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Baroness Crawley: My Lords, I appreciate my noble friend's concern, but I hope that I can reassure him. First, we do not plan to identify further MEHRAs. Identification of a MEHRA is important, but the practical measures that we are going to put in place are just as important. We have two proposals: one is the upgrading to IMO status of some recommended tracks through the narrows south of Shiant Islands; the other is the introduction of a new traffic separation scheme off Neist Point. Those practical measures and the automatic identification system now carried on many ships mean that the Minches will have as much robust protection as they could have had under a MEHRA.

The Earl of Mar and Kellie: My Lords, the designation sought is advisory and not very onerous. Is it true that the Secretary of State has not acted against tankers using the Minch because, among others, the Western Isles Council has expressed its concern to protect its undoubtedly beautiful western beaches from oil spills? Is that the right way to go about marine environmental protection in the Minch?

Baroness Crawley: My Lords, we have worked closely with the Western Isles Council, as we have with all the devolved authorities and the Scottish Executive. Of course, the final decision about the 32 MEHRAs and the MEHRAs in Scotland was agreed by the Scottish Executive. As the noble Earl will know, the methodology for deciding which areas of our coastline are to be MEHRAs is very robust. It has to ensure that there is assessment of the environmental sensitivity of the region, as he has set out, and the hazards from shipping—the possibility of collisions, groundings and so on.

Lord Geddes: My Lords, the noble Baroness referred to the IMO, an organisation, worthy though it is, not
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known for its lightning speed of reaction and response. To what extent are Her Majesty's Government able to take independent action in this respect and to what extent are they dependent on IMO approval?

Baroness Crawley: My Lords, the setting up of the 32 MEHRAs is a matter for the British Government. We are also within a protection zone of the IMO, but the setting up of these sensitive areas is a matter for us.

Lord Hanningfield: My Lords, the Minister suggested that there would be a much more rigidly enforced traffic separation system, but other such straits are covered by a radar system. Are there plans to introduce a suitable radar system to protect this valuable coastline?

Baroness Crawley: My Lords, it is worth noting that the Minches already benefit from an improved vessel traffic monitoring system because of the increased number of ships carrying the automatic identification systems. That, too, has an effect on enhancing the safety of navigation and providing additional protection for the waters and the coast around the Minches.

NHS: Cancer Plan

2.57 pm

Baroness Sharples asked Her Majesty's Government:

What action they will take to ensure that the National Health Service cancer plan target for a maximum two-month wait from urgent general practitioner referral to treatment will be met for all cancer patients.

The Minister of State, Department of Health (Lord Warner): My Lords, cancer patients are now being diagnosed and treated more quickly than ever before, with almost 97 per cent now receiving their first treatment within a month of diagnosis. The 62-day target from GP referral to treatment is challenging, but it has been achieved for breast cancer and for other cancers in some parts of the country. The NHS is working hard to ensure that this target will shortly be met for all cancer patients.

Baroness Sharples: My Lords, I thank the noble Lord for that reply. Is the information and advice given to GPs sufficient for them to decide whether a patient with cancer requires an urgent or a routine appointment at hospital?

Lord Warner: My Lords, we think that the advice is appropriate. It is kept under review by our medical advisers. The progress that has been made under this Government suggests that things are now working far better.
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Earl Howe: My Lords, the Minister will know that the Public Accounts Committee in the other place found that the monitoring of performance against cancer plan targets by cancer networks was inconsistent and, in five cases, did not take place at all. Does the Minister think that that is acceptable? If he does not, what do the Government propose to do about it?

Lord Warner: My Lords, I understand that issues arising out of the PAC report are being considered carefully. We know that the all-London cancer networks have completed action plans to implement the recommendation of NICE guidance on supportive and palliative care, for example, over the next three years. Work is going on in that area.

I remind the House that under this Government cancer patients are diagnosed and treated faster than ever before. In 1997, 63 per cent of patients with suspected cancer were seen by a specialist within two weeks of urgent referral by a GP: today, that figure is 99 per cent.

Baroness Neuberger: My Lords, will the Minister comment on the fact that while the referral rates have increased dramatically—a great cause of joy for many people—only 10 per cent of patients receive a record of significant matters discussed at their first diagnosis and at later key stages? Will the Government act to improve and monitor that while they continue to ratchet up referral times?

Lord Warner: My Lords, these are matters of clinical practice. I am sure that our national clinical director for cancer will be considering them and working with the NHS to try to improve performance in some of these areas.

Baroness Morgan of Drefelin: My Lords, is my noble friend aware that today, the All-Party Group on Cancer launched a report recognising the successes in cancer treatment and the achievements of the cancer plan? Will he welcome a debate on how to build on that success and how to revise and develop the cancer plan further? Does he agree that, although waiting time targets are a key driver for improving cancer services, they are complex and sometimes hard to define? Does he also agree that empowering patients more and ensuring that the time before research findings are used to patient benefit is reduced could further improve cancer services in the UK?

Lord Warner: My Lords, I am sure that the whole House welcomes the All-Party Group's document, A New Vision for Cancer, which is published today and the hard work that it has done in keeping cancer firmly on the agenda. We on the Front Benches are always willing to discuss whether we can secure improvements. We are only halfway through the 10-year cancer strategy and the general position is, "A lot done, still more to do".
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Afghanistan: Death Penalty

3.01 pm

The Lord Bishop of Oxford asked Her Majesty's Government:

What representations they are making to the Government of Afghanistan to prevent Muslim converts to Christianity in Afghanistan from being condemned to death.

The Parliamentary Under-Secretary of State, Foreign and Commonwealth Office (Lord Triesman): My Lords, Abdul Rahman has been released. On 22 March, my honourable friend Kim Howells made a public statement expressing the Government's concerns over the charges facing Mr Rahman. On 23 March, my honourable friend Ian Pearson summoned the Afghan chargé to relay our concerns. The British Ambassador in Kabul also raised these concerns on that day with the Afghan Ministry of Foreign Affairs.

The Lord Bishop of Oxford: My Lords, I thank the Minister for his reply. Although it is good news that Mr Abdul Rahman has been released, it is rumoured that it was on grounds of mental health, about which we know nothing. Does the Minister not agree that a fundamental issue of principle is involved? The preamble to the 2004 Afghan constitution says that it will respect the UN Universal Declaration of Human Rights, Article 18 of which says that there must be freedom for people to change their religion. Does the Minister not agree that a fundamental issue of principle is involved and that concerted international action is needed?

Lord Triesman: My Lords, I agree with the right reverend Prelate. There are many stories in the media about the cause of the release, and I shall not speculate on them. I know that individuals should be free to practise their faith without restraint. The Afghan constitution provides for freedom of religion under Article 2, and Afghanistan is a signatory to the six principal international human rights treaties, including the ICCPR, which guarantee freedoms of religion. We should all apply pressure so that the country lives up to those expectations.

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