Lastly, I hope with all my heart that today’s decision does not result in some utterly preventable disaster somewhere on the streets or in the skies above Britain. I was not present to hear what the noble Lord, Lord Tebbit, said about the Brighton bombing, but what one has to remember about it was that afterwards a spokesman for the provisional IRA said,
“we only have to be lucky once. You will have to be lucky always”.
The Minister said that this is about real threats to real lives, and it really is.
Lord West of Spithead: My Lords, I support the amendment and make no apologies for reiterating some of the things that have been said. Why do I support the amendment? I do so because there is a clear and present danger to our people in this country. The threat level is severe, as has been said, and there is no doubt whatever that there will be more attempted plots and, I am afraid to say, there may well be a successful plot, so people will die. We have lost data. We knew that we would lose data and the ability to get intercepts on these people as far back as six or seven years ago. Intercept is absolutely crucial in these terrorist crimes. When I was a Minister, every single one of the plots that we unravelled was done initially through intercept information. I think I am correct in saying that has been the case with every major plot that we have unravelled.
As the noble Lord, Lord King, said, the Prime Minister, the Home Secretary, the head of GCHQ and the head of the Security Service have all said that this Bill is urgent, and I do not think that one should take what they say on security lightly. The traitor Snowden has made us all less safe. Terrorists are now much cuter about using data in ways which mean that our law enforcement people cannot get hold of them. As an aside, it is rather amusing or ironic that Snowden is living in a country which is such a paragon in terms of ensuring that its people are not snooped at and looked at, but that is a different issue.
The fact that the fast-track Bill is very important does not mean that we should miss this opportunity to tackle this issue. The noble Lord, Lord Carlile, put it very neatly when talking about the amendments drawn up for the Joint Committee. It is absolutely extraordinary that we have not been allowed to see those. We understand that there will be more amendments given that we had emergency legislation last summer. Why did we have that? It was because we did not have a communications data Bill. We have a fast-track Bill now which includes data provision. Why is that? It is because we do not have a communications data Bill. How much better the situation would be if we had had a proper communications data Bill.
There is a two-month period now. In two months we formed a task force, sailed to the Falklands, recaptured them and said that we had won. We have two months in which the other place is doing almost nothing at all. Perhaps it could stop working a two-day week, take this Bill seriously with all the amendments, do all the necessary amending, and give itself enough time to provide the necessary safeguards for our people—it is right that they should have privacy safeguards—but also make them safer. I doubt very much that there will be another two months in which to do this in the other place after the election, as has already been touched on by a number of speakers, as things will start to happen then and we have to have new legislation by December 2016. That sounds very far away but it is not; it is very close. Therefore, it is highly likely that there will be more fast-track and emergency legislation, as my noble friend Lord Harris said, because we are missing a trick in getting this done.
I hope that the Conservative Party and the Labour Party will put this issue in their manifestos and make it a manifesto commitment. If the Liberal Democrats did so I would be absolutely delighted, but I fear that at the moment they do not seem to know which way is up on this issue. Will the Minister give that commitment?
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Lord Blencathra (Con): My Lords, I am the first Peer to speak against the amendments. I am very sorry that I have to disagree with my noble friends Lord King of Bridgwater and Lord Carlile of Berriew and the noble Lords, Lord West of Spithead and Lord Blair of Boughton. They have tremendous operational and political experience of dealing with terrorism and of working the legislation. I deeply respect their motives and their integrity but I respectfully suggest that they are wrong.
I and five other noble Lords and six MPs spent six months going through these amendments before us today with a fine toothcomb, but, in those days, they were in the draft communications data Bill. I say to my noble friend Lord Carlile of Berriew that they are largely the same amendments. There are some tiny changes, but they are largely, almost word for word, the same. When we started on the Joint Committee, we all had widely differing views. We had views at different ends of the spectrum, ranging from those who were totally committed to privacy at all costs to those who were committed to security at all costs. However, after six months of scrutiny, we produced a unanimous report.
I give noble Lords some examples of what we said about these clauses as they appeared in the draft communications data Bill and which are before us today as Amendment 11A and the other amendments in this group. We said that the 25% gap was misleading and unhelpful, part of the gap was due to a lack of ability of law enforcement agencies to use the data properly, and that there had been a failure to consult all the CSPs. We also said that there can be meaningful consultation only when there is clarity about the aims of the legislation and that no aims were specifically stated. We further said that Clause 1, or Amendment11A before us today, should be redrafted with a much narrower scope and that amendments to Clause 1 should be dealt with only by the super-affirmative
procedure. We added that the Bill should be redrafted to enable Parliament to address web logs which are at the heart of this legislation, and they still are today. We suggested that the Home Office commitment that third party provisions would be invoked only after the original data holder has been approached should be given statutory force and that the operation of the request filter should be transferred to the National Crime Agency. We added that new safeguards should be introduced to guard against the request filter being used for fishing expeditions, and that—although I agree entirely with my noble friend—any public authorities which make a convincing case to get communications data should be listed in the Bill—that is, the important deserving ones such as the police, the security agencies, the FSA, the United Kingdom Border Agency, the NCA and HMRC. We said that any changes to this list should be made by super-affirmative procedure. We recommended that the Government should consult on all the permitted purposes for access to communications data and that the Bill must be redrafted with new definitions of communications data, especially subscriber data, which is a catch-all for everything and helped to give it the name the “snoopers’ charter”. We said that a new hierarchy of data types needed to be developed and that data needed to be divided into categories which reflect how intrusive each type of data is, and therefore the different agencies which could have access to different levels of it. We said that content was not even defined in the draft Bill and that it should be expressly excluded from all categories of communications data.
I will stop there. That is enough to be going on with, although we had another 20 criticisms of the Bill. However, we did not just criticise; we also made suggestions on how to make a better Bill.
Lord West of Spithead: Does the noble Lord agree that, in two months of working on this issue and on the amendment, one could come up with something that covers and makes up for those errors and get something that makes us safe and puts those things right?
Lord Blencathra: I take the noble Lord’s point but I want to make it clear to the House—I apologise if I gave a misleading impression earlier—that I did not see an all singing, all dancing final draft of a revised Bill. However, I saw some very important revised clauses which went to the heart of the matter we are discussing. I do not believe that the Home Office can legitimately hand over those clauses now because the Government and their coalition partner do not have full agreement on everything that needs to be in the Bill and we have not seen David Anderson’s report. David Anderson may have some key points to make which will require the Home Office to rewrite the measure again. Therefore, I do not think that we can take forward some new clauses, bash them into this Bill with two months to go and bounce them into the Commons.
About half the criticisms that I have just listed apply to the proposed new clauses before us today. Nothing has changed. Indeed, the Home Secretary has confirmed that we got it about right in our Joint Committee report and she wants to bring forward a new data Bill incorporating our recommendations. I say to my noble friend Lord Carlile that the Home
Secretary did not say that she wanted the old draft data communications Bill with all its flaws, warts and all; she has made it constantly clear in her statements that she wants a new data communications Bill, but incorporating many of the amendments suggested in our report.
In those circumstances, I think that this House would be committing a grave error of judgment if it accepted these 18 proposed new clauses, which everyone agrees are thoroughly flawed. Of course, there is an imperative for new legislation in this area, but it has to be the best legislation which government and Parliament can invent. The risk of a terrorist attack is severe, but that is no justification for bad law, even if we had a sunset clause of just six months, or one month for that matter.
I am glad that my noble friend is not going to push this to a vote. I hope that other noble Lords will accept that. When we return to this matter in the new Parliament we will need a fully redrafted Bill that takes onboard Mr Anderson’s recommendations, which has had full consultation with the communication service providers that will have to implement it, and which has had a detailed Second Reading debate in the other place and in your Lordships’ House. The Home Secretary has made it clear that she wants new legislation but better than the clauses we have before us today. If we try to take any other shortcut, rather than new, properly worked out legislation, we will be seen to be acting in bad faith. That will make it infinitely more politically difficult for a new Government to bring in balanced measures that give the police and the security services the additional powers they need while protecting the fundamental privacy of the 60 million UK citizens who are not a terrorist threat. If it comes to a vote I reluctantly urge the House to vote against the amendments.
Lord Howard of Lympne: My Lords, it is always a pleasure to follow my noble friend Lord Blencathra, with whom I worked so closely and for so long in government. I am afraid that on this occasion I have to disagree with the contents of his speech. It seems to me that the answer to the points that he made was given by the noble Lord, Lord West, during his intervention. These amendments are not meant to be the last word on the provisions that the final Bill should contain; they are meant to give the other place an opportunity to reconsider these matters.
I am afraid that I was unable to be present at the debate in Committee, but I was able to listen to an exchange on the radio a few mornings ago between the noble Lord, Lord West, and the noble Lord, Lord Paddick. I found the arguments put forward during that exchange by the noble Lord, Lord West, wholly persuasive. That is why I came along this afternoon ready to support the amendment in his name and in the names of his co-sponsors. I have to confess to your Lordships that my determination to do so was reinforced in some measure by the belief—it is still not clear to me to what extent it was well founded—that the Conservative limb of the coalition was anxious to proceed with these proposals but were being prevented from doing so only by the pesky Lib Dems—I am so sorry, by my noble friends who sit on the Liberal Democrat Benches. That remains not entirely clear.
It seems to me that the case made by the four noble Lords who have sponsored this amendment is very compelling. It is clear from what my noble friend Lord King has said that we cannot take the matter further today and that, sadly, this legislation will not be put on the statute book before the general election. However, I join with those who have urged the Government and both of the major parties that might form the Government after that election to proceed with these measures with all possible haste.
Lord Paddick (LD): My Lords, to address the comments made by my noble friend Lord King of Bridgwater and other noble Lords, in my opinion there is no doubt that we all face a very serious threat of terrorism. There is also no doubt at all that, because of the way that technology has moved on, there is a gap that means that the police and the security services cannot now get the information on mobile phone communication that they used to, due to changes in the way that people communicate via the internet. The first issue is: where does the balance lie between measures that would close that gap and the freedoms and civil liberties that we all enjoy? The second is: how do we fill that gap technologically?
Noble Lords will be pleased to hear that I have done some homework over the weekend. Obviously, I am not a technology expert, but this is what I have been told by technology experts. I am very grateful to the noble Lord, Lord Blair, for saying that he has no issue with people who argue on the basis of principle. One of the effects of these amendments, as my noble friend Lord Blencathra alluded to, would be to require communications service providers to store 12 months of web logs—the history of every website visited by everyone who uses the internet in the UK. The Joint Committee that my noble friend Lord Blencathra chaired said that this has considerable implications for the privacy of everybody who lives in this country and who uses the internet. I am sure that that is immediately obvious to noble Lords across the House.
