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Wednesday, 6 January 2010.
3 pm
Prayers-read by the Lord Bishop of Bradford.
Mountain Rescue
Question
3.08 pm
Lord Faulkner of Worcester: My Lords, support for mountain rescue teams is a matter for the police authority and chief constable concerned as they have responsibility for co-ordinating inland search and rescue operations. Between them, police forces contribute almost £100,000 annually in direct support and additional amounts by way of support in kind. However, in recognition of the Mountain Rescue Council's concerns, I am pleased to say that my ministerial colleague in the Department for Transport, the Parliamentary Under-Secretary of State, the honourable Member for Gillingham, has offered to facilitate a meeting with my noble friend, interested parties and relevant government departments.
Lord Dubs: I am grateful to my noble friend for that very positive Answer and I look forward to such a meeting. Is he aware that during the recent floods in Cumbria the mountain rescue services were among the first on the scene and they did a fantastic job? They rescued perhaps up to 200 people and worked non-stop for many hours. Indeed, in the present climate difficulties they are working all over the country to help people who are isolated in the snow or in their vehicles. In the light of all that, does he agree that some additional support for these hard-pressed teams, who have had to replace much of their equipment for the reasons I have just stated, would be very welcome and would recognise the enormous contribution that they make not only in times of difficulty, such as the floods, but day in and day out for those of us who enjoy walking in the mountains?
Lord Faulkner of Worcester: It is for exactly the reasons that my noble friend expresses that we believe that this is the right time to have the meeting to which I referred in my first Answer. Certainly with the weather as it is, this is an appropriate time to pay the warmest possible tribute to the 3,500 volunteers who not only give their time to the mountain rescue service for free but also pay for the clothing and gear that they need to do this really important job. My noble friend referred to the mountain rescue teams in Cumbria. They played a very important part in the recent floods, particularly those from Patterdale and Keswick, who worked on search-related tasks co-ordinated by the Cumbrian police.
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Lord Roberts of Conwy: My Lords, will the noble Lord join me in highly commending RAF Valley at Anglesey for the superb support that it provides for the mountain rescue services in Snowdonia and for the many lives that it has helped to save over the past few years?
Lord Faulkner of Worcester: My Lords, I am delighted to do that. As the noble Lord may be aware, the patron of the mountain rescue service, Prince William, will shortly be serving at Valley, and his involvement in the mountain rescue service is hugely appreciated.
Lord Burnett: My Lords, I should declare that I am president of the Dartmoor search and rescue group, a post that I am extremely proud to hold. I am sure that the Minister will want to join me in paying tribute to the courage, commitment and dedication of the volunteers in that group and all the other volunteers up and down the country. They raise their own funds. Surely they should not be penalised by having to pay value added tax on the equipment that they have to buy.
Lord Faulkner of Worcester: I echo entirely what the noble Lord has said about the role of the mountain rescue service on Dartmoor and indeed in all other parts of the country. He referred to VAT, which is a rather more difficult and controversial issue. I am afraid that it is not possible for the British Government unilaterally to change the bodies that are covered by VAT because that would require approval from the European Union. There are other ways in which we can help the mountain rescue service other than going down the VAT route.
The Lord Bishop of Bath and Wells: My Lords, as a former member of the Upper Wharfedale cave and fell rescue team and, dare I say, as an active caver this year, I thank the Minister for his earlier Answer in relation to the meeting that is to be held shortly. Is it time for budgeting to be included in the emergency services' budgets for the rescue teams around the country?
Lord Faulkner of Worcester: One feels a little inadequate replying to such distinguished participants in mountain rescue and other rescue services. The caving teams are very important too. The question of funding will be on the agenda for the meeting to which I referred. The right reverend Prelate is right to say that the rescue services do not just do mountain rescue; they now cover flood relief and searching for missing people as well. Their new slogan is "More than just mountains", and that is certainly true.
Lord Judd: Does my noble friend accept that while we all pay unlimited tribute to the courage and dedication of the mountain rescue teams, the message is that they are volunteers? That is a message to the country as a whole about what can be achieved by that kind of spirit. We must never take it for granted. Does he therefore agree that, in forthcoming meetings with Ministers, sensitive and appropriate ways should be found to support them in every way? Does he also agree that there is a responsibility on the public as a whole not to abuse that spirit of voluntary commitment by behaving irresponsibly on mountains or elsewhere?
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Lord Faulkner of Worcester: My noble friend is correct. The importance of volunteers in so many areas of our national life cannot be underestimated, and perhaps the mountain rescue service is one of the best examples. I was speaking to the chairman of a branch of the mountain rescue service in the Black Mountains yesterday, and he made it clear to me that they are not at all interested in monetary reward for themselves; they do it out of a commitment to public service because they have a love of mountains, and they are mountaineers who want to help other mountaineers.
Lord Inglewood: My Lords, I declare an interest as chairman of the All-Party Group on Mountain Rescue, and I congratulate the Government on holding the meeting referred to by the Minister in his reply to the noble Lord, Lord Dubs. I would like to draw to the Minister's attention the fact that the Scottish Administration are substantially more generous to the mountain rescue services than are the Government south of the border. I urge him to put that issue firmly on the agenda for discussion at that meeting.
