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Baroness Thornton: My Lords, a health navigator, as defined in the Turning Point report, has deep knowledge and generic skills to understand the system across healthcare, benefits, housing and criminal justice. We are providing health trainers at a local level, while the

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provision of health navigators is being discussed. Health trainers are working with local, often hard-to-reach communities. Twelve hundred of them are in post already. Their job is to work across those communities, providing support, signposting to local services and advice on diets, smoking cessation, exercise and issues of mental health.

Lord Filkin: My Lords, does my noble friend the Minister agree that the Turning Point report in its call for the personalisation of services in the future sets a fundamental challenge for public services in their organisation and professionalism? Does she welcome the Prime Minister’s strong endorsement of this approach and of making progressive change in this way?

Baroness Thornton: My Lords, that is absolutely right. Implementing personalisation of services across the boundaries of social care, housing, benefits, leisure, transport and health, with partners across independent, voluntary and community organisations, is vital. The report of my noble friend Lord Darzi recognises the relationship between health, social care and wider communities, which will be integral to the creation of a truly personalised healthcare system.

Baroness Tonge: My Lords, so that these health navigators do not become like the sat-nav in my car and cause more confusion—I am obviously a little confused myself this morning—as people try to find their way through health and social services, will the Minister tell us a little about the pilot schemes that have been operating, whether they will be evaluated and whether that evaluation will be made public, so that we can see for ourselves the results of those schemes? In the light of the report on community pharmacists this morning, might they, too, have these health navigators on their premises, which seem to be the most accessible point for most patients?

Baroness Thornton: My Lords, as the noble Baroness has clearly illustrated, several discussions are taking place about health navigators and health trainers. The health trainer system already exists, is being evaluated and is already delivering. For example, a former miner in Bolsover is working with the Bolsover Wellness scheme, which supports individuals and families, including people with diabetes and heart disease, across his own community. He is from that community and understands it; he follows the progress of those people; he is building his expertise and supporting the health needs of that community. The scheme is very practical and is being evaluated. One hopes that it will continue to be rolled out.

Lord Walton of Detchant: My Lords, will the noble Baroness accept that, some 25 years ago, the late Sir Douglas Black produced a comprehensive report on inequalities in health, the recommendations in which were rejected by the then Conservative Government?

Lord Jenkin of Roding: No, that is quite wrong.

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Lord Walton of Detchant: Well, my Lords, many of the recommendations were rejected. Ten years ago, the former government Chief Medical Officer, Sir Donald Acheson, produced another report on inequalities in health, which in turn resulted in very few positive developments. May we be reassured by the noble Baroness that this important report and its recommendations will not suffer the same fate?

Baroness Thornton: My Lords, my right honourable friend the Secretary of State, Alan Johnson, has confirmed that tackling health inequalities is central to the department’s work. The current national inequalities targets run till 2010. We are publishing a strategy this year which will draw on those reports. This is absolutely a priority.

Earl Howe: My Lords, in looking at health inequalities, should not the Government have as one of their first priorities a review of the resource allocation formula? For example, spending on cancer in Oxfordshire is £5,182 per head, while cancer patients in Nottingham receive £17,028 per head. Does the Minister think that that large difference in funding is purely and simply a reflection of the burden of disease, or might there be something wrong with the formula?

Baroness Thornton: My Lords, the incidence of cancer deaths—the second biggest cause of the inequality gap—is linked to geographic areas. In the areas of highest deprivation there is late presentation, and the investment has to go into the care in those areas.

Energy: Nuclear Reactors

11.30 am

Lord De Mauley asked Her Majesty’s Government:

The Parliamentary Under-Secretary of State, Department for Business, Enterprise and Regulatory Reform (Baroness Vadera): My Lords, the Government’s view is that the French nuclear regulator has rightly carried out its functions following the inspection of the nuclear power station being constructed in Flamanville by EDF by drawing the attention of the operator to the necessary areas of action. We also note that the regulator raised issues about the construction procedures at the site and not about the design of the reactor itself.

Lord De Mauley: My Lords, I am grateful to the Minister for that Answer. According to the NII, the migration of skills has placed a severe strain on its ability to find, train and retain the number of skilled employees it needs to assess the different types of reactor for which licences are being sought. What are the Government doing to address that?

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Baroness Vadera: My Lords, the Nuclear Installation Inspectorate is currently undertaking a recruitment campaign and has received a number of applications for the vacancies that it foresees in the next two to three years. The Treasury has allowed a 15 per cent pay flexibility in order to assist it.

