House of Commons
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Tom Pursglove (Corby) (Con)
I beg to move, That the House sit in private.
Question put forthwith (Standing Order No. 163), and negatived.
Access To Medical Treatments (Innovation) Bill
(8 years, 9 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Nick Thomas-Symonds (Torfaen) (Lab)
I beg to move, That the clause be read a Second time.
Mr Speaker
With this it will be convenient to discuss the following:
New clause 2—Identifying evidence on off-patent repurposed drugs and passing to relevant bodies—
(1) The Secretary of State shall require the National Institute for Health Research to develop and introduce a mechanism for—
(a) gathering and recording existing evidence on off-patent, repurposed drugs, including clinical trial evidence, and
(b) passing this information to relevant bodies.
(2) The Secretary of State shall determine the relevant bodies under subsection (1) and may revise that determination from time to time.
New clause 3—Appraisal in new indications—
(1) Where there is an off-patent, repurposed drug with strong evidence of its effectiveness in a new indication, the Secretary of State shall direct the National Institute for Health and Care Excellence (NICE) to conduct an appraisal in relation to the drug in its new indication.
(2) An appraisal under subsection (2) should include a cost-effectiveness analysis.
New clause 4—National commissioning policy for off-patent new drugs—
Where there is an off-patent, repurposed drug with strong evidence of its effectiveness in a new indication, the Secretary of State shall require NHS England to produce and disseminate a national commissioning policy.
New clause 5—Accessibility of the licensing process—
(1) The Secretary of State shall require the Medicines and Healthcare products Regulatory Agency to consult key stakeholders about steps to be taken to make the licensing process more accessible to organisations or individuals other than pharmaceutical companies.
(2) For the purposes of subsection (1), key stakeholders shall include, but not be limited to—
(a) patient organisations,
(b) medical research charities,
(c) relevant academics, and
(d) the British Generic Manufacturers Association.
New clause 6—British National Formulary: inclusion of off-patent drugs—
The Secretary of State shall require NICE and the British National Formulary (BNF) to review their processes for registering off-label uses of repurposed drugs where there is strong evidence of their effectiveness.
Amendment 10, in clause 1, page 1, line 3, after “treatments” insert “(including treatments consisting in the off-label use of medicines or the use of unlicensed medicines)”
Amendment 13, in clause 5, page 3, line 44, at end insert—
“(1A) For the purposes of section 2(2), the kinds of medical treatment that may be innovative medical treatments include (amongst other things)—
(a) the off-label use of an authorised medicinal product, and
(b) the use of a medicinal product in respect of which no marketing authorisation is in force.
(1B) In subsection (1A)(a), the reference to the off-label use of an authorised medicinal product is a reference to the use of the product—
(a) for a purpose other than one for which its use is specified,
(b) in relation to a person who is not within a description of persons for whom its use is specified, or
(c) in any other way in which its use is not specified.
(1C) In this section—
(a) ‘authorised medicinal product’ means a medicinal product in respect of which a marketing authorisation is in force;
(b) ‘marketing authorisation’ and ‘medicinal product’ have the same meanings as in the Human Medicines Regulations 2012 (S.I. 2012/1916);
(c) ‘specified’, in relation to a medicinal product, means specified in its marketing authorisation.”
Nick Thomas-Symonds
These new clauses and amendments, which I support, relate to off-patent drugs. I think it would be useful for me briefly to set out the context in which they arise. The Off-patent Drugs Bill, a private Member’s Bill that I introduced—it was debated on Second Reading on 6 November—is a UK-wide Bill that would create a duty on the Government to make cheap drugs available when pharmaceutical companies had no incentive to do so. The problem, put simply, is that if a drug is shown to be useful for a new purpose after its original patent has expired, a pharmaceutical company has no financial incentive to sponsor that off-patent treatment through the processes normally used to license it and ensure its adoption on the NHS. Those off-patent or off-label treatments are certainly available at low cost. The issue is simply that although clinicians can of course prescribe them, they tend not to be prescribed consistently across the medical sector, or indeed geographically.
The Off-patent Drugs Bill ran out of time that day, but I think it is accurate to say that the Government supported its aims but not the mechanism it proposed. None the less, in recognising that there is a problem, and with a shared position on both sides of the House on the need to encourage greater consistency in off-label prescribing, a lot of work has since been done, and on a cross-party basis. I am proud that new clause 1 stands in the name of Members from no fewer than eight political parties. The concept of encouraging greater use of off-patent drugs, and indeed my Bill, have significant support across the House and outside. I pay tribute to Jonathan Evans, the former Member for Cardiff North, who first introduced such a Bill in 2014. His successor, the current Member for Cardiff North (Craig Williams), has also supported my Bill.
Carolyn Harris (Swansea East) (Lab)
I congratulate my hon. Friend on the excellent work he has done on the Off-patent Drugs Bill. Given the consensus across the House, does he agree that now is the time for a firm commitment from the Government on that Bill?
Nick Thomas-Symonds
I am grateful to my hon. Friend for that intervention. I hope to hear such a commitment today, so I look forward to what the Minister for Life Sciences has to say in that regard.
That wide support for my Bill was shared by medical research charities, NHS clinical commissioners in England, the British Medical Association, thousands of members of the public who wrote in, and four medical royal colleges. Indeed, 40 eminent clinicians wrote to The Daily Telegraph in support of my Bill.
Since then, I am pleased to say that there have been good attempts on both sides of the House to build on that good will in relation to off-patent drugs. I want to thank the hon. Member for Daventry (Chris Heaton-Harris) for the highly constructive and pragmatic way in which he has been willing to take the off-patent agenda forward when speaking about his private Member’s Bill. I thank the hon. Member for Bury St Edmunds (Jo Churchill), who brings a strong personal perspective to the debate. Her sense of what is good for patients has been highly constructive in the debates we have had over the winter months. The hon. Member for Central Ayrshire (Dr Whitford), who used to be a breast cancer surgeon—in fact, she still practises—has brought a great level of expertise and experience in recent months, for which we are extraordinarily grateful. I also pay tribute to the Minister, who has been extraordinarily generous with his time and that of his officials in order to try and take this agenda forward, and for that I am extremely grateful.
I want first to make a point about clauses 3 and 4. While there is something of a consensus around responsible innovation, I had strong concerns about those clauses, as did many across the medical profession who thought that they might encourage a more dangerous type of experimentation, if I may put it that way. Looking at the amendments tabled by the hon. Member for Daventry, I can see that his intention is to remove clauses 3 and 4 altogether, which would be a very welcome step. That would mean that the principal remaining part of the Bill relates to the database of innovative medical treatments. The hon. Gentleman’s amendments 10 and 13 would bring the off-patent concept firmly into the purpose of this Bill, and therefore into the database. A lack of data was one of the barriers identified to more consistent prescribing of off-label treatments. The amendments would be an extremely welcome step forward, because they would not only enshrine in law the off-label aspect, but bring the data into the database so that it became more widely and readily available, assisting clinicians on the frontline. I sincerely hope that the amendments will be positively received by the Minister.
New clause 1 sets out an action plan for developing a pathway for off-patent repurposed drugs where strong evidence of their effectiveness in a new indication exists, with the aim of securing routine use. Put simply, this is an action plan with clear timeframes for progress. Again, this would be a welcome step forward.
New clause 2 would require the National Institute for Health Research to develop a mechanism for gathering and recording evidence on off-patent repurposed drugs, including clinical trials evidence, and passing it to the relevant bodies. The NIHR already has a dedicated horizon-scanning centre, but this would set up a dedicated stream for off-patent repurposed drugs to speed up getting them to the frontline and into routine use.
New clause 3 proposes that where there is strong evidence of effectiveness in a new indication, the National Institute for Health and Care Excellence should be directed to conduct a technology appraisal, including a cost-effectiveness analysis. While these drugs are extraordinarily cheap, some level of cost-effectiveness analysis would none the less be desirable, since to achieve routine commissioning, in England for a start, a persuasive business case clearly needs to be put to local hospitals and clinical commissioning groups.
New clause 4 is about having a national commissioning policy for off-patent drugs. It also requests that the Minister work with the devolved nations to produce something that is genuinely UK-wide. This has already happened in the case of NHS England working with Prostate Cancer UK to produce a commissioning policy for an off-patent repurposed drug called Docetaxel.
New clause 5 would make the licensing process more accessible. What would that mean in a practical sense? For example, an initial meeting where there is a discussion of the case and the likelihood of successful treatment could be free, a representative of patient organisations could be designated within the Medicines and Healthcare Products Regulatory Agency for patient organisations, and there could be a guidance document for non-pharmaceutical applicants.
Chris Heaton-Harris (Daventry) (Con)
Members may be aware that unlike the initial stages of my Bill, the journey of the Off-patent Drugs Bill promoted by the hon. Member for Torfaen (Nick Thomas-Symonds)—which is, coincidentally, further down on the Order Paper today—enjoyed widespread support from Members of this House, and outside this place among a whole host of charities and non-governmental organisations. My old colleague Jonathan Evans, a former Member of the European Parliament and the former Member for Cardiff North, introduced a similar Bill on these matters, which also gained widespread support. I have watched the progress of these Bills closely and read the briefings provided on them by several charities, and I could not help but notice the obvious links with my Bill and the importance of the subject it covers—increasing the use of effective off-label drugs.
The amendments that we are considering seek to work with the ideas of the Off-patent Drugs Bill and meet the same goal of spreading the use of off-label drugs. I am very grateful to the hon. Member for Torfaen for working with me, and others, so closely to include some of his very good ideas and thoughts in my Bill. He deserves a huge amount of credit for the work he has put into this, alongside the hon. Member for Central Ayrshire (Dr Whitford) and my hon. Friend the Member for Bury St Edmunds (Jo Churchill), who have been unbelievably strong champions of these issues.
The new clauses and amendments I am supporting do not reflect exactly the original Bill introduced by the hon. Member for Torfaen. That Bill sought to require the Secretary of State to seek licences for off-patent drugs in their new purposes. As the Government stated at the time, as the licensing authority in the UK, the Secretary of State cannot take up such a duty. However, that does not mean that a similar end result of increasing the use of such drugs cannot be achieved by other means. I very much hope that we can do so through this Bill.
Breakthroughs in research mean that several existing drugs have been found to be highly effective in treating conditions other than the ones for which they were originally produced. They potentially have huge life-saving effects and can alleviate the suffering of many people for many conditions. There are so many well-known examples. They were widely discussed on Second Reading of the Off-patent Drugs Bill, so I will not repeat all of them. The list includes the likes of tamoxifen and zoledronic acid, and of course the simple drug aspirin, which has so many other benefits in so many areas. The examples mentioned when we debated the hon. Gentleman’s Bill speak for themselves in showing us why his new clauses and amendments are so important.
As the hon. Gentleman has said in support of his Bill, doctors are nervous of prescribing off-label drugs. Even if a GP strongly believed in prescribing an off-label drug to a patient, they could well be put off. There are several reasons for that, and they were detailed in briefings circulated at the time. One is the matter of personal liability, which I will talk about in relation to other amendments. General Medical Council guidance shows that clinicians can currently prescribe off-label drugs, but that there are significant disincentives to do so. It states that a licensed treatment should be considered before an off-label or unlicensed treatment. It also indicates a greater level of responsibility for the doctor prescribing off-label, and therefore a potentially greater risk of liability, which would be a disincentive for a doctor in prescribing an off-label drug. Before a clinician has even started down this track, they are wary of picking an off-label medicine.
There is little incentive for a pharmaceutical company to pay for a licence when a drug can be manufactured generically. There is no incentive for any company to market the drug for a new indication, and there is no proper guidance for the use of such a drug. Without any stamp of approval, any marketing or any mechanism to provide guidance, there is nothing to encourage clinicians to use an off-label drug, other than their own medical knowledge.
Drugs without a licence for their second use are not marketed, so there is a lack of awareness, and the prescribing of them therefore varies when a new indication arises. There is no trusted and simple way to spread information about off-label drugs that are working. That means that some doctors may use the drug if they know of the indication, but lots may not. Without a system for sharing such information and spreading knowledge about these drugs, medical professionals deciding whether or not to prescribe them have to spend a huge amount of time reading the literature and undertaking research. The explicit mention, through the new clauses and amendments, of the inclusion of such drugs in the database will ensure that information about them is shared and reviewed, and that appropriate evidence is provided. By spreading awareness, the new clauses and amendments will therefore help to make prescribing more consistent.
On Second Reading of the Off-patent Drugs Bill, the hon. Member for Central Ayrshire said that experts in certain fields will prescribe many off-patent drugs whenever they feel it is necessary. For example, off-label prescribing is quite common in the treatment of secondary cancers. Experts in that area will have experience and will be aware of the evidence for use, but many other medical professionals will not be in such a position. If a drug is not in the “British National Formulary”, the dose cannot be checked.
When a clinician uses a drug every day or a specialist in a field sees conditions regularly, they know what works and what is best, and will therefore feel very comfortable in prescribing off-label. However, every medical professional is not an expert in every field. For the majority of the time, patients are not with such specialists. Their first point of call is not a clinical physician working in only one field, but a GP in their local practice or a nurse in their local surgery. I believe that the database has huge potential in helping to spread the knowledge and expertise required for better and further use of such drugs.
I hope that the amendments I have tabled will be agreed by the House—I believe they represent common sense—and that the Minister will listen to Members who have tabled the other amendments and new clauses. Although some of them are probing amendments, a huge amount of effort has gone into all of them. He is aware of the time and cross-party work that has gone into getting the Bill to this point. That has basically been driven by the hon. Members for Torfaen and for Central Ayrshire, my hon. Friend the Member for Bury St Edmunds and, to a certain extent, me. I would like to think that we will have got to a certain place by the end of today’s sitting, and that we can all leave the Chamber feeling that we have done some good.
Jo Churchill (Bury St Edmunds) (Con)
I congratulate my hon. Friend the Member for Daventry (Chris Heaton-Harris) on his success in bringing the Bill so far. The fact that we have reached even this stage is no small testament to his hard work on the Bill, particularly the discussions about the removal of the areas of concern—clauses 3 and 4—and the fact that he has been gracious enough to allow me and the hon. Members for Torfaen (Nick Thomas-Symonds) and for Central Ayrshire (Dr Whitford) to badger or cajole him into allowing us to table new clauses 1 to 6, but specifically my new clauses 4 and 6.
The Minister was not in the Chamber on 6 November to hear the arguments of the Members who proposed and supported the Off-patent Drugs Bill. Since then, however, he has engaged with many of us, for which I thank him. We felt that his Department’s response simply was not correct. Doctors may have been able to prescribe medicines for uses outside their licence or off-label where that was in the best interest of their patients, as the guidance says, but they just did not do so, or at least not consistently throughout the medical profession or the field and irrespective of the patient’s postcode. The prescribing of such drugs is more common in oncology, paediatrics, pain management and palliative care, which adds to the lottery effect for the patient.
The need for an action plan for an off-patent drug pathway is undeniable. When there is a strong indication of effectiveness, their routine use for an alternative indication should be secured. For example, the use of bisphosphonates, which were originally developed to treat osteoporosis, are now commonly used by 36,000 women living with secondary breast cancer in this country. Those drugs have already been through phased trials. No one in this place is suggesting that the highest levels of safety should not be applied to drug research and licensing at all times, but efficacy should drive clinicians’ decision making.
Patients, too, have a voice on this issue. I found my patient’s voice after my second primary cancer, and I wanted to use it for the benefit of others. Here I am now asking the Minister—not for the first time—to use his position to find a way to unleash the potential of research in this country and to unblock the system for everyone. My oncologist told me that a second primary cancer was luck—bad luck, but just luck—and I hope that we can all improve the odds just a little bit today.
I believe in the power of patients, clinicians, charities and pharmaceuticals to do the right thing—to increase their knowledge for those whose daily lives are dominated by serious disease and debilitating illnesses, and to ensure that treatments exist to help them. Particularly in the area of off-patent repurposed drugs, they need to be supported by key players, such as NICE, the MHRA, NHS England and medical research charities.
I assure the Minister that it is not mere chance the new clauses and amendments are supported by Members from all four corners of our nation. It is to show solidarity with our constituents—north to south, east to west—who want a co-ordinated approach. One of the most frustrating things for patients is the clogged nature of our drugs pathway. It seems to be beyond us to get drugs licensed, whether repurposed or not, and to the patient in a timely way. I ask the Minister to provide a timeline to support any action that can be taken.
New clauses 2 and 3 would require the National Institute for Health Research to develop and introduce a mechanism for gathering and recording evidence. Last week, I was surprised to learn from Professor Bruce, a clinician at the NIHR working in the musculoskeletal biomedical research unit, that in 50 years only one drug has been licensed for the treatment of lupus. Sadly, that licensed drug has spent four years being considered by NICE and is not available for wider use. To avoid the heavy use of steroids for the condition, rituximab is often used—a drug that was originally developed for lymphoma and rheumatoid arthritis.
Dr Philippa Whitford (Central Ayrshire) (SNP)
I rise to support new clauses 1 to 3, 5 and 6 and amendments 10 and 13. The only reason new clause 4 does not stand in my name is that it relates to NHS England, which is outwith my purview.
People are well aware of my objections to clauses 3 and 4. Many Members in this House and medical voices outside the House have real concerns about the danger to patients of doctors having to convince only one colleague before trying a completely unproven approach. As well as the danger to patients, I feel that there is a danger to our clinical trials system. Why would someone go through applications, a year of paperwork and phases 1, 2 and 3, when they could just cut to the chase?
I pay tribute to the hon. Member for Daventry (Chris Heaton-Harris) for being willing to sit around a table with the Members who were named by the hon. Member for Torfaen (Nick Thomas-Symonds) and the Minister, and to start with a blank sheet of paper and work out how we could do something useful. It has been a great procedure. I welcome the fact that later in the day the hon. Member for Daventry will propose the removal of the clauses on innovative practice and litigation.
Turning to the off-patent drugs proposals, 6 November was a very frustrating day in this House. Every single Member who spoke from the Back Benches spoke in favour of the Off-patent Drugs Bill, but the time ran away during the Minister’s response—not the Minister who is here today. That debate showed the appetite across the House to get something done on off-patent drugs.
The hon. Member for Bury St Edmunds (Jo Churchill) has explained most of what I was going to explain. There is still the issue that while specialists are steeped in the evidence and used to using drugs off label, those who are not are less sure. There is no automatic place where they can check a dose or an indication. Sometimes, it is the general practitioner who does not carry it through. We have had lots of discussions in this House about the changes in the NHS and the evolution to multidisciplinary teams out in the community. That means that there are far more non-medical prescribers. The further someone is from the expert prescriber, the less comfortable they are. They do not have easy access to somewhere they can check when they think, “Is that just my bad handwriting or is that really what I mean?” That is what new clause 6 on the BNF could achieve.
The BNF is used by everyone and is on every desk in the NHS. As the hon. Member for Bury St Edmunds said, people can either check a drug that they have had a letter about from the hospital or look something up when they think, “I don’t have anything for this. What exists?” We will also discuss that when we come to the database proposals. I welcome the fact that the database has been changed from being a registry of people doing their own thing to a place where information is shared.
On new clause 5, which I tabled, although the inclusion of off-patent drugs in the BNF will achieve the sharing of information and will, in a sense, give them a slightly informal kite mark, I feel that it is important to look eventually at providing a licence. The reason for my concern relates to the drug simvastatin, which is used all over the place to control people’s cholesterol and has been found to be useful in multiple sclerosis—a disease that plagues many people and causes a lot of suffering, and for which, frankly, we do not have a lot to offer. That drug is incredibly cheap, but if a company decides to tweak a little molecule of it, call it something else and put it out as a new wonder-drug for multiple sclerosis, we will be having debates in Westminster Hall about a drug that costs fifty grand and that the NHS cannot afford. Under General Medical Council rules, the cascade is still that a doctor must prescribe a licensed drug over an unlicensed or off-label one, regardless of cost. If a doctor was faced with fifty grand for simvastatin-new versus sixpence for the simvastatin we all know, they would have no choice, and we would be right back in the same position—relentlessly discussing the NHS’s access to drugs.
The drugs we are talking about are already safe. They have had a patent and been used for so long that they are now off patent, which means that they have been around for a decade. We know their side effects, the common dosages and what to look out for. They should not have to start at point zero of the licensing process. We need a short licensing system, so that patient groups, academics, charities and the British Generic Manufacturers Association can say, “We think there is something useful here.” We have put provisions in new clauses 2 and 3 for the NIHR and NICE to have capacity in their systems to provide a funnel for evidence on such drugs.
These drugs are not developed by big pharma, so there are not huge costs that have to be recouped. The purposes of them are usually found by academics and clinicians, so pharmaceutical companies should not make a massive profit out of them. The benefit should be that the NHS can afford them and patients can access them. We have many debates about access to medical treatments in the House, usually in Westminster Hall and usually about drugs that are eye-wateringly expensive. In this case we are talking about drugs that are proven and cheap. We need to come up with a system that makes them accessible to patients.
I commend the Minister for the time, that, as others have said, he has given the four of us around a few tables, hammering these provisions together. I hope that we will be supported in working them through and actually doing some good for the NHS and our patients.
Anne Marie Morris (Newton Abbot) (Con)
It is with great pleasure that I rise to speak in support of this important Bill, introduced by my hon. Friend the Member for Daventry (Chris Heaton-Harris), and the amendments he has tabled. Specifically, I rise to support amendment 13. I am sure that the hon. Member for Torfaen (Nick Thomas-Symonds) will be disappointed that his private Member’s Bill did not make it to Committee stage, but I hope that he is happy to see some of it included in this Bill.
I had my reservations about the Bill as it stood originally, and I have reservations about some of the amendments, but I believe that amendment 13 will increase the use of off-label drugs in a safe and secure way. Those drugs can often be a cheaper and quicker way to tackle a disease, as they do not have to go through the rigmarole of being developed and licensed, which can take many years and many billions of pounds. NICE states that an unlicensed medicine is one that
“does not have a UK marketing authorisation and is not expected to do so in the next 2 years”,
whereas an off-label medicine is one
“with an existing UK marketing authorisation that is…used outside the terms of its marketing authorisation”,
and for which
“it is not expected that the existing UK marketing authorisation will be extended to cover this use in the next 2 years.”
The inclusion of off-label use classes in the database as innovative medical treatments will allow the medical profession to see where off-label use has been effective, even if it is at the other end of the country. However, we must be careful not to place off-label uses on a pedestal and allow people to cling on to false hope. They are the most vulnerable people in our society, often looking for any treatment that may help them, but we must ensure that any drug that is prescribed off label is used responsibly and ethically. I believe that the database will help by allowing doctors to see what is effectively a large sample trial that gives them more information on a particular treatment. I therefore support amendments 13 and 10.
Mrs Flick Drummond (Portsmouth South) (Con)
I thank my hon. Friend the Member for Daventry (Chris Heaton-Harris) for bringing this important private Member’s Bill before the House and for his work in ensuring that all parties agree with it. It seems that a lot of work has gone into it by Members throughout the House, and as someone who was not part of those discussions, I am grateful to them for doing that work for everybody else.
The NHS benefits from one of the most rigorous health technology assessment organisations in the world, which provides clear and robust evidence of the clinical benefits of new interventions. However, the introduction of innovative treatments is complex, not straightforward, and the difficulty for the life sciences industry in getting new treatments to the market means that UK patients are often the last to see the benefits of new innovations in their disease area.
Heidi Alexander (Lewisham East) (Lab)
I congratulate the hon. Member for Daventry (Chris Heaton-Harris) on navigating the Bill to this stage. His pursuit of legislation in this area has sparked an important debate on the Floor of the House about how we can improve access to innovative treatments.
I welcome the opportunity to speak on this group of amendments, and I support the broad thrust of all of them. I commend the hon. Member for Bury St Edmunds (Jo Churchill) for her speech and the contribution that she has made—she spoke with great knowledge and passion.
I am particularly pleased that my hon. Friend the Member for Torfaen (Nick Thomas-Symonds) has tabled new clauses on the important issue of off-patent drugs and off-label uses, which he has championed. I was sorry to see his Bill fall on Second Reading in November and hope we can make more progress with the Government today.
Improving access to off-patent drugs so that people, no matter where they live or by whom they are being treated, are offered well-evidenced treatments that might not be routinely commissioned, is an ambition shared by many in the House, regardless of political persuasion. The Minister shares those objectives. Over the past few weeks and months, he has worked with key stakeholders and discussed the issue with them.
I express my support for new clause 1, which requires the Department of Health to produce an action plan for developing a pathway for off-patent, repurposed drugs, where strong evidence of their effectiveness in a new indication exists, with the aim of securing their routine use in such an indication. I hope the Minister can commit to such an action plan and put forward a clear timetable for progress, which is long overdue. I also hope he can offer the House reassurance on the proposals in new clauses 2 to 6, all of which have merit and deserve proper consideration by the Government.
Mr Speaker
Order. The hon. Lady had wished to contribute but toddled out of the Chamber at the appropriate moment. I would have called her but did not because she was not here. Does she still wish to speak?
Rebecca Harris
Very briefly, Mr Speaker.
I support the Bill and commend all those who have worked towards it in the many iterations it has been through in this House and the other place—I can see that Members of the other place are taking an interest in our proceedings today.
I am chairman of the all-party parliamentary group on brain tumours. Brain tumour research has desperately lagged behind other areas of cancer research, and we desperately need to find new sources of treatment. Sadly, brain tumour is still the biggest cancer killer of the under- 40s—children and young adults. The Bill could be a great step forward in the sharing of information.
I commend the Minister, as all hon. Members have. Without wishing to sound too toadying, we have a Minister who is committed to taking forward progress on research in a way that we have not seen previously.
It should be pointed out that the NHS is a superb innovative organisation that does huge amounts of research. We do not hear that said often enough of the NHS. From my point of view, the most important bit of the Bill is the database, which will mean we can take forward the research we do in the NHS so that people can have access to information—not just patients, but clinicians, who might not know as much as we or they would hope. I very much hope the Bill makes progress.
The Parliamentary Under-Secretary of State for Life Sciences (George Freeman)
It is a great pleasure to take part in the debate and to support a package of amendments that have been agreed by Members on a cross-party basis over the past few weeks and months. Very often in private Members’ business, the Government take the view that the intentions are fine but the mechanism is flawed, and that the Government legislate while MPs raise issues. However, with this Bill, we have struck a blow for joined-up thinking and cross-party working in pursuit of patients’ interests—I will say more about that on Third Reading.
With my hon. Friends the Members for Daventry (Chris Heaton-Harris) and for Bury St Edmunds (Jo Churchill), and the hon. Members for Torfaen (Nick Thomas-Symonds) and for Central Ayrshire (Dr Whitford), and with the help of Opposition Front Benchers, we have managed to deal with three Bills with which the House has been preoccupied in recent months—the Bill initiated by Lord Saatchi, which looked to change the culture of innovation; the Bill introduced by the hon. Member for Torfaen, which promoted the use of off-patent repurposed drugs; and this Bill, introduced by my hon. Friend the Member for Daventry, which seeks to promote access to innovative medicines. With the package of amendments we have agreed, we will end up with a Bill that moves forward on those three areas of concern for Members in all parties of the House. Today is a rare and rather wonderful moment because the amendments are supported by every party in the House—I cannot speak for the United Kingdom Independence party because I have not heard anything from it, but all other parties support the Bill.
We have three groups of amendments to get through so I will try to be brief in dealing with the specific points, many of which have previously been raised and discussed. I should take this opportunity to pay tribute to and thank my officials who, over the past three to six months, have tirelessly worked with Members on both sides of the House in an unusual way to help to draft amendments that we can all support. I thank them for their diligence in doing so.
Broadly, the intention of the package of amendments is to introduce off-label repurposed medicines in the Bill, and to put it four square at the heart of the agenda. As the hon. Member for Torfaen said, I wholeheartedly supported the intention of his Bill and its predecessor, but not the mechanism. We now have a mechanism that will work.
I appreciate that the new clauses are probing and that hon. Members are seeking my reassurance on how the Government will take things forward. New clause 1 is a request for an action plan. Nobody seriously thinks that we should put an action plan in the Bill, but let me set out my commitment and that of the Government to pursuing this agenda with time and rigour. As I have said in other places, the truth is that the world of drug discovery is changing profoundly. The transformational power of genomics and informatics create a wholly new opportunity both to discover new medicines and target them at individual patients much more quickly, and to discover repurposed uses of existing drugs in a way that we have not been able to do previously. The 100,000 Genome Project, which the Government have initiated and funded, has already begun to identify existing drugs that have uses in indications that were not hitherto known. The pace at which new drugs are being developed and discovered is increasing, which is a credit to the creativity of the sector.
That sets the backdrop for the creation of my post and the accelerated access review that I have launched. As all hon. Members know, I am committed to putting in place a landscape that accelerates the use of NHS resources to support research. When we launched the strategy, the Prime Minister said that every patient should be a research patient and that every hospital should be a research hospital. We are determined to ensure that the daily footprint of diagnosis and treatment is used more intelligently to support research.
The accelerated access review is looking at that in a lot of detail and is an extensive piece of work. Colleagues have referred to the interim report—the final recommendations are due to arrive on my desk at Easter. I am very happy to give a commitment that, in our response to that report, we will pick up the points made in the debate and in the Bill on ensuring that we look at repurposing and off-label uses of existing drugs as much as we look at innovative medicines.
In new clauses 2 and 3, hon. Members are probing me to give details on how the National Institute for Health Research and the National Institute for Health and Care Excellence can put into practice the mechanism that we have discussed. On new clause 2, there are very open mechanisms currently for applications to the NIHR to research existing medicines. The NIHR—I am delighted that we have reconfirmed our £1 billion a year funding for it—conducts research every year into existing medicines, and there is a clear process for that. It would not be appropriate to legislate in a Bill to tell organisations that are subject to the Haldane principle, which is sacrosanct for the Government, what to do. We want research to be led by that principle, but I am happy—I will say more about this in a moment—to ensure that, through the process, we explore mechanisms for ensuring the NICE can look at evidence and develop evidence-based guidance on off-label medicines, so that doctors are aware of which drugs are being used in an off-label indication.
On new clause 3, I am delighted to confirm that, after discussions, NICE is now looking at ways to collect evidence on repurposed medicines. It is looking at taking evidence and how it could use, through its existing evidence review process, evidence on repurposed medicines specifically. I have asked whether we might be able to put a mechanism in place to find a way to somehow put that into the “British National Formulary”. I would not want to put that mechanism into the Bill, because we need the freedom to evolve the mechanism and to get it right. I hope that is a helpful reassurance.
Nick Thomas-Symonds
I would just like to make two points. First, the “British National Formulary” is UK-wide. Secondly, and just to probe the Minister further, is he able to give an approximate timeframe for when he thinks the process might be complete?
George Freeman
The hon. Gentleman makes two good points. This is, of course, UK-wide. One of the challenges, as a UK Minister, is to put in place a framework that will support this across the UK while respecting the different mechanisms in the devolved Administrations. I hope the Bill will provide a basis for a similar mechanism in areas where there are different formats. I believe that in Scotland, Northern Ireland and Wales, but particularly in Scotland and Northern Ireland, there is a hunger to do that. I believe the Bill will support those existing mechanisms.
Dr Philippa Whitford
We have moved on from talking about the BNF. I accept the comments about listing groups that would be considered in new clause 5. Does the Minister accept, however, that we still need to deal with the cascade of prescribing to ensure doctors are not forced to prescribe a licensed medicine, which is actually just a minimal moderation of an off-patent drug at a vastly expensive cost? That means we still need some kind of change to the licensing or short licensing process in the future.
George Freeman
The hon. Lady makes an important point about the classification of different drugs available to clinicians. Without detaining the House with too long a peroration on that classification, it is worth setting out that there is a clear cascade.
Clinicians can use unlicensed medicines in situations where, in their clinical judgment, and with patient consent, they believe it is the right thing to do. They are subject to all their usual professional undertakings. There are then off-label uses of drugs: drugs that do not have a licence for a particular indication but which the clinician, on the basis of evidence, is able to prescribe when they feel that evidence is compelling. The Bill now goes to the heart of that and will help to provide reassurance. For many clinicians, being able to click on a mouse with their patient and say, “For your condition there are one, two, three or no off-label medicines available for which NICE has looked at the evidence,” would be a powerful catalyst in helping to promote off-label use. There are generic drugs, which have been patented and brought to market, that are available at a heavily discounted open price.
There are then on-patent drugs, which have been brought to market and are still subject to a patent. The manufacturer has an exclusivity, which is the period in which their sunk costs in bringing the medicine to the system, can be reimbursed. That is an important protection to make sure we continue to have a thriving life science sector that can take the risks of investing in new drugs. Typically, new drugs take 15 years and £2 billion to develop. If there were no patenting mechanism, there would simply be no enthusiasm to do that research, which has a very high failure rate. In law, there is a key point of principle, which is that a licensed drug should be used first and that an unlicensed drug cannot be used purely on the basis of cost. That is a really important principle. An unlicensed drug can, however, be used on the basis of evidence. That is why the mechanism will allow NICE to look at the evidence and to signal to clinicians that they have the evidence basis on which to use the drug in an off-label indication.
One of the issues we have dealt with in discussions is the whole question of the European licensing of medicines. If we were to go down that route—I know the hon. Member for Central Ayrshire understands this—I can assure the House we would be here not just for weeks and months, but years. I am leading for the Government on reforming the European landscape of 21st medical research. The central role of protecting innovators’ sunk costs is really important to our life sciences sector, and the new clauses and amendments create a mechanism by which we can accelerate off-label use without running a coach and horses through that.
Dr Whitford
I accept the Minister’s points, but my concern remains that if in 10 years we have simvastatin in its current form versus a new name that is just a tweaked simvastatin at a thousand times the price, doctors will, under GMC rules, have to go for the one with the licence, as opposed to the off-patent one, even if it is in the BNF. I accept that the BNF mechanism will absolutely increase usage, but we still need to consider the longer term, given that in the future we might have huge numbers of off-patent drugs with new purposes.
George Freeman
The hon. Lady makes an interesting, important and useful point that I undertake to pick up in our consultation in response to the accelerated access review. The landscape will continue to change fast over the next few years. The Bill, as amended, will promote the greater use of off-label medicines. Crucially, the database mechanism, which, I reassure everybody, is very different from the original registry proposed in a precursor Bill—it is to make clinicians aware of what drugs are available—will generate data that will be incredibly powerful in helping the system to adapt and use the freedoms I hope to give it through the accelerated access review. That will ensure we are better and faster at getting these repurposed medicines into use.
I am delighted to say that the Government are happy to support amendments 10 and 13. Amendment 10 would set out in the Bill that its purpose specifically includes promoting access to the innovative use of licensed medicines outside their licence indications. It puts four square at the heart of the Bill the aims of the Off-patent Drugs Bill, which was promoted by the hon. Member for Torfaen (Nick Thomas-Symonds), and which, as hon. Members across the House have commented, had a lot of in-principle support. I am pleased, therefore, that we have found a form of words that moves it forward. At the heart of it, there is a clever protection for clinical sovereignty. We are not telling clinicians what they have to prescribe or putting in law a requirement that they prescribe in a particular way. We are giving them information on evidence-based off-label drugs. The feedback from clinicians so far is that it genuinely will help them to understand, promote and prescribe off-label uses.
Amendment 13 seeks to clarify the definition in the Bill of innovative medical treatments to make it clear that it includes off-label and unlicensed medicines. I mentioned earlier the pace at which genomics and informatics were uncovering new uses for drugs—some have referred to it as finding diamonds in the dustbin. There are extraordinary applications among the existing pharmacopoeia of tens of thousands of drugs. We now realise that many of them have particular impacts and effects. That is all to the good. It is thanks to the power of our life sciences sector that we are beginning to uncover those, and the Bill will support that.
With those comments in support of amendments 10 and 13, I hope I have given hon. Members enough reassurance and that they feel able to withdraw or not press the probing new clauses. I will be happy, following Third Reading, to put in place, through the accelerated access programme, a clear plan for keeping on top of the system’s implementation and tracking the use of repurposed medicines. We will continue with the work we did with charities through the winter and with the very helpful discussions we had with the charitable sector, and the Department will look annually at the data and whether the landscape is changing, and if it is, we will keep that under review.
Nick Thomas-Symonds
I am grateful to Members across the House for their contributions and to the Life Sciences Minister for his clear response to the six probing new clauses. I am pleased to hear that the Government will accept amendments 10 and 13. As I said in my opening speech, having off-label treatments in the Bill and the database will make a significant difference and help move things forward. I was also pleased with his reassurance to the hon. Member for Central Ayrshire (Dr Whitford) that we will continue to review the system, as, I hope, the number of off-label treatments and prescriptions increases.
In view of the Minister’s commitments and acceptance of amendments 10 and 13, I do not propose to press new clauses 1, 2 and 3. New clauses 4, 5 and 6 are in the names of the hon. Members for Bury St Edmunds (Jo Churchill) and for Central Ayrshire (Dr Whitford). I beg to ask leave to withdraw the motion.
Clause, by leave, withdrawn.
Clause 1
Access to innovative medical treatments
Amendment made: 10, page 1, line 3, after “treatments” insert
“(including treatments consisting in the off-label use of medicines or the use of unlicensed medicines)”—(Chris Heaton-Harris.).
