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Lord Rooker: According to the Bill, the Electoral Commission is going to produce a leaflet explaining the AV system; it will go through every front door in the country. We would like to see a draft of that leaflet, because that is where the value judgments come in.
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Lord Lamont of Lerwick: I referred earlier to New Zealand, where an official leaflet explaining the system was provided. Afterwards, there was a great argument about whether it had been impartial.
Lord Deben: If there is to be a leaflet from the Electoral Commission-I find that idea difficult, because the Electoral Commission will have an attitude that comes through-will it give a full and detailed explanation of why AV has not always worked and will there be an explanation of why the first past the post system is on occasion thought to be better? That is the only way in which there can be an unbiased leaflet. If it merely explains AV, it will lead people to believe that the system is sensible, when it manifestly is not, because the leaflet will have the Electoral Commission's name on it and will therefore be taken more seriously than it would be if it did not. It seems wholly unacceptable that the Electoral Commission should interfere in something that is none of its own business.
Lord McNally: I think that the opponents of the yes vote are already getting their excuses in. The leaflet will help people to make a decision and factually explain both systems. I am not sure that the outcome of the 1975 referendum owed itself to a government leaflet in the way that the noble Lord, Lord Gilbert, suggested.
Lord Lamont of Lerwick: But does the Minister remember that the leaflet that was published had a map of the United Kingdom on the front that left Orkney and Shetland off, which were the only areas to vote against continuing our membership of the EEC?
Lord Rennard: My Lords, could I invite the Minister and other noble Lords to confine their arguments more to Amendment 39B, which deals with civil sanctions, and perhaps make other arguments when we are dealing with other relevant parts of the Bill?
Lord McNally: I am only glad that my noble and learned friend Lord Wallace was not here to hear of that dreadful omission from the 1975 leaflet.
Lord Campbell-Savours: Perhaps I may help the Minister. I attended a meeting of the Electoral Commission in the House about two months ago. The commission was so scrupulous about not wishing to indicate any view that it found it difficult to answer questions, which Members listening to its explanation of what was going to happen found hardly credible-indeed, they started laughing. It is trying to be independent, but it would be very helpful if we could see some of the leaflets that it is planning to put out.
Lord McNally: I will not promise that this Committee on the Bill will become a drafting committee for a leaflet, but I share the noble Lord's view of the Electoral Commission. It is nobody's poodle; it will take its responsibilities very seriously. If it says that it is going to produce a factual leaflet, I believe it.
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Lord Soley: I declare an interest as one of the parliamentarians who offer advice to the Electoral Commission when it asks for it. It recognises the problems involved in making a bald statement. It seems to me that it faces the alternative of making a very bald statement that the alternative vote is this and the first past the post system is the other, so that both sides are covered in a very limited way, or of getting into descriptions. That is where you hit the rocks, because as soon as you start describing systems you inevitably talk about advantages and disadvantages, even if it is by implication.
There is a real problem both for the Electoral Commission and ultimately for this House. How far does the commission offer advice on what should be done by a Government or by this House as opposed to simply stating what the current position is or what it would be if a certain amendment or change was made? There is a case for saying either that Parliament rather than the Electoral Commission should decide all the details or that the leaflet must be agreed by the various parties in advance. It is quite a minefield. There are other people in this Chamber who have been at meetings with the Electoral Commission. I do not doubt that it is trying to do its best, but there is a genuine difficulty as to what powers it leaves to Parliament to define and describe and how much authority it takes in trying to describe without falling into the trap of being biased, however unintentionally.
Lord Lamont of Lerwick: I support what the noble Lord has said. A leaflet describing the pros and cons of different electoral systems cannot be factual, as there are values and opinions. The assertion that one voting system means that people will have more than 50 per cent of the electorate's support is open to argument. Of course you can go into a certain amount of detail about whether a fourth preference is as valuable as a first preference, but the argument is even more complicated than that. Surely the Government ought to consider the possibility that there should be no leaflet of any kind from the Electoral Commission. The Electoral Commission has chosen two designated organisations, both of which will receive public funds. Why not leave it at that? Why do you have to have somebody listing the pros and cons in a way that will inevitably be attacked from both sides?
Lord Tyler: My Lords, I am tempted to ask, as the Irishman did, "Is this a private fight or can anyone join in?". I cannot at the moment see where Schedule 19C to the 2000 Act, on civil sanctions, gets anywhere near the issue of the leaflet. If we can all discuss anything anywhere in the Bill, I have several suggestions about what we might discuss. We can come back to this later. I think that it is an important issue but it is not covered by this group of amendments. Please can we have some time later to discuss the issue? I sympathise with the point that the noble Lord, Lord Soley, is making, but it ain't here.
Lord Soley: I agree with that, too. The problem is that the Minister raised it.
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Lord Soley: If it was not the Minister, it was someone else and he responded to it. It was the Minister who started talking about the leaflet.
Lord McNally: We can discuss this under Schedule 1 to the Bill.
Lord Soley: I would be happy with that. Let me be clear. I was responding to the exchange that took place in which the Minister talked about a leaflet.
Lord McNally: As we drift down this stream, we do, I confess, go into inlets and rivulets.
Lord Falconer of Thoroton: This provision introduces civil sanctions in relation to criminal offences set out in Schedule 9. As I understand it, the criminal offences, of which there are 12 in paragraph 8, are designed to ensure that either permitted participants or authorised-
Sorry, there is not much point me asking a question if you are chattering away.
Baroness Northover: I have got two ears.
Lord Falconer of Thoroton: She has got two ears. I agree with that. I will go on. I am sure that the fact that she has two ears has some significance to the story.
There are 12 offences identified in paragraph 8. The purpose of the offences, as I understand it-though I stand to be corrected by the Minister-is that the only people who should be spending money in relation to the referendum are either permitted participants or authorised participants. Therefore the purpose of the criminal offences is to prevent expenditure by anyone other than those people. The way that this is dealt with, as a matter of the criminal law, is to say that if there is a transaction where in effect somebody else's money is spent, either directly or through a permitted participant or an authorised participant, it is made a criminal offence by paragraph 8 of Schedule 9.
The essence of each of the criminal offences, as I read them-again, I stand to be corrected-is that you have to know if you are committing a criminal offence that either as an authorised or a permitted participant you are using somebody else's money or as an individual providing the money you know that you should not be spending it on the referendum. Know or ought to know, I should say. What I am interested to know, and that seems a perfectly sensible structure, is what the circumstances are in which it will be decided to bring criminal proceedings and what the circumstances are in which it will be decided to employ a civil sanction. Obviously it will depend on the facts in every case but if know or ought to know is part of it, what distinctions will people rely on in order to determine whether it is civil or criminal? This will be important, because paragraph 8 is obviously intended to be a deterrent to people from breaking the law in relation to the limits that apply-
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Lord Lamont of Lerwick: Does the noble and learned Lord agree that the fact that we are debating sanctions in a sense validates the questions that were asked
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Lord Falconer of Thoroton: I completely agree. I find the idea that we should not be talking at some length about authorised participants and permitted participants entirely wrong. That is why the Minister's response to the last series was so disappointing. The last series went right to the heart of the issues that relate to the funding of the referendum, because everybody around the House wants a situation in which the same rules are imposed on everybody. I am sorry that the noble Lord, Lord Lamont, got a slapping from the noble Lord, Lord Tyler, for raising the question of the government leaflets, although it was obviously a slapping that he was quite able to cope with. That seems to be the one area where it is authorised to spend money that does not come from an authorised participant or a permitted participant.
I do not dismiss as a joke what my noble friend Lord Gilbert said. Presumably one of the most significant sources of what will be regarded as reliable information in relation to this referendum will be what the Government themselves or the Electoral Commission-I cannot remember which-produce in relation to these leaflets. That will probably be where one of the most significant amounts of expenditure will be. However, I return to my question to the noble Lord-
Lord Lipsey: Before the noble and learned Lord returns to his question, as he must, did he note that when the outbreak of violence took place on the other side-I think that he called it "slapping"-the Minister calmed it by saying that we could talk about all this when we get to Schedule 1? Has he noted that Schedule 1 makes no reference whatsoever to this leaflet and is of no relevance to it?
Lord Falconer of Thoroton: I was not sure when the noble Lord, Lord Tyler, and the Minister envisaged that we should have this debate. If they could identify on which particular issues we should have it, that would be fine. My question-
Lord Grocott: I have been glancing through the Bill, because the reference to the crucial issue of the leaflet hit me by surprise. The Minister looks irritated every time I make a suggestion; that seems to be the effect that I have on him. This is what Committee stages are for. Sometimes almost out of a clear blue sky a very important issue arises. It seems that we are not going to debate this now. The only part that I can see immediately thumbing through the Bill that refers to the role of the Electoral Commission is on page 19. It says:
"The Electoral Commission must take whatever steps they think appropriate to promote public awareness about the referendum and how to vote in it".
I cannot see anything that refers to leaflets. That is quite probably ignorance on my part, but that was the nature of the debate.
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Lord Rooker: My noble friend should turn over the page and see sub-paragraph (2) at the top of page 20. That is permissive, whereas the paragraph that my noble friend read out is compulsory. There is a real problem in paragraph 9 of Schedule 1 about the leaflet and the information. There will be a long debate on sub-paragraphs (1) and (2) of paragraph 9 when we get to it, because what is in the Bill seems quite contradictory to me.
Lord Falconer of Thoroton: The offences under paragraph 8 are knowledge and ought-to-know offences. Can the noble Lord give some indication, because it will obviously be important to the people involved, of what circumstances will determine whether the sanction is civil or criminal? The offences have maximum terms. What is the maximum civil sanction that can be applied? Who will determine whether it is a civil sanction or a criminal sanction?
Lord McNally: First, I do not believe that the role of the Electoral Commission is as passive as the noble Lord, Lord Soley, suggests, as was demonstrated by the fact that it suggested a better question for the referendum, which was taken on board by the Government and implemented in the Bill. I supported the establishment of the Electoral Commission and welcomed the introduction of political input into its deliberations. I remember when we first discussed it, the noble Baroness, Lady Gould, and others and I pointed out that there was a necessity to have some sensitivity about how political campaigning was carried on by mainly voluntary organisations. The Electoral Commission has performed its duties well, and I have every confidence in its being able to carry out its responsibilities under the Bill.
Lord Howarth of Newport: I am glad to hear the Minister affirm his confidence in the Electoral Commission. Does he repudiate the very unkind remarks about the chair of the Electoral Commission made by his right honourable friend Eric Pickles a few months ago? The chair came under heavy personal criticism from his right honourable friend.
Lord McNally: I shall not comment one way or the other on extraneous interventions like that, for goodness' sake.
The noble Lord, Lord Lipsey, gave me a slap about getting irritated, but the point is that these election rules and regulations-most of the schedules to the Bill-are straight lifts from existing legislation put in place by the last Labour Government, so it comes as a surprise that people who were Ministers in that Government suddenly find all kinds of loopholes and dangers in that legislation. We have transposed into the schedules existing legislation, bringing it as up to date as we can with this amendment and this clause.
I am not a lawyer but, as far as I understand it, the civil sanctions have been brought in because, as I said earlier-and this is not in my brief but from my understanding of it, so perhaps if I am wrong one of the experts behind me can correct me-the criminal sanctions in the existing legislation were felt to be far too heavy-handed, particularly as they applied to volunteer officers in political parties. A range of civil sanctions were brought in that allowed the Electoral Commission
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As noble Lords know from briefings sent to them, the Electoral Commission is following very closely these deliberations and listening very closely to the points made by noble Lords on all sides. I have every confidence that, if a point is made that the Electoral Commission thinks is of substance and needs to be dealt with, it will not hesitate to bring this to the attention of Ministers and Members of the Opposition, just as it has done in the past. The clause is a fairly narrow one to make provisions regarding the regulation of loans and bring the regulations under the referendum up to date with the legislation already introduced on 1 December.
Lord Soley: I do not want to continue the discussions that we have had other than to close them down. This is all the fault of my old and noble friend Lord Gilbert, with whom I had the great pleasure to be an international observer at the first free elections in Mongolia, which was quite an experience for both of us-and an even bigger experience for the Mongolians. I should say, in case I misled the House or the Minister, that I did not intend to imply-and I do not think that I implied-that the Electoral Commission was passive, which was the word that he used. I simply tried to describe the dilemma facing organisations such as the Electoral Commission as to whether Parliament should make more detailed rules, or whether they should make them and keep things on a very simple basis. That is a very important debate, but it is one that we get to under Clause 9.
Lord Lipsey: In the same spirit, I think that I misrepresented Schedule 1, and therefore the Minister, because there is a proposal in there on which it would be possible to hang a discussion about a possible leaflet-namely, the public information measures. I apologise for that and ask the Minister to confirm that it would be fully in order for the House to have a proper debate about the very important issues raised about the leaflet when we get to Schedule 1.
