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House of Lords

Wednesday, 25 June 2008.

The House met at three o'clock (Prayers having been read earlier at the Judicial Sitting by the Lord Bishop of Exeter): the LORD SPEAKER on the Woolsack.

NHS: Healthcare Travel Costs Scheme

Lord Lewis of Newnham asked Her Majesty’s Government:

Baroness Thornton: My Lords, it is important that patients and the public are able to access the financial help available to them. The revised Healthcare Travel Costs Scheme was launched on 1 April 2008 and we are developing a performance regime that will monitor the uptake of the scheme, while placing a minimal administrative burden on the NHS.

Lord Lewis of Newnham: My Lords, I thank the Minister for that reply. Although I appreciate that the local hospital has the prime responsibility for administration and publicity of the scheme, a recent survey by Macmillan Cancer Support claimed that only 19 per cent of patients were informed about the previous scheme. Considering the very large cost that is involved when NHS appointments are missed and the dramatic impact that travel-to-hospital expenses can have on patients’ finances, is the noble Baroness willing to review the Government’s position in, say, six months, so that we would have a real idea of how well the publicity is going?

Baroness Thornton: My Lords, I am pleased to inform the noble Lord, who made a very sensible point indeed, that we will be conducting a review of the scheme to evaluate the effectiveness of the provisions during their first year. That is not quite the six months he asked for. He is quite right to say that the take-up of the old scheme was not as good as it should have been, which meant that people who needed and were entitled to help were not receiving it. The noble Lord is also right to say that the effectiveness of the new scheme depends almost completely on commitment and delivery at local level. Our review will be undertaken following the end of the financial year 2008-09 and will, indeed, focus on the impact of the revisions on the take-up of the scheme and the financial impact on NHS organisations.

Lord Graham of Edmonton: My Lords, I am sure the Minister appreciates that many people will benefit from the scheme. What positive steps are being taken to promote it?



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Baroness Thornton: My Lords, I thank my noble friend. Part of the review and the launch of the new scheme was a commitment to enhance and promote awareness of the HTCS. It is the responsibility of NHS organisations to promote the scheme. However, to assist them to do that, the Prescription Pricing Authority provides leaflets and posters. A range of application forms and leaflets that deal with help for healthcare costs are available through a variety of different organisations—primary care trusts, hospital trusts, DWP, NACAB, universities, pharmacists, GPs and dental surgeries—to be distributed to patients. In addition, we are sending quarterly mailshots every three months to dispensing doctors, pharmacists and key contacts. We hope that that will enhance the take-up of the scheme over the year.

Lord Clement-Jones: My Lords, I note the Minister’s reply to that supplementary question, but at this time last year the noble Lord, Lord Hunt of Kings Heath, in reply to a Question of mine, said that he would redouble the department’s efforts to improve benefit awareness and take-up among cancer patients. The noble Baroness adumbrated a number of steps, but who is taking responsibility at national level for improved take-up? What incentives are being built into the system?

Baroness Thornton: My Lords, the HTCS is being promoted very strongly at a national level but, as the noble Lord will be aware, the actual take-up depends on the efficiency of hospital doctors, GPs and dentists in informing patients that this scheme is available. Guidance has been issued as a result of the relaunch. We have indeed redoubled our efforts to promote the scheme right across the piece and we are very optimistic that this will make an impact.

Lord Morris of Manchester: My Lords, addressing the House on 7 June last year, my noble friend Lord Hunt of Kings Heath—then a health Minister, aware of its importance to Macmillan Cancer Support—agreed to ask the Healthcare Commission if it could monitor benefit information given to patients through its annual health check. Can my noble friend Lady Thornton tell us what reply was received from the commission?

Baroness Thornton: My Lords, that is an extremely reasonable question. I do not have the detailed answer here. We are aware that cancer patients face particular difficulty in paying the cost of their travel to treatment, but the principle of the scheme is that those on low incomes are eligible. That does not necessarily address the issues that cancer patients face. I undertake to find out what answer was given to my noble friend at the time and to let the noble Lord and the House know.

Earl Howe: My Lords, the Minister will know that for many people who travel a lot to hospital for cancer treatment, the cost of doing so can amount to several hundred pounds out of their pocket if they are not part of the scheme. For those people, one can view the scheme as not so much nice to have but a vital part of their care and treatment. In that context, is there some way in which from the outset commissioning processes could be used to boost and promote the scheme to patients?



