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House of Lords

Monday, 15 December 2008.

2.30 pm

Prayers—read by the Lord Bishop of Norwich.

Prisoners: Voting


2.36 pm

Asked By Lord Pannick

The Parliamentary Under-Secretary of State, Ministry of Justice (Lord Bach): My Lords, in response to the Hirst judgment, the Government committed to undertake a two-stage consultation: the first stage concluded in March 2007. We remain committed to a second-stage consultation, looking at how the judgment could be implemented. In doing so, the Government will need to take account of the wide spectrum of opinion on the issue, as well as the practical implications for the courts, for prison authorities and for the conduct of elections.

Lord Pannick: My Lords, I thank the Minister for that Answer. Can he please tell the House when consultation will begin on implementing the 2005 judgment of the European Court and will he please give the House an assurance that the Government are not seeking to delay implementation of that judgment until after the next general election?

Lord Bach: My Lords, I cannot tell the noble Lord when the second-stage consultation will begin. The second consultation will cover some very big issues, not least how voting rights might be granted to serving prisoners and how far those rights should be extended.

Lord Lester of Herne Hill: My Lords, will the Minister explain to the House how it is that the Republic of Cyprus and the Republic of Ireland, which are not even parties to the Hirst judgment, managed to give effect to the judgment, giving postal votes in the case of the Republic of Ireland, without difficulty? Can he explain why it is that we remain among the top 10 countries in the Council of Europe that have delayed unduly, in leading cases, in giving effect under the convention to our international treaty obligations?

Lord Bach: My Lords, I hope the noble Lord will forgive me if I quote him. He said:

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“Neither I nor the committee—

the Joint Committee on Human Rights—

I remind him that this Government have done more for human rights than any previous Government. I cite the Human Rights Act, the Freedom of Information Act, the Access to Justice Act, the Constitutional Reform Act and the Equality and Human Rights Commission. We have not just talked about it; we have actually done it.

Lord Woolf: My Lords, does the Minister agree that it is very important that the Government maintain their reputation as supporters of human rights, not only for the furtherance of human rights in this country but also around the globe?

Lord Bach: My Lords, I agree with the noble and learned Lord entirely. Of course it is important that our high reputation continues in this field for exactly the reasons that he gives.

Lord Waddington: My Lords, while clearly it is up to states which adhere to the convention to abide by the decisions of the court, some of us find it surprising that a bare commitment by signatories to the convention to hold free elections has been interpreted as a commitment to grant to people in prison the right to vote. In the light of that and other cases, may not the time have come to look at the convention to consider whether perhaps it needs amending, so that while continuing to safeguard basic freedoms, it does not go far beyond that and in some cases—I am not referring to the instant cases—even offend against common sense?

Lord Bach: My Lords, the European Convention on Human Rights, which was first formulated largely by British lawyers in the late 1940s and early 1950s, is something that both Governments have signed up to in the past. I presume that a Conservative Government in the future would support the continuation of it because it represents an important statement of rights. We introduced the Human Rights Act to support it and back it up and I hope that we have support from the Official Opposition for that.

Lord Dubs: My Lords, I am sure that what the Minister said about what the Government have done to further human rights in this country, including introducing the Human Rights Act, will be welcome. It is therefore a little disappointing that, in terms of this judgment, the Government seem to be dragging their heels. Does my noble friend agree that a simple device would be to give these prisoners postal votes and that could be done very quickly? I do not understand what the difficulty is. Can my noble friend explain?

Lord Bach: My Lords, I know that my noble friends feel strongly about this issue. It is not about the liberty of the individual in the sense that so many cases are decided by the European Court of Human Rights. It

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is at heart about policy—a policy that Governments of both colours have supported for many, many years and a policy that probably attracts public support—so of course it is unusually difficult to come up with a satisfactory solution to the judgment by the Grand Chamber. The Grand Chamber said at paragraph 82 of its judgment that the “margin of appreciation” is wide though not all-embracing. It is that margin of appreciation between national member states and the judgment that is so difficult in this particular case.

Lord Elystan-Morgan: My Lords, this is about human rights and the rights of the individual. More than three years have elapsed since the Hirst judgment. In the light of the excellent record of Her Majesty’s Government in relation to human rights, can the Minister give an undertaking that months rather than years will be allowed to elapse before this matter is resolved? Does he agree that, even in the case of prisoners in a prison, the delay of justice is a denial of justice?

Lord Bach: My Lords, I cannot give any guarantee to the noble Lord, sympathetic though I am to him usually. I cannot do any better than quote what my noble and learned friend Lord Falconer of Thoroton, then the Lord Chancellor, said in the foreword to the first document that was published on this in December 2006:

“Successive UK Governments have held to the view that the right to vote forms part of the social contract between individuals and the State, and that loss of the right to vote, reflected in the current law, is a proper and proportionate punishment for breaches of the social contract that resulted in imprisonment”.

