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The Health Select Committee's report praises the Government for being the first in the world to adopt a policy that makes patient safety a priority and welcomes the creation of the National Patient Safety Agency and the work of the National Reporting and Learning System to facilitate systematic reporting and learning from adverse events involving patients.

The committee was concerned that not all services are safe enough yet and made several recommendations for the future improvement of patient safety.

The government response welcomes the Health Select Committee's report and sets out the measures that the Government have been taking to improve patient safety as part of their quality agenda.

Today's publication is in the Library and copies are available to honourable Members from the Vote Office.

Identity Cards


The Parliamentary Under-Secretary of State, Home Office (Lord West of Spithead): My honourable friend the Minister of State for Borders and Immigration (Phil Woolas) has today made the following Written Ministerial Statement.

I am pleased to announce that provisions in the Identity Cards Act 2006 are being commenced as from Tuesday 20 October 2009 so as to enable applications to be made for identity cards at a fee of £30. This will apply to people working in the Home Office, the Identity and Passport Service and elsewhere who are engaged on work relating to the issue of identity cards, and will be extended later in 2009 to residents of Greater Manchester and airside workers at Manchester and London City airports and in early 2010 to other locations in the North West.

Legal Aid


The Parliamentary Under-Secretary of State, Ministry of Justice (Lord Bach): My right honourable friend the Lord Chancellor and Secretary of State for Justicehas made the following Written Ministerial Statement.

It is 10 years since the Legal Services Commission (LSC) was established under the Access to Justice Act 1999. In that time there has been considerable change in the way that legal aid has been delivered, with a strong focus on ensuring that the people who need help most-the vulnerable in our society-have access to justice.

Legal aid expenditure amounts to £2.1 billion a year. This is comparably one of the most generous schemes in the world. Costs per head of population run at £38 per head2 compared with £30 in Scotland, £36 in Northern Ireland and the following in comparable

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common law countries: £8 in the Republic of Ireland, £5 in Canada, £8 in New Zealand and £9 in Australia. In the current climate, it is even more important that this public money is managed efficiently and effectively. We have worked with the LSC to take necessary action to protect public funds and focus them on helping those in need.

One of the first steps is to conduct a review of legal aid and to consider ways in which the delivery of legal aid services might be improved. The Access to Justice Act (Section 2) envisaged that the Government may eventually want to separate the Community Legal Service (CLS) and the Criminal Defence Service (CDS) to ensure that CLS resources are not swallowed up by the CDS and that the latter plays its full part in delivering an efficient and effective criminal justice system.

I have invited Sir Ian Magee to conduct a review. The terms of reference of the review are as follows:

To review the existing delivery and governance arrangements of the legal aid system, and make recommendations that:

explore the separation of the CDS and CLS and options for doing so effectively and efficiently should that be the recommended way forward;provide for effective and transparent financial management of both funds and their administration;provide for effective ministerial accountability and policy direction in respect of both the CDS and CLS, whilst continuing to ensure that every application to the CLS and CDS funds is decided fairly, within the criteria, at arms length from government; andidentify appropriate delivery models for both the CDS and CLS and their relationship with the ministry.

I have asked Sir Ian to report to me in early January.

In addition to this review, the Ministry of Justice and the LSC are reviewing the current financial and governance frameworks to ensure that where there are any potential opportunities for immediate improvement, these are taken forward without delay.

2 Costs per head for "legal aid" are shown as much lower in most mainland European systems but their costs are not comparable with common law countries because the systems are so different and many costs attributed to legal aid in common law jurisdictions are subsumed within the total costs of the judicial systems in mainland Europe-see European Commission for the Efficiency of Justice: European Judicial Systems.

Northern Ireland: Equality Commission


Baroness Royall of Blaisdon: My right honourable friend the Secretary of State for Northern Ireland (Shaun Woodward) has made the following Ministerial Statement.

I am pleased to announce the appointment of four new commissioners to the Equality Commission for Northern Ireland. Anna Carragher, Lyn McBriar, Dermot Nesbitt and Peter Sheridan took up office on 21 September 2009.

