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House of Lords

Wednesday, 5 November 2008.

The House met at three o'clock: the LORD SPEAKER on the Woolsack.

Prayers—Read by the Lord Bishop of Chelmsford.


Lord Teverson: My Lords, I beg leave to ask the Question standing in my name on the Order Paper. In doing so, I declare an interest, in that my wife’s daughter is married to a non-British citizen.

The Question was as follows:

Lord Brett: My Lords, the Government are committed to a policy of supporting managed legal migration to the UK, from which our economy and society derive great benefits. For those seeking to settle in the UK as spouses, it is important that we have provisions to enable us to differentiate between genuine and failed or sham relationships. The Immigration Rules facilitate the entry of those in genuine relationships, while preventing abuse.

Lord Teverson: My Lords, I thank the Minister for that reply. I know he takes a great interest in this area. However, can he assure me that the only test that is relevant to a British citizen being able to live with their non-British husband or wife in the UK is that the marriage is real? That should surely be the only test. Should not the state avoid getting involved in anything beyond that?

Lord Brett: My Lords, my interest in this subject is enhanced by the Question, and other questions of this sort. The test the noble Lord mentions is important but it is not the only test. A number of rules are required to be followed as regards migration of spouses or others. We have a two-year probationary period to ensure that a distinction is made between genuine and potentially sham relationships. We have a requirement as regards seeking and achieving proficiency in the English language and a requirement that spouses entering from abroad will be supported for two years without being a burden on the state. These are important parts of our migration policy and of our ability to sustain and support the relationships of which the noble Lord speaks.

Lord Palmer: My Lords, I recently married in the Palace of Westminster a resident of Texas. My spouse was told that she had to travel half way round the world in order to get her visa. Surely in these days of modern technology, particularly with the internet, she ought to have been able, without leaving the United Kingdom, to get her passport stamped to state that she could reside here as my wife.

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Lord Brett: My Lords, I still seek the first Question Time when I will not have to say, “I shall write to the noble Lord”. On this occasion I congratulate him on his new-found status and on the fact that his bride is from Texas. I trust that she is celebrating the new American presidency today, as are most Americans.

Lord Anderson of Swansea: My Lords, there are frequent allegations that marriage is one of the greatest sources of abuse of our immigration system and that at the end of the two-year period there is very limited monitoring of whether marriages still subsist. What proposals do the Government have to meet these anxieties?

Lord Brett: My Lords, continuing my previous theme, it is nice to say, “Yes we can”. We are concerned about the danger of forced marriages and that is why we have a monitoring period. A unit was launched by the Foreign and Commonwealth Office and the Home Office in 2005 to look at marriages which may not be genuine and may be forced. The UK Border Agency is in the process of developing a code of practice to deal with alleged forced marriages. There are 300 to 400 cases per year, mostly involving young women, and these are the subject of investigation.

Lord Avebury: My Lords, in their response to the consultation document on marriage visas, the Government say that they are not sure that the existing powers to revoke ILR after two years for reasons of deception are sufficient in law, and that they may need to put something into the Citizenship, Immigration and Borders Bill that is coming up in the Queen’s Speech. An inquiry was being made into that by the Forced Marriage Unit. Has that come up with any results? Have the Government decided whether it is necessary to extend the law in the way that was foreshadowed?

Lord Brett: My Lords, I should perhaps make it clear that the English language provision is a requirement not for entry but for settlement. The document Marriage Visas: The Way Forward was published this summer. It was widely consulted on; some 120 organisations were consulted. There seems to be broad support for the Government’s position, but it is a developing situation, and one cannot anticipate the Queen’s Speech.

Lord Greaves: My Lords, the Minister emphasises that new spouses coming to this country need to learn English. Would it not be sensible to give them free English lessons rather than make them pay for those lessons?

Lord Brett: My Lords, there is a long answer and a short answer. The short answer is, “I think not”.