Lord Redesdale: My Lords, are there enough nuclear safety inspectors to act in Smart procurement? We are talking about major problems at the reactor at Flamanville in Normandy which could adversely affect the cost of any new nuclear build.

Baroness Vadera: My Lords, the function of the UK regulators is to assess the regulatory environment and the safety security environment, not procurement. The procurement will be undertaken by whichever utility companies express an interest and get the right licences. That is a matter for the private sector developers of nuclear.

Lord Jenkin of Roding: My Lords, does the noble Baroness recollect the joint communiqué issued between the Prime Minister and President Sarkozy at the end of March? It stated that the two countries would aim to,

Indeed, the Secretary of State, Mr Hutton, met the French energy Minister,

Is it hoped that this may lead to the regulators recognising each other’s generic design assessments?

Baroness Vadera: My Lords, the recognition of generic design assessment is undertaken by the Nuclear Installation Inspectorate and must remain a national responsibility. The agreement that is referred to is an agreement on the sharing of information, exchange of experts and increasing of secondments in order to make both national regulators more effective. There is also further co-operation between Governments on issues around skills, waste and research.

Lord Skelmersdale: My Lords, there seems to be a single market in practically everything else; why not in the nuclear industry?

Baroness Vadera: My Lords, there is a global market in the nuclear industry. The last sizeable reactor was built in France with Japanese components and American technology, so it is a global market.

Lord Brooke of Sutton Mandeville: My Lords, how many people currently working in the British nuclear industry speak French?

Baroness Vadera: My Lords, I would offer to write if I thought that that information was available, but I do not think that it is.

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11.34 am

Baroness Royall of Blaisdon: My Lords, with the permission of the House, my noble friend Lord Malloch-Brown will repeat a Statement on Zimbabwe after the first debate.

Procedure Committee: First Report

11.35 am

The Chairman of Committees (Lord Brabazon of Tara) rose to move, That the first report from the Select Committee be agreed to. (HL Paper 63).

The report can be found at the following address:

The noble Lord said: My Lords, I beg to move the Motion standing in my name on the Order Paper. The report recommends the trial adoption of a new procedure for Law Commission Bills. This procedure was proposed by the Leader of the House, following commitments that she made during the passage of the Legislative and Regulatory Reform Act 2006. She has also discussed the procedure with colleagues across government.

The aim of the Law Commission, as noble Lords will be aware, is to ensure that the law is as fair, modern, simple and cost-effective as possible. To this end, it regularly publishes reports with draft Bills, most of which, although not all, are technical and uncontroversial. Unfortunately, the pressure of time means that the implementation of Law Commission Bills has not kept pace with their production. The new procedure, which is described in full in the report, will, we hope, help to clear the backlog. Once the procedure has been tried out on no more than two suitably uncontroversial Bills, the committee will review how it has worked and make final recommendations accordingly.

Moved, That the first report from the Select Committee be agreed to (HL Paper 63).—(The Chairman of Committees.)

Lord Goodhart: My Lords, I have been a great admirer of the work of the Law Commission ever since it was created by the late Gerald Gardiner, the then Lord Chancellor in the first Harold Wilson Government. Since then, it has added many achievements to its name. As the Chairman of Committees said, most of them are minor and technical, but some are of considerable importance, such as the Land Registration Act.

There is a problem of delay because of the difficulty of getting Law Commission Acts on to the agenda for Parliament. Ministers do not like spending time on that. The noble and learned Lord, Lord Irvine of Lairg, was particularly helpful in this matter as Lord Chancellor, but not all others have been equally helpful. The result is that far too many Law Commission projects have remained on the shelf for far too long. During the passage of the Legislative and Regulatory Reform Act 2006, the noble Baroness, Lady Ashton of Upholland, who is now Leader of

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the House, worked very hard to try to achieve an alternative method for dealing with Law Commission Bills that would reduce the amount of time that they spent on the Floor of the House and therefore make it easer to deal with them. The noble Baroness hoped at the time to be able to produce something that would come out at the same time as the Bill was enacted. Unfortunately, she failed to do this, but she kept at it in the following two years and, despite the fact that she has now risen to much greater heights and a much more demanding job, she has now succeeded.

We now have a pilot scheme, which we should all welcome. I am sure that my party does. I am also sure that Mr Justice Etherton and the members of the Law Commission will also welcome it. I hope that it is a great success and will enable Law Commission Bills to pass much more quickly.

