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House of Lords

Tuesday, 8 July 2008.

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

Prayers—Read by the Lord Bishop of Leicester.

NHS: Connecting for Health

Baroness Sharples asked Her Majesty’s Government:

Baroness Thornton: My Lords, the national programme for IT, which is being delivered by the department’s NHS Connecting for Health agency, is delivering front-line systems and services that are bringing major benefits for NHS organisations, staff and patients. The most recent National Audit Office report of May 2008 said:

However, certain aspects still have some way to go.

Baroness Sharples: My Lords, can the noble Baroness confirm that this IT scheme has already cost £12.7 billion and is five years late? What is the future? Really, I cannot see any. And what about Accenture and Fujitsu leaving?

Baroness Thornton: My Lords, there is a lot of mythology about the cost of the national programme. However, it is not, and has never been, over budget. The recent NAO report confirms that the cost of the original contract at £6.2 billion has not changed, and that the overall programme cost is substantially unchanged from the figure in the earlier NAO report of £12.7 billion.

The fact that Fujitsu’s contract was terminated is in fact a sign of the programme’s strength. The programme is still on course, and our contractors are not paid until they have delivered. In that sense, no money has been lost.

Baroness Prosser: My Lords, have the people who are involved in this work—NHS officials, clinicians, and so on—been consulted about the programme and, if so, what were their views?

Baroness Thornton: My Lords, large numbers of clinicians were involved in the original specification. The programme continues to receive high levels of support among front-line and managerial staff. An overwhelming majority say that implementing it is very important. Sixty per cent of clinical support for the initiative is, we think, a reasonable consensus. Some clinicians have in the past been resistant to change and are nervous about the new technology, but the key way to change attitudes for the programme is to continue to demonstrate successful delivery and improved services.

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Earl Howe: My Lords, the 2004 NHS Improvement Plan said that in 2008, each patient,

As at March 2008, just over 150,000 summary care records had been uploaded on to the spine, representing 0.24 per cent of UK medical records. Is that a satisfactory rate of progress?

Baroness Thornton: My Lords, the noble Earl will be aware that the debate about summary care records has been rumbling along. My noble friend Lord Warner concluded that there were many compelling reasons to have a ministerial task force in 2006. So the gradual rollout is in early adopter sites; they are subject to independent evaluation by University College London, which reported on 6 May 2008. NHS Connecting for Health is currently considering the finding that the clinician treating patients should seek consent to view before accessing a summary care record. Patients can choose not to have a summary care record, but evidence from our early adopters is that under 1 per cent of people make that choice. We are very confident that, over time, this will roll out as a very successful programme.

Earl Ferrers: My Lords, I think that my noble friend asked whether that was a satisfactory rate of progress. Will the Minister answer that?

Baroness Thornton: Of course, we could always do better, my Lords, but, with new technology, it is better to get it right.

Lord Broers: My Lords, large software systems are notoriously difficult to write correctly and impossible if the specifications are not stable. Can the Minister assure us that the specifications are stable?

Baroness Thornton: My Lords, if that is a very technical question, I am probably not in a position to answer it. However, given the amount of consultation that went into the specification, and the time taken to make sure that we get it right and that data security and confidentiality are top priorities, we are confident that this is moving forward at the right speed.

Baroness Barker: My Lords, does the Minister agree that there is a considerable effect on privacy of medical data when the operating code for the system is not held by the NHS but is retained by the suppliers? If so, what is the department doing to ensure the integrity of private medical information?

Baroness Thornton: My Lords, the IT systems implemented as part of the programme have high standards of security control, requiring a smart card that is issued only to staff providing NHS proof of identity along with a password. All moveable data must be encrypted to protect their confidentiality, and those are the property of the NHS. At local level, NHS trusts are accountable for applying security policies and standards. Where losses occur, they exclusively involve items such as local laptops or paper-based records and are based on human error rather than technical failures.

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Lord Elton: My Lords, the noble Lord, Lord Broers, asked a fairly simple question: is the specification stable? That is, are the authorities asking for something different from time to time as the system is developed? Can the Minister assure us that the specification has remained, and will remain, the same?

