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We deliberately gave the CQC a new wide range of tough, independent enforcement powers, enabling it to take direct and independent action against service providers, and we expect it to do so. We are in constant dialogue with the Care Quality Commission about such issues. We take up these matters of concern, including this one, as part of our ongoing sponsorship of the commission as a regulator.

Lord Rix: My Lords, is the Minister aware that research by the Learning Disability Coalition has revealed a financial shortfall for the social care of people with a learning disability of over £200 million a year for the next five years? Will the Green Paper, due to be published in June, address that issue?

Baroness Thornton: My Lords, I am pleased to inform the noble Lord that the Green Paper, which will be with us in June, will lay out a series of options for reforming the care and support system to ensure good quality and cost-effectiveness. The paper will outline funding systems that are sustainable and affordable for individuals and the state. It will be the start of a dialogue that is of great concern and interest to the noble Lord and many others in the House. That dialogue will then lead to proposals on how to take this forward.

Baroness Wilkins: My Lords, is my noble friend aware that the NCVO’s quarterly charity forecast survey, released today, reveals that almost one in five charity leaders expects to reduce staffing levels by the end of May? People in need of social care rely on the support of a wide variety of voluntary organisations, which face major cuts to their funding. While the recently announced support for the sector is welcome, how and when will those funds be distributed? Charities need assistance now, before the recession has a massive impact on their work.

Baroness Thornton: My Lords, my noble friend points to a very important matter: the role of the third sector in supporting the disabled and elderly, as well as many other groups. Because that extra support is being provided through the Cabinet Office’s budgets to the third sector, I am afraid that I do not know the timetable. However, I will undertake to find out and write to my noble friend.

Lord Waddington: My Lords, is the noble Baroness aware—I am sure that she is—of a case that received a great deal of publicity in the papers the other day? It concerned a council sending its representatives round to somebody’s house with the police who, armed with a battering ram, proceeded to kidnap an old lady and take her out of the care of her daughter. On the face of it, that seemed completely outrageous. Will there be some sort of inquiry into that? It looks to have been a case of a council going completely over the top, simply because the daughter had not gone through the normal procedures to arrange for her mother’s release.



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Baroness Thornton: My Lords, I read of that case and was extremely concerned. I undertake to let the noble Lord know what the department is doing, and what the inquiries are leading to, on that case.

Baroness Barker: My Lords, what is the Government’s advice for people who had intended to fund residential and social care costs by disposal of capital assets but now cannot sell their homes?

Baroness Thornton: My Lords, the department has a scheme in place to assist people in precisely that situation; it is about deferring the payment and sale of houses, so that people do not lose out because of the fall in the value of their homes.

Swine Flu

Question

3.23 pm

Asked By Lord Jenkin of Roding

The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): My Lords, with the changing nature of issues around the swine flu, I apologise to the House if my Answer might seem slightly long. On 27 April, the WHO issued a communication on swine flu and, later in the day, raised the level of influenza pandemic from alert phase 3 to alert phase 4. That recognises that the situation has taken a significant step towards a pandemic. It still does not mean that a pandemic is inevitable, but rather that the threat is increasing. A pandemic is declared only when the WHO raises the pandemic alert to level 6.

As the Prime Minister announced earlier today, we can report five confirmed cases: two adults in Scotland; a 12 year-old in Devon, who travelled on the same plane as the Scottish couple; one adult in London and one adult from Birmingham, both of whom travelled from Mexico when symptomatic. All these infections were acquired from Mexico. In total, 76 cases are under investigation. In response, the Prime Minister also announced further procurements of antiviral stock in addition to face masks and antibiotics. We are also contacting every household in the UK, using television and newspapers, to let people know what they can do to protect themselves and their families.

Lord Jenkin of Roding: My Lords, I am sure that the noble Lord does not need to apologise for giving a very full Answer on a very serious subject. We recognise that a Statement will be made later this evening. However, I would like to pick up what he said about the distribution of antivirals such as Tamiflu. He will know that earlier this year his department gave evidence on pandemic flu to the Select Committee in a long and very detailed paper headed, Plans for Distribution of Antivirals and Testing of Plans. Does he recognise that the key feature of that is a national pandemic flu line service? We were told that this would be,



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But does the noble Lord recollect that on Monday he told the House that the flu line,

What will be the arrangements for the distribution of Tamiflu before the flu line is up and running?

Lord Darzi of Denham: My Lords, as I said on Monday, the flu line will be up and running in the autumn of this year. We have interim measures through NHS Direct to deal with the communications side of obtaining Tamiflu. The NHS is ready for this. We have included it as part of our operating framework. I reassure the noble Lord that COBRA is also looking at this very carefully. We will make further announcements over the next few days.

Lord May of Oxford: My Lords, expert opinion is agreed that the best use of antivirals against flu is targeted local prophylaxis; giving them to contacts in the family and the schoolroom. A month ago, the head of the relevant section of the Health Protection Agency agreed that before the Select Committee, and yet a month ago the policy of the Health Department remained to give this to people who were symptomatic with flu. Can the noble Lord assure us that this policy has either changed in the past month or will be the subject of urgent review?