Lord Faulkner of Worcester: My Lords, I suspect it will not need me to put that on the agenda and that the mountain rescue service and my noble friend will ensure that it is covered. The funding of the mountain rescue service in Scotland is a devolved matter, and the decision that the Scottish authorities take to support it is a matter entirely for them. My noble friend on the Front Bench whispered to me that they have more mountains in Scotland than we do in England, so it is obviously a more relevant service in that part of the country.
Baroness Masham of Ilton: My Lords, does the Minister agree that the rescue dogs do a wonderful job too? They sometimes find people on mountains and in the snow when people cannot.
Lord Faulkner of Worcester: My Lords, the noble Baroness is absolutely correct. The role of dogs in rescue in all sorts of situations, particularly in the snow, is obviously of crucial value.
NHS: Feeding
Question
3.16 pm
Asked By Baroness Knight of Collingtree
To ask Her Majesty's Government on what grounds decisions are made to forbid hospital staff and carers from helping patients to eat.
Baroness Thornton: My Lords, unless there are clinical reasons for withholding them, patients are entitled to food and drink of adequate quantity and quality and to help to ensure that they eat and drink. Hospital staff should ensure that a patient's oral nutrition and hydration are being provided in a way that meets the patient's needs, and that any problems, such as difficulty in swallowing, are managed effectively.
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Baroness Knight of Collingtree: My Lords, is the Minister aware that following the admission of a Mrs Beryl Alice Waters to Queen's Hospital in Burton-upon-Trent on 30 September, her family were informed by a staff nurse Willis that nurses and carers were forbidden to help patients to eat. This information was given in front of a consultant and two other doctors in the course of a ward round, and they in no way denied it. Why are such orders issued?
Baroness Thornton: My Lords, the noble Baroness has been very concerned about this issue, and I agree with her that this can be very distressing indeed for families and carers. As I have already said, there may sometimes be clinical reasons for withholding food and drink from a patient. However, if such a message were ever given other than for clinical reasons, it would certainly not be endorsed by the Department of Health, and local managers would need to investigate and account for it. Ensuring that patients have adequate nourishment is part of the core caring of nursing.
Lord Brooke of Alverthorpe: My Lords, I declare an interest as a trustee of Community Service Volunteers. We have a fair number of our volunteers working in a variety of hospitals, doing a variety of tasks. Could the Minister tell me why they are not permitted to help people feed themselves?
Baroness Thornton: My Lords, my noble friend knows that we have long recognised and supported the enormous value of friends groups and volunteers, and the contribution they make to patients' experiences in the NHS. Indeed, some trusts are using volunteers to help patients to eat and drink. Volunteers who do this have to receive training and supervision, particularly when patients have difficulty chewing or swallowing. I believe that we should encourage voluntary organisations that provide this wide range of important services to encourage their members to receive this training, and to put pressure on their health authorities. If they have got volunteers who want to help in this way, they certainly should be able to do so.
Baroness Tonge: My Lords, the Minister must know that lack of help with feeding and, indeed, inadequate cleaning in a lot of our hospitals are often due to lack of time because of government-imposed targets and management rules. What advice would she give to NHS staff who face disciplinary action, suspension and often damage to their careers when they expose malpractice that has been imposed by their own managers?
Baroness Thornton: The noble Baroness knows-we have discussed this in the Chamber-that the NHS has a well developed procedure for dealing with whistleblowers and for protecting people who bring such problems to the attention of their hospital administration. We do not accept that there is a link between targets and issues of feeding and nourishment because, apart from anything else, this Government have increased the number of nurses by 89,000 since 1997.
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Lord Trefgarne: My Lords, is the noble Baroness aware that the Answer that she gave to my noble friend Lady Knight was to some of us puzzling and disappointing? Is it not clear that such instructions as my noble friend referred to have been given, should not have been given and should now be countermanded?
Baroness Thornton: I hope that I gave the impression that I absolutely agree with that point and want the issue to be investigated.
Lord Carlile of Berriew: The example given by the noble Baroness, Lady Knight, was but one of certainly more than 100 that are available. Will the Government now invite the General Medical Council and the other regulators to create a code of practice so that these awful examples can no longer occur?
Baroness Thornton: I am not sure from where the noble Lord received the figure of 100; he might please let me know. However, I am glad to be able to inform him that from 2010-11 the Care Quality Commission will be operating a new registration system, which will cover both health and adult social care providers. One of the proposed registration requirements is ensuring that people get the nourishment that they need to prevent harm through lack of sufficient nutrition and hydration.
Baroness Howarth of Breckland: My Lords, does the Minister think that this is a question of training? What is being done to ensure that nourishment is on the training agenda? I declare an interest as the chair of Livability, a large charity that deals with disabled people. We have had the opposite experience of having our staff invited to go into the hospital to help with feeding because some hospital staff have been uncertain about how to treat some of our very disabled patients.