Chris Heaton-Harris
On a point of order, Mr Deputy Speaker. I am unsure of the process. What happened to amendment 13?
Mr Deputy Speaker
It comes later. It is about three pages further on in the dossier. It has not been lost, and we will be coming to it, so the hon. Gentleman can rest assured. It is there.
Chris Heaton-Harris
I beg to move amendment 1, page 1, leave out lines 7 to 9.
Mr Deputy Speaker
With this it will be convenient to discuss the following:
Amendment 11, page 1, line 18, in clause 2, leave out from beginning to “involves” in line 19 and insert
“In this section, “innovative medical treatment” means medical treatment for a condition that”.
Amendment 2, page 2, line 26, leave out clause 3
Amendment 3, page 3, line 19, leave out clause 4
Amendment 4, page 3, line 40, in clause 5, leave out “this Act” and insert “section 2”
Amendment 12, page 3, line 42, in clause 5, leave out paragraph (b)
Amendment 5, page 4, line 1, in clause 5, leave out “this Act” and insert “section 2”
Amendment 6, page 4, line 3, in clause 5, leave out “this Act” and insert “section 2”
Amendment 14, page 4, line 8, in clause 6, leave out “Sections 1 to 5” and insert “Sections 1, 2 and 5”
Chris Heaton-Harris
I just thought I would check about amendment 13, Mr Deputy Speaker. This whole experience has been a steep learning curve when it comes to procedure in the House. Perhaps we have invented a few things on the side as well, given how we have gone about our business here. I do not want to speak too soon, but if we could conduct all our health debates in the positive and constructive tone that has characterised these debates and the process behind the Bill, we might improve our heath service in leaps and bounds, rather than getting caught up in unnecessary politics. But that is where we are.
My amendments 1, 2 and 3 would remove, among other provisions, two clauses on clinical negligence. I want to talk about the reasons for their removal and the original idea behind the clauses. As right. hon. and hon. Members who have been following the progress of my Bill will know, many of the ideas in it came from Lord Saatchi’s Medical Innovation Bill in another place. Those ideas have not had the smoothest of journeys in this place. I have been regularly reminded by hon. Members—I thank those here today—and others outside this place that these clauses have not enjoyed the support of stakeholders.
Such concerns have been around since before the Bill was even drafted. Unfortunately, the echoes of those concerns haunted the first mention of the word “innovation” in the clause, and I decided from conversations I have had that those concerns could not be quelled in time. Throughout the process, I was clear that I wanted to listen to everybody with something to say on this matter. I have met and read the briefings of everyone who has contacted me wishing to share their views, and I hope it has been evident that I have been up front, honest and very clear about my intentions. I tried to solve the concerns of Members and the medical community who believed the clause would have negative and unintended consequences. That is why I tabled these amendments.
I hope that this process reflects favourably on Parliament and shows how a piece of possible legislation can evolve with a huge amount of stakeholder engagement and with parliamentary opinion taken on board. Since the beginning, I have focused on the sharing of good practice and transparency—and, indeed, on the failures of treatments through a database. Those ideas are reflected in clause 2 and have received much support.
I wanted to maintain the camaraderie built up around the Bill and have been unable to find the support I needed for the more controversial clauses, 3 and 4. Clause 3 sets out the steps that a doctor would need to take to show that he or she had acted responsibly using the Bill. They were intended to reflect the steps that a responsible doctor could be expected to take under common law when innovating. In relation to a proposed treatment, clause 3 would require the innovating doctor to
“obtain the views of…appropriately qualified doctors”
with
“appropriate expertise and experience in dealing with patients with the condition in question.”
Clause 4 expressly preserves the common-law Bolam test, the key precedent for judging whether a doctor has acted negligently.
The two clauses received strong opposition, which I will not go into too much. However, I worked closely with many officials from the Department of Health, and I want to thank them, because I had read the briefings that were so adamant in saying how dangerous parts of the Bill would be, so it was nice to have some of the best and brightest legal and parliamentary counsel remind me again and again that they viewed them as perfectly safe and did not see them as a danger to patients.
Dr Philippa Whitford
Does the hon. Gentleman understand the danger of undermining our clinical trials systems, in that, using the Bill, a doctor would have to convince only one colleague before they could go ahead and try something completely new? The recent tragedy of the patient who died while taking part in a phase 1 trial shows the need for steps and procedures to reduce the risk.
Chris Heaton-Harris
The hon. Lady knows that I would obviously have preferred to retain clauses 3 and 4, but I have to agree with her: the body of opinion stands on her side of the argument, not mine, so the simple answer is yes.
I remind the House, though, that there was a decent and honourable purpose behind clauses 3 and 4. Dr John Hickey, the former head of a primary care trust, contacted me to say that,
“as a registered medical practitioner, a former NHS Trust Chairman and with 30 years’ experience in the field of legal medicine with the Medical Protection Society (last five years as Chief Executive), I believe I am adequately qualified to comment on your Bill.”
He went on to say:
“Over the last 30 years I have seen how doctors have increasingly practised defensive medicine…because of the fear of litigation and disciplinary action by their regulators; this defensiveness is not in patients’ best interests.”
In fact, it may interest Members to hear that, in reading the debates on the Bill introduced by the hon. Member for Torfaen (Nick Thomas-Symonds) and the recent debate on the Mesothelioma (Amendment) Bill, I have seen much stated that supports the action I wanted to take in clauses 3 and 4 to reassure doctors who fear litigation. For example, the British Medical Association’s parliamentary brief for the Second Reading of the Off-patent Drugs Bill stated that there were
“two barriers to the use of off-patent drugs in a new indication: 1) Clinicians’ confidence in prescribing: clinicians take on a personal and professional liability if they prescribe an off-patent drug in a new indication”,
and therefore they require reassurance. The brief goes on:
“GMC guidance also indicated a greater level of responsibility for the doctor prescribing off-label and therefore potential greater risk of liability which would be a disincentive for a doctor prescribing off-label drugs”.
That is a simple statement of the purpose of clauses 3 and 4: to give doctors a supplementary way to assure themselves that they are doing the right thing where they might want to do something they believe to be in their patients’ best interests, in a fully evidenced, responsible and honest way.
Similarly, the Multiple Sclerosis Society’s brief on the same subject states:
“Guidance from the General Medical Council is clear that a doctor takes on an extra level of personal liability when prescribing off-label, which would be a significant disincentive to prescribing”.
Breast Cancer Now says that, because of personal liability,
“doctors can be unwilling to prescribe drugs for new purposes, even where…clinical evidence is strong”.
As Lord Freyberg stated in the mesothelioma debate in the other place,
“The fastest way to save lives is to see if the drugs for common cancers work on the rarer ones as well, given the shared mechanism of disease across cancer. This is off-label research and until we fix the issue of liability, as advocated by the noble Lord, Lord Saatchi, we will continue to send thousands, like my sister, to an early grave.”—[Official Report, House of Lords, 20 November 2015; Vol. 767, c. 407.]
There was therefore plenty of reason and evidence to support clauses 3 and 4, but I guess politics is all about being pragmatic, and I believe that the provisions that we have already discussed are worthy in themselves of inclusion in a sensible Bill, because they will do some positive things. It is therefore with some reluctance, as I am sure the House will understand, that I have decided to table these amendments, which strike the elements relating to clinical negligence from my Bill.
Anne Marie Morris
I support my hon. Friend’s amendment 2, which would remove clause 3—the responsible innovation clause—from the Bill. I know that his heart was absolutely in the right place when he first put the Bill before the House; however, I am glad he has tabled the amendment, as I am sure the majority of us, if not all of us, are present in the Chamber to ensure that the rest of his Bill, particularly the provisions dealing with the database, gets through.
I have received briefings from all manner of medical bodies, as I am sure all colleagues have, stating that the Bill would do more harm than good for patients. A letter signed by nine different medical bodies, including the Academy of Medical Royal Colleges, the British Medical Association and the Patients Association, says that
“this Bill will actually harm good innovation by weakening patient protection, adding unnecessary bureaucracy and undermining good scientific practice.”
By removing clause 3, amendment 2, along with amendment 3, will allay those fears. There will no longer be any fears about doctors using quackery, as some people outside the Chamber have put it. Instead, there will merely be a database, set up by the Secretary of State, who may by regulation confer functions on the Health and Social Care Information Centre, although I note that the hon. Member for Lewisham East (Heidi Alexander) has tabled amendments seeking to change who the Secretary of State has to consult before making any regulations.
At a constituency level, a number of concerns have been raised with me by those in the healthcare sector who believe this Bill, or at least this clause, would do more damage than good. There was a misconception among some people that it remained a carbon copy of Lord Saatchi’s Medical Innovation Bill, which was introduced in the last Parliament. Although my hon. Friend’s Bill is indeed similar to Lord Saatchi’s, the amendments he has tabled will completely dispose of any similarity at all. Innovation sounds like such a good idea. To most people in the street, it sounds like a marvellous thing and therefore taking “innovation” out of the Bill must be a bad move. However, innovation must be achieved through the correct means and must not pose any danger to patients.
The argument goes that innovation has decreased in recent years owing to the legal complexities and doctors’ fears of negligence claims against them if something goes wrong. There is no evidence of that, according to the Medical Protection Society, the Medical Defence Union, the General Medical Council and various other medical—
Debate interrupted.
Criminal Legal Aid
(8 years, 9 months ago)
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Andy Slaughter (Hammersmith) (Lab)
(Urgent Question): To ask the Under-Secretary of State for Justice if he will make a statement on the provision of legal aid services.
The Parliamentary Under-Secretary of State for Justice (Mr Shailesh Vara)
As the Lord Chancellor and Secretary of State for Justice announced yesterday, the Ministry of Justice has had to play its part in reducing the budget deficit, and economies have had to be made in every area of expenditure. In the last Parliament, spending on legal aid was reduced from £2.4 billion to £1.6 billion. Further changes in the legal aid system were due to be implemented in the current Parliament, with a second reduction in litigation fees in July 2015.
At the time when the fee reduction was proposed, the market was made up of about 1,600 legal aid firms. After careful negotiation, the then Justice Secretary decided to adopt a system of “dual contracting” to drive greater efficiency and consolidation in the market. Over time, however, opposition to that model has increased. Solicitors’ firms feared that it would lead to a less competitive market, and barristers feared that choice and quality would diminish. Besides, a process of natural consolidation was already taking place in the market.
Although we understood those arguments, we also needed to deliver reductions in expenditure, but since July 2015 there have been two significant developments. Her Majesty’s Treasury has given us a settlement that allows greater flexibility in the allocation of funds for legal aid, and it has become clear that there are real problems with pressing ahead. We currently face 99 legal challenges and a judicial review of the entire process. Litigation will be time consuming and costly for all. We have therefore decided not to go ahead with the introduction of the dual contracting. We have also decided to suspend for 12 months the second fee cut. The Legal Aid Agency will extend current contracts to ensure that the service continues until replacement contracts come into force later this year.
We will review progress on joint work with the profession to improve efficiency and quality before returning to any decisions on the second fee reduction and market consolidation.
Andy Slaughter
This is a happy day. A serious threat to the integrity of the justice system and the livelihoods of thousands of hard-working professional people—the mainly small and local solicitors’ firms that are the bedrock of local justice—has been lifted, and we welcome that.
Nothing is more important to securing access to justice than the ability of citizens to obtain competent and timely legal advice when accused of criminal conduct, but that basic human and civil right was put at risk by the Government’s ill-conceived plans. What on earth was the Department playing at in the first place? This is the latest in a series of U-turns, and once again a written statement was issued at 3 pm on a Thursday. We are only here today thanks to you, Mr Speaker, because you granted the urgent question.
Everyone who cares about the criminal justice system in our country has been saying that the Government’s proposals for new criminal contracts were a disaster from the day on which they were proposed, in June 2013. That was not only my view or that of the Law Society, the Criminal Law Solicitors’ Association, the London Criminal Courts Solicitors’ Association and the Justice Alliance; it was the view of everyone in the justice system, and I pay tribute to them all for the magnificent campaign they have fought. It was also the view of the Government’s own experts, but the former Lord Chancellor still failed to register the chaos over which he was presiding. I credit the current Lord Chancellor with having the common sense to bring this farce to an end, but I wish the Government had listened to my right hon. Friend the Member for Tooting (Sadiq Khan) when he proposed the scrapping of the scheme exactly a year ago.
What we cannot do is draw a line and forget what has happened. Questions remain to be answered, and I ask the Minister to answer the most urgent of them today. How much public money and civil service time have been spent on the abortive tendering processes, the court cases and the consultations in the past three years? Will the Minister refer his own Department to the National Audit Office, so that it can be independently investigated? Will he apologise to the firms that have closed, laid off staff or cut salaries when faced with losing contracts, and also to those who have spent thousands of pounds on bidding and winning contracts and, in many instances, taking on extra staff whom they will not now need? Will he go further, and establish what assistance can be given to those firms? Will he remove the remaining uncertainty over the second fee cut? Given that he imposed it and has now decided to remove it for at least a year, what timescale and criteria will he apply to future fee levels?
Finally for today, given the NAO’s and the Public Accounts Committee’s scathing criticisms of the civil legal aid cuts—incidentally, I learned just before entering the Chamber that the NAO has also reported a £1.1 million loss by the aborted Just Solutions International, the commercial arm of the Ministry of Justice—will the Minister bring forward the review of the Legal Aid, Sentencing and Punishment of Offenders Act 2012?
This has been an appalling use of taxpayers’ money. It has posed an existential threat to a fundamental part of our legal system, and it has caused uncertainty, failure and distress to thousands of hard-working small businesses throughout the country.
Mr Vara
I welcomed the comments made by the hon. Member for Hammersmith (Andy Slaughter), although they were very brief. I must add, however, that his attempt to criticise what has been described as the Lord Chancellor’s sensible decision was opportunism, pure and simple. He obviously has a selective memory. I remind him that in 2009, when Jack Straw was Justice Secretary, he abandoned the criminal legal aid best value tendering scheme at a very late stage, just before the 2010 general election. I do not recall the hon. Gentleman’s grumbling to his boss at the time, and Jack Straw certainly does not recall hearing his voice. This needs to be put into proportion.
Let me now deal with the hon. Gentleman’s questions. When we embarked on the dual contract process, we had the support of the Law Society; the hon. Gentleman may wish to reflect on that. We have said that we will suspend the second fee cut for a year. We will then work with the professions, and will form a definite view in due course. As for the Legal Aid, Sentencing and Punishment of Offenders Act, the hon. Gentleman knows only too well—because I have said it many times at the Dispatch Box—that a review will take place within three to five years. [Interruption.] The hon. Gentleman is chuntering away, as he is wont to do on a regular basis. He says, “How much money?” He knows full well that all shades of Government, both Conservative and Labour, if they listen to people and feel that a decision needs to be changed, will make that change. Just as the Labour Government made decisions to change policies, we have made such a decision. I do not recall previous Governments wasting time and effort in trying to make calculations when they have made a change of direction.
Our decision has been welcomed by the profession, and we are pleased about that. We now want to look forward and move ahead.
Robert Neill (Bromley and Chislehurst) (Con)
The intelligent lawyer and the intelligent decision maker are alert to the dictum attributed to Keynes: “When my information changes, I change my conclusions.” Surely the Lord Chancellor should be commended rather than criticised for doing that on this occasion.
Will my hon. Friend give us some more details of the particularly welcome initiative to involve the professions themselves through the proposed advisory council?
Mr Vara
My hon. Friend is right to say that the Lord Chancellor should be commended. Mark Fenhalls, QC, the chairman of the Criminal Bar Association, said yesterday:
“It takes courage to make such decisions.”
Perhaps the hon. Member for Hammersmith will reflect on that sentiment.
The Lord Chancellor has his advisory board, and he will be working with the profession to ensure that as we progress further, the public will benefit, and the taxpayer who funds the legal aid budget will gain the maximum possible value.
Sarah Champion (Rotherham) (Lab)
Steve Hynes, director of the Legal Action group, has said:
“In its planning and execution the MoJ has demonstrated shocking incompetence with this tender exercise.”
Will the Minister now launch a review of his own Department’s competence?
Mr Vara
I appreciate that the announcement was made a relatively short time ago, and that the hon. Lady has probably not had an opportunity to hear what the profession has said. The profession has wholeheartedly welcomed the proposals, and I think she should note those comments, rather than individual comments.
Oliver Colvile (Plymouth, Sutton and Devonport) (Con)
Will my hon. Friend write to me, explaining what impact the proposal will have on lawyers in the west country, especially those in my constituency, which contains, at Charles Cross, the busiest police custody suite in England?
Nick Thomas-Symonds (Torfaen) (Lab)
I should first say that I used to be a barrister before entering Parliament, and remain a non-practising door tenant of Civitas Law in Cardiff.
A year ago, the previous Lord Chancellor said these very reforms were both sustainable and essential. I thought that was completely wrong and I am delighted that the current Lord Chancellor agrees with me, but can the Minister tell us why the previous Lord Chancellor got so many things so badly wrong?
Mr Vara
It lowers the tone of this debate when, not for the first time, the hon. Gentleman takes his lead from the hon. Member for Hammersmith by resorting to personal abuse. There have been two significant developments, which have allowed us to make the announcement. First, thanks to the economies we have made elsewhere in the MOJ, Her Majesty’s Treasury has given us a settlement that allows us greater flexibility in the allocation of funds for legal aid; and it has also become clear, as I have said, that there are real problems in pressing ahead as initially proposed. We recognise those issues and we want to do the best for the profession, and that is why we have taken this decision.
Mr Steve Reed (Croydon North) (Lab)
The Minister’s Department has wasted close to £15 million now on ill-judged projects. What does this latest U-turn bring the running total to?
Mr Vara
The hon. Gentleman talks about millions of pounds; may I just remind him of the billions that were squandered and wasted when his party was in government, and that if it was not for its squandering and mismanagement, this Government would not have had to take the tough decisions we are having to take?
Conor McGinn (St Helens North) (Lab)
The Saudi prison contracts, the secure college, the book ban, the outsourcing of the collection of fines by courts, the criminal courts charge, and now two-tier, the latest in the long line of U-turns by the Justice Secretary on measures taken by his predecessor. If he is looking for his next U-turn, may I suggest he looks at the repeal of the Human Rights Act—and, of course, the closure of the court in St Helens?
Mr Vara
I am sure the hon. Gentleman’s constituents will be grateful that he managed to slip in that last bit concerning his court. As I have told him previously, no firm decisions have been taken on that issue. On other matters, I am pleased that the hon. Gentleman pays such detailed attention to what is happening in the MOJ.
Carolyn Harris (Swansea East) (Lab)
I welcome the Justice Secretary’s move to scrap the two-tier system. He said HM Treasury has given him a settlement that allows him greater flexibility in the allocation of funds for legal aid. Will he give us more detail about the settlement and whether it will extend further than what he has already said?
Mr Vara
I refer the hon. Lady to the Chancellor’s autumn statement. He said he would be allowing £700 million-plus for the courts reform programme and there would be £1.3 billion for reforming the Prison Service. We in the MOJ are also consolidating our estates programme generally in terms of the offices and space we use. If the hon. Lady reads the statement, she will also be aware that my Department will be making 50% administration cuts by 2019-20.
Mike Kane (Wythenshawe and Sale East) (Lab)
The Justice team must be spinning like tops at the moment. Would the Minister care to estimate how many U-turns there have been since the new Secretary of State took his position?
Closure of St Paul’s Place BIS Office (Sheffield)
Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
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Louise Haigh (Sheffield, Heeley) (Lab)
(Urgent Question): To ask the Secretary of State if he will make a statement on the announcement by the Department for Business, Innovation and Skills online yesterday morning that it is to close its St Paul’s Place site in Sheffield, which houses 250 jobs, and relocate them all to central London.
The Minister for Small Business, Industry and Enterprise (Anna Soubry)
The Department for Business, Innovation and Skills is committed to delivering efficiency savings and contributing to the Government’s deficit reduction targets. As such, we have developed the BIS 2020 strategic plans to modernise the way BIS works, reduce operating costs, and deliver a simpler, smaller Department that is more flexible and responsive to stakeholders and businesses. As part of these plans, the Department has announced its intention to close the BIS office in Sheffield at St Paul’s Place by January 2018.
All staff and departmental trade unions were informed of this decision yesterday, 28 January, and the statutory 90-day consultation process will now begin. Those staff most affected by this decision have been fully briefed and comprehensive support to all those facing a potential change or loss of job will be provided. This will include professional, external careers advice; professional outplacement support; working with the Department for Work and Pensions to host a jobs fair; allowed time out of the office to find jobs; and financial advice workshops.
This decision has not been taken lightly. Our current locations are based on what we call legacy decisions—decisions taken some time ago—and what can at best be described as ad hoc organisational changes. In future, our structures need to be designed in a more streamlined, efficient way. To support this effort, we will bring the number of locations we operate down from around 80 now to approximately seven centres, supported by a regional footprint for work at a local level. Each centre will focus on a key business activity and will bring together expertise and help to build our capability.
We have, and will continue to have, many more people based outside London than inside London.
Louise Haigh
Thank you, Mr Speaker, for granting this urgent question on an issue of such importance to people in Sheffield and to the Government’s hopes to build a northern powerhouse, because this decision came out of the clear blue sky for my constituents yesterday morning. The first any of them heard of it was when the permanent secretary arrived in their office at 9.30 yesterday morning. It speaks to this Government’s London-centric focus and contempt for the north of England that they think a consolidated
“combined central HQ and policy centre”
has to be, by rights, in London rather than in Sheffield where the operating costs are cheaper and the perspective on UK investment is much broader.
So why, despite Lord Maude of Horsham’s commitment to end “Whitehall palaces”, has the proportion of the civil service workforce in the capital gone up since 2010? The House will be aware that this is just the thin end of the wedge, as part of the BIS 2020 strategy, so can the Minister tell the House exactly when she is going to bother to announce which offices are going to be closed—or will civil servants have to wait uneasily at their desks for an appearance from the permanent secretary?
Secondly, the board at BIS must have seen a business case for the BIS 2020 report, prepared by McKinsey & Company at great cost. Will the Minister publish the business case so that we can see how the Government can possibly hope to reduce operating costs by moving to central London?
Indeed, is it not economically irresponsible to create more jobs in central London, which is suffering an incredibly overheated housing crisis? Given that there is a 40% cut to partner organisations coming down the line, can the Minister rule out today, categorically, that the Insolvency Service and the Skills Funding Agency based in Sheffield will not be closed?
Sheffield has already lost 500 jobs at HMRC, 100 jobs at Forgemasters and 400 jobs at the local authority. People in my city will be right to ask: why have the Tories got it in for Sheffield?
Anna Soubry
As somebody who was born and bred only 17 miles from Sheffield, I do not need any lectures from the hon. Lady, and in particular not from the Labour party given that the last Labour Government closed offices in York and Liverpool and axed over 1,500 jobs in Preston and across the Fylde coast as part of a major rationalisation of DWP offices.
The hon. Lady may not be familiar with, and understand the nature of, the Sheffield city regional deal, which was supported by people from all political parties, and rightly so, and I find it very sad, and somewhat shameful, that the hon. Lady seems to in some way criticise the northern powerhouse—[Interruption.] She laughs, and I hope Hansard will record that. The northern powerhouse has been supported, as I said, notably by some of our outstanding Labour leaders of councils across the whole of the north, and rightly so.
As I have said, there will be six business centres around the United Kingdom, including the following: a business-facing centre, likely to be in south Wales; an institutional and research centre, likely to be in Swindon, but which may initially also include Bristol; a further education funding centre, whose location is yet to be decided, but we are seriously considering Coventry; one or two higher education student finance centres, initially in Glasgow and Darlington; and a regulation centre in Birmingham. Conservative Members understand the need to ensure that taxpayers’ money is spent wisely, efficiently and effectively, and that is what we will do. All of this is our clearing up of the mess that was left by the previous Labour Administration.
Mr Gordon Marsden (Blackpool South) (Lab)
I congratulate my hon. Friend the Member for Sheffield, Heeley (Louise Haigh) on her urgent question. Today’s announcement that the Department for Business, Innovation and Skills is scrapping its office in Sheffield, which has 247 jobs, is a hammer blow to the people there. It is also a huge worry and a warning to the 12 other BIS regional offices, six of which are in the north, that they are at risk from this so-called restructuring. What assurance can the Minister give us that there will be no compulsory redundancies in Sheffield, and will she tell the House what offers of relocation expenses or even relocation itself there will be?
The BIS press statement talked vaguely about six business centres, which the Minister also mentioned in her answer, but they are servicing a centralised headquarters in London. Will the Minister say precisely where those centres will be—we have been told that possibly five will be in the south, and one in the north—and how many people will work in them? Are they simply a hastily drafted afterthought? Will they be just fig leaves, ministerial post boxes or possibly even digital fig leaves?
The BIS statement also said that the closure would reduce operating costs, so will the Minister tell the House what savings there will be from this closure, which comes on the backs of the people of Sheffield? The union, Prospect, said yesterday, that it was given only 30 minutes’ notice of this announcement. What discussions did Ministers have with workers and trade unions before the announcement was made?
The announcement comes on the back of the latest Centre for Cities report, which places Sheffield in the low wage, high welfare economy—half of the UK’s biggest cities are in that report. The report underlines the stark north-south divide and undermines all the Chancellor’s spin and rhetoric about a rebalanced economy. It is no wonder that civil servants told Radio Sheffield that they felt betrayed.
In the light of the 100 jobs lost at Sheffield Forgemasters and HMRC’s November announcement, to which my hon. Friend the Member for Sheffield, Heeley has already referred, I have to ask whether this is what the Tory industrial strategy amounts to—cutting and running. This is not a strategic approach; it is a kick in the teeth. The Financial Times said that 20% of civil service jobs had been lost in the regions since 2010 as opposed to only 9% in London. With infrastructure spending in the north standing at £539 a head and London’s at £3,386, BIS is shifting more jobs to the Chancellor’s Whitehall comfort zone and exposing the empty rhetoric of his northern powerhouse.
Did the Minister’s Department discuss the decision with the Secretary of State for Communities and Local Government who is busily promising devolution to local authorities while her officials are undermining it, and did the Minister’s Secretary of State discuss the closure with the Chancellor and did he approve it? Did BIS speak to council leaders in Sheffield and across West Yorkshire to see whether an alternative package could be put together? This Government need to tackle our skills emergency. [Interruption.] Perhaps the Minister should listen. The Government have dithered and missed opportunities—[Interruption.] Will the Minister stop chuntering from a sedentary position? They have missed opportunities to save our steel industry—[Interruption.]
Mr Speaker
Order. This speech will be heard—[Interruption.] Order! Minister, you have had your say, and you will have further says. There is something here about a basic dignity. Just sit and listen. It is not about you; it is about the issue. It is not about the hon. Gentleman either. Be quiet and listen. That is the end of it. It is not a request; it is an instruction.
Mr Marsden
As I was saying, the Government need to tackle our skills emergency and poor productivity, but they have dithered and they have missed opportunities to save our steel industry. They are now abandoning a great historic steel town. They are comprehensively failing to deliver enough of the high-skilled, better paid jobs for England’s regions that Labour wants to see. Let me see whether the hon. Lady will be as candid in expressing disappointment about BIS pulling the plug on Sheffield as she was about the Chancellor’s poor tax fix for Google.
Anna Soubry
Thank you, Mr Speaker. It is not about me; it is not. It is about the workers. I am very proud of, and pay tribute to, all those civil servants who work in the Department for Business, Innovation and Skills, and indeed I am proud of all our civil servants, which is why Conservative Members understand how important it is to have a sustainable civil service and to spend public money wisely.
There were so many questions in what apparently was a speech that I have not got the time to answer them all. [Interruption.] If I have to shut up and listen in silence, so, too, does the hon. Member for Blackpool South (Mr Marsden). What is goose for the gander is also goose for that hon. Gentleman.
Of the 20,000 staff paid for by BIS, only some 2,000 —about 10%—work at No. 1 Victoria Street. The vast majority are spread around the country. I pay particular tribute to the 60 who work in BIS local and provide an outstanding service not only locally, but to us working in the ministerial team at No. 1.
Let me repeat this: members of staff who have been affected have been fully briefed. Comprehensive support will be provided. Some of the staff will be able to transfer and apply for jobs in London; others will of course take voluntary redundancy. Mr Speaker, I do take great exception to Labour Members who stand up and talk down the great city of Sheffield, which has an outstanding city deal. That is recognised locally, which is why it has been supported by political parties of all colours in Sheffield. Labour Members might do well to listen to their own members locally before spouting nonsense and talking down the great city of Sheffield.
Conor McGinn (St Helens North) (Lab)
I do not know why the Minister seems to be taking criticism of her decision so personally. The people who should be doing that are the hundreds of workers whose jobs are at risk and who have not heard a shred of sympathy or regret from the Minister. Local government leaders in Sheffield and places such as St Helens do not need to receive the praise of the Conservative party; they are already doing fantastic work in encouraging investment and jobs to come to our areas. Public sector jobs provide the economic ballast for our areas. The Government cannot keep cutting jobs and services and expect us to build a northern powerhouse. We are the people who are working on the ground in communities and we do not need to hear from the Minister on a day when people might be losing their jobs.
Anna Soubry
I am sorry, Mr Speaker, but there was no question there. The hon. Gentleman made a speech. It was not accurate and it was rubbish.
Mr Speaker
It was also perfectly orderly, of which I am the judge. The hon. Lady should stick to the discharge of her responsibilities to the best of her ability. I am the arbiter of good order. I handle those matters, and I certainly do not require any advice from a junior Minister.
Robert Jenrick (Newark) (Con)
Representing the Nottinghamshire communities—we are 15 to 20 miles from Sheffield and many of my constituents commute into Sheffield for work or to use public services—which include the childhood home of my right hon. Friend the Minister and of her mother, who is a formidable lady, it gives me no pleasure to hear of the job losses today. None the less, it is surprising to hear Labour Members criticise the Sheffield city deal, because my constituents in Nottinghamshire explicitly want to be part of it, as do the constituents of my friend and neighbour, the hon. Member for Bassetlaw (John Mann), because it is such a good deal, creating as it does both jobs and opportunities.
Anna Soubry
Dare I say it, Mr Speaker, I do not think there was a question there. As it happens, I agree with everything that my hon. Friend said.
Sarah Champion (Rotherham) (Lab)
I do not recognise any of the criticisms that are being laid on my party about Sheffield. We are very proud of it, which is why we are here today. I would like the Minister to explain simply why taking jobs from Sheffield to London is in any way supporting the region or the Government’s ideal of a northern powerhouse.
Anna Soubry
I hoped that I had explained that to the hon. Lady. We are having to ensure that we spend public money wisely. Unfortunately, that means that we have to reduce the number of people who are working for us. We must make sure that we use the money to best effect, which is why we considered the decision so very carefully, as I hope that she understands we would. Nobody on the Government Benches takes any pleasure whatsoever when anybody loses their job. That is why we are so keen to make sure that we put the support in. We are confident that many of the workers will choose to take new jobs down in London. The simple truth is that we have to take tough decisions. We took tough decisions during the five years of the previous Government and we saw the fruits of that in the reduction in the deficit, a reduction in debt and our economy once again getting back on its feet so that there are now more than 2 million people in work who did not have a job before.
Neil Coyle (Bermondsey and Old Southwark) (Lab)
In my short time in Parliament, this is perhaps the most undignified spectacle at the Dispatch Box that I have seen. Is it not also undignified for the Department for Business, Innovation and Skills to spend £200,000 of taxpayers’ money developing a business case to shut down jobs? When will that full business case be published?
Anna Soubry
I shall make inquiries. If I can assist the hon. Gentleman, I will. As I say, in difficult times when we have to make sure that we continue with our long-term economic plan, difficult decisions have to be made, but we take the view that this is the best way to spend public money more efficiently and more effectively.
Mike Kane (Wythenshawe and Sale East) (Lab)
I do a lot of training of young people who aspire to public life and I always tell them it is important to comport oneself well in public life. The Minister has fallen below that standard this morning, unfortunately. However, I agree with her that there are great Labour leaders across the north of England. One of those is Julie Dore, who is the leader of Sheffield city council and the driver behind the Sheffield regional deal. In relation to this matter, she said:
“Yet again the actions of this government speak far louder than their empty words about commitment to the north.”
Does the right hon. Lady agree with one of our great northern Labour leaders?
Anna Soubry
As I say, the Sheffield city regional deal is an outstanding deal for the people of that city and that area. As a result of it, I understand that the number of people in work in Sheffield has risen and unemployment continues to fall.
Mr Steve Reed (Croydon North) (Lab)
May I invite the Minister to do what she has so spectacularly failed to do so far this morning—apologise to the people who are at risk of losing their jobs and just show a little human compassion for people who this morning are fearful for their livelihoods, for themselves and their families?
Anna Soubry
I am sure Hansard will record that as I said to the hon. Member for Sheffield, Heeley (Louise Haigh), nobody enjoys it when people lose their jobs and nobody takes any pleasure in it. We will do everything we can to support those people who will have to be made redundant if we reach that stage. It is rich coming from Labour, which brought this country almost to the level of bankruptcy, which resulted in millions of people losing their jobs. I am delighted that we have now got 2 million more people in work, thanks to our long-term economic plan.
Access to Medical Treatments (Innovation) Bill
(8 years, 9 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Anne Marie Morris
I shall resume my comments on amendment 2, which would remove clause 3. The argument goes that innovation has fallen in recent years owing to the legal complexities and doctors fearing a negligence claim against them if something goes wrong. There is no evidence of this, according to the Medical Protection Society, the Medical Defence Union, the General Medical Council or various other medical bodies that have spoken out on the issue. They claim that the Bill needs to be completely rethought and that no amount of amendment would make it acceptable. I would like to think that the work that my hon. Friend the Member for Daventry (Chris Heaton-Harris) has done will go some way to meet the concerns expressed before Committee stage.
Those most likely to benefit from innovative medicine are likely to be those most in desperation. Those who have nowhere else to turn will often be allured by the carrot on the end of the proverbial stick, but we must make sure that the treatment is right for that particular person. The UK has a proud history of research through universities, research institutes, the private sector and, of course, the NHS. According to the UK Clinical Trials Gateway, there are currently 3,754 trials recruiting, and that does not include the innovation that goes on day to day in the NHS.
According to the Association of the British Pharmaceutical Industry, it can take over 12 years to develop a new medicine to the standards of quality, efficacy and safety that are laid down in legislation. It will typically cost £1.15 billion to do all the research and development necessary before a new medicine can be licensed for use. For every successful medicine, 25,000 compounds are tested, 25 of these in clinical trials, with five receiving approval for marketing. The pharmaceutical industry invests more in research and development than any other industry—£11.2 million is spent every day—and employs around 23,000 people in R and D. My hon. Friend the Minister for Life Sciences stated in September last year:
“Research and innovation in the NHS are critical for addressing ...challenges.”
I agree and therefore wholeheartedly support amendment 2.
Amendment 3, which would remove clause 4, was tabled by my hon. Friend the Member for Daventry, with the support of the hon. Member for Central Ayrshire (Dr Whitford) and my hon. Friend and neighbour the Member for Totnes (Dr Wollaston). It is important to address the legal aspects of the Bill and medical negligence. The common law test, which is the main test for medical negligence, has been around since 1957 and derives from the case of Bolam v Friern Hospital Management Committee. The Bolam test states that if a doctor reaches the standard of a responsible body of medical opinion, he is not negligent. This rule has served us well over the past 55 years and I believe it will continue to serve us well. However, if it needs to be amended, our judges are in a suitable position to do that. The 1997 case of Bolitho v City and Hackney Health Authority, where the courts refined the Bolam test, is a great example of our common law in action.
Although I am sure some will point out that the Bill does not explicitly change the Bolam test and clause 4(3) appears to address the concerns that were expressed about the Saatchi Bill, I worry that lawyers would still find a way around this. Why tempt fate to change something that is not broken? Judges and lawyers know where they stand with the common law, so maintaining the status quo will give both doctors and patients the protection they need from negligent treatment. If the removal of clause 3 is agreed to, it is right that clause 4 should also be removed as it would no longer be necessary, and the common law of negligence and the Bolam test can continue to operate effectively, as they have done for 55 years. I therefore support amendment 3.
Heidi Alexander
This group of amendments, and in particular those which leave out clauses 3 and 4, are very welcome and have my full support. I appreciate that making such extensive changes to a Bill at this stage is not easy, but the hon. Member for Daventry (Chris Heaton-Harris) has been true to his word, and has rightly decided not to proceed with these clauses in the face of strong opposition.
Members who were present on Second Reading will have heard some of the grave concerns expressed by medical royal colleges, research charities and patient groups. I think it would be fair to the hon. Gentleman if I say that those concerns, which I shared, were more about the unintended consequences of clauses 3 and 4, than about the stated aim of his Bill. However, the effect of these amendments, if they are passed, is that the sole purpose of this Bill is now to give the Secretary of State the power to establish a database. The hon. Gentleman knows that on Second Reading, along with many other hon. Members, I said that I believed the Secretary of State already had this power.
