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House of Lords
Thursday, 3 May 2007.
The House met at eleven o’clock: the LORD SPEAKER on the Woolsack.
Prayers—Read by the Lord Bishop of Newcastle.
Royal Assent
The Lord Speaker: My Lords, I have to notify the House, in accordance with the Royal Assent Act 1967, that the Queen has signified her Royal Assent to the following Act:
NHS: Consultants
Baroness Knight of Collingtree asked Her Majesty’s Government:
How many consultants are currently suspended from their duties in National Health Service hospitals; and what estimate has been made of the resulting annual cost.
The Minister of State, Department of Health (Lord Hunt of Kings Heath): My Lords, since April 2005, the National Clinical Assessment Service has collected figures on the total number of doctors and dentists suspended from duty. There were 31 consultant exclusions in England at 31 March 2007. In 2003 the National Audit Office report The Management of Suspensions of Clinical Staff established that the average cost of excluding a doctor was £188,000 per year.
Baroness Knight of Collingtree: My Lords, does that figure include the amount paid to consultants who have to be brought in to do the work which otherwise the suspended consultants would have carried out?
Lord Hunt of Kings Heath: My Lords, the figures were produced by the National Audit Office in 2003, so they go back a long way. No work has been done since then. My understanding is that the figures were based on an average 47-week suspension for doctors and that the average cost of excluding a doctor was £188,000; for other clinical staff, the figure was £21,400. I assume that this was a comprehensive costing but I am happy to provide the noble Baroness with further details.
Baroness Gardner of Parkes: My Lords, years ago I asked a Question on this because of a consultant doctor who had gardening leave for some 13 years, and I believe that there were some instances of leave being even longer. I was told that this process would definitely not continue. What is the longest period of suspension of any of the people presently receiving pay at full rate?
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Lord Hunt of Kings Heath: My Lords, I am sure that the gardens turned out very well at the end of 13 years. Overall, there has been a huge improvement in the position of suspended doctors. The BMA used to produce figures which suggested that at any one time 500 hospital doctors were suspended, but the current figures show a huge reduction.
I do not have information on the longest suspension; indeed, in some cases, it could be regarded as confidential. However, I can assure the noble Baroness that the work of the National Clinical Assessment Service has ensured that except for a limited number of cases where the problems have proved intractable, the evidence is that it can get involved and deal with the problems much more quickly. More generally, I have asked the National Clinical Assessment Service to produce statistics that would show the length of suspensions in a way that is acceptable and gets over some of the confidentiality issues. It has not yet done that work but I will of course place the information in the Library when it is established.
Lord Soley: My Lords, does my noble friend remember the dreadful headlines in the 1990s about consultants playing golf, costing the health service a large amount of money and not being used effectively? I remember them. The health service was virtually on its knees then. Now, we need to recognise that there are problems—
Lord Soley: My Lords, there are problems, but we now have consultants working much harder and more effectively. Will my noble friend confirm that the effectiveness and amount of work done by consultants is infinitely better than it was in the 1990s, and will he keep making the improvements that we are seeing at the moment?
Lord Hunt of Kings Heath: My Lords, I thought that my noble friend put that question very well indeed. I also pay tribute to the noble Baroness, Lady Gardner of Parkes, because she has raised this matter over many years. However, the establishment of the National Clinical Assessment Service has ensured that if a doctor is suspended for any length of time it must come to the attention of the NCAS, which gives very good advice to local employers. The record shows that that is working very well. It is why the number of suspended doctors has fallen so dramatically.
Earl Ferrers: My Lords, does the Leader of the House agree that Questions and Answers should be short?
Lord Hunt of Kings Heath: My Lords, I always thought that I was pithy in my Answers, but I cannot answer for those who ask the Questions.
Baroness Neuberger: My Lords, with reference to the Minister’s earlier answer regarding the National Clinical Assessment Service, new rules were introduced in June 2005 to reduce targets on suspension rates and require resolution within 13 weeks, 19 weeks less than
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Lord Hunt of Kings Heath: My Lords, my understanding is that progress is being made but there is still some way to go before the NCAS reaches that target. However, I pay tribute to the work of the NCAS. It has been outstanding. This major problem, identified for so many years, has now largely been dealt with.
Lord Colwyn: My Lords, have the Government considered the impact on costs for doctors following the proposals for remediation and rehabilitation as set out in the White Paper Trust, Assurance and Safety, which in 2003 estimated costs of £7.3 million a year? Has that figure been revised?
