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Electoral Commission Report: Delivering Democracy?

Lord Rooker: My right honourable friend the Minister of State for Local and Regional Government has made the following Written Ministerial Statement.

My right honourable friends the Deputy Prime Minister and the Secretary of State for Constitutional Affairs are jointly publishing today the government response to the Electoral Commission's report, Delivering Democracy?

In its report, the commission set out its evaluation of the electoral pilots in June 2004. It found that the elections were successfully delivered; there was no evidence that all-postal voting led to an increase in fraud; and a majority of more than 2:1 were either very or fairly satisfied with the all-postal voting arrangement in their pilot area.

The commission also found that voters wanted to have choice about the way in which they vote. That is consistent with the Government's long-term goal of multi-channel elections, including voters having the options of electronic, postal voting and voting in person.

We are not, however, persuaded by the commission's arguments that all-postal voting should not be pursued at UK elections. They are not supported by the outcome of the June elections, where turnout was substantially higher in the pilot regions and a large majority found the all-postal method acceptable. Furthermore, the turnout achieved in the north-east regional referendum underlined the value of all-postal voting in increasing participation.

In its report, the commission proposes the development of a new model of voting. We welcome the opportunity to contribute to that work and will have regard to the progress of the work when assessing any new proposals for all-postal voting.

The Electoral Commission also indicated that it would not support pilots in May 2005—or any at all until the new model was in use. We have decided not to issue a prospectus inviting applications for pilots in the county council elections in May 2005. It remains, however, open any time, to local authorities to apply
 
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to run all-postal pilots. The Government remain committed to a programme of electoral pilots in 2006 and subsequent years, including e-voting pilots.

We hope that the publication of this response will substantially move forward the modernisation agenda for elections.

Copies of this government response to the Electoral Commission's report will be placed in the Libraries of both Houses.

Representation of the People (Variation of Limits of Candidates' Election Expenses) (City of London) Order 2005

Lord Rooker: My right honourable friend the Minister of State for Local and Regional Government has made the following Written Ministerial Statement.

The following draft statutory instrument, on which we are seeking the approval of both Houses, has now been laid before Parliament: The Representation of the People (Variation of Limits of Candidates' Election Expenses) (City of London) Order 2005.

Subject to parliamentary approval, the order would give effect to the Government's proposal to increase the maximum limits of candidates' election expenses for the City of London ward elections and elections by liverymen in common hall in line with changes in the value of money since the limits were last set in March 1997.

We have also placed in the House Library a summary of the responses—including those from the Electoral Commission and other key stakeholders—that we received from a consultation on the draft instrument.

Shipman Inquiry

The Parliamentary Under-Secretary of State, Department of Health (Lord Warner): My right honourable friend the Secretary of State for Health has made the following Written Ministerial Statement today.

The fifth report of the Shipman inquiry, Safeguarding Patients: Lessons from the Past—Proposals for the Future, Cm 6394, was published today, together with the Government's response to the inquiry's fourth report, The Regulation of Controlled Drugs in the Community, Cm 6249. This follows the publication of reports on the extent of Harold Shipman's criminal activities; on the 1998 investigation by the Greater Manchester Police; and on death certification and the coroner system. The inquiry is now working on a supplementary report to the first of those reports and hopes to publish this final element of its work early in the new year.

The Government express their profound thanks to Dame Janet Smith and her team for the care and attention that has gone into the preparation of each of her reports. We also reiterate our sympathy to the relatives and friends of Shipman's victims and express our thanks to them for their valuable contribution to the inquiry's work.
 
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The inquiry's fourth report, published on 14 July 2004, analyses the means by which Harold Shipman was able to obtain his lethal armoury of controlled drugs and finds weaknesses in current systems of control and in the ways in which those controls were operated. The report recommends strengthening current arrangements in four main areas: first, a new integrated, multi-professional inspectorate to inspect the management of controlled drugs in National Health Service primary care to replace the existing unco-ordinated arrangements for inspection; secondly, restrictions on the right of general practitioners to prescribe controlled drugs in certain circumstances, for example prescribing for oneself or one's immediate family or prescribing beyond the requirements of one's normal clinical practice; thirdly, auditing the prescribing of controlled drugs in primary care and the movement of supplies of controlled drugs in the community; and fourthly, better information to patients on the special legal status of the controlled drugs that are prescribed for them.

