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House of Lords

Tuesday, 26 February 2008.

The House met at half-past two: the LORD SPEAKER on the Woolsack.

Prayers—Read by the Lord Bishop of Southwark.

Cyclists: Road Accidents

Lord Berkeley asked Her Majesty’s Government:

Lord Bassam of Brighton: My Lords, measures to reduce death and injuries to cyclists in road accidents include providing better infrastructure, funding cycle training and improved testing and training for motorists, and encouraging cyclists to protect themselves by making themselves conspicuous and by wearing a safety helmet. Other initiatives, such as anti-drink-drive and anti-speeding campaigns and the provision of 20 mph zones, can contribute to cyclists’ safety.

Lord Berkeley: My Lords, I am grateful to my noble friend for that Answer—the Government are investing a lot of money in new cyclists’ facilities. Does he agree that one of the main campaigns must be to encourage children to cycle to school? Once they have learnt to cycle and used cycles as children, they will carry on doing so as adults and will, I hope, cycle to work. What exactly are the Government doing to encourage cycling to school safely—with new cycle routes or whatever—and so to encourage parents to allow their children to do that?

Lord Bassam of Brighton: My Lords, we are doing many things. In January this year, we announced that we are investing in cycling a record £140 million over the next three years, through Cycling England. Much of that money will be directed towards improving training and standards of cycling. That is a very good investment when it is put into the hands of those who train schoolchildren. It will provide—by, I think, 2012—for some extra half million children to have access to new cycle training and will create some 250 additional links to school to encourage home-to-school cycling.

Baroness Trumpington: My Lords, have the Government—

Lord Bradshaw: My Lords, does the Minister agree that a lot of the cases of cyclists being killed or seriously injured occur because of collisions with lorries? I believe that the Government are undertaking a major review that will result in much larger lorries—those towing trailers—being let on to British roads. Will he ensure that when the study is presented to the Government, it will evaluate the damage that is being done by bigger lorries to people such as cyclists?

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Lord Bassam of Brighton: My Lords, as ever, the noble Lord makes a very useful point. Of course we will look carefully at road safety issues involving lorries. He is right to say that there is potential for lorries to cause harm, serious injury or death to cyclists.

Baroness Trumpington: My Lords—

Lord Marsh: My Lords—

Baroness Trumpington: Oh well.

Lord Marsh: My Lords, does the Minister agree—I will understand if he would not dare do so—that in addition to cyclists running into lorries there is the serious problem of pedestrians being hit by cyclists?

Lord Bassam of Brighton: My Lords, that is an issue about which noble Lords appear to be particularly exercised. The last time we had a short discussion on this topic, a number of noble Lords said the same thing. Yes, of course, we have occasional instances of pedestrians being hit by cyclists, but it is profoundly the case that pedestrians are most at risk from cars. Sadly, cases of pedestrians being hit by cars in any given year generate a lot of fatalities—last year, there were some 471—although, thankfully, those numbers are coming down. The number of pedestrians who are injured by cyclists is very small. I think that there were 47 recorded incidents in which there was some form of injury.

Baroness Trumpington: My Lords—

Noble Lords: Hear, hear.

Baroness Trumpington: My Lords, perhaps I had better sit down. What are the Government doing to improve the lighting on cyclists at night? Every evening when I leave here in the dark in a taxi, I would be prepared to give evidence on behalf of the taxi driver if he hit a cyclist who has no lights on the back of his bike and is impossible to see until you are on him.

Lord Bassam of Brighton: My Lords, I thought that the noble Baroness was going to tell me that she had taken up cycling as well as giving up smoking. She is right that we should remind cyclists to take much more care, because it is important that they are visible. A key component of encouraging safer cycling is to ensure that, as part of the training, cyclists are told to be more visible and to have sensible lighting fixed to their cycles.

Lord Haskel: My Lords, is the Minister aware that the Parliamentary Advisory Council for Transport Safety recommended that there should be a 20 mph default speed limit in built-up areas? Does he agree that, as well as reducing the number of road deaths, that would mean that pedestrians and cyclists could share the road? That would certainly encourage people to cycle and it would encourage children to cycle to school, as my noble friend suggested, as there would be much less likelihood of injury.

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Lord Bassam of Brighton: My Lords, I agree that 20 mph zones are a good thing, certainly in urban areas. However, it is for a local authority to determine where it is most appropriate to put 20 mph zones. Such zones certainly have a significant impact on reducing accidents and deaths. I shall give a couple of statistics. The Transport Research Laboratory found that, in the UK and other EC countries, child road accidents fell by 67 per cent and cyclist accidents by 29 per cent in areas where there were 20 mph zones. I do not think that there should be default zones of 20 mph because I believe that the beauty of 20 mph zones is that they are self-enforcing. If you impose a default speed limit of 20 mph, you perhaps lose that benefit.

