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Lord Brett: My Lords, stop and search is a vital tool in preventing, detecting and reducing crime. Increases in stop and search reflect the importance of these powers to support effective policing, enabling the police to intervene and disrupt. We are working with community groups to ensure that this power is exercised proportionately and fairly, and raises community confidence.
Lord Sheikh: My Lords, I thank the Minister for that response. The figures show that black people are almost eight times more likely to be stopped than people from white communities. Furthermore, stop and searches under Section 44 of the Terrorism Act have trebled in the past year. The situation in relation to ethnic minorities is disturbing. Does the Minister agree that action must be taken to curb this unacceptable trend and that the police must exercise their powers with care and caution?
Lord Brett: My Lords, the noble Lord asked two questions. On disproportionality, we are not happy with the figures that have been produced. We are working to improve them, the key to which, and indeed to effective policing, is community support. We have therefore put in place a package of measures as part of the police pledge to treat everyone fairly and with dignity. A new form of trial known as POPproblem oriented policinghas been used in Staffordshire which we hope to extend. On the noble Lords second point about the number of people who have been stopped under the Terrorism Act, those stop and searches are for reasons which are well understood, not least what my briefing calls euphemistically the incident in Haymarket in 2007.
Baroness Howells of St Davids: My Lords, is the Minister aware that use of the powers under the Terrorism Act is putting a severe burden on young black men in this country? We are told by the figures that they are more than eight times more likely to be stopped. That trend was reversed after the Macpherson report. Does the Minister have any proposals to ensure that the police use their discretion wisely rather than pick on people who are usually much better citizens than criminals, and who are now being disfranchised of their right to walk the streets of Britain in peace?
Lord Brett: My Lords, as I said in the previous answer, the community has a major part to play. Eighty-seven per cent of the stops were in the Metropolitan Police area. We have an extensive community programme which represents each of the 12 boroughs, with community involvement and independent advisory groups. Those involved meet each month and have before them all the figures on the three forms of stop and search that exist under Sections 44 and 60 of PACE. That is where we want to understand where there has been misuse of stop and search. Guidance is given to police officers, which is built up into a bigger picture. A quarterly meeting takes place with representatives from the entire Metropolitan Police area, including the Metropolitan Police Authority and community groups. Latterly, there has been set up at a national level a stop-and-search community panel chaired by Doreen Lawrence. It,
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Baroness Hanham: My Lords, the Minister referred to a POP in Staffordshire. I am not sure that, if given a broader name, it would be known as the West Midlands pilot, but, if not, perhaps I may ask about the West Midlands pilot on stop and search, which was designed to reduce the number of forms being filled in and resulted, so the Home Secretary claimed, in a greater clampdown on knife crime. When will this pilot be reported on?
Lord Brett: My Lords, the noble Baroness raises two questions. Perhaps I may deal first with the second one, on knife crime. The issue rightly came to great prominence in London because communities in which it was happening were very concerned and supported police in their stop-and-search programmes. Those have been successful in reducing crime in that area. We hope that we shall see an end to the killing of young people in London, or at least a reduction in serious violence towards them. The readiness to carry weapons seems also to have been affected because that, too, has reduced. We hope to maintain the support of communities and young people. I am pleased to say that Operation Blunt on knife and gun crime has had that support.
On the noble Baronesss question about the pilot, it was of course Sir Ronnie Flanagans report which suggested that we should use the expensive but efficient electronic equipment that we have to reduce form-filling. That is ongoing and we believe that it will be successful.
The Lord Bishop of Manchester: My Lords, will the Minister indicate what level of stop-and-search figures there are for the Greater Manchester area and, in so doing, does he agree that the Greater Manchester police force has done sterling work in reducing the level of gun crime in that area in the past 12 months or so?
Lord Brett: My Lords, I join the right reverend Prelate in congratulating the city of Manchester, its police force and the police authority on a very successful campaign against gun crime. I am afraid I do not have the actual figures for Greater Manchester, but I will seek them and make sure that they are sent to him.
