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The noble Baroness, Lady Miller, mentioned that she has talked about cybercrime for some time. I have touched on thatit has been growing and we have been aware of it. The reason we have gone about it the way we have is that the connectivity increased and the capability of attacks got bigger. We needed to co-ordinate it more, and that is why we are where we are. However, it is a complex thing, and to get all these people to work together is complex and difficult. We are very lucky in this countrywe have some remarkably capable people, and we need to grow more of them. We need to become a centre of excellence in the world, because we are ahead of anywhere else. We worked really closely with our American cousins and there are very close links between GCHQ and the NSA. But of course they are in a far worse place than us because they were connected up long before we were. They were using computers and talking to each other when we were still on quill pensnot quite, but you know what I mean. But as we came into that computer age later, our government net, for examplethe gsi.gov.uk nethad a very restricted number of portals. It is quite difficult for people get in, and we know the number of attacks. The American system has more than 8,000 portals in its government network. We know from some of our pointy-headed hackers how easy it is to get into it, and therefore the Americans have a real problem to resolve. We are working very closely with them on this, and in fact we were doing this work at the same time, if not before, them. Therefore, it is rubbish when people say that President Obama has grabbed this, that he has jumped ahead of us and that we are not catching up. We have been working with the Americans and I think that we have delivered a great deal.
The noble Baroness, Lady Miller, mentioned the EU convention. We are still working on that, as there are complexities and difficulties within government. The ethics part is for individuals but aspects of law are also involved. We have to get all these things right. We are still working on that and we hope that it will be completed fairly soon.
The noble Baroness is absolutely right about individual members of the public. Although I have now been made the Minister responsible for cybersecurity, I sometimes feel like an ingénu? in this area. It is quite daunting and horrifying to see how people who want to get money out of you or cause damage can fool you into giving up data. Part of this whole package is intended to teach our people so that they are aware of the risks. Very often, the weakest link in any net is the human being. People are sent something, they open it
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As I said, far from this being done somewhat late and in a bit of a rush, I think that we have acted in a timely and sensible way. There is no confusion or duplication; we are tying things together. Very shortly, the Home Office will produce something on serious and organised crime. We are addressing every one of these areas and pulling them together. I think that what we have done is rather impressive, but I had better stop now and allow more questions to be asked.
Lord Jopling: My Lords, I thank the noble Lord for his Statement. However, does he agree that measures to address the threat to states from cyber attack have to be global and all-inclusive? I hope to heaven that he does agree with that. If he does, is it not quite extraordinary that the only short passage in his relatively long Statement referring to the global impact and the global measures that are needed is where it says that the Government will,
That is only a tiny fragment dealing with the essential urgency of a global approach to these matters. One cannot help but come to the conclusion that the Governments approach to this, once again, is all talk and no action.
The Minister has been boasting about what the Government have done but perhaps I may ask him two questions. First, if the Government regard this massive threat as urgent, why has the Council of Europes Draft Convention on Cyber-crime, which the United Kingdom signed seven and a half years ago in November 2001, not yet been ratified? What could the reason be for that? Secondly, NATOs Cyber Defence Management Authority has been operative since April last year. The United States has signed up to it but the United Kingdom has not. All this adds up to the irresistible view that the Government have spent these past years half asleep in relation to these matters. What are they going to do to harness the serious threat of cybercrime on a global scale?
Lord West of Spithead: My Lords, we have a set of work streams and one that the office for cybersecurity will tackle relates to international engagement. We are engaged internationally. As I said, we are almost joined at the hip with the US, and that stems from the agreement signed in the late 1940s between the NSA and GCHQ. We are working very closely with the US on its huge project to sort out the problems that it has in this area. Indeed, at times the US has used us to help in finding out what some of the problems are. We are working with the US very closely, as we are with
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I mentioned to the noble Baroness, Lady Miller, that we are working on the agreement with Europe, which we hope to have ready soon, although there are complexities in these matters. I agree entirely about NATO, and I think that we will have to put in more effort there. That is why I want an international engagement stream, because I believe that we need to be closely involved. It is a global issue, although I think that there is a difference of equity among people. We have a greater understanding with the US by a quantum amount than we do with almost any other country. However, that does not mean that we do not need an international work stream, and that work will be done.