Viscount Tenby: My Lords, while we all agree with the noble Lord’s proper concerns about the safety of cyclists in relation to predatory motorists, I want to turn the question on its head and refer to something that my noble friend said earlier. What steps are the Government taking to protect pedestrians from cyclists? First, would he think it a useful beginning to enforce the law on riding on pavements? Secondly, and perhaps most important, could he make it a legal requirement for bicycles to carry a bell, as they used to do in the old days?

Lord Bassam of Brighton: My Lords, I used to have a bell on my bike, but it rusted up, I am afraid. The noble Viscount makes a fair point about enforcement. One positive thing that we have done is to ensure that community support officers, along with the police service, can impose fixed penalty notices, which has aided and added to enforcement. It remains the case that the major problem for pedestrians is the potential for a road traffic accident caused by a car and not a cycle. We need to keep a sense of proportion about these issues.

Mental Health: Spirituality

2.45 pm

Baroness Murphy asked Her Majesty’s Government:

Baroness Thornton: My Lords, the National Institute for Mental Health in England has worked with various faith groups, including the National Spirituality and Mental Health Forum and looks forward to maintaining positive relationships with these groups.

Baroness Murphy: My Lords, I thank the Minister for that reply. Does she agree that after seven years of demonstrably successful work at a time when the new Mental Health Act is causing great anxiety among black and minority ethnic groups because of

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their overrepresentation in compulsory mental health services, it is a great shame that a project that increases the understanding of cultural and religious beliefs in the expression of mental illness is apparently coming to an end? Does she also agree that it is a government priority that staff are trained in the understanding of the culture and beliefs of service users and carers?

Baroness Thornton: My Lords, the noble Baroness, Lady Murphy, is widely respected for her work and expertise in this area. The loss of the forum would be a very serious setback. However, I am optimistic that the work of the forum will continue, though it will be organised at local level with the regional centres which are committed to working with it. The forum has now formally established itself as a charitable organisation and can apply for funding in its own right. The noble Baroness is perfectly correct about staff training. Indeed, that is part of the Government’s programme for race equality delivery in the mental health programme.

The Lord Bishop of Southwark: My Lords, I understand that most programmes and projects connected with NIMHE are being carried forward under the continuity programme until at least September this year. Will the Minister explain why this important project is being singled out for adverse treatment by removing its national strategic focus when the Prime Minister’s new year message emphasised the importance of faith and human dignity?

Baroness Thornton: My Lords, I thank the right reverend Prelate for that question, and I was pleased to note that the Synod of the Church of England debated spirituality and mental health at its meeting last week. The Government have not singled out this organisation for detrimental treatment. Indeed, I am assured that now that the forum is properly established as a voluntary organisation it is in a position to seek financial support through different sources, including Section 64 of the general scheme through which the Department of Health provides support for the voluntary and community sector. I am also assured that NIMHE—a rather unfortunate acronym—will be happy to support the forum as it seeks to attract such funding.

Lord Roberts of Llandudno: My Lords, as Britain is becoming increasingly multicultural and multifaith, is it not essential that we have a real progressive policy from the Government to meet the needs of all sections of the community, and have well trained social workers, psychologists and others who can really deal with the issues, instead of decreasing this facility?

Baroness Thornton: My Lords, that is a very important question. Noble Lords will know that some of the reasons for the seeming overrepresentation of BME communities are very complex and not fully understood. There is strong evidence of high rates of severe mental illness among BME communities, and the NHS needs to reach people in these communities.

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The implementation of the action plan to deliver race equality of mental health care remains the single largest project of the institute’s work.

Baroness Finlay of Llandaff: My Lords, has the Department of Health given an instruction to strategic health authorities and those commissioning services that the spirituality concerns of patients with mental illness are particularly important and that they are clearly outlined in the book by David Enoch, I want a Christian Psychiatrist, in which he describes the importance of trust in establishing a therapeutic relationship, particularly with those who have entered the criminal sector through their mental health disturbances?

Baroness Thornton: My Lords, the noble Baroness is completely correct that spirituality involves a dimension of human experience that psychiatrists are increasingly interested in because of its potential benefits to mental health. However, your Lordships will also know that local priorities are set locally. Local PCTs are being encouraged, through their relevant strategic health authority, to plan and develop services according to the needs of their local communities and are being given the resources to do this.

Baroness Neuberger: My Lords, given the agreement around the House that spirituality plays a major role in the mental illness of some people in some of our hospitals and in our communities, can the Minister tell us what the Government will do to ensure that there is further training in spirituality of all faiths for those working in mental health? That training should include chaplains working in mental health.

Baroness Thornton: My Lords, the noble Baroness is absolutely correct and would certainly be familiar with this. Psychiatrists, patients and carers should all be fully informed about local chaplaincy services, and know that they now involve clergy and other personnel from many faiths and humanist organisations, as well as several Christian denominations. Chaplains have made a point of establishing good relations across the field. Close liaison with mental health teams will support a holistic approach in this area.