The Association of Medical Research Charities has said that primary legislation is not required to set up a database of innovative medical treatments. According to the House of Commons Library, section 254 of the Health and Social Care Act 2012 gives the Secretary of State power to direct the Health and Social Care Information Centre to establish a system for the collection or analysis of information. Indeed, in Committee, the Minister signalled his intention to introduce such a database, regardless of whether this Bill becomes law. He said at that time:
“If the Bill does not, for whatever reason, reach the statute book, I would happily proceed towards establishing such a database”.––[Official Report, Access to Medical Treatments (Innovation) Public Bill Committee, 16 December 2015; c. 22.]
With that in mind, I have to question whether what is left of this Bill is needed at all.
There also seems to be some confusion, even in the Minister’s own mind, about the purpose of the Bill. The Daily Telegraph claimed on 22 January that the Minister had told it that changes in the reworked Bill could help to cut the length of time it took to bring a new drug to market by a third, from 15 years to 10 years. Yet when my hon. Friend the Member for Ellesmere Port and Neston (Justin Madders) received a written answer to a question on this very subject on 28 January, the Minister’s reply was:
“The Bill is not specifically designed to reduce the length of time it takes to bring a new drug to market”.
I would be grateful if the Minister clarified the apparent contradiction in those remarks. Having said all that, I support all the amendments in this group. Indeed, they represent a positive step forward in terms of the overall Bill.
George Freeman
The amendments seek to remove the part of the Bill that sought to take forward the original proposals put forward by Lord Saatchi to provide reassurance to clinicians that fear of negligence should not be a barrier to innovation. I want to say something about the Government’s position on this point, which, as the hon. Member for Lewisham East (Heidi Alexander) has said, has been a point of some contention.
The Government share the ambition that fear of negligence should not be a barrier to innovation. Indeed, we have looked carefully at the provisions of the original Saatchi Bill and of this Bill, and taken legal advice in order to be sure that the proposed mechanism would in no way change medical negligence law, and that is indeed the case. Notwithstanding that, I have also repeatedly made it clear that if the Bill’s provisions were to create confusion, undermine patient, public and clinician trust and confidence and trigger a lawyer-fest of discussion about whether the mechanism did or did not have that effect, it would have had the opposite effect to that which it was seeking. In those circumstances, the Bill could trigger more confusion about medical negligence.
My hon. Friend the Member for Daventry (Chris Heaton-Harris) has done a sterling job in the past few months to get round all the various parties and reassure them that, in law, the proposed mechanism does not change the legal framework for medical negligence. However, as he himself has candidly said, such has been the level of opposition—and indeed some misunderstanding, not least because there are three Bills on this subject in the House—that this proposal has started to have the opposite effect. As I said on Second Reading and elsewhere, we would never be able to support a Bill which, despite its intentions, undermined public and patient trust and confidence in our world-class medical and clinical research landscape. The fact that a coalition of lawyers, clinicians, patients and charities was concerned about the clause meant that it would inevitably have to be removed if the Bill was to receive any support from the Government. I congratulate my hon. Friend on doing his very best to develop the debate and, in the end, deciding that it would be better to remove the clause and focus on the areas on which there is agreement.
In accepting the amendments that remove the provisions on medical negligence from the Bill, it is worth pointing out that I do not want the hon. Member for Lewisham East to misrepresent my position on this. Both the chief medical officer and the NHS medical director had advised us that they believed the proposal was safe, and we had no fear that it would in any way endanger patient safety. The point is that if it triggers legal, political or patient concern, it is self-defeating.
As I have said repeatedly at the Dispatch Box, fear of negligence is just one concern in a whole field of barriers to the adoption of innovation. I do not believe that it is the biggest barrier; I never have. The biggest is the difficulty of getting information to clinicians on the busy frontline of our national health service on the pace, scale and volume of innovative medicines that are coming through the system. That is why I believe that my hon. Friend’s refocusing the Bill on that, and on the introduction of a new mechanism for getting information on off-label drugs and innovative medicines in development, is very helpful and powerful.
Heidi Alexander
Will the Minister tell us why it is taken him so long to reach this conclusion? Will he also be clear about the contact that his officials at the Department of Health might have had with the hon. Member for Daventry (Chris Heaton-Harris) or Lord Saatchi on previous incarnations of this Bill? It strikes me that the Department has supported this Bill for a number of months and years in its different incarnations.
George Freeman
I am absolutely delighted that the hon. Lady has asked me that question, because it gives me the chance to deal with this matter directly. I am surprised at her question, in an age in which people want the Government to work in a cross-party way and to support private Members’ Bills and enable Back Benchers to get business through, and I have gone out on a limb to work in a cross-party vein. Sadly, however, the hon. Lady seems stuck. I thought this morning might have been a day on which to celebrate that joined-up work. Let me deal with the specific points that she has raised.
Right at the beginning, I said that I supported the aim of Lord Saatchi’s Bill to tackle the issue, such as it is, of medical fear of negligence if it is getting in the way of innovation. Indeed, we made it clear that we supported the aims of the Off-patent Drugs Bill, but not the mechanism involved. We also made it clear that we supported the aim of the Bill introduced by my hon. Friend the Member for Daventry to promote access to information about innovative medicines. I am surprised that the hon. Lady cannot get away from wanting to criticise that attempt. I believe that it is a good thing that we have reached joined-up consensus today on a package of amendments.
The hon. Lady should not believe everything that she reads in the papers. The article in The Daily Telegraph to which she referred talked about the accelerated access review, which I am leading and which I would like to think she welcomes and supports. My comments on speeding up the pace at which we can get innovative medicines to patients were in connection with that. I read the piece too, and it was misleading because it gave the impression that I thought this Bill would have the effect that I want the accelerated access review to have. I was merely making the point that the Bill in its current form could support the wider accelerated access review and the landscape that I am trying to put in place.
Heidi Alexander
I should like to state for the record that it has never been the Opposition’s desire to play political games with this Bill. We have always been concerned about what is in the best interest of patients, and I would like to make that point clear to the Minister and place it on record.
George Freeman
I am grateful to the hon. Lady for that clarification; it is most welcome.
I want to deal with the point that the hon. Lady and one or two others have made about the necessity of the Bill, given the powers that Ministers already have in relation to data. The Health and Social Care Information Centre, created under section 254 of the 2012 Act, can collect data, but there are restrictions on who it can disclose those data to. The Bill will enable disclosure to doctors, which could be limited by using just section 254. The 2012 Act also contains specific provisions relating to the HSCIC having a role in establishing other databases, so this approach is more in keeping with the general approach in the legislation.
The Bill might not pass in its current form, as it still has to go to the House of Lords. However, the point I made in Committee was that although I support the intention of that database provision, the law regarding the use of data in the NHS is complex and difficult, as Members know well. If the House wants the database to be created, having a Bill that makes very clear what it wants the database to do and requires Ministers to come back with proposals for it would be extremely helpful. In conclusion, I support these amendments.
Amendment 1 agreed to.
Clause 2
Database of innovative treatments
Amendment made: 11, page 1, line 18, leave out from beginning to “involves” in line 19 and insert
“In this section, “innovative medical treatment” means medical treatment for a condition that”.—(Chris Heaton-Harris.)
Heidi Alexander (Lewisham East) (Lab)
I beg to move amendment 8, page 2, line 20, at end insert—
“(b) the General Medical Council,
(c) the British Medical Association,
(d) the Association of Medical Research Charities,
(e) the Royal Colleges,
(f) the Academy of Medical Sciences,
(g) the Medical Research Council,
(h) the National Institute for Health and Care Excellence,
(i) the Medicines and Health Products Regulatory Agency, and
(j) any other body or individual that the Secretary of State considers it appropriate to consult.”
Mr Deputy Speaker (Mr Lindsay Hoyle)
With this it will be convenient to discuss the following: amendment 9, page 2, line 20, at end insert—
“(6A) Regulations under subsection (1) may not be made unless the Secretary of State is satisfied that the regulations have the approval in principle of—
(a) the HSCIC,
(b) the General Medical Council,
(c) the British Medical Association,
(d) the Association of Medical Research Charities,
(e) the Royal Colleges,
(f) the Academy of Medical Sciences,
(g) the Medical Research Council,
(h) the National Institute for Health and Care Excellence,
(i) the Medicines and Health Products Regulatory Agency, and
(j) any other body or individual that the Secretary of State considers it appropriate.”
Amendment 15, in clause 5, page 4, line 1, leave out subsection (2) and insert—
“( ) References in section 2 to medical treatment include references to treatment carried out for the purposes of medical research (but nothing in section 2 is to be read as affecting the regulation of medical research).”
This amendment makes it clear that the database for which clause 2 provides may contain information about treatments carried out for the purposes of medical research (including, for example, in the context of a clinical trial).
Heidi Alexander
Setting aside the fact that I question whether what is left of the Bill is necessary, if the database is to be created, it is important that we get its design right. The Association of Medical Research Charities has expressed concern that the database might adversely impact patients and medical research. For such a database to be effective, it will need to be appropriately regulated and quality controlled. I believe that it can command the confidence of the medical profession only if it is developed in consultation with it. With that in mind, amendments 8 and 9 deal with the bodies that the Secretary of State must consult and get approval from before introducing regulations establishing a database of innovative treatments.
As the Bill stands—this is set out in clause 2(1)—to make those regulations the Secretary of State need only consult the Health and Social Care Information Centre. Restricting the statutory consultees to only one organisation seems highly restrictive and is inconsistent with the Bill’s explanatory notes, which state:
“The detailed design of the database would be consulted upon with professional bodies and organisations.”
Amendments 8 and 9 would make the legislation clearer on which bodies should be consulted.
I note that the Minister was unable to support similar amendments tabled in Committee because he felt that the list was “not exhaustive”. Indeed, he went on to say:
“Although it represents a helpful list of consultees, such a provision would need to include many more organisations. While I understand the intention behind the amendment, restricting the process would not be helpful”.
The hon. Member for Daventry (Chris Heaton-Harris) then said:
“I know from my consultation on the Bill with stakeholders that we would need longer lists than those in the amendments.”––[Official Report, Access to Medical Treatments (Innovation) Public Bill Committee, 16 December 2015; c. 22-23.]
With those constructive comments in mind, I have included in the list a provision allowing the Secretary of State to consult
“any other body or individual that the Secretary of State considers it appropriate to consult.”
I know that there were concerns that the list of specified organisations could become out of date. However, given that these regulation-making powers would likely be used only once—to create the database—I do not believe that concern is wholly justified. Indeed, if the Minister, or any hon. Member, believes that an inappropriate organisation is on the list set out in my amendments, I would be keen to know which organisation they feel should not have a say in the creation of the database.
I hope that these important amendments will address the concerns raised in Committee and that hon. Members will now be able to support them, because they will ensure that we get the design of the database right.
Anne Marie Morris
I will speak first to amendments 8 and 9 and then turn my attention to amendment 15. As the hon. Member for Lewisham East (Heidi Alexander) explained, amendments 8 and 9 would add a whole host of bodies—I think that I counted eight—that the Secretary of State must consult before making regulations under subsection (1). This relates to the conferring of functions on the Health and Social Care Information Centre in connection with the establishment, maintenance and operation of a database. The hon. Lady has talked articulately about why the two amendments should be made, but I have some concerns.
My main concern, despite everything the hon. Lady said, is that adding all these organisations that the Secretary of State must consult will just add to the complication of the database. The amendments not only ask the Secretary of State to consult, but ask that all these organisations approve the regulations. Adding these extra organisations will just add to the confusion about who is policing the system. Is the consent of all those organisations needed before a treatment can be removed, or can it be removed just by the Health and Social Care Information Centre? If a complaint is made about what is on the database, does it go to the Secretary of State, the NHS or the Health and Social Care Information Centre, or does it have to be put in front of all those organisations again?
I understand that the hon. Lady might not have all the answers to my questions and that these issues go deeper than just her amendments, but I do not think that adding extra layers of consultation will help to simplify the Bill or make it any easier to implement the database, which, if put together correctly, could do much good and help many people across the country and, potentially, the world. I do not support amendments 8 and 9, because I believe that they will add unnecessary complications to the database and impede the good work that it could well achieve.
Amendment 15 has been tabled by the Minister, who has spoken eloquently throughout these debates. Including references to treatments carried out for the purposes of medical research will enhance the database, because it will allow the inclusion of clinical trials and other forms of medical research. Including medical research in the Bill will hopefully help to address the UK DUETS database. Mr Deputy Speaker, you will be glad to hear that that is not a database of UK singers who perform together; it is the database of uncertainties about the effects of treatment. It publishes treatment uncertainties from a wide range of people, including patients, clinicians and research recommendations, among others. By including medical research on the database, hopefully we can remove a few more treatment uncertainties from the database or, on the flip side, identify treatment uncertainties with greater ease and therefore tackle them head-on.
Clinical trials are vital if we are to put our NHS resources into the right treatments. They can help find out how to prevent illnesses, detect and diagnose illnesses or treat illnesses. The earlier we can do that, the more lives we can save, so I support any move to increase clinical trials, which I believe this amendment will do. It is my belief—I am sure that my hon. Friend the Minister will correct me if I am wrong—that his amendment will also increase knowledge of clinical trials among clinicians by adding them to the database. Sir Francis Bacon said that “knowledge is power”, and I do not believe that is any less true when it comes to medicine and saving lives. I fully support the Minister’s amendment.
Oliver Colvile (Plymouth, Sutton and Devonport) (Con)
I congratulate my hon. Friend the Member for Daventry (Chris Heaton-Harris) on introducing this Bill. Let us hope that it has a successful outcome later. I should remind you, Mr Deputy Speaker, that I am the Government’s pharmacy champion and vice-chairman of the all-party pharmacy group. Consequently, the majority of my comments will be based very much on pharmacists as dispensers of medicines that will include off-label ones.
I enter into the debate with some trepidation having listened to the hon. Member for Central Ayrshire (Dr Whitford), who was incredibly well-informed and very persuasive. I hope that my comments will be practical and constructive. I want to concentrate on the data-sharing of summary care records, as well as information to do with these medicines, and the decriminalisation of pharmacists for dispensing errors. I hope that the Minister can clarify his position on some of this stuff when he winds up.
Mr Deputy Speaker (Mr Lindsay Hoyle)
The hon. Member for Daventry (Chris Heaton-Harris) may have to shake his watch a little longer. I call Jo Churchill.
Jo Churchill
I spoke earlier about the new clauses we tabled, but I did not emphasise my own need for us not to paralyse the database. It is vastly important, given the wider horizon of genomics and informatics, and we have not even touched on how it could accelerate the whole system and improve patient outcomes significantly. We need to put patients at the front and centre of the process, and allow enough flex for the system to be the best and the database to be the finest in the world. We have the finest scientists, the greatest charities and some of the best academic minds at our disposal.
The database may also revolutionise the life sciences industry, to which my hon. Friend the Member for Newton Abbot (Anne Marie Morris) has just referred. That industry generates 1% of our export market from one drug. The power for this billion-pound industry to grow and to improve health—not only in our own country, but across the world—has to be seen to be believed. It costs upwards of £1 million to take a drug to market. What on earth would incentivise a company to do that if it could not get some sort of payback? We must not tie the hands of the people who can find the answers. Many such companies start as micro-companies, spun off from the great universities of our country, but many of them fail in what they call “death valley”. Our health system needs to modernise, digitise and reform to collect, collate and use our health data in the right way.
I believe that clinical trials are vital. I would take part in one, as a dear friend of mine recently did, to give other people a better chance of beating their disease. That is why we must not constrain the database in a way that, like a straitjacket, would completely constrict the industry and academia. At the same time, we must maintain the rigour in dealing with science for which our country is so famed. I believe that the power behind that science is patient data, and every patient holds an answer. With the support of clinicians and charities, and with a strong sense of purpose from the Government, I want data to be used for the benefit of patients. I will stand here and make my point over and again for these five years if we wreck the ability for a database to be a power for good in this Chamber today.
Dr Philippa Whitford
I wonder whether the hon. Lady will clarify what she is saying. The database that is referred to in the Bill will share information on drugs and trials that ought to be available to anyone, whether a pharmacist, a GP or a doctor. It is simply about information sharing. Is she referring more to a database of patient information from which we can learn in the future? Obviously, that is outwith the scope of the Bill, but it has been held back by the various data challenges that have been faced.
Jo Churchill
I apologise. Yes, I have confused the two, because I really believe that if we are not careful, what we do today will have an effect on our ability to bring that second broader database to fruition, which would give us the information we need to drive the trials, the life science industry and so on. Databases need to be fit for purpose. I could not have put it better than the hon. Lady did. We want the database that we are talking about today to be fit for purpose, but we do not want to put too many constraints or too much rope around it if that will stop us moving forward with clinical trials and with the whole area of genomics and patients.
I want every life to mean or have meant something. A patient should be able to choose to give knowledge as their legacy. Data hold the answers—the answer for my constituent whose two-year-old had a brain tumour; the answer for a family I know who have diabetes in several generations; the answer for a family member whose humour is tested by Parkinson’s that attacks his body. Personalised medicine should be a reality. As was pointed out in a paper yesterday, we are doing great things with CRISPR—clustered regularly interspaced short palindromic repeats—and across the piece.
Like me, every patient is somebody’s parent, partner, child or friend. That must not be forgotten. If the database we are discussing allows for information to be given that is appropriate to the individual, with care taken by the clinician right through the pipeline, it has to become a force for good. We should not wrap it up in too many constraints, but should allow it to develop. We must allow the Under-Secretary of State for Life Sciences to give us a lead in how to proceed in this field in the most effective manner.
The use of data offers the possibility to accelerate medical trialling from seven to two years and to link research together to find new insights. My glasses are not rose-tinted. I would want assurances about the use of my data, as any sensible person would. I want the recommendations of the accelerated access review to be implemented. The use of health data will be central to solving this country’s health challenges, not least in terms of cost, and its economic challenges. Our medical future will be uncertain unless we unleash the potential of information about patients for patients. I therefore support the Minister’s proposal.
Chris Heaton-Harris
It is always a pleasure to follow my hon. Friend the Member for Bury St Edmunds (Jo Churchill). Her knowledge and the way she goes about her business in the Chamber on this subject mean that it is always worthwhile to listen to her. What she says is powerful and she beats a trail that many will follow. She will get to the place she wants to get to eventually. I am very hopeful that this process today is one step along the way. I hope she gets some comfort from the fact that she is beginning to open doors, open minds and, in this case, open up information to registered medical practitioners about a host of treatments that they might not have known existed.
First, I will deal with what I perceive to be a Government amendment, amendment 15, which was tabled by my hon. Friend the Minister. I will then deal with the amendments tabled by the hon. Member for Lewisham East (Heidi Alexander).
Mrs Drummond
That was a very moving story about Emma. Does my hon. Friend envisage that the database will include international research and data from around the world?
Chris Heaton-Harris
Strangely enough, the Bill confers only a general power on the Secretary of State to provide such a database, and stakeholders and practitioners want clarification on how the database will operate and what sort of thing it might contain. Ideally, in the future, perhaps we could include what my hon. Friend suggests—who knows?—but the Bill confers a very simple power on the Secretary of State at this point in time. The very simple answer is, as it stands, no.
Mrs Drummond
My hon. Friend mentions that Emma got her treatment from the United States, where there is a lot of innovation and research. Would it not be great if we could expand that database to include research from around the world?
Chris Heaton-Harris
Yes, but in responding to amendments 8 and 9, which were tabled by Her Majesty’s loyal Opposition, I know that, when the Secretary of State and the Minister choose to use the power conferred on them in the Bill, they will confer far and wide on how the database is set up and used. Perhaps my hon. Friend will have an opportunity at that time to put her point in the consultation on how wide and extensive the database should be.
I mentioned Emma’s story because it was about evidence sharing within our existing system, which every single Member would like. Of Emma’s treatment, the NHS stated that it could not find evidence to approve the effectiveness of the operation that saved Emma’s life, and then withdrew funding for it. However, in its consultation on the matter, the NHS did not talk to the surgeons at the hospital where Emma was treated. There is a general point. I could tell hundreds if not thousands of stories in which a simple flow of information and data, or innovation or other things in our NHS, could improve the quality and type of care that is given to patients.
Amendment 15—the Minister’s amendment—states:
“References in section 2 to medical treatment include references to treatment carried out for the purposes of medical research (but nothing in section 2 is to be read as affecting the regulation of medical research)”.
That is an important amendment because it signals the Government’s intention to use the database wisely when it comes to dealing with research. Research has come on in leaps and bounds, meaning that a huge number of new treatments are coming into our NHS through clinical trials and innovative ideas everywhere in the system.
Dr Philippa Whitford
Although people who work in an academic unit will be very aware of trials—a lot of trials are UK-wide, but European Organisation for Research and Treatment of Cancer trials are Europe-wide and occasionally there are worldwide trials—people who work in district general hospitals, where there might be greater numbers of certain types of patients, are often less aware. Adding a listing of trials under any disease topic or area of clinical practice could be helpful in attracting clinicians to say, “I am aware that you can access a trial in Birmingham or Manchester.” The measure might promote trials to the busy clinician who is not directly involved in academic research.
Chris Heaton-Harris
I thank the hon. Lady, and I completely concur. I can foresee great benefits for those in the outer reaches of the NHS who do not necessarily come across information about many of the trials that are taking place. One of the biggest criticisms of the original formulation of my Bill was the fear in connection with getting people on to clinical trials. I would like to think that we have not just overcome that issue, with the amendments we are discussing and the latest version of the Bill, but have gone some way along the line to help improve the ability of registered medical practitioners to have knowledge of such trials. I completely concur with the hon. Lady’s point. We have innovation everywhere, so there is a real purpose behind having a database, regardless of whether the Minister has had the ability to set one up before now.
On research, Lord Winston made a very important point particularly well in the other place on Second Reading of the Mesothelioma Bill. He stated:
“There is no question that in the field of treatment there is a great deal of research.”
He had a list of a number of chemotherapeutic agents that were being looked at, saying:
“In recent years I can count at least 10 or 11”.
He then went on to name them. They are impossible for me to pronounce, so I will not do so here today. He said that,
“there are various combinations of those therapies with other well-known mitotoxic agents. These have included trials”.
He went on to say:
“Other treatments have been researched: of course there is surgery…and there are now attempts to try to reduce the tumour inside the lung membranes.”
He spoke about three trials that Cancer Research UK is conducting to emphasise the wide range of “stuff”, as he put it, that is going on.
“One is some work with HSV1716, which is a virus that acts against dividing cancer cells. It comes from the herpes virus…a very good example of where we might make a breakthrough in treatment. Then there is a different strand of research with ADI-PEG 20, which in combination with other drugs such as cisplatin affects a particular amino acid in the chain of cell division”—
which could prevent cancer cells from multiplying.
“That has been specifically targeted for the treatment of mesothelioma. A compound, GSK3052230, developed by GSK, is I think about to enter phase 3 trials very shortly. That attacks the FGFR1 gene, and therefore stops cancer cells growing.”
This is where he makes the point exactly:
“There is now an increasing emphasis on understanding that, if we are going to improve outcomes for patients with a variety of different cancers, and other chronic long-term conditions, we need to move away from a generalised approach to managing disease towards personalised, precision medicine”.—[Official Report, House of Lords, 20 November 2015; Vol. 767, c. 395-7.]
Medicine is going to change. Research is going to change. Spreading the information about that across our NHS, and how quickly we can do that and learn from success and failure in our NHS, is a very, very important matter.
Anne Marie Morris
Does my hon. Friend believe that personalised medicine should become a reality over the next little while and not a research project, and that unless we have freedoms within the database we will never have the knowledge to find out that we can truly have personalised medicine?
Chris Heaton-Harris
I truly believe that personalised medicine will become a reality. I would like to think that a database would aid the spread of knowledge about how individual medicines are being used and who they might affect in different ways, so yes, I nearly completely agree with my hon. Friend.
Dr Whitford
I have two small points. First, personalised medicine, particularly for breast cancer, has been evolving for years. Right from when we could tell whether a cancer fed on the female hormone oestrogen or not, we were targeting the treatments towards patients. We have been moving that way and it will accelerate.
I know it is not the subject of the Bill, but I hope that the accelerated access review will consider in general how we get drugs to patients—a subject that we debate relentlessly in Westminster Hall. I see a negative feedback loop coming from among colleagues who used to be trialists, such as myself. We registered patients and did all the work to take part in research, but when the drugs were finally made available, the NHS could not afford them. We need a totally different way of accessing those drugs. The companies want to sell them, and we and patients want them.
Chris Heaton-Harris
The hon. Lady speaks with way more experience and knowledge than I do, but from everything I found out during my research for the Bill, I completely concur.
Oliver Colvile
Does my hon. Friend also recognise that an enormous amount of research is taking place in many of our medical schools, especially Peninsula medical school in my constituency and the one in Exeter?
Chris Heaton-Harris
Clinical research and innovation is happening across our NHS every day. Would it not be wonderful if every registered medical practitioner could see what was going on, without too much effort or work, by tapping into a database and getting a better understanding of the picture around them?
This is the crux of the matter. Treatments are not what they used to be; there is not a one-size-fits-all policy. As medicine progresses and personalises even further, the mind boggles trying to imagine the sheer number of treatments that will be available in our NHS in the future. How can we expect every clinician to know about all the possible treatment routes? How can we not, therefore, provide them with somewhere to record them and their outcomes?
As Lord Giddens stated in the debate I mentioned earlier, we are experiencing a digital revolution. Given how far technology has come in our lifetimes and what is now possible, we can truly say we are living through a different age of digital capability. It is moving at such a pace that we struggle to keep up with it ourselves. It is not unfounded to say we might be living through a period of unparalleled innovation in medicine and other frontier areas of science more generally. Thanks to the strides in treatment and the speed of technological development, we have an opportunity to create and record life-saving data like never before. It is surprising that we do not have such a database already. The Bill sends an unambiguous political signal to the Government that we would like them to get on with it.
The Bill defines innovation as a situation where a doctor departs from the existing range of accepted medical treatments for a condition. This will be well understood by doctors, who are best placed to know whether treatments are acceptable and responsible. The definition of what can go on the database is deliberately wide because I want the Minister to have as wide an ambit as possible.
I want quickly to mention another stakeholder I met, Nutricia, a company dealing with advanced medical nutrition. It kindly welcomed the Bill:
“This Bill marks an opportunity for patients managing a range of diseases and conditions to get access to the most innovative medical care, and to actively support their inclusion in patient pathways in an on-going manner. This should not simply be confined to pharmaceuticals, as patients can benefit from innovation across a range of sectors, for example medical nutrition.”
Medical nutrition—otherwise known as medical foods—describes a special category of foods designed to meet the needs of patients whose disease or health concern requires medically determined nutritional support. Medical nutrition is a scientifically formulated food that is available in many different formats. Applications can range from those with rare conditions, such a child who inherits a metabolic condition meaning that the consumption of a specific amino acid commonly found in normal foods can lead to brain damage, right through to people with common cancers who may as a consequence lose weight rapidly and be at risk of malnutrition for a period of time. Nutricia was therefore keen that we maintained the widest possible definition for how the database could be used.
Medical nutrition also provides benefits in the treatment pathways of other diseases, including various cancers, strokes, cerebral palsy and pressure ulcers. Nutricia has stated that,
“we must seek to streamline the adoption of innovative care of all kinds—not just pharmaceuticals—so that clinicians have a resource which will mean that there are no more missed opportunities, and patients have every available chance to manage their condition.”
Bob Stewart (Beckenham) (Con)
I am very ignorant compared with a lot of people in this Chamber, so my question is probably a question from a fool. I do not mean it to be, but when I go to a doctor and they are sitting in front of a computer, I make the assumption that if they have a question, they go into the computer and get an answer. Am I wrong in saying that cannot or does not happen, and would this new list work much better?
Chris Heaton-Harris
I will give way to the hon. Member for Central Ayrshire, who will give a much more informed answer.
Dr Philippa Whitford
I think the hon. Member for Beckenham (Bob Stewart) has a much greater admiration for what a computer on a desk can access at that moment when a GP has a 10-minute appointment. What they are actually looking at is the patient’s records. They also have the ability to prescribe, but to track something down they would have to shut those systems down and go into something else, as with searching the internet. They cannot do that live, in front of a patient, and that brings up an important point. If the new system is meant to be used live, in front of patients, it will have to interact with the NHS computer systems, which someone can literally click on and use to look things up relatively easily, in the way we look things up in the BNF at the moment.
Chris Heaton-Harris
I thank the hon. Lady for her explanation to my hon. and gallant Friend the Member for Beckenham (Bob Stewart).
It is important that doctors are aware of the changing methods by which care is being delivered. Innovation in the delivery of care must be recognised in the tapestry that is our wonderful national health service. I fully welcome the Minister’s amendment to my Bill. It makes it more worth while. The improvements we are making to the Bill today are dramatic, but they have not come out of thin air; they have come from a great deal of work. A great deal of thought has gone into them, which I very much appreciate.
Finally, and briefly, let me turn to amendments 8 and 9, in the name of the right hon. Member for Lewisham East (Heidi Alexander).
Chris Heaton-Harris
Soon to be right honourable—I shall try to get her promoted to that position. I am sure there are some Privy Council positions awaiting on the Labour Benches.
I completely understand where the hon. Lady is coming from in trying to ensure the widest range of consultation on, actually, pretty much anything. Forget this Bill; when the NHS does something, it should try to interact with stakeholders who have direct and indirect concerns. As it stands, the list in her amendments looks like a preferred list of consultees, although I have a range of concerns about the listing, the order and so on. Given the way we have gone about this Bill—there has been a great deal of understanding and working together—I would like to think that when my hon. Friend the Minister answers this point and indicates what the Secretary of State would do with the power, how he would consult and which groups he would consult with, the hon. Lady will perhaps consider not pressing her amendments, in the full knowledge that there will be the widest possible consultation, should this Bill become law.
George Freeman
I shall deal with amendments 8 and 9, tabled by the hon. Member for Lewisham East (Heidi Alexander), and amendment 15, which I tabled on behalf of the Government. I shall also deal with some of the important points that Members have raised.
I have to say that I am not here every Friday, but I think that today’s debate is setting a high standard, both in terms of the issues that are being raised and the way in which it is being conducted. I hope that those who take a close interest in the Bill and are watching the debate are observing the cross-party nature of our discussion of some very important issues.
I thank the hon. Member for Lewisham East for her support for the spirit of cross-party working. The sector needs to be confident in the knowledge that the House is paying close attention to the issues that underlie the Bill—issues relating to data, informatics, genomics, drug trials and research—in a cross-party spirit. As the hon. Lady knows, in the course of my work I have paid tribute to the last Labour Government’s pioneers, Lord Drayson and David Sainsbury, who did so much to create the Office for Life Sciences. I think the debate reflects that spirit, and I welcome the hon. Lady’s restatement of her support for it.
I also welcome amendments 8 and 9, which specify and flag the importance of a wide group of consultees. I entirely agree with the principle of the amendments. Indeed, I would go further and include a range of patients’ groups, charities and others. I give the hon. Lady—and the House—a commitment, which I am happy to put in writing, that I will seek to involve all the organisations on her list, and indeed others, in the consultation that will take place following the Bill’s enactment.
As an experienced parliamentary operator, the hon. Lady knows that including lists of organisations in a Bill is always a mistake, because in the end it creates more problems than it seeks to resolve. However, I will happily write to all the bodies that she has mentioned, and to all Members as well, with a list of those who I think should be involved in the consultation.
James Morris (Halesowen and Rowley Regis) (Con)
I know that the Bill is specifically about access to medical treatments, but, as chair of the all-party parliamentary group on mental health, I know that there is a growing need for the ability to share information about both drug-based and non-drug-based interventions in mental health care. Has any consideration been given to the sharing of information about mental health care in particular, and how would that fit into the framework of the Bill?
George Freeman
My hon. Friend has made a typically interesting and important point. I pay tribute to his work on mental health.
In no area of pharmacology and pharmaceuticals is drug discovery, drug use and prescribing more complex than in mental health. One of the projects on which I worked before entering the House was at the Institute of Psychiatry at King’s College London, where Professor Simon Lovestone has pioneered the use of informatics and data to integrate research into mental health conditions and the compiling of patient records information, MRI scans and, latterly, genomic information, to assist understanding of both the causes of disease and the way in which different patients respond to different drugs. As my hon. Friend will know, mental health care involves a wide range of very complex and, in some cases, very powerful drugs, and information about how those drugs work and how different patients respond is therefore crucial. I certainly want to ensure that we do not exclude mental health from the Bill’s provisions.
I tabled amendment 15 in connection with clinical research, an issue that received much attention during the Bill’s earlier stages. When—before these amendments were tabled—the Bill made provision for medical negligence, the Government were determined to ensure that none of its provisions would in any way undermine the United Kingdom’s world-class and world-rated landscape for the regulation of clinical trials. So the previous Bill contained a provision stating that nothing in it applied to clinical research. Now that my hon. Friend the Member for Daventry (Chris Heaton-Harris) has tabled amendments to remove the clauses dealing with medical negligence so as to create instead a Bill focused purely on the provision of data on innovative medicines to clinicians, I suggest that we remove that exclusion of clinical research and make sure that the database—now that it has nothing to do with negligence—actually covers drugs in research. That would make sure that we do not preclude the inclusion of drugs in clinical trials that clinicians may want to recommend to their patients or investigate their patients’ eligibility for.
Heidi Alexander
I have listened carefully to the debate on this group of amendments. Although I know that the hon. Members for Bury St Edmunds (Jo Churchill) and for Newton Abbot (Anne Marie Morris) have concerns about creating excessive bureaucracy, I think those concerns are somewhat overstated. The Bill already requires consultation before regulations are made. I am seeking to ensure that the appropriate organisations are able to have their input into the process. However, in the spirit of cross-party working for which the Minister has developed a fondness this morning, I beg to ask leave to withdraw my amendment 8 and not to press amendment 9.
Amendment, by leave, withdrawn.
Clause 3
Responsible Innovation
Amendment made: 2, page 2, line 26, leave out clause 3 —(Chris Heaton-Harris.)
Clause 4
Effect on Existing Law
Amendment made: 3, page 3, line 19, leave out clause 4 —(Chris Heaton-Harris.)
Clause 5
Interpretation
Amendments made: 4, page 3, line 40, leave out “this Act” and insert “section 2”.
Amendment 12, page 3, line 42, leave out paragraph (b).
Amendment 13, page 3, line 44, at end insert—
‘(1A) For the purposes of section 2(2), the kinds of medical treatment that may be innovative medical treatments include (amongst other things)—
(a) the off-label use of an authorised medicinal product, and
(b) the use of a medicinal product in respect of which no marketing authorisation is in force.
(1B) In subsection (1A)(a), the reference to the off-label use of an authorised medicinal product is a reference to the use of the product—
(a) for a purpose other than one for which its use is specified,
(b) in relation to a person who is not within a description of persons for whom its use is specified, or
(c) in any other way in which its use is not specified.
(1C) In this section—
(a) “authorised medicinal product” means a medicinal product in respect of which a marketing authorisation is in force;
(b) “marketing authorisation” and “medicinal product” have the same meanings as in the Human Medicines Regulations 2012 (S.I. 2012/1916);
(c) “specified”, in relation to a medicinal product, means specified in its marketing authorisation.”’—(Chris Heaton-Harris.)
Amendment 15, page 4, line 1, leave out subsection (2) and insert—
‘( ) References in section 2 to medical treatment include references to treatment carried out for the purposes of medical research (but nothing in section 2 is to be read as affecting the regulation of medical research).”—(George Freeman.)
This amendment makes it clear that the database for which clause 2 provides may contain information about treatments carried out for the purposes of medical research (including, for example, in the context of a clinical trial).
Madam Deputy Speaker (Natascha Engel)
We now come to amendment 5. With the leave of the House I will put the questions on amendment 5, 6 and 14 together.
Chris Heaton-Harris
On a point of order, Madam Deputy Speaker. I was under the impression that amendment 5 would be called only if amendment 15 was not carried. Please could you give me some clarification on that point?
Madam Deputy Speaker
The hon. Gentleman is right; we will take amendments 6 and 14 together.
Amendment made: 6, page 4, line 3, leave out ‘this Act’ and insert ‘section 2’.—(Chris Heaton-Harris)
Clause 6
Extent, commencement and short title
Amendment made: 14, page 4, line 8, leave out ‘Sections 1 to 5’ and insert ‘Sections 1, 2 and 5’.—(Chris Heaton-Harris.)
Third Reading
Chris Heaton-Harris
I beg to move, That the Bill be now read a Third time.
It is a tiny bit of a relief to get to this point in the proceedings. I guess I should start by thanking a number of people, the first of whom is the inspiration for this Bill. As I explained in my Second Reading speech, I followed in some detail what Lord Saatchi had been doing in another place, especially when his Bill reached its Report stage and Third Reading, and I thought some of his ideas were very much worthy of legislation in this place. Unfortunately, the inspiration for his Bill was the terrible loss that he suffered, but I would like to think that what we have done here today will be a true and lasting legacy for him to remember his wife by.
I should also like to thank the Under-Secretary of State for Life Sciences and all the officials in the Department who have given me advice—nearly always constructive and helpful—especially a gentleman called Peter Knight, who very kindly hosted a round-table for a whole host of organisations, and anyone else who was interested. It was only the people who were being really stroppy about the Bill who refused to come. He kindly explained what the database could and should be doing, and what its potential was, which alleviated a huge amount of concern. He also enlightened a number of people on the direction of travel that we were taking. I thank my hon. Friend the Minister and all his officials for their help and understanding.