Lord McNally: I give that assurance and sincerely hope that the noble Lord, Lord Strathclyde, has it on his list to deal with that schedule.
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Lord Bach: I can make this point fairly briefly, but it is a point of some significance and I should be grateful for the Minister's response. The amendment looks, rather unusually, at the interpretation clause of the Bill. Clause 7(1) says that,
I have been lucky or unlucky enough to take a number of pieces of legislation through your Lordships' House, and to hear many others taken through it. Bills with interpretation clauses have, as a standard, defined "the Minister" as "the Secretary of State". That seems pretty sensible and uncontroversial and has the advantage of having been used traditionally. In this case, it would be whoever is Secretary of State for Justice at the relevant time, although, as I understand it, strictly speaking it could be any Secretary of State who would be entitled to take the orders through, which is why "Minister" appears in the Bill. But to say,
in this Bill is, it seems to us at least, to personalise the position. I shall explain why.
The role of the Lord President of the Council, whoever that may be at a particular time, is set out on the website of the Privy Council and defined as follows. It says that that person:
"Presides at Privy Council meetings, including any Emergency Privy Councils ... Considers for approval a number of Statutory Orders concerning Health Care, Veterinary, and Scottish Higher Education matters ... As a member of the Privy Council Committee for the Affairs of Jersey and Guernsey, reviews Laws and Orders relating to the Islands, and makes recommendations to Her Majesty concerning their approval ... Deals with Ministerial correspondence and Parliamentary Questions relating to Privy Council Business, such as the appointment of High Sheriffs ... Determines cases, where the Lord President acts as University Visitor, in a private capacity".
6.30 pm
None of these duties relates to any of the duties placed on a Minister in relation to the provisions of this Bill.
The real reason why page 5, line 27, reads as it does is to capture the current Deputy Prime Minister's responsibility for constitutional reform. He is the Lord President of the Council as we speak. This is the current Deputy Prime Minister, whose responsibilities regarding constitutional reform are also exercised by the current Lord President of the Council, by virtue of them currently being-of course-the same person. This alignment, however, is not in the job description of the Lord President of the Council, as I have attempted to explain to the Committee.
This inclusion is wrong. Simply and plainly, it is wrong to write this responsibility into law in the interests of one individual-the person who happens at present to hold that position. That individual, of course-the Deputy Prime Minister-will not be Lord President of the Council for ever; it is doubtful whether any successor would want the responsibility of signing an order into effect. That is not part of the responsibility-normally-of the Lord President of the Council.
If the Bill had said, "'The Minister' means, in this case, 'the right honourable Nick Clegg'", we would think that a bit odd. If the Bill remains as it is, it might
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Lord Lipsey: My Lords, this is not the greatest matter before us, but it is an important one and I support the amendment. If there is one rule that one learns in life, it is that making two people responsible for something is a recipe for it not getting done properly. There is not one person to blame or to take the lead and it leads to confusion and non-action. That is my first point. My second point relates to precisely the other side of the coin of the argument put by my noble friend Lord Bach; namely, the present occupants of this position. On the one hand you have the Justice Secretary, who is a passionate supporter of first past the post. On the other hand, you have the Deputy Prime Minister, the Lord President, who is a passionate supporter of AV. They have come together in this coalition and that is simply a fact.
But honestly, there is scope here for mischief-making-and I used to be a journalist. There could be real mischief: for example, the Justice Secretary waits until the Lord President of the Council has gone off for the weekend to make some amendment or order under the Bill to suit his book. More likely, there will be journalistic mischief-making, where the fact that these two gentlemen agree on the Bill when they do not agree on the subject of it is elevated and makes a good diary paragraph. I am sure this Government's backs are extraordinarily broad. They probably do not read the newspapers at all and are not the least interested in the gossipy things that I suspect might arise from this, but it does seem a completely pointless goal to leave the matter without a goal-keeper so that anybody can have a pot-shot at it.
Lord Howarth of Newport: Does my noble friend agree that this is significant in terms of proper accountability to Parliament? Parliament needs to know which Minister within the Government holds responsibility, and the statute ought to make that clear.
Lord Lipsey: My noble friend makes clear in more formal terms what I meant by confusion. Parliament is indeed one of the bodies that could end up confused.
Lord Newton of Braintree: My Lords, one of my problems at the moment is that I can hardly stray into these debates without finding that somebody stirs me up. That has happened on this occasion. I was Lord President of the Council for five years, probably longer than anybody else since the war-with the possible exception of Herbert Morrison-or indeed, since the role was created.
I am strongly inclined to stick with my noble friend; he will be glad to hear that, I hope. The clue to this is what was said by the noble Lord, Lord Bach, which completely refutes what has just been said-I am somewhat surprised to say-by the noble Lord, Lord Lipsey. The phrase used in legislation-I do not know how it was done when there used to be Ministers as well as Secretaries of State-is "Secretary of State". It
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My point therefore, and declaring my former interest, is that I do not see why the Lord President of the Council, who is certainly a Cabinet Minister and with the status of a Secretary of State, should not have the same ability to do what all other Cabinet Ministers designated as Secretaries of State can do. I stick with my noble friend.
Lord McNally: I think I am now 2-1 up in the interventions of my noble friend Lord Newton; I am very pleased about that. It is an interesting thought. I am surprised that the other side should leap on this to assume that it was the Secretary of State for Justice. As I explained, I am here in my capacity as Deputy Leader of the House of Lords, and covering Cabinet Office business. When I studied my constitutional stuff at university, I learned that "Secretary of State" was a portmanteau term in government, not specific to any one person.
The noble Lord, Lord Lipsey, talks of scope for mischief-making. For half this Committee, we have constantly been told that this project has been driven through by Nick Clegg and Nick Clegg alone. If we go through the various Hansards, we will find that Nick Clegg has been named more often by the Opposition than any other single person. The Government have put into the Bill who has the responsibility for this legislation. It applies to something that will be carried out next May, when we will be celebrating the first of the five years of Nick Clegg being Lord President of the Council, but nevertheless it is relevant to this Bill. It is simply a matter of common sense to have him named. I agree with my noble friend, Lord Newton. In the past, there have been people who have carried the dual title of Lord President and Secretary of State because of that curious anomaly of what Secretaries of State can do. As I remember it, it used to be only the Minister of Agriculture who was not a Secretary of State. All the rest were. I am sure it is not mischief-making.
The arrangements in the Bill make sense. They allow the Deputy Prime Minister to take key decisions with nationwide effect, but also enable decisions with a specific territorial flavour to be made by the territorial Ministers. For this reason, I urge the noble Lord to withdraw his amendment.
Lord Bach: My Lords, I shall of course withdraw the amendment but this is an interesting point because, as far as I know, it has never been done before. If the Minister has some precedent for it, I will be proved wrong. What most upsets me about the whole debate is having stirred up the noble Lord, Lord Newton. I do not enjoy doing that at all, although he does not seem much stirred up to me.
Lord Newton of Braintree: Only in the nicest possible way.
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Lord Bach: Then I feel much better for that. I still do not see why both positions are there. If the Minister is right in his argument, why are the words "Secretary of State" included at all? Why is it not just the Lord President of the Council or, if the Government want to put other Ministers in, why not say the Prime Minister, too, or the Chancellor of the Exchequer? I do not see why both names are there when the precedent is that it is the Secretary of State, but perhaps-
Lord Campbell-Savours: Could the answer be that there is some concern among those involved in the "pro" campaign that the Lord President of the Council might be identified with Mr Clegg, who himself will be identified with the most derogatory remarks about the electoral system that is being promoted?
Lord Bach: My Lords, I was trying to be as polite as I possibly could be. One of the dangers of personalising it in this way, as I think my noble friend Lord Campbell-Savours is hinting, is that Mr Clegg may be either so popular that his name, as it were, in making the orders means that what he wants will occur or, heaven forbid, so unpopular that whatever he does or suggests means that what he wants will not happen. To that extent, I agree with my noble friend.
Lord McNally: On the point about Secretaries of State, I think the intention is that those in mind are the Secretary of State for Scotland and the Secretary of State for Wales.
Lord Bach: So, for England, is it the Lord President of the Council?
Lord McNally: If there was to be anything specifically territorial, the Secretary of State could take responsibility there. That is my interpretation of it, but there is no great mystery about it. It is simply that, as I said at the very beginning, the Lord President is steering this Bill. He steered it very successfully through the House of Commons and we are doing the same.
Lord Bach: The Minister is being unfair to himself. The Lord President of the Council was hardly seen in the House of Commons while the Bill went through it. I think that he moved the Second Reading and did not appear again until Report. But we are seeing a great deal of the noble Lord, which is of course always a huge pleasure.
Baroness Liddell of Coatdyke: I am a bit confused about something that the Minister said about the territorial responsibilities of the Lord President. Having been a Secretary of State for Scotland, I am not absolutely clear that that is the position. It might be helpful if the Minister could seek greater clarity from his inestimable advisers.
Lord McNally: This is about the Lord President's territorial responsibilities. With the ability of my friends opposite to become confused, I should never have intervened again. I am sorry, for it was a very bad mistake as the noble Lord was just about to withdraw.
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Lord Howarth of Newport: Can I press the Minister a little bit on his statement just now that the Lord President-the Deputy Prime Minister-steered this legislation very successfully through the House of Commons? Is his concept of successful passage through that House that the Bill was programmed and that very important sections of it were not examined either in Committee or on Report? Yes, the coalition got its way in the House of Commons but the upshot of that is that there is a particular duty on this House to examine the Bill in the most minute detail, precisely to make up the deficit caused by the failure of the House of Commons to examine this legislation properly. What does the Minister mean by successfully steering the Bill through the House of Commons: that the Bill should be properly scrutinised, or simply that the Whips should ensure that it passes without being scrutinised?
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Lord McNally: I have been around Whitehall and Westminster only for about 40 years, but during the whole of that time people from the Opposition Benches have stood up and made that speech about various bits of legislation. In fact, as noble Lords opposite will know, the time offered in the other place for scrutiny of the Bill was positively extravagant, matched only by the verbosity and time-wasting of the spokesmen for the Opposition, who used every opportunity to waste time exactly so that somebody at this end could make the complaint that the noble Lord has just made-and the noble Lord, Lord Rooker, knows that more than most.
Lord Rooker: When I took this Bill on holiday to read in the summer, it was 153 pages. When it arrived in this House, it was 300. Yet the Minister has the brass neck to say that the other place was time-wasting, when the Bill doubled because of 286 government amendments that were put into the Bill in the House of Commons. Come off it!
Lord Lipsey: Perhaps I might make a helpful suggestion to the Minister to move things on, because we are getting into other waters. He said something incredibly helpful just now: that this is intended to give part of the powers to be exercised by a Secretary of State for Scotland and a Secretary of State for Wales-by a territorial Minister; that is what the noble Lord said, as he will find when he checks in Hansard-and part of them to be exercised by the Lord President. That is perfectly sensible and a very good description. All he therefore needs to do is to agree to introduce at the next stage of the Bill an amendment that makes that clear and we can move on.
Lord Soley: I would not have intervened again, except for the way that the Minister addressed his last comment. That was not helpful. It is where he actually makes matters worse. My noble friend Lord Rooker is exactly right. The noble Lord talked about his vast experience but I know of many experiences of both kinds of Government increasing a Bill by piling in extra clauses that then come before this House. It does not help to try and score a party-political point. The other side of the argument is that on the last occasion
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My advice to the Minister is not to get into this party-political knockabout. A Bill like this, which is very important to the Government but very complex, will inevitably expand over time if it is hurried through in the way that the Government are doing. That is what has happened and that is why all those extra clauses, to which my noble friend Lord Rooker referred, have been added. It also explains why some people on the Minister's own side who were opposed to certain aspects of it complained about the lack of time in the House of Commons. I simply say: for heaven's sake, drop this idea that it is all one party's fault. That is nonsense.
Lord Howarth of Newport: Does my noble friend agree also that the fact that the Bill has been added to on such a massive scale by the Government during its passage through the House of Commons-indeed, we have just been examining a new government amendment-indicates that it was prepared in great haste? Yet at the same time, the Government are insisting that the Bill must move very fast indeed towards the statute book. Can it be right to prepare a Bill so hastily that large-scale improvisations have to be made by the Government in extending it, even as they insist that it is rushed through and therefore skimpily scrutinised?