Lord McNally: My Lords, my locus in this is that, when I was in the position of my noble friend Lady Miller, I worked on the pre-legislative scrutiny of the Communications Bill and the RIPA legislation. I listened to the Minister and heard his passion for co-ordination. Perhaps I may ask him to think again and not just to give an off-the-cuff reaction to the idea put forward by the Constitution Committee and my noble friend for a Joint Committee to look at these issues. The more he spoke, and the more enthusiasm he expressed, it seemed that the bit of co-ordination missing from the puzzle was parliamentary oversight. Therefore, that suggestion for such a committee bears re-examination.
When we carried out pre-legislative scrutiny of the Communications Bill, we took a conscious decision to leave the internet out of the scope of parliamentary legislation. It was felt that it was such a wonderfully dynamic opportunity that it was wrong to encumber it with legislation. However, should the amazing growth of technology be revisited or should the internet still be free?
Linked to that, I also worked on the RIPA legislation, where it was often a case of the blind leading the blind. I make no comment about the noble Lord, Lord Bassam, but certainly some of the technology went way above my head. I remember that we built in quite strong safeguards for civil liberties. My noble friend asked whether the RIPA legislation was still fit for purpose in term of developments in technology.
Finally, I went to a very interesting briefing by Vodafone the other evening, where, again, the convergence of technologies was explainedthe phone as a computer with access to the internet and so on. To make this work, we will have to have an active buy-in by private companies with commercial considerations as well as national and international obligations. Is the Minister sure that we can get the buy-in from the private sector for the objectives that he has set out?
Lord West of Spithead: My Lords, the noble Lord raises a number of very important issues. As noble Lords will know, we are looking at the RIPA legislation because we are not convinced that it is being used by, for example, local councils in the right way. That was never intended and we want to ensure that that is resolved and that there is proper guidance. Without a doubt, we need to look at the legislation in that context.
As regards ethics and the Joint Committee and the question of parliamentary oversight, there is of course the committee for the national security strategy. I thought that it would have been named already, as I know that it is being talked about in the other place with the Speaker and so on. It will have some oversight of the national security strategy. I undertake to look at cybersecurity on its own and see whether the committee will cover that, or whether we need, with the ethics committee, some other joint aspect. So I commit to that, but I would not want to give an off-the-cuff answer on it. The matter is too complicated; some of it will be the business of people within the other place as well as here, and to say more would be beyond my remit.
One feels at times that the internet is a bit of an ungoverned space. The noble Baroness, Lady Miller, has often mentioned the issue of deep packet inspections and the like, and I have some concern about that. We have managed to get a lot of voluntary agreement on things such as child pornography, which is super, and I am pleased that we have achieved that. However, it proves more difficult in some other areas, and the internet is now so all-pervasive that we will have to think about this. At the moment, though, there is nothing planned, and we would have to think about how to move forward in a very broad, all-party context. So we are not doing anything, but it is a nagging concern at the back of my mind.
Some of the CSPs and ISPs have been very good about working with us. BT, for example, has been fantastic: it has engaged with us and helped us in saying, Weve had this many attacks; this is happening; what about trying this?. It works closely with us, as generally these companies do, but some are better than others. All of them, though, are beginning to understand that, given the state threats, the threats from serious and organised crime£50 billion a year or so is lost around the world, and that amount is getting bigger all the timeand the threat to each individual, such as identity theft or bank account attacks, it is in all our interests to work together, and I think that generally they will.
Moved By Lord Walton of Detchant
To call attention to the role of the National Health Service in learning from and promoting medical and scientific research, clinical teaching, health care delivery and social enterprise and cohesion; and to move for Papers.
Lord Walton of Detchant: My Lords, the United Kingdom has a proud record of achievement in medical research. It has received more Nobel prizes for physiology and medicine than any other country of comparable size, and it stands high in the world in the citation indices of peer-reviewed publications in medical and scientific journals. In this debate I shall concentrate on medical research and teaching and upon the vital contribution of the NHS, and I shall leave my noble friend Lord Mawson to discuss how the NHS contributes to social enterprise and cohesion.
