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Lord Davies of Oldham: My Lords, I agree with the noble Baroness: we are not into "predict and provide", or simply making an assessment of the number of airline journeys that might be made and extending airports to meet that capacity. She will recognise from the figures that I have quoted that the potential expansion is so huge that it will need some response, even if it was scaled down very significantly. In some respects it will need to be, because of the necessity of meeting our Kyoto targets for emissions of carbon dioxide, to which reference was made earlier. To meet those requirements, we shall need to restrict some aspects of air travel. However, she must also appreciate that demand is such that to go some way to meet it requires extension to airport capacity, without any doubt.

Policing of State Visit of President Bush

3.10 p.m.

Lord Corbett of Castle Vale asked Her Majesty's Government:

The Minister of State, Home Office (Baroness Scotland of Asthal): My Lords, given the Home Secretary's responsibility for policing and security issues, he has of course had a number of briefings by senior officers of the Metropolitan Police on the security operation for the state visit. Senior officers

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have also had discussions with other relevant government departments and organisations including the Mayor of London.

Lord Corbett of Castle Vale: My Lords, I thank the Minister for that response. Now that those protesting about a range of American policies have pledged to do so peacefully, is she satisfied that the Metropolitan Police will not impede demonstrators getting their views across to both the president and the public? Is she able to join those of us demonstrating against the illegal duties that the US has put on imported steel, which put at risk jobs both here and in the rest of Europe?

Baroness Scotland of Asthal: My Lords, the answer to my noble friend's first question is, "Yes". We are satisfied that appropriate provision will be made to enable people to protest peacefully if that is their desire. Secondly, I am happy to reiterate that the World Trade Organisation has made clear that the United States steel safeguard measures are inconsistent with the WTO rules and must be lifted. We have urged the US Administration to make it clear that they will comply with the WTO decision. The alternative is that the EU countermeasures—additional tariffs on US goods to a value of 2.4 billion euros—will come into effect as early as 6th December.

Viscount Bridgeman: My Lords, does the Minister agree that despite the stridency of the legitimate protests, the tolerance of which this country can be proud, there exists in the United Kingdom a vast reservoir of people who will wish to welcome with courtesy and good will the head of state of a country with which this country has such close ties?

Baroness Scotland of Asthal: My Lords, I absolutely agree with the noble Lord's statement. The relationship between ourselves and the United States is a very longstanding and deep one and prevails irrespective of the administration in being at any given time.

Lord Avebury: My Lords, did not President Bush himself say that he was delighted to visit a country where people still enjoyed the right to demonstrate? Will the noble Baroness confirm that when they demonstrated previously against the Iraq war, 1.5 million people were on the streets and not a single one was arrested for any offence connected with public order? In the light of those facts, does she not think that it would be useful to vary President Bush's arrangements so that he could have an opportunity to watch the demonstration?

Baroness Scotland of Asthal: My Lords, first, I join in the noble Lord's delight that we can demonstrate. I can certainly agree with his statement regarding the president's own views. I can also say that the president will have adequate opportunity to be delighted in the way that the noble Lord indicates.

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Lord Hylton: My Lords, I declare an interest as a council tax payer in London. Can the noble Baroness confirm that the extra cost of policing will not simply be loaded on to Greater London but will be accepted as a national responsibility?

Baroness Scotland of Asthal: My Lords, I can certainly reassure the noble Lord, first, that the Metropolitan Police are well funded for policing major events such as this. If, however, this went substantially over what they can afford, there are mechanisms for forces to be able to apply to the Home Office for a special grant to cover difficult-to-meet costs.

Lord Imbert: My Lords, does the Minister agree that there seems to be a misunderstanding about the role of the Metropolitan Police in restricting some demonstrations and marches? The restrictions are being imposed not because of President Bush's visit—they are not anti- or pro-President Bush—but because of the Sessional Order that ensures that Members of Parliament and Members of your Lordships' House can attend Parliament to carry out the democratic process.

Baroness Scotland of Asthal: My Lords, as a former commissioner the noble Lord has particular experience of this matter. I am certainly delighted to confirm that what he says is, as so often, absolutely correct.

Lord Berkeley: My Lords, is my noble friend aware that a structure which has many similarities to the Field of the Cloth of Gold has been erected in front of Buckingham Palace. Do the two leaders see some significance in that?

Baroness Scotland of Asthal: My Lords, other than saying doubtless it is a thing of beauty, I have no comment to make.


Lord Grocott: My Lords, with permission, I should like to say a word about proceedings later today. This afternoon we should receive the Commons amendments to the Sexual Offences Bill. We will consider those amendments after consideration of Commons amendments to the Extradition Bill, but not earlier than 6.45 p.m. The Commons amendments to the Sexual Offences Bill will be available in the Printed Paper Office from 3.45 p.m. Peers who want to table amendments to the Commons amendments can do so in the Public Bill Office from 3.45 p.m. until 5 p.m. At 6 p.m. a Marshalled List of amendments will be available in the Printed Paper Office. I shall ensure that these events are indicated on the annunciators. If

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there are any complications later in the afternoon I shall do my best to come back to the House to explain them.