Lord Falconer of Thoroton: My Lords, I have to rise in relation to the rather casual accusation made by the noble Lord, Lord McNally, that it was just time-wasting down the Corridor. As the noble Lord will know, because he has been a Member of Parliament himself down there, the effect of the guillotine Motion-although he was perhaps not there when there were guillotine Motions-is that certain amendments are not reached because there is not enough time. The idea that they talked on and on to make it last seems to be misplaced. The worry about what the noble Lord said is that that casually dismissive remark is the sort of remark that is then used to dismiss parliamentary scrutiny of Bills-"we can dismiss what is being said because it is all time- wasting". I thought one of the principles on which his party and the other party with which he is now in coalition put to the electorate was that we would respect Parliament more rather than treating it with the contempt he has just shown.
Lord Campbell-Savours: Before my noble friend sits down, I refer him to column 843 of House of Commons Hansard of 2 November where Bill Cash objected in the strongest terms to the fact that the Government, with the use of a programme Motion, were denying the House the right to debate large parts of the Bill. Is my noble friend aware that Conservative MPs at the other end are egging us on? We are telling them that we want to deal with the Bill in a reasonable way, but they are egging us on to block the legislation. Conservative
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Lord Falconer of Thoroton: I did not know what Mr Bill Cash said in the other place but it would help in relation to respect for Parliament if the noble Lord, Lord McNally, would think about withdrawing what he said.
Lord McNally: I have been around this Parliament for 40 years and I do not need lectures from the noble and learned Lord about respect for its traditions and for its importance. I did not suggest anything other than something he knows darn well. For as long as I have been here, and long before, Governments have brought in guillotines and Oppositions have complained about lack of time and scrutiny. That is all that I said. That is all that is in Hansard. I am not going to take lectures from the noble and learned Lord about respect for this Parliament and its institutions. I have given my life to this. I believe in it passionately. I respect it as much as the noble Lord, Lord Rooker, respects it. No more, no less. But I am not being lectured to or allowing my words to be twisted. I am simply saying something that every noble Lord knows is a simple truth-nothing more, nothing less-and certainly with no disrespect to Parliament.
Lord Rooker: Say sorry to Chris, then.
Lord Falconer of Thoroton: I have understood the Minister to say that the interventions by Members of Parliament down in the House of Commons were done for time-wasting purposes. I regard that as expressing contempt for their contributions. That is what I was suggesting he might think about withdrawing.
Lord McNally: More than one person has commented that the Opposition spent overlong on certain parts of the Bill and then used that as an excuse for not dealing with other parts of the Bill. Just as I have argued with colleagues who have got a little tetchy about the Opposition's tactics, I know full well that, as one of my old text books used to say, the principal weapon of an Opposition is delay. I do not object to that, but neither do I fail to recognise it when I see it.
Lord Grocott: This is a Bill of 300 pages-and I do not apologise for repeating this-which plans to change the constitution of our country. I hope the noble Lord is not arguing that to spend five days-I am speaking from memory now, but I am pretty certain that I am right-on the Committee stage in the House of Commons and two days on Report is an inordinate or generous amount of time. I hope he is not suggesting in any way, shape or form, that the time that we have spent in this House on the scrutiny of crucial groups of amendments is any more than they properly deserve. If he does think that, I would appeal to him to let us know which group of amendments should not have been discussed or were addressing anything other than very serious matters about our constitution. He gives the impression that he is very irritated-perhaps I am wrong, perhaps we are over-sensitive on this side-at
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While I am on my feet, the next amendments after mine are six government amendments. I hope that the noble Lord will not do anything other than a proper courtesy to the House in explaining these amendments in proper detail. I absolutely assure him that neither I nor any of my colleagues, and I suspect any on his side of the House, will accuse him of time-wasting.
Lord Bach: My Lords, I am surprised that my little amendment has developed into the excitement that we have enjoyed in Committee for the past few minutes. I have one serious point to make. I ask the Minister to reconsider his attack-maybe he did not mean the words, I do not know-on a particular individual at the other end who is a colleague of mine in the opposition justice team. It is an unwarranted attack on an individual. If the noble Lord wants to attack tactics, that is fine, but do not attack an individual, a Member of Parliament, for doing what most of us would consider to be his duty-and indeed what the noble Lord did so well when he was sitting on the Opposition Benches just a few months ago. Before I withdraw the amendment, I ask the Minister to consider-
Lord Rooker: I do not want to prolong this, but this is the result of this place not having a Speaker. In the other place, if anybody down there had said about somebody up here what was said by the noble Lord, Lord McNally, the Speaker would have ruled it out of order. You are not allowed to criticise named Members of this place down in the other place. There is no benefit to it, because we do not get anywhere doing it. We have no Speaker here to stop that kind of immature comment and we ought to have.
Lord Bach: I give the noble Lord the chance, please, if he will do that-
Lord McNally: If the noble Lord, Lord Rooker, wants to call me immature, that is part of the rough and tumble of politics. I am not going to say sorry. For goodness' sake, again, I really hope that people outside read Hansard and then they can make a judgment about the handling of this Bill. I am willing to go into the details of this and argue it. We have had everything from the Mongolian elections to the sensitivities of-the Member for the Rhondda Valley, was it? I cannot remember which one it was.
Lord Bach: I am extremely disappointed that the Minister, who is normally a parliamentarian of the highest order, should on this occasion not think it right to withdraw what he said about an individual Member of Parliament. I very much regret that. It
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Baroness Hollis of Heigham: Spoilsport!
Lord Bach: Yes, spoilsport I may be, but on the basis of the debate that we had about the issue itself, the proper thing is to withdraw my amendment which I intend to do. However, I give the noble Lord just one last chance. Why not just say he is sorry for what he said about an individual Member of Parliament? His criticism has been heard. Why not withdraw it now? I beg leave to withdraw.
7 pm
40A: Clause 7, page 5, line 34, at end insert-
""registration officer" has the meaning given in section 8 of the 1983 Act;"
Lord McNally: My Lords, if, when he reads Hansard, the Member for Rhondda is hurt by my remarks, I will try to comfort and reassure him that there was nothing personal in them.
These are minor and technical amendments which ensure that there is single definition of "registration officer" which applies throughout Part 1 of the Bill. This single definition replaces the existing definitions given in the various provisions in Part 1, but does not change the meaning. The amendments provide that "registration officer" has the meaning given in Section 8 of the Representation of the People Act 1983. For England, Wales and Scotland, the individual is the officer who has been appointed to this role for the relevant area. In Northern Ireland, the Chief Electoral Officer for Northern Ireland is the sole registration officer. I beg to move.
Lord Falconer of Thoroton: A drafting point: there appear to be random definitions contained in Clause 7(1). For example, we do not have definitions of "regulated transaction", "responsible person" or "relevant donations", which are terms referred to. Yet, suddenly, we have a definition of "registration officer". What is the basis upon which some terms are defined in Clause 7(1) and not others? Will this not lead to confusion?
Lord McNally: As I understand it, this is an attempt to clarify the specific case of "registration officer". We do not anticipate the kind of confusion that the noble and learned Lord anticipates in other definitions, but it is important to have a common definition for registration officers.
Lord Falconer of Thoroton: I do not want to be a total brute here, but will the noble Lord write to me? It is pretty clear what "registration officer" means throughout the Bill, but if you do not also define the other terms, there is the possibility that there will be some difference among courts as to what it is meant. Can the Minister set out the basis for selecting some terms to be defined but not others? If he would like to write to me about
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Lord McNally: The noble and learned Lord has brought an entirely new atmosphere to the debate for which I am most grateful. I offer to write to him on the specific point.
40B: Clause 7, page 5, line 37, leave out subsection (2) and insert-
"( ) A Westminister parliamentary constituency, as it exists on the day of the referendum, is a "voting area" for the purposes of this Part."
Lord Grocott: My Lords, the amendment could not be simpler in its objective. It would shorten the Bill, and is about how the election will be conducted and declared. It refers to Clause 7(2) of the Bill, which says, in defining the various voting areas, that they shall be,
- "a district in England ... a county in England ... a London borough ... the City of London ... the Isles of Scilly ... a constituency for the National Assembly for Wales ... a constituency for the Scottish Parliament ... Northern Ireland".
My amendment simply deletes all that and replaces it with the most commonsense way to consider and declare an election relating to the House of Commons: to say that the results will be declared on a constituency basis. It basically replaces 10 lines with two.
I am emboldened in moving the amendment, not least by the contributions of the noble Lord, Lord McNally, in his responses in various other clauses, where he has repeated time and time again that his intention is to follow as closely as possible what happens in parliamentary elections in all the details of how this referendum is conducted. I could quote any number of examples, and that is precisely what my amendment does. For example, in the debate the other day on whether voting in the referendum at the age of 16 should be allowed, the noble Lord said in rejecting the amendment:
"Then as now, the Government's position on the franchise and in all other aspects relating to how the referendum is run is that we should follow the arrangements for parliamentary elections".-[Official Report, 13/12/10; col. 464.]
That is precisely what I am doing with the amendment.
Noble Lords may ask why. What is the point of having elections conducted and returned on the basis of parliamentary constituencies? The clue is in the Title to the Bill: the Parliamentary Voting Systems and Constituencies Bill. My reason for moving the amendment is that the Bill goes to the heart of the relationships between constituents and the Member of Parliament. That is what it is about, and why I and others are so concerned about it in many ways.
I will concede, perhaps the only concession I could make to supporters of the alternative vote system, that the proposal has the merit of not disconnecting Members of Parliament with their constituencies. I have long believed-and this is why I support first past the post more than any other system-that, to use the cliché,
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I am not criticising AV in suggesting that the results should be declared on a constituency basis. I am saying that the constituency results are important. Of course, I freely concede that the most important result of a referendum is to know what has happened nationally. You total the votes up and see who has won and who has lost; that is basically what happens. As I have said, however, this is about constituencies and the verdict of people in their constituencies. During the referendum, if noble Lords ignore the national picture for a moment, we are in effect saying to people, "For generations, your parents, grandparents and perhaps in some cases great-grandparents have returned Members of Parliament from this area"-which we hope is a coherent area, but we will come to that later in the Bill. "Are you happy with how you have been choosing your Members of Parliament? Because some people are saying that they are dissatisfied with how that is done".
By returning the results in individual constituencies, you are at least relating the conduct and outcome of the election to the very heart of what this change in our constitution, should it be carried, is about. It is, frankly, pointless and irrelevant to do as the Bill does: to declare results on the basis of boroughs in the United Kingdom, for example. What on earth is the basis for that? Does it tell us whether the borough of this, that or the other voted for or against the referendum? Nor do I understand the significance of declaring one constituency for the whole of Northern Ireland.
Lord Tyler: As the noble Lord knows, I share his view about the connection between a representative and his or her constituency. He and I take that seriously. I am sure that he has looked at the evidence given by the Electoral Commission, to which many tributes were earlier paid for its independence and the care with which it is preparing for this. Therefore, does the noble Lord note that it summarises its view on his amendment by saying that it would create an unnecessary risk to the successful delivery of the scheduled elections and referendum? That is pretty specific. Will the noble Lord address that point? We are sympathetic to his general point. Our concern is the practical issue.
Lord Grocott: I will address that point precisely in a moment. I am currently simply pointing out that, in relation to a normal parliamentary election, to have the various categories of electoral district as laid out in the Bill offers meaningless figures. It is particularly confusing in Scotland and Wales, where the results of the referendum debate-which is, I repeat, about parliamentary elections-will be based on the constituencies of the National Assembly for Wales and the constituencies of the Scottish Parliament. I do not know too much about Scottish politics, but I do know that the constituency boundaries for Scottish parliamentary elections are different from the constituency boundaries for the House of Commons. It is suggested that that is not the appropriate area in which to consider and declare the results, but it simply makes the whole operation more confusing if they are declared on a different basis.
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The noble Lord, Lord Tyler, rightly drew my attention to the wording of the report by the Electoral Commission. I do not think that I have ever been referred to by the commission before, so this is a moment in my life-I do not know about anyone else's. I have to say that I have a fair bit of concern about what the commission has said, and I hope that when he sums up the Minister does not simply repeat it but gives some credence to the points that I am making. The commission says that:
"Amendment 40B seeks to change the voting areas for the referendum so that they are the same as UK parliamentary constituencies"-
the simplest possible proposition, of course.
"The voting areas currently in the Bill reflect the voting areas for the scheduled elections on 5 May 2011, the polls for which are to be combined with the poll for the referendum if they take place on the same day".
That is a statement of fact, but now comes-for me, at any rate-the contentious bit:
this is the Electoral Commission, the independent body to which the noble Lords, Lord Tyler and Lord McNally, have paid tribute-
- "that it is the Government's intention that the referendum should take place on 5 May 2011. We do not support this amendment as making such a significant change to the rules for the referendum this close to 5 May would create an unnecessary risk to the successful delivery of the scheduled elections and the referendum".