Lord Darzi of Denham: My Lords, I reassure the noble Lord in relation to the scientific basis of prophylaxis. Our policy is for the HPA to make that risk assessment. Post-exposure prophylaxis is part of that policy. I reassure the House that the 50 close contacts with the young girl whom I mentioned earlier are being given antivirals. The whole school year, totalling 230 children, were also given post-exposure chemoprophylaxis.

Lord Kirkhill: My Lords, will the Minister confirm that when he mentions NHS Direct, that includes NHS 24 in Scotland?

Lord Darzi of Denham: My Lords, I believe that my responsibilities do not extend as far as Scotland. However, I am more than happy to look into that. I understand that the Minister in Scotland has already made announcements in relation to their plans in managing the communications side.

Baroness Tonge: My Lords, can the Minister confirm that there are still stocks available of last winter’s flu vaccine against the H1N1 influenza A virus? Can he further confirm that it imparts some immunity on young people—not all, because it is not specific for swine flu? Can we, therefore, not use those stocks up in vaccinating our young people who are said to be most at risk?

Lord Darzi of Denham: My Lords, we do have a stockpile of 430 million vaccinations in relation to seasonal influenza. The issue is not the stockpile but whether there is evidence that it will have any impact. We are constantly consulting scientists at the moment to see whether there is any benefit of using that stockpile. I agree with the point, but we need the scientific evidence before we start giving people prophylaxis.



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Lord Crickhowell: My Lords, the Science and Technology Committee has also been told by the department that primary care trusts in England are arranging 3,221 collection points for antivirals, yet we have seen a large number of reports in the press in the past couple of days that GPs do not seem to be fully aware of the plans. In view of the fact that antivirals should be given, wherever possible, within 48 hours of the symptoms becoming clear, can the Minister assure us that urgent steps are now being taken to ensure that in all PCTs the information is available to GPs?

Lord Darzi of Denham: My Lords, these stockpiles will be in every PCT and we have plans in which we will let every general practitioner know where the stockpile and the distribution sites are. That announcement will be made in due course, as I highlighted earlier.

Baroness Finlay of Llandaff: My Lords—

The Minister of State, Department of Energy and Climate Change & Department for Environment, Food and Rural Affairs (Lord Hunt of Kings Heath): My Lords, I am sorry, we have reached 30 minutes, but there is a Statement later on today.

Arrangement of Business

Announcement

3.31 pm

Lord Bassam of Brighton: My Lords, with the leave of the House, my noble friend Lady Royall of Blaisdon will now repeat the Statement on Afghanistan and Pakistan. At a convenient point after 7.30 pm, my noble friend Lord Darzi of Denham will repeat the Statement on the swine flu update. Given that the House will have two Statements repeated today, I advise noble Lords that, if Back-Bench contributions to today’s Second Reading were kept to no more than eight minutes, the House should rise not long after the target rising time of 10 pm.

Business Rate Supplements Bill

Order of Consideration Motion

3.32 pm

Moved By Baroness Andrews

Clauses 1 to 5, Schedule 1, Clauses 6 to 23, Schedule 2, Clauses 24 to 32.

Motion agreed.



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Marine and Coastal Access Bill [HL]

Order of Consideration Motion

3.32 pm

Moved By Lord Hunt of Kings Heath

Motion agreed.

Afghanistan and Pakistan

Statement

3.32 pm

The Lord President of the Council (Baroness Royall of Blaisdon): My Lords, I am sure that the whole House will join me in sending condolences to the family and friends of a British soldier from the 1st Battalion Welsh Guards who was killed in southern Afghanistan yesterday.

With the leave of the House, I will repeat a Statement made in another place by my right honourable friend the Prime Minister. The Statement is as follows.

“With permission, Mr. Speaker, following my visits earlier this week, I should like to make a Statement on the Government’s strategy in both Afghanistan and Pakistan. First, I am sure that the whole House will join me in paying tribute to all those serving in our Armed Forces and remembering with gratitude those who have given their lives in the service of our country. As I saw again on Monday, our Armed Forces are facing enormous challenges with great skill, determination and courage. They are the best in the world and we are immensely proud of them.

Our counterterrorist strategy published last month set out how we are working to tackle terrorism around the globe, but one priority, indeed the greatest international priority, is the border areas of Afghanistan and Pakistan, which are the crucible for global terrorism, the breeding ground for international terrorists, and the source of a chain of terror that links the mountains of Afghanistan and Pakistan to the streets of Britain.

Pakistan and Afghanistan are, of course, different countries at different stages of development, but as the document we are publishing today emphasises, together they face the shared challenge of terrorism. In Afghanistan the Afghan Taliban are using mines and suicide bombs to carry out attacks on our troops and on innocent civilians. In Pakistan the army and security services are now dealing with the wider territorial

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ambitions of the Pakistan Taliban. Last year alone in Pakistan itself 2,000 civilians and security personnel were killed in terrorist attacks. Suicide bombs in Pakistan, once relatively rare, were used 60 times last year and are at the same level this year—an almost tenfold rise in just two years. We know that terrorist leaders orchestrate attacks around the world from the border areas. We also know that the stronger connections which now exist between the Afghan and Pakistan Taliban, and between them and al-Qaeda and other terrorist groups, now require us to take further more determined and concerted action.