That has been the policy of successive Governments. We have to find a way now of implementing the court’s judgment.

Agriculture: Bluetongue


2.45 pm

Asked By Lord Livsey of Talgarth

The Minister of State, Department of Energy and Climate Change & Department for Environment, Food and Rural Affairs (Lord Hunt of Kings Heath): My Lords, we have no plans to ban imports of bluetongue-susceptible livestock into the UK. Movements of susceptible species are governed by EC regulation 1266/2007, which was developed with the best available scientific advice, balancing risks proportionately against impact on trade. Where new evidence has become available, rules have been adjusted. We will continue to consider emerging evidence and any implications for movement conditions, including the findings of ongoing investigation into the recent BTV1 case.

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Lord Livsey of Talgarth: My Lords, will the Minister acknowledge that all cases of BTV1 are a result of importing live animals from mainland Europe? I am aware of what the Minister said about EU rules, but to avoid a catastrophe it is essential that action should be taken now to prevent imports of live cattle and sheep into the UK, which I believe would be a disaster for farming livestock systems in the UK. Is it not now essential to act and persuade the European Commission to give us permission to do this?

Lord Hunt of Kings Heath: My Lords, I certainly agree that it is important to learn the lessons of the case of the imported cattle that were detected with BTV1, although I doubt whether one can draw the conclusion that imports should be banned because of it. Undoubtedly, lessons have to be learnt. We are in discussions with the European Union. The noble Lord will probably know that new proposals were made at the beginning of this month in relation to what are described as preventive vaccination zones. We will look at that very carefully.

Lord Tyler: My Lords, will the Minister confirm that the British Veterinary Association pointed out last week that this form of bluetongue, serotype 1, is not susceptible to any licensed vaccine? Is that not a particular reason for taking action now? Does he recognise that those of us with farming neighbours and constituents who suffered the devastation of foot and mouth, and before that BSE, believe that this looks like the Government dithering and delaying?

Lord Hunt of Kings Heath: My Lords, we are not dithering or delaying. The policy developed by the Government, through advice from the core group on which a great deal of farming interests are represented, is that this proportionate approach is the best one. A vaccine is available but it has not been licensed in the United Kingdom. Of course we will look at these matters very carefully. There is no complacency on the part of the Government but it is essential to take a proportionate approach in this area.

Lord Wedderburn of Charlton: My Lords, will my noble friend comment on the report that this disease affects cattle, or are the Government considering among their options dividing the sheep from the goats?

Lord Hunt of Kings Heath: My Lords, at this time of the year divisions of sheep and goats are always of great moment. Bluetongue is an insect-borne viral disease to which all species of ruminants are susceptible, including sheep, cattle, deer, goats and camelids, which embrace camels, llamas, alpacas, guanaco and vicuna. It does not affect horses or pigs.

Lord Taylor of Holbeach: My Lords, the vaccination programme that the Government have set in train does not provide protection against BTV1. To allow the import of cattle from areas where BTV1 is prevalent is surely to take an unnecessary risk with the health of the nation’s livestock. I do not understand the Government’s position. There is no protection against this disease, so why import livestock from such areas?

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Lord Hunt of Kings Heath: My Lords, the proportionate approach that the Government have taken is consistent with what has been happening under EU regulations and with the advice that we have received through the core group. In the case of BTV1, as a result of the tests that took place on the import of those cattle, the problem was identified, the cattle were culled and further investigations are taking place. We are in discussion with Europe about any further action that needs to be taken. I do not think that that is complacent at all. No one could be complacent, but we have to be proportionate in the way in which we deal with this matter.

Baroness Byford: My Lords, can the Minister tell us whether, in the eight cases that have been referred to, the imports came directly to individual farmers or whether they came via a trader? If the latter, could the Government not look at the way in which this operation is carried out?

Lord Hunt of Kings Heath: My Lords, the noble Baroness is quite right that we need to look at the chain to make sure that all lessons are learnt. In the case that we are talking about, eight cattle left a place in south-west France. The animals are believed to have received the right vaccinations. They left the protection zone just after the minimum 60-day waiting period. We are undertaking further investigations into this matter. I assure the noble Baroness that, if there are issues in relation either to traders or to the farmer himself, we will take them up and investigate. If changes need to be made to the rules, we will make those changes.

Lord Tebbit: My Lords, does the Minister not agree that this Question, like the previous one, underlines the fact that Her Majesty’s Government no longer have the power to act as they might well believe is in the national interest?

