The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): My Lords, the National Commissioning Group currently commissions the use of ventricular assist devices as a bridge to heart transplant from designated transplant centres. Before making this technology more widely available as an indefinite long-term treatment in end-stage heart failure, we need to be patient and ensure that there is clear evidence of benefit. We remain open to considering research proposals to improve the knowledge base.
Lord Crisp: My Lords, I thank the Minister for his encouraging reply, which I take it is inviting people to put forward those research applications. Perhaps he will confirm that. I ask a slightly wider question. Given the innovation that is taking place in this area with, for example, Professor Westaby at Oxford, who has managed to keep a man alive for seven-and-a-half years successfully with an implanted heart pump, and the problems with organ donation, including the issues of presumed consent, does he not think that the Government should be taking a more active role in promoting the development of alternatives to organ transplant?
Lord Darzi of Denham: My Lords, in answer to the noble Lords first point, we always welcome research applications of the highest quality that will receive approval though a peer review process. The Government are committed to innovation through the next stage review and the announcement in my interim report in October of last year of the creation of the Health Innovation Council. I see the NHS over the next 10 years being at the cutting edge of innovation. The development of technologies such as medical devices that will enhance the quality of life will be at the forefront of the efforts of the Health Innovation Council.
Lord Walton of Detchant: My Lords, does the Minister accept that the Jarvik heart used by Steve Westaby in Oxford, which kept a man alive for seven-and-a-half years, was the first generation of these devices? Now a new generation of such devices is coming on stream as well as other forms of pump
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Lord Darzi of Denham: My Lords, before anything can be referred to the National Institute for Health and Clinical Excellence we need to have adequate data on its effectiveness and cost effectiveness. As the noble Lord alluded to, innovation in this type of technology is moving fast and we are seeing second generation and even third generation devices. The last paragraph of an article by Professor Philip Poole-Wilson in Nature this week states:
There is currently an overwhelming need for formal trials evaluating mechanical assist device therapy in patients with various diagnoses, in order to determine safety and efficacy, to better inform patients of their clinical options, and to direct expensive medical care in an appropriate direction.
Baroness Gardner of Parkes: My Lords, the Question refers to the shortage of donated organs. We all want to see more and I welcome the suggestion that there will be legislation on opt-out. But is the Minister aware that I have received letters from people stating that they would happily give most of their organs but that they do not wish a blanket provision for everything? For example, they might especially wish not to donate organs for use in embryology experimentation. Will he ensure that when the Government bring forward that legislation it includes an opt-out for only one organ? Without that, we may lose people who would otherwise give all their other organs, which would be very beneficial.
Lord Darzi of Denham: My Lords, I am grateful for that intervention, and I could not agree more. A debate has already started on presumed consent and the opt-out. I have no doubt that the task force that we have asked to look into this complex area will come back with recommendations to deal with some of the issues kindly raised by the noble Baroness.
Baroness Murphy: My Lords, what proportion of BBSRC funding is currently devoted to the kinds of tissue engineering and nanotechnologies that will be required to develop the sorts of materials for artificial organs?
Lord Darzi of Denham: My Lords, I will be more than happy to look into that and refer to the amount of funding from the BBSRC. In the context of the Question, we are talking about mechanical medical devices rather than tissue regeneration. However, R&D funding is on a significant rise. Recent announcements by the National Institute for Health Research and the creation of a number of biomedical research centres and biomedical research units show that tissue engineering is one of the strongest themes in these applications.
Baroness Barker: My Lords, perhaps I may return to the Ministers first Answer to the noble Lord, Lord Crisp. Does the Ministers review of the NHS include the possibility of an LVAD network in which
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Lord Darzi of Denham: My Lords, the NHS next stage review is not going as granular as left ventricular assisted devices and what sort of networks we will be creating. However, it is an important question. It is the view of the professional bodies and of the Government that the assessment of patients suitability for ventricular assist devices is best done in centres that also assess suitability for heart transplants. Those centres have the best concentration of highly skilled teams for assessing the treatment options and then carrying them out.
Viscount Bridgeman: My Lords, has the Minister taken into account the Spanish experience, where presumed consent is built into the legal system? It is very seldom used, family consent is almost always obtained and there is a very low family refusal rate. The net result is that three times as many organs are available in Spain as in the United Kingdom.