Most of all, however, I would like to thank the hon. Members who are in the House today. I was a Member of the European Parliament, and I guess we have Europeanised the system here. I am not a great European—I like to consider myself a decent Eurosceptic—but there are some practices in the place where I used to work that enable you to listen to people on all sides of an argument, and that allow you to evolve and learn from their better experience and knowledge and put that into your own work. I want to thank the hon. Members for Torfaen (Nick Thomas-Symonds) and for Central Ayrshire (Dr Whitford), and of course my hon. Friend the Member for Bury St Edmunds (Jo Churchill), who is an unbelievable force of nature. I am sure that she will make waves for the Minister if he does not stick to some of the promises he has made today. I also thank Her Majesty’s loyal Opposition, who all the way through this process have been willing to engage with me, to listen and to criticise, completely and correctly. I therefore thank the hon. Members for Lewisham East (Heidi Alexander) and for Ellesmere Port and Neston (Justin Madders).
Where we have got to now is not a bad place. I have received a briefing from Empower, which is one of the charities that is keen to ensure that patients get the best treatment. I will quote from its briefing, because this is not something I would ever say about myself. It states:
“We are particularly pleased by the ingenious step of absorbing Nick Thomas-Symonds’ Off-Patent Drugs Bill into the amendments. Mr Heaton-Harris’ database of innovation combined with off-patent access to medicines is a hugely positive step forward, and one Empower fully supports.”
The briefing included a note from Graham Silk, a gentleman who was doing some media on this yesterday, having joined Empower’s drive for spreading innovation. He said:
“I was diagnosed with leukaemia in 2001, and I’m still here today because of medical research facilitated by the patient data of the leukaemia community. I was one of the lucky ones by being in the right place at the right time. But we need to start taking luck out of the equation by spreading this information faster and wider. This database could have the power to do just that.
Indeed the drug that saved my life has already shown early promise in other conditions, the off-patent provisions in the Bill could also see patients granted access to a far broader set of treatments which would really open up our health system.
I am looking forward to continuing Les Hatpin’s legacy”—
Les was the power behind Empower—
“by working with Parliament, policy makers, and frankly anyone who will listen, to see our health service modernise and digitise to the benefit of patients.”
Jo Churchill
That clearly encapsulates what we need to be doing: putting the patient at the centre, backed up by a charity, such as that leukaemia charity, and supported by clinicians. We could not want a more virtuous situation.
Chris Heaton-Harris
I completely concur with my hon. Friend. I would like to think that Graham, when he looks at our proceedings today, will be pleased at where we have got to, and the process by which we have got here, and is looking forward to his wishes becoming fact.
There have been some questions about whether the database is required at all. I will talk about this gently, because I do not want the cross-party consensus to break down at such an important moment in proceedings. I know—I have learned a huge amount in this process—that there are many mechanisms already available for sharing treatments, but they are far from being available to all medical practitioners, and in my view they are insufficient. Besides that, there is no comprehensive database of treatments that are not regulated under the Medicines and Healthcare Products Regulatory Agency; there are just many smaller ones, such as registries for specific diseases or databases for particular regions.
For example, the most recent figure I could find for the total number of registers used by medical professionals is from 2002. Back then the Department of Health commissioned a report into disease registers in support of the White Paper, “Saving Lives: Our Healthier Nation”. The report found that there were well over 200 registers in existence in England. The number of disease registers already in existence in England was obviously large, although possibly larger than was generally appreciated. Even though the review was not exhaustive, it identified about 250 registers. The report stated:
“We would not be surprised if there were more than 400 specific registers in existence in England.”
That rendered the situation on data collection at best confusing, and at worst it makes finding evidence and navigating through that data almost impossible. I hope that the database set out in the Bill will provide clarity through the vast web of registries, information and data that already exist and help clinicians find evidence for innovative treatments simply and quickly.
That is particularly important today, because research has come on in leaps and bounds, meaning that a huge number of new treatments are coming into the NHS and innovative ideas are everywhere. There is great potential for what this could do. South London and Maudsley NHS Foundation Trust has developed a computer system that allows it to carry out research using the information from the trust’s clinical records. The system is known as the clinical record interactive search system, and it is anonymised. It is hoped that it will make a very real and positive difference to future treatments and care. The system allows clinicians and researchers at the hospital to look at real life situations in large quantities. This makes it easier to see patterns and trends such as what works for some and does not work for others. For example, case registers have been used extensively in mental health research, which was commented on earlier. Recent developments in electronic medical records and in computer software to search and analyse these in an anonymised format have the potential to revolutionise this research tool. The case register has been hailed as representing a new generation of this research design, building on a long-running system of fully electronic clinical records and allowing for in-depth analysis of data while preserving anonymity through technical and procedural safeguards.
Historically, medical records of some kind have always been kept. In keeping with the tradition of careful, methodical scientific observation, they have frequently been developed into disease registers through which the incidence, course and health service use of specified diseases can be monitored and investigated. In the context of changing social, political, professional and technological factors, a large number of psychiatric registers were constructed throughout the 20th century. However, owing to the expense of maintenance, often then carried out manually, the limited information available, which relied on data sheets completed by clinicians in addition to their routine workload, the practical difficulties of monitoring data quality, and limited funding, many of these programmes closed, and a vast amount of the information collected, which could have been useful, was lost.
Now we live in a time in which rapid technological advances and other developments over the past decade have led to new possibilities for the development of data-sharing. With electronic clinical records increasingly complementing handwritten notes, large volumes of clinical information are contained in an electronic format. The possibility of what we can do with this is unbelievably exciting. So far, we have not really harnessed the data that we already have. There is so much potential to make great changes, and this Bill is a tiny pigeon step in the right direction.
There has obviously been a huge amount of interest in this Bill from a whole host of groups. Some have concluded that the database is not needed, some have concluded that it is a good idea, and some have raised a number of questions about it. I would like specifically to thank the Association of the British Pharmaceutical Industry for its briefing on my Bill, which was circulated to Members of Parliament this week. It states its concern that the Bill will promote the prescription of unlicensed medicines and says that that is worrisome because there is hierarchy of risk involved with prescribing off-label and unlicensed medicines that makes unlicensed treatments the more risky route. It is completely correct. Promoting the prescription and use of these treatments when that is best thing to do for patients, is, I would like to think, exactly the sort of information that the Bill will share around the place to enable people to do the best thing.
With the amendments tabled today, the Bill promotes treatments in clinical trials, which are by their very nature unlicensed, as well as off-label drugs, other licensed but perhaps underused or very new treatments, and other unlicensed treatments. Clearly, it will not change the fact that, under MHRA guidance, more risk is involved when using unlicensed drugs. This, rightly, will remain the case, as these drugs have not received regulatory approval and are not yet deemed safe for use. No guidance or law of liability is changed at all by this Bill, with the tabled amendments. However, the Bill will spread information behind how these drugs are being used and allow responsible registered medical practitioners to access more information, much more quickly, to make better decisions for themselves.
The ABPI also wrote that the database undermines the UK medicines regulatory system and gives doctors the ability to prescribe unlicensed or off-label medication. As I have said, that is perhaps not terribly bad, but I would like to think that we are not undermining any regulatory system. The Bill simply does not contain provisions that would do so. I want to give the ABPI some help with its questions, and I would like to think that this debate—the points made by the Minister about how he will use the power, and those made by hon. Members on both sides of the Chamber underlining the cross-party nature of the provisions—shows that the Bill is worthy to be sent by this House to the other place and that it will do patients, registered medical practitioners and our NHS the world of good.
Nick Thomas-Symonds
I echo what the hon. Member for Daventry (Chris Heaton-Harris) has said about the cross-party work, thanks to which the Bill is now in its current state. I again put on the record my thanks to him for his flexibility, and to the hon. Member for Bury St Edmunds (Jo Churchill) for her impassioned contribution.
I am delighted that amendments 10 and 13 have been agreed to, because it is extremely important to include off-label drugs in the Bill. I am very pleased by the Minister’s positive response to those amendments. I want, if I may, to make one request of the Minister. I did not press my new clause 5, on the accessibility of the licensing process. Will he write to me specifically about that? I would be extremely grateful for some clarification about precisely what the measure will be. Will he, in his closing remarks, confirm that he will do so?
I want to put on the record my thanks to the charity Breast Cancer Now, and particularly to Jenny Goodare of that charity, who has done a great deal of the facilitating work. I also thank my parliamentary assistant, Briony Robinson. Her father, who is in fact an oncologist, has also made a great contribution to all the work on the Bill.
Ultimately, the work that has been done, especially during the winter—I made the point earlier that no fewer than eight political parties were represented by those who signed new clause 1—demonstrates the very broad swathe of opinion both in the House and beyond. Whatever side of the House we sit on, we all come into politics to try to make a difference. I sincerely hope that what we have done today will make a significant difference.
I look forward to holding the Minister to the promises he has made. I have no doubt that the hon. Members for Bury St Edmunds and for Central Ayrshire (Dr Whitford) and I will continue to be rigorous in ensuring that that is the case. I just hope that the Minister will be ambitious in the measures he has said he will bring forward.
Anne Marie Morris
I once again congratulate my hon. Friend the Member for Daventry (Chris Heaton-Harris) on bringing forward the Bill. I am sure I will not be the first to tell him what a feat it is to get a Bill through this House, with all its complexities, to Third Reading. Clauses 1 and 2 will give many people throughout the country hope that there is a cure for many well-known and not so well-known diseases. The database will make it much easier for clinicians up and down the country to find them and provide a better quality of life for many people.
I commend my hon. Friend for the time he has put into the Bill, and the effort he has made to obtain cross-party support on a number of issues. His work with the hon. Member for Torfaen (Nick Thomas-Symonds) to include some of the provisions of his Off-patent Drugs Bill is to be commended. Although I did not support all the hon. Gentleman’s amendments, I do believe, as I stated on Report, that amendments 10 and 13 will help many people to live healthier and happier lives for years to come. I therefore congratulate him on his contribution to this Bill.
Some great medicines have been developed through the use of off-label treatment, and I believe that they will continue to be developed, even without the new clauses that the hon. Gentleman tabled. I do not profess to be an expert in the field of off-label treatment, but I know that drugs such as infliximab, adalimumab and methotrexate are now regularly used in the treatment of Crohn’s disease and ulcerative colitis, having previously been used to treat rheumatoid arthritis and cancer. The use of those treatments has come on leaps and bounds over the past 10 years, and that in an environment where, it is claimed, doctors are scared to innovate. As I have stated, I do not profess to be an expert in these matters, but I do know that many doctors communicate not just countrywide, but across the boundaries of diseases, and learn from each other. The database that the Bill establishes will allow that to be achieved with much greater ease.
A member of my office staff has been fortunate enough to benefit from the drugs that I have just mentioned. Indeed, he informs me that he was one of the first people, if not the first person, to be given the drug adalimumab to treat Crohn’s disease. He was prescribed it in Southampton back in 2007, when it was not licensed for use in children. Had the doctors not taken innovative steps to prescribe a medicine that had not yet been licensed, he would not have had such a fulfilling life—something that many of us take for granted. That is just one example, and I am sure that Members across the House have many more examples of doctors using innovative medicines to help out constituents and loved ones with all manner of diseases. I am therefore delighted to support the Bill on Third Reading and the great work my hon. Friend the Member for Daventry has done to get us here.
Heidi Alexander
It is a pleasure to follow the hon. Member for Newton Abbot (Anne Marie Morris) and my hon. Friend the Member for Torfaen (Nick Thomas-Symonds).
In opening this debate on Third Reading, the hon. Member for Daventry (Chris Heaton-Harris) said that it was something of a relief to get to this stage. I have to say that I agree with him. I congratulate him on getting his private Member’s Bill through to its Third Reading. His commitment to the Bill has ensured that the crucial issue of improving access to innovative treatments and medicines has been debated in detail on the Floor of the House, which is a good thing.
I am conscious that we have already spent considerable time today debating a Bill that is now relatively straightforward, so I will keep my remarks brief. In short, the amendments that have been made today have made the Bill safer and have focused it on the area that the hon. Gentleman feels most passionately about—namely, the power to create a database.
Although I still question whether legislation is needed to give the Secretary of State this new power, the Bill is a vast improvement on what it was previously, and I will not oppose its Third Reading. I am sure that the other place will take a keen interest in scrutinising the Bill, as it has had extensive debates on this subject in the past and, indeed, on similar private Members’ Bills.
I urge the Minister to think very carefully about the design of the database. Even if he does not wish to broaden the list of statutory consultees, I hope that he will engage with the medical profession and other stakeholders to ensure that he gets the database right.
I congratulate the hon. Member for Daventry once more on navigating the Bill to this stage and on taking account of the very real concerns that I and many others have expressed to him.
George Freeman
May I share in the sense of relief? I, too, congratulate my hon. Friend the Member for Daventry (Chris Heaton-Harris). As others have said, it is no mean feat to steer a private Member’s Bill through this House. For all sorts of very good reasons, there are many obstacles to doing so. The process is designed to ensure that only those Bills that command a majority, if not unanimous support, and that clearly address something that the House feels is a priority make it on to the statute book. He has achieved something remarkable in getting this far, although he is right to emphasise that he has only come this far and that the Bill now goes on to the upper House. I pay tribute to his work. Everybody here has acknowledged the quiet, careful, considerate decency and tenacity with which he has got around and listened to people.
I genuinely believe that the Bill will be a powerful mechanism in the new landscape of personalised and precision medicines that we are developing in this country. It will help busy clinicians on the frontline of our health and care sector by making easily available at the click of a mouse information on innovative medicines—both new medicines and innovative uses of existing medicines—that they can prescribe or recommend to their patients.
It is a pleasure to have reached this point, having embarked—somewhat bravely, some of my officials might have said—on a process of supporting the intentions behind three Bills that the House has considered over the past 18 months. I have been determined to work with Back Benchers to reach a solution that the House and the Government could support.
The Bill captures the spirit of two others: the Bill tabled in the other House by Lord Saatchi, which was intended to promote a culture of innovation and innovative medicines in our health system, and the Off-patent Drugs Bill tabled by the hon. Member for Torfaen (Nick Thomas-Symonds), which was intended to promote greater use of off-label and repurposed medicines. My hon. Friend the Member for Daventry intends to promote greater access to information. I pay tribute to all three people, because their work in initiating their Bills has led to the House reaching unanimity.
I thank and pay tribute to the hon. Member for Central Ayrshire (Dr Whitford). Ministers do not always agree strongly with Scottish National party Members, but it is nice to be able to do so on this occasion. She brings to the House a lot of expertise in her field as a medical specialist, and she has played an important role in bringing the Bill to this point. I also thank my hon. Friend the Member for Bury St Edmunds (Jo Churchill), who brings her own experience of surviving cancer and a passion for the subject. The Members I have mentioned and others who have spoken today and in earlier debates have brought us to a much better place, with a Bill that commands and deserves respect and support.
I want to say something about Lord Saatchi, who commenced the debate on this subject. Passing legislation through Parliament is always a messy business. The anti-slavery campaigners took years, and all sorts of legislation that we can look back on with great pride had previously fallen at various hurdles. It takes tenacity to make things happen. This is not the same Bill as Lord Saatchi’s and it does not tackle the issue that he wanted to tackle of some clinicians fearing negligence cases, but I believe that it tackles the central issue that he was trying to address by creating a culture that promotes greater use of innovative medicines. I believe that he has secured, in his way, a legacy for his late wife Josephine that he can be proud of.
Lord Saatchi and Members who have spoken today have become part of a growing movement of patients, charities and campaigners who want us to accelerate access to innovative medicines. I often hear demonstrations from my window in the Department of Health, with patients sometimes chaining themselves to railings. I have yet to hear a demonstration asking us to take longer to regulate and assess drugs and bring them to market. Indeed, the demonstrations that I have heard in the past year have been by patients asking for quicker access to medicines. Mothers whose children have rare diseases have been asking why we are not moving more quickly to bring genomically and infomatically targeted medicines to their children. I have taken part in more debates on this subject than on any other in the past year.
I want to mention a number of people who, appropriately, have been referred to today, including the late Les Halpin. He founded Empower: Access to Medicine with a passion that his death would not be in vain and that his experience of dying from a rare disease would inspire and motivate others to invest more in research and accelerate innovative medicines being brought to patients. The campaign, which was started for him, is continuing to grow and build support for the agenda that we have discussed today.
Graham Hampson Silk has also been mentioned. Ten years ago, he was given four years to live, but because of the extraordinary work of NHS clinicians and NIHR researchers at the Birmingham Institute of Translational Medicine, led by the inspired Professor Charlie Craddock and supported by Cure Leukaemia, Graham is alive. He is using his life to campaign for quicker access to innovative medicines. He is alive because Charlie Craddock got him access to a drug that was in research in America, raised money and flew Graham to the States, and then got the drug into the Institute of Translational Medicine. In fact, that institute has pulled into the greater midlands area more than £20 million of free drugs in trials.
I should mention Emily and a number of the other mothers who have been to my office on a number of occasions in the past six months to discuss muscular dystrophy and Duchenne. The extraordinary progress of our medical community in genomics and informatics unlocks new treatments, but the mothers and fathers of children with rare diseases look on with frustration that we are unable to get the insights to benefit their children and families more quickly. As the first Minister for Life Sciences, I am driven every bit as much by their advocacy, passion and commitment.
The truth is that a lot of people are not interested in this space until they get a diagnosis or until someone in their family gets a diagnosis, at which point people become very interested in research, data and genetics. I am very pleased that their names and a number of others have been mentioned. My hon. Friend the Member for Daventry has struck a small blow in the march of that army for accelerated access to innovative medicines.
I want to say something about the landscape in which the Bill will land, the leadership that the UK is showing to create that landscape and the changes that will benefit patients and our NHS. The truth is that the traditional model of drug discovery is breaking down in front of our very eyes—the very long, 15-year, $2 billion process by which traditional pharmaceutical products are developed and brought to patients. That is too long for the industry and patients, and it is too expensive. Increasingly, the breakthroughs in genomics and informatics mean that drugs can be developed for specific patient groups around specific genetic biomarkers with much greater precision and be brought into the system much more quickly. They do not have to go through 15 years of randomised control trials when there is a genomic biomarker that guarantees they will work in certain patients and informatics to support that claim. That allows us to get medicines into targeted groups much more quickly.
That quiet revolution, which the UK is seeking to develop through our various initiatives, is principally driven by two transformational technologies: genomics and informatics. Genomics allows us to understand the cause of so many diseases—in many cases, the cause is inside the cells in our bodies—and to understand, at scale, why different patients respond to different drugs and why they respond to different diseases in different ways. It also allows us to centre our research on the experience of real patients with real diseases in real time.
Allied with informatics, that allows us to use the NHS to look at huge datasets of patients over the past 20 or 30 years, which is an incredibly powerful resource. Large-scale anonymised data allow us to identify patterns. When we re-analyse the data, we find that many of the drugs that have failed in traditional drug discovery, which could happen because of a side effect, a serious side effect or a death in the late stage of trials when the drug is trialled in the largest number of people, are dream drugs for a small sub-segment of the population. Part of that revolution is about allowing us to identify which patients would have responded much more quickly, which cuts down the time, cost and risk for companies in developing and thus reducing the price. It also cuts down the time that patients have to wait and to have more accurate dosing—we can get the right drug in the right dose to the right patients more quickly.
Mr Peter Bone (Wellingborough) (Con)
I put on the record my thanks to my hon. Friend the Member for Daventry (Chris Heaton-Harris) for his success in driving the Bill through. I have heard only today that a constituent of mine is getting a treatment for prostate cancer earlier because of the Minister’s intervention. I am sure that that is part of what the Government are driving. I wanted to thank him for that while I had the opportunity.
George Freeman
My hon. Friend is very kind. I thank him for his comment and am very pleased to hear that news.
We are putting in place various initiatives to support the new agenda, and seeing the beginnings of some successes. On the request made by the hon. Member for Torfaen, I will be happy to write to him about the proposals and how we envisage the measure working. There is quite a lot of work to be done on how the process of using a NICE evidence review to assess the evidence for an off-label claim. I am not prevaricating for any reason other than that I do not want to pre-empt that work, which we are getting on with.
Nick Thomas-Symonds
I am grateful to the Minister for that. New clause 5 was also about easier access to the licensing process itself, on which I made a few suggestions on Report. If the Minister addresses that specifically when he writes to me, I will be very grateful.
George Freeman
I will happily come back to the hon. Gentleman on licensing. We have discussed this at some length, but I am happy to confirm the situation. There is a very strong legal set of constraints on how we handle licensing, but I will happily write to him to confirm the position.
I would like to respond to the request, by the hon. Member for Lewisham East (Heidi Alexander) from the Opposition Front Bench, to take very seriously the design of the database. I agree. We need to make sure it works well. Datasets are already available, but we need to connect them up better to give clinicians the right information they need. I am absolutely happy to give an undertaking to engage very closely with the medical profession, and all who have taken an interest in the Bill, to ensure this measure has the intended effect. I also give an undertaking to the House that I want to put the patients’ voice right at the heart of this and to invite the Association of Medical Research Charities and others, as we put the proposals together.
I want to take up the point raised by my hon. Friend the Member for Wellingborough (Mr Bone) and update the House on the range of initiatives, which the database will sit in the middle of, that we are putting in place. As the landscape for drug discovery changes profoundly, the Government are intent on making sure the country leads in this new model of personalised, targeted, patient-led research, moving from a world in which a drug is traditionally developed around a notional theoretical target that is normally developed in an academic laboratory and then, if it is lucky, put through a process to raise money and be spun out or partnered. That original target is turned into a drugable target that a pharmaceutical company can make a drug against. The early synthetic chemical compounds are tested against vast libraries. With luck, they are taken through pre-clinical testing and extensive in vitro and in vivo testing. They then go “over the wall” as the industry refers to it, into development to phase 1, phase 2, phase 3 and phase 4 trials, through MHRA and European Medicines Agency safety approval, to NICE for health economic approval and then to the NHS to decide how to best use the drug.
That landscape still works for many drugs and is still the conventional system in which drugs are developed. In truth, however, the breakthroughs in genomics and informatics mean we can, and are, developing a different landscape. The Government are investing in the cell therapy catapult and the precision medicine catapult so that we lead in academic research, working with industry partners on the new model of personalised and precision medicine. It is why we set up the biomedical catalyst to support quick funding for small companies and academic groups developing key technologies in this space.
It is why I am delighted that we announced, in the autumn statement, ring-fenced funding for the Medical Research Council and the other research councils. That budget is now £700 million a year for leading research around the UK. It is why we confirmed the £1 billion-a-year commitment to the National Institute for Health Research, an embedded clinical research network at the heart of our NHS all around the country that is the jewel in the UK crown, and the establishment of the NIHR Office for Clinical Research Infrastructure, allowing innovators internationally to come in and work in our research hospitals. The progress of NIHR means we now have over 200 industrial studies on new medicines in the UK. We are increasing year-on-year the number of patients enrolling on clinical trials, including, importantly, first-in-man and first-in-patient studies. The UK is now going back up the international league for drugs having their first exposure to people, here in the NHS and the NIHR.
It is why, on informatics and genomics, we launched the Genomics England programme. In 2012, the Prime Minister announced that we would be the first nation on earth to sequence 100,000 entire genomes—those of NHS patients—and link them with their hospital records. The project has captured the world’s imagination—I have called it the NASA of 21st biomedicine—and triggered phenomenal academic and industrial investment in the UK. It is already driving new diagnostic insights into rare diseases and insights into how we can use existing medicines better.
It is also why we have invested in the clinical practice research datalink and the aggregating of the NHS’s long-term cohort studies. These are phenomenal resources for research. Before coming to the House, I was involved in one, funded by the MRC and Cancer Research UK, that involved 250,000 women at risk of ovarian cancer. As a part of that, we collected blood, tissue, genomic and medical record information. I am proud that, after the academic study was finished, a group of medics at University College London, along with MRC Technology, UCL Ventures and CRUK, used that database to form a company called Abcodia Ltd, an ageing biomarker company. The database contains biomarkers that allow us to diagnose not just cancers but a range of diseases in ageing women much earlier. The scale of that dataset allows us to lead.
My hon. Friend the Member for Daventry mentioned Professor Simon Lovestone, at King’s College London, who led the world in the use of informatics and integrated medical records in mental health and who has now gone to Oxford University to pioneer that work. The Government are investing in genomics and informatics because it is a transformational technology that is changing the way drugs are developed.
I want to entice the House to think about where this might go and the direction the Bill points us in. This new world is coming fast. The first genome to be sequenced, 10 years ago, cost £10 billion. It now costs $5,000 and can be done in 24 hours. Not least because of the leadership of Genomics England, it will soon be possible to do it in minutes for a few pounds and pence. That will allow the NHS, when patients arrive with cancer, rare diseases and, increasingly, any disease, to identify the right genomic diagnostic and profile the right treatment and drug much more quickly. When a patient arrives, whether at a GP practice, hospital or clinic, we will, in due course, be able to do a quick and easy genomic diagnosis.
Thanks to the Bill, front-line clinicians will be able much more quickly to identify innovative drugs from which their patients might benefit. That will not happen overnight; it will not happen by Easter; it will not happen by the end of this parliamentary Session, but it is a quiet revolution of 21st century medicine that we are leading, and data and information sit right at its heart. My hon. Friend has taken three Bills that were generating more heat than light, crystallised their essential purpose, which was noble and well-intended, and brought them together in one Bill. I hope that it will be treated in the Lords in the way that this debate and cross-party consensus invite and that it will not be significantly re-amended, not least because, if it is, it will probably run out of time to reach the statute book.
Many people comment that the House spends too much time doing yah-boo politics for its own sake. Today, we have struck a blow for joined-up government and parliamentary process. It is wonderful to see MPs from all mainstream parties—I have not heard anything from UKIP—in support of a measure that offers real benefits for patients and front-line clinicians, without undermining the latter’s clinical sovereignty over patients. It is about giving them information, so that they can make the exquisite clinical judgment we all want them to make. I am happy to commend the Bill to the House and to congratulate all those involved, and I am delighted to have done my bit to help strike a blow for joined-up government.
Chris Heaton-Harris
On a point of order, Madam Deputy Speaker. Would it be in order for me to thank Abigail Bishop-Laggett, my member of staff who has worked so hard on getting the Bill to this point?
Madam Deputy Speaker (Natascha Engel)
That is a very nice comment, but not a point of order.
Question put and agreed to.
Bill accordingly read the Third time and passed, with amendments.
Child Victims of Human Trafficking (Central Government Responsibility) Bill
(8 years, 9 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Peter Bone (Wellingborough) (Con)
I beg to move, That the Bill be now read a Second time.
I am delighted to follow my hon. Friend the Member for Daventry (Chris Heaton-Harris), who has piloted through such a successful Bill. I would like to pick up, in general terms, on what the Minister for Life Sciences said at the end of the previous debate, which is that it proves what Back-Bench MPs can do when they work together to achieve something. I want to talk about that a little more in relation to human trafficking and my Bill. It is only three clauses long, but it goes to the heart of the problem we have with human trafficking and modern-day slavery. However, I need to set it in the wider context of modern-day slavery and human trafficking.
Way back when I was first elected as a new Member of Parliament in 2005, the Labour party was in government, and at one of my constituency surgeries on a Friday I got a note through the door. It was anonymous, but the person who wrote it was a prostitute from Northampton who was very concerned at what was happening to young women who were being brought into this country—we now call it trafficking, but at that time people did not talk about it. I thus became aware of this issue and I then met someone called Anthony Steen, who at the time was Member of Parliament for Totnes—a most extraordinary person. He has changed the view of trafficking and modern-day slavery not only in this country, but across the whole of Europe. He formed the all-party group on human trafficking and modern slavery, and I was one of its officers.
At that time, the Home Office under the Labour Government did not really recognise that trafficking existed.
Mr Bone
I am going back many years. [Interruption.] I am going to develop that point. I am not blaming anyone in particular other than the Home Office—of course, everyone will agree with that—and I am not really blaming the Home Office. It was just that people did not understand the issue. Indeed, if we went back to the days of what people might think of as traditional slavery, I am sure people would have denied it existed. It was only because of what William Wilberforce and others did that people got to know more and more about it. Indeed, I quite confess that when I came to Parliament, I had no idea about human trafficking or modern-day slavery, and I certainly did not think I was going to get wrapped up in trying to solve the problem.
Anthony Steen and a small number of us travelled all over Europe, to places such as Moldova—to places that, to be honest, I had not even heard of—and found out about this terrible, terrible crime being committed of people being trafficked across borders. In those days it was mainly for purposes of sexual exploitation, although it has now turned into labour exploitation.
The traditional way for these women—we call them women, but in many cases they were actually young girls, way under the age of 18—in very poor countries such as Moldova to be trafficked would be for somebody of their own age, quite often a female, to befriend them. They would then tell them there was a job in Belfast, say, in a restaurant—this is from a true case, from one of the dependencies of the old USSR. These women would come over expecting to work in a restaurant—and there was, indeed, a genuine restaurant. Because of the free movement rules in the European Union and Schengen, they would not be checked, but could come straight across Europe and into this country, and although I really do not want to make a European Union point, I will. Years and years ago, a long time before all this stuff appeared in the press, we warned that while free movement might have many advantages, it was certainly of great advantage to the traffickers, because there was very little chance of their being caught.
This is what would happen. The girls would arrive, all happy, looking forward to—in this case—a job in a restaurant in Belfast, and looking forward to a better life, more money, and excitement. Those girls never actually made it to the restaurant. They were locked up in a terraced house in Belfast. I say “locked up”. One would expect the lock on a bedroom door to be on the inside, but in houses such as that one they were on the outside, so that the young women could be locked in.
Andrew Griffiths (Burton) (Con)
I know that my hon. Friend could not resist making the Europe point. Will he explain something to me? I entirely understand his point about Schengen, but how did the girl manage to travel from the Schengen area to the United Kingdom without being stopped at the border?
Mr Bone
My hon. Friend has made a good point. Years ago, before I came to this place, I ran a travel business which had an operation in Florida, and I would quite often fly over there with new members of staff who were young girls. So there was a middle-aged man taking two or three young women across to America. Every time we arrived, we were stopped at immigration, and the women were taken away and interviewed to establish whether this was a genuine operation and I was not actually trafficking people. We used to get parents to write letters, and so on. But those immigration authorities did a proper, thorough job.
As for our borders, citizens of the European Union have a right to come here. It was not as though those girls were breaking any immigration rules. This is not about immigration at all. They had an absolute right to come into this country, because they were EU citizens. I have always argued that, in obvious cases like that, we should be much more willing to take people to one side and find out whether the operation is genuine or not. The trouble with this operation, however, was that it looked as though it was genuine because the girls were going to a Belfast restaurant to work.
I think that about 70 young women went through that process, and were locked into the terrace house. I do not want to use the word “rape” lightly but they were, in effect, being raped repeatedly. They were not in a position to escape, they were not giving permission, and there was no question of their earning any money. Eventually, those young women were rescued. In that instance we did something really well, but I am afraid that we are still doing something rather poorly.
When I was a member of Anthony Steen’s group, I discovered that there was a Government-funded centre in London—it was, in fact, funded by the Ministry of Justice—which was run by a left-wing organisation. All the trafficked victims were supposed to be accommodated in 24 beds, which is laughable, because there were so many more victims than 24. There was quite a big row about it at the time, and it is to the Government’s credit that they changed the policy. They took the money away from that organisation and gave it to the Salvation Army. They said, “Work with all sorts of different agencies around the country, religious and non-religious, and they will give you added value. If Newcastle, for instance, already has a hostel that is able to look after trafficked victims, why not give it some money, and then you will have that added value.”
The system worked terrifically well. The money started with £1 million, and despite the huge economic downturn that we have experienced, that amount has increased to, I believe, about £3 million. Adult victims of human trafficking are really well looked after. We must remember that an 18-year-old girl who has gone through this trauma cannot be just put in a house; they have to be looked after. The trauma is enormous and they must overcome that. We do that really well, and the Government, and the Prime Minister in particular, should take great credit for it. The Prime Minister has shown great courage on the human trafficking issue, but the problem comes with how children are looked after; they do not go into that system, and that is what I am trying to solve with this Bill.
The Parliamentary Under-Secretary of State for Refugees (Richard Harrington)
I feel I should say at this stage that Anthony Steen’s operation is based in Watford in my constituency, and I am very familiar with it. I was going to say this as part of my concluding remarks but, time being as it is, I felt I should say now that not just he but all the different umbrella groups in the anti-trafficking field are housed in the building above Watford Junction station, so I see him quite a lot. I know my hon. Friend is part of that, and Sir John Randall introduced me to him in the first place, and I think it is a wonderful organisation.
Mr Bone
I am very grateful for the Minister’s intervention, and I am very glad that we have this particular Minister at the Dispatch Box, because I know he has worked with Anthony Steen and John Randall on this issue, and I greatly appreciate that.
The Government have done exceptionally well. John Randall is, of course, one of our ex-colleagues in this House. I remember that in the Corridor upstairs we had what we called an exhibition, but it was a role play about human trafficking and his son played a trafficker—very convincingly, as well—and that brought home to Members just how under the radar this situation is.
Mr Steve Reed (Croydon North) (Lab)
When the POPPY project, which I believe was the organisation the hon. Gentleman was talking about, lost its funding, some of the successor organisations were criticised for putting rescued women in mixed-sex hostels, which was deeply inappropriate.
Mr Bone
There was a big row about the POPPY project and I am broad-brush about this: I think the Salvation Army operation has been a huge success, and I am absolutely convinced that no other country in Europe looks after rescued adult victims of human trafficking better than ours, and we can be very proud of that.
Let me rewind a bit to when I was traipsing around Europe with Anthony Steen. He is a man it is impossible to say no to; I have seen him blag his way into all sorts of establishments that we had no right to be in, and he did so fearlessly. In some places he talked to traffickers and took great personal risks. His influence is what drives me to continue this fight on this particular issue.
At that time, back in 2005, there was a Council of Europe convention on human trafficking. The COE is a very good body. It brings together 47 countries in Europe. The idea is that if we can get something through the COE that everyone agrees with, it is a really good standard. What happened to this convention happened when a Labour Government were in power, but I am absolutely not blaming the Labour Government because it equally would have happened if a Conservative Government had been in power at that time because of the way people looked upon human trafficking: we could not even get the convention signed. Then, after lots of pressure, the convention was signed, and then that turned out to be no use because until it is ratified, it does not come into force, so then we had a fight on that and it was eventually ratified.
Many of the things that were then discussed became part of the Modern Slavery Act 2015, such as tougher penalties for traffickers, quite rightly. There was originally a problem with the hurdle that had to be mounted to prosecute traffickers. The Crown Prosecution Service had decided that in order to get successful prosecutions, it would have to go for lesser charges. That was sorted out; traffickers can be jailed now for 14 years. Tougher border controls are hugely important, too, because I do not want to be punishing traffickers and rescuing victims, as I do not want them to be victims in the first place. There is a lot to do in Europe on that, but obviously, our border control is important. In a wonderful example of co-operation, the Metropolitan police and the Romanian police worked together and broke up a notorious gang and saved many people from being trafficked. Police operations all come down to intelligence and working together across Europe.
Mr Christopher Chope (Christchurch) (Con)
Does my hon. Friend accept that there is not just an issue with border controls, but a lot of concern about forged documents and passports? There is a report in today’s press that the United States is thinking of withdrawing its visa waiver scheme for some European countries—for example, for Belgium—because there are up to a million forged EU passports in circulation.
Mr Bone
My hon. Friend is quite right that this is not, as I have portrayed it, just a European Union issue. I wanted to use that example because I did not want to get into the arguments about immigration and migration control. People from the EU have the right to be here and can be trafficked, but of course human traffickers operate across the world. Traffickers bring people in from Nigeria, and use all sorts of terrible things to keep them in prostitution. If someone were in a town and forced into prostitution, one would think that there would be ways for them to escape, and there probably are, but they are under acute mental pressure. They may be told that their parents will be killed or that their children will be harmed. If they come from Nigeria—this may seem strange to us—voodoo spells may be used. All those things have to be dealt with, and we are beginning to deal with them. The problem of forged passports is important.
I do not accept what the Home Office used to say, which is that if we create a safe environment for people who have been trafficked, it will be a pull factor. That is complete and utter rubbish. People can come in and claim asylum anyway. They do not need to pretend to be trafficked; there is no advantage to that at all, and I really reject the idea. There are more slaves today across the world than there were in Wilberforce’s time; it is just that we do not see them on the docks. Great credit should go to the Government for what they have done in this regard.
Going back to the Council of Europe situation, a good convention was eventually signed and ratified. One thing we wanted for the protection of people who have been trafficked was the appointment of a rapporteur —I would say a commissioner because the word rapporteur sounds far too “European Union” for my liking. We had a long battle on that with the Government. By this time, we were in the coalition Government. A cross-ministerial group was appointed, which was complete rubbish. We knew that by how many times the Ministers bothered to turn up. It was a complete farce. We had a battle on that. MPs from both sides of the House and from all parties—the hon. Member for Foyle (Mark Durkan) was a great support—called Westminster Hall debates to put pressure on Ministers and to ask lots of questions. That all followed on from what Anthony Steen did.