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Equality for all is at the heart of the Government's vision of a modern, fairer society.

The Equality Commission is a key institution of the Belfast agreement and plays a vital role in protecting and promoting equality for all members of our diverse society in Northern Ireland. The commission is now marking its 10th anniversary and it is facing new challenges, not least working with an increasingly diverse, multicultural society in a testing economic environment.

I am confident that the four new commissioners bring a wealth of knowledge, skills and understanding, helping the commission to meet the challenges ahead and build on their considerable achievements over the past 10 years.

Sri Lanka


The Minister for Europe (Baroness Kinnock of Holyhead): My right honourable friend the Secretary of State for Foreign and Commonwealth Affairs (David Miliband) has made the following Written Ministerial Statement.

I, together with my right honourable friend the Secretary of State for International Development (Douglas Alexander), would like to inform the House about the Government's ongoing active engagement in Sri Lanka following the end of the conflict almost five months ago between the Liberation Tigers of Tamil Eelam (LTTE) and the Government of Sri Lanka.

When I visited Sri Lanka with French Foreign Minister Bernard Kouchner in April our three areas of focus were to: urge the Government and LTTE to minimise the humanitarian impact of the then ongoing hostilities and to improve conditions for internally displaced persons (IDPs); to call for a strengthening of the rule of law to address human rights concerns; and to encourage urgent action on setting out a political process to address the grievances of minorities. I will cover each of these in turn.

In summary, as I explained to Foreign Minister Bogollagama in New York at the end of last month, we remain deeply concerned about the situation, not least but not only because of the forthcoming monsoon. Lives are at stake but so is the long-term health of Sri Lanka.

Humanitarian Situation

The last stage of fighting created almost 300,000 IDPs, the majority of whom were moved to camps in the north of Sri Lanka, near Vavuniya. Approximately 253,000 still remain inside IDP camps. The latest UN figures of 28 September show that only 7,000 people have returned to their place of origin and a further 8,000 vulnerable IDPs have been released to host families. I can report some improvement since my honourable friend the Parliamentary Under-Secretary of State for International Development (Mike Foster), my right honourable friend the Member for Kilmarnock and Loudoun (Des Browne) and I visited the camps in three separate visits in late April/early May. Sanitation facilities have improved and malnutrition cases have decreased markedly. Access for humanitarian agencies

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is better but remains ad-hoc and there is scope for further improvements. The IDPs continue to have inadequate access to healthcare and following a drop in the river level delivery of adequate water has been problematic in recent weeks. Unusually heavy rains during August demonstrated that the camps are ill-equipped for the sustained heavy rains expected from mid-October to December during the monsoon season.

We are concerned over the lack of freedom of movement for the IDP population because of the nature of the "closed" camps and over the ongoing separation of families and the heavy military oversight of the camps. We are also concerned that there is no independent visibility of the process by which over 11,000 IDPs have been identified as suspected LTTE cadres and moved to separate camps and that the UN and International Committee of the Red Cross (ICRC) have had no access to them since July.

The seriousness in which we continue to hold the humanitarian situation was demonstrated by the visit last week of my honourable friend the Parliamentary Under-Secretary of State for the Department for International Development. He visited areas of the former conflict zone, IDP camps and centres for the rehabilitation of former child combatants. He saw for himself the conditions for civilians inside the camps and ongoing contingency preparations for the monsoon.

Since September 2008, the Government have allocated £12.5 million of humanitarian aid to Sri Lanka. In the final stages of the war we used our funding to help the ICRC and the UN to deliver critical humanitarian assistance to civilians trapped in the conflict zone and to ensure facilities in IDP camps met minimum standards. Following the end of the conflict we have continued to support critical work inside the IDP camps, for example funding UN agencies to vaccinate children against polio and measles and to provide emergency drainage in an attempt to minimise the impact of the forthcoming monsoon rains. However, in recent months we have increasingly focused our support on activities designed to facilitate the speedy return of civilians to their home areas. For example, we have funded the International Organisation for Migration (IOM) to provide temporary identity cards to IDPs and transport for those returning to their homes and funded the Mines Advisory Group (MAG) to demine civilian areas of the former conflict zone. All of the UK's humanitarian funding continues to be channelled through neutral and impartial humanitarian aid agencies to help those who need it most.