Lord Hunt of Kings Heath: Absolutely not, my Lords. Of course this Government act in the national interest. It is in our interest that we work closely with our European allies. The EU has taken a sensible, proportionate approach to dealing with these issues. Considerable discretion is given to this country on the way in which it operates those rules, and we have every ability to argue in Europe for changes in those rules. That is the Government standing up for the national interest.

Older People: Pain


2.52 pm

Asked By Baroness Neuberger

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The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): My Lords, as a clinician, I agree that the assessment and management of pain should be at the heart of all good clinical practice. I therefore welcome this report, which sets out the important issues relating to pain in later life and reflects older people’s experiences. It will raise awareness of important issues among those responsible for meeting effectively the healthcare needs of their local population.

Baroness Neuberger: My Lords, I thank the Minister for his reply. Given that estimates by Help the Aged and others suggest that 5 million older people in the population—possibly including some of us—are experiencing chronic and severe pain, and given that ageist attitudes predominate, as expressed by such statements as, “What do you expect at your age?”, will the Minister assure us that the Government plan to bring forward the timetable for introducing legislation on age discrimination in health and social care to within the lifetime of this Parliament?

Lord Darzi of Denham: My Lords, before I address the noble Baroness’s second question, I must say that it is imperative to understand that no one, irrespective of age, should tolerate pain. I appreciate that awareness in this area is extremely important, because we are living in a century when all of us are getting older and, at the same time, there is a suggestion that pain is a symptom of ageing, which it is not. As far as concerns age discrimination, older people deserve to be treated with dignity and respect in all care settings. That is why the Government are bringing forward the equality Bill that includes a commitment to end unfair discrimination in the NHS.

Baroness Gardner of Parkes: My Lords, among the valuable comments in the document, one is highly relevant:

“Doctors sometimes see us as an illness rather than a whole person”.

Does the Minister agree that although we have wonderful specialist services, we still need to have general physicians because, as in this case, it is sometimes difficult to determine someone’s problem? Is he aware of the wonderful work done by the Chronic Pain Policy Coalition?

Lord Darzi of Denham: My Lords, obviously I support what the noble Baroness said in relation to pain management. This important document will increase awareness among the public and patients. At the same time, it will remind clinicians that they should give higher regard to chronic pain. I take most of the recommendations and could not agree more with some of the other work that has been done in this field.

Baroness Greengross: My Lords, a 2007 report by the Picker Institute referred to pain as a hidden problem. Does the Minister agree that people being left in harmful, unnecessary and sometimes excruciating pain is intolerable? Will he immediately give guidance to the Care Quality Commission to prioritise addressing this issue while we wait for the single equality Bill?

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Lord Darzi of Denham: My Lords, the recommendations in this report highlight a number of things, and I should summarise some of them. Pain management in older people is highly relevant and is often regarded as a normal part of ageing, which is not the case. Clinicians should give high regard to the management of chronic pain. We are aware that self-reporting of pain by older citizens is an issue. We need to identify better ways of assessing pain in older people and in patients with dementia. The management of pain should be looked at in a different way. We all know that there is an altered physiology and that that may impact on the effectiveness of therapy. I could not agree more about the role of the regulator. We have set the standards, the National Institute for Health and Clinical Excellence has clear standards, and the CQC has the role of ensuring that they are met.

Baroness Barker: My Lords, in March 2007, the British Pain Society and the British Geriatrics Society produced a comprehensive evidence-based assessment framework for pain in older people. What is the department doing to encourage take-up of that valuable tool by GPs and secondary care staff?

Lord Darzi of Denham: My Lords, the commissioning guidance for PCTs has taken on board those recommendations. The 18-week chronic pain pathway is part of the commissioning tool. We are strengthening commissioning, and we have an assurance system to ensure that PCTs are working with their providers not just to address acute pain problems in hospitals, but, more importantly, chronic pain management in primary and community settings.

Earl Howe:My Lords, in the light of what the Minister said and implied about the patchiness of services in this area, does he consider that any future review of the national service framework for older people should include a standard to address persistent pain in older people?

Lord Darzi of Denham: My Lords, the noble Earl raises the NSF for older people, which was published in 2001. We need to be much more proactive in the evidence base, and I hope that the national quality boards, which will be created under the health Bill that will be discussed in Parliament in the new year, will address the standards and their updating, including for chronic pain management.

Baroness Pitkeathley: My Lords, my noble friend mentioned self-reporting. Would he agree that older people are notoriously bad at reporting pain and think that they have to put up with it? What role does he see for patients’ organisations in this regard?

Lord Darzi of Denham: My Lords, the noble Baroness has raised an important fact. Self-reporting is a challenge in older patients. Working with patients groups, we need to identify assessment and other tools, such as visual analogue scales or even a visual language scale, by which patients who may find it difficult to communicate will be able to express their pain symptoms.

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