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Earl Howe: My Lords, in the wake of such an array of speeches on so many different topics and at the end of five days of debate, the task that falls to the three concluding speakers is far from easy. One statement that I can make now and without difficulty is that today's debate has been particularly distinguished, including three superlative maiden speeches. I join others in congratulating the noble Lords, Lord Rowlands, Lord Griffiths of Burry Port and Lord Cameron of Dillington, on their contributions, all of which demonstrated how fortunate we are to have them in our midst.

The right reverend Prelate the Bishop of Portsmouth was the first of many speakers to focus on education. I am sure that we all found ourselves empathising with the endorsement that he gave to the value of religious education and the sacred geometry. The theme of education was powerfully taken up by the noble Lords, Lord Rowlands and Lord Griffiths, the noble Baronesses, Lady Massey and Lady Sharp, and, with his great depth of experience, the noble Lord, Lord Dearing. I was glad to hear the wise observations of the noble Lord, Lord Northbourne, on how essential is the parental contribution to a child's development and the need to maintain parenting and relationship education.

Perhaps I may say that it was equally inspiring to listen to the noble Baroness, Lady Wall, speak on the theme of work-related skills and training. My noble friend Lord Wakeham did well to remind us of the important contribution made by the independent sector to the educational well-being of our nation.

These occasions are nothing if not diverse, and the speech of my noble friend Lord Peel reminded us what a wise source of advice he is on matters relating to the land. I hope that the Minister will take careful note of my noble friend's observations on wildlife management and rural housing. Equally, there are few people better qualified to speak about the rural economy than the noble Lord, Lord Cameron, whose nuggets of wisdom on rural housing and training are, I believe and hope, a foretaste of future contributions from him.

I also listened with attention and respect to the noble Baroness, Lady Miller of Chilthorne Domer, in her critical appraisal of the legislative proposals that are emanating from Defra. My noble friend Lord Dixon-Smith widened the scope of the debate most usefully with his warnings on climate change—a theme with a direct link to that taken up by the noble Lord, Lord Palmer, who reminded us most cogently of the potential of biofuels.

For the first time in many years, the gracious Speech contained only a passing reference to the National Health Service and no promise of any health-related legislation. It therefore does not surprise me that that fact alone provoked a number of noble Lords into making some extremely thoughtful contributions on issues relating to health. The noble Lord, Lord Faulkner of Worcester, did not disappoint us with his well informed contribution on
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tobacco and public health. My noble friend Lord Fowler made a characteristically compelling and impassioned call for more concerted action to combat HIV/AIDS. We heard, as we do on each occasion that he speaks, a set of well judged observations on NHS dentistry from my noble friend Lord Colwyn. The noble Baroness, Lady Barker, spoke on a variety of health-related themes, with almost every word of which I found myself in agreement.

My biggest regret is that, despite a reference to the draft Mental Health Bill, the Speech held out no certain prospect of mental health legislation coming before Parliament during the coming Session. I predicted last year that that would happen, and it gives me no pleasure to have been proved right. Some of us may well have our doubts that a full legislative Session is ahead of us; but if the Government want us to believe that it is, it would have been reassuring to hear from Her Majesty that pre-legislative scrutiny would be followed by the publication of a Bill.

That said, it must be a matter of concern that the draft Bill has attracted serious criticism from, among others, the Mental Health Alliance and the Royal College of Psychiatrists. The proposals in the draft Bill for compulsory detention and treating people against their will have been described by Paul Farmer of the MHA as,

Mike Shooter, president of the Royal College of Psychiatrists, has characterised the Bill as ensuring,

In a gracious Speech that contains welcome news about enhanced rights for the disabled, who include people with mental illnesses, that is a rich irony. The distinctive hand imprint of Mr David Blunkett is as much here as it is just about everywhere else in the gracious Speech, and some of us can hope only that the scrutiny committee will come forward with proposals that would remove the Bill's worst excesses.

One Bill that we shall see is the Mental Capacity Bill. I am sure that the Minister will be pleased to know that we shall give that Bill a broad welcome. I certainly believe that by clarifying and codifying the current law in this area and by providing a coherent structure of decision making, based on common law principles, we shall strengthen the protection afforded to those who, for whatever reason, lack capacity to take decisions for themselves.

