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House of Lords

Monday, 14 June 2010.

2.30 pm

Prayers-read by the Lord Bishop of Leicester.

Several noble Lords took the oath or affirmed.

Death of a Member: Baroness Delacourt-Smith of Alteryn


2.37 pm

The Lord Speaker (Baroness Hayman): My Lords, I regret that I have to inform the House of the death of Baroness Delacourt-Smith of Alteryn on 8 June. On behalf of the House, I extend our condolences to the noble Baroness's family and friends.

Elections: Fraudulent Registration


2.38 pm

Asked By Lord Naseby

The Minister of State, Ministry of Justice (Lord McNally): My Lords, the Government are committed to tackling electoral fraud by speeding up the introduction of individual electoral registration. This will improve the accuracy of the register and ensure that only those entitled to vote get on to the electoral register. We are also considering the Electoral Commission's report on the queues at polling stations on 6 May and the Government will take any appropriate steps necessary to prevent a repeat.

Lord Naseby: My Lords, I thank my noble friend for that succinct Answer. Is he aware that on 23 February I asked a supplementary to a Question for Oral Answer about how many recommendations from the Electoral Commission the then Government had implemented? I received a holding response that afternoon and later a letter was placed in the Library which indicated that there were a great many outstanding items. In the light of the last election when over 1,000 queued up and then could not vote, and there were serious problems with the register itself, as indicated by the Commonwealth monitoring group, is it not time to look at the role and powers of the Electoral Commission so that we have full and fair elections and can trust in the results?

Lord McNally: My Lords, I share the aspirations of my noble friend, but it is fair to put the case into perspective. There were problems at 27 polling stations

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out of 40,000. That was a bad piece of public relations and terrible pictures went around the world, but in fact represented a very small percentage of the actual turnout.

On the powers of the Electoral Commission, I think it is true to say that it has few teeth; whether it should be given more teeth or its powers transferred elsewhere is a matter for discussion and examination after we have its report on the recent general election.

Lord Bach: My Lords, all sides agree that individual registration is the way forward. However, does the Minister agree that the danger is that if we move too quickly, it is a near certainty that many of our fellow citizens will drop off the register, thus adding to the 3.5 million people whom the Electoral Commission estimates are currently unregistered? Does not the Northern Ireland experience, where 10 per cent of the population immediately fell off the register following a sudden switch to individual registration, show us how careful we must be?

Lord McNally: My Lords, it is quite clear that the noble Lord, Lord Bach, is holding on to his old briefs. Yes, that is exactly why the implementation of the new form of registration has been taken at a measured pace. The experience in Northern Ireland was of a very large drop. However, again, we have got to get into perspective the fact that 91 or 92 per cent of people are on the electoral register. We are trying to balance the need for a clean and credible register against the points of caution the noble Lord has pointed out.

Lord Rennard: My Lords, does the Minister accept that it is now time to consider changing polling day from a Thursday to avoid the kind of problems we had in the recent general election, with large queues of voters unable to vote in the middle of the evening? By switching voting to the weekend we would avoid disruption to schools and enable more people to participate in our elections.

Lord McNally: My Lords, I have a great deal of sympathy with my noble friend's argument for weekend voting. However, he may well be aware that the consultation on this matter did not show a great deal of support for the idea. We may come back to this issue, but the problems on 6 May, the day of voting, lay elsewhere.

Lord Strabolgi: My Lords, given the long queues to which the Minister referred, particularly in the evening, which prevented so many people getting to a polling station in time to vote, will the Government consider making polling day a bank holiday so that voting can be spread throughout the day? This would be of help to people who have to work in the daytime and cannot get to the polling station until the evening, sometimes after travelling long distances.

Lord McNally: My Lords, my noble friend Lord Shutt, who has experience of Yorkshire habits, said that in his part of the world the voters would all go to Blackpool if they were given a bank holiday, so the idea has some attractions.

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Lord Campbell-Savours: My Lords, can the Minister assure the House that, during the period the coalition is in government, local authorities will have ring-fenced budgets for electoral registration offices and that the budgets will not be cut?

Lord McNally: Such questions are always extremely difficult to answer because we never know what is going on at No. 11 Downing Street, as the noble Lord knows well. One of the commitments of successive Governments has always been that they supply sufficient budget to enable our democracy to function properly. I cannot imagine that we will move from that situation.

Lord Elton: My Lords, the noble Lord, Lord Bach, mentioned 10 per cent of the population dropping off the register in Northern Ireland. How many of those 10 per cent should not have been there in the first place?

Lord McNally: I am not sure. We all know all the jokes about Northern Ireland voting. This Government take fraudulent voting very seriously. Wherever in the country there is fraud, we will prosecute with the firmest intention of getting convictions.