What has not been mentioned is what I have learnt since we were in Committee. When people use web-based means of communication such as WhatsApp—according to my noble friend Lord King of Bridgwater, ISIL is one of the groups that uses this means of communicating —Facebook Messenger or any others, all these communications are encrypted. The vital data that the police and the security services need are held on servers that are mainly in the United States of America. Even if these amendments were agreed to, and even if these web logs were kept, there are serious doubts as to whether the American companies would comply with the UK legislation.
Another aspect of these amendments, and of the draft data communications Bill, would require United Kingdom communications service providers to skim off the encrypted data transmitted to and from the secure servers in the United States, in case the Americans decided that they were not going to play ball. This would cost in excess of £1 billion, and it is unlikely that the UK-based communications service providers would do so. Because of the levels of encryption, and because companies such as Facebook are constantly
reviewing their encryption and making it more and more difficult to decipher, even if that data were captured there is serious doubt that the UK communications service providers would be able to make head or tail of it. Plus, they would not be able to decide what part of that encrypted data was the content of messages or Facebook pages and how much was simply who sent the message to whom, from where and at what time—that is what these amendments and what the draft data communications Bill was about. The noble Lord, Lord West of Spithead, talked at length about intercept evidence. These amendments and the draft data communications Bill have nothing to do with interception. They are about only what is on the envelope of the message, if you like, not its contents.
So what do we do? Obviously, something has to be done to try to get that data. That is why the coalition Government have appointed Sir Nigel Sheinwald as special envoy on international data sharing to sit down with the US Government and US companies to identify ways to overcome legal jurisdictions so that we can tackle crime and terrorism without compromising the privacy of the law-abiding majority. This is not a situation where these servers in the United States are beyond our reach. In 2013, US companies processed around 30,000 requests for “envelope” data from UK authorities. There is already consultation and collaboration and it is producing results.
These amendments are disproportionate, are likely to cost billions of pounds and certainly cannot be implemented immediately. Almost all communications service providers in the UK do not currently keep this data and have no storage capacity and capability to store it. That would be a long-term project; nothing of use would come out of it in the six months that my noble friend Lord King of Bridgwater talked about as a stop-gap measure. These amendments are likely to jeopardise the collaboration that we already have with the Americans, which is serving the police and the security services reasonably well.
Mention has been made of a debate that the noble Lord, Lord West of Spithead, and I had on BBC Radio 4 at the weekend on “Week in Westminster”. During that programme, the noble Lord said that the amendments tabled last week were too broad and that, if it had come to a vote last week, he certainly would not have voted for them. As these amendments have been changed hardly at all since last week, I assume that the noble Lord, Lord West, will not vote for his own amendments.
Lord West of Spithead: Having shared that with only 11 million people, I am shocked that the noble Lord should do so in here.
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Lord Armstrong of Ilminster (CB): My Lords, at this stage there is no need for me to rehearse all the arguments in favour of this group of amendments. The terrorist threat has increased and is increasing, and those upon whom we rely to prevent and detect terrorist crime depend on access to the communications data of those intending and planning to commit terrorist crime. I will not go in detail into everything that the
noble Lord, Lord Paddick, has said, although I do not think that the noble Lord, Lord Blencathra, or I could agree with all of it.
Those agencies have been increasingly conscious that the provisions in RIPA 2000, now nearly 15 years old, badly need updating to take account of technological changes. The agencies have enjoyed the voluntary co-operation of many of the service providers, but many of the companies concerned, as we heard in the committee chaired by the noble Lord, Lord Blencathra, would like to see that voluntary co-operation underpinned by statutory provision. There are no doubt some who are reluctant to co-operate without there being statutory provision.
The Bill provides us with an opportunity to put in place some of the statutory provisions which would have been provided by a revised—“Blencathrated”, if I may call it so—communications data Bill, for the introduction of which we shall now have to wait until the next Parliament. These amendments are designed to take advantage of that opportunity. Their scope has been reduced since similar amendments were proposed in Committee. We have been denied the possibility of Blencathrating these amendments because the Home Office is not willing to produce a revised communications data Bill or the relevant parts of it. Therefore, these amendments are no more than a stop-gap, as the noble Lord, Lord King, described them, and they are no more than temporary to fill a stop-gap because there is a sunset clause which ensures that they will disappear in their present form in December 2016. Most of this limited stuff is taken up with safeguards, and more than three pages are taken up with an interpretation clause of definitions.
We know that the police and the intelligence and security agencies feel the need for these provisions and would welcome these amendments, limited and imperfect though they are. As has already been said, in passing these amendments your Lordships would not be deciding that they would be part of the Bill before us when enacted; we would be giving the other place the opportunity to take that decision. Surely that is where the final decision should lie.
If the noble Lord, Lord King of Bridgwater, were to decide to press these amendments, I would support them because I would not wish to have on my conscience any sense of shared responsibility for what might ensue if failure to include these provisions in the Bill resulted in failure to prevent a terrorist attack which might have been prevented, as well as all the consequences which might result from such an outrage, as was vividly and notably referred to by the noble Lord, Lord Tebbit.
Lord Harris of Haringey: My Lords, this is something of a mess. I was certainly alerted—and I know that other noble Lords will have been alerted at the same sort of time—to the developing problem of a gap in terms of communications data eight or nine years ago. It was so long ago that I can no longer remember exactly when it was. The gap is occurring because of the nature of the way in which communications take place using the internet, and it is a gap which is worsening and getting bigger.
Communications data, as opposed to intercept, are used in virtually all major crime and terrorist cases. They are an essential component, concerning who was there, who was where and who was communicating with whom. That is nothing new; what has changed is the way in which those messages are transferred from one place to another. It is a fact that it is no longer easy, using conventional means and conventional mechanisms, to keep track of that information, and that is causing the problem. It is a problem and a gap which has been getting worse over the last few years.
Something urgently needs to be done to remedy that gap, but it has not happened. The previous Government and this Government have failed to do something about it. We are now moving inexorably towards a general election, which is a few weeks away, and it will be down to whichever Government are in place after that to deal with this. I share the concern of the noble Lord, Lord King, that, following the election, that may not be a rapid, simple or straightforward process.
What do we do now? The first thing is not to oversell the importance of either these amendments or the mythical Blencathra’d amendments that may or may not exist somewhere else. The amendments will not be a magic bullet. The mere passage of these proposed new clauses, or a version of them, does not mean that terrorism will be prevented or that serious crime will stop, but they would be an essential and necessary tool in trying to minimise the risk. Let us not pretend that the failure to include them will automatically mean that there will be a terrorist atrocity. However, it will mean that such an atrocity will be that bit more likely and that it will be that much more difficult to deal with it and stop it.
This is not just a question of the legislative provisions and the fact that we are being dilatory in getting round to dealing with this issue. I understand and have all sorts of sympathy for Ministers in the context of a coalition where one side of the coalition is less keen on such a provision than the other and starts to position itself in advance of a general election. I have lots of sympathy for all that, but the fact is that collectively Governments over the past eight to 10 years have failed to address and deal with this issue.
There is a second vital element, which is that there is a degree of public support for and public buy-in to the changes that have been made. That is why not pretending that this is a magic bullet is so important. In the past, security measures have been oversold as the one necessary thing that will stop all these atrocities, and every time that excuse is used it has bred public cynicism about these measures.
Part of what has to happen is a proper public debate about why these powers are needed, why they matter and why they do not constitute the infringement of civil liberties and personal liberty that some people assume. Failing to have that debate has been a wasted opportunity over the last few years. When the Joint Committee produced its report, the Government should have used that as the opportunity to say, “Let’s have that public debate”. Had they done so, we might now be in a position where there was a public understanding of these issues and a readiness to go forward.
The reality is that if the noble Lord, Lord King, presses his amendments, people will say that the parliamentary process has been abused, and we have no doubt already had dozens and dozens of emails and letters saying precisely that. It is an abuse of the process because it does not allow the normal times for debate, but we have failed to give ourselves the time for that, and that is why we are in such a mess.
Should we agree to these amendments? No, because they do not incorporate the views of the Joint Committee; no, because we have not had an opportunity for the public debate; and no, because we have not had the report of the Independent Reviewer of Terrorism Legislation. I do not want to get into why we have not had all those things but the fact is that we have not. It would therefore be wrong to press ahead with these amendments at this stage, much as I personally believe that something along these lines is necessary and much as I personally believe that we should have taken action much sooner. However, the reality is that those other things are not in place. I blame the Government—of course I would because I am on this side of the House—for failing to have those other elements in place and for failing to ensure that there has been the necessary public debate. However, to press today without public support and public debate, and in the absence of having the views of the independent reviewer, clearly would be a mistake, particularly in the context in which people would see that the legislation had been rushed through by some sort of legislative sleight of hand.
The noble Lord, Lord King, gave the Government a week’s opportunity to move forward. The Government have not taken that opportunity. For the very reasons I have given about not having public support or having built things up, I do not believe that they should have responded to the noble Lord’s amendment last week by bringing forward their own amendments to do all this overnight. But it would have been an enormous step forward, and still would be an enormous step forward, if before Third Reading the Government were to publish the revised versions of the legislation that they have, even if they are not the final product, so that that public debate can start. Some of the myths about communications data and what the Government are trying to do could be dispelled.
We are in a sorry mess. Frankly, I do not think that the amendments in the name of the noble Lord, Lord King, solve the problem. They could conceivably make it worse. But for goodness’ sake, we need to treat people like adults, not pretend that this is a magic bullet, and allow the public debate to take place.
Baroness Ludford: My Lords, I cannot resist the opportunity to add my ha’penny-worth, to respond to my noble friend Lord Howard of Lympne, and to acknowledge proudly the label of pesky Liberal Democrat. I also thank the noble Lord, Lord Blair, for saying that he at least does not disagree that the Liberal Democrats have a position of principle here. However, I disagree with him about the 2004 Spanish election. The Partido Popular did not lose the election because of the bombing being by Islamists. It lost because it tried to misrepresent those bombings as being by ETA, which was against the advice of its own intelligence services.