I am afraid that there is a "but". The Minister will know that the Bill has excited controversy among those who believe that, intentionally or not, it opens the door to euthanasia. The assurances that the Government have given on that score, together with the declaratory Clause 58, are important and very welcome; but we shall need to examine the concerns that have been voiced with great care when the Bill goes into Committee. In particular, I am not yet persuaded that the definition of "best interests", as drafted, is tight enough to exclude some of the possibilities envisaged by the Bill's detractors. I am disappointed, too, that under the Bill, someone who lacks capacity is given only limited rights of access to an independent advocate. That is also a matter we shall need
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to look at. That is one of the major differences between the Mental Capacity Bill and the draft Mental Health Bill, and we need to ensure that, where the two Bills overlap, the same rights and the same safeguards should feature in each.

After the publication of the Government's public health White Paper the other day, with its apparent tone of urgency, I am not sure what we are meant to think about the absence of any announcement of a public health Bill. The noble Lord, Lord Faulkner, omitted to say in his otherwise impressive speech that, as we understand it, Ministers do not intend to introduce any legislation to ban smoking in public places that will come into force before the end of 2008. As I said when the Statement was repeated, I firmly believe that a voluntary agreement with the hospitality industry would have delivered better and speedier results than that proposal, with less pain all round. However, relieving non-smokers in pubs and bars of the effects of tobacco smoke, though not unimportant, is only a small part of the passive smoking problem.

Most passive smoking occurs in the home. The main focus of the Government's strategy should be on reducing the number of smokers. That number has remained almost static since 1997, and the main reason is the flourishing black market in cheap cigarettes. The White Paper announcement promised action to reduce tobacco smuggling, but the noble Lord, Lord Warner, when I asked him about that, was unable to clarify precisely what was intended. Perhaps I am not alone in suspecting that the assurance about bearing down on smuggling was founded more on bravado than on anything more concrete.

The gracious Speech picks up another theme of the public health White Paper, namely, alcohol abuse and under-age drinking. However, it does so in the shape of the clean neighbourhoods and environment Bill—another measure in which the palm-print of Mr Blunkett is everywhere visible. We understand that the Bill will allow the imposition of fixed penalty notices for under-age drinking. I have to question—in common, incidentally, with the Law Society—whether on-the-spot fines are an appropriate method of dealing with miscreant children, especially in the absence of any supervision or follow-up support. That is not the way we will solve the problem of alcohol abuse in the young.

Alcohol abuse is a complex problem, but my firm belief is that the root causes have to be addressed rather than just the visible manifestations, and that this should primarily be by means of support and guidance for individuals and for families. The same Bill would permit the courts to compel people who have been given an anti-social behaviour order to undergo drug treatment without being convicted of a criminal offence. Again, I must question that approach. The one thing that is needed in any course of treatment for dependency is the motivation of the person concerned. You cannot in practice compel people to abandon an addiction. I fear that this part of the Bill is seriously misconceived.

In the summer, the Department of Health announced the rationalisation of a number of so-called arm's length bodies. Among them was the Commission for Patient
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and Public Involvement in Health, which is to be abolished altogether. Abolition will require primary legislation, yet the gracious Speech signalled no such measure. It is a most extraordinary situation that a national statutory body, created by this Government, a body which has been functioning fully for a matter of only a few months, a body which has consumed a very sizeable sum of public money in establishing itself, should be axed by the very same Government who brought it into being. But it is even more extraordinary that a major part of the plan for what is to take the place of the commission is as yet undecided and the subject of a consultation paper.

When the legislation was originally before us, the Opposition supported the creation of the commission as a national promoter of patient and public involvement in health; as a support mechanism for patients' forums; as a setter of standards; and as an adviser to government. Why now do the Government appear to believe that these functions are better off being fragmented; and how in future are patients' forums to be supported and represented centrally? The whole agenda for patient and public involvement, which the Government profess to believe in, has been called into question by this decision. If we want patients' forums to thrive as the successors to Community Health Councils, this is a mighty odd way of making those bodies feel valued. I should like to know how long the commission will continue to perform its functions to the full and when the Government will announce what arrangements are to follow.

Such a sizeable programme of legislation as this one is a tall order for a full Session of Parliament, but an impossible order for a Session that many predict will be truncated some time in the spring of next year. One thing that this House needs to insist upon, no matter how long the Session extends, is that we should be allowed, and given the necessary time, to do our job. Thirty-four Bills, excluding those in draft, are in prospect, including six from the Home Office. That is a huge burden, even for that department. We can give ourselves no a priori assurances that the detail of any of them can be taken as read. The function of this House is to scrutinise and where appropriate to propose amendments. Therein lies also, for many of us, the satisfaction of making a difference. I believe that we can look forward to what lies ahead in that constructive spirit. I undertake that Her Majesty's Opposition will strive to make the measure of all that we do one thing, and one thing alone—the public good.

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