Lord Darzi of Denham: My Lords, Spain enjoys an excellent donation rate, but it is important to contextualise it. Following the change in Spanish law to a system of presumed consent, it was some 15 years later, after systematic change in the donation process in Spain, that the rates began to climb to the successful levels enjoyed today. So we need to take that in the context of the initial recommendations of the task force, which the Government have fully recommended and which are in the public domain, and in the context of waiting for the new recommendations in relation to the opt-out. It is much more complex than just presumed consent.
Lord Bassam of Brighton: My Lords, the Royal Parks permitted two enclosed events to be held in a marquee-type structure in Victoria Tower Gardens during the month leading up to Christmas 2007. The Royal Parks is reviewing the holding of similar events this year.
Baroness O'Cathain: My Lords, I thank the noble Lord for that Answer, but it really is not satisfactory. Why does the Royal Parks encourage a commercial corporate entertainment organisation to despoil Victoria Tower Gardens? The grass in this area has not recovered from what happened in December. It is an area greatly loved by parliamentarians, residents,
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Lord Bassam of Brighton: My Lords, I suppose that I have always thought that our parklands should encourage transcendent beauty, but the Royal Parks has a policy of making its eight parks available for commercial lettings. That has had a long history for many decades. Its policy was developed in close consultation with Westminster City Councilthe local licensing authoritythe DCMS and other stakeholders, including the police and local residents. The Royal Parks makes very good use of the commercial opportunities and the money that comes from them is ploughed back into maintaining the parks to the very high standards of which the noble Baroness and many other Members of your Lordships House obviously approve.
The Royal Parks are managed to provide public access and enjoyment of the open air. Events held in the Royal Parks should be broadly consistent with these ideals. With this in mind, there are a number of events we dont normally consider, these include: Private parties.
Lord Bassam of Brighton: My Lords, the Royal Parks has to make its own commercial decisions on these matters, but it obviously took the view that this was an appropriate event. It was well organised and well marshalled. It closed by 12.30 am. I understand that there was very little noise nuisance and in fact no complaints about these events have been received. It is important that public access is maintained, but one could fairly argue that a night-time party does not exactly prevent people from using the park.
Lord Howarth of Newport: My Lords, unless the view is takenand I do not think it should bethat the public should be charged for admission to the Royal Parks, are not the only two available sources of revenue government grant in aid and charges for special events? If for necessary reasons of public economy grant in aid is not enough to pay for the very high standard of maintenance that we require, are we really entitled to grumble if the Royal Parks raises additional revenue from occasionally permitting private or other events in the parks, however loath we are to see the public temporarily excluded from areas of the parks or otherwise inconvenienced?
Lord Bassam of Brighton: My Lords, I am not aware that anyone was particularly inconvenienced by these two events. I stand to be corrected on that. The Royal Parks should actually be congratulated on the way in which it has approached the generation of extra income, which has been valuably reinvested back into the Royal Parks estate.
Lord Thomas of Gresford: My Lords, does the Minister not agree that Victoria Tower Gardens is not much more than a dank field surrounded by a few bushes? Is it not time for us to have an appropriate garden similar to those enjoyed by legislatures elsewhere in Europe and the rest of the world? I know that my noble friend Lady Walmsley has great plans for the gardens and has discussed them with interested parties. Would the noble Lord be prepared to support such an initiative?
Lord Bassam of Brighton: My Lords, I am not sure that I agree with the description that the gardens are dank. I have enjoyed the odd picnic out there on a nice, warm summer lunchtime and I have been a user of that park for many years. The noble Lord does the Royal Parks a disservice. One can always have improvements in a park. I love parkland; when I was leader of my local authority we had some 13,000 acres of open land. We enjoyed our parks, and we still do.
Lord Skelmersdale: My Lords, is the Minister aware that his answer that the party happened at night and did not inconvenience people is slightly erroneous, because it takes some time to set up the structures for these events and often even longer to take them down? Those are the times that the public is inconvenienced.
Lord Bassam of Brighton: My Lords, my recollection of December is that the weather was not too brilliant. Yes, there may well have been some inconvenience, but no complaints were made about the erection of the structure used for those events. There is a danger that noble Lords could be accused of becoming killjoys when people hold party events in parklands.
