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15 May 2008 : Column 1117

Lord Harrison: My Lords, will my noble friend remind the noble Lord, Lord Pearson of Rannoch, that it was the Government led by the noble Baroness, Lady Thatcher, who in their wisdom created the single European market and that the European Union has an obligation to oversee that market, not only for the protection of consumers but also so that entrepreneurs—in this case, food supplement businesses—can operate freely and successfully within it?

Baroness Thornton: My Lords, I probably do not need to remind the noble Lord, Lord Pearson, of these issues. The UK Government, supported by the FSA, are indeed negotiating hard to make the supplements directive as flexible and workable as possible.

Lord Inglewood: My Lords, can the Minister confirm that the Government are working to establish a liberal rather than a restrictive market in these products, not least bearing in mind the fact that European citizens of whatever country are subject to the same general physiological laws relating to poison?

Baroness Thornton: My Lords, that is absolutely correct.

The Countess of Mar: My Lords, the latest figures from the Department of Health indicate that some 5,000 people have died from adverse drug reactions. Can the Minister give a comparable figure for the number of people who have died as a direct result of poisoning from food supplements?

Baroness Thornton: My Lords, I am afraid that I do not have those figures but I shall endeavour to find them and let the noble Countess have them.

Baroness Tonge: My Lords, in view of the renowned energy and determination of the noble Lord, Lord Pearson, can the Minister encourage him to tell us what supplements he is on?

Baroness Thornton: My Lords, I would not dream of encroaching on the noble Lord on such a matter.

Lord Pearson of Rannoch: My Lords, as the noble Baroness was good enough to mention me, perhaps I may respond. I cannot believe that it is of interest to the House, but I have to confess that I am not on any food supplements or any medication. However, a very good friend of mine will suffer seriously if this directive goes through. As there is a minute left on the Clock, perhaps I could ask the Minister whether she has consulted another website, that of the National Association of Health Stores, which says that these directives are on the verge of overwhelming the whole industry and that it wants,

Baroness Thornton: My Lords, I did indeed look at that website. The UK Government and the FSA share the concern that the maximum amounts are set at levels based on risk; in other words, we do not wish to encroach on the liberal regime that we have in the UK.

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Earl Howe: My Lords, at the moment some 300 nutrient sources are not on the Commission’s positive lists but have temporary exemption from prohibition. However, the derogation lasts only until 2009 and for many ingredients the cost and work involved in providing further and detailed information prior to the deadline will be prohibitive. Is there not a case for encouraging the Commission to agree a rolling extension of those derogations for key ingredients, unless of course they are deemed unsafe?

Baroness Thornton: My Lords, the noble Earl’s last point is the key one. My information is that there are some 120 outstanding submissions relating to nutrient sources that currently do not have adequate scientific assessment, but that does not mean that they will not have that assessment. If some of them are deemed unsafe, there are substitutes for almost everything on that list.

Airports: Heathrow

11.29 am

Baroness Sharples asked Her Majesty’s Government:

Lord Bassam of Brighton: My Lords, all airside staff must pass stringent physical screening and searches every day. As part of the layered approach to security, all airside pass holders at UK airports, regardless of their nationality, are also subject to extensive pre-employment background checks, and those engaged in security activities must also pass a counterterrorism check. A fundamental review of personnel security screening across the transport sector was commissioned last December and will report in the summer.

Baroness Sharples: My Lords, while I thank the Minister for that reply, can he explain why foreign workers from inside and outside the EU are not checked for possible crimes committed in their countries of origin, especially those who work—as the noble Lord mentioned—airside?

Lord Bassam of Brighton: My Lords, it is obviously very difficult to check on the criminal records of those overseas; I am sure that the noble Baroness accepts that. We cannot currently do that for applicants. The Criminal Records Bureau is developing agreements to exchange data for employment vetting purposes with other EU member states and jurisdictions, and these measures will complement the checks that employers undertake to satisfy themselves about potential employees.

Baroness Harris of Richmond: My Lords, can the Minister have a discussion with the Security Industry Authority to see whether it can be of any help in this matter, particularly with regard to looking at people from overseas who apply for jobs? I find it extraordinary that, because we are not within the Schengen information system, we do not get the information we need about people who should not be here taking on those jobs.

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Lord Bassam of Brighton: My Lords, we already work very closely with the Security Industry Authority, which has been doing extremely valuable work. I asked for some of this data. The right-to-work checks have thrown up many cases that are now subject to a challenge process, ensuring that we have greater levels of security. The Security Industry Authority is also working very closely with the UK Border Agency.

Lord Hylton: My Lords, does the noble Lord agree that the distinction between airside and non-airside workers is somewhat artificial? Surely there is mixing of personnel in certain common areas. Has the vast quantity of commercial vehicles entering airports been adequately taken into account from a security point of view?

