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Lord Warner: My Lords, it is not for Ministers and the Government to give detailed prescriptions to the NHS that override the judgments of individual clinicians in relation to individual patients. All noble Lords must try to hold on to that issue in relation to what is, I freely acknowledge, a very emotional area. I have already stated the Government's position; it is down to individual clinicians to consider with patients whether Herceptin is appropriate—as the noble Lord said, it is not appropriate in all cases—and that PCTs should not rule out treatments, either on principle or for funding considerations.

Baroness Symons of Vernham Dean: My Lords, does not my noble friend have some difficulty with the figures given by the noble Lord, Lord Forsyth of Drumlean? Of course such decisions should be made on the grounds of medical advice, but if 28 per cent of doctors say that they are never allowed to prescribe the drug in those circumstances, it looks as though these decisions are being taken, not necessarily on principle, but on grounds of cost. Surely, that is ground for concern, given what my noble friend has, quite rightly, articulated as being the Government's policy.

Lord Warner: My Lords, with all due respect to my noble friend, the figure of 28 per cent came from a study produced on "Panorama". I have no idea whether that particular study is valid; I have not seen the research methodology. I can tell the House that as a health Minister one sees many studies that turn out to be methodologically flawed when the information is probed. I am sure that other Ministers in this House have had the same experience. In the particular cases
 
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of the alleged 28 per cent, it is down to those doctors to discuss the individual patients causing them concern with the people in the PCT.

Business

Lord Grocott: My Lords, with the permission of the House a Statement will be repeated later today. The Statement will be on child support and it will be repeated by noble friend Lord Hunt. We will hear it after the first debate, introduced by the noble Lord, Lord Hurd.

Business of the House: Debates Today

The Lord President of the Council (Baroness Amos): My Lords, I beg to move the Motion standing in my name on the Order Paper.

Moved, That the debate on the Motion in the name of the Lord Hurd of Westwell set down for today shall be limited to three hours and that in the name of the Baroness Knight of Collingtree to two hours. —(Baroness Amos.)

On Question, Motion agreed to.

Iran

11.36 am

Lord Hurd of Westwell rose to call attention to the situation in Iran; and to move for Papers.

The noble Lord said: My Lords, I am most grateful for the opportunity to start a discussion among your Lordships about Iran, which I think is timely and of great importance. What happens in Iran is linked with events in Iraq, Afghanistan and Palestine, and to some extent we cannot make sense of this situation unless we look at the whole. An observer 10 years ago, trying to look forward, might have guessed that the Palestine dispute would remain unsettled. But I do not think that even in a nightmare he or she would have supposed that Britain would have 8,000 troops deployed in southern Iraq and be sending 4,000 troops to southern Afghanistan for three years. Both are dangerous missions in disorderly places, with troops in both cases in danger, not primarily from foreign invaders but from those Afghans and Iraqis who resent our presence as a foreign occupation. Nor would the observer have guessed that while extending ourselves in those two places we would be locked in a tense argument with a powerful country lying between those two deployments, because of well founded fears that Iran has an ambition to copy Israel and Pakistan by becoming the third nuclear military power in the region.

My first point is this. I wish I felt confident that the planners in Whitehall, the Chiefs of Staff and, above all, the Cabinet sometimes looked at these linked issues as a whole. Of course they come from different
 
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backgrounds. We find ourselves in these situations—originally I had written "wandered into these situations"—for different reasons, but the situations are related. My worry, based on some experience, is that the more difficult the issues in each case, the more short-term will be the consideration of those issues. That is the first point on which I would like some reassurance.

It is easy to oversimplify—we all do it all the time—by trying to fit all these situations into one category. Some talk about them as part of the war against terror, the struggle for energy, the battle against tyranny and in favour of democracy, or the clash of civilisations or religions. All of those are elements. Just as the countries and situations are geographically linked, so are the elements within them. But we can only conclude, I believe, that we find ourselves in a thoroughly dangerous situation. It is dangerous for British troops, dangerous for British interests and dangerous for the peace of the world.

The handling of that situation, looked at as a whole for a moment, will require exceptional skill from the Government. It will involve disposing our Armed Forces, which are second to none in skill and, where necessary, cunning, and diplomatic and intelligence services, which have a high and deserved reputation. But all that depends on skilled, clear leadership from the Government. I hope that the Government and all of us will not be ashamed to learn from some mistakes of the recent past. Above all, I urge that this time, across the whole range of linked issues, we get our facts straight and put them plainly to Parliament and the public.

I have a special reason for making that last point. It is very hard, even for those of us who try to follow these matters, to follow them successfully and to discover what is happening on the ground in any of these areas, but particularly in Iraq, Iran and Afghanistan. The media—this is entirely understandable and many of us have discussed it with journalists—are hugely concerned partly with the expense but overwhelmingly with the danger of sending people to cover these situations. That is particularly true in Iraq. It may well become true in Afghanistan, and there are different difficulties in Iraq.

The result is that there is no continuous thread of reporting in our newspapers. I find that I have to read the Herald Tribune or the Wall Street Journal—American newspapers—to get anything like a continuous thread of reporting. It is as if we are passengers in a vehicle driven by Ministers, as is right, but we are to some extent blindfolded. We therefore rely, more so than in other issues, on Ministers to see clearly and to have our confidence won as passengers by what they tell us. That is a big responsibility on government and it applies in these situations even more than usual.