Bearing in mind the unprompted mini-debate that we had earlier about how neutral the Electoral Commission could be, were it to provide a descriptive leaflet of AV on the one hand and first past the post on the other, the commission's comment on this amendment rang alarm bells in my brain. It is not commenting in any shape or form on the merits of the argument that results should be by constituency; it is commenting on the basis of whether this would be convenient to the Government, who want the referendum on 5 May 2011. That is a pretty inappropriate thing for the Electoral Commission to say. By all means it could say, "The Government want to do this but of course that's none of our business; they might change their mind".
What is even more significant and concerns me, although I cannot believe it to be true, is that the Electoral Commission appears not to have seen the result of the amendment proposed by my noble friend Lord Rooker and carried, which gave the Government all the flexibility that they might need to deliver the Bill in a timely way with proper scrutiny. As it now stands, the Bill says that the referendum does not have to be held until October next year, which would give plenty of time for the oddity in the way that these election results are declared to be rectified.
This is not rocket science. Having a general election on the same day as local elections-maybe this is helping the Government, I do not know-is a tried and tested operation. To repeat myself, I am suggesting that the referendum should be counted just like general election constituencies. I have not done an exhaustive list, but we know that this year's general election was held on the same day as local elections, as were those in 2001 and 1997. I am certainly not likely to forget the
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I am concerned that the Electoral Commission, no less, should be advising us to turn this amendment down-and I hope that I have demonstrated that it is at least worthy of consideration-on the grounds that it does not meet the Government's timetable. When the Minister comes to respond to this, I hope that he does not use that argument. As I said when I intervened on my noble and learned friend Lord Falconer earlier, I feel a bit hurt by all this, or maybe he should, because when he proposed the amendment earlier today he was able to quote the Electoral Commission as broadly agreeing with what he was saying but it did not recommend that we should vote for his amendment. Now it broadly disagrees with what I am saying but it is telling the House to throw it out-and, by implication, the noble Lord, Lord Tyler, obviously takes it very seriously. Perhaps I should not take this personally.
7.15 pm
Lord Rennard: I wonder whether the noble Lord is trying to make it difficult for the referendum to be held on 5 May, in contrast to the noble Lord, Lord Rooker, who said specifically that he was arguing in his amendment that the referendum could be held on 5 May or at a later date if that was more convenient. Is the position of the noble Lord, Lord Rooker, not wholly different from that advanced by the noble Lord, Lord Grocott, who is trying to make it difficult to have the referendum on the day that the other place has voted for it to be held on?
Lord McAvoy: I do not want to raise the temperature again, but nevertheless this point has to be made: does that intervention from the noble Lord, Lord Rennard, not indicate clearly that there is no filibustering going on, there is no organisation and what is happening here is genuine scrutiny?
Lord Grocott: Since the degree to which we are genuine is being tested at the moment, the House will simply have to accept my absolute, total, 100 per cent, categorical-I cannot think of any other adjectives-assurance that when I tabled this amendment, I did so, believe it or not, because I thought that it would be a better referendum if the results were declared by constituency, which is never normally a problem in general elections. It came as a surprise to me that the Electoral Commission thought that there would be all sorts of administrative problems in doing so, particularly-I am repeating myself now, I know-because time and again local elections and parliamentary constituency elections have been held on the same day.
I hope that the Minister's notes do not say that this is just another silly amendment from the Opposition and that it should be knocked down. I hope that he recognises that there are people who have lived and worked in areas of this country, many of them for
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Lord Rooker: My Lords, I did not really see the significance of my noble friend's amendment when I was reading through the Bill, and I missed this.
I am thinking back. I know that we are going to be told that the 1975 referendum was not declared by constituency. If I remember rightly, one of the arguments used at the time was, "It would be very uncertain if MPs who had campaigned on one issue about the EU found that their constituents had gone against them". I recall it being a bit mixed up. I was part of the no campaign, in that sense-I certainly voted no, anyway. In this case, though, the issue is very personal to the MPs concerned because it is about their voting system.
Take the districts. I used to represent part of Birmingham. The whole of the city gets lumped together, no one gets embarrassed about which way a particular constituency has gone and everything is in the melting pot. It is easier to count when all the constituencies have been lumped together, but where does that leave the Members of the Welsh Assembly and the Scottish Parliament elected on that day? They will be out campaigning. The results will be declared in their constituencies for AV or not. So, you will be covering it up for some so as not to cause embarrassment, but not for others.
I am unaware of a constituency called "the Isles of Scilly". If I remember right, the Isles of Scilly are part of a constituency on the mainland. That is my understanding. Why on earth are they singled out in this way? On Northern Ireland, I hope that we will not have the argument about there being an east and a west and a green and an orange. We do not want any arguments about which constituency went which way. We do not want any arguments about lumping it all together. You cannot use all these arguments to defend this set of voting declarations. Whichever you use for one is contradicted by the other.
It cannot be being done for the administrative convenience for the Electoral Commission. It is not doing the counting. The counting officers are doing the counting-a well-oiled machine, highly sophisticated in counting votes in this country based on wards and constituencies. I freely admit that a little bit went wrong but not on the counts. Why deviate from that? Why deviate from the tried and tested system that we know works for counting? People know where to go. They know where their counts are. The type of people who do the counting go to the same place virtually every year and are almost on a permanent contract. Why interfere with a system that works? I have offered up some of the issues.
I would like an explanation about the City of London. Normally when there is a count for the constituency, are we referring to the City of London as the city or as
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Lord Howarth of Newport: I support my noble friend Lord Grocott. This referendum is to be about the choice of a parliamentary voting system, so it is bizarre not to declare the results on the basis of parliamentary constituencies. If it were a referendum about how local government is organised, one might see some sense in the stipulations-districts, counties, London boroughs and so forth-that are set out in Clause 7(2). However, those units are irrelevant to the question at issue in this referendum, so my noble friend's case is self-evidently sensible.
I also join my noble friend in his mild but firm stricture on the intervention of the Electoral Commission. The proper responsibility of Parliament is to ensure that the system put forward in this Bill is well designed. The expedience for the Government of ensuring that the referendum takes place on 5 May must be a secondary consideration. I would have hoped that the Electoral Commission would also want to make it its priority that the system that it is there to oversee and to administer is appropriately designed. I am disappointed that it has not done so in this case.
Lord McAvoy: My Lords, I rise briefly to indicate my support for my noble friend Lord Grocott's amendment. As a former Member of Parliament for a Scottish constituency, I can bring a perspective as to how this will be viewed. As my noble friends have said, this proposed referendum is on a voting system for Westminster. It seems incongruous and, quite frankly, plain daft that the results will not be declared on a constituency basis. These days, when people are looking for more transparency and accountability from MPs, it is absolutely right that, if it is an embarrassment to the MP if the constituency goes a different way from the way he or she campaigned, that should be known. So be it-that is the way it is.
As a unionist, I take exception to the fact that Scottish Parliament seats seem to be given primacy over Westminster seats when it comes to a voting system for the Westminster sovereign UK Parliament. It is wrong in principle and sends out the wrong messages. It will give further incentives and justification for those in nationalist politics in Scotland to continue that drive to say that somehow we in Scotland are different from our friends, neighbours, relatives and colleagues in England, Wales and Northern Ireland. No, we are not. We are all part of a British state. As well as being proud of our individual countries, we are British citizens. There is nothing wrong with that at all.
These proposals are an indication that the Bill has been rushed. Time and again we have come up against things which it would seem common sense to do but which are not done. The fact that these things have not
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I totally accept that people have different opinions in Scotland but for my part and, I am quite convinced, for the majority in the constituency of Rutherglen and Hamilton West the Westminster Parliament is-I say this without any disrespect to the Scottish Parliament-the prime Parliament. I can imagine hearing the howls of anguish-"Trust the perfidious English!"-if the Westminster Parliament organised a referendum for the voting system for the Scottish Parliament that did not give due respect to the Scottish Parliament, the forum for which it was proposing a change in the voting system. What is good for the goose et cetera.
The noble Lord, Lord McNally, has paid tribute to my noble and learned friend Lord Falconer for lowering the temperature a wee bit. It is certainly not in my nature to up the temperature. It might be stretching credibility to say that I feel intimidated but I certainly feel on occasion a bit reluctant to come forward to speak. Time and again I hear not only the accusations from the Front Bench on the other side but also the sneers and ridicule from other parts of the Chamber when somebody rises to make a point. This is the third time that I have spoken this evening. The other two times I spoke for two or three minutes. That is hardly filibustering, dragging things out or not co-operating. It is making sure that the Bill is scrutinised and that we can come forward and point to things that we believe are wrong. There are differences of opinion-a whole host of them. There is no concerted effort from this side of the House as far as I can see. I am certainly not part of it.
I will not repeat my noble friend Lord Grocott's quotation from the Electoral Commission. However, it quite took my breath away that the Electoral Commission-a so-called independent organisation-in effect tells Members of this House not to put forward or vote for any change because that would prevent the Government from having the referendum on 5 May. It is breathtaking and quite disgraceful. I hope that we do not get any more of that sort of comment or, quite frankly, blackmail from the Electoral Commission. I support my noble friend.
Lord Bilston: My Lords, I, too, support my noble friend Lord Grocott's amendment. I hope that the noble Lord, Lord McNally, will accept it because, as has been pointed out, this is very much an issue for constituencies. I was privileged to represent my constituency for many years-for 14 elections. I lived and worked as the local representative for over 40 years.
As an aside, let me say that not one person has ever said to me, "You are illegitimate because you haven't got 50 per cent of the vote". In all the time that I represented the constituency that I was proud to represent, I served all the people. That constituency of Wolverhampton South East will figure in the voting
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My point is that the campaign will be based on constituency boundaries. That is how this referendum should be fought, because the people in every constituency should have the right to say aye or no in it. As I say, I genuinely hope that a multitude of people-not a low vote but a substantial, solid vote-will say no in this referendum, which should be based on our constituency boundaries.
7.30 pm
Lord Campbell-Savours: My Lords, I briefly intervene to raise something that has not yet been raised. It is to do with the relationship between Members of Parliament in particular parts of the world. The noble Lord, Lord Tyler, referred to a practical issue and it is a practical issue that is of interest to me. I have been sitting here pondering how this would work. We are told that the yes campaign will essentially be a people-based campaign. There is a feeling in the yes campaign that the intervention of politicians might be unhelpful. However, the reality is that politicians, particularly MPs, will want to be involved. It will not be possible to keep them out, particularly where they may have a strong view. Yet the fact that the legislation is framed in this way might lead to campaigns being organised on a district-wide basis. I know that, in the Labour Party, district parties are never as well organised as the constituency parties. I presume that this might well be the case for other political parties.
I suggest that a campaign that is essentially district based might diffuse the role that the MP might wish to play in its organisation. MPs may well find, if the campaign is district organised, that they have to go into neighbouring constituencies. When MPs go into neighbouring constituencies, it often leads to problems-indeed, to problems inside parties, where people from the same political party represent neighbouring seats. In a curious way, by organising the campaign on a district-wide basis, we might interfere to some extent with the role that Members of Parliament wish to play in the campaign because they simply want to avoid argument. The point that I am making is rather subtle in that it deals with relationships between MPs, but the Government should not altogether ignore what I am saying. Ministers in the Government will know from experience that what I am referring to is a reality.
Lord Falconer of Thoroton: My Lords, this is a serious and sensible amendment. It would take some persuading on the part of the noble Lord, Lord McNally, to convince people that my noble friend Lord Grocott's proposal is not the more sensible approach.
I will explain what the Bill currently proposes for the referendum in Clause 7(2). It proposes to divide the whole country into a series of voting areas: a district in England where there is a district council; a
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That means that the public will become aware of how people have voted in the eight different sorts of voting area specified in the Bill. For example, people will know how a London borough has voted and how Northern Ireland as a whole has voted, but not how individual constituencies have voted in Northern Ireland, whether they are individual constituencies for the Northern Irish Assembly, local authority constituencies or parliamentary constituencies. Nor will it be possible to work it out, because the voting area is the whole of Northern Ireland. In London, you will not be able to tell how individual constituencies have voted.
What is the purpose of this extraordinarily complicated system? Is it, I ask myself, trying to parallel where elections are taking place on the same day as the proposed referendum, namely 5 May? No, because in Northern Ireland the whole of the country is chosen to be the voting area. No, because in London there will be no local authority elections. In Scotland there will be voting in Scottish Parliament constituencies but local authority elections will also be going on. On the face of it, this seems to be an overcomplicated system for identifying voting areas, in which the disclosure of how the votes are cast bears no relation to either parliamentary constituencies or anything else.