In the 64 years since I became a doctor, advances in medical and scientific knowledge have been astonishing, and my theme today is to convince your Lordships that todays discovery in basic medical science results in tomorrows practical development in patient care. This is translational research, meaning that basic scientific discoveries are translated into new methods of management of disease and its prevention. For anyone practising medicine before the NHS, as I did, the vast range of new and effective drugs has been phenomenal. Serious diseases which I saw as a young doctor, like diphtheria, poliomyelitis and scarlet fever, are rarely, if ever, seen, due to effective vaccination, while rubella, which may damage the foetus in a pregnant woman, and mumps are now controlled. Measles, too, should have virtually disappeared in the UK, were it not for the misguided campaign, based on flawed research, that caused the MMR vaccine scare.
With new antibiotics emerging, many bacterial infections have been defeated, but antibiotic resistance has caused the emergence of strains like MRSA and drug-resistant tuberculosis, while AIDS, still a major challenge, is now more effectively controlled by appropriate medication. Methods used when I was a young neurologist to identify the cause of strokes and to locate brain tumours, for example, often involved great discomfort and potential risks, but new methods of imaging, such as CT and ultrasound scanning, magnetic resonance imaging and its functional variant, have given us information about abnormalities in the bodys internal organs undreamed of a few decades ago.
Admittedly, there are still some incurable diseases, not least in neurology, even though developments in molecular biology, including gene identification and the discovery of the missing or abnormal proteins resulting from such gene defects, have raised hopes of new treatments for many such conditions, perhaps by gene therapy or other variants. The prospect of the repair of damaged tissues, so-called regenerative medicine, sometimes using adult stem cells but more often using the highly effective pluripotential embryonic stem cells, which can readily be converted into nerve cells, liver cells, kidney cells, heart cells and indeed many cell types, brings within sight the prospect, if not of immediate cure, certainly of amelioration.
As I always told my students, though, while there are still many incurable diseases, none is untreatable. All can have their effects modified by pharmacological, biological, physical or psychological means. I quote as an example the improved care of patients with the most severe form of muscular dystrophy, the Duchenne type, affecting young boys, who have progressive difficulty in walking and are confined to a wheelchair from about the age of 10. When I first began research in the 1950s, many such boys died in their mid-teens from heart failure or respiratory infection, having become grossly deformed through neglect of supportive measures. Now, in specialised centres such as London, Oxford and Newcastle, where ventilatory care is available, the average age at death of these boys is in the 30s, whereas in the south-west of England it is still in the late teens. As a result of a detailed survey by an All-Party Parliamentary Group and the Muscular Dystrophy Campaign, improvements in services for
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I must mention briefly the issue of stroke. This country has been lagging in its introduction and development of stroke units and in introducing new and improved methods of treatment. We know now that if one can recognise stroke and one regards it as an emergencythe public, the paramedics and the medical profession need to be much better informed about thisand if a patient is admitted within the three-hour deadline and can have an immediate scan to demonstrate whether the stroke is due to an infarct, as the result of the blockage of a vessel or a haemorrhage, then, if it is an infarct, clot-busting drugs and thrombolysis can improve the condition greatly. At the moment only 1.5 per cent of patients with ischaemic stroke in the UK are receiving thrombolysis. This is unacceptable, and measures must be taken to improve that position.
Many years ago, as a member of your Lordships Select Committee on Science and Technology, I chaired an inquiry into research in the NHS. Our report was endorsed by the then Conservative Government, who accepted that while much research and many treatment trials were being conducted in the NHS, there was no dedicated line of funding for health service research. Concerns then about the freezing of clinical academic posts in universities, appointments that involved not only teaching and research but also patient care, led to a major decline in recruitment. That inquiry led first to the Culyer report on NHS research, the Richards report on clinical academic medicine and, several years later, the outstanding Cooksey report on NHS research. Dame Sally Davies now presides over a National Institute for Health Research, supporting much research in the NHS.
The Conservative Government responded to our report by agreeing that 1.5 per cent of the NHS budget should ultimately be devoted to R&D, but the figure has never yet exceeded 0.9 per cent. While that is substantial, in view of increased NHS funding, what plans do the Government have to increase this figure to somewhere nearer the agreed target? Might additional academic health science research centres be established in places that narrowly missed out in the first tranche? As the recession bites, may we also hoperecent government statements are encouragingthat increased government spending on science, especially in the annual grants to the Medical Research Council and the BBSRC, will be maintained?