My honourable friend the Parliamentary Under-Secretary of State for International Development used his visit to highlight our concern about the lack of progress on returning IDPs to their homes and to urge the Sri Lankan Government to meet their own target of returning the majority of IDPs by the end of the year. He further encouraged the Sri Lankan Government to release IDPs who have already been screened. He made clear that it was not acceptable to transfer IDPs from one closed camp to another in a different part of the country, as has happened in some cases.

Freedom of movement for the IDP population is critical if a humanitarian crisis is to be averted in the IDP camps when the monsoon rains fall. The

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humanitarian gains made in the IDP camps risk being lost from the resulting deterioration in water and sanitation facilities and consequent effect on health indicators. We are working with others to press for freedom of movement to be restored to the IDPs.

During his visit, my honourable friend the Parliamentary Under-Secretary of State for International Development confirmed that once the critical monsoon season is over we will only fund life-saving emergency interventions in the existing closed camps and that we will not support people simply being transferred from the existing closed camps to new closed camps. £4.8 million of UK funding remains available to help the Sri Lankan Government in the process of recovery from the conflict in the areas of de-mining, support to enable the return of the IDPs to their places of origin and to help them recover their livelihoods.

We continue to support multilateral engagement in Sri Lanka. The UN has a key role in focusing international concern; co-ordinating the international humanitarian response; and providing advice and support to the Government to help heal the rifts that divide Sri Lanka's communities. We welcome the involvement by UN agencies on the ground in Sri Lanka and the ongoing senior level engagement that has included visits to Sri Lanka since the end of the war by UN Secretary-General Ban Ki-Moon, Lynn Pascoe the Under Secretary General for Political Affairs and Walter Kaelin, the UN's Special Representative for the human rights of IDPs. The UN's experience and expertise in working in post-conflict environments is widely acknowledged and I urge the Sri Lankan Government to engage constructively with all levels of the UN.

At the International Monetary Fund (IMF), the UK took the decision in July not to support the stand-by arrangement for Sri Lanka. Whilst we acknowledged the need to help Sri Lanka avoid a damaging balance of payments crisis that would have disproportionately affected the poorest and most vulnerable members of society, we judged that the risks of a default had diminished and that the humanitarian and political situations posed risks to implementation of the programme. The programme was passed by the IMF board and we will now turn our attention to monitoring the programme's implementation through a robust review process.

Human Rights

The wider human rights situation in Sri Lanka remains very worrying following the end of the conflict. Although reduced, reports of extra-judicial killings, abductions, disappearances and intimidation have continued. Media and civil society organisations who are critical of the Government remain at particular risk and continue to be the victims of anonymous death threats and, in some cases, violent attack. The recent sentencing of a journalist, Tissainayagam, to 20 years imprisonment sent a very negative message about media freedom in Sri Lanka. A culture of impunity continues, with no progress towards identifying the individuals behind recent high-profile human rights abuses, such as the murder in January of Lasantha Wickrematunge, a leading newspaper editor. We welcome the fact that in two recent cases, the alleged abduction of a university student and the killing of two youths in

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southern Sri Lanka, the Government have ordered investigations into alleged police involvement and action is being taken through the Sri Lankan courts. The Sri Lankan Government continue to retain extraordinary emergency powers which limit the fundamental democratic freedoms of its citizens. With the LTTE defeated and a substantially reduced terrorist threat we hope to see the emergency regulations lifted soon.