Lord Campbell of Alloway: My Lords, does the noble Lord accept that when he said that that is not the only test, there was a sigh of relief in the House?

Lord Brett: My Lords, the sigh of relief on that occasion may have been for the short answer that I gave rather than anything else. Primarily, it is a balance between what we require of migrants, whether spouses or others, what they contribute to our society and how we support them. The Government’s balance is about right.

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Lord Swinfen: My Lords, are the two spouses interviewed separately when applying for a visa? That would give an opportunity for someone being forced into marriage to declare that fact.

Lord Brett: My Lords, I suppose it depends entirely whether the interview takes place in the country of origin or the country of receipt. I will write to the noble Lord on that point.

Baroness Howells of St Davids: My Lords, will the Minister indicate the specific actions that the Government will be taking when dealing with the spouses in forced marriages?

Lord Brett: My Lords, the point of dealing with forced marriage is to ensure that young people—not just women; some 15 per cent of cases involve men—are not forced into marriage by whatever form of coercion, whether threat of physical or emotional harm or the threat of bringing shame on the family. Forced marriage is not permitted in the United Kingdom. That is why we have a serious investigation into each individual case, and that is why we are raising the age at which someone can sponsor or be sponsored to be a spouse from 18 to 21. That comes into effect on the 27th of this month.


3.13 pm

Lord Jopling asked Her Majesty’s Government:

The Minister of State, Foreign and Commonwealth Office (Lord Malloch-Brown): My Lords, first, I am sure that the House will wish to join me in sending our profound condolences to the family and friends of the soldier of 2 Battalion the Royal Gurkha Rifles who was killed in Afghanistan yesterday.

On 12 December 2007, the Prime Minister set out the UK’s long-term comprehensive framework for security and for political, social and economic development for Afghanistan. The strategy sets the strategic objectives for Her Majesty’s Government as a whole. We will have succeeded in Afghanistan when the democratic Government of that country have built sufficient capacity to maintain a stable security situation and the rule of law, enabling them to extend governance, reduce the drugs trade and build a successful economy.

Lord Jopling: My Lords, I join the noble Lord in sending condolences and thank him for that Answer. Do the Government agree with Brigadier Carleton-Smith that there is no exclusively military solution in Afghanistan? Does the noble Lord agree that that implies that, in the end, there will have to be talks with all sides, maybe including the Taliban? Given the fact that there is a new Administration in the United States, which hopefully and mercifully promises to be more subtle, more realistic and, above all, more multilateral than in the past—indeed, the President-elect has already this morning talked about repairing alliances—will the Government start now, with the Americans and others, to prepare ways best to conduct those talks, when the time is appropriate for them to begin?

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Lord Malloch-Brown: My Lords, I assure the noble Lord that, although we feel the need to prevail militarily in Helmand and Afghanistan, we have always and consistently been clear that a military victory alone will not secure the stable peace that we wish for; it is necessary to have a political track as well. The Government of Afghanistan must reach out to tribal leaders and other groups who have aligned themselves with the Taliban and bring them back onside. We are already working with General Petraeus, the new commander, and we have seconded individuals to his team to prepare strategic options for the new President.

Lord Ahmed: My Lords, are the Government of Pakistan assisting NATO and United States forces to achieve our strategic goals? Why is it necessary for NATO and the United States to bomb inside Pakistan? Does my noble friend agree that a destabilised Pakistan is more dangerous than a destabilised Afghanistan?

Lord Malloch-Brown: My Lords, I assure my noble friend that NATO is not bombing inside Pakistan. What he has in mind is a United States action, which is primarily a matter for the United States and Pakistan to resolve. However, I certainly confirm to my noble friend that we all believe that the newly elected democratic Government of Pakistan must be allowed to prevail. Were it to fail, that would be a great setback for all our objectives in the region.