My noble friend Lord Paddick has put extremely well, and much better than I could, all the objections of principle. The storage of everyone’s web browsing for 12 months, even if it is only up to the first forward-slash, would blur the boundary between communications data and content. It could reveal an awful lot about people’s health, sexual characteristics, political views, marital problems and other potentially embarrassing personal information. This is simply too much power to give to the state. Yes, 12 months’ storage of everyone’s web browsing history is an objection of principle.
I also stress the practical difficulties of scooping up third-party data and setting up a transatlantic jurisdiction on a war which we are destined to lose. From my time as a Member of the European Parliament in the last few years, I have some experience of this in the wake of the Snowden revelations and the whole impact that had on the attempt to get data sharing across the Atlantic without the framework of a transatlantic data-protection agreement. The noble Lord, Lord Cashman, who is not in his place, will remember those debates. We need to work co-operatively with US-based companies rather than try to overreach ourselves in terms of jurisdiction. I fear that the reaction to that, which already has happened in the last few years, is that it could lead to fragmentation and balkanisation of the internet. The glory of the internet is that it is global. We in the West look askance at what is happening in China and Russia in trying to cut themselves off from the global internet. I foresee that that could happen transatlantically as well. Companies in the United States are under a great deal of pressure to comply with at least the safeguard provisions of US law, partly as a result of the lively public debate there in the last 18 months, which is unlike in this country where there has not been so intense a public debate. Of course, we know that they are going faster and faster down the route of encryption, with all the problems that my noble friend Lord Paddick mentioned.
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One of the few changes between last week and this week in the amendments proposed is the removal of the filtering arrangements. Last week, I said that I was afraid that the filter could increase the risk of phishing expeditions but the reply is that, equally, it might protect against unnecessary intrusions. I am not necessarily reassured by the removal of the filtering requirement. The requirement to retain weblogs would increase the size of the haystack by a huge factor. Some estimates say that it would be by a factor of 1 million, which will not make finding the needle any easier. Intelligence agencies already face challenges in making use of the data that they have.
There is a huge risk to privacy in the storage of such massive volumes of data. We have had numerous examples of data breaches. Who needs reminding—but I will—of the 25 million child benefit records lost by HMRC, while eBay had its database of 233 million customers hacked? Mention has been made of Edward Snowden. Of all people, the CIA had a database which was vulnerable to, some would say, whistleblowing, and, some would say, theft by Edward Snowden. City banks have had their systems hacked. Surely, the kind of database and the volume being talked about here
would be a hackers’ honeypot. Compared to what risks such a database would present, we ain’t seen nothing yet.
Without being discourteous, signing up to amendments which some of the sponsors say they would not vote for and floating a proposition only so that it can be discussed at the other end seems quite a peculiar way to legislate. I would have thought it more sensible to legislate on the basis of clauses that it is accepted represent some reasonable, coherent scheme. This certainly does not.
Finally, I say to my noble friend Lord Carlisle that I do not believe that there is agreement on the extent of the capability gap in government. My noble friend Lord Blencathra, who, once again, has given a most impressive speech, said that the committee did not get any cogent explanation from officials. My understanding is that there still is not an agreement, so we do not even know the target that it is proposed to hit. Until there is such an agreement, essentially that is delaying any sensible proposal on communications data.
Baroness Neville-Jones (Con): My Lords, the noble Lord, Lord Harrison of Haringey, said that there is a danger of people being cynical about this legislation. It is also a danger that people will be cynical if, having been warned of an increasing threat and the growing capability gap, the then Government fail to take action. It has a danger of casting doubt on the seriousness of the warnings. The noble Lord, Lord Paddick, also raised a series of objections to what is being proposed today. I entirely agree with him that the legislation when it comes forward will not provide a complete answer. It certainly will not because technically it is not possible for it to do so. There is no doubt that we will need international co-operation. He is also right about the importance of Nigel Sheinwald’s mission.
Encryption undoubtedly makes the task a great deal more difficult and we will not get around some of it. The noble Lord, Lord Paddick, is also right to say that it is a long-term task. However, I do not conclude that that is an argument for delay—rather the contrary—nor is the argument that because we cannot do everything we should do nothing.
I am unhappy with the situation at which we have arrived and it is clear that we shall not make progress today. However, data communications are central to our future capability in counterterrorism. It is an important matter and we should not engage in further delays. I am unhappy that the Government could not find a way of producing legislation that we could have looked at seriously. They could have found a way had they wished to but, if they are not going to, I hope that whichever Government come to power after the election will honour the commitment to priority and that early and good legislation will be passed.
Baroness Smith of Basildon: My Lords, we had a full, thorough and interesting debate on this issue last week, as we have had today. When the noble Lord, Lord King, suggested that he had been criticised for bringing it forward, he will recall that my criticism is that we have not had enough opportunity to discuss legislation on this issue over the past two and a half years.
Last week’s debate was, in some ways, a Second Reading, which was a sensible approach to take. This is a controversial and complex issue. These are detailed amendments—18 amendments over 14 pages—and there is a lot to consider and discuss. It is highly unusual to have amendments on an issue such as this introduced at the Committee stage of a semi fast-tracked Bill that has already been through the Commons. It is for that reason that I felt it was sensible to have the kind of debate that we had last week. We are now talking more about the detail.
I strongly object to the comments of the noble Lord, Lord Blair. He described the debate today and the political debates as the art of the preposterous and suggested that there was some kind of cosy arrangement or deal between the Front Benches. If he has read my comments or heard them in the debate last week when we discussed this, he will know that we were clear in our views on these specific amendments. Nothing has changed and his comments contrast sharply with those of the other noble Lords whose names are on the amendment. No other noble Lords, from all parties or none, have cast any doubt on the willingness and determination across your Lordships’ House to tackle terrorism and on the need to constantly keep under review the proposals and provisions we have in place. We have made our position clear and the suggestion that there is no good reason to oppose these proposed new clauses is incorrect and unfounded.
I do not want to repeat all the comments I made—it is not necessary—but I reiterate that I understand why noble Lords have brought these amendments forward for debate. When the Government published their draft data communications Bill it was, as we have heard from the noble Lord, Lord Blencathra, seriously criticised by the Joint Committee of both Houses set up by the Government as defective in many ways. We went into the details of that last week and the noble Lord, Lord Blencathra, has raised some of those issues today. Basically, it was far too broad, a point made also by the noble Lord, Lord West, lacked safeguards and inadequate penalties for abuse in some areas, and serious concerns were also raised about the accuracy of information and the costings of the draft legislation. The Government accepted that criticism.
I hear a telephone ringing. That will be the Home Secretary phoning the noble Lord, Lord King.
However, we now understand that, although there may not be a new draft Bill, there are drafted amended clauses to the Bill. However, they have never been presented to Parliament and we have never seen any further detail or evidence of them. The noble Lord, Lord Carlile, agreed—he has not seen anything either. I said to the Minister last week that it would be helpful if not only the noble Lord, Lord King, had seen them but also the Official Opposition, who may be in position to legislate on these issues in government.
The Government have never sought to introduce an amended Bill. They have brought forward the Data Retention and Investigatory Powers Act, which was fast-tracked last summer, and the clauses in this Bill. When DRIPA was debated, all parties agreed to our proposal that there should be a full and thorough investigation and report on this issue by the Independent
Reviewer of Terrorism Legislation and that this should be on a statutory footing. In the two and a half years since that report, there has not been a wider debate or a fuller public consultation, a point raised by the noble Lord, Lord Harris, on the new proposals.
The Government have never sought the views of Parliament on the proposals they have picked up on following the report of the Joint Committee but now, just prior to an election, they have said that they want to revisit the issue after the election. What has happened in the past two and half years? Why has this issue not been brought forward? Both the Home Secretary and the Prime Minister have said that something has to be done to address changes in technology and how this is used, but legislation, debate and any proposals have to be far more specific than “something has to be done”.
A statement to the effect that we will have to return to these issues later in the year after the general election is not a particularly dramatic pledge. Any Government will have to do so. We made clear our commitment to that in the last debate. It is why we insisted that David Anderson’s report should be produced prior to the election. DRIPA expires in December 2016. New legislation not only needs to be debated before then but needs to be in place and operational. It is a matter of the highest priority for any Government who take office, and David Anderson’s report will be crucial. He will have presented his report in May.
The public are entitled to expect both security and protection of liberty. They are not mutually exclusive unless we take both to an absolute position on either side, but we do not. We seek to balance both those objectives and the public expect us to bring our good judgment from an informed position. In many ways, the debate around these kinds of amendments is best addressed in your Lordships’ House. It has the experience, the expertise, the commitment and the interest of noble Lords to provide the probing and scrutiny needed to fully examine these amendments and to consider the changes needed.
However, today we are asked to consider them without the opportunity to make other amendments or any significant changes and without the kind of scrutiny that your Lordships’ House is used to providing. The amendments are largely based on the ones that were so heavily criticised—a criticism accepted by the Government—and then withdrawn. I do not know whether noble Lords see the irony in this that I do. It is not unheard of for the House of Commons to pass flawed, inadequate legislation because when it gets to the House of Lords, “They will sort it out up there”. It happened with this Bill in regard to judicial oversight in Part 1. Ministers asked MPs in the other place to reject our amendment on judicial oversight on the ground that they would table something and sort it out when it got to the House of Lords. This is the first time I have been aware of the House of Lords being asked to pass defective legislation so that the House of Commons can then sort it out. I hope it will not be a trend.
I appreciate the comments about there being two months left of this Parliament. It remains open to the Government—as it always has over the past two and a
half years— to provide the detail, the evidence and the time but it appears now that the changes to the Bill are not ready.
I thank the noble Lords, Lord King and Lord West, for their courtesy in discussing their amendments and sharing their views with me. However, most of the changes they have made and the proposals they have put forward do not address the criticisms made by the Joint Committee. I appreciate the point about organisations having access—I agree with it—but limiting the purpose of the Bill to national security and serious crime was not criticised by the Joint Committee. It thought its purposes—to save life, for example—were justifiable.
I also note that those proposing the amendments may have expected greater co-operation from the Government and to have sight of the work previously undertaken on the draft Bill. The noble Lord, Lord Carlile, raised that issue, as did the noble Lord, Lord King. However, that has not been the case. The noble Lord, Lord King, made clear that the Government consider that further work is needed—that this had not been a priority for the Government. Moreover, noble Lords have had these discussions with the Home Office and possibly the Home Secretary, and they have far greater access to security information than we do as Her Majesty’s Opposition. Given the quote from the Home Secretary used by the noble Lord, Lord King, did he also ask why this has not been a priority if she considers the threat to be that great?