Lord Bassam of Brighton: My Lords, I think it has. I cannot agree with the noble Lord that the difference between airside workers and non-airside workers is blurred. Airside workers have to be physically searched. A whole range of physical security measures is in place for staff and used daily; that is clearly not the case for those working non-airside. Staff are subject to detailed security checks in much the same way as the noble Lord or I would be as passengers. They have to go through those very rigorous checks whenever entering airside, so there is a very clear distinction.

Baroness Hanham: My Lords, I am delighted at the information that has come to light on this. Would the noble Lord, in his capacity as Minister for the Home Office, say what action the UK Border Agency is now going to take to ensure that people who are working airside at airports are not in fact illegal immigrants?

Lord Bassam of Brighton: My Lords, right-to-work checks are made. All non-EU nationals must prove their right to work in the UK. Staff have to go through a background check that looks at their work history over the previous five years. You would have to be a long-term sleeper in an organisation to get past that check. Those checks are very rigorous and full references have to be taken up. If there is any hint of failure to match those checks, that person is rejected as a potential employee.

Lord Wallace of Saltaire: My Lords, does the Minister recognise that, if we are asking other Governments for information on the potential criminal background of people, we have to provide information ourselves? That needs some form of international regulation, and that is one of ways in which the European Union provides a rather useful multilateral framework for exchanging data under safeguards. That is one of the arguments that the noble Lord, Lord Pearson of Rannoch, has so far failed to recognise in our very lengthy procedures over several days on a related matter.

Lord Bassam of Brighton: My Lords, the noble Lord makes a perfectly reasonable Euro-enthusiast point; I am sure that noble Lords will appreciate that. We obviously have data-sharing protocols and arrangements in place. We are trying to work with

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many other jurisdictions to ensure that we can share that data on a like-for-like basis. It is complicated because different offences are treated differently in different jurisdictions, but we need to have that. That is an issue that the Magee review and the Stephen Boys Smith review will be looking at together.

Lord Forsyth of Drumlean: My Lords, for how much longer are the Government prepared to tolerate the poor administration carried out by the British Airports Authority at Heathrow, which is doing real damage to our competitiveness as well as causing great inconvenience to travelling public? Is it not time that we applied the big stick of competition to BAA’s position in respect of its ownership of this airport?

Lord Bassam of Brighton: My Lords, that is rather wide of the Question, but I know that that point often comes up in your Lordships’ House. The noble Lord was a member of an Administration who carried out that privatisation some years ago. No doubt he probably feels the weight of responsibility for some of that.

Baroness Sharples: My Lords, the Minister has not answered the Question on those with criminal records in foreign countries.

Lord Bassam of Brighton: My Lords, I answered the Question, partly in response to the comments of the noble Lord, Lord Wallace of Saltaire. I accept that it is an issue; we are looking at it and want to tackle it. As I said earlier, trying to have common standards for the nature of convictions in foreign jurisdictions is not an easy issue. However, we are mindful of it, and very much on the case. We cannot afford to have weakness and porous borders. We must ensure that staff working in airports and in the transport sector are rigorously checked. Everyone accepts that.


11.37 am

Baroness Royall of Blaisdon: My Lords, progress yesterday on the European Union (Amendment) Bill was not quite as swift as we had hoped for. Therefore, following discussions between the usual channels, the Committee stage will resume at around 7 pm on Monday 19 May. This additional three hours—the House will not sit later than 10 pm on Monday evening—will ensure that the Committee stage will finish as planned, on Tuesday 20 May.

NHS: Hospital Feeding

Baroness Knight of Collingtree rose to call attention to the case for improving arrangements for feeding patients in NHS hospitals; and to move for Papers.

The noble Baroness said: My Lords, noble Lords will be aware that I have raised this question on a number of previous occasions and they may wonder why I am doing so again. I regret to state that it is because I have never, in answer to numerous Questions,

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letters to—and even interviews with—Ministers, as well as several speeches in debates and an attempted parliamentary Bill, had any real indication that the wrong I seek to address is being effectively tackled. Yet that wrong is not a minor one. We are talking about sick people in hospitals being deprived of food, liquids and care to such an extent that, sometimes, they do not survive.

When I first raised this matter, some Members of this House and, of course hospital trusts, rubbished my allegations and refused to accept that any of it was happening at all. They really cannot do so today. There is a mass of hard evidence that my claims are only too true. Television programmes have highlighted it. There is hardly anyone who has not heard of the familiar allegation of nurses placing food or a cup of tea too far from a bed-ridden patient for the plate, cup or tray to be reached. The nurse bustles in some 15 minutes later, exclaiming, “I see you don’t want that, then”, and whisks it away before the patient can say a word.