Lord Imbert: My Lords, have we failed to learn the lessons of history in central Asia? We have had an obsession with Afghanistan for more than 200 years. We have seen other nations leave Afghanistan with their tails between their legs. If we fail to equip our troops properly to do the job with which we have charged them, will we see another infamous and humiliating retreat from Kabul, such as that which this country suffered—the historians in this House will correct me if I am wrong—in 1842?

Lord Malloch-Brown: My Lords, while I, like the noble Lord, am a great respecter of history, I say to him that this action in Afghanistan is driven by the astonishing international attack made on 9/11 against the United States. The whole world came together to endorse action to ensure that never again would Afghanistan be a haven for such terrorists. As to vehicles, we have just committed some £30 million to upgrade the Snatch vehicles, although I know that they are controversial to some. Last week, we also announced the procurement of nearly 700 new vehicles and the upgrading of 200 more, because we must have the right equipment for our troops.

Lord Ashdown of Norton-sub-Hamdon: My Lords, will the Minister accept that, whatever the Prime Minister may have said a year ago, the baleful fact remains that the dynamic is increasingly moving against us in Afghanistan? If this is to be turned around, while more troops and resources may be necessary, they will not be sufficient unless they are backed by two factors, which we still do not have. The first is an international plan with clear priorities, prosecuted by an international

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community capable of speaking with a single voice. The second is a regional context that can play among Afghanistan’s neighbours. Without those two things, more troops and more resources will not be sufficient.

Lord Malloch-Brown: My Lords, although there have been some setbacks in the situation in Afghanistan, I think that it is too strong to say that the dynamic is running against us there. The asymmetrical warfare adopted by the Taliban with the targeting of civilians has led to civilian casualties across the country, which is to be deeply regretted. However, I certainly agree with the noble Lord that we need an effective, coherent international strategy, which we and the Americans are working with our allies in the United Nations to achieve. I certainly endorse his suggestion that having regional neighbours as partners is critical to success.

Lord Howell of Guildford: My Lords, we on this side share in sending condolences to the bereaved of one more hero killed in Afghanistan. We also endorse what the noble Lord, Lord Ashdown, wisely said about the desperate need for a more effective, unified command. Obviously, we will have to wait a couple of months before we hear the new American policy, although it seems to include more troops and modest ambitions, in the words of Mr Obama. From our point of view, how do we view the questions of more troops, better equipment and closer co-operation with Pakistan? This may be rather a daring thought, but is there any mileage in trying to get some co-operation even with Iran, which has the same objectives as we have over a wide area in Afghanistan?

Lord Malloch-Brown: My Lords, the noble Lord will agree that we need to wait and see what the new President’s strategy is. There has been a lot of speculation but he now needs an opportunity to develop his thinking. We certainly believe that additional troops can be useful but we have always made it clear that that must be combined with an appropriate political approach. We hope that the American approach will emphasise both things. With a new leader committed to multilateralism, as the noble Lord said earlier, we very much hope that this will be an opportunity for NATO to re-engage and that the new President, Mr Obama, will use some of his new-found multilateral authority and friendships to bring a broader NATO commitment back to this operation.

NHS: Accident and Emergency

3.22 pm

Baroness Masham of Ilton asked Her Majesty’s Government:

Baroness Thornton: My Lords, most patients’ experience of accident and emergency has improved dramatically in recent years. In 2007-08, nationally 97.9 per cent of patients were admitted, transferred or discharged within four hours of their arrival at accident and emergency,

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against a four-hour standard of 98 per cent. Of the 157 acute trusts that provide accident and emergency services, 45 did not achieve the standard for the whole year, but that is improving this year.

Baroness Masham of Ilton: My Lords, I thank the Minister for that reply. Is she aware that on 13 October at 9.15 in the evening I went to St Thomas’ A&E department with cellulitis and that the waiting time was five and a half hours? Is she aware that no one checked the patients, who included two small babies who were breastfeeding, during that time? It was a very uncaring situation. Does she agree that, with drug-resistant TB, this is a very unsatisfactory situation?