My noble friend Lord Harris made a powerful speech in which he said that we govern by consent, but in the two and a half years that the report has laid on the table gathering dust, we have not had an opportunity to have the public debate that would ensure that we have public consent and approval for any measures which are brought forward on data communications and retention.
We know that legislation in this area has to be kept up to date, it has to be necessary, and it has to be proportionate. Following the election in just a few months’ time, when David Anderson has reported and we will have had the report from the Intelligence and Security Committee, there is a time imperative to replace DRIPA and to ensure that our legislation is fit for purpose. We will have to consider new legislation. It may be that some of the provisions in the draft Bill and the suggestions in the report of the Joint Committee are already being outpaced by the advance of technological change—given the time lag we have already had over the past two and half years. But what is clear is that we will need an evidence-based approach from the Government. We will need to explain to and engage the wider public in the debate, and your Lordships’ House will have to scrutinise any proposed legislation to ensure that it addresses both the security issues and those of public liberty. The proposals must do just what they are intended to do—we have often debated their workability—and they have to be proportionate and necessary. We will debate exactly what the provisions would do and their impact.
However, that is not what we are being asked to do today. We are being asked to support these specific, flawed amendments with no guarantee that the Government will provide any additional time in the House of Commons
for them to be debated in full. No doubt the Government delay has wasted time, but these amendments do not resolve that. I am grateful to all the noble Lords who have put them forward because we have been given the opportunity to hold two very good debates on both the principles and the substance. However, if the amendments are put to the vote today, I regret that on the information we have, we will be unable to support them.
6.30 pm
Lord Bates: My Lords, this has been an excellent debate. The points which have been raised have in effect focused on six main areas: the threat, the power, the amendments themselves, the draft Bill, the technology and the procedure. With the leave of the House, I will use those as the outline for my remarks.
I shall first say something about the nature of the threat because context is all in the legislation we are bringing forward. The noble and learned Lord, Lord Lloyd of Berwick, expressed his concerns about the nature of the threat. It is important to remind ourselves that since April 2010, more than 750 people have been arrested for terrorism-related offences. More than 210 have been charged and over 140 have been successfully prosecuted. In Committee, the former Director of Public Prosecutions, Lord Macdonald of River Glaven, outlined some of the content of those cases and the intended acts of terrorism which those who were prosecuted had intended to carry out. We were horrified at the list he presented. Let us be clear: we are seeking to address a very real threat.
Other noble Lords, including my noble friend Lord Paddick, have made reference to the use of technology. Perhaps I may put this into context for the benefit of the noble Baroness, Lady Smith. Certain caricatures are not helpful here. Clearly she dealt with one, but let me deal with another one, which is that this legislation has somehow been left on the shelf to gather dust. That is not the case because of the Data Retention and Investigatory Powers Act 2014—legislation that came directly out of the draft communications data Bill. That legislation was taken through this House on a fast-track basis last July. The IP and the technology elements contained in this Bill are also drawn from the communications data Bill. Moreover, since the start of this Government, the Counter Terrorism Internet Referral Unit has secured the removal of 65,000 items from the internet that were encouraging or glorifying acts of terrorism. More than 46,000 of those items have been removed since December last year. At present, content relating to ISIL, Syria and Iraq represents around 70% of the unit’s caseload. I do not want the House to be under any misapprehension as to the seriousness of the threat or that the police and the security services are not making daily efforts using the powers they have to keep us safe, and we should express our gratitude to them.
It is worth making another important point here. To say that taking forward measures of this nature to attack terrorism might somehow be seen as alienating the Muslim community—which was the example that was given—could not be further from the truth. Bombs and bullets do not discriminate between religions and faiths, as we saw in Paris where the personal protection
officer for one of the journalists who was also murdered was a Muslim. We need to remember that as we move forward, and we also need to remember that we might not just be looking at terrorism by jihadists. Mohammed Saleem, an 82 year-old Muslim from Birmingham, was stabbed to death by a far right extremist who then went on to try to bomb mosques in Walsall, Wolverhampton and Tipton. These threats cross cultures and religions. We have talked about republican terrorist threats in Northern Ireland, but those are different. What we are talking about here are the specific acts of people who seek to subvert the democratic process and curb people’s freedom and liberty by undertaking violence in order to advance their cause.
Those are the points I wanted to make in relation to the threat, because it is real. Is there a gap? Yes, we believe that there is a gap, and that has been repeated on many occasions. The security services believe that these additional powers are absolutely necessary as a matter of urgency in order for them to work on closing the gap. We must recognise that the nature of the threat is mutating, if I may use that term, on almost a daily basis, such are the advances in the technologies and in the capricious use of them by those who seek to do us harm.
Perhaps I may turn now to the draft Bill which was under consideration. My noble friend Lord Carlile dwelt heavily upon this. We did have a debate in Committee and during that debate I did say that I would look again at what we could actually share with the House at that point. I have to say that we tried—again, I do not want to be caricatured by the notion that the Government took away a request that was made by a highly respected source, the noble Lord, Lord Carlile, and then somehow forgot about it. We worked on that very seriously. When we looked at it carefully, there was a view that the amendments which had been shared with the noble Lords, Lord Blencathra and Lord Armstrong, were draft clauses and in many cases had been superseded by legislation which was contained in the Data Retention and Investigatory Powers Act and in this Bill. It was therefore felt that it would be unsafe to do anything at that stage. Moreover, those particular clauses were under the active consultation and review of the Independent Reviewer of Terrorism Legislation, as well as that of the police and the security services. For a whole host of reasons, it was felt that they would not be advisable. We did try to secure the review for noble Lords, but we were not able to do so at that time.
I turn now to the amendments which are before us. The amendments are significant, and I pay tribute to my noble friend Lord King, who has been tenacious in the way he has advanced his cause and pressed us on this issue over the past week. When a phone went off and the noble Baroness, Lady Smith, commented that it could be the Home Secretary for my noble friend, that might in fact have been the first hour that has gone by over the past week when there has not been a telephone conversation—not that the content of them could ever be disclosed, under any circumstances, under present legislation. There has been regular contact.
My right honourable friend the Prime Minister has said very clearly that he regards this as a priority and as a pressing need. The Home Secretary has said it is a
priority and a pressing need. The important thing to say is that we do regard it as a priority, but not the amendments before us at this stage. This is a principal part of what we say to the sponsors of these particular amendments. It is perhaps made more difficult because of the legislative stage we are at with the Bill. We would be faced with sending the 14 pages and 18 or 19 clauses down to the other end, not for them to consider at Second Reading or to discuss and run through in Committee, but for them to vote on in a fairly truncated parliamentary procedure. That might be something which would cause concern. I am simply placing pieces of a jigsaw here to try to explain to my noble friend why, reluctantly, the Government feel that they are not able to support these amendments in their present form.
Then, of course, there is the procedure that we move on to from here, which has been settled. Section 7 of the Data Retention and Investigatory Powers Act says:
“The Secretary of State must appoint the independent reviewer of terrorism legislation to review the operation and regulation of investigatory powers … The independent reviewer must, in particular, consider … current and future threats to the United Kingdom … the capabilities needed to combat those threats … safeguards to protect privacy … the challenges of changing technologies … issues relating to transparency and oversight … the effectiveness of existing legislation (including its proportionality) and the case for new or amending legislation”.
That commitment was made in legislation and has to be delivered by 1 May. Further consideration is under way by the Royal United Services Institute, in addition to further consideration undertaken at the present time by the Intelligence and Security Committee, of which my noble friend is a distinguished former chairman. That work will be extremely important in informing us all in Parliament what the scope and content of that Bill should be.
Finally, I want to come to the point about timing. This is probably the strongest argument which my noble friend Lord King has put forward. The threat is real, and the need is now. We cannot see this as something which can be kicked into the long grass; it has to be a priority for the new Government. I believe that there is just reason to claim that that might be the case and that it may not be subject to the kind of experiences that I acknowledge he may have had with previous legislative arrangements. The Data Retention and Investigatory Powers Act is sunsetted to the end of December 2016. If we work back from that, as we have done, we realise that we need legislation to replace that well in advance of that date, as there certainly cannot be any gap in the coverage of that very important power. If it needs to be in place before that, it necessarily needs to be introduced very early on in the next Session, to allow it to follow its appropriate course through Parliament.
Lord West of Spithead: I thank the Minister for giving way. Is he saying then that this will be a manifesto commitment?
6.45 pm
Lord Bates: The noble Lord will recognise that I am a little too junior to actually write the manifesto. What I can say for absolute certain is that the Prime Minister and the Home Secretary have made clear, in the most
forthright terms, their personal belief that this legislation is needed and that it must be introduced as a matter of urgency in the new Parliament. I hope that that will deal with some of the scepticism which there might be about the power.
I was trying to set out that there is a particular legislative need. Whatever Government are there after the general election, they will have to start to do something very early on, simply because it will take seven to nine months to actually get it in place. However, when it does start, it will start with due consideration of the Joint Committee’s work and the excellent work of the noble Lord, Lord Blencathra. It will start with the excellent debates and consideration that we have had, thanks to my noble friend’s putting forward these amendments in Committee and now again on Report. It will have the benefit of the input of the Independent Reviewer of Terrorism Legislation, of the Intelligence and Security Committee and of other individuals who work in this area. It will be a better piece of legislation for that, providing that it is enacted.
With these comments, I am trying to be as frank as I can in explaining, in a transparent way, where we have got to—where we are—and where we need to be as a matter of urgency in the next Parliament. I hope that my noble friend will see that the Government are grateful for his urging and that we have responded by being more forthright than perhaps we have been before about our intentions. In that spirit, I hope that he will feel reassured enough to be able to withdraw the amendment at this stage.
Lord King of Bridgwater: My Lords, we have had another most excellent debate in what the whole House, I believe, recognises is an extremely serious and dangerous time. It is right that the House should be addressing this issue. I start by thanking the Minister for the way he has responded successively to two very important debates, first in Committee and now on Report. I thank him also for the extremely courteous and constructive way in which he has responded to the representations that I and other noble Lords have made. I thought that we were going to fall out for a moment, because I thought he said I had been tendentious—but I was corrected very quickly by my noble friend beside me, who told me that the word he had used was “tenacious”, which is certainly much more acceptable.