The noble Lord, Lord Grocott, has pointed out that a theme has run through the responses of the noble Lord, Lord McNally, to all this. It is that the Government have tried, in putting forward practical proposals, to stick to the normal electoral arrangements. I have never seen these electoral arrangements in any other sort of election. They are overcomplicated and arbitrary in terms of the areas in which declarations will be made, whereas a network of arrangements already exists for parliamentary constituencies. Whenever an election is called, it seems possible to set up a system for declarations and results. On the face of it, the parliamentary constituencies network looks to be far and away the most straightforward and practical. It does not involve these extraordinarily complicated arrangements. Why is the proposal of the noble Lord, Lord Grocott, not a simple way of giving effect to the sort of proposition that the noble Lord, Lord McNally, has been making?
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Lord Rennard: In terms of simplicity for the counting areas, does the noble and learned Lord not accept that in Scotland the proposal of the noble Lord, Lord Grocott, would make things rather more complicated? His amendment suggests that the voting areas should be based on Westminster parliamentary constituencies. If the referendum is held on 5 May next year, as is envisaged as a possibility even under the amendments of the noble Lord, Lord Rooker, and if you are counting the votes on the basis of Scottish parliamentary constituencies rather than on the quite different boundaries of the Westminster parliamentary constituencies, it is impractical to have one set of counting areas for the referendum and a different set for the elections to Scottish parliamentary constituencies. Therefore, the reason for the amendment is to try to make it impossible, or at least very difficult, for the referendum to take place on 5 May, and is not in the interests of simplicity, as the noble and learned Lord suggests.
Lord Falconer of Thoroton: I take the point in relation to Scotland. That is probably the only place where one can see some logic in the proposals. However, one cannot see any logic in relation to the rest of the UK. Therefore, maybe the answer-and if the noble Lord were to make proposals on this I might support him-is for us to stick with the Scottish constituencies, but leave everything else to be done on the basis of Westminster constituencies. There needs to be some explanation for why this extraordinary procedure has been adopted.
In addition to the points about practicality, there are two others. First, we have to do this without the benefit of the Electoral Commission's views, because, as the noble Lord, Lord Grocott, said, the commission has said that that would simply delay the referendum. Sadly, the commission has not given this House the benefit of its views on whether this proposal is more practical than the one in the Bill. Secondly, there is a real force in the argument which states that if we are talking about parliamentary constituencies and how they vote in the future, there is a logic and a force in saying, "Let's see how individual parliamentary constituencies voted", because, for the life of me, I cannot see the logic in saying, "We'll disclose how a London borough or the whole of Northern Ireland voted, but we won't tell you how individual constituencies voted".
Lord McNally: My Lords, if anything that has happened over the past four hours suggests that I am not enjoying this process, it is entirely untrue. I will write to Chris Bryant in the morning. I would not want him to think that I was attacking him personally. I am certainly not someone who has objected to the interventions of the noble Lord, Lord McAvoy. A number of Labour MPs have stopped me with a look of sheer amazement and said, "You heard Tommy McAvoy speak?".
On the point about the Electoral Commission, I hope that noble Lords do not put sinister interpretations on this matter. If our intention is to hold the referendum on 5 May, as is absolutely clear and we continue to make clear, it is no more than the Electoral Commission's duty for it to say that, if amendments A, B or C were
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Being a skilled advocate, the noble and learned Lord, Lord Falconer, can draw out these various bodies and make a case for a real mishmash of voting areas. In fact, the provisions that we have included in the Bill in relation to voting areas for the referendum ensure, as much as possible, that the same boundaries will be used for the referendum on the voting system as are used for other polls with which the referendum is combined. There is nothing more or less to it than that. The intent of the clause-as is the case in so much of the Bill-is to make the core decision that the electorate are being invited to make as simple as possible.
On the specific question of the noble Lord, Lord Rooker, I can tell him that the City of London is designated separately because, as he will know, it is a separate local government area within London. The other areas are the London boroughs.
7.45 pm
Lord Falconer of Thoroton: If the principle is that the counting areas for the referendum are to be as close as possible to those for the other elections taking place on the same day, why will there be one counting area for the whole of Northern Ireland, given that it will be holding Assembly elections on the same day?
Lord McNally: I will write to the noble Lord on that. It seems that one element of confusion is that we are not asking United Kingdom constituencies to make a decision-we are asking for a national vote. It will be a yes or no poll, designed on a national basis.
Lord Howarth of Newport: My Lords, I understand the argument about administrative convenience and, of course, that argument is not negligible. However, does the Minister not think it is important that people should know how the votes have been cast, parliamentary constituency by parliamentary constituency, on what the future electoral system for those constituencies should be? Surely that is a matter of some importance to not only Members of Parliament but members of political parties, the generality of citizens and those who seek to evaluate and learn the lessons from this campaign. This is an important consideration which should not be set aside simply on grounds of administrative convenience on the day.
Lord McNally: I stand by the case for administrative convenience, but the fact that there will be a national vote, not individual constituency decisions, is the important issue. In fact, I had forgotten, until the noble Lord, Lord Rooker, helpfully reminded me, that the referendum in 1975 was not declared on a constituency basis,
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Lord Rooker: I accept that. However, the referendum in 1975 was to make a decision on whether the country-I repeat, the country-should stay in the EU or not. On 5 May next year, the issue is whether 650 individual constituencies should use a different voting system.
Lord Rooker: Of course it is. Therefore, people are entitled to know at a local level. While the noble Lord is on this point, I should say that only the count is affected here. If there is a delay in the count, so what? The Electoral Commission cannot delay when the voting take place, but what happens after the close of polls and the way that the votes are counted is what my noble and learned friend is on about. If it takes another half a day to count the votes and divide them, so what? That cannot delay the poll. It cannot affect the target date of 5 May, can it?
Lord McNally: I am not sure that I accept the argument that there is an overwhelming interest in knowing the results of a national decision constituency by constituency.
Lord Rooker: Perhaps MPs should have a free vote when the Bill returns to the other place. Let them decide; after all, they are the ones with the supreme vested interest. There is no interest more vested for an MP than their constituency boundaries and knowing what their constituents actually feel.
Lord McNally: As the noble Lord said, they have a vested interest. I want to make a national decision in the national interest.
Lord Lamont of Lerwick: I accept the argument that the noble Lord is putting forward, though there remains the mystery of Northern Ireland. However, there is also the mystery of London. Why is London on a borough basis when there are no elections in the boroughs?
Lord McNally: I suspect that, again, the decision is based on administrative convenience, which is not a dishonourable reason. What we are trying to do, as I have said so many times before, is to make the procedure as straightforward as possible. I believe there was an amendment in the other place. Perhaps, when this Bill goes back to the other place, Mr Chris Bryant will put down an amendment for a constituency base.
Lord Howarth of Newport: Is the noble Lord really saying that it does not matter whether Members of Parliament hear the voices of their constituents, and whether Members of Parliament know what judgment their constituents have come to on this matter of what the parliamentary voting system should be?
Lord McNally: The noble Lord is a master at pious interventions. Members will campaign, make their voices heard and assess their constituencies. I give way to my noble friend.
15 Dec 2010 : Column 677
Lord McAvoy: I am grateful to the Minister for giving way. The year 1975 was a long time ago. The year 1997 was a long time ago. Surely a general election is also a national poll affecting the whole country, and that is declared by constituency. What is wrong with moving away from the old superior top-down style of saying, "Well, the country will vote and you won't know locally"? Surely that is progress.
Lord McNally: The country will know locally. However, we are making a national decision. We are adopting systems and procedures which make things as simple and straightforward for electors as possible.
Lord Campbell-Savours: Perhaps I may ask a question which is very relevant. For a moment, the Minister obviously felt that Chris Bryant of the other place would have the chance to table an amendment to deal with this matter, but he cannot do that under the procedural arrangements because we are going to ping-pong. If that is the case, could the Minister accept the amendment and enable Members in the other place to do precisely what he suggested that they might wish to do?
Lord McNally: That is a merry thought, but no. We will resist this amendment and we urge the noble Lord to withdraw it.
Lord Grocott: My Lords, any neutral observer would say that this is a simple and straightforward proposition that the results of a referendum about parliamentary constituencies should be counted and declared on the basis of parliamentary constituencies. It is not rocket science and it is not complicated. It is common sense, and I think the Minister knows as much. What has been established in this debate-I had not realised how clearly it would be established-is what a complete dog's breakfast the list of counting districts is in the Bill. I will not go through the list again, but it is pretty random. It is a case of: wherever you can find a returning officer, let us have an election counted and declared. It is of no significance, no interest and no consistency that I can see.
I remind the Minister that we do not hold referenda or make decisions in this House on the basis of convenience for the Electoral Commission. The Electoral Commission's report is essentially saying "It is not a convenient way of doing it", which was the nub of the argument that the noble Lord, Lord McNally, presented to us-that it was much more convenient to hold elections on the basis of these various randomly selected electoral areas as determined in the Bill. I believe that my noble friend Lord Howarth made the point that it is treating a national referendum on changing the constitution as being a secondary event on the day-"Oh, we're counting borough elections, so we might as well count the referendum within the same electoral areas". If I may say so, all the arguments on any kind of coherent principle have been on one side, and the arguments for convenience have been on the other. Indeed, he admitted it was for convenience and I do not think I am misrepresenting him.
Lord McNally: It is for the convenience of the electorate.
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Lord Grocott: I would have thought that the convenience of the electorate and certainly respect for the electorate would be in constituencies, which is what the Bill is about. We should let them know the result of their own votes, and we are not telling them that. I find this particularly astonishing from a Liberal Democrat, and from other Liberal Democrats here, who have been telling us for as long as I have been in politics that people have been queueing up to change the electoral system in this country-that they are desperate to get rid of it. I would have thought that they would have looked forward with pride to a returning officer in their constituency or their former constituency declaring the massive support within their area for the alternative vote system of elections. They may not, of course, and it seems to me that doubts are growing as I look at the faces opposite. However, if the Minister is really saying that we should not do it on this basis, I am afraid that it has been characteristic, and it inevitably builds up frustration, that we make perfectly sensible, straightforward, logical proposals here which are in the interests of the electorate, and they are dismissed in a few sentences. Therefore, I wish to test the opinion of the House.
7.56 pm
Contents 90; Not-Contents 161.
Anderson of Swansea, L.
Andrews, B.
Bach, L.
Bassam of Brighton, L. [Teller]
Beecham, L.
Berkeley, L.
Bilston, L.
Boateng, L.
Brett, L.
Brookman, L.
Browne of Ladyton, L.
Campbell-Savours, L.
Carter of Coles, L.
Clark of Windermere, L.
Clarke of Hampstead, L.
Clinton-Davis, L.
Corston, B.
Crawley, B.
Davies of Coity, L.
Davies of Stamford, L.
Desai, L.
Dixon, L.
Drake, B.
Dubs, L.
Elder, L.
Elystan-Morgan, L.
Evans of Parkside, L.
Falconer of Thoroton, L.
Farrington of Ribbleton, B.
Faulkner of Worcester, L.
Finlay of Llandaff, B.
Foster of Bishop Auckland, L.
Gale, B.
Gilbert, L.
Graham of Edmonton, L.
Grantchester, L.
Grocott, L.
Guildford, Bp.
Harris of Haringey, L.
Haworth, L.
Hayter of Kentish Town, B.
Healy of Primrose Hill, B.
Hollis of Heigham, B.
Howarth of Newport, L.
Howells of St Davids, B.
Hunt of Kings Heath, L.
Jones, L.
Jones of Whitchurch, B.
Judd, L.
Layard, L.
Lea of Crondall, L.
Liddell of Coatdyke, B.
Liddle, L.
Lipsey, L.
McAvoy, L.
McDonagh, B.
McFall of Alcluith, L.
McIntosh of Hudnall, B.
McKenzie of Luton, L.
Massey of Darwen, B.
Maxton, L.
Morris of Handsworth, L.
Myners, L.
O'Neill of Clackmannan, L.
Patel, L.
Pendry, L.
Pitkeathley, B.
Prosser, B.
Quin, B.
Rendell of Babergh, B.
Rogan, L.
Rooker, L.
Rosser, L.
15 Dec 2010 : Column 679
Royall of Blaisdon, B.
Sherlock, B.
Simon, V.
Smith of Basildon, B.
Soley, L.
Stevens of Kirkwhelpington, L.
Stevenson of Balmacara, L.
Stoddart of Swindon, L.
Taylor of Blackburn, L.
Taylor of Bolton, B.
Thornton, B.
Touhig, L.
Tunnicliffe, L. [Teller]
Wheeler, B.
Wilkins, B.
Young of Norwood Green, L.
Addington, L.
Alderdice, L.
Alliance, L.
Alton of Liverpool, L.
Anelay of St Johns, B. [Teller]
Astor of Hever, L.
Attlee, E.
Avebury, L.
Barker, B.
Bell, L.