Baroness Thornton: The noble Baroness makes an important point. The Nursing and Midwifery Council has made it a requirement for nutrition principles to be taught and assessed in practice as part of the pre-registration nursing programme. Skills for Care and Development has undertaken a review of its occupational standards with the Food Standards Agency and is introducing nutrition and healthy eating standards. We have endorsed the British Association for Parenteral and Enteral Nutrition screening week, which establishes the extent of nutrition on admission to hospitals and care homes, for example. We acknowledge that there are issues, which we are trying to anticipate. We are trying to make sure that we minimise the effects of malnutrition as people come into hospital and certainly that they receive the right kind of nourishment while they are there.
Lord Lawson of Blaby: My Lords, in answer to my noble friend, the Minister appeared to be saying that hospital volunteers should not be permitted to help a patient to eat, however great the need, unless they had had special training. Does she really mean that?
Baroness Thornton: Yes, I think that we do mean that. The reason why we mean it is that, for example, someone who has had a stroke and has problems with swallowing will need specialist help with eating. A
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Iran
Question
3.24 pm
Asked By Lord Corbett of Castle Vale
To ask Her Majesty's Government what representations they have made to the Government of Iran about violence towards pro-democracy demonstrators.
The Minister of State, Foreign and Commonwealth Office (Baroness Kinnock of Holyhead): My Lords, we admire the courage of the thousands of ordinary men and women who strive for recognition of their rights in Iran. We have consistently condemned the violence meted out against those who simply ask that their basic freedoms are respected. The Foreign Secretary made this clear in his statement on 28 December, as did our ambassador to Iran when summoned to the Iranian Foreign Ministry on 29 December. We will continue to seek an improvement in the human rights situation in Iran and speak out wherever and whenever we see such flagrant abuses of civil liberties.
Lord Corbett of Castle Vale: I thank the Minister for that response but is she aware that the anger over the stolen presidential election in June has now turned to demands for an end to the religious dictatorship by demonstrators, 11 of whom were killed on 28 December while thousands more have been arrested over the past few weeks and face torture? Will the Government signal our strong support for those demanding democracy and human rights by recalling our ambassador in protest at the violence used against the demonstrators and by supporting tighter sanctions against this menacing regime?
Baroness Kinnock of Holyhead: I thank my noble friend for those comments. We have repeatedly and consistently made clear our concerns about the deteriorating human rights situation in Iran. The Foreign Secretary's recent Statement was an extremely strong one. We have also been taking very strong measures to ensure that there is a response at EU and UN level. On sanctions on human rights abuses, we are, of course, prepared to look at all the options that may have a positive effect and make a difference to the lives of ordinary Iranians, such as seeking multilateral sanctions to get Iran to comply with Security Council resolutions on nuclear programmes. But this reflects wider international concern about the failure of the Iranian regime to live up to its international obligations. I do not think we should consider recalling our ambassador because those diplomatic contacts are extremely important and political dialogue has to play its part in trying to work towards the return to, or at least the establishment of, democratisation in Iran.
Baroness Afshar: My Lords, I thank the British Government for persisting in negotiations with the Iranian Government because I think that is the only
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Baroness Kinnock of Holyhead: I thank the noble Baroness for her continuing commitment and interest in these matters. I think she would be very interested to know that the Foreign Secretary met Shirin Ebadi when she was in London and, of course, continues to condemn excessive use of force and the arrests of people who are only demonstrating and standing up for their rights. The situation in Iran is deplorable-according to Amnesty, it is the worst that has existed for 20 years. We remain committed to improving the human rights situation and we will continue to urge the Iranian Government to abide by the international human rights obligations they have actually signed up to.
Lord Waddington: Does the Minister agree that there have been attempts at negotiations with the Iranian regime for years now and that they have got precisely nowhere? The regime's promotion of terrorism abroad, its contempt for human rights at home and its determination to become a nuclear power make it highly improbable that any negotiations will get anywhere in the future. Surely what is needed now is tougher action by the international community and, in particular, tougher sanctions.
Baroness Kinnock of Holyhead: The noble Lord will recall that I have already said that under the United Nations there is consideration of a sanctions resolution. However, today on the BBC it was reported that China has already said that it will block such a resolution. It is encouraging and important to note that the human rights resolution was agreed by the UN Human Rights Council in December, because that also sends a clear message of international concern about the human rights situation in Iran. However, I do not underestimate what the noble Lord says and understand that we need to seek many more ways of dealing with this regime; it is facing the biggest ever challenge to its legitimacy, which we welcome.
Baroness Falkner of Margravine: My Lords, it is reassuring to hear the Minister talk about using all channels to deal with Iran, which is seldom brought to its knees through threats and use of force. Apropos sanctions, will the noble Baroness confirm that, despite what appears to be China's statement today, Her Majesty's Government will continue working with Russia, which seems to be re-evaluating its relationship, and with China to bring about successful sanctions resolutions in the UN Security Council, and will continue to keep channels of negotiation open with the Iranian Government?
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