We must also acknowledge the massive support of research funding provided by the Association of Medical Research Charities, of which the Wellcome Trust is pre-eminent, although the disease-oriented charities have also made crucial contributions. In my view, it was a sad day when, some 20 years ago, the Advisory Board for the Research Councils removed infrastructure funding from the University Grants Committee, funds specifically allocated under the dual-support system to provide well-found university and hospital departments and laboratories, and passed that money to the research
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The Charity Research Support Fund, introduced by government and providing infrastructure funding for charity-funded research, is, I fear, inadequate, and I would welcome the Minister's comments. A recent survey by a notable charity found that only 5 per cent of 245 researchers funded by charities considered that fund adequate. One-third of those researchers found that universities were becoming increasingly reluctant to support applications for charities for research grants for that reason.
The NHS does, of course, play a vital role in the undergraduate and postgraduate education of doctors, nurses and other healthcare professionals. I was disappointed that education was not highlighted in the NHS Constitution. I shall be interested to hear from the Minister how the proposed health innovation and education clusters will nurture such education. The doctors and nurses of tomorrow are dependent on the facilities of the NHS for their undergraduate and postgraduate training. Do the Government accept that we must maintain the opt-out from the European working time directive for young trainee doctors? The restriction on working hours will have an adverse effect on training, and surgeons in particular are deeply concerned that, under the restricted hours now proposed, the training of surgeons will suffer.
Has the MTAS scheme proved a disincentive for young doctors wishing to take time out from training to undertake research? When I was head of a department, many young men and women came to the department in the course of trainingas registrars and senior registrarsbefore moving on to apply for consultant posts, but a very large number of them took a year out from their formal NHS training to undertake a programme of research. I am informed by many heads of departments that, because of the MTAS scheme, that is becoming increasingly difficult for many young doctors to do. In my view it is crucial to recognise that a period of time spent in research nurtures the development of young doctors who benefit from that, and in the end it improves their ability to undertake practice and clinical care.
Happily, the NHS continues to fund many clinical academic posts in our universities, recognising the crucial role that such individuals play not only in teaching and research but also in patient care. Initiatives of the Academy of Medical Sciences and the Wellcome Trust in supporting clinical academia have been admirable, so that academic medicine is now in better heart. However, there are storms on the horizon as some health service trusts and even foundation trusts have questioned the need for such posts to be funded by the NHS. Does the Minister agree that the vitality of clinical academic medicine is essential if high quality research, teaching and patient care are to be maintained?
Finally, the NHS offers an ideal environment for clinical trials of new forms of treatment, trials often expertly assessed by the National Institute for Health
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For more than 40 years I was stimulated and inspired by my responsibilities in clinical academic medicine, involving teaching, patient care and research. I firmly believe that those three branches of academic activity are interdependent and mutually beneficial, and that the NHS is probably the finest clinical laboratory that exists anywhere in the world for the pursuit of clinical and translational research with the objective of improving disease prevention, treatment and cure. May it continue to flourish. I beg to move.
Lord Woolmer of Leeds: My Lords, I congratulate the noble Lord, Lord Walton of Detchant, on obtaining the debate today and on the typically informative and vigorous way in which he has introduced our discussion. I pay tribute to him for his distinguished medical and academic career in this area. As a non-medic, among a number of distinguished medics who are to address your Lordships this afternoon, I shall speak with some humility about the issue of quality. To set the scene, I shall talk about quantity. Ninety-three per cent of patients requiring admission to hospital are admitted within 18 weeks; not many years ago the waiting time was two years. In quantity terms there has been a real improvement.
When I was an MP, 30 years ago, I got to know someone in my constituency who had cataracts in both eyes. He was a working-class man who was quite poor and could not afford private treatment. He was virtually blind but he never received treatment in the health service before he died. Now there are 250,000 cataract operations a year and the average wait is 10 weeks. I often think of that man when I consider that statistic.
As regards hearing, I declare an interest in that one of my granddaughters was born profoundly deaf. Under the National Health Service, she had cochlear implants on both sides and, thank goodness, she is a very vigorous and energetic four year-old. Hearing is a very big problem for a lot of people: 400,000 people a year are referred to audiology departments. They are not the big glamour operations for many people but they are very important to people's lives. That is the quantity issue and I now turn to the issue of quality.
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