Benjamin, B.
Black of Brentwood, L.
Bonham-Carter of Yarnbury, B.
Bradshaw, L.
Bridgeman, V.
Brooke of Sutton Mandeville, L.
Brougham and Vaux, L.
Browning, B.
Burnett, L.
Caithness, E.
Cathcart, E.
Cavendish of Furness, L.
Chidgey, L.
Clement-Jones, L.
Colwyn, L.
Cope of Berkeley, L.
Cotter, L.
De Mauley, L.
Deben, L.
Denham, L.
Dholakia, L.
Dixon-Smith, L.
Dundee, E.
Dykes, L.
Eaton, B.
Eccles, V.
Eccles of Moulton, B.
Eden of Winton, L.
Elton, L.
Falkland, V.
Falkner of Margravine, B.
Faulks, L.
Fookes, B.
Fowler, L.
Fraser of Carmyllie, L.
Freud, L.
Garden of Frognal, B.
Gardiner of Kimble, L.
Gardner of Parkes, B.
Geddes, L.
German, L.
Glentoran, L.
Goodhart, L.
Goodlad, L.
Greaves, L.
Grey-Thompson, B.
Hamwee, B.
Hanham, B.
Henley, L.
Hill of Oareford, L.
Hodgson of Astley Abbotts, L.
Hooper, B.
Howard of Lympne, L.
Howard of Rising, L.
Howe, E.
Howe of Aberavon, L.
Howe of Idlicote, B.
Howell of Guildford, L.
Hunt of Wirral, L.
Hussein-Ece, B.
Inglewood, L.
James of Blackheath, L.
Jenkin of Roding, L.
Jones of Cheltenham, L.
Jopling, L.
Kilclooney, L.
King of Bridgwater, L.
Knight of Collingtree, B.
Lamont of Lerwick, L.
Lawson of Blaby, L.
Lee of Trafford, L.
Lester of Herne Hill, L.
Linklater of Butterstone, B.
Lucas, L.
Luke, L.
McColl of Dulwich, L.
Macdonald of River Glaven, L.
MacGregor of Pulham Market, L.
Mackay of Clashfern, L.
Maclennan of Rogart, L.
McNally, L.
Maples, L.
Marland, L.
Masham of Ilton, B.
Mawhinney, L.
Mayhew of Twysden, L.
Miller of Chilthorne Domer, B.
Montgomery of Alamein, V.
Montrose, D.
Morris of Bolton, B.
Naseby, L.
Neuberger, B.
Neville-Jones, B.
Newby, L.
Newlove, B.
Newton of Braintree, L.
Noakes, B.
Northbrook, L.
Northover, B.
Norton of Louth, L.
Oakeshott of Seagrove Bay, L.
O'Cathain, B.
Oppenheim-Barnes, B.
Patten, L.
Plumb, L.
Rawlings, B.
Razzall, L.
Reay, L.
Redesdale, L.
Rennard, L.
Roberts of Conwy, L.
Roberts of Llandudno, L.
Rodgers of Quarry Bank, L.
Rotherwick, L.
Ryder of Wensum, L.
Sanderson of Bowden, L.
15 Dec 2010 : Column 680
Seccombe, B.
Selborne, E.
Selkirk of Douglas, L.
Sharp of Guildford, B.
Sharples, B.
Shaw of Northstead, L.
Sheikh, L.
Shipley, L.
Shutt of Greetland, L. [Teller]
Skelmersdale, L.
Spicer, L.
Stedman-Scott, B.
Steel of Aikwood, L.
Stewartby, L.
Strathclyde, L.
Taverne, L.
Thomas of Gresford, L.
Thomas of Winchester, B.
Tonge, B.
Tope, L.
Tordoff, L.
Tugendhat, L.
Tyler, L.
Ullswater, V.
Verma, B.
Wakeham, L.
Wallace of Saltaire, L.
Wallace of Tankerness, L.
Walmsley, B.
Wei, L.
Wilcox, B.
Williams of Crosby, B.
Williamson of Horton, L.
Younger of Leckie, V.
House resumed. Committee to begin again not before 9.07 pm.
Loans to Ireland Bill
First Reading
8.07 pm
The Bill was brought from the Commons, endorsed as a money Bill, read a first time and ordered to be printed.
Hospices and Palliative Care Services
Question for Short Debate
8.08 pm
To ask Her Majesty's Government what plans they have for the future of hospices and palliative care services.
Viscount Bridgeman: My Lords, I hope that we shall have an hour of singing from the same hymn sheet. I am very grateful for the opportunity to introduce this debate on this most important of subjects. It comes at an important time for the hospice movement in the United Kingdom, for the interim report of the independent funding review has just been released. On 11 November, the noble Baroness, Lady Finlay of Llandaff, led with great distinction a debate on palliative care for cancer sufferers, and this debate, I suggest, is entirely complementary to that one.
I declare an interest as the former chairman of St John's Hospice in central London. This is one of a number of hospices which cater for the three main killer diseases: cancer, HIV/AIDS and motor neurone.
No debate on palliative care or end-of-life treatment is complete without the mention of Dame Cicely Saunders, who is widely accepted as having founded the hospice movement in the United Kingdom. It is a worthy tribute to her memory that a recent report by the Economist Intelligence Unit puts the United Kingdom first, ahead of 39 other countries, in the provision of end-of-life care, and this was attributed in part to the "well-established hospice movement".
In the short time available to me, I wish to speak briefly on funding. In the past, there has been a certain complacency on the part of every Government towards the funding of hospices. The unadorned truth is that
15 Dec 2010 : Column 681
Up to now, there has been no national tariff for hospices contracted to the NHS. The disadvantages of this are obvious, as it makes it difficult to produce long-term strategic budgets, and inevitably it means that the funding as between different hospices is going to differ significantly. Additional funds invested through the end-of-life care strategy have not been invested in a consistent way. In many cases, hospices are forced to carry an overhead for negotiating staff with the many PCTs to which they are contracted, and they are ill-equipped to afford this. Some of the less well-resourced establishments inevitably lose out. I would mention that a joint report by Healthcare at Home and Dr Foster estimates that delivering end-of-life services in the home could save the NHS £160 million a year.
I am very pleased that the NHS tariff group is reporting on behalf of palliative care. Now we have a real opportunity in the review of commissioning to move towards 100 per cent funding across the board. However, does that mean that fund-raising from the third and voluntary sectors will no longer be required? Most certainly it does not. It will simply mean that that part of a hospice's expenditure which is clearly clinical will be looked after within the commissioning structure, leaving those involved in fund-raising to concentrate on amenities such as day centres, bereavement counselling and the training of volunteers and carers, which are not part of the NHS's responsibility.
Before leaving the subject of funding, I wish to mention the particular case of children's hospices, where currently the contribution to operating costs tends to be at the lower end of the scale, although I am aware that these hospices are likely to receive a greater element of mainstream primary care than their adult counterparts and they also receive Section 64 additional funding. The number of children with life-terminating illnesses is, mercifully, relatively small. Nevertheless, there is a danger that for that very reason the special needs of children's hospices may be overlooked. I hope that that will be recognised in the current review.
As the population ages, so will the burden of care increase. There will be more long-term conditions and, with those conditions, there will inevitably be symptom-control elements, and it is those that palliative care must address. It is fair to say that all the national strategies for older people and those with dementia recognise the role for palliations, and I hope that the department will ensure that that is reflected in the commissioning structures which, I hope, will be the product of the fundamental review.
I turn to community support. Speaking in the debate initiated by the noble Baroness, Lady Finlay, on 11 November, I referred to the totem of the hospice
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I mention as an example of admirable community support the single point of access project in Westminster. The project delivers a single telephone number for patients to use to access all palliative care services in the borough. It has been made possible only by numerous teams giving up their systems and working together with the out-of-hours GP co-operative to run the system. With the impending amalgamation of services between Westminster, Kensington and Chelsea, and Hammersmith and Fulham, it is to be hoped that that service will be available in all those three boroughs with the minimum of bureaucracy and optimal cost savings, and that that will form a useful pattern for other authorities.
An important component of that scheme is out-of-hours work. That is of concern to all branches of primary care, but it is particularly vital with palliative care, for one simple reason: pain does not keep office hours. I know that the matter of 24-hour cover is already being addressed across the country. Currently, it is piecemeal, with services varying from telephone advice only to personal visits. The palliative care funding review, in its interim report, recommends that the Government use the forthcoming NHS operating and outcome frameworks to ensure that a structured 24-hour service is put in place.
Finally, I say a word about education. This is of course a subject in itself and time does not permit more than a passing reference to it. Palliative care is now included in GP training, but that specialised training needs to extend right across the palliative care community, from qualified doctors to undergraduates and carers-both hospice-trained and from outside. Training is too big a subject to be left to the charitable sector. I hope that the Minister will confirm that it is to be given high formal priority in the commissioning structure.
We in the United Kingdom can take pride in the leadership that we have given to the hospice movement worldwide, achieved through the dedication and commitment of staff, consultants and volunteers. They deserve our gratitude. I end by thanking those noble Lords who have chosen to take part in the debate. I look forward to their contributions and to the reply from my noble friend.
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8.17 pm
Lord Faulkner of Worcester: My Lords, I congratulate the noble Viscount, Lord Bridgeman, on securing this debate, and I welcome this chance to express my admiration for the wonderful work that is performed by our hospices across the country.
I speak with first-hand experience of two hospices which I have got to know in the City of Worcester in the past year. They are Acorns Children's and St Richard's Hospices. I found my visits to them both heart-warming and humbling. The most impressive feature of both-apart, of course, from the quality of the care that is provided at them-and this is true of other hospices all over the country, is the commitment of volunteers. Acorns in Worcester, for example, is able to draw on the support of 250 volunteers who cook, clean and do the gardening for them. St Richard's tells me that it has 900 volunteers who, last year, saved the hospice £765,000 in wages, had they needed to pay people for the jobs they did. Charity shops are of course also a hugely important revenue stream. St Richard's has more than 350 volunteers in its shops, which can be found across the county selling furniture, electrical items, books, women's and men's clothing and bric-a-brac.
Both hospices benefit greatly from the extraordinary generosity of local philanthropists and other members of the local community. One of the most remarkable people in Worcester is Mr Cecil Duckworth, who is a freeman of the city and a massive donor to Acorns, the building of which was largely down to him and his generosity, and to an 84 year-old lady who lives next door to the hospice and donated the land free of charge.
Mr Duckworth's other great contribution to the City of Worcester is to bring top-class rugby to the city. His Warriors team runs an ambassadors scheme in which three players a week visit the hospice. They were there on the day when I visited. He allows for a constant stream of fundraising events at the Sixways ground, where the Warriors play, such as a fireworks display. The home match on Boxing Day will be given over to raising money for Acorns, and the players will be wearing a shirt designed by their children. St Richard's will also have 20 volunteers at the game selling raffle tickets for their car draw.
Another great supporter in the city is the mayor, Councillor Mike Layland. Last Tuesday he was pulling pints at a local bar which was donating all the takings over a two and a half hour period to Acorns because that is one of the mayor's chosen charities.
At present, around a third of the running costs of each hospice is covered by statutory funding, but there is great uncertainty about whether this will continue with the reorganisation of the National Health Service. The replacement of PCT commissioning with GP commissioning is not suitable for many hospices-in Acorns the children are looked after by consultants and not by GPs-and a centralised tariff-based system that produces a minimum of 30 per cent of the hospices' care costs is needed.
It is very hard to think of a better representative of the big society than the hospice movement. I hope that when he replies the Minister will be able to give some reassurance about future levels of funding.
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8.21 pm
Lord Alderdice: My Lords, I thank my noble friend Lord Bridgeman for not only securing the debate but for introducing it with his usual elegance and eloquence. I identify myself both with his comments and those of the noble Lord, Lord Faulkner of Worcester, in praising the importance of the hospice movement and its work, the significance and value of voluntarism, and the need for public, financial and other resource support.
In the short time available to me I wish to address one specific issue-the need for thoughtful and real support for the staff who work on the front line in the hospices. Some years ago I became aware of this issue when I was doing a consultancy for the Belfast Hospice. It became apparent to me that there is a specific kind of emotional strain and stress on those who work in the hospice movement on the front line with the patients. With all other forms of care, there is a variegation of patients and the acuteness of their problems. However, in a hospice, when a patient comes in everyone knows that this is moving towards the end and there is an intensity about the emotional involvement that is quite unique.
In addition, the situation moves inevitably to a form of bereavement. Even if the patient moves out of the hospice and comes back in, it is inevitably moving in that direction. As human beings we are created in such a way that we can deal with bereavement and emotional intensity, but what I saw with some of the hospice workers who were working on the front line with patients was a psychological equivalent of march fractures. All the time there was the development of a close emotional bond and then the experience of bereavement-and then straight into the same situation again and again and again. Many of those who experienced this time after time themselves became subject to emotional trauma-sometimes they fell physically ill-after a number of years.