When I first came to the House, Anthony Steen was the only person doing anything, and then everybody started to realise that there was a problem. People may think that the Government make all their decisions in Downing Street and that we are just here to tick the boxes, but it was not like that, and we proved that with the previous Bill. On human trafficking, it was absolutely not like that. Private meetings went on, and so on. We finished up with a Modern Slavery Act 2015, which increased the penalties for trafficking, toughened border control and improved the rights of victims to prove that they were victims, which is a complicated thing, but we did not deal with the situation of child victims. We dealt with victims, but forgot that there was a huge loophole.
Members will recognise that probably every week in their constituency advice surgeries, they have someone in front of them who is clearly in need of help and social care. The problem is that the health service says the person needs social care and the local council says the person needs social care, but they blame each other for not funding it. I will develop the argument a little later.
Adult victims of human trafficking are a central Government responsibility, that of the Ministry of Justice. Unbelievably, children who are victims of human trafficking finish up in local authority homes and, bizarrely, are indirectly the responsibility of the Department for Education. How that works I have no idea. In fact, it does not work.
I do not know of any legislation in which we deliberately set out to treat adults better than children. I return to my example of the 18-year-old who was tricked into coming to Belfast and started off in the restaurant but finished up in a terraced house. It must be an horrendous experience to be repeatedly raped, and many of those people come from countries in central Europe that are deeply religious.
Mr Steve Reed
The hon. Gentleman is making a powerful case against what is going on, but is he aware that, according to the police, the most common route by which men who want to abuse women find them is through classified ads—small ads—in local newspapers? Does he agree that Government organisations and publicly funded bodies should seek to exert pressure on those newspapers to abandon carrying such adverts by withdrawing state funding if they refuse to do so?
Mr Bone
I am grateful to the hon. Gentleman for raising that important point. It is interesting that the front of the paper will damn human trafficking, and the back of the paper will advertise it. That used to be true, but now advertising tends to be on the internet.
There has always been an argument—I take no view on this—that if prostitution is banned, as has happened in Sweden, human trafficking will stop, and if prostitution is legalised, if I may use that term, as in Holland, there will be human trafficking galore. The truth is, as the record shows, that it does not matter—there is human trafficking in Sweden and there is human trafficking in the Netherlands. People feel very strongly about the issue of prostitution, which is quite right, but to say that if it is banned it will stop human trafficking does not meet the facts. We have to accept that whatever happens we will have to deal with human trafficking.
The slight worry about the Swedish model is that because it happens underground, there is even less likelihood of prostitution being detected and the girls may be subject to even worse treatment than where prostitution is open. I have no view on that, other than to say that the evidence is clear that trafficking carries on in both countries.
Returning to the Belfast situation, human trafficking is usually discovered by members of the public. Neighbours who live in the street suddenly realise that there are a lot of men going into the building at all hours and they never see the people who live there. So they report it to the police and the police raid the property and rescue the girls, at which point the support kicks in, which is what my Bill deals with. The problem is that although those girls might be rescued, the 70 who went before have been moved on.
The frustrating thing about this is that the gangs that do the human trafficking are the same people who do drugs and guns. They know that human trafficking is a better deal because once drugs have been used, they are used up, but a girl can be sold on, time and again. I will tell the House about something that used to happen at Gatwick airport. A girl would come through border control and be met by someone. They would sit in a coffee shop and other men would bid to buy her. That was happening a few years ago.
What frustrates me—I have had this argument with the Government—is that we put a huge amount of resources into fighting drugs and guns but only a tiny amount into fighting human trafficking. That needs to be addressed. We need to put more money into police intelligence operations, because that is how they discover where the gangs are. When we break these gangs up, we are breaking up the drug and gun gangs at the same time. These are not nice people. They are extremely evil. Also, there are often family organisations involved.
Let us say that some girls come over from Hungary. They come across Europe without any border checks and into this country without any border checks. They arrive in Belfast and work in a restaurant for perhaps two days before being put into prostitution. The argument the traffickers use is to tell the girls that they have to do this to pay back the debt—a made-up amount—that they have incurred in being brought over to this country. This is patently evil.
It is difficult for me to imagine the trauma that these young women go through, but it is absolutely awful. Many of them have never had sex before. There is a case on record of young girls being brought together in a house by a Russian gang for the purpose of human trafficking and one of them refusing to do as she was told. You know what? They executed that person in front of the rest of the girls. Should we not be putting more money into dealing with these people? I think we should.
Let me talk about the problem as I see it. I really want to praise Members on both sides of the House, and particularly the Prime Minister, for what we have already done on human trafficking and modern slavery. The Modern Slavery Act 2015 would not have become an Act if the Prime Minister had not made it a priority. We did so much, but we missed this one thing and, my goodness, it is the old problem of central Government, local authorities and empires.
Let us take as an example a 19-year-old girl who, having been rescued, is looked after by the Salvation Army. In due course, she will become a responsible citizen of this country. But what happens to a 15-year-old child who has never had sex with anyone before but is now being repeatedly raped? What trauma is she going through? Thankfully, the police rescue her, but what is their duty at that point? They have to hand her over to the local authority. There is no requirement for the local authority to recognise her as having been trafficked. It just treats her like a missing or homeless child. There is no special care for her, and that is wrong. These children have been traumatised. They have not simply run away from home because they have had an argument; they have been through the most brutal experience and they need specialised care.
A few years ago I submitted a freedom of information request to all councils to see what they could tell me about children who have been trafficked. Most of them could tell me nothing, because they did not bother to record them, but some did make an effort and were much better. The frightening thing was that the majority of those children had been re-trafficked within about a week, probably to the same evil gang. What happened to those children when they were back in the hands of those horrible people? I presume that they were beaten up and tortured before being put back into that lifestyle and then sold on to somewhere else in the country.
The first problem is that we do not know what happens to those children. That should be the responsibility of Government, and certainly of local government, as I have argued. I just do not accept that children who have had such a terrible time can be put into local government control. Even the best foster carers, unless they know about human trafficking, cannot possibly deal with them.
I rarely leave this place, because I think that MPs should be here when Parliament is sitting, but I did go to the Philippines with Anthony Steen. The Philippines has a great problem with trafficking, but it deals with child victims so much better than we do. They are put in a safe home, where they could never be discovered, and they are looked after by female staff and they go to school. I had the privilege of meeting a young women—she was then 21—at her wedding. When she was younger she had been trafficked and repeatedly raped, so she had come through on the other side. I also met someone who had just gone into the system. The poor girl was blind and had had the most horrible existence. The great advantage of that system was that those girls would never be re-trafficked.
We can learn from that example. To the Government’s credit, Barnardo’s has run a similar pilot scheme, which I think has been a huge success. However, that is where we come up against a problem. Central Government do not want to take on another responsibility and extra cost —that is the attitude we come up against—and local government does not want to lose part of its empire. Come on, Government; that is patently absurd. There is no extra cost, because someone is supposed to be looking after those children. Why not make it the responsibility of the Ministry of Justice? We should treat those children the same way we treat adults by having safe homes for them around the country. There is a huge problem with inter-department squabbling and budgeting, but I argue that we must put all that to one side and do for those children what we do for adults. How can it be Government policy that child victims of human trafficking are treated worse than adult victims?
The Bill will probably not make progress today, but I hope that the principle behind it will be considered seriously. Before concluding my remarks, I will go through the Bill so that hon. Members understand it. It contains only three clauses. Clause 1 amends section 17 of the Children Act 1989 so that children who have been trafficked are no longer the responsibility of the local authority. Clause 2 sets out a duty to provide for child victims of human trafficking—it basically states that we should treat them the same way as we treat adults. Clause 3 deals with the formalities.
While I would like this Bill to move into Committee and to the Lords and become an Act of Parliament, I know that in reality it will not, but I hope that by airing the issue I have moved things forward. Given that we have a Minister who is known for his caring and compassionate attitude, a Government who really have done things about human trafficking, and an Opposition who wholeheartedly support improving things for victims of human trafficking, surely we could all work together. This has been a cross-party movement; the APPG was of course cross-party. It would be a crowning moment, and a recognition of what Anthony Steen did, if in due course the principle of child victims of human trafficking being a responsibility of central Government became a reality.
Sarah Champion (Rotherham) (Lab)
I give huge congratulations to the hon. Member for Wellingborough (Mr Bone), who for a very long time has been an incredible campaigner on this issue. It is absolutely to his credit that we are debating this Bill, and I wish we had longer to go through it, because it deserves that.
Human trafficking remains a significant and growing problem. It is estimated that there are 20,000 modern-day slaves in this country alone—a terrifying statistic. Members on both sides of the House share a determination that we should do everything that we can to end trafficking, and particularly to support the victims—including children, who are so often overlooked. Recent figures from the National Crime Agency demonstrate all too clearly the scale of the task. In 2014, 3,309 potential victims of human trafficking were reported, of whom 732 were children. That is the highest number since we started recording the figures, and it represents a 22% increase on the number of child victims of human trafficking reported in the previous year.
The impact of exploitation on child victims of trafficking cannot be overstated. I am grateful to the hon. Gentleman for giving some examples. Of the identified child victims in 2014, 32% were trafficked for sexual exploitation. Among trafficked girls, the figure rose to 49%. The exploitation of trafficked children leaves them with highly complex needs that are not being met by current provision. However, despite my concerns, I cannot support the notion of central Government having responsibility for a particular group of children. Transferring this responsibility would leave trafficked children outside mainstream provision of care, which may be discriminatory. Furthermore, I am concerned that it could lead to an even more fragmentary response for victims.
I served on the Modern Slavery Bill Committee, where we heard moving testimony about the dangers faced by trafficked children—in particular, the risk of re-trafficking. Research has shown that 60% of trafficked children in local authority care go missing; most are never found again. Trafficked children who go missing are highly likely to be returned to exploitation. That children identified by the authorities should be allowed to disappear without trace is both shocking and indicative of a failing system.
Despite the passing of the Modern Slavery Act, there has been very little change in the delivery of support to child victims. Only one section of the Act was specifically designed to improve the response to child victims—the introduction of child trafficking advocates—and this is yet to be enacted. In Committee, the Minister clearly recognised the need to implement the provisions as soon as possible, and pointed out that the Government had begun the trial prior to the necessary legislation being passed. It is therefore concerning that despite the passage of the Act and the successful completion of the trial, the Government have delayed the introduction of child trafficking advocates, instead opting to conduct further testing of the model. The need for independent advocates has been accepted by the Government, and the proposals have been trialled and positively evaluated. It is vital, therefore, that the Government now proceed without further delay to implement the scheme nationally.
The Modern Slavery Act was a historic piece of legislation, and the Government should be commended for the commitment they have shown to ending human trafficking, but the task remains incomplete. I urge them to do everything they can to ensure that child victims of trafficking receive the support they so desperately need.
The Parliamentary Under-Secretary of State for Refugees (Richard Harrington)
I, too, pay tribute to my hon. Friend the Member for Wellingborough (Mr Bone) not just for putting forward and speaking for the Bill, but for all the work he has done. As I said when he kindly took an intervention from me, the work that Anthony Steen has done and is still doing is particularly pertinent for me, since it is impossible for anyone to end up at Watford Junction station without seeing his operation there.
I am very short of time, so I will get straight to the point. My hon. Friend’s proposal is that the Government should take over dealing with the trafficking of children by placing it under national control in a national organisation, rather than the current situation of dealing with it locally through local authorities. Our contention is that that is not the best way to deal with it. I am afraid I cannot accept his assertion that children are, to use his expression, treated worse than adults.
We have set a clear expectation on local government in caring for children who are trafficked or unaccompanied by making important revisions to the statutory guidance for local authorities. The guidance is clear that unaccompanied asylum-seeking children and child victims of human trafficking are some of the most vulnerable children in the country and that placement decisions
“should take particular account of protecting the child from any continued risk from traffickers, and from a heightened risk of going missing.”
We have also published strengthened statutory guidance on children who run away or go missing from home or care. The guidance clearly sets out the steps that local authorities and their partners should take to prevent children from going missing and to protect them when they do.
The Government have strengthened multi-agency arrangements for co-ordinating and sharing intelligence in relation to vulnerable victims. Such multi-agency safeguarding hubs—or MASHs, as they are called—are being set up across the country and are helping to share information about and to co-ordinate more effectively in safeguarding children and vulnerable adults from harm.
Richard Harrington
I am afraid I do not accept what my hon. Friend says about children who go missing. I am happy to discuss that with him separately. [Interruption.] We do not know.
I briefly want to mention one point made by the hon. Member for Rotherham (Sarah Champion) in her very thoughtful speech. I agree with her about bringing in officials to be advocates for such children, but the Home Office is being very careful. It has very recently been decided that further trials are needed. That is not the result of prevarication, as though the Government do not want to act, but because of a fear of not getting it right. We have a one-off chance to do this. The Minister for Children and Families, who is very interested in this subject, is in the Chamber, for which I thank him.
A lot of work is under way. It is not as though the Government are oblivious to the issue. It is most important that children at risk of trafficking and those who have been trafficked do not fall outwith the system or are treated separately from adults. We must continue to deliver at this pace, because the Government will not tolerate the exploitation of any child, whether they are from the UK or foreign-born.
The question my hon. Friend the Member for Wellingborough has asked us is whether we can achieve that aim by transferring responsibility for victims of child trafficking from local to central Government. We believe that that is not the answer, because the work in progress to care for such victims better meets the standards required for vulnerable individuals. We are giving it a lot of resource and doing the work to beef it up—for example, our help for unaccompanied children in Kent—which demonstrates the Government’s commitment. There is a ministerial implementation taskforce to consider child protection, so we are not oblivious to the issue.
I have made a careful note of the very good points made by my hon. Friend, but I am afraid that the Government cannot agree to his Bill becoming law for the reasons I have explained. That does not mean that this debate is a spurious use of time, or that he has not made very interesting and relevant points. I hope he does not find it disrespectful that I have to say, reluctantly, that the Government cannot accept his core proposal. He has been in this House for a long time and will understand that it is not possible for us to do so, but he was right to use this opportunity to air the issue. I am sure that some of the points that he raised will be discussed again in the House and be taken into consideration. For that reason—
Business without Debate
Hon. Members
Object.
Bill to be read a Second time on Friday 4 March.
HOMES (FITNESS FOR HUMAN HABITATION) BILL
Resumption of adjourned debate on Question (16 October 2015), That the Bill be now read a Second time.
Hon. Members
Object.
Bill to be read a Second time on Friday 11 March.
CIVIL PARTNERSHIPS ACT 2004 (AMENDMENT) BILL
Motion made, That the Bill be now read a Second time.
Hon. Members
Object.
Bill to be read a Second time on Friday 11 March.
VICTIMS OF CRIME ETC (RIGHTS, ENTITLEMENTS AND RELATED MATTERS) BILL
Motion made, That the Bill be now read a Second time.
Hon. Members
Object.
Bill to be read a Second time on Friday 11 March.
REPRESENTATION OF THE PEOPLE (YOUNG PERSONS’ ENFRANCHISEMENT AND EDUCATION) BILL
Resumption of adjourned debate on Question (11 September 2015), That the Bill be now read a Second time.
Hon. Members
Object.
Bill to be read a Second time on Friday 4 March.
MESOTHELIOMA (AMENDMENT) (No. 2) BILL
Motion made, That the Bill be now read a Second time.
Hon. Members
Object.
Bill to be read a Second time on Friday 26 February.
WORKING TIME DIRECTIVE (LIMITATION) BILL
Motion made, That the Bill be now read a Second time.
Hon. Members
Object.
Bill to be read a Second time on Friday 5 February.
CROWN TENANCIES BILL
Motion made, That the Bill be now read a Second time.
Hon. Members
Object.
Bill to be read a Second time on Friday 5 February.
HOUSE OF COMMONS (ADMINISTRATION) BILL
Bill read a Second time; to stand committed to a Public Bill Committee (Standing Order No. 63).
Gangs and Youth Violence: London
(8 years, 9 months ago)
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Mr Chuka Umunna (Streatham) (Lab)
I have asked just two questions at Prime Minister’s questions on a Wednesday since I was elected in May 2010, although I have had various exchanges with the Prime Minister in this Chamber outside Prime Minister’s questions. On 7 July 2010, I told the House during PMQs that my constituent, Zac Olumegbon, had been murdered a few days before in a planned attack close to his school. He was just 15. On 8 June 2011, I came straight to the House from meeting the family of my 18-year-old constituent, Nana Darko-Frempong, who had been fatally shot outside his block of flats on the Tulse Hill estate in my constituency just a few days before.
On both occasions, I told the Prime Minister that this loss of life was totally and completely senseless and unacceptable. I said that I did not feel that we were getting to grips with this problem, which has been blighting our inner-city streets. On both occasions, the Prime Minister said that he agreed with me and that the Government would do all they could to stop the tragic loss of life and violence that we see.
Last Friday, more than five years after I first raised this issue with the Prime Minister, another constituent and his family came to my surgery. Last year, my constituent’s younger son was stabbed on the same estate as Nana. He has since been taken into foster care in another part of London for his own safety. In recent weeks, his brother was stabbed on another estate in Streatham, critically injured and taken to hospital. He cannot leave hospital because it is deemed too unsafe for him to return home.
Both those sons are victims, like Zac and Nana, of the serious youth and gang violence that continues to grip parts of my community. My constituent had come to the UK with his sons from Somalia, a country ravaged by lawlessness, extreme violence and civil war, because he wanted a better future for his children and for them to be safe. He is completely bewildered by what has happened. When I asked him whether he felt his sons would be safer in Mogadishu than in London, he told me that he felt it would be less dangerous for them to live there than here. He massively regrets moving them to our capital city. That is a damning indictment of the situation on London’s streets.
Ms Karen Buck (Westminster North) (Lab)
My hon. Friend is making an incredibly powerful speech. Two days before Christmas, a young man I had last seen when he was doing work experience in my office was surrounded by a group of 20 youths and stabbed through the heart. He was incredibly lucky to survive. That is just one example of what a Home Office report recently indicated—that gang membership is rising, not falling. Does my hon. Friend agree that this is the worst time for the Government to consider creating insecurity through either their policy on tackling gangs and serious youth crime or their resourcing for it?
Mr Umunna
I could not agree more with my hon. Friend. We have worked together on the issue since I have been in the House, and I pay tribute to her for continuously shining a light on what is happening in her constituency and across London.
I do not want to say any more about the case of my Somali constituents, except to highlight that I have written to Ministers about the family in detail, and I ask—I beg—that Ministers exercise their discretion to grant my constituent’s two sons in particular the appropriate papers, which they do not have at the moment, so that they may travel back to Somalia to be with their mother, as the family wishes.
The case illustrates that for all the promises that have been made and all the attempts that local government and national Governments of different political persuasions have made to deal with the problem—I am not making party political points today—we still have a major problem of youth violence and gang culture, which is having an impact on a small minority of our youngsters in inner-city areas such as mine. The Evening Standard’s “Frontline London” campaign has done a lot to shine a light on that, and it is reporting today yet another murder of one of our teenagers on London’s streets.
According to Citizens Report, a not-for-profit independent organisation that carries out data research in this area, 17 teenagers lost their lives to gang and youth violence in London last year. That is an increase on the 11 young people who lost their lives in 2014. It is true that it is not the same level that we saw in about 2008-09—in 2008, 29 teenagers lost their lives on the streets of London—but let us be clear that one life lost is one too many.
Much of the violence is perpetrated by young people who are deemed to be gang-affiliated. Last year’s report on gangs and youth crime by the Home Affairs Committee, of which I am a member, noted that there is no comprehensive national figure for the number of gangs or the number of young people affiliated or associated with them. Some question whether we should even use the term “gang”. What does it mean? I am grateful to the Centre for Crime and Justice Studies for what it has said about that. However, if we are using that term for the purposes of this debate—I accept that maybe we should not—the Metropolitan police’s latest intelligence is that there are 225 recognised gangs in London, comprising about 3,600 gang members. Those people mainly span the ages of 16 to 24, but I know of children much younger than that—I use the word “children” deliberately —who are involved with groups perpetrating acts such as we are discussing.
Mr David Lammy (Tottenham) (Lab)
I am grateful to my hon. Friend for championing the issue and securing the debate. Does he recognise that the gangs matrix profile shows that, although older young people are being picked up, that is driving down the profile of those who carry knives? Twelve and 13-year-olds are carrying knives for older individuals. That really needs to be examined.
Mr Umunna
I am grateful to my right hon. Friend for raising that issue. He is absolutely right. In addition to age is the fact that, increasingly, vulnerable girls and young women become wrapped up in this and are used and abused and exploited sexually. In the short time we have this afternoon, it is impossible to set out all the reasons why young people end up getting involved in serious youth violence, but there are common themes. My right hon. Friend has spoken about that many times.
Mr Steve Reed (Croydon North) (Lab)
I am delighted that my hon. Friend has brought this important issue before the House. Does he share my view, which is derived from consulting the communities that are deeply affected by gang violence, that, above all else, they want more of a say and more control over the interventions that are brought to their communities and more control over how resources are used to tackle the problem at source?
Mr Umunna
My hon. Friend is absolutely right, and he did very good work as the leader of Lambeth Council, where my constituency is situated. He is an expert in the matter. We have seen the great work the council is doing with its youth community trust, which seeks to do just what he says.
I am struck by the way in which the gang or group that the young people become involved in has become a surrogate family. There are sometimes parenting issues in their actual families, but sometimes there are not. I know of lots of young people who have been involved who come from very strong families. There is an idea that they are in workless households, but sometimes the problem is that two parents are holding down two jobs just to make ends meet and they do not have the time to be there.
The second issue, which is connected, is the lack of things for our young people to do out of school hours. I lose count of the number of community meetings I go to—all my colleagues who have spoken will have had exactly the same experience—when constituents say, “There are just not enough things for our young people to do.” We have to develop the professional occupation of youth work. Youth workers should be seen in the same way as our teachers; they should be put on a pedestal in the same way, because they spend almost as much time, if not more, with our young people.
Often, our young people will want to affiliate with a group because they fear not being affiliated to a group. There is a sense among them that they need to be part of a group for protection.
Another issue is the rampant consumerism that surrounds our young people—my right hon. Friend the Member for Tottenham (Mr Lammy) talked about that in his book following the 2011 riots—and the popular culture that sometimes glamorises the lifestyle that goes with it. I used to be a trustee of a charity, the 409 Project, which unfortunately went under because it did not get funding. We found that money, or specifically a lack of money, was often the cause of the violence and criminality. The young people we dealt with told me how money led to the cycle of robbery and revenge: those who do not have the latest consumer good robbed those who do, but they were equally hard-up. We are not making any excuses—there is no excuse for that kind of violence—but unless we understand why it is happening, how can we hope to prevent it?
Finally, there are not enough jobs for young people, particularly young people who have left education. A disproportionate number of young people who are impacted are people who look like me—black and minority ethnic children. The unemployment rate among our BME youngsters is 25%. For young black males, it is a staggering 35%, in 2016, when we are the fifth largest economy. That is a disgrace.
What are we to do? First, the Government have to reverse their decision to disband the very important ending gang violence and exploitation peer review network, which I know they are planning to do this April. I praise them for setting it up. It is a good network doing important work. It is a retrograde step to disband it; doing so will seriously compromise efforts to reduce gang and youth violence. If it is being done to cost-cut, I say we cannot put a price on the lives of our young people.
Secondly, there needs to be a far more joined-up approach at both local and national levels. It is a constant challenge: there is the youth offending team, children’s services, education and health. There needs to be a much more joined-up approach at a national level. One of the good things the previous Labour Government instituted—my hon. Friend the Member for Gedling (Vernon Coaker) was the Minister who set it up—was a cross-departmental working group that brought together Ministers to make sure this issue was being looked at in a holistic, joined-up way at a national level. The Prime Minister should forget that the group was set up by the previous Labour Government and reinstitute it without delay. The chair of the group should submit an annual report to the Home Affairs Committee, which could then call on the chair to give oral evidence.
Thirdly, there has to be an increased focus on the very-hard-to-reach youngsters who are out of work. Clearly, there is still more work to be done—just look at the figures.
Fourthly, we have to do much more intensive work in our schools to educate young people and get into their minds. We need to win the argument about what the lifestyle can lead to. We have to offset the glamorised image of what it is to be in a gang with a proper programme of intensive education. There also has to be much more effective enforcement. Every single lever must be used to send a message to key individuals in gangs that their criminal activities will be dealt with and their violence sanctioned—that is the point: sanctioned. If they are never caught and people do not see them being caught, even for minor infringements, they will carry on doing what they are doing.
Finally, I am sure the Minister would be surprised if I did not mention that this work is costly. It costs money and it requires resource. I agree with my constituency neighbour, my hon. Friend the Member for Croydon North (Mr Reed). We have to do this at a local level, but I do not understand how our local authorities can be expected to do it when their central Government grant has been cut by 56%. Youth services are particularly hit—more than any other.
Mr Steve Reed
My hon. Friend is making excellent proposals, which I hope the Minister will welcome. He has not yet mentioned the effect of domestic violence. As I understand it, one of the single biggest predictors of a young person becoming involved in violence is that they themselves have experienced, or been subject to, domestic violence in the home, leaving them to grow up without a properly formed sense of right and wrong. Does he agree that more work should be done in the home, early doors, particularly where there are instances of domestic violence?
Mr Umunna
I completely agree with my hon. Friend. In addition to domestic violence, we should mention the fact that some issues, particularly in the home and in the family, can arise as a result of substance misuse and mental health issues. Mental health issues are always prevalent in cases like this.
I will finish by saying to the Minister that I do not believe we can put a cost on the life of any young person in London, but ultimately, if the Government invest in this area, they will not have to spend the moneys they would otherwise spend on putting the perpetrators of these acts through the criminal justice system. Once and for all, let us not have to have another debate in the House of Commons—let us deal with the issue.
The Parliamentary Under-Secretary of State for Refugees (Richard Harrington)
I congratulate the hon. Member for Streatham (Mr Umunna) on securing this important debate. He has had a very long-standing interest in tackling gangs in London and in his constituency. He explained the background in an extremely eloquent manner and in a way we could all understand.
Tackling gangs and serious youth violence, in both London and in other areas around the country, is of course a priority for the Government. I am aware, and everyone in the House is aware, that gang and youth violence has a devastating impact not just on their victims and their families, but on the communities in which they live. We see young lives wasted, or worse.
On Wednesday 13 January the Government published their refreshed approach to tackling gangs, in a paper entitled, “Ending gang violence and exploitation”. The paper sets out how our approach is focused on both reducing violence, including knife crime, and preventing the exploitation of vulnerable individuals by gangs. The refreshed approach builds on the ending gang and youth violence programme, established by the Home Office in 2012. This was based on a small Home Office front-line team working with an extended network of external experts who would visit a local area and produce a report with recommendations for local action to build local resilience. Since 2012, 52 areas have been part of this programme, including 26 London boroughs.
The programme will end in March, after four years of operation, as the hon. Gentleman said, but it is being replaced by the “Ending gang violence and exploitation” approach, based on what the Government and experts believe is the changing nature of the gang problem. The EGYV programme supports a front-line team of three people and an extended peer review network of more than 80. The peers come from local authorities, the voluntary sector, the police and others with a background in gangs, and are paid to visit local areas and make recommendations. It is then for that area—this brings me to the local point the hon. Gentleman made—to decide how and when to take those forward. As I have said, since 2012, 52 local areas have been visited, reviewed and reported on. Lambeth was subject to one in 2014.
We are now building on that programme. We will not be conducting any Home Office-funded peer reviews, because that has been dealt with, but we have provided the tools for local areas to conduct local assessments based on the same principles. We are committed to keeping peer reviewers, local area leads and other experts together by setting up the ending gang violence and exploitation forum. The forum will meet regularly—two or three times a year—and allow front-line practitioners directly to advise the Home Office officials of the latest issues and challenges; to share best practice with other practitioners; and to help inform the development of the new approach. It will be set out in more detail at the conference the Home Office is convening on 1 March—very soon—and which will be attended by more than 120 people with expertise in gangs.
Mr Umunna
I am grateful to the Minister for touching directly on this point I raised, but the disbanding of the network is a retrograde step. It is not the same as what the Government will reinstitute in its place. The nature of how gangs operate and proliferate changes, which is why we need the constant peer review the network provides. From what I understand and the information local partners have been given, it is basically being replaced by a couple of conferences, two civil servants who have added this to their responsibilities, and a mailbox.
Richard Harrington
I thank the hon. Gentleman for his point, but I think I have covered it already. The network is ending, but it is being replaced, so I cannot accept his point.
The hon. Gentleman said there should be a joined-up approach. I would point out that there is an interministerial committee on gangs, chaired by the Home Secretary, which brings together all the Departments. He made a good point, but one that is being dealt with. These interministerial committees, which I have dealt with in other fields, are taken very seriously and attended at a senior level.
Richard Harrington
I am sorry; I cannot take an intervention, because of the time.
The Government are moving towards a cross-governmental approach on many things. The Government have identified six priorities to support the refreshed “Ending gang violence and exploitation” approach, based on what has been found and what we have been told—it is not a question of the Government saying, “This is what it will be.” Let me briefly go through the six priorities. The first is tackling “county lines”, which is the exploitation of vulnerable people by gang members to sell drugs. This is linked to urban gangs operating in drug markets in more suburban areas or surrounding towns. Our second priority is to protect vulnerable locations, which is linked to gang-related exploitation and refers to places where vulnerable young people can be targeted—for example, pupil referral units and children’s care homes.
Our third priority is reducing violence, including knife crime, which I will return to in a few moments. Better information sharing is a key part of reducing violence. The fourth priority is safeguarding gang-associated women and girls, who are regarded as being particularly vulnerable. Our fifth priority is to promote early intervention, because we know that intervention can stop young people becoming involved in gang and youth violence in the first place. Our sixth priority is to provide meaningful alternatives to gangs, such as education, training and employment.
Let me turn briefly to knife crime. The Government are aware of concerns about knife crime and we continue to work with the police and other partners to tackle it. Police-recorded knife crime is 14% below what it was in 2010, but it has increased by 9% in the 12 months to September 2015. According to the Office for National Statistics, the picture behind the rise is complex and may be the result of improved recording by the police, a genuine rise in knife crime and a more proactive police response. The Government are reviewing what can be done with the Metropolitan police and other agencies. We have co-ordinated a week of action against knives in February, and the Under-Secretary of State for the Home Department, my hon. Friend the Member for Staffordshire Moorlands (Karen Bradley), is having a round table with retailers, the police and the National Police Chiefs Council on this issue. I should also stress that there are already strict controls on sales of knives to under-18s and how knives can be marketed.
It is also important that we work with the NHS and the voluntary sector, as many victims of knife crime end up in the NHS in our emergency departments. In London alone, the Home Office has awarded more than £1 million to the Mayor’s Office for Policing and Crime from the police innovation fund to support information sharing between health services and community safety partnerships. The Home Office has a clear policy, and the funding is being used to extend the youth intervention programmes run by Redthread, a voluntary sector organisation, in the four major trauma centres in London, which include St George’s in Tooting. This work is aimed at young people at hospital with knife injuries. Youth workers based in A&E talk to the young people at the “teachable moment” about what brought them there and whether they can be given support to prevent similar incidents from happening again. We are following the project very closely.
To conclude, I should like to repeat my thanks to the hon. Member for Streatham for securing this debate and providing Members with an opportunity to discuss this important issue, which can have such an impact on communities. I can assure the hon. Gentleman that the Government regard gangs and serious youth violence as a continuing priority and, through the new “Ending gang violence and exploitation” approach, we will continue to work with national and local partners to address this issue.
Question put and agreed to.
Ministerial Correction
(8 years, 9 months ago)
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Transport
(8 years, 9 months ago)
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Jim McMahon
I share the Minister’s appreciation for the staff and for the patience of passengers, but I think the point is being missed. Because money has been taken away from routine maintenance and flood defences, there has been a massive effect on our local economy. If an assessment has been carried out, surely it should be made public.
Claire Perry
I am afraid that I have to disagree with the hon. Gentleman’s facts, although I hate to do so at his first Transport questions. The Government have announced that overall flood spending in the next period will be £1.7 billion higher than it was in the previous period. Within the transport budget, about £900 million is dedicated to things like making sure that the banks and cuttings are safe—those things that are often the first to go when there is heavy flooding. Improving the resilience of the rail network and making sure that it is fit for a 21st century climate are at the heart of the record level of investment that this Government are putting into the railways.
[Official Report, 28 January 2016, Vol. 605, c. 402.]
Letter of correction from Claire Perry:
An error has been identified in the response I gave to the hon. Member for Oldham West and Royton (Jim McMahon) during questions to the Secretary of State for Transport.
The correct response should have been:
Claire Perry
I am afraid that I have to disagree with the hon. Gentleman’s facts, although I hate to do so at his first Transport questions. The Government have announced that overall flood spending in the next period will be higher than the £1.7 billion it was in the previous period. Within the transport budget, about £900 million is dedicated to things like making sure that the banks and cuttings are safe—those things that are often the first to go when there is heavy flooding. Improving the resilience of the rail network and making sure that it is fit for a 21st century climate are at the heart of the record level of investment that this Government are putting into the railways.
Written Statement
(8 years, 9 months ago)
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National Minimum Wage
(8 years, 9 months ago)
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The Minister for Skills (Nick Boles)
I am pleased to announce that the Government are publishing evidence to support the Low Pay Commission’s National Minimum Wage recommendations for 2016. This document contains economic analysis that the Low Pay Commission may want to consider when making its recommendations.
A copy of the evidence will be placed in the Libraries of the House and will be available from the BIS website at: www.bis.gov.uk.
[HCWS500]
House of Lords
Airports Act 1986 (Amendment) Bill [HL]
Lord Empey (UUP)
My Lords, I understand that no amendments have been set down to this Bill and that no noble Lord has indicated a wish to move a manuscript amendment or to speak in Committee. Therefore, unless any noble Lord objects, I beg to move that the Order of Commitment be discharged.
Public Advocate Bill [HL]
(8 years, 9 months ago)
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Lord Wills (Lab)
My Lords, this Bill arises out of my experience as a Minister devising the Hillsborough Independent Panel that was set up by the Government of Gordon Brown towards the end of his premiership. This was a more complicated and difficult process than perhaps the current public record suggests. The problems I encountered during that process made me reflect on the wider implications for public policy in the case of large public disasters such as Hillsborough, and this Bill is the result.
I want to place on record my gratitude to Ministers in the Ministry of Justice, the Justice Secretary, the Parliamentary Under-Secretary in the other place, Caroline Dinenage, and the Minister of State here, the noble Lord, Lord Faulks, for the courtesy and consideration they have given to my representations to them about the Bill. I am also grateful to their officials, who have been generous with their time in discussing details of the Bill with me. Above all, I want to pay tribute again to the families bereaved in the Hillsborough disaster in 1989, who campaigned for so long with such dignity and persistence in the midst of their grief until, at last, they have begun to see the results of their campaign for justice. Without their efforts, the panel would never have been established, and without their efforts, it would never have achieved what it has.
In 2009, I met representatives of those families on several occasions to discuss with them what outcomes might satisfy them. One message that came through over and over again was that they wanted to find a way to prevent other similarly bereaved families suffering and having to endure in the way they had suffered and endured for 20 years. This Bill is designed to do just that.
This is not the time to rehearse the history of those years between the disaster and the setting up of the panel, but that history illustrates the extent to which bereaved families and injured survivors can feel alienated from the official process for responding to such public disasters and how lack of transparency is one of the key reasons for that. It revealed the extent to which the experience and responses of bereaved families and injured survivors can illuminate what happens in such disasters, and why, and reveal flaws in the official response to them. That all this is now in the public domain is a tribute to the outstanding work done by the members of the Hillsborough Independent Panel, so ably and compassionately chaired by the then Bishop of Liverpool, who many noble Lords will remember from his time in your Lordships’ House, with powerful support from Home Office officials. The bereaved families were all well served by their labours. I should also pay tribute to the current Prime Minister and the current Home Secretary who continued to support a panel set up by a previous Labour Government and followed through on its report.
The fact that finally the families bereaved at Hillsborough have been able to achieve much of what they campaigned for should not lead to any complacency about the systems currently in place to respond to such public disasters. When the full record of what happened after the Hillsborough disaster is eventually made public it will show, I believe, how the successful outcome of the Hillsborough Independent Panel was the result of a series of fortunate coincidences. There was nothing inevitable about it. This can be seen from, among other things, the fact that the intense difficulties experienced by those bereaved at Hillsborough have been experienced by those bereaved in other public disasters including, for example, the Lockerbie terrorist atrocity, the sinking of the “Marchioness” in the Thames and the wreck of the “Derbyshire” in the South China Sea. Those bereaved families have not all made the progress the Hillsborough families have eventually been able to make.