On Iran, it seems to me that the Government must be right in opposing further proliferation in principle, and in this case in particular, and that they are right to distrust the assurances of a regime which is
 
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undemocratic, oppressive, unreliable and a friend to terrorism. They have also been right to build up pressure on that regime through mobilising diplomacy, and they have been right in their tactics. They have been right to join our European partners; the Foreign Secretary has been right to take the initiative with his colleagues in France and Germany; they have been right to get the approval of the European Union as a whole; and they have been right to set off down a diplomatic path. I believe that that will increasingly be the pattern for the future—for example, in our relationships with Russia.

We have a choice as Europeans. There is no compulsion and no treaty obligation but there are shared analyses and shared interests, which I believe increasingly will lead us, as in this case, not to squabble and fly off in different directions, as we did over Iraq, but to come together and work together.

The other big difference over the handling of Iraq is that this European effort is in partnership with the United States. European diplomacy was first accepted rather sceptically and grudgingly but then warmly welcomed by the United States, and it is now part of that country's policy. This is the United States in the second term of President Bush. The rhetoric and the speeches are broadly the same—there is a continuity—but the practice is different. I have seen it described in one newspaper today as "neo-realism", following the neo-conservatives. It is the rediscovery of diplomacy, and perhaps it is the State Department reasserting its control over foreign policy.

The first phase of this diplomacy, based on the IAEA, ended without agreement. That is not particularly surprising because I believe that we are in for a very long haul. But the achievements have occurred through the IAEA conclusions about the concealment and non-compliance practised by Iran. Those conclusions, and the endorsement of them by a wide range of the international community and, now, the acceptance that there needs to be a transfer of the discussion to the Security Council and acceptance even by Russia and China, are important, although limited, achievements. Now there is a pause until March and then the Security Council will discuss the matter. Again, there is a big difference between what one might call Bush 1 and Bush 2. There is no longer scorn of the Security Council but a reliance on it.

The pressures build on Iran, but I believe that they will take a long time to build effectively. Can the Minister tell us something about the status of the Russian proposal to enrich uranium for Iran in Russia? Is that acceptable to us or to the United States? What are the prospects for it, and what is Iran saying about it?

I should mention sanctions because that issue is in the background of both this debate and the Security Council debate. I shall not press the Minister for details, but I hope that the Government will be calculating what might do some good, what might increase the pressure and what the traffic in the Security Council is likely to bear. The United States already applies extensive sanctions to Iran because of
 
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history. What would therefore be involved is the Europeans, Russia, India, China and so on joining in some of those sanctions to help build up the pressure.

Perhaps I may say a word about the use of force. There are always bellicose journalists who urge us to bring on the bombers, but I think that everybody, including those in Washington, is fully aware of the grave risks involved. It may be tempting to speculate on a focused attack just on nuclear installations. However, we know from Iraq that there is no such thing as an attack that is so focused that no innocent people are killed. Any such attack involves killing considerable numbers of innocent people. I am not qualified to comment on the technical possibilities of a focused attack on nuclear installations, but such an attack would leave an untouched, angry and revengeful government in Tehran with probably a united people behind them. That would be true whether the United States or Israel launched the attack. An attack by Israel would be regarded—accurately, to a large extent—as a joint effort with the United States.

I have not seen the next point made before. However, Britain would be vulnerable in the above situation. We have chosen to station our troops, in modest numbers, whether in southern Iraq or southern Afghanistan, where we are uniquely vulnerable to this kind of retaliation from nearby Iran. We cannot realistically and for ever rule out the use of force. If the regime in Iran or its successor moved from words and piled up an unmistakable danger, I do not think that we could entirely rule out the use of force. But we should not deceive ourselves that we can have some sort of strike without a war, or some sort of war that does not involve huge dangers and damage and many, many thousands of casualties, our own and Iranian.

I should say something about democracy and the attitude and appeal of the President of the United States. In a way his appeal to the Iranian people was similar to the appeal to the Iraqi people. But there is a difference. Saddam Hussein and his family were corrupt and self-seeking and built palaces as part of the parade of power. In Iran we are dealing with puritanism as well as patriotism. President Ahmadinejad appeals to the poor, dresses simply and behaves simply. He has the same sort of appeal as Hamas on the West Bank and in Gaza and as the Muslim Brotherhood in Egypt. We should not neglect the importance of the puritan appeal in an area of the world that is marked by such glaring inequalities.

Patriotism is also important. Iran is an ancient country with a huge history of which it is very conscious. This is more than simply a platitude for after-dinner speeches; it is a relevant political fact. We have forgotten so much of our history and, in a way, the Iranians remember too much of theirs. They remember past glory; they remember humiliation—at our hands, Russian hands and American hands; and the coup of 1953 against Mossadeq—things which we never knew or have forgotten. Out of this comes a deep reluctance to be told by other people how they should behave.
 
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I will not deal with the question of exiles and the rights of the PMOI because other noble Lords will make that point. They may be right in urging the deregistration of that organisation from the terror list. But I do not believe that we can say that exiles from abroad hold the keys to the future of Iran. We made that mistake in Iraq and I do not think that we should repeat it, however admirable and brave these people should be.

We need to build up the pressures, but also to indicate the rewards. An Iran which accepted to forswear military power; recognised the need for peace with Israel, as all the Arab governments do, and had decent respect for human rights—that Iran—should have a notable part in deciding the future of the Middle East and the security of the Gulf. Arab countries are already beginning to talk about the possibility of observer status for that sort of Iran. We should say this now so that it clearly sees both the pressures building against it if its increasing isolation continues, but also the rewards available if it takes the other course. The pressures are inevitable, and we should build them up, but the rewards should be evident. That requires patience. And patience, in the rather hectic, media-driven world in which we live, is often mistaken for weakness. I am clear, however, that patient strength is the only way in which to see our way through these great dangers. I beg to move for Papers.

11.52 am


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