Bill

3.9 p.m.

The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath): My Lords, I beg to move that the House do now resolve itself into Committee on this Bill.

Moved, That the House do now resolve itself into Committee.—(Lord Hunt of Kings Heath.)

On Question, Motion agreed to.

House in Committee accordingly.


Clause 1 [Meaning of "NHS body" and "qualifying hospital patient"]:

Lord Clement-Jones moved Amendment No. 1:

    Page 1, line 5, at end insert—

""delayed discharge" means a delay in transfer occurring when—
(a) the patient is eligible for discharge from a general and acute hospital bed to another care setting, subject to a single assessment process; and
(b) a multi-disciplinary team decision has been made that the patient is ready for, and safe to, discharge or transfer to another care setting, but the patient is still occupying such a bed;
"eligible for discharge" means judged fit for discharge in accordance with—
(a) a clinical recommendation; and
(b) discharge procedures adopted by NHS trusts in accordance with guidance issued by the Secretary of State or the Assembly;"

The noble Lord said: It is always a pleasure to speak to Amendment No. 1 at the Committee stage of any Bill because of the close attention that noble Lords pay to the proceedings at such a time. That is particularly

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the case when dealing with an important Bill such as this because I suspect that many of your Lordships will be back in the Chamber for Divisions, both in Committee and on Report.

In moving Amendment No. 1, I shall speak also to Amendment No. 2. The Bill should clearly define the mischief that it intends to remedy. The whole edifice of the Bill rests on the question of discharge. Yet, although qualifying patients and the delayed discharge periods are defined, nowhere in the Bill or, so far as I can see, in the Hospital Discharge Workbook is there any legal definition of "discharge" or "delayed discharge". The definitions set out in Amendment No. 1 are designed to generate some certainty about this issue.

Currently some 5,000 patients of all ages are delayed in acute hospital beds when they are ready to leave hospital, although the figures appear to be steadily reducing. There is general consensus that it is bad for older people to be delayed in acute hospital beds once they are ready to leave: they may lose the confidence needed to regain independence when they return home; and they have an increased risk of infection and of losing mobility during an extended stay in hospital. Once they are well enough to leave the hospital environment, most people would rather be in a more homely environment with their own possessions around them.

However, the definition itself is crucial to the patient's onward journey. David Gilroy, the Deputy Chief Inspector of the Social Services Inspectorate, gave the following definition to the Health Committee inquiry:

    "The approach the Department takes is to define a delayed transfer of care as occurring when a patient is ready for transfer from an acute hospital bed but is still occupying such a bed. A patient is ready for transfer when: (a) a clinical decision has been made that the patient is ready for transfer; (b) a multi-disciplinary team decision has been made that the patient is ready for transfer; and (c) the patient is safe to discharge or transfer".

He went on to tell the Select Committee:

    "The stuff about (a) or (b) is because sometimes the clinical decision is taken as a part of the multi-disciplinary team approach and then (b) is satisfied. Where a consultant makes a separate decision not joined up with the multi-disciplinary team approach, both have to be satisfied. That is what that is about".

In other words, it needs to be made clear on the face of the Bill whether a person's readiness for discharge is a matter for co-decision through multi-disciplinary assessment or whether it is a straightforward clinical decision.

As drafted, the Bill's emphasis on "safeness for discharge" is a purely clinical judgment, and it appears that the Government are going back on their own definition. By including a definition of both "eligibility" and "delayed discharge", linked to statutory guidance, the amendment seeks to ensure that discharge and the patient's onward journey through the social care system are a matter of co-decision. It seeks to move away from the notion of "frictional" delays, which, by health Ministers' own admissions, will vary from locality to locality, as will the definitions. At Second Reading it was pointed out by many noble Lords that discharge can often be

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interpreted in different ways in different localities, and that can, indeed, lead to hardship. That is why a common definition is needed under the Bill.

Amendment No. 2 is a probing amendment designed to clarify the relationship between this legislation and arrangements for joint management systems as care trusts under the Health and Social Care Act. Introducing a mechanism whereby one part of the care sector has a legal obligation to impose financial penalties on the other inevitably raises boundary problems where there are integrated structures.