Sadly, we must assume that such tragedies involving large-scale loss of life will occur again; they always have, and they always will. So this Bill seeks to provide a better way of responding to them on behalf of the bereaved and the injured survivors. It does so on the basis that there is an identifiable pattern to the process that follows a public disaster such as those I have mentioned. The nature and extent of a public disaster very often demands a response from government. The questions raised are almost always the same: who is to blame and what can be done to stop it happening again? Finding the answers does not put the bereaved families anywhere near the centre of that process. The state naturally assumes for itself the dispensation of justice, and the needs and wishes of victims, including the bereaved, are not paramount. As the process unfolds, there is an inevitable tendency for those in official positions who fear that they might be blamed in some way for what happened to close ranks and skew the results of any investigation, as they are so often in a position to do. The report of the Hillsborough Independent Panel graphically illustrated this in the way that it has exposed the behaviour of the police.
Yet the interests of justice and good government would not necessarily be best delivered by removing the state altogether from the process of responding to public disasters. The challenge, therefore, is to strike a better balance between the impartial discharge of justice and good government and protecting the interests and feelings of the bereaved and injured survivors. The Hillsborough Independent Panel pointed the way towards how that might be done, and the Bill seeks to learn those lessons. The first, in my view, was the benefit of the panel review system, which was able to circumvent the constraints of data protection legislation and so was able to reveal new facts. Then there was the importance of the trust placed in that panel by the bereaved and the confidence that they felt the panel was working in their interests. Next was the importance of the bereaved being able to articulate their views collectively. Importantly, the process revealed the problems caused by the absence of any consistent advocate for the bereaved at the heart of government to overcome any interests working against them. Lastly, I have little doubt that it was the extraordinary persistence and dignity and solidarity of the Hillsborough families’ campaign that generated the momentum that led to the panel and its achievements. This will not necessarily be replicable in similar situations in future.
I draw three conclusions from that. The first is the importance of transparency. Without this, the bereaved will never achieve anything approaching closure, and without it it is difficult, and often impossible, for the public policy lessons to be learnt and necessary reforms made. The second is the creation of an institutionalised, independent and adequately resourced advocate for the bereaved. Those who are bereaved in future public disasters should not have to rely on ad hoc remedies extracted over such a long period, such as those that in the end delivered some progress for those bereaved at Hillsborough. The last is the need, as I said, to organise some collective expression of the views of the bereaved.
Those conclusions underpin the Bill, but in my view they do not suggest replacing the existing system of responding to public disasters, such as the coronial system and public inquiries. They clearly still have a critical role to play, to ensure that any overarching public interest is protected. Rather, the Hillsborough experience suggests augmenting the system to protect better the interests of the bereaved. The Bill proposes the establishment of an independent and adequately resourced advocate for those bereaved in public disasters and injured survivors. The constitutional position for such a public advocate is based on what I believe to be the successful model of the Independent Reviewer of Terrorism Legislation, and would have a similar relationship to central government. The unpredictable and ephemeral nature of the demands on such an advocate would, I think, preclude any permanent establishment. However, to ensure that such an advocate was adequately resourced to deal with whatever demands were placed on them, they would be located within a government department—the Ministry of Justice would appear to be an obvious candidate—with the ability to call on the resources of that department as required.
The Bill stipulates, crucially, that two conditions would need to be satisfied before the advocate was required to act. The first would be that in the advocate’s opinion an event had occurred that had led to a large-scale loss of life and involved serious health and safety issues, a failure of regulation or other events of serious concern. In other words, the advocate would not be required to act in all circumstances where there was a large-scale loss of life. Secondly, to act, the advocate must have been asked to do so by 50% plus one or more of the total of representatives of those deceased due to the event and any injured survivors of it. In effect, the bereaved and any injured survivors would have a veto on the advocate’s role coming into effect.
When those two conditions had been satisfied, the public advocate would be required to act as a representative for the interests of the bereaved and survivors, and act as adviser and guide for them and any other representatives that they might have during any police investigation into the disaster and during the inquest. Following any such police investigation and the inquest, on request by a majority of the legitimate representatives of the victims and in consultation with them, the advocate would set up a panel, consulting the bereaved on its composition, to be in the position of data controller, so replicating the position of the Hillsborough Independent Panel. The panel would review all relevant documentation, which would be made available to them on request from all responsible agencies, and report on it—again, replicating the position of the Hillsborough Independent Panel. In effect, the Bill intends to give the bereaved a veto on the establishment of such a panel and its composition.
The Bill then sets out the conditions that would govern the disclosure of information to an advocate’s panel, and these are based on the safeguards in the Freedom of Information Act. I have incorporated them into the Bill because I believe that the Act is generally regarded as successful legislation, notwithstanding the Government’s current commission looking into reforms to it. Even that commission, which is widely regarded as hostile to the Act, seems, if media reports are to believed, to be considering only relatively minor amendments to it, and therefore it seems sensible to rely on its tried and tested provisions.
Lastly, the Bill contains provisions for the advocate to send to the Lord Chancellor a report on an annual basis summarising its work and the conclusion of support relating to a particular event, and at any other time when it identifies a need so to do, and the Lord Chancellor would lay before Parliament a copy of any reports received from the advocate within 15 days of their receipt. That provision is designed to ensure that Parliament retained oversight of the work of the advocate, and represents a further safeguard of the interests of the bereaved and injured survivors.
Since the Hillsborough disaster there have been significant improvements in the coronial system, set in train 12 years ago by my noble friend Lord Blunkett, and I am very pleased that he is speaking today. He remarked then on the importance of,
“providing a high quality service to the public at large and particularly to the bereaved, recognising their special needs and the input they can make to the death investigation process”.
Moreover, there is now the precedent established by the Hillsborough panel report and the subsequent inquest, which I hope will mean that in future bereaved families will not have to campaign as the Hillsborough families had to do for so long. However, the Bill is still necessary, because it gives the bereaved and injured survivors greater control over the process than they currently have, for all the welcome reforms to the coronial system and all the precedents established by the Hillsborough Independent Panel. Rather than relying on ad hoc responses by government, victims, the bereaved and injured survivors would have a right to support and transparency.
My drafting of the Bill could well be improved, and it certainly makes a number of subjective judgments which may well have to be revisited—for example, the trigger mechanism which enables the public advocate to act, as I recognise that many bereaved and injured survivors might well not want to take part in a continuing process and their feelings must be respected. Another example is the definition of who should qualify as bereaved or a representative of the deceased, which may well also need to be revisited.
However, these are details which the Government, with all the expert resources at their disposal, can easily address and improve. Therefore I hope that today the Minister will feel able at least to express support for the principle that the Bill seeks to establish, of approving support for those bereaved by public disasters and injured survivors and giving greater powers to them. I hope that he can also suggest today a way to make progress on entrenching those principles in public policy. I beg to move.
Lord McNally (LD)
My Lords, as I rise to speak I suspect that going through the mind of the noble Lord, Lord Faulks, is a conversation we had when he took over from me as Minister of State at the Ministry of Justice, when I said, “Don’t worry—I’m not going to be one of these ex-Ministers who haunts you when you’re doing the job”. I am in fact speaking twice today but that is still my resolution. It is a great pleasure to follow the noble Lord, Lord Wills, and to speak before the noble Lord, Lord Blunkett, on this matter. Both bring incredible experience as well as local and national expertise to the Bill before us. As we all know, the noble Lord, Lord Wills, is an ideas man and has a terrier-like determination once he has something in his sights.
I am very pleased to be able to support a Second Reading for the Bill. The debate is bound to be dominated to a great extent by the Hillsborough disaster. My parents were both born in Liverpool and I have a large number of cousins and second cousins and the rest dotted around Merseyside, so I know the trauma and hurt that Hillsborough caused. However, it is also important, as the noble Lord, Lord Wills, indicated, that this should not just be the final piece in the Hillsborough puzzle but should look forward to the disasters that will inevitably happen in the future.
Hillsborough, as the noble Lord, Lord Wills, indicated, was all too familiar, as regards how major disasters happen. Families and the bereaved feel excluded from the process; those with responsibilities become defensive and uncommunicative; and ranks are closed to protect reputations, avoid culpability, and protect commercial or operational confidentiality. The wheels grind slow and the lay person feels excluded, as professionals seem to take over what is for individuals not simply today’s headline but a deeply personal tragedy.
Hillsborough only now comes to closure over a quarter of a century after it happened. Lessons have to be learned by the football authorities. I remember where I was when I heard on the radio that there had been a disaster, and my first reaction was, “Not again”. Ibrox, Bradford—any of us who were regular football attenders knew that health and safety at football grounds was a joke. Now I think again, there have been massive improvements over the last 20 years in ground safety and the quality of the offer to the football fan. However, the lessons of Hillsborough still need to be learned. They need to be learned by the police, certainly as regards crowd control, which was unbelievably amateurish at Hillsborough, as we now know, and as regards their own internal behaviour, discipline and inquiries. They are hard lessons to learn, but learn they must.
The noble Lord, Lord Wills, paid tribute to the changes in the coronial system and the guidelines on speed and information now under way. It is worth while noting that the inquest into the 7/7 bombings, conducted by Lady Justice Hallett, received almost universal commendation for the skill with which she conducted it. The noble Lord, Lord Wills, is right to say that neither the Bill nor its supporters have any intention of getting away from the inquest system properly conducted. Government and politicians also sometimes failed to listen or act. Sometimes that is because of the reaction when these things happen, when our compensation culture kicks in and there is a defensiveness against that. However, that does not go against the key hurt which the Bill intends to address.
I agree with the noble Lord, Lord Wills, that there is no room for complacency. There is much more room for transparency; if any lesson runs through this like through a stick of Blackpool rock, it is about the need for transparency and openness in dealing with these issues. Therefore I join the noble Lord in urging the Government in dealing with the Freedom of Information Act to treat it as the precious asset it is. I end as the noble Lord did; the headline in yesterday’s Independent said:
“Hillsborough trauma ‘could be avoided’ under new plans to help families of disaster victims”.
That sums it up. On that ground alone, the Bill is justified in being given a Second Reading.
Lord Blunkett (Lab)
My Lords, I will speak briefly to commend my noble friend Lord Wills for his work on the Bill and for bringing it forward to us. He and the noble Lord, Lord McNally, have concisely and clearly laid out why this legislation is necessary and that while there may be tweaks to the content and to the way it finally emerges, the need to get this right for the future is unarguable.
We make progress slowly. As my noble friend Lord Wills generously suggested, as Home Secretary I oversaw modest improvements to the coroner’s court system and greater transparency, with the considerable help of the late Paul Goggins, who as a Minister and Member of Parliament was an exemplar of how to get things done and to do so with care and thought for others—which is at the root of my noble friend Lord Wills’s proposition. At the very moment when people are hurt the most—in one sense disabled the most from being able to be advocates on their own behalf and for those loved ones they have lost—we need to assist them to be able to articulate that hurt and to seek redress. More important than redress itself is to be able to investigate and put right those aspects which can be identified as having gone very badly wrong so that others do not have to suffer in that way. Therefore an advocate is needed most at the moment of greatest hurt.
I suggest that it would be remiss of us to allow this proposition to fall, particularly during its process, on the grounds of cost. I know—and am learning as I go along—that we do not deal with finance in this House, but there are costs involved in picking up issues much later in the day, a number of which have been listed by the noble Lord, Lord Wills. When an inquiry is held, a process is set in train to bring comfort and redress, and to provide knowledge about what happened and what needs to be put right. The cost of that is much greater down the line than if that process is brought into play quickly and easily. The terrible hurt and trauma involved for the individuals who have fought with tenacity for what they see as justice, as well as setting the scene for others for the future, following the Hillsborough disaster —a fight that has been ongoing for 27 years—as well as other instances that have been listed, can be avoided.
It has been said to me that people are losing loved ones in tragic circumstances on a daily basis, and we should be cognisant of the fact—I am very mindful of this—that numbers are not always a reflection of that. Therefore, it will be important to get the terms right regarding when an advocate should be brought in to represent those who are bereaved, to speak on behalf of those who can no longer speak for themselves, and to unlock the systems which those of us who have been in government are all too familiar with. There is a tendency—I plead as guilty to it as anyone else—not to want to close things down but to hear what suits the moment best.
Until last May, I represented the area around the Hillsborough stadium in the city of Sheffield. I am deeply mindful that in the aftermath of the disaster, even with the Taylor inquiries, people did not know the truth and therefore were subject to listening to what others were saying, sometimes making unjustifiable judgments. We have to avoid that. The quicker an advocate can come on to the scene—the noble Lord, Lord McNally, mentioned Lady Justice Hallett—the more likely it is that we will get to the truth quickly and avoid myth and countermyth and the terrible hurt that goes with that.
It is really important that we pick up what is an excellent idea and hone it into a mechanism that will work for the future. I hope we will ensure that we do not put people through years and years of distress, and very often anger, because systems do not work and because those in power and those with influence—who, understandably, are getting on with their job—are felt not to be listening and learning. If we can avoid that, we will do a great deal for individuals who are in that situation but we will also ensure that our democracy works better.
Lord Wood of Anfield (Lab)
My Lords, I want to be brief. I applaud my noble friend Lord Wills for this excellent proposal and I urge people on all sides of the House to support it.
The proposal draws its inspiration from one of the few positive developments to have emerged from the shameful saga of the events following the Hillsborough disaster—the Hillsborough Independent Panel. As my noble friend Lord Wills made clear, it is not a proposal to replace the existing mechanisms that we use to respond to public disasters, but to augment that process with an independent, adequately resourced advocate for bereaved families.
The grief suffered by the families, friends and loved ones of the 96 who lost their lives at Hillsborough is unimaginable for the vast majority of us. But what is extraordinary, and shameful, is that over a quarter of a century later the families of the 96 are still waiting for final justice and for the final truth to emerge. For much of that time, those in positions of power—through a combination of negligence, obfuscation, intransigence and professional self-interest—have combined to prevent the full facts of what happened coming to light.
However, if there are any silver linings in this grim, appalling episode in our national life, it is that eventually the Hillsborough Independent Panel system emerged as an ally of and advocate for the bereaved. It was able to circumvent the constraints of freedom of information and data protection legislation, and became trusted by the families both to listen to their experiences and to be an advocate in their search for the truth inside government and other public authorities.
I do not think we can understate how intimidating it is for families thrust by tragedy into the public limelight to deal with public authorities, government and the state, or how huge the information gap is when you are outside the system, unable to access it, and, to paraphrase Donald Rumsfeld, when you don’t know what you don’t know, as well as when you don’t have the first clue how to access what you know that you don’t know, or how the myriad laws, rules, provisions and jurisdictional boundaries make navigating the system impossible for those who are not experts on process, government lawyers or senior professionals.
And all that is assuming that the various agencies of the state—from central to local government, the police, officials staffing inquiries, civil servants and employees of other public bodies—show co-operation, judgment, sensitivity and objectivity towards the families concerned. But sadly, as we know from the Hillsborough tragedy, that cannot always be assumed, so families may face not just the might of the state but parts of the state that have interests of their own to protect—those, which, I am afraid, cannot be assumed to be honest brokers and which can come across as adversaries, with resources far greater than those of the families.
The value of a state-provided advocate in the event of future public disasters is clear: to act on behalf of the bereaved as an adviser during the investigation and inquest; to get access to documentation that the families would not be able to access and to report on the contents; and to require resources, commission advice and issue reports. These are functions that cannot simply be provided by collective legal representation. As my noble friend Lord Wills set out, there is a precedent here, although as my noble friend Lord Blunkett made clear, work will obviously need to be done on clarifying when this would and would not apply.
What makes this proposal so necessary is not just the experience of the Hillsborough families but the experience of families who have suffered so much in previous public disasters. We know that the barriers to establishing the truth about the circumstances of disasters have been experienced by other families in other tragedies. I shall take just one example: the Aberfan tragedy in Wales in 1966, when a coal slip killed 116 children and 28 adults. This was a tragedy caused in part by the negligence of public authorities, yet the families faced a stunning combination of insensitivity and professional self-protection in the inquiry process that resulted from it. At one point, the Charity Commission, in 1967, gave advice to the Aberfan Disaster Fund on financial compensation for the families who had lost children. It said that before any payment was made, each case should be reviewed to ascertain whether the parents had been close to their children and were likely to be suffering mentally. One bereaved mother wrote to the chairman of the National Coal Board, Lord Robens, about the way that she felt the inquest had treated her and other families. She wrote that the response of the NCB and other authorities,
“adds to the feeling that our children, whatever they meant to us and whatever value they may have been as citizens, are now dead, and being so, value little to this country, and also value little to those who caused them to die. They are now it seems and within the letter of the law to be written off, as cheaply as possible and the matter closed ... Is there no room for social conscience?”.
There is little we can do about the unnecessary suffering caused by the impenetrability of government and public authorities for those who have suffered in disasters such as the Aberfan tragedy, but there is something we can do for those among us all who may lose someone they love in future tragedies. As my title betrays, I am a lifelong Liverpool football fan. I myself tried to get a ticket for the Hillsborough game when I was 21, and I have a son who, I think, has a lifetime ahead of him of attending Liverpool games. Imagine losing someone you love in those circumstances and feeling helpless in the face of searching for the real reasons, because of the way our government and our public bodies work. Why would we wish that on anyone?
This is a sensible, practical proposal. It needs more work but is definitely in the right territory. It builds on something that has worked in the case of Hillsborough and may help in future to prevent the type of suffering that has been inflicted on Hillsborough victims’ families for over 26 years—practically my entire adult life. I congratulate my noble friend Lord Wills on this proposal and urge all Members of your Lordships’ House to support it.
Lord Bach (Lab)
My Lords, on behalf of Her Majesty’s Opposition, we welcome the Bill and congratulate my noble friend Lord Wills on introducing it. I have some personal reasons for welcoming it: I was a ministerial colleague of my noble friend and my honourable friend Maria Eagle MP at the Ministry of Justice at the crucial time when, after a shamefully long period, the Hillsborough tragedy began to be properly investigated. Great credit is due to both my noble friend and Maria Eagle for the work they did when jointly Ministers of State at the Ministry of Justice.
All this, of course, is in no small measure due to the work of many, many people. However, I want to mention, as my noble friend Lord Wills did, the previous Bishop of Liverpool, our erstwhile colleague in this House, and, if I may, the now shadow Home Secretary, the right honourable Andy Burnham MP, who played an enormous part in what has happened. However, as my noble friend said, it is the bereaved who deserve more credit than anyone.
This Bill is timely, in the sense that the inquest is moving now towards a conclusion, but 27 years after a national tragedy such as Hillsborough is, as other speakers have said, far too long to wait for a definitive judgment on what happened and why. I am very conscious, as I know the House is, that the inquest is not yet finished, so I will avoid, as will others I am sure, any comment on any conclusions it may or may not reach. What is clear is that this sort of delay must never be allowed to happen again. In our judgment, this Bill is a serious attempt at ensuring that it never does. In a civilised country, the agony of relatives of those who die in a tragedy such as this should never be added to by their having to wait an appalling length of time to find out the truth.
I can be brief today. There are strong rumours that the Government are sympathetic to this Bill and the idea behind it, and I hope that those are true. I am sure my noble friend will agree that there are probably some drafting changes that need to be made at a later stage. However, it is important that the Government, in as much as it is within their power, allow time for this Bill to progress in this House and, most importantly, reach the other place with a real chance of going through its various stages and becoming law—unless, of course, they have some other intention in relation to the Bill. We look forward to hearing what the Minister has to say on that point.
Today, at Second Reading, we are debating the principles behind the Bill. However, I hope my noble friend will forgive me if I raise two possible issues for the future. The first is whether the independence of the public advocate—a very important concept and a crucial principle—should not perhaps be set out in the Bill itself, perhaps as part of Clause 1(1). Secondly, is there an argument for saying that the public advocate should always be the chair of an advocates’ panel rather than just a member? Might this enhance the confidence of the bereaved and ensure more transparency? I pose these questions for further consideration. In short, today, I hope the House will celebrate the introduction and Second Reading of this Bill. It is an important step forward and we on this side of the House are delighted to support its Second Reading.
The Minister of State, Ministry of Justice (Lord Faulks) (Con)
My Lords, I thank the noble Lord, Lord Wills, for introducing this Bill and giving the House the opportunity to debate this important matter today. He was kind enough to pay credit to officials and Ministers in the Ministry of Justice who have engaged with him, and he has been helpful and constructive in explaining what lies behind this Bill. Let me make it clear at the outset that the Government share his desire to ensure that bereaved families and injured people are properly involved and supported throughout the investigation, inquest or inquiry process following a major incident.
There was unanimity in the contributions that your Lordships have heard, which echoes what lies behind this Bill. The noble Lord, Lord McNally, spoke of the sad history of disasters in football grounds and the sometimes inadequate inquiries that have followed those. He was right, however, to reflect on the improvements that have taken place, and he gave as a shining example the inquiry into the 7/7 disaster, conducted by Lady Justice Hallett.
The noble Lord, Lord Blunkett, who has particular experience of these issues, was absolutely right to praise Paul Goggins, who did so much in his modest way—I came across it briefly in committees—to help promote the interests of those so often neglected in such situations. The noble Lord made the important point that although cost must not be excluded from government consideration, we must think about costs further down the line.
The noble Lord, Lord Wood, and other noble Lords, made the point that these proposals augment rather than replace the existing mechanisms. Indeed, as I understand it, the noble Lord, Lord Wills, very much accepts that. The noble Lord, Lord Wood, also referred to the fact that, in the wake of these disasters, what confronts those who are sadly affected by them can be intimidating, and they are placed in a quasi-Rumsfeldian dilemma. He was right, too, to remind us of the Aberfan disaster and the dreadful noises made by the establishment in its wake.
A number of noble Lords, including the noble Lord, Lord Bach, referred to possible drafting imperfections. I know that the noble Lord, Lord Wills, is perfectly aware of the fact that there could be improvements, and the noble Lord made specific reference to them.
Notwithstanding those potential improvements, I reiterate that the Government are fully committed to making sure that victims have a voice and do not feel alienated from official processes. Indeed, I am pleased to say that much of what is proposed for the role of a public advocate already takes place, and it is fair to say that there has been much progress.
The noble Lord’s Bill is driven by the concern that following a major incident involving the loss of life in the past, such as the “Derbyshire” sinking in 1980, the Hillsborough disaster in 1989—which has been a significant focus of the debate—and the “Marchioness” tragedy in the same year, bereaved families have undoubtedly felt ignored and swept up in official processes. They have felt that once the state starts to look into the matter, their needs and wishes are not paramount, or even important, and that the process can be confusing and lacks the transparency that the noble Lord, Lord McNally, stressed as being important. In order to address this, the Bill would create the role of a public advocate to represent bereaved families and injured survivors to ensure they understand all the processes and are supported through them, and to review and make sure they have access to the documents used in the investigation.
I know that this is a matter in which the noble Lord has, as he modestly told us, a long-standing interest, as well as considerable expertise and experience. He has been closely involved with the families who were bereaved in the Hillsborough tragedy and who are now involved in the final stages of the inquest into the death of their loved ones. Indeed, it is right to say that Sir John Goldring is currently in the course of summing up to the jury in that inquest. We do not expect a decision for a few weeks yet, and quite what form that decision will take we do not know; it may be a narrative verdict or it may be something more narrow.
I had a meeting with the noble Lord, Lord Watts, who is unable to be here today, and he asked me to say that, given his personal experience, he very much supports what lies behind the Bill, without necessarily committing himself to the actual words.
The Government acknowledge that there were significant issues in the way in which the Hillsborough families were treated in the various processes which followed and we agree that it is vital that lessons are learned and that their experiences should not be that of others in the future. It is because we agree that the needs of the family are so important that we have already taken a number of steps forward.
Reference was made to the Coroners and Justice Act 2009 and the suite of rules and regulations underpinning it. They reformed the way in which coroners’ investigations and inquests are now conducted following a major disaster. These reforms have been in place since July 2013 and have the central aim of putting bereaved people at the heart of the process. The aim is that they receive the support they need and that the process is transparent and understandable from the time of a death being reported to the coroner until the end of the inquest hearing.
Under the reforms we have taken forward, bereaved people have the right to request most documents involved in a coroner investigation and inquest and they can expect the coroner’s office to update them at regular intervals. They can also expect the coroner’s office to explain each stage of the process so that they understand what is happening and why. They can expect compassion and respect for their needs to be central to the investigation and inquest.
They will also have the resource of the Guide to Coroner Services, which my department published in February 2014. This explains clearly and simply what they can expect from the coroner and his or her staff and what to do if that does not happen. Under the 2009 Act, a key role of the coroner and his or her office in an investigation is to make sure that “interested persons”, including bereaved people, understand the process of investigation and are informed of their rights and responsibilities. They are entitled to receive documents and other relevant information, such as hearing dates, so that they can fully participate in the process. Many coroners now also have a support service which provides emotional and other practical support to those attending inquests on the day.
Under the Inquiries Act 2005, the inquiry chair is under a statutory obligation to have regard to fairness. Core participants, which will clearly include all those with whom we are concerned, are entitled to disclosure. The inquiry chair will act as data controller, devising and implementing mechanisms for obtaining, handling and securely storing documents provided to and generated by the inquiry. There is guidance for those running inquiries, including inquiry chairs, teams and sponsoring departments, which sets this out.
Therefore, much of what is in the Bill setting out what a public advocate would do is already happening in the existing processes. We are today in a very different climate from that at the time of the Hillsborough tragedy and in the intervening years. The needs of bereaved people are rightly much more central. I hope noble Lords agree that the current landscape brought about by these reforms and the hard work and contributions of so many makes it less likely that what happened to the Hillsborough families will occur again.
We are not, of course, complacent about this but I believe that, at the moment, there is no need for the public advocate role that the Bill envisages. However, the Government agree that the needs of bereaved families, in particular, must be paramount and that the principles that lie behind the Bill are right. Bereaved families should feel that their voice is heard and confident that processes are fair and transparent. They should feel that they fully understand what is happening and able to participate effectively.
We are, therefore, willing to consider whether the existing processes can be improved and whether any of the principles in the Bill can be incorporated into the existing system. We could, for example, place more firmly in the guidance which is already available to inquiry chairs and teams how important the needs of the families are. We can look at whether the positive things coming from the Hillsborough inquest, not yet concluded, such as the family forums set up to keep the families informed of the investigative processes and to give them a safe space in which to discuss issues, can be replicated in other major inquests and inquiries.
As to specific next steps, I commit to meeting the noble Lord, Lord Wills—not immediately but as things progress—so that our feet can be held to the fire to see whether steps can be taken to reflect what lies behind this and further to improve the significant steps forward we have made.
On behalf of the Government I thank the noble Lord, Lord Wills, for raising the profile of this important issue and for his valuable input, which is welcomed. I hope he will accept my assurance that the Government will continue to ensure that bereaved families and injured persons are central to the inquest and inquiry processes and that their voices will not be ignored.
Lord Woolf (CB)
My Lords, does the Minister feel that the role of the advocate to the inquiry could be closely used to adopt many of the points required by those who support this Bill?
Lord Faulks
The concerns which would be represented by a public advocate—were there hypothetically to be one—should be properly reflected in the way that an inquest or inquiry is carried out. We are not at the moment persuaded that a public advocate as set out in the Bill is necessary. However, we do not rule out possible improvements to ensure that those factors which would be reflected in what a public advocate did find better representation in the existing arrangements.
Lord Wills
My Lords, I am extremely grateful to all noble Lords who have taken part in this debate. It has been relatively short, but it could make a profound difference to all those who in the future, out of a clear blue sky, find their lives transformed by a terrible public tragedy.
The noble Lord, Lord McNally—who I regard as my noble friend whatever the technical position is—made a powerful statement from his own experience about why the Bill is needed. I am grateful to him for his words of support, as I am to my noble friend Lord Blunkett, who brings to this a wealth of experience from the heart of Government, as well as personal experience as the MP for many years representing the constituency containing the Hillsborough stadium.
My noble friend Lord Wood, who was working at the heart of the Gordon Brown Government when the Hillsborough Independent Panel was set up, drew attention again to the need for this Bill and gave the telling example of Aberfan, which I remember as a young boy. I am also grateful to my noble friend Lord Bach, who expressed support from the Front Bench. His idea of putting the independence of the advocate in the Bill is excellent and I should like to adopt it going forward. We will obviously discuss the other issue he raised in due course. So I am grateful for all the support I have received from all noble Lords, who spoke with all their authority and years of experience, and I am glad that the Government have listened to what they had to say.
I also express my gratitude to the Minister for his characteristically thoughtful, sympathetic and thorough approach to all the issues raised by the Bill. Of course, I did not expect him to commit the Government to wholeheartedly adopt the Bill today, but his cautious words pointing towards a possible way forward are perhaps the most that I could have expected. I am grateful for them and I certainly will—with what the noble Lord, Lord McNally, referred to as my terrier-like capacity—pursue him for the meeting that he kindly offered. In due course, I hasten to add.
Of course, I recognise all the improvements that the Minister described. As he said, the situation is significantly different from what it was 20 to 25 years ago. However, there is an issue that I would like to explore with him further, perhaps in Committee, because there is a fundamental distinction between what he has described as the improvements that are taking place and what I think are the improvements the Bill would bring about. It is to do with the independence of the advocate. The changes that he has described are still in the gift of the Government and the institutions of the state. I think it is important because all the experience of disasters that other noble Lords have described more powerfully than I shows how easy it is for the bereaved and the families of injured survivors to feel excluded by the process, no matter how well meaning it is or what is set out in all the guidance, and no matter what the experience and how diligent, thoughtful and empathetic those agents of the state are. Nevertheless, for all the reasons that have been set out today, it is sometimes very easy for families to feel excluded. Having someone who is independently advocating their cause and, crucially, doing so independently of the state and seeking to bring about the transparency that is so important in these cases, is the difference between the position that the noble Lord has set out and the position in the Bill.
I am sure that we will have opportunities to explore this further and I am grateful for the offer of a meeting, which as I say I will take up, so perhaps the issues can be considered further in Committee. In the mean time, while again expressing my gratitude to all noble Lords who have taken part today and to the Minister, I now ask your Lordships’ House to give the Bill a Second Reading.
Road Traffic Act 1988 (Alcohol Limits) (Amendment) Bill [HL]
(8 years, 9 months ago)
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Lord Brooke of Alverthorpe (Lab)
My Lords, I am grateful for the privilege, the opportunity, and not least the luck in the ballot to get the chance to bring forward this Private Member’s Bill. I am also grateful to all those who have kindly assisted me, including our clerks and the many outside organisations and campaigners who support this aim, and of course to the noble Lords who are going to speak today. I offer apologies from my noble friend Lord Rea, who was down to speak but has had to scratch.
This is a simple Bill whose objective is to better protect innocent citizens from accidental death, injury and harm from vehicle drivers who consume alcohol and then drive impaired. It also seeks to protect the drivers themselves. Specifically, it amends the Road Traffic Act 1988 to lower the maximum alcohol limits permissible when driving in the UK from the present blood alcohol concentration of 80 milligrams of alcohol per 100 millilitres of blood down to 50 milligrams of alcohol per 100 millilitres of blood. There would be corresponding changes to breath and urine limits, but in this debate I will refer solely to the limit change using the acronym BAC.
The Act would apply to the whole of the UK, although, as most noble Lords know, Scotland has already enacted this. What they may not know is that the Welsh Assembly has proposed the adoption of a BAC limit of 50 for the Principality, and across the Irish Sea the North Ireland road traffic amendment order not only proposes a lower 50 BAC limit, but an even lower limit of 20 BAC for novice and some commercial drivers.
This amending Bill is precisely in accord with what was piloted from 2014 through the Scottish Parliament. As a consequence, I regret that Clause 2 contains a provision to reduce the limit below which a person could elect to have a specimen of breath replaced with a specimen of blood or urine. This statutory option was removed from the Road Traffic Act 1988 by Part 1 of Schedule 11 to the Deregulation Act 2015 which came into force in April 2015. 1 will therefore need to withdraw Clause 2 later, and I hope that this will make life easier for the Minister.
The European Union does not have a directive on a drink-drive limit, but as long ago as 1988 it first proposed harmonisation throughout Europe at a 50 BAC limit, which it recommended should be adopted. Over the years it has been adopted by all European Union countries except two: Malta and the UK. So I ask: who offers better protection to their citizens, and are the interests in favour of sticking with the present limit being better protected than innocent lives and limbs? To get the answers we need to look at a bit of history and then come up to current developments. These have been recently summarised by Professor Richard Allsop in his 2015 paper for the RAC Foundation entitled Saving Lives by Lowering the Legal Drink-Drive Limit.
It is now well recognised that drinking and driving impairs performance and is a leading cause of road traffic accidents. But, as some noble Lords may recall, that was not always the case. Even in the mid-1960s there was still debate as to whether moderate drinking increased or decreased the risk of collision. But others had recognised the danger much earlier. As long ago as 1954, the World Health Organisation reported that,
“the inference cannot be avoided that at a blood alcohol concentration of 50 milligrams per 100 millilitres of blood, a statistical significant impairment of performance was observed”,
in more than half the cases it examined in the experiments it had undertaken. As a result, the WHO recommended a BAC limit many years ago.
The UK set up its own study in 1953 using what it called laboratory “tasking”, resembling driving vehicles on the road, which reported in 1959. It did not agree with the WHO’s recommendation but, while it acknowledged that substantial impairment of performance still occurred at levels below 80 BAC, it was suggested that those below that limit should not be criminalised. That was the reason given for not embracing the lower limit. In 1962-63 there was a large-scale study at Grand Rapids in the USA. This study quantified the relationship between BAC level and the risk of collision, and provided convincing evidence of greatly increased risk dependent on a driver’s alcohol level.
So why was the 80 BAC limit chosen? The choice of 80 BAC made by Barbara Castle, the then Minister of Transport, should be understood in the context of the evidence available at the time, and in 1967 it was probably influenced by several other salient factors too. The Grand Rapids evidence indicated that the average risk of involvement in a collision was roughly doubled at 80 milligrams. Further, 80 milligrams was within the range of levels then being considered or implemented by other countries. It was plausible that public and parliamentary acceptance could be gained, partly on the basis of advice that most people could have three small drinks without exceeding the 80 limit. However, the Royal Society for the Prevention of Accidents has long contended that 80 was not decided solely on the basis of empirical accident risk assessments, but was influenced upwards by the need to make acceptable to the public the introduction for the first time ever of legislation limiting the amount of alcohol that drivers could consume.
Eighty milligrams was the level at which the Grand Rapids evidence in the form in which it was published enabled the increased risk to be established with the conventional statistical 95% level of confidence against a background of genuine difference of opinion as to whether the risk was increased or decreased. The last of these points is more statistically technical than the others, but it carried weight among those preparing advice for Ministers, as no doubt former Transport Minister the noble Earl, Lord Attlee, may pray in aid when he comes to make his points. But I will argue that that precise basis is relevant to the case for lowering the limit.
What has happened since 1967, as well as the widespread harmonisation of a 50 BAC limit in so many other countries, including Scotland? Importantly, there have been further large-scale studies, including those conducted in the late 1990s at Fort Lauderdale and Long Beach in the USA. They were similar to the Grand Rapids study, but were helped by advances in statistical techniques which had been developed since the 1960s. Further studies were done in nine states in the USA between 2006 and 2008, and all were read across to the UK in a similar way to the original Grand Rapids evidence. They indicated that the increase in the risk of a driver’s involvement in a collision if they have a BAC of 80 milligrams to be nearly three times as much for collisions leading to injury and about six times for collisions leading to death as compared to the mere doubling which had informed the setting of the limit at 80 BAC in 1967. Even at the lower BAC level of 50, which this Bill proposes, the increases in risk are respectively about 1.5 and 2.5 times more—that is, double the Grand Rapids figures back in 1967.
There is now a broad consensus that risk of involvement in a collision is increased rather than decreased by moderate drinking. Acceptance of this changes the appropriate statistical process for assessing the level of confidence in analysing the Grand Rapids and similar data from a two-tailed to a one-tailed test. The meaning of this for the Grand Rapids data in the form in which it was published is that increased risk is established with a statistical 95% level of competence from 60 BAC upwards instead of the then 80 upwards as applied. There is a stark difference, and there was also a stark difference of opinion on this in 1967.
The foregoing may seem a bit dry, but the science proves that the 1967 BAC of 80 is now not only outdated but can mislead to risk life and limb. At the end of the day, of course it is the motorist’s right to decide whether or not to drive after drinking, but they have a right to know the facts about the risks and impairment that drinking has on their driving. It is the Government’s duty and responsibility to provide those facts, especially when quite innocent citizens are involved or affected through drink-driving motoring accidents. Even though I am moving this, I ask the Minister, first, do the Government accept that the 1967 BAC of 80 carries far more risk than was originally believed? If so, what do they intend to do about correcting that? If, however, they maintain that 80 is still appropriate, I would like them to revalidate the figure and produce the science from a more scientific perspective than we have done previously.
Of course, it can be argued that limits do not really matter, and it is the deterrent of being caught and punished with heavy penalties that really counts. To a degree, that is, no doubt, true. In the 1970s, 1980s and 1990s, the UK achieved major reductions in road deaths, injuries and accidents with 80 BAC. This was because the Government more vigorously enforced the limit than did many other countries, even though some had lower limits than we had.
This House produced two EU Select Committee reports on the Commission’s call for a 50 BAC limit in 1998 and 2002. Both supported the Commission’s recommendations. In response to the first, the Government, using their words, “was minded” to move to 50. The transport department supported it also. It was delayed, however, on the basis that it intended to deal with the matter in the context of a possible EU directive. That never came but, instead, in January 2001, the Commission issued a non-binding recommendation that member states should set a 50 BAC limit. It was scrutinised here and, again, adoption of the 50 BAC limit was recommended. The department supported the reduction but, to many people’s surprise, including my own as I chaired the sub-committee, the Government did an about turn at the 11th hour. Instead, they said that they wanted to review the issue in their proposed longer term motoring strategy that they were about to undertake.