People have given me explicit examples of their relatives or friends not being given any food or liquid at all, with no explanation or excuse. Others have reported that if they do not take food in, the patient will either get nothing or be given totally unsuitable or inedible food. Some patients get cheese slices, wrapped in something that they cannot undo; sandwiches are also wrapped that way. Some get hard-crust bread with which their dentures cannot cope. Of course, this does not happen in every hospital, as thousands and thousands of really exemplary nurses are caring devotedly for their patients. I make no criticism whatever of them, but we deceive ourselves if we think that standard is universal. It is not. We must recognise the truth and seek to be effective.

Last summer, my noble friend Lord Patten and the noble Lord, Lord Carlile, both of whom, by the way, wrote to me this morning greatly regretting that they were not able to attend or speak in this debate, came with me to see the then Minister, the noble Lord, Lord Hunt, about my complaints. Perfectly reasonably, he asked for some solid proof—names, addresses, dates, hospitals and all of the relevant details.

I had a large file of cases, and spent some two to three weeks contacting every single such complainant personally, by phone and letter. I asked whether they minded my reporting, and possibly making public, the details of their experience. A large number did mind. Quite frankly, some of them were scared, which worried me. They knew what happened to whistleblowers and feared facing unpleasant consequences if they needed hospital treatment themselves. Some said that there was really no point at all in complaining, as the relative or friend about whose treatment they had complained had died of it and was gone. As for taking legal action, that is never really possible unless someone is very rich. The NHS is the biggest and mightiest business in all of Europe, and it is difficult indeed to take a case up against it. In fact, I am told that it is nearly impossible to find a lawyer who will do so.

With the agreement of some complainants, however, I was able to give the Minister a dossier of 22 cases

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where bad nursing and no feeding were alleged. Names, ages, addresses, dates and hospitals where deficiencies occurred were all accurately listed. I do not blame the noble Lord, Lord Hunt, for what happened next. He passed on the cases for investigation, perfectly properly. I blame those charged with investigating; their arrogance and blindness to the facts was absolutely appalling. Not all—a few hospitals tried hard to respond properly, the health authority in the north-east being one, although I still do not quite understand why or how the families’ sworn allegations to me were not judged to be evidence. However, most authorities did not respond as they should have. Eight out of my 22 cases, so carefully detailed, did not get one word of comment. Other authorities commented on only parts of the complaint but totally ignored other parts.

Allegations about lack of feeding were hardly ever referred to, although one or two mentioned a rather mysterious red tray—but no explanation of what that meant was ever made to me. I have since found out that, if a red tray comes along carrying the food, it is meant to signal that the patient needs help to eat. The authorities did not tell me that, and gave me no clue at all whether, or how, or to what extent the red tray signal actually results in help being given. Nurses are extremely busy and do not have time to spoon-feed people. I recognise that difficulty. Yet complaints are coming in all the time about lack of feeding, red tray or no.

An old MP friend and colleague of mine in the other place visited his wife, who had cancer. He sat by her bed as long as he could. After three days, he thought, “That’s strange; I haven’t once seen this girl being fed”, so he asked the nurse, “When do you feed my wife.” “Oh, we’re not feeding her”, the nurse said. “Not feeding her”, he said, “Why? Who said that? Did she ask for it? Did I ask for it?”. He created an awful row, and the result was that his wife was fed and things got better. I listed all this carefully in my complaint. The response was, “In this case, communications failed”. That was it, nothing else. The authority admitted the allegations were true, but there was no explanation and no apology.

Other allegations of poor care, in addition to lack of feeding, which were totally ignored included two examples of deaf aids being removed and never returned because they were lost. If you are reliant on a deaf aid and you cannot hear what is being said to you, you give rather peculiar answers, you are immediately put down as being a bit gaga and therefore your feeding is not normal. Nothing of that was ever referred to, although I think it is a very serious complaint. A man who was told to arrive at the hospital no later than 7 am when no bed or food was available until 10 pm was another complaint not mentioned. A husband who had to dress his wife’s bedsores because nobody else did was not mentioned either. There may be perfectly reasonable reasons why all these things happened. If so, the reports I received failed to respond to them.

The letter from the health chief executive summing up the whole matter said:

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How could he possibly say that in the light of what I have told the House? Considering that eight of my cases were never investigated or commented on and a number of specific complaints were not referred to in the responses made, I find those words from the chief executive astounding in their complacence and arrogance. They are also extremely depressing because they obviously show that he is perfectly satisfied with the situation as it is and will take no steps to alter what is going on.

Further examples are coming up all the time. In the past 24 hours, I have received lengthy communications from Age Concern, the Stroke Association, the Royal College of Nursing, Help the Aged and others concerning up-to-date cases of this happening. A headline in the Daily Telegraph of 8 February 2008 read:

An earlier headline read:

I admit that some patients come into hospital undernourished before they ever step over the threshold, but the Department of Health’s own figures show that the nutritional condition of at least 8,500 patients a year worsens while in hospital.

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