I will just address some of the comments that have been made. I do not mean to be unkind to the noble Lord, Lord Blencathra, but he rather repeated the speech that he made in Committee. He spent some time criticising the amendments we have put down, but these are not the amendments that we wanted to move. As he knows, we tried to change them but the Government did not feel able to co-operate in that respect, so we had to make do with what we had. I also draw some comfort from this quote from his own Joint Committee’s report:
“Our overall conclusion is that there is a case for legislation which will provide the law enforcement authorities with some further access to communications data”.
I will be the first to say that that sentence then has various other qualifications about the need for improvement—the committee had lots of worries and concerns about it—but that is the basis on which we went forward.
My noble friend Lady Neville-Jones answered the noble Lord, Lord Paddick, very well. The noble Lord’s weekend of research brought out very clearly how difficult this issue is, how complicated it is and how much will have to be done before this can actually be brought in. Some might argue that if you have all those complications before this gap—which has been generally recognised to exist—can be closed, leaving open the inability of our country and our security agencies to necessarily meet the threats that they may face, then we had better get cracking on that now. Dealing with the international complications and the issues around encryption are very important points which need to be dealt with.
The noble Baroness, Lady Ludford, who I get the impression is against the idea of having any Bill at all—although I may be misrepresenting her—slightly misrepresented the position taken by the noble Lord, Lord Blair. He did not say that the terrorist attack in Spain caused the change of government. He made a very interesting point that I had not quite focused on. In the context of the time in which we live, as we move towards an election, I understood him to be referring on the Spanish connection to the way in which terrorists have often used election time, a time of political uncertainty, to cause an outrage. That would appear to have been the case in Madrid.
Our debate has brought out some general concerns. I do not think that there was any argument whatever about the threat. The noble Lord, Lord Harris, made a most interesting and constructive speech on the challenges that have to be faced, including the challenge of looking at both sides of the problem. Of course, we are aware at all times of the risks of overstepping the mark and of alienation. I lived through a time in Northern Ireland when the measure of internment without trial—a necessary measure at one time—had undoubtedly significantly increased the problems of terrorism that we then had to face. We in this House and others have a responsibility as legislators to get that balance right.
I am impressed by the statements of the Prime Minister, the leader of the Opposition, the shadow Home Secretary, the Home Secretary and both Front Benches, who make no apology for saying that the threat is severe. That is its standing at the moment. For anybody who did not understand what “severe” meant, those statements were made before events in Paris and Belgium. We are undoubtedly in a time when we need to be able to ensure that our defences are as strong as we can make them.
I understand that it is unusual for such a substantial amendment to be put down at the Committee stage of a Bill in this House. I was not sure whether the noble Baroness, Lady Smith, was suggesting that it is for this House only to do modest revisions to what comes from the Commons and not for it to be on occasions an initiator, inviting the Commons to give their views on what we are putting forward. I certainly do not sit in this House on the implication that I am not allowed to initiate good ideas if I think them necessary, particularly if I think that they will support the security of our nation—but I may have read too much into that.
What we have got out of this debate is not, unfortunately, co-operation on the tabling of more up-to-date amendments which might have given the
House of Commons a chance to consider whether they could be incorporated in the Bill. We now move forward to an uncertain time: an election time with no certainty as to who the Government may be or how long it will take to undertake any of the new legislation which I think everybody—certainly, all those in positions of responsibility in the major parties—believes is essential. At such a time, we have to ensure that in every way we can we give support to our security and intelligence agencies in their work. My noble friend Lord Howard said in debate on an earlier amendment that the security of the nation is the first responsibility of the Home Secretary. She has made it absolutely clear that she wishes to see this legislation in place as soon as possible but has set out her own timetable for it. I am quite clear what the positions of the Government and the Opposition are in not supporting these amendments, but at least we have given the opportunity for these matters to be thoroughly examined.
I do not think that when this Parliament resumes, in whatever guise it is, people will have any excuse for not knowing what the strength of feeling is on this issue. I think that a number of us, who fortunately do not have to stand for election, will be on their tails in this matter. We will be able to resume the charge and try to ensure that, at the earliest possible opportunity, the security of our nation is supported in the best way we can. Against that background, I beg leave to withdraw the amendment.
Amendments 11B to 11T not moved.
12: After Clause 22, insert the following new Clause—
“Authority-to-carry schemes: entry into force etc
(1) An authority-to-carry scheme comes into force in accordance with regulations made by the Secretary of State by statutory instrument.
(2) The Secretary of State must not make regulations bringing a scheme into force unless—
(a) a draft of the regulations and the scheme to which they relate have been laid before Parliament, and
(b) the draft regulations have been approved by a resolution of each House.
(3) If the Secretary of State revises an authority-to-carry scheme, the revised scheme comes into force in accordance with regulations made by the Secretary of State by statutory instrument.
(4) The Secretary of State must not make regulations bringing a revised scheme into force unless—
(a) a draft of the regulations and the revised scheme to which they relate have been laid before Parliament, and
(b) the draft regulations have been approved by a resolution of each House.
(5) Regulations under this section may include transitional or saving provision.”
Lord Ashton of Hyde: My Lords, we move now to Part 4 of the Bill—I hope, briefly—dealing with aviation, shipping and rail. I hope that these government amendments will find favour with your Lordships. During Committee, I acknowledged the concern of
noble Lords that the Bill as drafted provided only for indirect parliamentary scrutiny of an authority-to-carry scheme made under Clause 22. The Delegated Powers and Regulatory Reform Committee expressed a similar concern in its report on the Bill.
In recognition of your Lordships’ concerns, the Government undertook to consider further how we could provide for more direct parliamentary scrutiny of such a scheme. I am pleased to inform the House that Amendment 12 provides for direct scrutiny by laying before Parliament regulations subject to affirmative procedure which bring a scheme, or a revised scheme, into force. With this approach, the scheme comes into force by regulation. This will allow for schemes to be similar in format to the 2012 scheme, which carriers will be familiar with and where the use of plain English makes it more easily accessible to foreign-registered carriers. Amendment 12 enables this. Amendment 13 is a consequential amendment to Clause 23. I beg to move.
Lord Rosser (Lab): We had an amendment in Committee when this issue was discussed, in the light of the report of the Delegated Powers and Regulatory Reform Committee in particular, its view that Clause 18 constitutes a significant delegation of powers to the Secretary of State and that the Bill should be amended so that the powers are exercisable by statutory instrument. In their response, the Government said that they were considering the report of the DPRRC, would reflect on the concerns expressed in the debate and then return to this issue on Report. The Government have done that with their Amendments 12 and 13, which we support. We thank them for their further consideration of this issue.
Clause 23: Penalty for breach of authority-to-carry scheme
Consideration on Report adjourned.
Mental Health Services: Sign Language Users
Question for Short Debate
6.58 pm
Asked by Lord Ponsonby of Shulbrede
To ask Her Majesty’s Government what assessment they have made of mental health services for deaf people using British sign language.
Lord Ponsonby of Shulbrede (Lab): My Lords, the current provision of mental health services for British Sign Language-using deaf people is poor and it is likely to get worse if the Government do not wake up to the problems which will be caused by the move towards using co-commissioning groups for specialised services within the NHS.
Last March, I held a similar debate on the physical health of deaf people. This debate is about mental health services for BSL-using deaf people. It draws on similar research, namely that 40% of deaf people are likely to experience mental health problems in their lifetime, compared to 25% of the hearing population. Indeed, recent research by the Sick Of It campaign suggests that the figure for deaf people could be much higher than 40%.
What makes deaf mental health different? The incidence of schizophrenia among the deaf population is about the same as for the hearing population, but for more common mental health problems such as depression and anxiety the incidence is much higher. This is believed to be due to a variety of factors but particularly to social isolation and also difficulty communicating with parents when deaf people are growing up. I find it interesting that deaf people who have deaf parents are less likely to experience mental health problems.
A deaf person with a broken leg should be able to receive good care at their local hospital, provided a BSL interpreter is used. However, for mental health provision a deaf or signing clinician is needed. A therapeutic relationship needs to be established one-on-one and not via a third party. A specialised therapist would be in a much better position to spot visual clues that are relevant to diagnosis and treatment—for example, pressured signing and alternative signs, where some signs have a double meaning.
Unfortunately, access to specialised support is not available in most parts of the country. This leads to a second-rate and sometimes dangerous service. The current tiers of service within the United Kingdom are as follows: for in-patient services there are currently three units, in Manchester, Birmingham and London, as well as secure private units. This means for most deaf patients that their nearest in-patient unit is a considerable distance away.
Community provision is supposed to be commissioned by NHS England, but in practice there is a postcode lottery. Deaf people in most parts of the country have no access to a specialised community service. The result is that deaf people are dependent on assessment and treatment from non-signing hearing professionals. This frequently leads to misdiagnosis, which can in turn exacerbate the initial problem. The lack of community teams also means that, when deaf people are in-patients, they often have to stay longer than necessary in hospital as discharge is difficult because of the lack of community support.
For psychological therapies, the national Improving Access to Psychological Therapies, or IAPT, programme worked with strategic health authorities and primary care trusts to train deaf IAPT therapists. These therapists were employed by the charity SignHealth and commissioned by PCTs to provide a regional and/or
local service. However, since the transfer of commissioning, these contracts have started to come to an end as co-commissioning groups have not been renewing the contracts. As I speak, the BSL IAPT service in Bristol, B&NES, South Gloucestershire, Swindon and Wiltshire has announced that it will close at the end of March. It seems that the CCGs are going back to commissioning IAPT services individually. As a result, there is no mechanism for them to join together again to commission a BSL service as part of IAPT.
In this situation, deaf people are usually told by their IAPT provider that they can book an interpreter if needed. This is a retrograde step, akin to offering an English speaker therapy with a foreign-speaking therapist, with an interpreter if needed. While the BSL component may be a minor issue for commissioners and providers, it is a huge issue for deaf people. Most will now go back to suffering in silence. This step backwards also means that deaf people can no longer self-refer to IAPT services and must go through their GP, who in practice is often a barrier to accessing the service. It is interesting and revealing that SignHealth’s IAPT service had a recovery rate of 76% compared to the 44% achieved by hearing mainstream IAPT services. Adding an interpreter to a therapeutic dynamic lessens the chance of a good therapeutic relationship and adds to the cost.