Lord Hunt of Kings Heath: My Lords, as the noble Lord will know, following our announcement a few weeks ago work is being undertaken to prepare the ground to introduce those measures, and looking at the cost will be a part of that additional work. The revalidation and relicensing process, and the new approach of the General Medical Council incorporated in it, is designed for early intervention and to deal with these problems before there has to be a question of suspension or direct referral to the GMC. I very much hope that these measures will be cost effective.
Lord Patel: My Lords, would the Minister be surprised if I said that the efficient working of the NCAS has not only reduced the number of suspensions but allowed for assessment and retraining of doctors, who then go back to work?
Lord Hunt of Kings Heath: My Lords, I pay tribute to the noble Lord, who is the chair of the National Patient Safety Agency, in which the NCAS is now placed. My understanding is that, when the NCAS considers that it is safe and appropriate for a doctor to return to work, 70 per cent of those are able to do so. That is comparative to the best rates in the world including those in Canada and the west coast of the United States, which are regarded as best practice countries. Not only is the process being speeded up and the number of doctors suspended coming down but many more of them are getting back into work, which is excellent news.
International Law: Journalists
11.12 am
Lord Faulkner of Worcester asked Her Majesty’s Government:
Whether they will seek to secure an amendment to the 1995 Rome statute of the International Criminal Court in order to make the killing of journalists in war zones a crime under international law.
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The Parliamentary Under-Secretary of State, Foreign and Commonwealth Office (Lord Triesman): My Lords, the Government are strongly committed to ensuring that journalists are afforded the necessary protection under domestic and international law. Under relevant existing provisions of the Rome statute and the additional protocol 1 to the Geneva conventions, journalists are regarded as civilians. To direct intentionally an attack against civilians not taking direct part in hostilities is currently a war crime. Therefore, it is our view that no amendment to international law is necessary in this respect.
Lord Faulkner of Worcester: My Lords, my noble friend will know that it is now more than four years since ITN’s Terry Lloyd, Fred Nerac and Hussein Osman were killed in Iraq. Terry Lloyd was shot by a US marine while in the back of an ambulance moving away from the battle zone. Despite a verdict of unlawful killing by the Oxfordshire coroner, there has still been no indication that the United States is prepared to make the person responsible available to stand trial.
Does my noble friend agree that journalists in war zones perform a very special role on behalf of all of us and that that should be recognised in the way that my Question and the campaign by ITN proposes? Surely they are our eyes and ears and to regard them just as civilians does not take into account the public interest that they serve.
Lord Triesman: My Lords, those three journalists and many others have played an heroic role reporting in most dangerous circumstances. I think that everybody will pay them full tribute. By specifically highlighting journalists as being different, there is a risk, which the International Committee of the Red Cross has drawn to the attention of all of us, of marginalising the role of others. Humanitarian and NGO workers do desperately vital work in war zones. There is no reason why they should not be afforded the full protection of international law as well. Happily, international law is capable of doing that. I want to see all of them treated properly and with full respect to international law.
Lord Wallace of Saltaire: My Lords, does the Minister accept that the changing nature of conflict—we no longer have war between states but usually conflict between terrorist groups and resurgencies of one sort or another—makes the role of a journalist, who operates to some extent autonomously from the formal military forces of western countries, much more difficult and in many ways ambiguous? Is he confident that the instructions to the British, American and other militaries take this unavoidable ambiguity and necessary autonomy into account?
Lord Triesman: My Lords, I do not think that our forces, those of the United States or others should be in any doubt or sense any ambiguity. UN Security Council Resolution 1738 specifically calls on all forces of all countries involved in any kind of conflict to
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Lord Howell of Guildford: My Lords, does the Minister accept that we should be concerned today, on World Press Freedom Day, and every day, with the need not merely to protect the freedom of journalists to report—I say “freedom” as opposed to the abuse of that freedom by the press which, alas, is very widespread—but to condemn those who kill them in war zones, sometimes accidentally and sometimes through deliberately targeting them, which is particularly vicious? I refer also to journalists who are murdered by certain regimes and others in the course of their work, of which there have been in the past few months some particularly unfortunate examples in Russia and elsewhere. In reinforcing what he has already said, will the Minister remember that we should be particularly concerned about journalists and their families who are deliberately murdered for holding and promoting views on press freedom?
Lord Triesman: My Lords, I greatly welcome what the noble Lord said. To have a good civil society you must have a free press and people must be able to do the job that is involved in having a free press. For those reasons I welcome the campaigns around the world by journalists’ organisations, their unions and International PEN. We should always support them most solidly.