Baroness Thornton: My Lords, the specification will not remain the same because medical progress happens. Therefore, the specification will have to change from time to time as medical progress takes place.

Lord Haskel: My Lords, does my noble friend not agree that this is a hugely ambitious project and that the NHS deserves some credit for attempting it?

Baroness Thornton: My Lords, as of the end of June, a typical day in the NHS saw 320,000 prescriptions transmitted electronically, 25,000 choose-and-book electronic bookings made, more than 50 per cent of NHS referral activity being from GP surgeries to outpatient appointments, 2 million queries recorded and 1.5 million digital images such as X-rays kept to service NHS patients.

Employment: Graduate Women

2.44 pm

Baroness Sharp of Guildford asked Her Majesty’s Government:

Baroness Thornton: My Lords, by not fully utilising the skills and talents of the available workforce, the economy loses out, as it is operating below its productive potential. That is why the recruitment and retention of women is so important. The Government are tackling the issue of retention of women employees in a number of ways—for example, through improving maternity rights, providing more access to childcare and extending the right to request flexible working.

Baroness Sharp of Guildford: My Lords, I thank the Minister for that Answer. Is she aware that, since 1998, more women have graduated than men and, indeed, more women than men have got firsts? Is she also aware that in 2007, for the first time, more women than men graduated in science subjects? Is she further aware that only 25 per cent of those women continued in careers in science and technology? What are the Government doing to ensure that, given the shortage of skills in this sector, these women are being used to make the most of their capabilities?

Baroness Thornton: My Lords, the noble Baroness is completely correct. Overall, women make up a higher proportion of students across science, engineering and technology, but they are still predominantly choosing areas of study that take them into professions relating to health and welfare rather than engineering and technology. The Government have funded a £7.5 million scheme—the Resource Centre for Women in SET—which was launched in September 2004 and works with

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British business to help to maximise the opportunities for professional women in science, engineering and technology and to try to close the skills gap. For example, £1.5 million is specifically aimed at women who want to return to careers in science, engineering and technology and £325,000 has specifically been allocated to a scheme to increase the number of female graduates taking up SET courses. There is definitely more to be done.

Baroness Kingsmill: My Lords, I know that my noble friend the Minister shares with me concern about the waste of female talent in this country. The absence of women in leadership positions in the public sector is of concern, as it is in the private sector, where only 10 per cent of women hold board positions. Are the Government giving any consideration to measures introduced in Norway to require companies to have 40 per cent of women directors on their boards?

Baroness Thornton: My Lords, my noble friend will know that we are not in favour of quotas and, while we have considered the work that has been undertaken in Norway to encourage women into top jobs, that is not a route down which we intend to go.

Baroness Boothroyd: My Lords, as the Minister may know, only 600 women a year go into apprenticeships in the construction, engineering and ICT industries, compared to almost 24,000 men. What are the Government going to do to make good that gross imbalance?

Baroness Thornton: My Lords, the noble Baroness is completely right. It is a matter of great regret that we do not have more young women going into plumbing and engineering, for example. The Government are supporting a number of organisations, including Women into Science and Engineering and Women and Manual Trades. With CITB-ConstructionSkills, we are trying to provide through our work with schools the incentive for girls to consider those careers as ones that they might enter.

Baroness Gardner of Parkes: My Lords, does the Minister agree that, particularly in the health and social care professions, it would be beneficial to have an additional register of non-practising people so that women, during phases when they were not in employment, would still be kept on a register to show that they were professionally qualified and able to return to work?

Baroness Thornton: My Lords, the noble Baroness knows that I have a great deal of sympathy with her campaign on that issue, so I can only say that, yes, that is a very useful suggestion.

Lord Smith of Clifton: My Lords, it is not just Norway; Spain, too, has enacted legislation to have 40 per cent of women directors on major company boards. At the moment the figure here is only 11.5 per cent and those women are paid 27 per cent less than their male counterparts. When will the Government grasp this nettle? At this rate, the Church of England will have 40 per cent of women bishops before the boards of our companies get there.