Baroness Miller of Chilthorne Domer: My Lords, does the Minister accept that communities generally support the use of the Police and Criminal Evidence Act allowing police to stop people when they have reasonable suspicions, but that it is the misuse of the Section 44 powers under the Terrorism Act that upsets them? Will he make sure that that abuse, where it happens, ceases?
Lord Brett: My Lords, there is a difference. Section 44 powers, which are policed heavilya senior police officer has to be involved and the Home Secretary has to give approval within 48 hoursare used for a particular reason at a particular location and are
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Clauses 1 to 7, Schedule 1, Clauses 8 and 9, Schedule 2, Clauses 10 to 34 , Schedule 3, Clauses 35 to 38, Schedule 4, Clauses 39 to 46, Schedule 5, Clause 47, Schedule 6, Clauses 48 to 50, Schedule 7, Clause 51, Schedule 8, Clauses 52 to 57, Schedule 9, Clauses 58 to 60, Schedule 10, Clause 61.
Baroness Barker: My Lords, I return to the subject of direct payments. Noble Lords who followed the Bill in Committee will remember that although this is a policy that has strong support around the House, a great many questions remain unanswered about how the policy will work in practice and, in particular, about the effects it will have on continuity of service for patients.
Last week, the noble Lord, Lord Darzi, very helpfully shared with the Committee the range of submissions that have been received from primary health trusts and strategic health authorities for the sorts of services that might be provided to patients using individual budgets and direct payments. I thank him for sharing that information. I am moving Amendment 32 and speaking to Amendment 33 at the same time, which I hope will help the House move more speedily through our deliberations. When the noble Lord, Lord Darzi, revealed that there had been applications for services as disparate as maternity care and palliative care, I think that it became apparent that the potential scope of direct payments and individual budgets within the NHS was perhaps far wider than many had believed up to that point. Many who are strong advocates of the policy of giving people either a notional budget or an actual sum of money believed that we were talking about a very limited number of treatments for chronic conditions.
From the information which the noble Lord has shared with us, it is now apparent that these pilots have the potential to bring about enormous change in the way in which health services are planned and delivered. Noble Lords who took part in our deliberations in Committee will have noted that I referred in great detail to the IBSEN report on research into the pilot projects for individual budgets in social care. That was an extensive piece of research: perhaps one of the biggest pieces of research into social care that the department has done in recent years. Yet that report, detailed though it was, still could not answer a great many fundamental questions about the effectiveness and cost-effectiveness of individual budgets.
As I said in Committee, individual budgets in social care may well bring about provider failure. In fact, it is almost certain that they will do so, although provider failure may be less of a problem in social care than it would be in the NHS when we are talking about the potential for acute services to decline. I should inform the House that the noble Lord, Lord Darzi, was kind enough to enable me to meet the officials who will be responsible for commissioning the research into the pilots in health. I am most grateful to him for that.
I understand that the department intends there to be extensive research and believes that particular attention should be paid to the different demographics of people who will have individual budgets and to different conditions, but I still maintain that this is a policy of such potentially profound impact that there is a need for these pilots to be thoroughly and completely researched. Moreover, they should not, as the social care pilots were, be the subject of an announcement well before the research is completed. I remind noble Lords that in December 2007, before the social care pilots had been finished, the then Care Services Minister, Ivan Lewis, announced that individual budgets would be the way forward for all social care. That was misguided.
Amendments 32 and 33 should be viewed together. Amendment 33 would require PCTs taking part in these pilot projects in health to commission information, advice and support services. Noble Lords who took part in Committee will realise that the inclusion of the word support in the amendment is indicative of the
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I also listened to the arguments made by the noble Lord, Lord Darzi, in Committee when he stressed that the department did not wish to be prescriptive in its requirements on PCTs, but I believe that it is important that the House lays down a marker that says that information, advice and support must be provided. Individual users of services are free to ignore such a service and not to use it, but we need to say at this stage that the success of individual pilots depends on people who have individual budgets, and their carers, being able to access support and guidance that will enable them to find their way around a very complex service.