I understand there has been a meeting between SignHealth and the Minister, Norman Lamb, in recent weeks. It is not yet clear whether a solution to this problem can be found by the Department of Health or NHS England. The important thing—and the purpose of this debate—is for deaf people to have access to a BSL service wherever they live in the country.
I also mention the pilot service dealing with dementia in deaf people. The Deafness Cognition and Language Research Centre works in partnership with the National Hospital for Neurology. This service is threatened with closure as it appears it does not fit in the commissioning structure we currently have. This is another example of services being so specialised and niche that co-commissioning groups, even clustered ones, have too few patients to make it viable. The problem is that the number of patients in each co-commissioning group is too small to commission effectively and there is no mechanism for the groups to co-operate nationally. There has never been national success in commissioning deaf mental health services at a local or regional level. Deaf mental health services have always been considered a low priority, no doubt because deaf people are a largely silent minority. Co-commissioning would be a backwards step from where we are now, which is bad enough. If anything, psychological therapies need to move up to a national approach, with responsibility remaining local. Moving specialised services down would leave them in the same poor position as deaf IAPT services.
I gave the Minister notice of a couple of questions. First, what progress is there with moves to commission a BSL IAPT service? Secondly, would the Minister commit to addressing the problem I have outlined with BSL community and secondary services available to all BSL-using deaf people? It has been suggested that a working party be set up as appropriate to address the issues I have raised today.
Every BSL-using deaf person deserves a care pathway. Currently, the pathway is broken and getting worse, and this would not be acceptable for any hearing person in the United Kingdom. There is wide acceptance among experts as to what is needed. I hope the Minister will use this opportunity to set out the Government’s plans for addressing the mental health needs of BSL-using deaf people. I beg to move.
7.08 pm
Baroness Tyler of Enfield (LD): My Lords, I thank the noble Lord, Lord Ponsonby, for securing this debate and drawing attention to this important issue. A few weeks ago, I opened a debate in this House about the many challenges confronting mental health services as well as the important new policy and service development instigated by this Government. I particularly appreciate the chance to speak today about the problems that deaf people face in accessing effective mental health care.
It is really important to remember that when we speak of deaf people, we speak of a large and extremely diverse group. There are 9 million deaf or hard-of-hearing people and 700,000 severely or profoundly deaf people in the UK, 50,000 of whom use British Sign Language as their first or preferred language. While some deaf people were deaf at birth or from a young age, others become deaf late in life. The mental health needs of deaf people will differ depending on these factors.
Nevertheless, deaf people as a group share a disproportionately pressing need for mental health care. It has been estimated that 40% of deaf people have a mental illness. The prevalence of common mental disorders such as anxiety and depression in the deaf community is nearly double that of the hearing population and behavioural and personality disorders are between two and five times more common among sign language users.
Deaf children are particularly in need of mental health services as the particular challenges of their life make it more likely that they will experience mental health problems. More than 90% of deaf children are from families with no first-hand experience of deafness, which can lead to isolation and troubled relationships with their families. It is salutary to note that deaf children are twice as likely to be abused or neglected as hearing children.
Let me now turn to the issue of prevention. For many people who lose their hearing as adults, the experience of becoming deaf can adversely affect their mental health. For example, research shows that older people with hearing loss are twice as likely to develop depression as their peers without hearing loss as well as increased feelings of loneliness and social isolation. Like, I am sure, other noble Lords, I am conscious of this from the first-hand experience of close relatives. By providing people with hearing aids, we can reduce these risks. Those who wore hearing aids experienced less depression and anxiety, had more and better family and social relationships, and felt better about themselves than those who did not.
It is impossible to avoid the issue of funding and it is complex. To set the overall context, while very welcome additional funding has been made available
for specific mental health initiatives, our recent debate made clear that mainstream mental health services have suffered from disproportionate cuts in comparison with physical health services for both adults and children. Within this context, specialist services for deaf people remain a particular concern, not least given the current architecture of health service commissioning. In short, while secondary and tertiary mental health services for deaf people are commissioned on a national basis, primary mental health care is the responsibility of local clinical commissioning groups, and this, of course, includes mental health services for deaf people. So while the specialist in-patient units for deaf people in London, Birmingham, and Manchester that we have already heard about may receive adequate funding, commissioning for community services is extremely patchy. That is mainly because the deaf community within the area covered by each CCG is relatively small and there is therefore little incentive for it to prioritise the needs of deaf service users. The result is that only a handful of services receive local commissioning.
Let me try to bring this to life. Until early last year, deaf service users were able to access a deaf therapist fluent in sign language through the British Sign Language Healthy Minds IAPT service developed by the charity SignHealth, which was referred to by the noble Lord, Lord Ponsonby, with funding from the Department of Health. The programme was extremely successful and nearly doubled the rate of recovery from 44% to 75%, which is extremely impressive and important. However, in the restructuring of the NHS, clinical commissioning groups were often hesitant to commission the service, preferring to use hearing therapists with interpreters, even though the evidence shows that this is not as effective. Meanwhile, the service was often considered too small scale to qualify for national commissioning. Because of these challenges, the service is rapidly shrinking and some staff have been made redundant. Can my noble friend the Minister say what the Government are doing to support CCGs to increase the data collected in their local community to help inform mental health commissioning for deaf people?
In such circumstances, deaf people seeking talking therapies, which I greatly support, often have little choice but to resort to mainstream services. Deaf people are often not given adequate access to interpreters, as we have heard. Indeed, a 2012 survey of British Sign Language users found that 68% of respondents did not get an interpreter for their GP appointment, despite having asked for one. Many others must wait longer for treatment and travel further in order to secure access to an interpreter. What plans do the Government have to increase the provision of medically skilled interpreter services?
Even when there is access to an interpreter, going through therapy with an interpreter can present significant challenges. The 2012 survey indicated that 41% of deaf patients felt confused following their appointment as they had trouble understanding the interpreter. This may be due to cultural reasons. It is important to recognise that the life experiences of deaf people differ in ways that go well beyond language, especially if they have been deaf from birth or a very young age. The relationship between a hearing therapist and a
deaf service user can be made more difficult by cultural barriers as well as linguistic ones. It is no surprise or indeed criticism that mainstream mental health service providers often lack the specific expertise necessary to understand the unique life experiences of deaf people and work effectively with deaf clients. It is just that a specialist service requiring specialist expertise is needed.
Moreover, the inclusion of an interpreter, as the noble Lord, Lord Ponsonby, said, inevitably changes the dynamic in a therapeutic situation in ways that can be detrimental. For example, the sorts of topics discussed in therapy can be difficult enough to tell to a therapist without having to wonder whether one’s words will be faithfully conveyed by the interpreter. As the deaf community is small and close knit, there is a real chance that the patient will know the interpreter, and because qualified interpreters are hard to come by, the options are limited and there are few alternatives if a patient is uncomfortable with his or her interpreter.
As we have heard, there are specialist in-patient psychiatric units for deaf people in London, Manchester, and Birmingham, but the quality of care that deaf people receive is adversely affected by a lack of community resources. A recent report by the National Deaf Mental Health Service has shown that deaf adults in specialist and general in-patient programmes were in hospital for twice as long as hearing patients, not because of actual clinical need but because the community services they would need on discharge were not available. The current dearth of specialist services for deaf people is not inevitable. As Dr Sally Austen, a specialist for deaf people with mental health problems and a former chair of the British Society for Mental Health and Deafness has pointed out, if specialist deaf services were to include partially deaf people, the economies of scale would change. Dr Austen has also suggested that what is called “tele-mental health”, including online services, may also provide a solution for deaf patients with poor access to appropriate providers having to travel very long distances.
This is an extremely important discussion, and yet is not one that we often have. The last government strategy on the topic was back in 2005. If nothing else, what we have already heard—and more is to come—about the wide array of challenges that deaf people face in securing access to mental health care should surely convince us of the importance of updating our aims for this type of healthcare provision. I therefore, finally, ask my noble friend the Minister what plans the Government have to update the 2005 Mental Health and Deafness:Towards Equity and Access document so that it can become the cornerstone of all our work.
The UK has had a proud history of providing excellent mental health services for deaf people. It would be a tragedy to neglect that history by failing to give deaf people the access to therapy that they so clearly need and deserve.
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Lord Borwick (Con): My Lords, I declare an interest as a trustee of the Ewing Foundation for deaf children.
I am grateful to the noble Lord, Lord Ponsonby, for again raising for debate important issues on deafness, but I rather disagree with the noble Lord on the
definition of deafness. It should not be defined as the characteristic of those who use sign language, because there are a host of elderly deaf people who do not use BSL and many children born with a profound hearing loss now have cochlear implants which, although leaving them still with a significant hearing impairment, enables them to communicate in spoken languages. Similarly, improvements in hearing aid technology have made it easier for other deaf children to communicate in a spoken language. The
Oxford English Dictionary
defines “deaf” as lacking the power of hearing or having impaired hearing. That is the definition we should use; a definition that depends on BSL implies that BSL is the only characteristic, and that is problematic.
Today’s debate is particularly important because there is a lot of evidence of depression and mental health issues among deaf people, including those who use sign language. All the evidence suggests that hearing loss can substantially increase the risk of mental health problems. Anxiety, paranoia and depression are particular risks. Those with hearing loss are overrepresented among samples of patients suffering from paranoid psychoses in later life. Older people with hearing loss are more than twice as likely to develop depression as their peers without hearing loss. It is therefore important that the appropriate mental health services are available for deaf people and that the right steps are taken to improve outcomes.
I know that some will argue that, because not everyone can use sign language, deaf people who use it may experience depression and mental health issues even more acutely. Deaf people using sign language to communicate may have fewer opportunities to access appropriate special services too, and there are still a few children who use BSL as their only language who would struggle to access mainstream mental health services because of language barriers. This no doubt accentuates the feelings of frustration. There is research showing that deaf children who live in families where BSL is the only language are less likely to experience mental health problems than deaf children in families who use English. If you cannot communicate with your family, it is little wonder that you feel isolated. However, that research is dated.
New technology, such as digital hearing aids and cochlear implants, is reducing the need for the BSL language, and early detection is further breaking down the reliance on BSL. We have to remember one crucial point in this debate: there is a whole range of deafness, and not all the people on the spectrum use BSL, but new technology and early detection mean that many more can take a full and active part in a hearing society while still being able to use sign language if they choose. Doors are opening and many deaf people or partially deaf people can enjoy the best of both worlds rather than becoming frustrated by the limitations of just one. Being able to access both deaf and hearing communities is going to be good for the mental health of those with hearing difficulties.