Lord Corbett of Castle Vale: My Lords, I declare an interest as a member of the National Union of Journalists. Given the immense peril in which Alan Johnston, the BBC correspondent in Gaza, is currently placed—our prayers are that he is still alive—can the Minister tell the House what further pressure we are putting on the Palestinian authorities to try to secure his release?
Lord Triesman: My Lords, we are in constant contact with the Palestinian authorities. We try to co-ordinate this with the BBC and its director-general, Mark Thompson. We desire to get Alan Johnston’s secure release. A few days ago, I said in the House—I hope that the House will bear with me—that if I were to go into further detail I would probably assist those holding him rather than him.
Lord Avebury: My Lords, has the Minister noted that at an inquest in Australia it was found that certain journalists were cold-bloodedly murdered by the Indonesian invading troops in East Timor in 1975? Notwithstanding the fact that this occurred many years before the coming into force of the Rome statute, does the Minister consider it profoundly unsatisfactory that the relatives of the victims, who included British citizens, have no remedy for the loss of their loved ones?
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Lord Triesman: My Lords, of course I do. The idea that people have no remedy or cannot achieve—forgive the rather clichéd word—“closure”, as it is described in those cases, is bound to be very unsatisfactory. I also feel that about, for example, the nearest and dearest relatives of the aid workers being murdered in Darfur. Those people are all doing heroic jobs, and I want all of them to be covered by the same international standards of law. If we can stand behind that, we are standing behind a good value.
UN: Convention on the Rights of Persons with Disabilities
11.21 am
Lord Morris of Manchester asked Her Majesty’s Government:
Baroness Morgan of Drefelin: My Lords, I am pleased to say that the UK was among the first 82 signatories to the convention when it opened for signature on 30 March 2007. That is the highest number of signatories in the history of a UN convention on its opening day. Since then, a further three states have signed, making a total of 85 signatories.
Lord Morris of Manchester: My Lords, I thank my noble friend and her ministerial colleague Anne McGuire, who has worked with such distinction to put Britain at the forefront of the drive for a UN convention.
Having signed the convention, will the Government now also be signing the Optional Protocol to allow the appropriate UN body to speed up its full implementation where disabled people can show their rights are being violated?
How many member states have now signed the protocol? And would it not seem inconsistent if, having already signed a similar protocol relating to the rights of women, we do not sign this one as well?
Baroness Morgan of Drefelin: My Lords, I thank my noble friend for his kind remarks and for his question. The House may be interested to know that not only have we paid tribute in this House to my noble friend’s pioneering role championing the rights of disabled people but, at the ceremony to mark the opening for signature of the convention, Prince Ra’ad Bin Zeid, in the name of the Hashemite Kingdom of Jordan, also paid tribute to his pioneering role.
Some 48 UN member states have signed the Optional Protocol. It is not the custom of the Government to sign optional protocols, because we believe that at present there is not necessarily enough value in signing a protocol for UK citizens because the petitioners petition a monitoring committee that is not a court of law and therefore cannot offer compensation or necessarily even legal interpretation. However, almost as an experiment, we have signed the convention on women’s rights, and we are reviewing
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Baroness Uddin: My Lords, I welcome the advancement that we have made in disability rights. Given what the Minister has said, has the signing of the convention impacted on individual disabled rights in this country?
Baroness Morgan of Drefelin: My Lords, it is early days. We have only just signed the convention, and we are going through the process that we need to go through thoroughly to work our way towards ratification. It is the first time that the EU has signed a convention in this way, and our ratification process needs to be taken in tandem with the EU. It is an extremely important step forward. We believe that it will have an important impact on the rights of the 650 million disabled people throughout the world. We are committed to taking it forward, and I feel very optimistic about the contribution that this Government can make.
Lord Lester of Herne Hill: My Lords, from these Benches we greatly welcome the Government’s lead with regard to this important convention. We welcome the fact that it recognises that the 800 million people with disabilities experience serious human rights violations and we welcome the Government’s announcement that they will enable enhanced treaty scrutiny in this case, by referring the convention to the Joint Committee on Human Rights, on which I serve.
Perhaps I may ask the Minister about one or two points. First, why is the Department for Work and Pensions handling this issue rather than the Department for Constitutional Affairs, which has a broad remit? That is odd. Secondly, what is the timescale for the process of considering the changes that need to be made to British law to give effect to the convention? Finally—
Lord Lester of Herne Hill: Finally, my Lords, returning to the question of the noble Lord, Lord Morris, why is the United Kingdom out of step with, for example, the Optional Protocol to the International Covenant on Civil and Political Rights, in not accepting the Optional Protocol?
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