I have one final word to say in support of these two amendments. It is important to say again, as I did the other day, that the pilots in social care were introduced at a time when health and social care funding was being dramatically increased. These pilots will be introduced at a time when public services are facing unprecedented levels of demand. At such a time it would be perfectly understandable if commissioners and providers of services sought to make economies, some of which would be false. It is of the utmost importance for this policy, and for the service users, to include these two factors in the pilots at this stage. I therefore beg to move.
Baroness Wilkins: My Lords, if the noble Baroness, Lady Barker, is speaking also to Amendment 33 then perhaps I may say that I totally support her comments on the importance of support, advocacy and advice. Ensuring that these pilots go well and that any future direct payments in health are a success will definitely depend on ensuring that this amount of support and advocacy are in the Bill. Without that, and, as the noble Baroness says, with the economic situation ensuring that cuts will be made wherever possible, I fear for the future. I totally support her Amendment 33.
The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): My Lords, Amendment 32, laid by the noble Baronesses, Lady Barker and Lady Tonge, would make it an explicit requirement to have an independent review of all direct payment pilots. There is no difference of principle here. We intend to commission a robust and comprehensive evaluation for the pilot programme as a whole. I know that the noble Baroness, Lady Barker, is concerned about the potential effect of personal budgets on other services, as we discussed last week on the first day of Report. We want this to be examined in detail and our recently published tender for evaluation makes that clear. When the time comes, we want the evaluation to help to inform our decisions about the future of direct payments and whether changes need to be made. However, I recognise the importance of the issues which have been raised both today and last week and I accept that there may be a case for being more explicit in the Bill about our intentions. I undertake
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Amendment 33, which the noble Baroness, Lady Barker, also tabled, deals with the provision of advice, advocacy and support for recipients of direct payments for healthcare. It will allow the Secretary of State to require primary care trusts,
from third parties such as the voluntary organisations. Our policy has always been that people should be properly supported. That is the core principle of personal health budgets, as I made clear in Committee and as we emphasised in our policy document, Personal Health Budgets: First Steps. Again, I am happy to consider these issues further in the light of this debate and the debate last week. I shall consult the noble Baroness and report back to your Lordships House on Third Reading. With that commitment, I hope the noble Baroness will agree to withdraw that amendment.
Baroness Barker: My Lords, I really am most grateful to the Minister for agreeing to look at both of these amendments. I agree that they may be technically defective, but I am immensely gratified that he has seen the importance of both issues. I beg leave to withdraw the amendment.
Lord Darzi of Denham: My Lords, the break between Committee and Report has allowed me to reflect on the debate we had on the unsustainable provider regime.
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As I said in Committee, it was always intended that the Secretary of State would give reasons for his final decision. On reflection, I think that the noble Earl made a compelling case for including such a requirement in the Bill. I agree that the Bill will benefit from the clarification on the point to achieve a level of transparency that will help build confidence in this process.
These amendments would place a requirement on the Secretary of State to explain the reasons for his decision in the notice of his decision in proposed new Section 65K(2) and 65W(2). I hope noble Lords agree that this amendment increases the transparency of the scheme, and I thank the noble Earl for suggesting this important improvement. I beg to move.
Earl Howe: My Lords, with this amendment we move to perhaps the most controversial part of the Bill: Part 3. But I should like to bring us backI hope brieflyto the debate that we had in Grand Committee on the provisions in Clause 18 relating to specialist tobacconists. Specialist tobacconists, as many noble Lords will know, are shops which, as their name implies, specialise in stocking cigars, pipe tobacco, snuff and other upmarket products for the connoisseur smoker. They are few in number: there are only about 50 such outlets across the country as a whole.
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