If these workers were able to move out into another aspect of hospice care-education, administration or teaching-or to move into the NHS and bring with them their experience of palliative care, pain relief and dealing with cancer and other terminal illnesses, they would be freed of that emotional involvement and make a tremendous contribution. The burden of my request to my noble friend is that the NHS will engage with the hospice movement to provide opportunities for support and constructive engagement that values the experience of those involved in the hospice movement but ensures that they do not find themselves suffering because of the enormous emotional commitment they made to this peculiarly special and costly form of caring.
8.24 pm
Baroness Masham of Ilton: My Lords, the noble Viscount, Lord Bridgeman, who is chairman of the Hospital of St John and St Elizabeth in London, takes a great interest in everything. I visited the hospice attached to that hospital with the All-Party Parliamentary Group on HIV/AIDS some time ago. The hospice does not discriminate-it takes people who have HIV, cancer or some other condition. People can die in a safe place and receive spiritual support from people who understand their conditions.
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Some of the children's hospices now have units for teenagers. This is a very good development because teenagers do not fit in with small children or adults; they need their own space. The hospice at Boston Spa in Yorkshire has such a facility.
I also visited the hospice at Sunderland which is, I am told, the only hospice in the UK that is solely funded by the NHS. I ask the Minister whether, once the GP consortium comes into being, this hospice will still be funded by the NHS. There are dedicated people working in the NHS but, with so many cuts emerging, questions need to be answered to give reassurance to those who feel vulnerable.
Many children with muscular dystrophy need to be able to swim to help their condition. I am told that some of the hospices have swimming pools. Would it not be possible for children with muscular dystrophy to have swimming sessions in these pools when they are not being used? This would benefit both parties in these difficult economic times. It would be good if people could help each other. Would this not be a little bit of the big society?
My husband died in an A&E department after years of complicated medical conditions, including cancer. He developed pneumonia and needed antibiotics through a drip. This was not possible; it was on a Sunday. There is a desperate need for palliative care in the community for those who wish to die at home.
8.26 pm
Lord Howard of Lympne: My Lords, it is a pleasure to follow the noble Baroness, Lady Masham, and I join in the congratulations to my noble friend Lord Bridgeman on securing the debate. I declare an interest as chairman of Help the Hospices.
Your Lordships have spoken eloquently and in moving terms of the quite extraordinary work that is done in our hospices. It is true, as my noble friend Lord Bridgeman said, that this is an area of care where we are recognised as providing the best in the world. A number of noble Lords have pointed out that the hospice movement is an outstanding example of the big society. I am pleased to place on record that the Prime Minister has acknowledged that there is no better example of the big society than the hospice movement. I feel immensely privileged to hold the position that I do-although I have held it for only a few weeks-and to be able to contribute in whatever small way I can to this outstanding movement. I described it in the debate of the noble Baroness, Lady Finlay, as the jewel in the crown of our healthcare system, and I believe that to be true.
In the short time available I wish to make three points, although that may prove to be a little ambitious. First, as a number of your Lordships have pointed out, although the debate is concerned with the portion of funding that goes to hospices from the Government-we are asking the Minister for some indication of that today-it is true and will remain true that the greater part of the funding for hospices will come from local and charitable sources. It is therefore at least as important for the future of the hospice movement that everything is done to encourage charitable giving and volunteering.
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Secondly, I draw attention to the fact that a number of new providers are entering the field of palliative care. This is a healthy development which may well increase the availability of palliative care and support at the end of life. I hope that the new providers will recognise that local hospices can provide a source of experience, expertise and knowledge for the public, private and voluntary sectors in improving care for people affected by terminal illness.
Lastly, as local councils take on a wider responsibility for health and social care within their communities, it is very important that they should recognise that good-quality palliative care can reduce pressure on expensive acute services and deliver personalised care for people in their own homes. It is essential that the palliative care funding review and the coalition Government's review of social care funding being led by Andrew Dilnot should work together to develop a comprehensive funding settlement that reflects the nature of the care and support for people affected by terminal illness. I hope that the Minister will be able to respond positively to these points and that the Government will take them on board when they come to implementing the review.
8.30 pm
Lord Patel: My Lords, I too am grateful to the noble Viscount, Lord Bridgeman, for calling this debate and I echo his words about children's hospices. It is on that that I will concentrate my brief remarks.
It is crucial in this debate that we consider palliative care for children as well as adults. There are 20,000 children and young people in the United Kingdom who will die before they reach adulthood. Some of them will die when very young; others will deteriorate slowly over many years. Families caring for these children and young people, often 24 hours a day, seven days a week, can feel under enormous emotional, physical and financial strain. Relationships can suffer, careers may have to be abandoned, siblings who are well can feel left out and normal family activities become almost impossible. Children's hospices offer a lifeline to these children, young people and their families, helping ordinary people in extraordinary circumstances to cope with the challenges of everyday life. They provide a range of flexible, practical and free support at home or in the hospice to the entire family, often over many years and at any stage of a child's illness from diagnosis for as long as it is needed.
There are currently 45 children's hospices in the United Kingdom, 40 of which are in England. They provide flexible comprehensive care at home and in the hospice, help with pain control in children, support for families, end-of-life care and bereavement support. They are all registered charities, receiving very little statutory funding and relying on the generosity of the public. They struggle to get funding from primary care trusts. Only around 9 per cent of their funding comes from PCTs and local authorities. The palliative care funding review is a unique opportunity to put in place long-term funding. Localised GP
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8.33 pm
The Earl of Selborne: My Lords, I join others in thanking my noble friend Lord Bridgeman for introducing this debate and giving us the opportunity to talk about the future of hospices and palliative care. Like my noble friend Lord Bridgeman and the noble Baroness, Lady Masham, I make a plea for the cause of palliative care in the community. I declare an interest as a patron of a charity called Hospices At Home TLC, which operates in Hampshire, where I live, West Sussex and Surrey. Developed from the palliative nursing service and funded by the Big Lottery, it provides help for adults with a limited life prognosis and their family and carers.
As my noble friend Lord Bridgeman reminded us, surveys consistently show how many people would prefer to have support at home and to die at home if that is feasible. Of course this requires the relevant level of care in the community to be provided. My noble friend mentioned that the significant figure of £160 million could be saved, but specialist therapies, specialist medical equipment, volunteers working alongside nurses and bereavement counselling are the sort of services which are being provided by charities and the hospice movement.
There are difficulties, some of which arise from the interface with the primary care trusts. Sometimes they are not always aware of their own criteria for qualifying for continuing care in the community. While the gold standards framework aims to improve the organisation and quality of care for everyone in the last years of life, it is often when a patient is placed on the palliative care register that patients and families and carers are not able to understand just what support, and further support as the condition changes, is available within the primary care trust area. I simply make a plea that everyone involved with the primary care trusts not only understands for themselves the criteria for support but makes them accessible in a way that everyone else can understand. We need to move towards a national cover for palliative care services in the community. We are enormously lucky in our area to have just such a cover.
8.36 pm
Lord Judd: My Lords, the hospice movement is indeed fortunate to have a champion like the noble Viscount, Lord Bridgeman, with his compassion and detailed knowledge. I declare an interest as president of the West Cumbria Hospice at Home, a pioneer hospice in this kind of care for those who wish to die at home. It is impossible for me to speak too highly of the quality of commitment of its staff, volunteers and trustees. Volunteers provide a compassionate service
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Hospices are usually charities with their own supporters from whom they receive the bulk of their funds. This is often an intensely local relationship, with communities feeling real ownership of the organisation. This is well illustrated in west Cumbria, where the local community has taken the hospice to its heart and where there is just such a widespread sense of responsibility for its work. This is well evidenced by the upwards of 1,500 women who each year participate in a midnight six-mile sponsored walk, cheered on even at that late hour by the local community.
Any legislation will have to be tuned to this spirit and recognise that, for example, any pressure to merge could all too easily destroy an ethos which is so essential for success. That is not to say, however, that there should not be encouragement towards collaborative working between neighbouring hospices. There is a risk that some hospice charities might in effect be perceived largely as fundraisers for the NHS. This must be robustly rebutted. Instead hospices should be encouraged to lead in their sphere and should receive absolutely essential financial support by commissioning.
In the NHS White Paper, there is a clear move from focusing on targets to focusing on outcomes and quality. Hospices have always focused in this way. This, of course, requires so-called soft measures where evidence is not always easy to provide. Again, any legislation needs to be considered against a very different background from what is more usual in the NHS. The central role of the GP commissioning consortia envisaged in the White Paper gives hospices a real opportunity to become the preferred provider for these services at the local level. Hospices which are already the main high-quality provider could in many cases, given the necessary support of commissioning, expand the services they provide to become far more comprehensive. This could be by providing more general palliative care services in the local community and by embracing activities not normally currently covered-education, dementia care, care for chronic and end-of-life conditions, as well as the essential and demanding care for the dying.
Finally, I make a plea: we must be wary lest unimaginative bureaucratic reporting requirements, such as detailed statistics and the standards expected in preparing them, at times place a disproportionate burden on the volunteer-dependent charities. This could inadvertently dampen the very spirit which is so essential to a hospice's success.
8.40 pm
Lord Patten: My Lords, I am very happy to follow the noble Lord, Lord Judd, who put his finger with great accuracy on the importance of localism in support for hospice movements, whether in hospitals or hospices in the community-a point also reflected by my noble friend Lord Selborne. That localism underpins much of what my noble friend Lord Bridgeman described in his speech, which was absolutely spot on.
I wish only to address the spiritual aspects of palliative care, whether in home, hospital or hospice. I guess that when in centuries past hospice-like or palliative care was given it was largely the preserve of the religious.
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While I warmly welcome the extra sums that have been found in these hardest of times by the coalition-the £40 million for hospices and the extra money for palliative care for children-as well as the review that is being undertaken, I ask my noble friend Lord Howe whether he will ensure that the needs of the dying who wish to see a representative of the British Humanist Society, an imam, a rabbi or a priest are not forgotten. That very valuable body, the Association of Hospice & Palliative Care Chaplains, does a great deal to spread good practice in the area of palliative care-it must be terribly demanding and emotionally draining work-helping both patients and their families. As more emphasis is put on dying at home, ways to enhance the good work of this network of chaplains and their colleagues in more community-based care must be developed and the spiritual dimension must not be forgotten.
8.42 pm
Baroness Finlay of Llandaff: My Lords, in securing this debate, the noble Viscount has exemplified his tireless work for hospices and is to be congratulated. Hospices' futures depend on stable funding. The service exists to help people to live as well as possible until their natural death and to support their family, including children.
The report of the Palliative Care Funding Review, which was chaired by Tom Hughes-Hallett from Marie Curie, has drawn heavily on the Welsh model. I declare with a certain pride an interest as the chief architect of that model. We realised that every patient with complex end-of-life-care needs, wherever they are and whatever their diagnosis, should have access to specialist palliative care advice and support to underpin general services in primary and secondary care, irrespective of the bed that they are in, be it at home, in hospital or in a nursing home. We realised also that there will always be some who need to be in specialist hospice beds because they have complex needs. However, the ad hoc way in which hospices have grown up means that some areas have good provision while others remain devoid of it.
We wanted fairness of access for patients, so we developed a funding formula. We calculated that there needs to be one hospice bed or a hospice-at-home virtual bed per 15,000 of population. My rough calculation for England suggests that the numbers are pretty good but poorly distributed. We stipulated the minimum number of specialist staff needed for community palliative teams to oversee hospice beds and for different hospital support teams. This indicated the core service that the NHS should fund, irrespective of provider. If charitable funding dried up, there would still be a core service in every area.
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We instigated seven-day working by specialist nurses, costing around £10,000 per team-that was all-with 24/7 on-call consultants to advise any healthcare professional across Wales by telephone or even visit if necessary. In hospitals, these nurses, visiting the wards and sometimes going to A&E, have facilitated discharge to home, and patients have not needed to be admitted. They have also set up home care, so that when the patient gets home everybody is expecting them.
Every dying person with complex needs should know that specialist help is available if needed. Our national standard is that every referral must be responded to within 48 hours. Fortunately, almost all are seen on the same day or next day; a distressed dying patient cannot wait. Direct patient and family feedback provides dynamic quality assessment, while service data inform performance monitoring.
Three years on, we are convinced that per-patient payments will be an accounting nightmare. The complexity is too wide-ranging. Patients need a rapid response and true choice over place of care and hospices need funding stability. End-of-life care cannot be left just to voluntary donation; its commissioning must be a core duty of budget holders.