Similar problems arise in respect of partnerships and pooled budgets under the Health Act 1999 flexibilities. In those situations, it appears to be the legal position that social services are responsible for the reimbursement under Clause 4 but, with the PCT's agreement, may delegate that responsibility to a pooled budget. However, 16 pooled budgets are now in operation around the country and they have been set up explicitly to deal with delayed discharge issues. If, as seems clear from the Explanatory Notes, the fines are taken out of the pooled budget, will the extra investment in social services go back into the pooled budget?

In the case where a PCT which has been redesignated as a care trust has all social services functions—or, at least, the functions which cover provision of all services for older people and adults—delegated to the care trust, would the care trust be responsible for any necessary reimbursement of the acute trust? Furthermore, what happens where the delayed discharge qualifying patient in the acute hospital setting is the responsibility of a PCT which has been redesignated as a care trust and where the patient may be receiving what is essentially primary care as an in-patient?

In many ways, the "frequently asked questions", which accompany the Bill, attempt the impossible—that is, to answer the questions relating to the Bill. Those questions make clear that it is impossible for a local system to agree not to implement the charging scheme or for an NHS trust not to claim the reimbursements. Once the legislation commences, all partners must act on the legal duties.

That rigidity of implementation risks undoing all that has been achieved by progressive legislation over the past few years in breaking down barriers between health and social services and encouraging a culture of joint working, as pointed out in extenso at Second Reading. That is no more so than in the case of a care trust where the NHS and the local authority pool not only their financial resources but their legal responsibilities also. It seems highly probable that the attempt to apply this scheme to established care trusts may, in any event, result in charging decisions that are ultra vires under the Health and Social Care Act. This limited amendment is designed to ensure that the legislation will not result in lengthy and expensive judicial review proceedings. I beg to move.

3.15 p.m.

Earl Howe: I support Amendment No. 1 and

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identify myself fully with what has already been said, but perhaps I may take the noble Lord's remarks a little further. The Bill is misconceived and has many serious shortcomings, but it seems to me that one of its regrettable consequences will be bureaucracy. To require a local authority under Clause 3 to prepare a care plan for discharge may fit very snugly into this wonderful new procedure but it leaves dangling in the air something that is tried, tested and very important—the single assessment process.

By definition, the care plan for discharge proposed in the Bill will be based not on the fact of how the treatment has turned out but on someone's guess about what may possibly happen during the course of the in-patient stay. Very often when a patient is admitted, ward staff can flag up their belief that he will need to go into residential care following treatment. That prediction can later be confounded when the patient makes a full recovery and goes home without the need for community services. Equally, events can often move the other way: the patient can unfortunately die in hospital soon after admission.

In other words, in many cases, the care plan for discharge is likely to be made redundant by subsequent events. Inaccurate conjectures by ward staff can lead to wasted work as well as misleading expectations. That simply cannot be a sensible use of resources. What is envisaged in the Bill is over and above the single assessment procedure. Its sole purpose is to determine the point in time when social services start to be fined. Therefore, it is a device that will not only cut across good working practice but will also exist for entirely non-therapeutic reasons.

There is also a serious human dimension. What concerns me greatly is that when a local authority begins its discharge plan it will have to start making inquiries about a patient's financial status. It will need to do that in order to be sure that the patient is not in a position to be a self-funder and therefore responsible for arranging his own onward care. Cash-strapped local authorities will be under a considerable degree of pressure to do that in every case.

That conjures up a pretty distasteful picture because front line social care managers will be put under pressure to delve deeper and deeper into the individual's financial affairs at a time when the person has just entered hospital and may be ill and very vulnerable. They will make those inquiries, often without being in a position to say to the patient with any degree of accuracy what sort of care he will need when he comes out of hospital. The whole position is invidious. I wonder whether the Government have thought about the issue in those terms.

Clinicians will say that the only care assessment and discharge plans that really matter, as the noble Lord emphasised, are those which are accurate and agreed at the time the patient is deemed to be "ready and safe for discharge". That is the accepted position under the guidance for the single assessment process. The Bill appears to take a coach and horses through the established joint working practice. I should very much like to hear the Minister's response.

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