The Parliamentary Under-Secretary of State, Ministry of Justice (Lord Hunt of Kings Heath): My Lords, courts dealing with care and adoption proceedings already have a statutory duty to state the reasons for their decision when making an order or refusing an application. In addition, we will be piloting providing written information in some cases, to assess the costs, impacts and benefits.
Baroness Knight of Collingtree: My Lords, does the Minister agree that it is never right that any woman, whatever her circumstances or record, should have her newborn child taken from her and put up for adoption without the right of appeal? Is he aware that this has been happening and that some of the more than 2,000 women who have lost their babies in this way have not been able to appeal because the family courts have refused to give a written judgment?
Lord Hunt of Kings Heath: My Lords, clearly it is important that the appropriate processes are in place. These are critical decisions for all involved. As far as the question of information is concerned, there is already a statutory duty on courts to state the reason for their decision, but in some courts that may well be done at an oral hearing rather than through a written statement. That is why we are embarking on a pilot next year to see the impact of providing further written information.
Baroness Pitkeathley: My Lords, I declare an interest as chair of CAFCASSI shall not spell out its full namethe organisation whose workers deal with these most complex and difficult issues. Indeed, that is the point that I make to my noble friend. Does he agree that it is very difficult to make simple decisions or simple statements about complex and difficult family situations such as those that the noble Baroness alluded to?
Lord Hunt of Kings Heath: My Lords, my noble friends question allows me, first, to congratulate her on her outstanding work in turning CAFCASS around, which has been quite remarkable. She makes an important point: clearly these are difficult decisions. Protecting children has to be the paramount consideration
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Lord Elystan-Morgan: My Lords, in the making of a care order, is it not the case that, whether the court be a magistrates court or a judges court, first, there has to be a clear statement as to the finding of fact in order to justify a finding that the child has suffered significant harm; secondly, that the making of the order must in all the circumstances be wholly necessary; and, thirdly, that the final form of the care plan must be acceptable and the most appropriate one for the child in those circumstances? In adoption matters, which are even more important, should not all the information that can be given be produced in court?
Lord Thomas of Gresford: My Lords, it is not a question of striking a balance. Is the Minister not aware of the requirement in the Family Proceedings Rules that the judge keep a note of the substance of the oral evidence and record in writing not only the courts reasons but its finding of fact, as the noble Lord, Lord Elystan-Morgan, pointed out? Mr Justice Munby and Mr Justice McFarlane have on two separate occasions had to draw the Governments attention to these provisions. Why are they not being carried out?
Lord Hunt of Kings Heath: My Lords, I am not sure that I follow the noble Lords argument. The practice directions make it quite clear that parties to proceedings can receive transcripts of those proceedings without the leave of the court. The issue that was debated in the various consultative papers that came out in 2006 and 2007 was whether written information should be made available. That is what we will be piloting.
Baroness Trumpington: My Lords, was the Minister not absolutely horrified by what my noble friend said in her original Question? He spoke of appropriate processes. Is there any reason why appropriate processes should not sometimes be wrong, and can they be changed?
Lord Hunt of Kings Heath: My Lords, we have to place our confidence in the judicial system to ensure that proceedings are carried out effectively, and we do so. However, the noble Baronesss Question was about written reasons. As I said, next year we will embark on a pilot to see how that would work in practice and what the implications for the courts would be.
Lord Henley: My Lords, does the noble Lord accept that the perceived secrecy in many of these cases leads a great many people to feel that justice that has not been seen to be done is justice that has not been done and that therefore a degree of greater openness might assist in this field?
Lord Hunt of Kings Heath: My Lords, I understand the noble Lords point. The question of public confidence in the privacy of proceedings has certainly been discussed and embraced in the consultation papers that the Government have put out in the past two years. Clearly, protecting childrens privacy is a paramount consideration here, but of course the court has to strike a balance between protecting children and young persons, the general interest in open administration and individuals claims to be present. That is why the consultation paper concluded that we should see whether more written information could be made available, but in all these matters the paramount interest of the child must come to the fore.
Lord Rees-Mogg: My Lords, does the Minister agree that the child may be better protected by information being available to the public than by privacy? Privacy is not necessarily a guarantee of the childs security.
Lord Hunt of Kings Heath: My Lords, I hear what the noble Lord says. As noble Lords will be aware, the 2006 consultation paper contained a proposal to allow more open access to the media. However, in the ensuing months, in discussions with childrens organisations and at various meetings and events arranged with children who have been through care proceedings, a very strong view came back from the children that privacy was indeed paramount. That has had a strong influence on the Governments decision in this area.
The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): My Lords, we recognise that pharmacies could play an increased role in the provision of contraception and other sexual-health services because of their accessibility and convenient opening hours. We will work with primary care trusts over the next year to pilot the supply of contraception, including the contraceptive pill, through NHS arrangements. We will also work with the pharmacy profession to ensure robust standard-setting and appropriate training so that pharmacists are competent to provide this service.
Baroness Finlay of Llandaff: My Lords, I thank the Minister for that reply, which is the best that I could possibly have hoped for, and I am delighted that the Government are to embark on pilots. Do the Government recognise that the current data on abortions, which show that a third of women undergoing termination of pregnancy have had a previous abortion, do indeed represent a contraceptive failure in the country? Will the Government couple moves in the pilot programme
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Lord Darzi of Denham: My Lords, the noble Baroness made the point that there is strong evidence of an association between the provision of the full range of methods of contraception and a reduction in teenage pregnancies and abortion rates. I have no doubt that improvements in sexual health and the provision of choice in acquiring oral contraceptives will significantly reduce unintended pregnancies.