During the ensuing decade, deaths and injuries continued to remain high but were reducing slowly, although the 2007-08 recession saw the biggest fall for quite some time. Opinion polls, however, particularly those conducted by the motoring associations, began to reveal growing public concern about drink-driving and support for the lower limit. This culminated in December 2009 in an independent review of drink and drug law by Sir Peter North QC. Most judged his report in 2010 as an excellent piece of work. On drink-driving, North was convinced by the evidence that the risk of involvement in a collision is increased by even moderate drinking. In particular, the review found that lowering the limit from 80 milligrams to 50 milligrams could save over 100 lives a year, based on evidence from NICE, as well as preventing many more serious accidents.
As a consequence, he recommended that the 80 BAC should be reduced to 50 for five years, after which there should be a further review with the aim of establishing a 20 BAC. The newly elected House of Commons Transport Select Committee in 2010 was not so convinced. It believed that the North report sent mixed messages. It in turn sent few messages or recommendations from its report. It did not dispute that drivers were impaired further at 50 BAC and saw an effectively zero limit, although too great a step at that time to take, as probably the best option in the longer term. Instead, its key recommendation was that,
“any reduction in the legal drink drive limit should only occur after an extensive Government education campaign, run in conjunction with the pub, restaurant and hospitality industries, about drink strengths and their effect on the body”.
The committee’s report evidence shows that heavyweight lobbying was on it from the drinks industry. In that decade, 5,330 people were killed and 170,000 casualties were also witnessed in the UK.
Since the North review in 2010, there has been a levelling off in the previous declining figures for drink-related road deaths and casualties. Further models, including that proposed by the RAC Foundation’s report authored by Professor Richard Allsop, also associate significant, if not as dramatic, reductions in death and injury which a drop to 50 BAC would produce. Allsop’s “cautious” estimate is that there would be 25 fewer deaths and 95 fewer serious injuries per year.
Even more recent news and perhaps the most compelling for change comes from Scotland where a 50 BAC limit is now in force. The BAC change has been accompanied by a wide-ranging publicity campaign which has stimulated a nationwide debate on drink-driving on a scale not witnessed previously. An RAC survey shows 79% of Scottish motorists believe that moving the limit to 50 is a positive move while a Scottish Government survey found that 82% of people agreed that it is unacceptable to drink any alcohol before driving, and only 12% of people disagreed with that, which was quite a surprise and a very big change in public attitudes.
I anticipate the Minister will express interest and welcome the Scottish developments. But I suspect that the Government will then want more time and data to assess what is happening north of the border—perhaps even two or three years before they get the figures that they would want to analyse. Meanwhile, the Government state that drink-driving “remains a priority”. But they have made only very small changes to the law over the past five years, nor have they indicated anything really radical ahead. In fact, their policy has probably stalled since 2010, which is why there has been a plateauing in the number of deaths and injuries. In addition, since 2010, police numbers have been cut by 23%, which has had an effect right across the whole of motoring, including drink-driving. I was not surprised, therefore, that 10 of the Government’s police and crime commissioners were in touch with me yesterday pledging support for this Bill. Furthermore, they were pointing out that from a financial perspective, the Local Government Association’s estimate that lowering the current drink-drive limit to 50 BAC would save almost £300 million annually by reducing the number of call-outs to accidents and the associated public sector costs of police, ambulances and hospital admissions. It argued that this funding could be ploughed back into making communities safer. It went on to say that it has overwhelming public support for this legal change. Research released only this morning from the RAC’s Brake, the road safety charity, and the Alcohol Health Alliance of an opinion poll of 5,000 respondents shows that 77% of people in the country favour a 50 BAC limit bringing England and Wales in line with Scotland and virtually the rest of the EU, apart from Malta.
Therefore, the Government have no problem in carrying the country with them on this Bill, apart perhaps the drinks industry. The public know increasingly on this topic what is right and what will help best to protect them. The cost of the change to this highly questionable and now unsafe law made back in 1967 will be minimal. It will be far outweighed by other cost savings, but even more importantly by the saving of more life and limbs. If, however, the Government delay—and it would be a delay because I believe, deep down, that they must know that this will have to come, as we cannot have differing levels between the UK countries, with trains and cars crossing borders every day as we have at the moment—I forecast that they can expect to see at least 600 people killed and around 25,000 casualties over the next three years as a result of maintaining the present level. The Minister and his colleagues can avoid or minimise these figures. They simply have to join the public view and do what is right now. I beg to move.
Earl Attlee (Con)
My Lords, I am grateful to the noble Lord, Lord Brooke, for so expertly moving the Second Reading of his Bill, although I have some difficulties with it. When the noble Lord, Lord Adonis, commissioned the North report, I assumed that he had identified the next step of our road safety programme, which would be to lower the blood alcohol level, or BAC, for drivers. I thought that the report was to provide the necessary evidence for the changes. In the UK, we have a very good road safety record because successive transport Ministers of all parties—one of them, the noble Lord, Lord Whitty, is in his place—have followed the evidence, expertly analysed by officials, rather than taking a populist course of action, which is what the noble Lord, Lord Brooke, has suggested the Minister should do.
At the time, I thought that, if a BAC of 80 milligrams would damage the hospitality industry, so be it. However, I must tell the House that I cannot recall ever seeing an impact assessment on the effect on that industry. My understanding is that the Scottish Government had not done one before lowering their BAC limit. To this day, I have never received any briefing from that industry on this issue.
When my party got into government, I found that the advice from officials regarding North was rather more complex than I thought it would be. Will my noble friend the Minister confirm that the Government have implemented all the significant recommendations in the North report, apart from lowering the BAC?
My first point is that any alcohol intake at all will cause a deterioration in driving capability and skills. The Grand Rapids report referred to by the noble Lord, Lord Brooke, shows that the chances of having an accident increase alarmingly after 80 milligrams. However, there is no safe limit and the best advice is not to drink and drive at all. I hope my noble friend the Minister can confirm that this is his position.
Secondly, we have some data available from the STATS19 system and the coroner’s records. For those accidents where at least one driver was killed, a staggering 19% were over the limit of 80 milligrams. However, for these accidents, only 1.7% had at least one dead driver who was between the proposed new limit of 50 milligrams and the current limit of 80 milligrams. That is a very small slice. There are lies, dammed lies and statistics, but this rather suggests that the problem lies not with those who drive with an unwise and imprudent BAC level of between 50 and 80 milligrams, but rather with those drivers who are totally non-compliant. I refer to them as unregulated drinkers.
That is not to say that the noble Lord, Lord Brooke, is wrong. It is obvious that the Bill would reduce the BAC level of compliant drivers—a bit—which could produce a commensurate reduction in accidents. My fear is that the reduction will not be as great as hoped, since compliant drivers will already normally be driving with a BAC of less than 50 milligrams. If I am right, I do not think that it will take compliant drivers very long to find out that they do not need to reduce their intake much, if at all.
Thirdly, we have a problem with what I have termed unregulated drinkers. These people are often clinically dependent upon alcohol. They do not know how much they have drunk and they have no regard for the law, so the noble Lord’s proposal will have precisely no effect on them at all. They are also very hard to catch. I suspect that this is because they drive on minor roads for relatively short distances: my guess is three or four miles in a rural area and one to two in an urban area, but with a very high risk of having an accident. Noble Lords will realise that the window of opportunity for the police to detect such drinkers is very short, apart from in the event of an accident. If we have a formal Committee stage, I am tempted to run an amendment about permitting the police to instigate random breath tests, if that is what they want to do to solve their problems.
Fourthly, this change would have some resource implications. First, I am told that all the evidential breath test equipment would have to be recertified and recalibrated. I do not find this a convincing reason for not making the change. But secondly, and rather more persuasively, a considerable amount of police time could be tied up processing drivers who get caught by the new limit. Of course, this might not be the case if, in fact, even today few drivers drive with a BAC of between 50 and 80 milligrams.
My fifth point is looking around the corner. We are very careful not to let drivers know how much they can actually drink while remaining compliant. One good reason for this is that we know that there is no safe limit. Another is that, if drivers knew what their intake limit was, they might be tempted to go closer to it. This could mean that, on average, drivers would consume a bit more and therefore, on average, have more accidents. It is possible that law-abiding motorists might use their own breathalysers to ensure compliance with the new and lower limit. This could result in an increase in average intake and, therefore, the accident rate. I hope that I am wrong.
The noble Lord, Lord Brooke, pointed to lower limits in other EU countries, but, with the exception of Sweden, they do not have as good a road safety record as we do and in any case, as the noble Lord well knows, they have different penalty regimes. However, Scotland will provide us with an almost-perfect laboratory. There will be the same enforcement regime as in England because they cannot change the penalties, but a lower BAC. After three or four years we will get the stats and data from Scotland, which will tell us which way to go.
The Library Note suggests that compliance has improved by 12.5 %. I am bound to say that that is a rather disappointing figure, but unfortunately consistent with my analysis. It will take time for properly analysed statistics to be available, but if they show a significant improvement then we should consider following the Scots. In the mean time, my counsel to the Minister is to leave the BAC alone and concentrate on eliminating unregulated drinkers.
Baroness Hayter of Kentish Town (Lab)
My Lords, I congratulate and thank my noble friend Lord Brooke of Alverthorpe for bringing forward the Bill. He has been a marvellous campaigner on this subject for a long time. It is a shame that the Government have not taken action, especially given what my noble friend said about their knowledge of the extra risks of people driving with a BAC between 50 and 80 milligrams.
We increasingly stand alone internationally by retaining the 80 milligram rather than adopting the 50 milligram figure. It is now just Northern Ireland, England, Wales and Malta in Europe that stick at 80 milligrams. In fact, four EU countries have a limit of zero. Indeed, proud Welsh girl that I am, I have to take my hat off to the Scots, who have done the deed—and the sky did not fall in. In fact, as the noble Earl, Lord Attlee, said, there has been a 12% drop in offences, while eight in 10 Scots believe that drinking any alcohol before driving is unacceptable.
This is always a difficult subject for me to discuss, as, a day short of my 10th birthday, I lost my mother because of a drunk driver. Who knows, she might have been saved and lived had she been wearing a seat belt. In those days, of course, they were not even fitted, much less compulsory. However, as a result of endless campaigning, and finally an Act of Parliament—in both of which my noble friend Lord Robertson of Port Ellen played a key role—the law was changed with regard to seat belts. Now, we would not think of driving without wearing one. That is what I want to see happening with regard to drinking and driving—I want it to be unthinkable. A step towards that is to reduce the limit because we know that that will reduce the number of accidents. I think we have done with campaigning—just as we did in relation to seat belts before we brought in the relevant law. It is time to make the change.
I pay tribute to those who have campaigned on this issue, not just my noble friend but organisations such as the Campaign Against Drinking and Driving—CADD—set up to help the families of those bereaved through drink-driving, the Livia Trust and others who campaign for safety on the roads. We owe it to them, to those who have lost loved ones, but also to those who have been injured through someone driving after drinking, such as the Paralympian, Simon Richardson, to make this change.
For myself, I could, being a moderate person, live with this measure being introduced gradually, perhaps initially for drivers under the age of 21—as we know, they are overrepresented among the fatalities—or, perhaps drivers in their first two years after passing their test, or while holding a provisional licence; but start we must. Fifteen per cent of deaths in accidents involve at least one driver over the limit. Those are tragic but avoidable figures. In 2013 there were 250 deaths and 8,000 injuries, 1,000 of which are very serious, due to somebody driving after drinking. Would we accept so many deaths due to any other cause and do nothing about it?
Clearly, as has been said, lowering the limit is not all that is needed. We also need enforcement and publicity for real change to be made. However, a reduction to 50 milligrams would make a difference. As my noble friend said, that reduction is supported by more than three-quarters of the population. We know that at 80 milligrams, drivers are six times as likely to die in an accident as those who have not drunk at all. This is partly because, even if they do not cause the incident, they are less likely to be able to avoid a dangerous incident after they have been drinking. We are well aware that there is a direct relationship between the amount that is drunk and the ability to function behind the wheel. Even between 20 and 50 milligrams, drivers increase their chance of an accident threefold. Up to 80 milligrams, the risk increases sixfold, and up to 100 milligrams, they are 11 times as likely to have an accident. Therefore, reducing the legal limit would lower the number of accidents and improve road safety for all of us.
We, of course, are not the first to call for this, nor are we the only people who support this change. My noble friend Lord Brooke reminded us of the North report of 2010, which estimated that a reduction to 50 milligrams would save 100 lives a year. That is two a week. Those are real lives: they matter. The noble Earl, Lord Attlee, said that of the people who died, only one was between the 50 and 80 milligrams level.
Earl Attlee
My Lords, only 1% were between 50 and 80 milligrams, compared with the others.
Baroness Hayter of Kentish Town
It is even more than that in terms of people and human lives, and when you think of the families affected. Surely that makes the case for us to make this change. As has been said, the Local Government Association has said that about £300 million a year could be saved in police, hospital and ambulance costs. That is without taking account of the costs to families. However, it is not just a question of victims. When I started to campaign on this issue for obvious reasons a long time ago, I was worried about the organisations representing drivers. In fact, the AA, the RAC, the Chief Fire Officers Association, the Police Federation and the Road Haulage Association all support this change. Let us listen today to the victims and to my noble friend Lord Brooke and, for once, not take the advice of the noble Earl, Lord Attlee, and give this Bill not just a Second Reading but our wholehearted support.
Baroness Randerson (LD)
My Lords, I thank the noble Lord, Lord Brooke, for bringing this Bill forward because I believe it is certainly time we looked again at the alcohol limits for driving.
One of the great social changes of our lifetime is being discussed here today. It is undoubtedly no longer socially acceptable to drink and drive. However, it was once so. I am a keen reader. If you read a book written earlier than, say, the 1960s, but within the 20th century and the driving era, you will see that this subject was talked about publicly and flippantly. That has changed. I well remember the controversy and public discussion when this limit was introduced.
There have been other similar social changes in our lifetime regarding smoking, attitudes to women and equal marriage. They have all been a journey, backed up, or led by, legislation. However, on drinking and driving we seem to be stuck in a bit of a time warp. There has been no legislative journey on this to any great extent. The world has changed since this limit was introduced in legislation. Drinking habits and patterns have changed and we undoubtedly drink more on average. Some people drink a great deal on a regular basis. Back in the 1980s, I was part of an interesting demonstration involving the breathalyser and the 80 milligram limit. I was a trainee magistrate taking part in a residential training course. Over dinner in the evening we were given a plentiful amount of wine, after which the police breathalysed us. Noble Lords will be relieved to hear that none of us was going anywhere other than to bed. However, what struck me was that some of the people who were breathalysed had drunk a disturbingly large amount but were still not over that limit. That is very worrying indeed.
Testing systems have become more precise, as have scientific and technical knowledge. They have all moved on since this limit was introduced, and social attitudes have changed. To accommodate the legislation, we now have the phenomenon of the designated driver. In my experience, the younger generation has, on the whole, an exemplary attitude to drinking and driving, and a group of young people normally has a designated driver.
As noble Lords have said, the alcohol limit in England and Wales is now one of the highest in the world. That is pretty risky, given that this is a crowded island with severe traffic congestion. Most other European countries have lower limits. As we have already heard, Scotland and Australia have recorded far fewer fatal accidents since the introduction of lower limits. My noble friend Lord Beith, who was in his place earlier in this debate, said to me that, in his part of the world, it was important to remember which side of the border with Scotland you were on if you were going to have a drink and drive. My noble friend does not drink. Simplicity is important for drivers and the public; confusion should not be allowed.
I welcome the Bill. I do not know if 50 is the right limit, but it is undoubtedly time to look again at this issue. I hope the Government will take the opportunity to announce an independent review, led by experts. We need this for public confidence, because 50 is, to a certain extent, a number plucked out of a range. It is a moderate number but many people would say it should be lower, or zero. We need a thorough look at this, so I urge the Minister that the Government should set aside pressure from the drinks industry and ensure that the issue is investigated fully.
Lord Rosser (Lab)
My Lords, I also congratulate my noble friend Lord Brooke of Alverthorpe on his Bill, which addresses an issue on which he and many others feel strongly and have actively campaigned for a considerable time.
As my noble friend said in his powerful and persuasive speech, the Bill lowers the maximum alcohol limits permissible when driving in the UK, from 35 to 22 micrograms of alcohol in 100 millilitres of breath and from 80 to 50 milligrams of alcohol in 100 millilitres of blood. It also provides for a similar reduction in relation to urine. As has already been said, the effect of these changes is to bring the drink-driving limits in the rest of the UK in line with those applicable since December 2014 in Scotland. The lower limit was introduced in Scotland following a consultation in which 74% of respondents backed a reduction in the drink-driving limit.
The Bill is driven by concerns over the devastating impact of alcohol on the ability to drive safely. Department for Transport figures indicate that, in 2013, some 15% of all deaths in reported road traffic accidents involved at least one driver over the limit, and that around 250 people died in accidents involving drink-driving. In addition to these figures, there are those who are injured, seriously and otherwise, in drink-drive accidents for whom, as I understand it, the figure was some 8,300 in 2013. The 2013 casualty figures relating to drink-drive accidents do show a fall from the previous year, but they are still far too high.
I was a sitting lay magistrate for many years, and dealing with drink-driving cases was an all too regular occurrence. The frequency with which defendants who were well over the limit claimed they had had little more than “half a lager” never ceased to amaze me. In the majority of cases I sat on, the defendant had not been involved in an accident but had been stopped for other reasons, including odd or irregular driving, and been found to be over the limit. The number of people driving on our roads whose driving ability is impaired by the amount of alcohol they have drunk is, of course, far, far higher than the stark death and injury statistics indicate, but each and every person who drives having recently drunk alcohol is a potential killer if their ability to drive—and speed of response to what is happening around them on the road—is impaired.
The official drink-drive accident statistics only cover incidents where there was a failed roadside breath test based on the current limit of 35 micrograms of alcohol per 100 millilitres of breath, or where there was a refusal to give a breath test specimen. As I understand it, the official figures do not cover accidents where the level of alcohol was below the current limit, but in excess of the limit in Scotland and, indeed, in virtually all other European countries. If I am correct, to that extent, the official figures almost certainly do not reflect the number of accidents and casualties which are related to the consumption of alcohol by one or more of the drivers involved in the accident. According to the European Transport Safety Council, the United Kingdom—outside Scotland—has the joint highest drink-driving rate in Europe, and the most common limit applied across the EU is the same as that proposed in the Bill. Four countries in the EU apply a zero alcohol limit. From this month, Department of Health recommended limits on weekly alcohol intake for men are either the lowest or about the lowest in Europe. However, when it comes to drink-driving, we have just about the highest alcohol figure in Europe allowable under the law.
It has been reported that, since the lower limit was introduced in Scotland, police figures show that the number of drink-driving offences there have fallen compared with the same nine-month period the previous year, even though, presumably, the number of potential offenders—and thus offences—has increased with the lower limit. However, not everyone in Scotland supports the lower limit. The Scottish Licensed Trade Association has apparently described the law change as a “catastrophe” for the sector, with a 5% decline in sales across outlets since the previous year. If this is the case, it perhaps also gives a feel for the extent to which alcohol was being purchased—and is probably still being purchased, albeit at a lower level—by people intending to drive. People’s jobs, of course, matter: so too, though, do people’s lives.
The Government have been saying since March 2013 that they will publish a Green Paper on improving the safety of newly qualified drivers. To the best of my knowledge, that Green Paper has yet to appear. In October 2013, a Transport Research Laboratory study, commissioned by the Government, proposed the introduction of graduated driver licensing, the aim of which is to enable young and novice drivers to build up ability and experience through a structured and phased approach. Apparently, this study was only made public through a Freedom of Information request from the insurance industry. Graduated driver licensing exists in various forms in a number of countries. The exact components differ, but one of the more common elements is a lower alcohol limit. The Transport Research Laboratory study said that the proposed introduction of graduated driver licensing should include a lower alcohol limit but, as I understand it, went on to state that this should preferably be extended to apply to all drivers. I do not wish to argue the case for graduated driver licensing, but it would also be helpful to know from the Minister what weight—or otherwise—the Government attach to the Transport Research Laboratory study’s view on lowering the alcohol limit for all drivers.
The Government have stated that tackling drink-driving is a priority, which is hardly a surprising stance and one that we of course share. But they have also said, in a Written Answer last October, that they would be interested in seeing,
“a robust and comprehensive evaluation of the change to the Scottish drink drive limit”,
rather than that they want to introduce similar limits here. I therefore assume that the question of an evaluation is one that the Minister will develop in his response. Given that tackling drink-driving is rightly a priority, I take it that the Government are actively, rather than passively, pursuing the question of when such an evaluation is likely to be undertaken and completed, and by whom. Perhaps the Minister will confirm that. Finally, perhaps he will also say what issues or considerations the Government think such an evaluation should address in order for it to be comprehensive—the word they have used in relation to it.
The Parliamentary Under-Secretary of State, Department for Transport and Home Office (Lord Ahmad of Wimbledon) (Con)
My Lords, first, I thank all noble Lords who have contributed to this debate. In particular, I thank the noble Lord, Lord Brooke, for bringing forward the Bill. I listened carefully to all the contributions and I thank him for his comprehensive, thoughtful and compelling contribution. He asked for my views on the BAC in 1967. I declare a personal interest: I was not even a twinkle in my parents’ eyes at that time—maybe I was. The Government consider it very important to monitor all the elements that contribute to the number of deaths on our roads.
My noble friend Lord Attlee talked about the lower number of deaths that occur in the United Kingdom. The noble Baroness, Lady Hayter, made a very personal contribution about her experience. I remember as a young child the experience of drink-driving was not on a personal level—I suppose I should declare an interest as someone who, on faith and on principle, does not touch a drop, which will perhaps give an inkling of my views in this respect. It is important to underline as a general point that it is not a case of doubt: if you are drinking, you should not drive. That is a message that successive Governments have sought to give and it is right on a point of principle that that is where the doubt first arises.
Although I do not drink, I have been to wine bars and pubs and I am sure there are notices to that effect but they do not go into detail about 50 milligrams or 80 milligrams. They have a simple, concise message, understood by people of all ages: if you are drinking you should not drive. In my student days, I did not drink but had to drive others who had drunk. It was not a pleasant experience, I can assure your Lordships—not least if we were pulled over to the side with a whole bunch of people who were perhaps more merry than I was. To say I was not merry would be an understatement.
Turning to the matters before us today, the noble Baroness, Lady Hayter, in a very poignant contribution, talked about how drink-driving leaves families shattered, hurt and bereaved. I remember giving evidence in court after someone smashed into the back of our car, quite late on a Saturday evening, clearly drunk, but he got away with it because he drove off. Thankfully, it was late at night and there were no passengers in the car but it formulates the challenge that we have to face. The Government have taken this issue very seriously and I will come on to those points in a moment.
On 21 December last year the Government set out their plans for road safety in Working Together to Build a Safer Road System. Our priorities and plans are quite clear. We will consult on ways to tackle dangerous in-car mobile phone use, reported by the RAC as being one of motorists’ top concerns, with a view to increasing penalties for drivers using handheld mobile phones. I start on that point because it is important to set out what the Government are doing to reduce the number of all forms of road casualties. In addition, we have set up a £750,000 grant for police forces in England and Wales to build on drug-driving enforcement capability. We are consulting on legislative changes to improve cycle safety by ensuring that sideguards and rear under-run devices are not removed from HGVs, and consulting on proposals to support safety for motorcyclists, who account for 19% of all road deaths. We are consulting on ways to incentivise and reward the uptake of more pre-test practice and a broader range of real-world driving experiences for those who are starting to learn to drive, and undertaking a £2 million research programme to identify the best possible interventions for learner and novice drivers. We believe that these are all important steps that will help to reduce casualties further. As the Minister at the DfT responsible for our agencies, including the DVLA and DVSA, these are areas that I have already looked upon as priority issues to take forward.
But let me come back specifically to drink-driving. As we have already heard, it is estimated that 240 people were killed in collisions involving illegal levels of alcohol in 2013. Drink-drive deaths in 2013 were among the lowest since detailed recording began in 1979, when 1,640 people were killed, and accounted for around 14% of all road deaths. However, these are 240 too many. While police continue to robustly enforce against this reckless behaviour, the numbers of those testing positive or refusing a breath test—and, alongside this, prosecutions and convictions—have been falling continuously. This is good news.
However, drink-driving is still responsible for too many deaths and injuries. In order to prevent this, the Government will continue to take tough action against the small number of drivers who ignore the drink-drive limit. Many drivers killed in drink-drive collisions, or prosecuted for drinking and driving, are significantly over the current drink-drive limit. We have prioritised enforcement efforts to identify and deal with these dangerous individuals. We have a robust approach to deal with these high-risk offenders. As I am sure noble Lords will be aware, last year we made it a requirement for them to undertake medical tests to ensure that they are not still dependent on alcohol before they are allowed to drive again.
The same legislation, the Deregulation Act 2015, also made an important change to drink-driving laws by removing the so-called statutory option that allowed those drivers who provided a breath test that was slightly in excess of the prescribed limit to demand a blood or urine test. By removing this provision, individuals have been denied the chance to sober up and so drop below the prescribed limit while waiting for a blood or urine sample to be taken. There is also no longer a requirement for the police to do a preliminary test by the roadside if they use a mobile evidential breath-testing device. This has paved the way for the introduction next year of mobile evidential breath-testing instruments, which will enable taking evidential samples at the roadside quickly and efficiently and before a suspect has the chance to sober up and fall below the limit. This has the potential to make the enforcement process more efficient, giving officers more time being visible on the road while they deal with drink-driving offenders. This will in turn help bring the message home to other motorists that if they drink and drive they risk getting caught—with serious consequences.
My noble friend Lord Attlee spoke about the North review. I assure him that we have implemented most of the recommendations, including, as I have already said, that relating to the statutory option for drink- drivers. We have also implemented the drug-driving recommendations. We do not tolerate any form of impaired driving. That is why we introduced the new drug-driving offence in March 2015, setting specified limits for 17 drugs. The police are being successful in taking these dangerous drivers off our roads: more than 4,500 drug drivers have been convicted since the new offence came into force, compared to fewer than 900 in 2014. Moreover, 20% of drug-drivers have a previous drink-driving conviction. By clamping down on drug-driving we are therefore removing a significant number of dangerous drivers from our roads.
With regard to the lower drink-drive limit, I accept that apart from Malta, all other European countries have a lower alcohol limit than England and Wales but, as my noble friend Lord Attlee pointed out, they do not have a better record on reducing drink-drive casualties. In England and Wales, the penalties for drink-driving are more severe than in other countries, including those with lower limits. I am sure all noble Lords will therefore agree that lowering the limit in itself is not going to change people’s behaviour. Neither would it be the best use of our resources in improving safety on our roads at this time. That said, with regards to Scotland, which the noble Lord, Lord Brooke, and others referred to, we will of course be very interested to see the full impact across casualties and the rates of drink-drive offences.
The noble Lord, Lord Brooke, and others mentioned waiting for the evidence base. One thing that I will take back from this debate is, certainly, to take up directly with the appropriate Scottish Minister when we are likely to see that substantial evidence base, with a view to holding a meeting. It is important to base our decisions on evidence and the Scottish experience will be crucial to that.
We have had strong successes in tackling drink-driving through rigorous enforcement, tough penalties and changing the social acceptability of drink-driving, including through our award-winning campaigns. This is how we will continue to tackle those people reckless enough to consider getting in their car after drinking. As noble Lords will know, our award-winning THINK! road safety campaigns remain an important tool to educate people about changes in our motoring laws and safer behaviour choices.
The noble Lord, Lord Rosser, talked about education—in part, about looking at the DVSA and graduate driving. For the first time since 2007, we are running a drink-driving campaign on television, ensuring a very wide reach. It tackles those drivers who we know drink before getting in a car. A staggering one in five men between 18 and 34 declare that they would consider having two or more drinks before driving, so our campaign aims to persuade them to change their behaviour in a way that we believe will work. We will of course evaluate this campaign, as we always do. The noble Baroness, Lady Randerson, pointed out the importance of having independent reviews and analysis. I will certainly take that back to the department and look at what work has been done in that respect.
In thanking all noble Lords for their contributions, let me reiterate that the Government regard this issue as a priority. I have highlighted some of the initiatives that we are taking in this respect. Clearly, more can and needs to be done but in changing any limits we must consider the evidence base, as I am sure the noble Lord, Lord Brooke, and others would acknowledge. However, I give my personal assurance that I will take back to the department the details and learning from what has been a very well-informed and, at times, personal debate. I would very much welcome a meeting with the noble Lord, Lord Brooke, to see how we can progress this matter because I believe, as do all noble Lords, that any life lost because of the reckless act of a particular individual wrecks lives and homes. We need to take action to ensure that we can eradicate this from our society.
Lord Brooke of Alverthorpe
My Lords, I am grateful to all who have spoken in this quite short debate. I thought that the noble Earl, Lord Attlee, would probably want to maintain the status quo for the time being but if he is contemplating tabling an amendment to go for random breath testing, which would help, I would be very pleased indeed to speak to him about it and would consider accepting an amendment from him in Committee. It will not be just one silver bullet that solves all the problems; neither would the Bill. There have to be a range of factors brought to bear. My complaint at the moment, as the House will have heard, is that the Government are stalling. Yes, the Minister has referred to a number of changes but, quite frankly, they are very small indeed.
The heart of this is that the Government have a policy of saying, “Don’t drink and drive” but in practice they do not try to put forward that policy. In truth, if there was such a policy, the limit would be 20 mg. The noble Earl, Lord Attlee, said that I had got the North report wrong. I have not; I have read the North report well and the Select Committee report. I have also read the Government’s response to the North report and the Select Committee. True, there has been no precise impact assessment made of how the industry would be affected but the industry made vehement and significant contributions to the work of the committee in 2010.
In particular, when the Government responded in Cm 8050, they said in paragraph 2.26 in regard to whether it would affect people that:
“The majority would not need to lower consumption to stay legal with a lower limit, but their response to the present limit suggests that they will not want to take any chance with the risk of offending. These responsible people have the choice to drink even less—and especially to drink less when they are out. If that happened, it would have a substantial impact on the businesses they patronise”.
That was the department’s view and I believe that it is what the Government support. That is why when they talk about a policy of “Don’t drink and drive”, they do not actually follow it through—because there is pressure from other quarters to continue to allow people to drink at low levels. What I have argued today is that those lower levels are dangerous. I have argued not solely about deaths but about those many thousands of people who are injured and still alive. There are such people around in wheelchairs, and so on.
Repeat offenders—those who go well over the limit—are an extraordinarily difficult group to deal with. I would not for a moment deny that and would be very happy to meet with the Minister and talk about that right across the board. But it is odd that in the evidence which has come out these people, when they are tackled, say that the one thing that would influence them would be to be told that there was no drink and driving whatever. Then they would not drink. That has never been tested and there is no science on it but that is the idea which they put forward. If we went to a 20 mg level in due course, maybe that would be the point at which it would be tested.
Scotland has already had a strong outcry from the drinks industry about the way that the changes affect it. To pick up the point of the noble Baroness, Lady Randerson, it is making a cultural change in Scotland. As she rightly argued, we have seen many other cultural changes but in this area we have been slow. It is now time to move on.
I thank my noble friend Lady Hayter so much for her support. I pay tribute to the work that she has done over many years. Many of your Lordships may not know that she was the original founder of Alcohol Concern, which deals not just with this issue but with a wide range of alcohol concerns. It has done tremendous work in campaigning over many years.
We need other changes, too. If restaurants and pubs have a problem, what I cannot understand is why the root of what takes their business away is not tackled: the cheap booze sold to the public in supermarkets. If we were to go to a minimum unit price then the pubs, restaurants and so on would be on an equal competitive basis and would find more people going to them than has been the case. They need not drink, as we would hope to be running a campaign saying that if you go to a restaurant and have a drink, you should have a non-drinking driver with a car among you. That is a very good campaign indeed and I would be happy to support efforts along those lines. A package of measures is needed. A minimum unit price, even though it is not being pushed here, is a significant part of it and would answer some of the criticisms that have been levelled.
There are a whole range of issues here that need to come together. I will be coming back in Committee. The British Transport Police has suggested that the present limit needs to be equalised with that in Scotland, where there is a disparity. I think that that arises under different legislation and I am not quite sure how it needs addressing. I will speak to the Minister about it and see whether it is appropriate to table an amendment to the Bill.
In the mean time, I thank all noble Lords for their contributions, in particular my noble friend Lord Rosser on the Front Bench. I know that he had a little difficulty in determining from our friends in the party at the other end just what line to take on the Bill. He pointed to some very interesting and useful statistics and facts. I rather suspected from the way he was speaking that he has been convinced that while he may not have had a strong lead on policy from the other end, he will now go back and give them a very strong lead on what the Labour Party’s policy should be. It remains for me just to thank everyone who has contributed. We will be coming back in Committee, as I have at least one amendment that I will be moving. I conclude by asking the House to give the Bill a Second Reading.
Criminal Legal Aid Services
(8 years, 9 months ago)
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The Minister of State, Ministry of Justice (Lord Faulks) (Con)
My Lords, I wish to repeat a Statement given as an Answer to an Urgent Question in another place by my honourable friend Shailesh Vara. The Statement is as follows.
“As the Secretary of State announced yesterday, the Ministry of Justice has had to play its part in reducing the budget deficit. Economies have had to be made in every area of expenditure. In the last Parliament, spending on legal aid was reduced from £2.4 billion to £1.6 billion. Further changes to the legal aid system were due to be implemented in this Parliament, with a second reduction to litigation fees in July 2015.
At the time the fee reduction was proposed, the market was made up of around 1,600 legal aid firms. After careful negotiation, the then Justice Secretary decided to adopt a system of ‘dual contracting’ to drive greater efficiency and consolidation within the market. But over time, opposition to this model has increased. Solicitors’ firms feared that it would lead to a less competitive market; barristers that choice and quality would diminish. In addition, a process of natural consolidation was already taking place in the market.
Although we recognised these arguments, we also needed to deliver reductions in expenditure. Since July 2015, however, two significant developments have occurred. HM Treasury has given us a settlement which allows greater flexibility in the allocation of funds for legal aid, and it has become clear that there are real problems in pressing ahead. We currently face 99 legal challenges and a judicial review of the entire process. Litigation will be time-consuming and costly for all.
We have therefore decided not to go ahead with the introduction of the dual contracting. We have also decided to suspend the second fee cut for a period of 12 months. The Legal Aid Agency will extend current contracts to ensure continuing service until replacement contracts come into force. We will review progress on joint work with the profession to improve efficiency and quality, before returning to any decisions on the second fee reduction and market consolidation”.
Lord Bach (Lab)
My Lords, I start by thanking the Minister for repeating the Answer given in another place. I hope the Minister will acknowledge that, although the announcement made by the Lord Chancellor yesterday is of course welcome to criminal law practitioners and others, it represents something of a disaster for his department. It was not only Her Majesty’s Opposition who opposed the two-tier contracting scheme when it was first mooted, way back in 2013 by the coalition Government, but practitioners, experts and many others. We all pointed out that it could not work, that it would mean the closure of too many solicitors’ firms and that it would result, seriously, in legal deserts where those facing criminal charges would not always be able to find advice and representation. That is why we welcome the U-turn.
However, now the scheme has been abandoned, it leaves behind it enormous costs for the Government, for many solicitors’ firms—whether successful or unsuccessful in their tenders—and, of course, for those involved in the litigation. Just think of all those wasted hours worked by civil servants, solicitors’ firms and others—and all for what? What do Her Majesty’s Government intend should happen next? Sometimes in government it is right to say sorry. Does the Minister agree that this is one of those times?
Lord Faulks
A Government should always say sorry when they make a mistake. This is a response to a difficult situation which confronted the Government. As I indicated, contractions were taking place within the market. There has also, fortunately, been a drop in the crime rate generally, and the need for consolidation was overtly acknowledged by the Law Society. So these changes were not, as was suggested by the noble Lord, going wholly against the grain, true though it was that many objected to those changes.
It is easy to say that this was a disaster for the department, but the noble Lord is not himself unfamiliar with changes in policy. In 2009, as he may well remember, the Labour Government altered their approach to criminal legal aid. Governments of all colours will, from time to time, in reviewing these difficult situations and in trying to balance the need for access to justice and the need to control public expenditure, adjust their plans.
What we have done has been welcomed by the profession. We have considerable regard and respect for the profession, particularly those criminal legal aid solicitors who go to the police station at highly inconvenient hours and provide valuable assistance to their clients. The profession has welcomed the abandonment of dual contracting, the suspension of the second fee cut and the Government’s intention to work with the professions, as we have indicated, to try to ensure that changes that will have to be made in due course are made with maximum co-operation from both solicitors and barristers.