Lord Brooke of Alverthorpe: Is it not a cause for concern, and no cause for complacency, if we have only 91 per cent of the eligible population registered? What steps will the Government take to ensure that the figure does not fall below 91 per cent? If possible, will they take steps to try to increase it?

Lord McNally: It is not a reason for complacency, and there is none. People are encouraged to register. Interestingly enough, the figure for registration in Australia, where there is compulsory voting, is 95 per cent, so we are not far off. Ours is a voluntary system of registration. We should continue to promote in our society the social contract that registration and voting involve. We should not chase voters by making it ever easier to vote without putting some challenge to the rest of the population and making it clear that there is a responsibility. If you have the honour, the pleasure and the freedoms of living in democracy, you participate by voting.

Health: Isle of Man


2.47 pm

Asked By Lord Smith of Clifton

The Parliamentary Under-Secretary of State, Department of Health (Earl Howe): My Lords, the current reciprocal healthcare agreement between the United Kingdom and the Isle of Man is due to end on 30 September 2010. My right honourable friend the

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Secretary of State will consider this matter, in consultation with other relevant parties, in good time to reach a decision by September.

Lord Smith of Clifton: My Lords, I thank the Minister for that reply. At the British-Irish Parliamentary Assembly plenary last March, it was unanimously resolved that the Government should continue with the reciprocal healthcare agreement. It would be very ageist if that agreement were rescinded, because people such as me-I declare an interest-could not get the personal health insurance that would be needed to go to the Crown Dependencies. Is this not a form of discrimination which is totally unacceptable?

Earl Howe: My Lords, it might be helpful if I were to clarify the current position. If the noble Lord were to go the Isle of Man, the agreement in place at the moment would enable him to receive emergency healthcare there-that is, healthcare that is immediately necessary-free of charge should he need it. The only reason for requiring travel insurance in addition would be to cover the cost of, let us say, an air ambulance back to the mainland or any extra costs that were non-medical arising out of the emergency. In that sense, the Isle of Man is no different as a travel destination than, let us say, the United States.

Lord Alderdice: My Lords, the previous Government rightly trumpeted one of the important advances of the Good Friday agreement: the establishment of the British-Irish Council, bringing together government representatives and Ministers from England, Scotland, Wales, Northern Ireland, the Republic of Ireland, the Channel Islands and the Isle of Man. Did the previous Administration raise this question at the British-Irish Council, which would seem the appropriate place to explore it? If they did, what was the response?

Earl Howe: My Lords, I am afraid that I cannot help my noble friend as I have not had access to the papers relating to the previous Administration. However, I can tell him that very cordial discussions and negotiations are proceeding at the moment, and the devolved Administrations will be consulted.

Lord Dubs: My Lords, the Minister in an earlier answer referred to the United States as being a parallel, but does he not agree that what we are after is that British tourists who go on holiday to the Isle of Man feel that they are covered at least as well as if they had gone on holiday to France? Does he agree that that is not the case and, unless insurance arrangements change, our people will suffer, as will Isle of Man people? Surely the right thing to do is to keep these reciprocal arrangements going.

Earl Howe: My Lords, if a UK resident were to travel to the Isle of Man, as I have said, and were to fall ill and need emergency care, they would receive that care free of charge. That is what the agreement currently covers. It was extended by the previous Government in March and will last until the end of September. We are using that window of opportunity

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to negotiate with the Isle of Man Government and, as I have said, these discussions at official level are proceeding very cordially.

Baroness Gardner of Parkes: My Lords, following the question from the noble Lord, Lord Dubs, about reciprocal arrangements in Europe, as I understand it we have to have a card, which we present if asked to do so, if we go for treatment in Europe. What is the position here? Are people coming from mainland Europe asked to present an equivalent card here? We hear so much about NHS tourism that it rather concerns me.

Earl Howe: My Lords, the rules are quite complicated. In the case of EEA countries, including the European Union, the UK has an obligation under EU law to pay what it is liable for in healthcare costs. Therefore, visitors from EEA member states are provided with NHS healthcare when visiting the UK and, indeed, vice versa. However, under the same regulations, the UK is entitled to claim the cost of treatment provided to citizens from EEA member states whom it has treated. Similarly, other member states can charge the UK for the cost of treating our citizens.

Health: Government Spending


2.52 pm

Asked By Baroness Thornton

The Parliamentary Under-Secretary of State, Department of Health (Earl Howe): My Lords, the Government are committed to reducing bureaucracy and improving efficiency. By streamlining and simplifying the infrastructure, we can ensure that clinicians focus on what really matters: delivering the best possible health outcomes for patients. All non-front-line organisations will be expected to operate efficiently and contribute to the Government's commitment to reduce central administration spending by one third. That is why we are reviewing how best to organise the national infrastructure. The review will report in due course.