Ragwort Control Bill

Read a third time, and passed.

Health and Social Care (Community Health and Standards) Bill

3.16 p.m.

Lord Grocott: My Lords, I have it in command from Her Majesty the Queen and His Royal Highness the Prince of Wales to acquaint the House that they, having been informed of the purport of the Health and Social Care (Community Health and Standards) Bill, have consented to place their prerogative and interest, so far as they are affected by the Bill, at the disposal of Parliament for the purposes of the Bill.

Bill read a third time.

Clause 2 [General duty of regulator]:

Lord Clement-Jones moved Amendment No. 1:

    Leave out Clause 2 and insert the following new Clause—

"General duty of the regulator
(a) is consistent with the performance by the Secretary of State of the duties under sections 1, 3 and 51 of the National Health Service Act 1977 (c. 49) (duty as to health service and services generally and as to university clinical teaching and research), and
(b) has regard to the impact of an NHS foundation trust on the local health economy."

The noble Lord said: My Lords, I make no apology for raising the matter set out in Amendment No. 1 once again, for the third time, on Third Reading. Very similar amendments containing in particular the last subsection of Amendment No. 1 were tabled both in Committee and on Report.

On Report, the Minister made some headway in his response to the amendment in its previous form which imported concepts of universality of access and the regulator's duties in that respect. However, the Minister really did not address the key issue in that amendment and at the core of the current amendment—the impact of foundation trusts on the local health economy and the regulator's duty to have regard to that. I thought that the noble Lord, Lord Warner, was quite cogent in his response to the noble Earl, Lord Howe, on how the regulator would carry out his duties. If the regulator is to be a genuine regulator, that must be at the core of his duties. One of the key concerns throughout the Bill's passage in another place and in this House has been about the impact of foundation trusts on other aspects of the health service in their locality. That is absolutely at the core of this amendment.

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On Report, the Minister addressed the local health economy and prayed in aid a number of arguments. He said that,

    "the creation of NHS foundation trusts will support the development of NHS services in local health economies".

That is an assertion. One hopes that will be so but it is not necessarily the case under the Bill as drafted. The Minister continued:

    "Foundation trusts will exist to provide and develop healthcare services for NHS patients in a way that is consistent with NHS values".

To support that, one can pray in aid the duty to act in accordance with, or in a way that is consistent with, the Secretary of State's duties currently contained in the Bill. However, it is not absolutely clear that that is the case. The Minister continued:

    "Over 95 per cent of their income will continue to come from NHS commissioning".

That is the case, but that does not mean to say that foundation hospitals ipso facto will have to have regard to their local health economies. They may well build up their strengths without regard to other facilities of the NHS in their area. I believe the Minister considered that the following point was the crunch point in his argument. He continued:

    "They will be under a statutory duty to work in partnership with other local NHS organisations and social services to deliver integrated packages of care centred around the needs of patients".—[Official Report, 6/11/03; col. 987.]

They have a duty of co-operation—I believe that is the precise phraseology—rather than a duty of partnership. However, that is very much open to interpretation. Foundation hospitals, along with all other facilities in the NHS, will have that duty, but who will police it? There will be no policing available. There will be little recourse to other organisations within a locality affected by the activities of a foundation trust. That is the reason for imposing this matter as a duty on the regulator. That is where it sits most comfortably. To assume that a foundation trust will act in accordance with the NHS Act and its duty of co-operation, particularly in the light of concerns expressed in both Houses and outside Parliament, seems to me a trifle optimistic.

I challenged the Minister regarding the intention that the regulator would have no oversight of the impact of employment contracts. I asked him to repeat what he said in Committee at col. 628 of Hansard of 13th October; namely that:

    "They are not issues which should be arbitrated upon by a third party, such as the regulator".—[Official Report, 6/11/03; col. 987.]

I agree with that. I do not see that the regulator has a particular role in arbitrating employment contracts. However, it seems utterly right that the regulator should have regard to the impact of such employment contracts. That is a very different matter. It is not a matter of meddling in industrial relations or employment matters; it is a matter of seeing what impact those employment contracts have on the local health economy. The regulator could then make representations and exercise his powers under the Act relative to foundation trusts.

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I very much hoped that between Report and Third Reading the Minister would have had a chance to reflect on the matter because it is absolutely at the core of the Bill. If the Minister were able to be more positive in this area, there would be a great deal more good will towards foundation trusts. It will not have escaped anyone's attention that the BMA recently wrote to the Secretary of State urging him not to introduce foundation trusts.

It is in the Minister's hands to provide considerable reassurance in respect of the regulator's duty. I beg to move.

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