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Baroness Thornton: My Lords, that is a very optimistic view of the recent decision that was taken and how it might roll out, if I might be so bold as to say that. This is not just the Government’s responsibility. The fact of the pay differential is that women directors earn 22 per cent less than male directors, but that is also the responsibility of the companies with the boards that employ those executives. The director-general of the IoD, Miles Templeman, said that,

I also remind the House that we are discussing the Equality Act.

Baroness Platt of Writtle: My Lords, is the Minister aware of our Science and Technology Committee’s report on science teaching in schools? I speak as patron of Women into Science and Engineering. One of the big problems is that most careers advisers are humanities based and are therefore not giving young girls particularly good advice on the excitement and rewarding nature of careers in science and engineering. That is an important thing that needs concentration.

Baroness Thornton: My Lords, the noble Baroness is completely right. One of the most effective methods is when organisations such as WISE send their members into schools to talk to girls about the benefits and excitement of doing those jobs. We need a lot more of that.

Baroness Greengross: My Lords, research shows that forward-looking employers find it easier to manage the right to request flexible working if it applies to all employees irrespective of care-giving status. Will the Government extend the right to request flexible working to all?

Baroness Thornton: My Lords, I believe that this is a matter that we will discuss when we debate the forthcoming Equality Bill.

Afghanistan: Taliban

2.51 pm

Viscount Ullswater asked Her Majesty’s Government:

The Minister of State, Foreign and Commonwealth Office (Lord Malloch-Brown): My Lords, NATO and Afghan forces have made significant progress in delivering security in Afghanistan. We have taken the fight to the Taliban and have defeated them again and again. However, we have long made clear that progress in Afghanistan will not be achieved by military means alone. The UK supports a politically led approach backed up by military pressure on the insurgents and by targeted development work.

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Viscount Ullswater: My Lords, I thank the Minister for his somewhat encouraging reply. I am full of admiration for the bravery of our troops and for their achievements in very difficult circumstances. However, will HMG open, or perhaps reopen, discussions with the Afghan Government to find a way to legitimise the growth of the poppy crop for commercial production of medical opiates? It would have two benefits: first, it would produce a respectable income for Afghan farmers and, secondly, it would starve the Taliban of the massive funds from the illegal narcotics trade that buy the bullets and bombs with which they continue their murderous attacks on the British, NATO and Afghan troops.

Lord Malloch-Brown: My Lords, I assure the noble Viscount that I sympathise with the spirit behind his Question. In entering this House and the Government I took a long hard look at this issue but was convinced by officials that a Government with such limited capacity would never be able to manage a legal market for opium. This proposal would supplement production and provide a second buyer, in addition to the illegal buyers. It would increase production rather than reduce it as the noble Viscount hopes.

Baroness D'Souza: My Lords, I am reliably told by my Afghan colleagues in Afghanistan that there is a worrying growth in anti-Western feeling or perception. Will the Minister say something about how that might be further and perhaps differently counteracted?

Lord Malloch-Brown: My Lords, the noble Baroness is of course correct. I am not sure that it is as new a phenomenon as she suggests. In fact, some recent opinion poll data suggest a peaking of anti-Western sentiment. We have always felt that we must demonstrate our support for both political progress and reconstruction in the country. Where our military operations touch on civilians, we must ensure that they are done to the highest standard, with the greatest protection possible of civilian lives.

Lord Sewel: My Lords, can the Government convey to the Afghan Government that the British public regard our commitment to Afghanistan to be in support of a noble cause? Can they also convey that that support can only be sustained if the Afghan Government can demonstrate that real progress is being made in the elimination of corruption within their police force and among government officials, and in much more effective control of the illegal poppy crop?

Lord Malloch-Brown: My Lords, I reassure my noble friend that we repeatedly send these messages to the Afghan Government. Corruption is a terrible cancer in that Government; it is partly a consequence of weak capacity and history, but it is unacceptable that it continues when so much Western assistance is given to a country. We hope that that Government will continue to take steps to address it. I certainly also endorse his observation on illegal narcotics. It is enormously important that the leaders of that industry are brought to justice.

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