Baroness Thornton: My Lords, the accident and emergency department at St Thomas’ is the one most frequented by noble Lords during their working week. I include myself in that, having taken a tumble in the Chamber and sprained my ankle some years ago. The fact is that during 2008-09 98.2 per cent of patients at St Thomas’ were seen, diagnosed and treated within four hours, although that does not mitigate the noble Baroness’s unsatisfactory experience. Nevertheless, the hospital seems to have given her clear information, however unsatisfactory, on which to base her decision and course of action. That would have been based on the particular situation at the time, although I do not know what that was. The aim is for a range of emergency care services to be available. We expect all patients to be seen according to their clinical needs, and they should receive high-quality and timely care.

Lord Dubs: My Lords, how do waiting times today compare with those in 1997?

Baroness Thornton: My Lords, the figures for 1997 were not collated, but in 2003 almost a quarter of patients spent over four hours in accident and emergency departments. Patients have told us over and over again that waiting times are a priority for them. It is worth noting that in the 1990s it was not uncommon for patients to wait on trolleys for up to 12 hours. Today, however, due to the hard work of NHS ambulance drivers, paramedics, nurses, doctors and other staff, and a large investment in services, that occurrence is quite rightly a matter for public comment and action by the trust in question.

Baroness Trumpington: My Lords, does the Minister share with me a feeling of enormous admiration, gained through personal experience, for those who work in the emergency departments? They often have to work in extremely unpleasant and dangerous situations, and they do so with terrific grace and efficiency. Perhaps I may also ask whether it is true that one is no longer allowed to send flowers to people in hospital. If she does not have the answer now, perhaps she could write to me.

Baroness Thornton: My Lords, I need to declare an interest: my brother is an ambulance driver. So, I completely concur with the noble Baroness’s comments. I will write to her about sending flowers. I do not think that that is the case. I have just dispatched some to someone in hospital, so I hope that it is not.

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Baroness Tonge: My Lords, I share the noble Baroness’s gratitude to all doctors and nurses working in casualty departments. But can the Minister tell us whether there is any evidence that NHS managers are indulging in a little creative reporting, such as discharging casualty patients after four hours and then readmitting them, or counting intermediate, casualty beds, A&E beds and assessment beds as in-patient beds? I should declare an interest. At one time I was a health service manager, but not in A&E.

Baroness Thornton: My Lords, there have certainly been accusations along the lines that the noble Baroness has outlined and we take them extremely seriously indeed. Any substantiated case of misreporting would obviously be considered a very serious issue. All the data received by the Department of Health should have been certified as accurate by the NHS trust and the chief executive. Anyone who thinks that any manipulation has taken place should certainly raise it with their medical director or chief executive.

Baroness Finlay of Llandaff: My Lords, I declare an interest as my daughter is an A&E trainee. Can the Minister tell us what investment is being made in minor injuries units and in units able to cope with patients who present at A&E because they have not, for whatever reason, been able to see their general practitioner? This group inflates numbers and detracts staff from cases involving major trauma and illnesses that may require a lot of time for complex decision-making, with a risk that patients are speeded through under pressure from the clock.

Baroness Thornton: My Lords, the noble Baroness raises a series of very interesting points, as usual. There is no reason why accident and emergency departments and the trusts that run them should not know the demands which will be placed on them from either a transient population or a very young population. They should be prepared to have the resources available. We now have 94 per cent more A&E consultants, 600 per cent more A&E registrars and many, many more nurses. The fact that we have to provide emergency care in a variety of different forms should not mean that any less care is taken.

Baroness Pitkeathley: My Lords, I understand that many incidents in A&E are alcohol-related. Can my noble friend tell the House how closely the part of her department that oversees A&E is working with the part of her department that deals with education about alcohol?

Baroness Thornton: My Lords, my noble friend points out something that is very important and that we are very well aware of. I do not have the details of how they are working together but will write to her about it. I suspect that they are working closely together because the issue has such a major effect on service delivery in A&E departments.

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