Much more care is being taken to focus on the mental and emotional health of deaf children. The National Sensory Impairment Partnership has worked with the National Deaf Children’s Society to produce documents for teachers of the deaf on emotional
well-being. The website for the National Sensory Impairment Partnership has published guidance for teachers on how to deliver a course called
Think Right Feel Good
. This helps teachers to understand and develop emotional resilience in deaf children.
There are a host of foreign languages in the UK. All speakers of unusual languages have the same problem: the inability to communicate except in their own community. The number of deaf young people who are reliant on BSL to communicate and access teaching and learning has declined significantly, and this will be reflected over the next few years in the adult population. I am full of admiration for the wonderful children who use BSL while learning to read and write English at the same time, but technology is changing that and we have to embrace it. It is so exciting that we can bring deaf people into the speaking world. Look at the new apps available on smartphones nowadays. Google Translate and Skype Translator both instantly translate foreign languages. Siri is starting to do so on Apple products. The app Mimix says that it will simultaneously translate from English into American Sign Language. MotionSavvy will translate the other way. I am sure it is not yet perfect, but a great start would be for BSL users to carry this sort of technology when having a vital conversation with a doctor. This is a story of success—not perfect by any means but apparently getting better.
It is, of course, very sad that the situation was so bad in the past, but the important thing is that things get better, and it will be ameliorated by technology, not by government expenditure. The overall priority should be to integrate deaf children into society, and as a fully integrated group they will no doubt have a similar incidence of mental illness, tooth decay and cancer as the rest of society. Any incidence of mental illness is appalling, but I am not sure that it is sadder because the victim is deaf than because the victim speaks Pashto or Welsh.
I ask my noble friend the Minister if he is able to publish data on the characteristics of children referred to specialist deaf mental health services. What percentage of the children are lip-readers, use BSL or have cochlear implants? I believe that more information will only help us to learn and improve. It would be very helpful to see the data on the characteristics of children referred to specialist deaf child and adolescent mental health services to see what we can learn. If we were aware of the most common profiles of children referred to the specialist services, perhaps this would inform preventive work and where it should be targeted.
7.25 pm
Lord Addington (LD): My Lords, in a short debate like this it is not uncommon when you come in at the end for much of what you want to say to have already been touched on, but in this debate I am afraid there has been the banging of guns and the falling of foxes all over the place. I am left with saying, as my noble friend who has already spoken has said, that much of what we are discussing here was touched on in our debate on mental health. I spoke then about the fact that all disability groups are overrepresented in the mental health sector—end of story. Anybody in those
groups who has problems in the outside world and suffers more stress will have mental health issues, as night follows day; the question is what we do to ameliorate the situation.
The noble Lord, Lord Ponsonby, has rightly pointed to a particular group here, because the whole question is brought into focus when you look at a particular group: you see the specifics as opposed to the general. The whole spectrum here is made up of a series of specific points. British Sign Language users are going to have their own specific problems. They are specific, as the noble Lord, Lord Borwick, has just said, to a section of those who have hearing problems, such as hearing loss. The group has quite profound problems, and the question we are looking at here is how we make sure that they can access and receive support. Even if the noble Lord is right and they are a declining group, they are still going to have problems in the future that must still be addressed, because if you do not address them you store up problems, costs and inconvenience for the rest of society in an ongoing process. I therefore congratulate the noble Lord on raising this issue, because unless you concentrate on the problem in this way it becomes a generality, and I very much commend him for raising it.
Then we come to technology, and here I must declare an interest as chairman of a company called Microlink, which deals with technology. There is a lot of interesting stuff out there that can be of some assistance to those with varying degrees of hearing loss. As has already been said, there are dozens of ways in which you can play with language and translate it. There are things that can be used, and we have probably only just started to touch on this. There is something that can translate language into text; I use it myself as a dyslexic. There are dozens of bits of technology out there.
However, as was pointed out to me with considerable force when I started doing research on this, the deaf community across the spectrum is already using an incredibly widespread piece of technology called texting. This had not occurred to me at all. Mobile phones? I am part of the generation that regards a phone as something you talk to. I am apparently in the stone age here. Phones that you can text on that use a simpler, less elaborate grammar are actually a very common way of communicating in the deaf community. Do health workers and mental health workers actually know—the noble Lord, Lord Ponsonby, spoke about the same problems—that this is a way of establishing communication that might well mean that you find an easier path through to therapy than using sign language interpreters? It might well be some form of back-up to the primary talking cures for all forms of mental health treatment, which are generally regarded as better, longer lasting, more maintainable than simply pumping somebody full of drugs, even if drugs have to be used at the same time. Unless there is some way of bringing all these things together to get the best outcome, we are going to miss a trick.
Unless we learn to use the technology coming through, which is increasingly available—here I am probably shooting my own company in the foot—we will incur more on-costs. A little awareness training—asking people in casualty if somebody comes in who is in a
very distressed state, “Have you tried communicating with them by text?”—may well relieve some of the stress, it may identify some of the symptoms more quickly. Could not a little bit of guidance here and there be worked in?
There are other forms of communication. My favourite one is called the UbiDuo. I like not only saying the word but the fact that it is instant typing to another screen that translates straightaway. The whole thing is about the size of a traditional laptop, so you can carry it around. That would be more appropriate for those who have good written skills, but there are lots of established pieces of tech that we are not getting the best out of. For the foreseeable future, we will need councillors who are skilled at using the specific sign language, with its rules of grammar, nuance and cultural references, but we may well need to support them and take some of the stress off them by using technology at the same time.
When all is said and done, the technology is generally cheaper. If we concentrate on that and make a funnel through to those very valuable—at times, irreplaceable—people, we will surely be doing all of us a favour.
7.31 pm
Baroness Hollins (CB): My Lords, I would like to add a couple of points to the debate from my experience as a psychiatrist. We have heard that deaf people continue to face unacceptable inequities in access to mental health services, and that is particularly the case for the estimated 25,000 deaf people in the UK who use British Sign Language as their first or only language. Deaf BSL users from black and minority ethnic communities, or who have additional needs arising from co-morbid visual impairment or intellectual disability, encounter even greater obstacles to accessing mental health services.
We have heard that deaf children are more likely to experience emotional, physical or sexual abuse, which contributes to later mental health problems. Deaf adults are much less likely to know how to report suspicions of abuse. Thus, children living in deaf communities are more likely to have their experience of abuse go unnoticed and unreported. The community interest company, Books Beyond Words, which I chair, has been commissioned by the NSPCC to help it develop pictorial resources to improve the reporting of such abuse to organisations such as the NSPCC.
We have heard that many deaf people leave GP consultations with no understanding of what went on, and consequently avoid going to see their GP altogether. Research has shown that a shocking one in seven people with hearing loss has missed a healthcare appointment because they did not hear their name being called in the waiting room. Those access problems continue despite the Disability Discrimination Act’s requirement for reasonable adjustments to be made, and they are compounded by a lack of deaf awareness training for professionals working in healthcare settings.
Within mainstream mental health services, few staff possess the BSL skills and experience needed to work effectively with deaf BSL users. Mental health services frequently fail to arrange for BSL interpreters to be present at appointments, often relying on family members,
including children, to act as informal interpreters. That practice is unjustifiable, particularly in mental health services, where sensitive and personal issues, sometimes including abuse, may be disclosed. There is also an ongoing shortage of BSL interpreters in healthcare settings and a lack of specialist training for those who wish to work with people with mental health needs. What steps will the Government take to increase the number of BSL interpreters within mental health services?
The Sign Health charity highlights that over the past three years, it has trained 18 deaf and three hearing BSL users to work as psychological well-being practitioners in several geographic regions, but only seven are currently employed, reflecting a lack of recognition of the need for their services. Does the Minister agree that such provision would constitute a reasonable adjustment, and can he assure the House that action will be taken to improve deaf people’s access to IAPT services provided by therapists sufficiently fluent in BSL?
Deaf people are also overrepresented in secure mental health settings, and are thought to be overrepresented in the prison population, which may reflect a prior failure to address their mental health needs. It suggests the need for specialist prison in-reach services, so that deaf people with mental health needs can be identified and supported.
I highlight the importance of addressing the social determinants of mental well-being in deaf people. The exclusion, isolation and barriers that deaf people experience in education, employment and the community can negatively impact on their social and emotional well-being, along with their education and employment outcomes, thus perpetuating the cycle of adversity which puts them at greater risk of mental health difficulties. Can the Minister assure the House that recommendations to address those factors will be included in the Government’s forthcoming action plan on hearing loss?
A couple of examples were given to me by a psychiatrist working in one of the national deaf mental health services of children who he visited in mainstream schools. One child was using only BSL in a mainstream school where nobody else knows BSL. A young person in a special school whose only language was BSL was in a class with seven young people with learning disabilities, none of whom was deaf or knew BSL. That is clearly unacceptable. I look forward to the Minister’s response and thank the noble Lord, Lord Ponsonby, for raising these important matters.
7.36 pm
Lord Hunt of Kings Heath (Lab): My Lords, I, too, thank my noble friend for instituting this debate and Sign Health for its valuable briefing. I welcome the input of the noble Lord, Lord Borwick, but my noble friend’s Question was quite specific. I fully accept that however widely you define deafness, the scale of mental health problems is serious and deserving of attention. I thought that the noble Lord, Lord Addington, put it well. The focus on British Sign Language users is valuable in itself, but it is also a signal of more general problems.
Interesting work published recently in the British Medical Journal has shown, first, as is well known, that deaf adults in the UK occupy poorer socioeconomic
positions, have poor literacy and have limited access to communicate through speech. Their health is generally poorer than that of the general population, with probable underdiagnosis and undertreatment of chronic conditions. As for mental health, other research shows that 40% of deaf people are likely to experience a mental health problem. Although the incidence rate of schizophrenia is probably similar to that of the hearing population, the rate of common mental health problems is much higher. Going back to the BMJ research published only a week ago, the rates of depression self-reported by deaf participants was 24% overall—32% for women and 14% for men.
In any response to the mental health issues facing many deaf people, it is abundantly clear, as the noble Baroness, Lady Tyler, said, that there is no national strategy to which one can turn to describe what services deaf people could expect from the NHS. That is related to confusion about what should be commissioned at national and local level. We see lots of indications that clinical commissioning groups find it very difficult to commission services for what inevitably will be a small population in their area.