Lord Lloyd of Berwick: My Lords, I too warmly welcome the report. Lord Gardiner, whom the noble Lord, Lord Goodhart, mentioned, was a great believer in law reform. He attached great importance to it. He believed that it should be carried out systematically and not left to chance. The Law Commission has always had the most distinguished membership since its first chairman, Lord Scarman.

The Law Commission has published a long series of reports, of which we have heard and all of which are of the highest quality. To some extent, it can be said that they have been a victim of their own success, because Parliament, for its part, has not found the time to implement the reports, or even in some cases, I fear, to consider them. This inevitably has been frustrating for the Law Commission, but more important still, it has been bad for law reform. What is now proposed is, to my mind, a great improvement. It will give Law Commission Bills a much higher profile, which is important. In due course, it may be possible to refine the procedure still further, but in the mean time, I hope that the trial period for which this scheme will run will prove to be a great success.

I add my thanks to the Leader of the House and congratulate her on fulfilling the commitment that she gave in 2006. Governments do not always fulfil their commitments, but in this case the Leader of the House has done so. She has proved to be a good friend to law reform.

Lord Brooke of Sutton Mandeville: My Lords, I declare an interest and make what is, I hope, a constructive suggestion. My brother was chairman of the Law Commission in the 1990s and found that the time invested in talking in-depth to the shadow Attorney General—then Mr Boateng, who is now our High Commissioner in South Africa—was extremely productive in reducing the misgivings of the Opposition about that legislation coming forward.

Lord Kingsland: My Lords, I always learn something new when I listen to my noble friend Lord Brooke.

I add my support to this initiative. There was an earlier attempt in the mid-1990s, within the framework of the so-called Jellicoe committees, to introduce a

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similar initiative. Unfortunately, it foundered because we were rather overambitious and introduced Bills which had an element of controversy in them. The key to the new procedure is to ensure that only Bills that are not politically controversial are allowed to run through the mechanism.

The noble Baroness, as both the noble and learned Lord, Lord Lloyd, and the noble Lord, Lord Goodhart, have said, has been infinitely patient in constructing this procedure. There have been moments when one thought the whole initiative would collapse. With her remarkable blend of dextrous adroitness—if I can express it in that way—the noble Baroness has achieved something quite procedurally remarkable. We are all very much in her debt.

Lord McNally: My Lords, I confirm what my noble friend Lord Goodhart has said: this has the strong support of these Benches. The noble Lord, Lord Brooke, made a very wise intervention. This pilot scheme will work best and be carried forward if the Opposition parties are fully involved and if it is used genuinely to break this log jam and agree non-controversial measures. That was very wise advice from the noble Lord, Lord Brooke.

Baroness Ashton of Upholland: My Lords, I shall briefly say two things. First, I agree completely with the noble Lords, Lord Brooke and Lord McNally. This is absolutely designed for us to work together. These Bills are defined as non-controversial because all parties agree them to be. If noble Lords look at the procedure, there is a break all the way through it. If, at any point, controversy were to be attracted to a Bill, anyone can stop it. That is the essence of the procedure. Secondly, I thank the noble Lords who have spoken in this debate; they inspired me to keep going and, indeed, gave me the ideas. None of the ideas in this procedure is mine; they all belong to the people who have spoken in this debate.

I pay particular tribute to Lord Justice Etherton, chairman of the Law Commission, who was determined that I should not give up on this. Within 10 minutes of becoming Leader of the House, I had a text message saying, “Aha—now you can do it.” I pay enormous tribute to him; this really does belong to him. I am very grateful to noble Lords. I hope this works and that, as we take it through, noble Lords will get involved so that we can refine it. I am sure there are things we can do to make it better. If it works, it will do something quite remarkable that has long been needed.

On Question, Motion agreed to.


11.44 am

Lord May of Oxford rose to call attention to the trend in the incidence of HIV/AIDS; and to move for Papers.

The noble Lord said: My Lords, I begin this timely and important debate by declaring my interest. I was the co-author, with two colleagues, of the first

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published estimate of the likely future demographic impact of HIV in Africa. I was living in the United States at the time of that study, which was then regarded by the World Health Organisation and the World Population Council as excessively pessimistic, but which, sadly, was accurate. It had much less demographic detail, but it got the transmission dynamics and epidemiology right.

As a result of that study, I was involved through the US National Academy of Sciences in its expert advisory committees, while my co-authors, Roy Anderson, who is about to succeed Richard Sykes as the Rector of Imperial College, and the third author and junior colleague, Angela McLean, who was then a graduate student and is now a professorial colleague in Oxford, were involved here with the All-Party Group on AIDS, several of whose members will speak in this debate.

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