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Baroness Thornton: My Lords, that is an extremely sensible suggestion, which I undertake to look into.

Baroness Barker: My Lords, as the scheme is supposed to be targeted at people on low incomes, can the Minister confirm that the review to which she alluded earlier will analyse which people benefit from the scheme in terms of their age and language ability?

Baroness Thornton: My Lords, I do not have the detail of what the questionnaire will look like, but I undertake to try to feed that in at this stage, so that we can ask those questions.

Lord Brooke of Alverthorpe: My Lords, is there a website on the topic; is it a national website; and are there references to websites about local arrangements available for people who need to take advantage of that facility? Is it possible to apply for assistance online? That is the kind of benefit that people would like to see from a government online system.

Baroness Thornton: My Lords, the information to which my noble friend refers is indeed available online through both NHS sites and local PCT and hospital websites. I am not absolutely certain whether you can apply online. Most people apply through the hospital to get the cash immediately. Some people apply by post. I will find out whether it is possible—I would be very surprised if it is not—to apply online.

House of Lords: Life Peerages Exhibition

3.08 pm

Earl Ferrers asked the Chairman of Committees:

The Chairman of Committees (Lord Brabazon of Tara): My Lords, the exhibition, “A Changing House”, marks the 50th anniversary of the Life Peerages Act 1958. The exhibition examines the changes in the membership of both Houses since the 19th century and is one of a number of initiatives taking place in Parliament to mark the 1958 anniversary. The proposal to hold the exhibition was approved by the Information Committee. The exhibition cost £105,000.

Earl Ferrers: My Lords, I am very grateful to the noble Lord the Chairman of Committees for that Answer. Does he agree that, whatever the merits of the exhibition, its structure does not sit comfortably in the splendour and graciousness of the Royal Gallery? Does he further agree that, although we are of course indebted to the life Peers, who have brought so much to this House—all sorts of things, including wisdom, ability, great competence and even, sometimes, charm—they have only been here for 50 years, whereas hereditary Peers have been here for 800 years? Will he consider having a conversation with the noble Baroness the Lord Speaker to see whether she would think of putting up another exhibition, in favour of the hereditary Peers, to show what they have done to make this House what it was, which life Peers have for so long, understandably, aspired to join? Should that not be done pro rata with the exhibition over there?



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The Chairman of Committees: My Lords, I am grateful to the noble Earl for his Question. As regards the structure of the exhibition, beauty is in the eye of the beholder. It may not be to everybody’s taste, but some people probably think it is lovely. Hereditary Peers have been here much longer than 50 years. Without them, there would be have been nowhere for the life Peers to join.

Lord Strabolgi: My Lords, is the noble Lord aware that the exhibition would attract more visitors if it had a better title than “A Changing House”, which does not do justice to its excellent contents or to some important innovations? The noble Earl mentioned hereditary Peers, but women Peers were allowed to sit here for the first time in the House’s history, to our great advantage.

The Chairman of Committees: My Lords, I note that the noble Earl, Lord Ferrers, and the noble Lord, Lord Strabolgi, are two of the six Members of this House who were here before the Life Peerages Act 1958 took effect. I am not sure that I can comment with any authority on the title of the exhibition. However, we expect many people to visit it, including members of the public on the Line of Route and on special tours, and Members and staff of both Houses. During the Summer Recess, the cash customers will also come through.

Lord Avebury: My Lords, if an exhibition is held along the lines suggested by the noble Baroness, Lady Trumpington, might it not be called the “End of the Peer” show?

Baroness Trumpington: My Lords, speaking as a rather common life Peer, perhaps I may ask why we do not have the use of the semi-circular space at the end of the corridor on the first floor. It seems to be used for House of Commons exhibitions all the time. Can we not share it? I very much resent that. I agree with the noble Earl, who is a hereditary Peer and, I hope, my friend: it is a desecration of the Royal Gallery to use it for these purposes. The space on the first floor should be as available to us as it is to the Commons.

The Chairman of Committees: My Lords, I compliment the noble Baroness, Lady Trumpington, as one of the most distinguished life Peers, and a female, to boot. There is a very nice photograph of her in the exhibition. I think the space she refers to is called the Upper Waiting Room. It is difficult to get any space at all from the House of Commons under any circumstances, but I can take this forward.

The Royal Gallery is now a serious working room for many noble Lords who have meetings there; therefore, one needs to be careful about the number of exhibitions held there. It should be used sparingly because it is a working room of the House.