The Government fully accept the need to improve arrangements for the management of controlled drugs and to do so in a way that does not hinder patients from accessing the treatment that they need. We fully accept the great majority of the inquiry's recommendations, and for the remainder we propose to achieve the same recommended ends by alternative action. Dame Janet Smith has seen our proposals and is pleased that we have accepted the principles underlying her report and that we intend to follow up her recommendations with rigorous action.

We will also follow through the implications of the inquiry's recommendations for other healthcare settings, including hospital care, the private sector, and care homes. Our proposals are set out in Safer management of controlled drugs—the Government's response to the fourth report of the Shipman Inquiry, Cm 6434, which is published today.

We will make it clear that responsibility for the proper management of controlled drugs is an integral part of the clinical governance responsibility of all NHS and private sector healthcare organisations. We will develop improved arrangements for the inspection of controlled drugs that strengthen rather than detract from that proper local responsibility.

We will ensure that the prescribing of controlled drugs, which in future will include prescribing by healthcare professionals other than doctors and dentists, takes place in the context of a general framework of good prescribing practice backed by clinical governance frameworks and appropriate professional regulatory sanctions.

We will also capture information on all prescribing and requisitioning of controlled drugs, including private prescribing, and provide analyses of prescribing patterns by prescriber and by patient for those operating the local controls. Information systems will be set up that will enable a full audit trail for the movement of controlled drugs into the community.

We will also ensure that patients receive appropriate information about controlled drugs in the context of
 
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an informed discussion with the health professionals involved in their care and against a background of information about the safe handling of prescription medicines more generally.

Finally, we will support all those actions through improved education and continuous professional development for healthcare professionals dealing with controlled drugs.

In her fifth report, Dame Janet makes recommendations in the following areas: handling patients' complaints and whistle-blowing concerns; the development of clinical governance in primary care; the availability of information about GPs; and professional regulation of doctors and the role of the General Medical Council.

We have been working hard with the medical profession and others over the period since the conviction of Harold Shipman to strengthen the systems, rules and regulations that govern the medical profession, and we are pleased that Dame Janet recognises the progress that has been made.

Dame Janet also welcomes the changes made to date in the NHS complaints procedure and in the increasing amount of information available about doctors' performance. She recognises the progress that has been made in developing systems for handling poor performance and aberrant conduct and the importance of continuing to develop clinical governance in primary care. Her recommendations build on all that work but also reflect her continuing concerns that, in some areas, there has been insufficient change to safeguard patients appropriately.

Dame Janet has made some very significant recommendations that would have a major impact on service delivery. We will need to study them carefully and discuss them with a wide range of stakeholders and interested parties. We also want to consider them alongside recommendations made in the recent inquiry reports into the activities of Clifford Ayling, Cm 6298, and Richard Neale, Cm 6315, both published on 9 September 2004.

She has also made significant recommendations concerning the constitution and operation of the General Medical Council. We have recently made changes to the constitution of the General Medical Council to ensure a far greater voice for patient interests. We will consider carefully the recommendations Dame Janet makes for further reform and the implications of her recommendations for other regulatory bodies in health and social care. Changes to the General Medical Council's disciplinary procedures have also recently been made and came into force only last month. We will consider carefully with the General Medical Council the recommendations in the report for further changes to these procedures.

The scale of Shipman's crimes was unprecedented, and his activities were totally abhorrent. No sanctions will stop conduct like that of Shipman, so our energies must be focused on prevention and early identification of problems. Standards of behaviour must be high, and action against those who fail to maintain those standards must be timely, firm and fair.
 
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In welcoming the inquiry's previous reports, my right honourable friends the Home Secretary (Mr David Blunkett) and the then Secretary of State for Health (Mr Milburn) emphasised the need to learn lessons from the mistakes of the past. All of Dame Janet's reports have provided us with an expert and detailed analysis of where systems failed. We are determined to ensure that all reasonable measures are taken to provide the safeguards that are needed and that the public rightly expect.


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