Equally, I fully accept that not all of that can be commissioned at the national level. We need to find a way that will help clinical commissioning groups to commission services locally for these smaller population groups so that there is much more of a cohesive approach. I do not think that CCGs will do it if left to themselves. That is the real problem that we face, alongside the funding issues around commissioning at a national level for speciality services. This is not an easy issue, but we have to do better than at the moment.
A number of noble Lords referred to the position facing speciality services, and I want to add to the points that my noble friend made about this. I want in particular to raise the question of the Deafness Cognition and Language Research Centre at University College London, which I understand is putting together a costed business case for a national neurological service for British Sign Language deaf users. I understand that it has met Norman Lamb; it has also met my colleague Andrew Gwynne. This has clear cross-party support. The centre is putting a business case forward to secure the presence of a clinic beyond 2015; I do not know if the Minister will be able to update me on progress in that area.
My noble friend and other noble Lords have mentioned the Improving Access to Psychological Therapies service, which showed very promising results from the date of its introduction. Other noble Lords referred to the outcome measures. This has clearly fallen foul of the problem of being delegated to CCGs to commission; they are clearly not going to do so. I had the privilege of meeting SignHealth with Mr Norman Lamb. We had a very good hearing and I was left with considerable optimism that some way would be found to fund this. Again, if the Minister were able to give us some updates on the progress of that, I would be very grateful.
We come back to the point that, if this is left to local CCGs, there is no hope for services that need a contribution from each CCG to make it viable. One way or another, we have to find a way for there to be some kind of national leadership. Indeed, if I were to
ask for one thing above all else, it is that the Minister would see if his department was prepared to produce some kind of cohesive strategy around deaf issues and mental health issues for deaf people. That would then give us some encouragement that we would be able to tackle these issues in a coherent way. I always thought that national service frameworks were a very good idea; I am not sure that the current Government think so but, if we are not to have them, we need something in their place.
I want to ask the Minister about the equality duty in relation to deaf people. Is he satisfied that the NHS understands its responsibilities under the equality duty? The noble Baroness, Lady Hollins, suggested that many staff in the health service are very much unaware of the issues for deaf people and the barriers that they face. The issue here is that we lack national standards against which local NHS bodies could judge their performance. The noble Baroness raised the question of reception and waiting room experience. The fact is that work has been done showing that 90% of deaf people have missed many GP appointments through not hearing their name called out in the surgery. That is just one example of the kind of communication problems that they face. At this point it would probably be better if I sat down and gave the Minister even more time to answer the questions.
7.44 pm
The Parliamentary Under-Secretary of State, Department of Health (Earl Howe) (Con): My Lords, I thank the noble Lord, Lord Ponsonby, for securing this short debate on the mental health of deaf people who use British Sign Language. Over 10 million adults in England live with some degree of hearing loss and, while some will be among the one in 700 babies born with hearing loss, many of us will develop hearing loss over our lifetime. With an ageing population, this figure is only going to increase, with the World Health Organization predicting that by 2030 there will be an estimated 14.5 million people in the UK with hearing loss, with adult-onset hearing loss predicted to be among the UK’s top 10 disease burdens.
We know from research that deaf people are at a much higher risk of mental ill health than the general population, with 40% of the hearing-impaired population and 50% of the profoundly deaf expected to experience mental health problems during a lifetime, compared with around 25% within the general population. It is therefore vital that we provide deaf people with appropriate services that support their mental health needs.
The Government are committed to improving mental health services and ensuring that those services have equal priority with those for physical health. Our mandate to NHS England makes it clear that everyone—I emphasise “everyone”—who needs them should have timely access to evidence-based services. Over £400 million is being invested over the spending review period to make a choice of psychological therapies available for all those who need them in all parts of England. We have put in place for the very first time waiting-time standards for mental health, a significant milestone on the road to parity.
The NHS is a universal service. I listened with care to the remarks from the noble Lord, Lord Hunt, about equality. NHS England is under a specific legal requirement in relation to tackling health inequalities and advancing equality. The Government will hold NHS England to account for how well it discharges this duty. We recognise the importance of deaf people being supported and enabled to communicate through British Sign Language where they wish to do so. Section 20 of the Equality Act 2010 requires CCGs to make “reasonable adjustments” so that disabled people are not placed at a substantial disadvantage compared with non-disabled people. The reasonable adjustment duty is an anticipatory duty, meaning that service providers are expected to anticipate the requirements of disabled people, and the reasonable adjustments that may have to be made for them, before any disabled person attempts to access the service in question. Simply put, it is not acceptable for health services not to be equipped to provide communication support to those who need it.
Equality legislation means that service providers and public bodies must provide a reasonable adjustment to their services to meet the needs of clients when it is reasonable to do so. This may be the provision of interpreters or services delivered in BSL. In September 2013 the Prescribed Specialised Services Advisory Group, PSSAG, considered a proposal from SignHealth for NHS England to commission psychological therapies for deaf sign language users. The PSSAG felt that although the provision of IAPT services using BSL was clearly complex, it did not meet the requirements for a specialised service commissioned directly by NHS England, and therefore responsibility for commissioning psychological therapies for deaf sign language users should remain with clinical commissioning groups. The PSSAG recommended that CCGs be signposted to the relevant organisations and informed about the services and support that they can provide to deaf patients.
From his remarks, the noble Lord, Lord Ponsonby, was clearly in favour of community and secondary deaf mental health services being commissioned as a specialised service. I am sure he will understand that any proposal of that kind would need to be considered by the PSSAG. However, with regard to NHS England retaining responsibility for existing specialised deaf mental health services, even if co-commissioning were introduced I can assure him that NHS England will retain the responsibility as set out in the mandate and the Manual for Prescribed Specialist Services for the specialised deaf services. Future collaborative commissioning arrangements have not been confirmed as yet, but that will not alter NHS England’s responsibilities as the responsible commissioner. However, we know that more needs to be done.
As the noble Lord, Lord Ponsonby, mentioned, my right honourable friend the Minister for Care Services, Norman Lamb, recently met SignHealth. At this point, I pay tribute to the exceptional work of SignHealth in promoting the same sort of access to healthcare and health information for deaf people as hearing people receive. I have visited SignHealth on more than one occasion. SignHealth impressed upon my right honourable friend the importance of psychological therapies for
deaf people through the Improving Access to Psychological Therapies service. Since the meeting, officials have been working to develop proposals in support of the commissioning and provision of psychological therapies for deaf people in England. The noble Lord, Lord Ponsonby, asked whether a working group could be established to look at this issue further. I believe that is a sensible suggestion, and I am happy to commit to it. In the mean time, we will remind clinical commissioning groups of the importance of commissioning IAPT services that are accessible to British Sign Language users.
We are committed to delivering health outcomes that are among the best in the world for people with hearing loss. We have made considerable improvements over recent years, including the rollout of a national screening programme for newborn children, significantly reducing waiting times for assessment and treatment and greater choice of hearing aid services—for example, through independent high-street providers.
NHS England is developing a new accessible information standard which will provide clear guidance to health and social care organisations on the steps they need to take to ensure that disabled patients, carers and service users receive information in appropriate formats, and communication support if they need it. This will include the provision of interpreters or BSL users for deaf people. NHS England has worked closely with SignHealth in the development of the standard, and SignHealth has offered advice about aspects of the standard which relate to deaf people. It is anticipated that the standard will be published in the spring and that organisations would then have 12 months to implement it. Alongside the statutory information standard, NHS England will publish guidance on making reasonable adjustments to meet the communication needs of service users with disabilities.
As well as an information standard, NHS England, alongside the Department of Health, is developing an action plan on hearing loss which will identify the key actions that will make a real difference to improve the lives of all those with hearing loss. The action plan is in its final stages of development with a view to being published soon. I hope that goes some way to address the question asked by the noble Lord, Lord Hunt, about a national service framework or the equivalent thereof.
I shall, of course, write to noble Lords whose questions I am unable to answer in the debate. My noble friend Lady Tyler asked me several questions. One was about the 2005 document Mental Health and Deafness—Towards Equity and Access. There are no plans to update that document. She also asked me, as did my noble friend Lord Borwick, about what we are doing to support CCGs to increase the data collected in their local communities to help inform mental health commissioning for deaf people. Our goal is to create the most open and transparent healthcare system in the world. To support this ambition, we need to build a truer, more up-to-date picture of mental health and well-being, both nationally and in each area. The current level of
information collected on IAPT represents the gold standard of data collection. We have robust information on the numbers of people accessing services, how long they wait, how many recover or improve as a result of treatment and the cost of these services, which is a genuine world first in mental health. Our ambition is to bring the same standard of information to all mental health services over time.
My noble friend and the noble Baroness, Lady Hollins, asked about the supply of medically skilled interpreter services. It is clear that we need to work across government and with the voluntary and public sectors to encourage more people to come forward to train and qualify as BSL interpreters. We know that it takes at least three to five years to train a person in BSL to level 3, which is a basic requirement for a therapist/clinician. NHS England advises us that this will be addressed within a framework for workforce planning.
My noble friend Lord Borwick spoke with tremendous authority about the mental health needs of deaf children. Children and young people’s mental health is a key priority for the Government, as I hope he knows. In August 2014, we launched the children and young people’s mental health and well-being task force. That task force brings together a range of experts. It is looking at how to improve the way children and young people’s mental health services are organised, commissioned and provided and at how to make it easier for young people to access help and support, including in schools, through voluntary organisations and online. That very definitely includes deaf children with mental health problems.
My noble friend Lord Addington spoke very powerfully about the use of technology. As he will understand, this is a decision for individual providers, but the NHS’s ambition is to embrace technology as part of its drive to offer modern, convenient and responsive services to patients, their families and their carers. General practices are leading the way on that. The NHS is working with local commissioners and is undertaking a number of pilots to redefine and improve the design of the future NHS 111 service, which includes improvements to the text relay service, making it easier for text relay users to navigate to a service provider. As regards the delivery of psychological therapies to deaf people, we are currently exploring the commissioning of online BSL or text-based models of delivery.
The noble Lord, Lord Hunt, asked me about the UCLH project. University College, London, has developed a case with the Deafness Cognition and Language Research Centre on what a deaf cognitive service should look like. We understand that proposals for the future of the services are under discussion.
I hope that in the time available I have been able to reassure the noble Lord, Lord Ponsonby, and indeed the House, of this Government’s continued commitment to meeting the specific needs of deaf people and that we take this issue very seriously.