The Lord Bishop of Exeter: My Lords, given that, until the mid-16th century, the Lords Spiritual formed a majority of the Members of this House, and given the durability of this Bench in any proposals for the reform of your Lordships’ House, might we also have a suitable exhibition on the contribution of the Lords Spiritual, housed in a suitably High Gothic pavilion?



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The Chairman of Committees: My Lords, I am sure we all agree that the Lords Spiritual have made a great contribution to this House over the years. Personally, I hope they will continue to do so for many more to come.

Baroness Symons of Vernham Dean: My Lords, does the Chairman of Committees agree that a suitable way of celebrating the Life Peerages Act would be for this House to reclaim its rights to the Pugin Room?

The Chairman of Committees: My Lords, yes, I quite agree. We have tried, we have failed and I am sure that we will continue to fail.

Viscount Falkland: My Lords, I declare an interest as the chairman of the Works of Art Committee. We will continue to meet the expectations of Parliament to create or take part in the creation of exhibitions so that the public can learn more about the House of Lords; but, at the same time, will the Chairman of Committees take particular note of the point made by other Peers that, as we have learnt from earlier exhibitions, we cannot make plans when there is not enough space to mount exhibitions? We have confusion in the Royal Gallery and, to some extent, in the Robing Room. With all respect to the noble Baroness, Lady Trumpington, even if we did not have to share the exhibition space she referred to, it would not be adequate for our plans.

The Chairman of Committees: My Lords, as I have said, there is difficulty about the available space for exhibitions. The desks in the Royal Gallery are much used by Peers for meetings. In Westminster Hall, the principal exhibition space, there is a completely different exhibition.

Elections: Joseph Rowntree Report

3.16 pm

Lord Tyler asked Her Majesty’s Government:

The Parliamentary Under-Secretary of State, Ministry of Justice (Lord Hunt of Kings Heath): My Lords, the report is being studied with interest. It finds that there is no hard evidence suggesting a significant increase in electoral malpractice since 2000. We continue to examine how the integrity of the electoral system can be strengthened.

Lord Tyler: My Lords, I am grateful to the Minister, but I am disappointed with his Answer. Do the Government accept that the legitimacy of election results largely depends on the integrity of the electoral register? Does the Minister accept that making voting more convenient, by postal voting on demand, weekend voting and so on, is much less important and should take second place to reducing fraud? Will he undertake to replace household registration with the much more accurate individual registration, which is supported by all official and independent authorities on this issue, in the forthcoming Constitutional Renewal Bill, which is

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due in the next Session? Does he recall the judgment in the Slough election court earlier this year? The commissioner concluded:

Lord Hunt of Kings Heath: My Lords, the noble Lord has completely ignored the 2006 Act, with the improvements to the system of administration and the introduction of personal identifiers, which the Electoral Commission has said work well. The Government agree with the principle of individual registration and are examining the practical consequences of moving to such a system. Overall, however, the system is one of great integrity and we should not—and the noble Lord should not—put doubt into the minds of anyone about that. Equally, it is right that we should do everything that we can to encourage people to vote, including encouraging more postal voting.

Lord Grocott: My Lords, given that the title of the report and its content are on the subject of the purity of elections, does my noble friend agree that the purest electoral system is that which provides for the closest possible contact and accountability between the electors and their elected representatives? Is it not obvious to most objective observers that the system that most provides for that is the time-honoured, tried, tested and proved system that we call the first past the post?

Lord Hunt of Kings Heath: My Lords, there is much to commend in my noble friend’s extremely objective assessment of electoral voting systems. To those who are passionately interested in this matter I commend the document recently published by my department that looks at the pros and cons of different electoral systems and provides ammunition for anybody who has any view on these matters.

Lord Henley: My Lords, in the past the noble Lord has justified the changes to postal voting and the increased ease with which people can post a vote on the grounds that it increases turnout and makes it easier for people to vote. What is the point of doing that if it increases the amount of fraud in the system?

Lord Hunt of Kings Heath: My Lords, it is surely good to do everything that we can to encourage people in this country to vote. We also have to ensure that, when evidence of fraud is detected, it is dealt with. That is entirely what the Government did with the 2006 Act, which the Electoral Commission, in commenting on personal identifiers, has said works well.

Lord Campbell-Savours: My Lords, why should we go down the individual registration route when fraud is confined to a very few areas in the United Kingdom? Why do we not target those areas, as was proposed in my amendments to the Electoral Administration Bill in Committee? Why do we not just revisit that principle?


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