Earl Howe: My Lords, is the Minister confident that the aims that she has articulated can be successfully delivered at local level, rather than at national level as at present?

Baroness Thornton: My Lords, the Government have been committed to an improvement in mental health services from the outset. Indeed, from 2001-02 to 2006-07, investment in adult mental health services increased by 31 per cent, or £1.2 billion. We now have 760 new mental health teams working in the community, 55 per cent more consultant psychiatrists, 70 per cent more clinical psychologists and at least 20 per cent more mental health nurses. We are doing our part to deliver this agenda.

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Alcohol: Misuse

2.51 pm

Baroness Neuberger asked Her Majesty’s Government:

Baroness Thornton: My Lords, I welcome the BMA’s useful report. Tackling the culture of harmful and binge drinking is a priority for the Government, and we are implementing a comprehensive strategy. The report will encourage doctors to play the key role of identifying harmful drinking at an earlier stage.

Baroness Neuberger: My Lords, I thank the Minister for her reply. However, given that all the evidence shows that both availability and price of alcohol are the key factors in binge drinking, this is not so much a matter for doctors as for government. Will the Government now consider introducing new laws, as recommended by that report, to regulate promotional activities on alcohol and ensure that both licensed premises and off-licences no longer sell alcohol as loss leaders?

Baroness Thornton: My Lords, I thank the noble Baroness for that question. The Government are working with the alcohol industry and other stakeholders to implement a strategy which includes a new public information campaign, an independent review of alcohol pricing and promotion, toughening enforcement for under-age sales and helping more people who want to drink less. Reducing alcohol-related hospital admissions is a new measure of performance for the NHS. We believe that this will encourage more NHS investment to identify those most at risk and provide advice and treatment. However, this strategy is not about preaching to or hectoring people. It is important that people have the necessary information to make their own decisions about the health consequences.

Lord Naseby: My Lords, as the Government, through the Minister, have said that it is a priority to address this issue, is the Minister aware that in Ireland, where the price of alcohol is considerably higher than in the UK, the effect in reducing consumption has been absolutely zero? Should the Government therefore not now review the 24-hour drinking policy that they introduced, when the police report that more than 180,000 offences have taken place since that new law came on to the statute book?

Baroness Thornton: My Lords, the noble Lord conflates two different points. On the price of alcohol, there is definitely increasing public concern that harmful drinking is fuelled by the sale of alcohol at heavily discounted prices and other promotional tactics. We currently lack comprehensive evidence on this issue and views are divided. The Department of Health has therefore commissioned an independent review of the relationship between pricing, promotion and harm, which will help to inform our understanding of this and our decisions on whether to take any action on the impact they have.

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Baroness Coussins: My Lords, is the Minister aware that the rules on advertising alcoholic drinks, which the BMA report would also like to restrict, have recently been significantly tightened up, and that the latest survey by the Advertising Standards Authority, on whose council I sit, has showed a compliance rate of around 95 per cent? In the light of this, does she agree that advertising may not be so much to blame as the TV soaps and reality shows that use drunkenness and alcohol misuse as forms of entertainment?

Baroness Thornton: My Lords, the Government need to look at both those things—they are not mutually exclusive—but we are not banning alcohol advertising without a very good reason. As the noble Baroness has said, there are tough rules on advertising, particularly to the under-18s, but the review of the interrelationship between alcohol pricing, promotion and harm will be reported on this summer, and it will include an examination of advertising in all its forms: TV, radio, above and below the line, sponsorship, and the internet. Depending on the review’s findings, the Government have made it clear that they are prepared, subject to public consultation, to consider new controls and, if necessary, legislation.

Lord Avebury: My Lords, when the Prime Minister took over last year, he undertook to implement vigorous action to curb the £20 billion of harm, including £7 billion to health alone, which alcohol was causing in England and Wales. Will the Government now review the perverse and irrational decision that was taken following the Cabinet Office’s interim analytical report of 2003, which showed that price and availability were the two main levers that could be used to curb consumption, and review their strategy so that these are incorporated into any decisions that the Government now take?

Baroness Thornton: My Lords, we know that the review of the Licensing Act is due out soon. Speculation in the press over the weekend pre-empted some of the release of that review, but we must wait to see what happens. We also know that studies undertaken by Cardiff University and Liverpool University have found that accident and emergency attendance in relation to violent crime has fallen by 2 per cent since the introduction of the new regime in 2005.

Lord Walton of Detchant: My Lords, is the Minister aware that Professor Oliver James and Dr Christopher Record in Newcastle-upon-Tyne have drawn attention recently to a frightening, indeed horrifying, increase in the incidence of liver disease and other effects of alcohol abuse in young people in the north-eastern region? What action are the Government taking to persuade the police and the owners of licensed premises to reduce under-age drinking and drinking in young people?

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