In our bilateral contacts we have encouraged the Government of Sri Lanka to tackle the culture of impunity in Sri Lanka. In this light we welcome the investigations and subsequent legal action against police officers involved in alleged abuses and encourage the Government to take similar action in all cases where such allegations are made. We have also been active in working with the EU to call for an improvement in human rights in Sri Lanka. An improvement is important too in the context of the investigation by the EU Commission looking at whether Sri Lanka should continue to benefit from the EU trade scheme, GSP+ which is dependent on the implementation of a number of human rights-related conventions. We have consistently encouraged the Sri Lankan Government to engage constructively with the Commission.

Political Settlement

At the end of May the Sri Lankan President issued a joint statement with UN Secretary-General Ban Ki-Moon recognising the need to work "towards a lasting political solution ... fundamental to ensuring long-term socio-economic development", and to take measures "to address possible violations of international humanitarian law during the conflict". The Government of Sri Lanka have stated their intention to begin a process of political reform and reconciliation after elections which are expected in the first half of 2010. They have made some welcome moves to reach out to minority communities in the interim. For example, the president recently opened a dialogue with the Tamil National Alliance, the principal grouping of Tamil politicians inside Sri Lanka, and for the first time in over 25 years the police force have begun a recruitment process in Jaffna, a majority Tamil area in northern Sri Lanka. The Government have publicly recognised that the Tamil diaspora can play a positive role in helping shape the future direction of Sri Lanka. I encourage the Government to continue with, and to broaden, its initial contacts with representatives of the diaspora. We are concerned that the Government have yet to make clear how they intend to address concerns that both sides may have been responsible for violations of international humanitarian law during the conflict.

The UK has consistently maintained that one of the prerequisites for lasting peace in Sri Lanka is a political settlement that fully takes into account the legitimate grievances and aspirations of all communities. When my right honourable friend the Prime Minister spoke to President Rajapakse on 18 May, he urged

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him to be magnanimous in victory. On the same day, I pressed Foreign Minister Bogollagama to seize the historic opportunity-and duty-to lay the foundations for the peaceful, secure and prosperous Sri Lanka that we all want to see. Despite some recent welcome developments the Government need to show greater urgency in making clear their plans for future political reforms if they are serious about wanting to win the confidence of Tamils, Muslims and other communities in Sri Lanka. We hope to see an inclusive, genuine political process initiated as soon as possible.

We have consistently called for a credible process of accountability, most recently during the visit to the UK of the Sri Lankan Attorney General and Justice Permanent Secretary in early October and the visit of the Sri Lankan Justice Minister in September. Addressing accountability could play an integral role in the process of reconciliation and will be essential in creating conditions for a sustainable end to the conflict. The recent broadcast of mobile phone footage purporting to show members of the Sri Lankan military summarily executing Tamils underlines the importance of lifting the fog of uncertainty surrounding events of the final months of fighting when independent observers had no access to the conflict zone.

The Government remain actively involved in working for a peaceful Sri Lanka. We have urged the Sri Lankan Government, in a number of direct contacts, to make greater progress on improving conditions inside the camps, on returning IDPs to their homes and on working for reconciliation. We urge that freedom of movement be returned to IDPs, and highlight the urgency of doing so before the monsoon. We also encourage swifter progress on the development of an inclusive political process to address minority concerns and for an improvement in the rule of law, including accountability for possible violations of international humanitarian law, as both would be essential for a sustainable end to the conflict.

We continue to work with other international partners, such as the US and India, the EU and the UN. My right honourable friend the Prime Minister's Special Envoy for Sri Lanka, my right honourable friend the Member for Kilmarnock and Loudoun, visited Washington and the UN (in New York and Geneva) in September to exchange views on Sri Lanka with other partners and will be writing to honourable Members this week to inform them of his visits.

The final death toll of the 25-year conflict may never be known, but it is likely that over 100,000 Sri Lankans of all communities died over the course of the conflict. The Sri Lankan Government need to steer the country away from the violence that has troubled the country for so long and towards long-term peace, security and prosperity for all its citizens. The Government will continue to work with the Sri Lankan Government and with other partners to help bring this about.

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