In our December 2007 strategy, we made the right long-term decisions for Afghanistan, decisions reinforced in the conclusions of the US review last month. Now, following our review to identify what is working and where we need to go further, I want to set out an updated strategy for our actions in both Afghanistan and Pakistan and how we will mobilise our resources to do this.

In both countries we are working with the elected Governments, including through our commitments to support economic development, with combined development and stabilisation spending of £255 million, £256 million and £339 million in each of the last three years, a total of almost £1 billion over three years. In both cases our involvement is focused on the tasks that are necessary to enable these countries to counter the terrorist threats themselves.

For Afghanistan, our strategy is to ensure that the country is strong enough as a democracy to withstand and overcome the terrorist threat. Strengthening Afghan control and resilience will require us to intensify our work in the following areas. First, we will build up the Afghan army and police and the rule of law and we should now adopt the stated goal of enabling district-by-district, province-by-province handover to Afghan control. Secondly, we will strengthen Afghan democracy at all levels, including by ensuring credible and inclusive elections and improving security through that period. Thirdly, we will help to strengthen local government in Afghanistan, not least the role of traditional Afghan structures, such as the local shuras. Fourthly, we want to give people in Afghanistan a stake in their future, promoting economic development as the best way of helping the Afghan people to achieve not just stability but also prosperity.

In Pakistan, our strategy to tackle the same underlying problem of terrorism results in different proposals. First, we want to work with the elected Government and the army. While Afghanistan’s forces are at an early stage, international forces will have to play a frontline role. By contrast, Pakistan has a large and well-funded army and we want to work with it to help it counter terrorism by taking more control of the border areas. Secondly, not least through our support for education and for development, we want to prevent young people falling under the sway of violent and extremist ideologies.

Let me address the proposals in turn. As I said to the House in December 2007, success in strengthening Afghanistan to withstand terrorism will ultimately depend on building the capacity of the Afghans to take control of their own security. So we will work to

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build up the Afghan national army from its current strength of over 80,000 to a total of 134,000 by late 2011. I believe we will need even more numbers than that in the future. Already 300 of our forces in Helmand are dedicated to training them. Nationally we are leading the training of non-commissioned officers and have trained over 18,000. Together with France we have also trained over 1,000 army officers.

Afghan army brigades, as many of you know, have fought bravely alongside our troops, as we saw in a major operation to drive insurgents out of Nad-e-ali earlier this year. Ninety per cent of the Afghan public see their army as an honest and fair institution. The same is not yet true of the police but it must be achieved if the Afghans are to spread the rule of law throughout their country. We already have 120 civilian and military advisers working with the police, and I can tell the House that as resources are freed from the south as the US moves in, we will over time shift the balance of our operations away from frontline combat and towards an enhanced contribution to the training of both the army and police in Afghanistan.

At its 60th anniversary summit earlier this month, the NATO alliance unanimously agreed that supporting the Afghans to build a stronger democratic Afghanistan was its highest priority. Afghanistan is about to hold its second presidential election: a safe, credible and inclusive election is essential. We are providing £15 million for election support and President Karzai has given me personal assurances about his determination to ensure credible, inclusive elections. I also reiterated to him the concerns that we have and which the whole world has over the Shia family law and I welcome his decision to review that draft Bill. I urged him to step up his Government’s efforts to tackle the corruption that has discouraged Afghans from backing democracy against the Taliban. I made clear that we will back the Afghan Government as they take forward the process of reconciliation. Our aim is to divide, isolate and then remove the insurgents, offering to those prepared to renounce violence and accept the Afghan constitution the prospect of work and security. But those who refuse must prepare for a long and difficult battle in which there can be only one winner: democracy and a strong Afghan state.

Just as the Afghans need to take control of their own security, they also need to build legitimate governance. So we will strengthen our efforts on localisation, civilianisation and the promotion of economic development so that the Afghan people have a stake in their own future. Our local joint civilian and military teams are supporting the Afghan social outreach programme in Helmand. In key districts we are helping district governors to reach out to the traditional tribal system through shuras, which, as I saw on Monday, are now empowering local solutions to local problems. To support this we have doubled the number of deployed civilian experts. We are encouraging other countries to follow this example, and urging the United Nations to play a greater role in co-ordinating the civilian effort.

Last month the Secretary of State for International Development announced an additional £50 million for development assistance, and today he is publishing his Afghanistan country plan. Britain remains Afghanistan’s third biggest donor, with more than £500 million

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committed over the next four years. In Helmand, this allows us to support the building of a road from Gereshk to Lashkar Gah and the refurbishment of the hydropower dam at Gereshk, from which up to 200,000 people will benefit. We are also investing £30 million over four years to work with the Government on a new programme of agricultural support that includes the wheat-seed programme in Helmand and gives farmers viable alternatives to poppy and, nationally, improved access to credit so that more Afghans can invest in their farms.


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