Baroness Thornton: I thank the Minister for that Answer. Notwithstanding the Government's proposed intention to create the biggest quango of all in the NHS board, what can the Human Tissue Authority and the Human Fertilisation and Embryology Authority expect from the bonfire of the quangos? Will it be a third of their work, for example? I choose those two because the Minister and many noble Lords in this House were closely involved in considering the legislation that led to the creation of those two important bodies.

Earl Howe: My Lords, the focus of the exercise that is going on at the moment is, on the one hand, to look at value for money and, on the other, to look at how

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best we can deliver quality. Therefore, the review will consider which functions should be carried out at a national or arm's-length level, which could be stopped with no detriment to the delivery of front-line services and which could be undertaken elsewhere in the system or, indeed, left to the market. So there is no target as regards getting rid of a certain number of bodies. The point of view from which we come is that of functions.

The Earl of Onslow: My Lords, can my noble friend help me? He implied that savings were to be made, which is excellent. If we are going to make savings in the National Health Service budget, why is the rest of the budget ring-fenced? If you can save £20 here, why not cut the budget by £15 and keep £5 for something else? Why undertake to spend all the savings rather than make them contribute to help after the ghastly state of affairs that was left to the Government?

Earl Howe: My Lords, the simple answer is that we have a duty to ensure that every pound that we spend is spent efficiently, wisely and with value for money at the end of it. As my noble friend will know, the cost of healthcare in this country has traditionally risen at a faster rate than inflation, so even if we are advantaged in the sense of being a protected department, we still have to find savings in order to continue to ensure that we can deliver quality care at an acceptable price.

Baroness Greengross: My Lords, I declare an interest as a member of the Equality and Human Rights Commission. Can the Minister assure the House that public authorities will be able to meet their mandatory equality duties, including carrying out equality impact assessments for all relevant policies and decisions, in spite of the difficult financial constraints?

Earl Howe: My Lords, I can reassure the noble Baroness that the imperative to ensure that quality and equality are considered is uppermost in our minds as we proceed with this exercise, and indeed as we go forward into what will be a very difficult financial year next year.

Lord Faulkner of Worcester: My Lords, given the huge success of the tobacco-control legislation passed in the previous Parliament, which has already produced so many benefits including, as we have seen from recent statistics, a dramatic reduction in the number of heart-attack victims admitted to hospital, will the Minister give an assurance that the excellent smoking-cessation programmes run by his department will be exempted from any programme of cuts?

Earl Howe: My Lords, smoking cessation is extremely important as a public health measure. I am sure the noble Lord will know that the coalition Government have set great store by their public health agenda. I cannot imagine that smoking cessation is going to disappear off the radar.

Lord Alderdice: My Lords, in respect of a number of agencies within the health and social care field, it is clear to practitioners that some of them have been

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inadequate in their regulatory and monitoring function and others have gold-plated way over the top in a quite counterproductive way. In his search for which agencies could be brought together and their experience shared or which could be changed in other ways, what are the principles that the Minister intends to use to produce a better and more appropriate regulatory monitoring framework within health and social care?

Earl Howe: My Lords, there are several principles. A reduction in the number of arm's-length bodies is only one of the possible outcomes. As I have said, we are not looking necessarily for a large-scale reduction in numbers, but we want to see both efficiency and the delivery of quality. With those two ends in view, the bodies that we end up with have to make sense in terms of what matters in our wider system reform, which is, as I have said, to deliver quality.

Lord Warner: My Lords, the Minister has said that he will be looking at functions in the review of bodies and that he will be looking to save one-third of running costs. In carrying out this review, will PCTs be examined carefully in terms of divesting themselves of their provider-arm functions so that they can concentrate on their commissioning functions?

Earl Howe: My Lords, strictly speaking, primary care trusts are not considered to be arm's-length bodies, but the coalition agreement, which I am sure the noble Lord has read from cover to cover, indicates the new role and the functions envisaged for PCTs. Further details of our plans will be announced very soon.

The Countess of Mar: My Lords, will the Minister be prepared to consider joining together animal and human medicines and health? With global warming, with so many of our illnesses now zoonoses-in other words, caused by animals-and with so many antibiotics and other drugs used in common, would it not be a good idea?

Earl Howe: My Lords, I am grateful to the noble Countess, particularly given her wealth of knowledge and experience in this area, for putting forward that suggestion, which I shall certainly take back with me.

Lord Rea: My Lords, if the Food Standards Agency is to be wound down, which would be regrettable since it would mean the loss of an important, independent voice, will its science-based public health work on nutrition continue to be funded at least at the present level, if not augmented, which it needs to be?

Earl Howe: My Lords, the Government fully recognise the important role that the Food Standards Agency plays in food standards, nutrition and food safety. Public health is a priority, and I reassure the noble Lord that the function that the FSA currently fulfils-to advise the Government and the public on nutrition-is one that we believe is equally important.

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