Baroness Tonge: My Lords, I welcome the easier access to contraceptive services that local pharmacists might provide. However, does the Minister realise that over the past decade primary care trusts have been saving money by closing family planning clinics all over the country and making it much more difficult for women to have a choice of contraception? How is he going to ensure that the full range of contraceptive methods, particularly long-acting reversible contraception, will be available?
Lord Darzi of Denham: My Lords, the Government recognise that community contraceptive services provide a valuable service. We also recognise that PCT funding for local provision is a local arrangement. However, we have set certain targets. Our key target is that 100 per cent of patients shall be offered an appointment to be seen in one of those clinics within 48 hours, if the need arises. From a primary care setting, in a QOF questionnaire we are looking at making the provision of long-acting contraceptive devices easier from a patient perspective.
Baroness Gardner of Parkes: My Lords, I am sure the Minister is aware that sexual activity occurs well before the legal age of consent. Will community pharmacists be required to ask the age of a person applying for the facility? If so, how will they be able to establish that someone is of an age to be entitled to apply? This has always been an issue. In the past, there have been separate youth services. What will the arrangement be under this system?
Lord Darzi of Denham: My Lords, the noble Baroness raises an important point not only about the age classification but about the safety of the application of an oral contraceptive. The recognition of age will be a matter for the professional judgment of the pharmacist. At the moment, there is no age limit from a pharmacy perspective, but we envisage that it will be compatible with supplying the morning-after pill, which is 16. It will be for the professional judgment of the pharmacist, and identification of some sort will probably be used to confirm the age of the individual.
Baroness Thomas of Walliswood: My Lords, the noble Baroness, Lady Finlay of Llandaff, mentioned the importance of sex education, but only for girls. Does the Minister not think that it is just as important to make boys aware of their responsibilities in this matter?
Earl Howe: My Lords, the Department of Health has a public service agreement target to reduce the under-18 conception rate by 50 per cent by 2010. The rate came down by some 11.8 per cent between 1998 and 2004, but how do the Government intend to accelerate that rate so that the department meets its 2010 target?
Lord Darzi of Denham: My Lords, as the noble Earl, Lord Howe, said, between 1998 and 2005, the under-18 conception rate fell by 11.4 per cent to its lowest level for 20 years. The under-16 rate fell by 12.1 per cent over the same period. Guidance on accelerating the delivery of the teenage pregnancy strategy highlights that the provision of young-people-focused contraception and sexual-health services trusted by teenagers and well known professionals working with them has the biggest impact on conception rate reduction in high-performing areas.
Baroness Tonge: My Lords, might I point out to the Minister, with respect, that the sexual-health clinics were given the 48-hour appointment target? Those clinics are overwhelmed by a need to treat sexually transmitted diseases in young people. Not only have their targets not been met in many areas, but they are not able to offer the full range of contraception and counselling that both young and middle-aged people actually need. The community clinics provided those services so well. When are we to get those services back?
Lord Darzi of Denham: My Lords, the Government are leading a major review and, as some of your Lordships may be aware, that next-stage review is my responsibility within the department. One area that we are looking at carefully is the well-being agenda, and one major issue that clinicians across the country are looking at is the provision of contraceptives and sexual health.
Returning to the original point raised by the noble Baroness, Lady Finlay, on the provision of and access to contraception through pharmacists; I feel strongly that that is probably the easiest route for the patient.
The Parliamentary Under-Secretary of State, Department for Work and Pensions (Lord McKenzie of Luton): My Lords, lifting Crown immunity for health and safety offences is a long-standing government commitment.
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Lord Ramsbotham: My Lords, I thank the Minister for that reply but I was surprised that my Question was to be answered by the department in which the Minister sits and not the Ministry of Justice. I am referring to the fact that there are currently 17,934 prisoners in cells designed for one but with two people in them, and 1,113 prisoners who are three to a cell in cells designed for two. Those cells are equivalent to open lavatories and, thanks to overcrowding, people are in many cases condemned to them for 24 hours a day.
Have health and safety inspectors or environmental and public health inspectors been into those cells? If not, why not? If so, where are their reports? Are they being denied access to those places through a suggestion that Crown immunity applies and that therefore they are not required to carry out their tasks?
Lord McKenzie of Luton: My Lords, had the noble Lord asked a more specific question around that point, I might have been able to give a more detailed reply from the Dispatch Box. I will write to him more specifically on those points. I should make it clear that although the Prison Service has Crown immunity, the provisions of the Health and Safety at Work etc. Act still apply. The criminal enforcement sanctions do not apply but an enforcement regime runs in parallel to those sanctions, although it is not strictly equivalent. I shall write to the noble Lord on his specific and detailed questions.
Lord Elton: My Lords, I declare an outraged interest as the husband of a Gurney who is a collateral descendant of Elizabeth Fry. How have the Government allowed things in Norwich jail to descend to such a state that the environmental health officers who have visited have found that the prisoners are at risk from broken soil pipes, mould, damp and vermin? The prisoners have also brought legal charges against the department, which has been forced to close the Gurney wing.
Lord McKenzie of Luton: My Lords, I am not aware of the detail in the case that the noble Lord raises. Again, I can write to him on that, but I stress that the provisions of the Health and Safety at Work etc. Act apply, that the Health and Safety Executive is engaged in inspecting prisons and that, where there are failures such as those cited by the noble Lord, there are provisions for Crown censures and, along the way, Crown improvement notices. I have a list of the notices that have been issued in recent times. I do not readily see one relating to Norwich, but I am not sure whether my list is complete.
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