8.45 pm
Lord Cavendish of Furness: My Lords, with her formidable experience and knowledge, it is always humbling to follow the noble Baroness, Lady Finlay. I join other noble Lords in thanking most warmly the noble Viscount, Lord Bridgeman, for introducing this debate so ably.
I have to declare an interest: some 20 years ago, I helped to found St Mary's Hospice in Ulverston in Cumbria. It is at the other end of Cumbria from the noble Lord, Lord Judd; Cumbria is enormous. I retain a connection, although I retired as chairman last year.
I should like to make two points. As I understand it, the independent report on end-of-life care by Thomas Hughes-Hallett has made an interim recommendation to the Government to the effect that hospice-at-home services should be the chief beneficiaries of whatever money may be available in future. I do not quarrel with that, nor do I want to second-guess the final report. However, I register two caveats. First, a significant minority of terminally ill patients want to die in a hospice or at least do not want to die at home. The other caveat is that a hospice building has uses beyond that of being where people are cared for as they approach death. It is a point of contact for members of the local community and provides a venue for day care, which is very important, bereavement counselling and much else besides. Perhaps most important of all, it has become the hub of expertise, especially where a hospice such as ours develops a speciality. In my case, because of the high incidence of mesothelioma in Barrow-in-Furness, which is the tragic legacy of asbestos in the shipbuilding industry, St Mary's has become something of an international leader in this field. Hospices innovate, as does palliative care in general. It would be dangerous to ignore the strength that an institution derives from having a physical core, albeit modest, which provides the springboard for training and innovation.
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The second point is that I believe that the hospice movement has stumbled on a formula that could be far more widely applied. With very little modification, it could do very much more in the fields of heart disease and end-stage respiratory illness. It could relieve much fear and distress among patients suffering from these complaints. It would also remove significant financial burdens from the NHS. The non-cancer element of hospice care averages, I think, only 10 per cent; at St Mary's we have a slightly larger percentage and my contention is that nationally it should be significantly higher still.
The ratio of funding between the state and our own fundraising efforts results in our having to find rather more than 70 per cent of what we spend. The reason why we were able throughout my time to raise such prodigious sums in a not very well-off area was that we successfully persuaded local people that the hospice belonged to them. In effect, the state meets the clinical costs-about 30 per cent-and we find the rest. This means that our care is essentially needs-led. I agree with my noble friend Lord Patten that, in this rabidly secular age, spiritual support has an important place and is much needed. This model, with its built-in synergy between public and private providers, can and should in my view form the basis on which new and enduring partnerships can build. It is indeed, as has been said, the big society at its best.
8.49 pm
The Lord Bishop of Guildford: My Lords, the hospice movement and the burgeoning of palliative care and research are indeed developments in which we lead the world, as the noble Viscount, Lord Bridgeman, said.
I declare an interest as a member of the council of King's College London. This year the Princess Royal opened the Cicely Saunders Institute of Palliative Care at King's College Hospital. This is the culmination of 15 years' work at King's and was funded through the Cicely Saunders International charity, the Wolfson Foundation and other charities. It is the first palliative care unit in the world, as far as I am aware, where patient care, teaching and research are all conducted under one roof.
As a Bishop I also speak-and other Bishops could say the same-of hospices in my diocese: Woking, Sam Beare, the Princess Alice in Esher, the Phyllis Tuckwell in Farnham and the CHASE Children's Hospice in Guildford. Hospices, as noble Lords have already said tonight, are wonderful places. They are places of peace and joy, more profound than trivial bonhomie. I think of a little girl, Tamsin, singing "Away in a Manger" two Christmases ago, only a few days before she died.
I do not need to rehearse the Christian inspiration for the hospice movement and the concomitant development of palliative care through pioneers such as Dame Cicely. It may be worth noting, however, that one recent development in our excellent hospices is the significant increase in palliative care offered in the home. The noble Baroness, Lady Masham, and the noble Lord, Lord Howard, alluded to this. There are now more out-patients being cared for through our hospices
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The availability of palliative care is, as we all know, subject to the lottery of the postcode. I therefore warmly welcome the interim report and look forward to the final report next year on how dedicated palliative care can be funded so as to be available to all. The interim report, which we look forward to and which was trailed by the noble Viscount, is looking at a national funding system locally delivered.
The content of palliative care is defined in holistic terms, including psychological, social and, indeed, spiritual care-I am grateful for the contribution of the noble Lord, Lord Patten, on that. The signs from the interim report are therefore good and far-reaching. The question for the future after the definitive report in the summer will be implementation. As TS Eliot put it:
"Life you may evade, but Death you shall not".
There can be a good death and that should be available to all.
8.53 pm
Baroness Thornton: My Lords, I congratulate the noble Viscount, Lord Bridgeman, on securing this short but important debate, which has had many very pertinent contributions. The goal of palliative care is to prevent and relieve suffering and improve quality of life for people with serious and complex illnesses. End-of-life care affects all of us; it is everybody's business and, as such, must be a central focus of any health, social care and housing reform agenda.
Much of the recent progress in end-of-life care was enabled by its inclusion as one of only eight high-level priorities in the NHS Next Stage Review, which the previous Government brought forward. Indeed, we made end-of-life care a priority; we made a commitment to it and, significantly, we increased funding to hospices. The key challenge facing the Government now is to ensure that end-of-life care continues to be one of the top few high-level organisational priorities at each stage of the forthcoming reforms. The proposals in the White Paper published this summer did not reflect the importance of end-of-life care sufficiently to guard against it being subsumed by other higher profile priorities. That is not just my opinion; it is also the opinion of the Palliative Care Association.
I have glanced at the results of the consultation published today and have yet to find the words "end-of-life strategy". It may be in the operation strategy document, which is my weekend reading. I echo my noble friend Lord Faulkner in his concern about how the new GP commissioning will deliver palliative care. I suspect that many organisations that have campaigned for end-of-life care so successfully in recent years will be concerned about what comes next. Diluting recognition of end-of-life care as a discrete, high-level priority risks undermining the progress made, and I suggest devalues end-of-life care as a government priority. I
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8.56 pm
The Parliamentary Under-Secretary of State, Department of Health (Earl Howe): My Lords, I begin by thanking my noble friend for tabling this Question for debate and introducing the subject so ably. I very much recognise the considerable knowledge that he brings to this subject, not least as a result of his past chairmanship of St John's Hospice in London.
Thanks to the dedicated work of hospices, many people do die well: where they choose, with the people they love, and with all the medical, psychological and spiritual care they need. The Government are committed to supporting the work of hospices. We have confirmed the £40 million hospice capital grant for 2010-11, allocated under the end-of-life care strategy, supporting 123 projects in 116 hospices. More generally, we are determined that care should be compassionate and appropriate and that it should support personal choice. We will do that by putting patients, their families and carers at the heart of everything we do.
The end-of-life care strategy aims to improve care for all adults approaching the end of their lives, whatever their diagnosis and wherever they are, including enabling more people to be cared for and to die at home if they so wish. However, while many people receive excellent care, others do not. There are still variations in people's experience by region, by age and, as my noble friend Lord Cavendish, pointed out, by disease, with greater emphasis given to people with certain conditions, particularly cancer. We can and must do better. We are taking forward a number of initiatives to improve end-of-life care services for everyone.
The issue of funding was introduced by many noble Lords, not least the noble Lord, Lord Faulkner of Worcester. I agree with much of what he said. End-of-life care needs a long-term system of sustainable funding. We committed, in the coalition agreement, to a per-patient funding model for palliative care. I listened with care to what the noble Baroness, Lady Finlay, said in that connection and I am grateful to her for the points that she made. My right honourable friend the Secretary of State for Health has asked Tom Hughes-Hallett, chief executive of Marie Curie Cancer Care, to chair an independent review of palliative care funding. I am sure that he will wish to take account of the experience and expertise of the noble Baroness in this area.
The review, covering services for both adults and children, is looking at options to make sure that the funding of hospices and other palliative care providers is fair. It will make recommendations for a funding system that will cover care provided by the NHS, a hospice or any appropriate provider, which encourages more community-based care so people can remain in their own homes, if they wish. It will be fair and transparent to all organisations involved in end-of-life care. The review is making good progress and I know
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The review's interim report, published on 3 December, sets out a definition of dedicated palliative care and initial thoughts on a national funding system, stressing the importance of 24/7 community services. I look forward to receiving the final report and its detailed recommendations for funding in the summer. Of course, the funding review comes with a caveat that it has to be affordable within the constraints of the current financial climate.
Beyond sustainable funding, we need to consider how we will deliver end-of-life services. The NHS operating framework, published today, emphasises the importance of implementing the end of life care strategy and of developing round-the-clock, community-based services. The best services already know that good end-of-life care is not only more effective, but can be less expensive than poor care. A recent National Audit Office report found that in a typical PCT, around 40 per cent of the people who died in hospital had no medical need to be there. They could have been cared for at home or in their care home if the community-based support had been in place to support them and their family or carers.
We want services that enable people to have more control over the care they receive when they are dying. As one way of achieving this, our intention is for people to be able to add their end-of-life care plans to their own summary care record. We need to develop the services that allow people to die in a place and in a manner of their choosing. I recognise that this is not easy. Nor can it be done overnight. There is a great deal of work to do. In 2013 therefore, we shall review our progress and see how close we are to giving people the control that they clearly wish for.
We need more imagination, more radicalism, more courage in commissioning. We need to shift the landscape of end-of-life care in favour of the service user. The best commissioners are already challenging old conventions, finding new ways of designing services, and new ways of bringing hospices and other community organisations together to meet patients' needs. Soon, new GP consortia will commission services. GP-led commissioning has clear advantages over the current model for end-of-life care. GPs have a better understanding of patient needs and better connections within the local community. They know what is available locally to support patients at the end of their lives. I firmly believe GP consortia will be advocates of hospices, not their enemy. But hospices themselves should be proactive. They should talk with their local GPs. They should also talk with their local authorities, which will play an increasingly important role in co-ordinating care, as we move toward joint-commissioning and planning through health and well-being boards.
My noble friend Lord Bridgeman dwelt with some emphasis on funding. The Department of Health is providing £286 million of additional funding to support implementation of the end-of-life care strategy over the two years 2009-11. A huge amount of money is being spent on end-of-life and palliative care. We
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My noble friend Lord Bridgeman and others were right to highlight the particular issues surrounding palliative care for children. The Coalition: Our Programme for Government, states that the Government will provide,
- "£10 million a year beyond 2011 from within the budget of the Department of Health to support children's hospices in their vital work".
As I have already mentioned, the children's palliative care services are being specifically considered by the palliative care funding review.
My noble friend Lord Bridgeman also asked me about 24/7 community services. The end-of-life care strategy encourages commissioners and providers to develop 24/7 community-based services for medical, nursing and personal care which people need to enable this to happen. The funding review has already highlighted the importance of treating 24/7 community services as a priority.
The noble Lord, Lord Faulkner, asked about future funding. I have already referred to our intention to introduce a per-patient funding system. More generally, the strategy makes clear the responsibilities of the NHS to ensure adequate support for hospices, including through stronger commissioning and adhering to the principles of the compact code of good practice. That should mean more funding stability, including longer-term contracts, for hospices. My noble friend Lord Howard referred, quite rightly, to the cost-effectiveness of palliative care. The new health and well-being boards will follow on from the current commissioning arrangements that are already directed at end-of-life care because improving quality and improving productivity are, effectively, the same things.
The noble Lord, Lord Patel, asked me about commissioning in the future and the noble Baroness, Lady Thornton, questioned the Government's commitment in this area. The NHS commissioning board will determine how best to deliver high-quality services, including end-of-life care, by working with GP commissioning consortia and making use of the various tools and levers it will have available. The board will commission NICE to develop quality standards to define the quality of care necessary to deliver the desired outcomes and use those standards to produce a commissioning outcomes framework. That framework will then be used to hold GP consortia to account. NICE has already begun the process to develop an end-of-life quality standard and we look forward to seeing the fruits of that work.
My noble friend Lord Bridgeman asked about the extent to which choice will be embedded in the system. We recognise how important it is to give people choice over the care that they get when they are dying and the place in which they receive that care but, as I have mentioned, we also recognise that it is not an easy task and cannot be done overnight. We need to do a lot of work and, as I have mentioned, we
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My noble friends Lord Patten and Lord Cavendish and the right reverend Prelate stressed the importance of spiritual care. The end-of-life strategy recognised that each person has spiritual, religious or emotional needs and that spiritual care is an important, integral part of the care given to people at the end of their life and to their carers and families. The department has produced a set of quality markers for end-of-life care and in the strategy's second annual report, published in August, we said that we would consult on the effectiveness of the quality markers and revise them. Those will include spiritual care and consultation will begin in the new year.
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