Lord Bassam of Brighton: My Lords, I suspect that a view is probably taken by Royal Parks because it wants carefully to manage its open spaces in the public interest. Yes, there is probably an informal level, but it obviously has to strike a balance between the pressure to generate some commercial income to invest back into the parks and properly maintaining the parklands to the standard which I am sure we all enjoy.
Lord Acton: My Lords, is not the noble Lord, Lord Thomas of Gresford, mildly out of order in referring to the noble Baroness, Lady Walmsley, as his noble friend? My impression historically is that she is his noble kinsman. That is slightly out of date; I may be wrong, but perhaps she is his noble kinswoman.
Lord Bassam of Brighton: My Lords, I must say that, when I was landed with this Question, I did not think that I would have to get into the business of splitting hairs between noble friends and noble kinsmen. I am sure that the noble Baroness, Lady Walmsley, and the noble Lord, Lord Thomas of Gresford, enjoy a very amicable relationship.
Lord Brooke of Sutton Mandeville: My Lords, to look on the bright side, does the Minister agree that things have moved on satisfactorily since the era when the sole evidence of the private sector in the Victoria Tower Gardens was Albanians selling frankfurters in the shadow of Rodin?
Lord Bassam of Brighton: My Lords, I do not think that I have had the pleasure of an Albanian frankfurter in the Victoria Tower Gardens, but the noble Lord is right to say that things have moved on somewhat.
The Minister of State, Department for Environment, Food and Rural Affairs (Lord Rooker): My Lords, it is not possible to provide the specific information requested. Post Office Ltd administered the sale of game licences and recorded sales information using its own accounting periods rather than calendar periods. However, for the accounting period September 2006 to August 2007, Post Office Ltd recorded the sale of the following number of game licences: in England and Wales, 82,350; in Scotland, 6,253; and in Northern Ireland, 1,661.
Lord Geddes: My Lords, I genuinely thank the Minister for that Answer. Can he confirm the thought that has now been around for some 11 years that the sale of game licences has a net negative impact on the Exchequer? Perhaps I may ask him further about the situation in Scotland, where game licences have not yet been abolished. I have had the pleasure to shoot twice in Scotland this year and I had to ask my host to buy a game licence for me. The first problem was that it was bought when I was not known and not seen, which seems curious. The second problem is that the licence was a,
Lord Rooker: My Lords, the economics make this a bit like the old dog licence: it should have been abolished years ago. However, Scotland is still operating licences. It is possible to get the licence to take or kill game for £6, I think. It can be obtained for an extra £1 through the British Association for Shooting and Conservation. It is true that the licence
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Lord Rooker: My Lords, since last September, about 2,000 licences have been issued through the association, but I do not know how many have been issued in Scotland. Everyone has probably wasted a load of moneythe licences cost between £2 and £6, but the cost of collection and administration is far, far higher than thatbut it is up to the Scottish Executive what they decide to do and how they decide to spend the money.
Earl Ferrers: My Lords, the Minister said that the licence should have been abolished years ago. Does he realise that, in the mists of time, when I once had the privilege of being an ornament in the Home Office, I too used to get badgered by my noble friend about these wretched licences? We agreed that the licence should be abolished. Then there was a general election; the Labour Government came in and decided not to abolish it. What on earth were they thinking of?
Lord Rooker: My Lords, I do not want to blow my own trumpet, but I arrived at Defra in May 2006; in July 2006, at the country landowners game fair, I announced that we would abolish game licences; and, a year later, we abolished them. Mission accomplished.
Lord Rooker: My Lords, I have no information about prosecutions. It is the same situation with the licence for dealing in game. Some local authorities charged and some did not. I do not think that anybody bothered about this. The licence had no effect on public health, no effect on food safety and no effect on gun safety. None of those issues is affected by the abolition of licences. It was like the old dog licencenobody bothered about it.
Lord Taylor of Holbeach: My Lords, I am not sure whether I should declare an interest, coming as I do from Lincolnshire, where we have our well sung Lincolnshire Poacher approach to these matters. If the Scottish Executive will not abolish these licences in Scotland, will they make them available at post offices throughout England and Wales for the convenience of shooters in England?
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