Although we have not yet calculated the overall cost, this will certainly have been expensive, which is of course a matter of regret. However, if it results in stabilisation of the legal profession and continued maintenance of high standards, then that is not a matter of regret. We will of course have to accept the characterisation of this as a U-turn. I am not sure that U-turns are always quite the disasters they are depicted as in the newspapers. If a responsible government department thinks again, that may be characterised as a U-turn or it may be considered an appropriate response to changed circumstances.
Lord Beith (LD)
My Lords, whether we regard this as a U-turn, a breath of fresh air from a new Secretary of State or simply a dose of realism in the department, it is welcome. But does the Minister recognise that a number of factors were reducing the number of solicitors doing criminal work in most towns and many rural areas, and that he will still have to address the danger that no one will be available, particularly if there is more than one defendant? While he is looking at that, will he also look at the fact that, since the scope changes, the number of claims on the exceptional cases fund has been surprisingly small, perhaps because people have never consulted a solicitor in the first place? Does that not need looking at as well?
Lord Faulks
The noble Lord is right that whatever the change in policy, it is important that we are satisfied that there are firms of solicitors that can represent people in whatever part of the country they are needed. When the replacement contracts come to be considered, that is clearly one of the factors that will be taken into account. The noble Lord also asked about the scope of legal aid generally and the exceptional funding provisions. They have been the subject of litigation and further clarification. One of the difficulties was that the forms that had to be filled in were perhaps not as clear as they might be. There has been considerable improvement in that regard, and the percentage of cases where exceptional funding has been obtained as a result of an application has increased considerably.
As a Back-Bencher looking at the LASPO Bill as it went through, I found the provisions on exceptional funding somewhat opaque, referring, as they did, to the Human Rights Act and Article 6. It was not always easy to know quite what the coalition Government were driving at. I think there is increased clarification of that. There has been a decision, although it is subject to appeal, but the noble Lord is right to draw our attention to exceptional funding.
Lord Cormack (Con)
Does my noble friend accept that it is extremely refreshing and encouraging when a Secretary of State listens, not least to the voice of this House, and makes an adjustment and a change of policy? None of us should be churlish in welcoming this very real change. Not the least of its advantages is that it has produced a situation where we have a legal profession that is in tune with the Secretary of State and a Secretary of State who is in tune with the legal profession.
Lord Faulks
I am grateful to my noble friend for that intervention. He is right that this House has always held the Ministry of Justice, in particular, to account with the galaxy of legal talent that is available around the Benches. I am certainly aware that any policy change is subject to great and close examination by all those here, not least this particular policy, which I have been asked about a number times in specific debates and in the course of Question and Answers. I reassure my noble friend and the House that the Secretary of State listens to what is said in this House and will continue to do so.
Lord Clinton-Davis (Lab)
The amount of complacency about changes in legal aid is absolutely bewildering. I speak as somebody who, in earlier life, was much involved with criminal legal aid. At the moment, there will be immense difficulties in recruiting young solicitors to do this work. I hold the view that it is desperately unsatisfactory. I hope the Minister will not again get up and say that economies have to made in legal aid. The economies that have already been made are devastating.
Lord Faulks
There is no complacency on the part of this Government. This Government value the contribution that solicitors make to the system as a whole, particularly those who work in criminal legal aid. The noble Lord is quite right: rates are not what they were and, as a profession, it has considerably fewer attractions than it once had. It is important that we continue to encourage able practitioners to go into areas where legal aid is the main source of funding. However, we have to bear in mind the interests of the taxpayer. We have constraints put on us by the Treasury. I particularly pay tribute to those who, despite the difficulties that are encountered, nevertheless pursue careers in this less profitable area of the profession. Our profession is often characterised as being full of ambulance chasers and fat-cat lawyers. These lawyers are very much not in that category.
Age of Criminal Responsibility Bill [HL]
(8 years, 9 months ago)
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Lord Dholakia (LD)
My Lords, my Bill is designed to raise this country’s unusually low age of criminal responsibility from 10 to 12. At present in England and Wales, children are deemed to be criminally response from the age of 10. This means that children who are too young to attend secondary school can be prosecuted and receive a criminal record. A 10 year-old who commits a grave crime—which includes serious violent and sexual crimes but can also include burglary—will be tried in the adult Crown Court. A child of 10 or 11 who is accused with an adult will also be tried in the Crown Court.
At 10 years old, the age of criminal responsibility in England, Wales and Northern Ireland is the lowest in Europe. In Ireland in 2006, the age was raised to 12, with exceptions for homicide, rape or aggravated sexual assault. The Minister will be aware from his experience that in Scotland in 2010 legislation provided that children cannot be prosecuted below the age of 12. Outside the British Isles, the age of criminal responsibility is invariably higher. In France, Greece and Poland it is 13. In Germany, Spain, Italy, Austria, Belgium, Hungary, Bulgaria and Romania it is 14. In the rest of Europe, it ranges between 14 and 18.
The United Nations Committee on the Rights of the Child has repeatedly stated that our minimum age of criminal responsibility is not compatible with our obligations under international standards on juvenile justice and the UN Convention on the Rights of the Child. In a statement in 1997, the committee said:
“States parties are encouraged to increase their lower minimum age of criminal responsibility to the age of 12 years as the absolute minimum age and to continue to increase it to a higher age level”.
Taking 10 and 11 year-olds out of the criminal justice system would not mean doing nothing with children who offend. It would mean doing what other countries do with 10 and 11 year-old offenders. It would mean doing what we do with delinquent nine year-olds—in other words, it would mean dealing with the causes of these children’s offending through intervention by children’s services teams. In the minority of cases where court proceedings are necessary, it would mean bringing children before family proceedings courts, which can impose compulsory measures of supervision and care. In the most serious cases, it could mean long-term detention in secure accommodation, but this would be arranged as part of care proceedings rather than as a custodial punishment imposed in criminal proceedings.
Those who oppose increasing the age of criminal responsibility often argue that children of 10 and 11 are capable of telling right from wrong, as though it automatically follows that they should therefore be dealt with in criminal courts. That does not logically follow at all. Most six year-olds have a sense of right and wrong but no one suggests that they should be subject to criminal prosecution. The point was made very well in 2012 in a report from the Centre for Social Justice, which was set up by the Secretary of State for Work and Pensions, Iain Duncan Smith. In 2012 the centre produced a report on the youth justice system entitled Rules of Engagement: Changing the Heart of Youth Justice. It said:
“There is now a significant body of research evidence indicating that early adolescence (under 13-14 years of age) is a period of marked neurodevelopmental immaturity, during which children’s capacity is not equivalent to that of an older adolescent or adult. Such findings cast doubt on the culpability and competency of early adolescents to participate in the criminal process and this raises the question of whether the current”,
minimum age of criminal responsibility,
“at 10 is appropriate”.
The evidence from international research is overwhelming, showing that children of 10 and 11 have less ability to think through the consequences of their actions, empathise with other people’s feelings and control impulsive behaviour. This does not mean that children aged 10 or 11 are not responsible for their actions, but that on any reasonable interpretation of the evidence they must be regarded as less responsible than an older adolescent or an adult. It cannot be right to deal with such young children in a criminal process based on ideas of culpability that assume a capacity for mature, adult-like decision-making.
In all other areas of law, whether it is the age for buying a pet, the age for paid employment, the age of consent to sexual activity or the age of smoking and drinking, children are not regarded as fully competent to take informed decisions until later in adolescence. The age of criminal responsibility is an anomalous exception. Ironically, a 30 year-old who had a mental age of a 10 year-old child would probably be regarded as unfit to plead and yet, by a strange twist of logic, a child of 10 is seen as capable of participating in the criminal justice process. I simply cannot accept that.
It is sometimes argued that there is no need to raise the age of criminal responsibility because the number of 10 and 11 year-olds who receive a youth justice disposal is small. “Small” is not necessarily the right argument. We are talking about normally fewer than 300 a year who are prosecuted and sentenced in court. Even though this represents a small proportion of those going through the criminal justice system, what happens to up to 300 vulnerable children can hardly be regarded as a matter of little importance. The fact that the numbers involved are relatively small is a strong argument for the Bill; it means that it would not be a huge burden in terms of resources to make alternative provision through welfare interventions and, where necessary, family court proceedings for the children who would otherwise have been charged and prosecuted.
Nor can it be argued that dealing with these children through non-criminal processes would put the public at risk. On the contrary, dealing with 10 and 11 year-old children through non-criminal procedures would be more effective than using the criminal justice process. The evidence shows that children who are dealt with through the criminal justice process are more likely to reoffend than those who are diverted from the criminal justice system and dealt with in other ways. Children who are officially labelled as offenders often react by trying to live up to the label and acting in increasingly delinquent ways to achieve status in front of their friends. Again I quote the Centre for Social Justice report, which says that,
“raising the minimum age of criminal responsibility would achieve important changes. Young children would not be tarred with the stigmatising ‘offender’ label which the evidence shows can exacerbate delinquency and would more likely have their victim status and welfare needs addressed, which the evidence suggests are currently often neglected”.
This is a particularly important point, as children who go through the criminal justice process at a young age are often young people from chaotic, dysfunctional and traumatic backgrounds involving a combination of poor parenting, physical or sexual abuse, conflict within families, substance abuse or mental health problems. The prospects for diverting the child from offending will be far better if these problems are tackled through welfare interventions than by imposing punishments in a criminal court. A welfare approach would avoid unnecessarily giving children a criminal record, which can make it harder for them to gain employment when they reach working age. As unemployment increases the chances of reoffending, this is another way in which criminalising children can increase rather than reduce the likelihood of future crime.
Of the 10 and 11 year-olds who are charged and prosecuted each year, very few receive a custodial sentence, and in some years none do. However, although the number of serious child offenders is small, the public will of course want to be assured that raising the age of criminal responsibility will not increase the risk from these young people.
Some people who generally support raising the age of criminal responsibility argue that an exception should be made for the most extreme cases, such as homicide or serious sexual offences. I am willing to consider this point in Committee but my inclination at this stage is to resist making exceptions. The most serious child offenders invariably have the most complex welfare needs. Their backgrounds include experiences of serious physical abuse, sexual abuse, emotional abuse and neglect, parental mental illness, rejection and abandonment by adults, traumatic loss, conduct disorder and serious emotional disturbance. They need a welfare-based approach, in secure care if necessary, to help them to face their unresolved trauma, to develop and mature emotionally, to reach an appropriate sense of guilt and to learn to control their emotional and aggressive impulses.
Noble Lords will recall the trial of the boys who killed James Bulger, who were aged 10 at the time of the killing and 11 when they were tried. Most foreign commentators were amazed that children of that age should be dealt with by a trial in an adult Crown Court. They questioned whether such young children could really understand the complexities of a lengthy criminal prosecution and trial, whether they should have appeared in the full glare of media coverage, whether they understood all the issues and language of the trial, whether they could give sensible instructions to their lawyers and whether their decision not to give evidence was simply because they were frightened of speaking in such a setting.
Exposing such young children to a criminal trial is no way to achieve justice. Moreover, the case took nine months to come to trial, during which time the defendants received no treatment or therapeutic help in case it prejudiced their pleas. That is a completely unacceptable way to deal with young defendants and one which would be unthinkable anywhere else in Europe. It should be equally unthinkable here. The two boys should have been dealt with in family proceedings and detained in secure accommodation, without all the ill effects which resulted from a public Crown Court trial.
I commend the Bill to the House. The simple proposition that it contains, if enacted, would be an important step towards dealing with vulnerable, difficult and disturbed children in a way that befitted our civilised society. I beg to move.
The Earl of Listowel (CB)
My Lords, I support the noble Lord in his call for a Second Reading of this important Bill and I wholly endorse and support every word that he has said. I hope particularly that what he said about the pitiable experience of 10, 11 and 12 year-old children going through a criminal court process—he mentioned a court process of nine months—will speak particularly to the Minister’s experience.
As vice-chair of the all-party group on children and young people in care and leaving care, I know only too well the background of many of these young people. Of course, 45% of children—55% of girls—in the criminal justice system have had an experience of foster care or children’s homes, so in my experience the noble Lord’s assessment is absolutely right.
I thank the Government for the efforts they have made to reduce the numbers of children in the criminal justice system over recent years. The Government have reduced it to one-third of what it last stood at, so from 3,000 to about 1,000. That is helpful in this area because it has reduced down to 300 the number of children we are talking about today.
That need not necessarily continue. Listening to the scientific evidence, many of us might assume that in the course of time, this will come about—we will have the same age of criminal responsibility as civilised countries have. However, this cannot be taken for granted and we need to act urgently on this matter. It takes only one ambitious unscrupulous politician to come along and say, “Look, we must be tough on crime and on the causes of crime”. We saw that in the past— I certainly saw in this House what happened then. We saw the numbers of children being criminalised shoot up and more and more children incarcerated because of a policy which is wholly counterproductive and which all the evidence speaks against. However, there is always that risk that an unscrupulous politician will choose to make political capital out of these young people.
I am very pleased to see the noble Baroness, Lady Massey of Darwen, in her place and to see that she will speak later. Of course she has for many years chaired the All-Party Group on Children and chaired our children and the police inquiry. I have no doubt that she will refer to our finding and recommendation that the age of criminal responsibility should be raised to at least 12 years of age.
Many of us will be sending a cheque to the taxman today or this week. I am very happy to pay for state services—I know how important they are. However, I rue sending a single penny that is not spent effectively. To incarcerate 10, 11 and 12 year-olds is an ineffective, wasteful use of public money. I think that the Government will particularly understand that. At a time when we are seeking to pay down the deficit and the Government are making very tough decisions, we cannot afford to indulge in policy which is counterproductive and wasteful for the public purse. No hard-working taxpayer wants to pay money to sustain legislation which is clearly counterproductive, and all the professional evidence points to that.
I recently had the opportunity to speak to parents who lost their children as victims of violence. Last year, I communicated with a number of parents whose children had, very sadly, taken their own lives, having been incarcerated in police cells. I spoke to one mother whose very troubled daughter had ended up in a police cell over the weekend. She had been very distressed and took her life shortly afterwards. Thanks to the work of those parents, the work of Just for Kids Law, which represented them, and the hard work of the Minister, we managed to change the PACE Act, and now it is not permitted for such children to be incarcerated.
My sense from talking to those parents was that they were not out to punish the state for what had happened—they were not pursuing it for criminal negligence—but they wanted to see that no other mother experienced the loss of a child as a result of incarceration. Generally crimes committed by children are physical crimes against other children. In that situation, many parents would want to be assured that the state was doing all it could to prevent such things happening again. That would be a primary consideration for them. We know that if we bring children into the criminal justice system, a third of them will reoffend within a year, and they receive, as it were, a schooling in crime by going through various institutions. As adults, they may well have a criminal record and it will then become harder for them to get a job. They are labelled as criminals and they may be confirmed in a career of crime. They may well go on to have children, who may follow in their footsteps.
If one says to a parent whose child has been harmed by another child or who has lost a child through violence from another child, “We are going to try our best to stop this happening to another child”, then the right, and effective, approach is a welfare one, with all the protections and the secure accommodation that the noble Lord referred to, rather than the wasteful, ineffective approach that we currently take.
I hope that institutions such as Mumsnet and the Mothers’ Union will look at this debate and seek to take up with the Government concerns about the welfare of these children and about protecting children from each other. Often, we are talking about very troubled children and we need to do something about them, but simply maintaining the status quo fails to protect our children in the most effective way. It is time to act. It would be the right thing to do to pass the noble Lord’s Bill. It would be the right thing for our children and for our hard-working taxpayers. None of us wants our tax to be wasted in the way that it currently is.
There is always the risk that we will go backwards. Towards the end of his career in the House, Lord Onslow learnt how many children we were incarcerating in this country, and I remember how passionately he advocated reducing the numbers. We could go back to increasing the number of children in that situation. Therefore, I ask the Minister—he may prefer to write to me—how much the youth justice system costs and how much would be saved if we raised the age of criminal responsibility to 14. That age is much more the norm in civilised countries, and I hope that this Bill will be a step towards that. If he could do some modelling, looking at the longer-term impact of a reduction in the number of children having a career of crime and coming back into the criminal justice system again and again, that, too, would be helpful.
Finally, I commend the noble Lord for his perseverance and for bringing this issue back again and again. It is, ultimately, a question of children’s rights. Here we are, in this country, punishing the very children who often we as a nation most let down. The noble Lord is absolutely right to keep persevering, and I am very glad that he has brought this to the House.
Lord McNally (LD)
My Lords, it is always an enormous pleasure to listen to and follow the noble Earl, Lord Listowel, on any subject linked to the welfare of the child, not simply because he keeps a close interest in these matters but because, when he speaks to the House, he speaks from direct experience of talking to children and those who work with children, who give us a message of the reality at the sharp end of this. We are always in his debt for these contributions. Likewise, as I have put on record before, I am grateful to my mentor, my noble friend Lord Dholakia—I was going to say “old mentor”, but he gets sensitive about the term “old”—who, over 20 years or so, has been a constant prod to me on reforming the criminal justice system.
As is on the register, I am the chairman of the Youth Justice Board, but I am not speaking today in that capacity.
Another thanks must go to the noble Earl, Lord Listowel, because what he said feeds into what I want to say, on his proposal to move the age of criminal responsibility into a wider context. If we are going to have a rational debate about that, we have got to put it in a wider context.
It is interesting that when we had the debate earlier today about drink-driving, the Minister was urged to look at Scotland as an example. Next month, the Scottish Government will receive the report of an advisory panel on raising the age of criminal responsibility in Scotland. That is something that Ministers, and all in this House who are interested in the matter, will be very keen to read. The Scots have gone for a slightly hybrid model so far; they have kept the age of criminal responsibility at eight, but no child can be brought before a court until the age of 12. The advisory panel has been looking at that and the suspicion is that it will advise a common age for both, but we will have to wait and see.
As my noble friend Lord Dholakia indicated, the long shadow of James Bulger’s murder on 12 February 1993 lies across any debate about the age of criminal responsibility. When I was appointed chair of the Youth Justice Board 18 months ago, I was interviewed by the magazine Children & Young People Now about how I saw the job, and I was asked what I thought about the age of criminal responsibility. I said that I was aware that the Scots were looking into the matter and thinking of raising it to 12 and that we could do likewise. The next day, a national newspaper rang James Bulger’s mother to ask her what she thought about changing the law so that James’s killers would have “got away with it”. It was a monstrous crime, but I think it intimidates proper debate about the age of criminal responsibility. The two boys who killed James would not have got away with it. However, the full trial, which began in Preston Crown Court on 1 November 1993, would not have been conducted as an adult trial, as it was, with the accused in the dock away from their parents and the judge and court officials in legal regalia.
I am well aware that since that time changes have been made to make trials involving young persons more child friendly. However, I spoke to a senior judge who visited Preston Crown Court recently and he told me that it had not changed in appearance since 1993. It remains virtually unchanged and, as he said, it is almost unbelievable that two 10 year-olds should face trial in such a place and in such a way. I know that it is Mrs Bulger who has received the life sentence, and I do not sympathise with the perpetrators at her expense, but much has happened in the past 20 years which has increased our understanding of crimes committed by children and our responses to it, as the noble Earl, Lord Listowel, so eloquently explained.
The Youth Justice Board was set up in 2000 following the Crime and Disorder Act 1998, which in itself followed the ground-breaking report of 1996, Misspent Youth, to address the specific challenges of offending by under-18s—children in the eyes of our law. The clear statutory aim of the YJB was to prevent offending by young people. For that reason, the continuing fall in the number of children entering into the justice system—statistics yesterday show another 9% fall last year—and the secure estate, which, as the noble Earl, Lord Listowel, said, is now down to about 1,000, only 50 of them girls, all points to the right direction of travel under successive Governments.
These outcomes are not the result of the work of the Youth Justice Board alone but the work of many hands. It is still work in progress, and the noble Earl, Lord Listowel, referred to the very high reoffending rate of those who have been in the secure estate. Progress certainly owes much to the work of the holistic, locally-based, cross-disciplinary approach of the youth offending teams, which the Youth Justice Board established. It also owes much to the police “buy in” at national and local level of programmes and protocols aimed at diverting young people from crime and the criminal justice system. The liaison and diversion services championed by the noble Lord, Lord Bradley, in his ground-breaking report mean that mental health needs are detected and dealt with sooner.
The Magistrates’ Association has shown vigour in looking at how best youth courts can adapt, and Mr Gove has recently expressed his interest in problem-solving courts. The Government’s Troubled Families initiative moves action upstream to tackle the multifaceted dysfunctionalities which are often the precursor of criminal behaviour, again as the noble Earl, Lord Listowel, explained.
Work by the Disabilities Trust Foundation at the Keppel unit at YOI Wetherby has shown the benefit of identifying and treating brain injury among young offenders. Research by University College London, among others, has shown that the brain evolves and matures over a long period after the age of 10. That is why, as we have heard, most European countries have ages of criminal responsibility higher than ours. Most continental jurisdictions espouse a welfare approach to offences by the young. Over the past 20 years, a lot of the undercurrent of the approach to youth justice in England and Wales has been, as I have illustrated, to use welfare rather than criminal sanctions in dealing with young offenders. I was pleased that during my time in government the Transforming Youth Custody initiative was taken forward to double to 30 the number of hours of education. It is significant that Mr Gove has asked an educationalist, Mr Charlie Taylor, to conduct an inquiry for him into youth justice services. I put on record my appreciation for the thorough and comprehensive way in which Mr Taylor has carried out his inquiry. I have already discovered that youth justice is a field well populated with strong opinions, but I do not think anyone will be able to say that they have not been able to bend his ear by the time his report is published.
On the eve of this debate, I came across a report by Dr Di Hart, working through a Churchill Fellowship award and supported by the Prison Reform Trust, entitled Correction or Care? The Use of Custody for Children in Trouble. I intend to invite Dr Hart to the House to present her report more fully. I shall briefly run through her recommendations, because they tie into the wider debate on welfare or punishment in our criminal justice system, which I think Mr Gove is ideally positioned to undertake because of the confidence that he has won in all areas. The recommendations in the report include:
“Reconsider the separation of justice, welfare (and psychiatric?) placement models … Develop a shared understanding of the best model for meeting children’s needs … Regional commissioning … Pilot a new model of residential care”—
something that I think has a certain urgency to it—
“Develop a shared data set to measure experiences and outcomes … Establish an expert panel to advise on good practice … Maintain the involvement of sentencers in tracking children’s progress”,
which is something that I know the Magistrates’ Association is interested in taking forward.
This debate is taking place in that wider context. I think that we are moving towards a system of looking after young people and children, in particular the very young, from the age of 10 upwards, in a more welfare-based way, precisely because of the point made by the noble Earl, Lord Listowel. The present system does not work; reoffending is far too high, and it is expensive. Even the most hardened “lock ’em up and throw away the key” people have to concede that we are wasting public money. A new, broader look at the context of this may achieve a national consensus, but we need to do it in a rational manner in the light of research, of experiences in other countries, of advances in medical and other scientific understanding, and of other changes recommended when the Taylor report is produced. This Bill is before us at an opportune moment, and I commend it to the House.
Lord Cormack (Con)
My Lords, I am glad to add my support and congratulations to the noble Lord, Lord Dholakia, on his persistence and for the calm and moderate way in which he has introduced the Bill, and for recognising in his speech that amendments might have to be made. My own inclinations march with his; nevertheless, these issues will have to be examined in detail in Committee. But the broad thrust of his argument is one with which I can closely identify myself.
We had a debate in your Lordships’ House last Thursday, introduced by my noble friend Lord Fowler, on the subject of prison reform. It was a good debate and a number of us who are here today took part in it. I think there was universal admiration for the way my noble friend introduced it and for the proposals he made. Another theme ran through the debate, which I would categorise as a collective sigh of relief at the change of direction of the Ministry of Justice since the present Secretary of State took over. He has already shown himself to be a sensible and sensitive man, and indeed we have had further evidence of that this very day in the Statement made by my noble friend on the Front Bench just before this debate started. So I hope that we are to some degree pushing at an open door. Although I do not expect, because I am fairly case hardened, my noble friend on the Front Bench to get up and metaphorically embrace the noble Lord, Lord Dholakia, I hope he will be able to give us some indication that the powerful points made in the noble Lord’s speech will be reflected upon.
I do not think anyone is saying that young children who commit wicked acts—and some do—should not be adequately dealt with, which of course involves a degree of punishment. The punishment is separating those young people from the environment which has perhaps inculcated, or certainly increased, that wickedness. No one is suggesting that it would be sensible to have sent the killers of James Bulger immediately back into the community. That would be utterly absurd. But was the paraphernalia of a full trial wise? I think not. What is important is that young people who do wicked things should be adequately dealt with. I agree with the advance to the age of 12. It is important to note that, if they are under the age of 12, putting them into the criminal justice system is not very sensible or even cost-effective.
One of the points that came up time and again in last week’s debate was reoffending. I have personal experience because I had a young offenders’ institution, Brinsford in South Staffordshire, in my constituency. If we had suffered from the same sort of background and lack of upbringing that many of the young men in that institution had had, we might have gone the same way. When once they become institutionalised, those young people tend to reoffend again and again. The noble Lord, Lord McNally, is nodding. How glad I am that he has his present role, because he understands these things. If young people under the age of 12 commit crimes, the whole thrust and emphasis of their treatment —I used that word advisedly—should be to try to ensure that they do not offend again.
Several times in last week’s debate, the famous remarks of Churchill when he was Home Secretary were quoted. He said that within every person there is some spark of goodness. You judge a civilised society by the way in which it treats offenders. The punishment is being sent to prison. The whole purpose of prison is to rehabilitate. Children should be sent somewhere where they can be nurtured as well as rehabilitated. Many who commit these dreadful crimes have no home to speak of. It is not being soft to say that one supports the proposition of the noble Lord, Lord Dholakia. One is being realistic. One is recognising that the age of criminal responsibility, which is determined by the state, must be determined with real regard for what children under the age of 12 can properly be able to answer for.
In a sense, I am thinking aloud in making these points. As one who has children and grandchildren, spent 10 years as a schoolmaster and 40 years as a Member of the other place, and over 30 years with prisons in my constituency, I really believe that Churchill was right when he said that in almost everybody there is a spark of goodness. If a child goes astray, the whole emphasis must be on trying to ensure that that child does not grow up into a hardened criminal. As I see it, that is at the root of the Bill of the noble Lord, Lord Dholakia, and his crusade—it has become that, as he has come back to this issue again and again.
I hope that when my noble friend—he is a man of real sensitivity and understanding—answers the debate, he will say that he will discuss the matter with the Justice Secretary. I hope he will indicate that he understands what exercises those of us who believe that the age has been set far too low. I slightly dissent from the noble Earl, Lord Listowel, for whom I have great admiration. In a throwaway line, he referred to other countries as being civilised without suggesting this one is. We are a civilised country and we are all proud to live in it, but every civilised country can make itself better and more civilised. This would be a small step in that direction.
Lord Parekh (Lab)
My Lords, I express my deepest gratitude to the noble Lord, Lord Dholakia, for introducing the Bill, and, more generally, for his persistent advocacy of the cause that informs it. I am also delighted to be following four noble Lords who have done splendid work in this area, and whose contributions I recognise.
Naturally, in a debate that has gone on for some years, many of the arguments made today have been made before. Therefore, it is difficult to find entirely new arguments. Naturally, I will repeat some of the arguments that have already been made, but also perhaps add one or two that I think are new and go to answer the point that the Government have made over the years as to why they will not accept the idea of raising the age of criminal responsibility.
The current age of 10 is unacceptable for at least four important reasons. First, it is far below the international norm. The United Nations Convention on the Rights of the Child recommends the age of 12. If one looks at other countries in a similar position to us, the situation is quite striking. The age of criminal responsibility is 12 in Canada and the Netherlands; 13 in France; 14 in Germany, Austria, Italy and Russia; 15 in Scandinavian countries; and 16 in Belgium, Luxembourg and Portugal. A striking exception, which makes the point, is the United States, where the age of criminal responsibility is six—but then the United States has never been a good model for criminal justice. I do not think that that is the country we would wish to emulate, in this respect at least.
The other important point is that those countries whose cases I have cited have been perfectly happy. Many of them settled on an age of criminal responsibility several years ago and have seen no reason to alter it or to bring it down. If they can live with the age that they have decided, there is no reason why we cannot.
The second reason for increasing the age of criminal responsibility has to do with the larger, cultural question. The age of responsibility reflects society’s attitude to its young people. Those taking a dim view of young people—almost a Calvinist view in which children are supposed to be little devils who must be tamed by force, which dominated the Victorian period—generally tend to go for a younger age of criminal responsibility. Sadly, this is true of our own country. We imprison four times more people than Portugal, 25 times more people than France and 100 times more people than Finland. Raising the age of criminal responsibility raises society’s respect for its young people and is a profoundly significant cultural factor. Rather than rush to lock up a child, society’s gaze is now fixed—should be fixed—on what can be done to prevent a child behaving in this way. That is an important, constructive point to consider rather than simply punishing a child who has behaved in a certain way.
The third reason that I wish strongly to increase the age of criminal responsibility is in response to the Government’s continual argument over the years that children of 10, or even younger, are able to differentiate between bad behaviour and serious wrongdoing, and, therefore, that if they are able to do that, they should be held responsible. I am afraid that I do not see the logic of that argument because responsibility does not have much to do with whether one is able to make a distinction or not; it has to do with a sense of agency and whether one is able to act on that distinction. One may be able to think of a child who is able to make a distinction between bad behaviour and serious wrongdoing. But the question is whether the child has been brought up in a certain way, is able to control his temperament and exercise self-restraint, is able to think through the enormity of what he is about to do and empathise with the person upon whom he is about to inflict punishment. If a child cannot do those things, he will be unable to act on the distinction that we talked about earlier. The child knows what serious wrongdoing is but cannot avoid it for the reasons that I have just mentioned. In that kind of situation, the response should be to intervene with children’s services teams and, where necessary, by family court proceedings. Criminalising such a child would mean a permanent stigma; it would mark him out for ever and offer little hope of reform or reintegration.
My fourth and final argument has to do with the point made by the noble Earl, Lord Listowel, which was repeated by the noble Lord, Lord Cormack, and others: namely, the sheer cost of this. Although the number is small—about 100 10 year-olds and about 400 11 year-olds have been criminalised—the question is: how much does it cost to keep people in prison, especially when one considers the question of reoffending? At that point one needs to ask: how much will this cost and what are the results of doing this? I therefore strongly suggest that common sense and economic cost analysis, as well as basic moral principles—plus, of course, our standing in the community of civilised nations—require that we increase the age of criminal responsibility from 10 to whatever we consider proper, but certainly no less than 12.
Lord Maclennan of Rogart (LD)
My Lords, the country should be very grateful to my noble friend Lord Dholakia for pursuing this question of the minimum age of criminal responsibility. I agree with the noble Lord, Lord Cormack, that this is a civilised country, but we are exceptional in our treatment of young people in respect of their criminal propensities. The circumstances in other European countries that have raised the minimum age of criminal responsibility are not necessarily different from ours. Belgium, Luxembourg, Lithuania and other countries have decided that the minimum age should be much higher than it is in this country.
We are also offending against the recommendation in the UN Convention on the Rights of the Child in making it clear that we are not prepared to accept raising the minimum age to 12, which has been supported by most countries.
The debate so far has been extremely effective. My noble friend Lord McNally, who is in charge of youth justice, made a very powerful speech. He spoke for himself and I hope he will be listened to by the Government. The noble Lord, Lord Faulks, who is answering the debate, has had his ear bent by the noble Lord, Lord Cormack, who suggested that he should be talking with our new and rather enlightened Secretary of State, who has made some significant changes in the nature of the laws we advocate in this country. I was a great admirer of Lord Bingham—Tom Bingham—who was a year ahead of me at college. His book, The Rule of Law, is one of the most heavyweight arguments about what we ought to be thinking about in this country. On equality, he said:
“Most British people today would, I think, rightly regard equality before the law as a cornerstone of our society … But we would also accept that some categories of people should be treated differently because their position is in some important respect different. Children are the most obvious example. Children are, by definition, less mature than a normal adult, and should not therefore be treated as a normal adult would expect to be treated. Thus they are not liable to be prosecuted for crime below a certain age (in Britain it is conclusively presumed that no child under the age of ten can be guilty of any offence, a younger age than in most comparable European countries); if convicted of crime, they should not be punished as a normal adult would be punished”.
That is a very wise statement.
The noble Earl, Lord Listowel, expressed in powerful terms how young people should be treated; how, if they are guilty of offences, they should not necessarily be dragged before a court and how doing so might make them reoffenders. That is too common in this country and we need to root it out. The whole purpose of our response to offences should be to root out the propensity to reoffend and to inspire people to live lives in concordance with the law.
My noble friend Lord Dholakia is introducing this measure at a very suitable time and I hope it will be recognised that the movement to raise the minimum age of criminal responsibility should not necessarily stop at 12 but should go beyond. As the UN has stated that 12 is internationally acceptable, that would be a very good move in the right direction but let us not end the argument there.
The Lord Bishop of Chelmsford
My Lords, in rising to support the noble Lord, Lord Dholakia—and, indeed, pledging the support of the church to this campaign—I need to declare an interest: I was a child once and got into some scrapes. Now I am a parent and in the work I do hardly a week goes by when I am not in schools. Indeed, last year I had the sad but very moving honour of opening a garden of remembrance in the diocese where I serve in east London for young people who were the victims of, indeed had been killed by, knife crime. So I do not underestimate the seriousness of the crimes that we are talking about, nor the fact that children and young people do commit them.
It is often said nowadays that children grow up too quickly. I wonder if we have rather short memories. Although there are invidious and unspeakable pressures on children today, it was only a century or so ago that many of our children—who are now safely tucked up in our primary schools—were going out to work in pretty difficult and challenging conditions. Until 1875, a 12 year-old could have sex legally in this country. It was changed that year to 13. Since then, over the past 150 years, a succession of laws and protocols have recognised that with regard to all sorts of things, from smoking cigarettes to going to the cinema to watching certain sorts of films to sexual intercourse itself, we grow and develop gradually.
The decision about when someone is an adult is best made looking back from a point where there can be certainty or at least widespread agreement that at this age—it varies for different activities; it is often 16, sometimes 18—this person really has developed and is able to take responsibility for who they are and what they do. So why, in the case of criminal responsibility, do we make the decision speculatively, hoping that it might be the case that because there is some general growing sense of what is right and wrong, that person so knows what they are doing that they can be held culpable for their actions as if an adult and in a court of law?
But a child of 10 is just that—a child—not yet at that point where there could be such widespread agreement about their ability to know the consequences of their actions, nor developed morally or socially, so that we could be sure that they know what is right. That is why the law does not let them buy cigarettes or watch certain films or go to bed with each other. Therefore, when crimes are committed—for they are still crimes even if the child is no longer labelled a criminal—to deal with them in a court of law not only contradicts every other measure we have made, not only offends against common sense, not to mention the day-to-day experience most of us have as parents and grandparents, but it makes—and perhaps this is the biggest reason for supporting the noble Lord, Lord Dholakia—any possibility of rehabilitation or amendment of life that much harder. Of course, we agree with the noble Lord, Lord Cormack, that this is a civilised society, but this legislation diminishes us. As has already been referred to more than once, the United Nations Committee on the Rights of the Child has called on the United Kingdom to raise the age of criminal consent. Quite simply, we should heed that call.
My right reverend friend the Bishop of Derby made this point well in a previous debate on this matter: there are interconnected social and familial roots which combine to make us who we are. Here, the consistent teaching of the church is at odds with a society that by defining everyone as individual misses the deeper, interdependent influences and relationships that form our personhood. As my right reverend friend said:
“Human beings are formed through relationships”.
Crime tends to happen, he said,
“when relationships go wrong or are handled destructively”.
Do not therefore curse the fruit if the soil in which the tree is planted is poisoned and unkempt. To jump to calling a 10 year-old a criminal may play well to the gallery of a certain sort of public opinion that too quickly craves a scapegoat and an easy answer, but misses what my right reverend friend then called,
“the science of social formation”.—[Official Report, 8/11/13; col. 483.]
That science is about where someone is made a person, particularly in the family but also in schools, churches and other faith groups and community groups.
Where this breaks down, criminal behaviour is of course not inevitable; but where crime occurs in those so young, these influences—or the lack of them—must be taken into account. Furthermore, as has been mentioned, neurological and other scientific advances illustrate that maturity in young people, especially boys, is slower than we may have thought. The male brain carries on developing until the age of about 25. Many of us wish that it would carry on for a bit longer still. To brand a 10 year-old as a criminal therefore fails to understand who that person is and who they are becoming, and our collective responsibility for that. It also risks excluding the possibilities of finding better ways to work with them to ensure that such crimes are never committed again, not just by that person but in the whole of our society. So to my mind even a move to 12, which I wholeheartedly support, is just a step in the right direction. As in France, where the age is 13, Italy, where it is 14, Denmark, where it is 15, and Spain, where it is 16, there are other steps which I believe we should take.
Jesus famously said of those who nailed him to the cross:
“Father forgive them, they don’t know what they’re doing”.
He was speaking to adults. How much more should those words apply to children? We can still abhor the crime. We can still, where necessary, impose compulsory measures of supervision and care, and in rare and extreme cases—like that of Jamie Bulger’s killers, which has been mentioned—we could still impose long-term detention in secure accommodation. But that would be part of a care and welfare proceeding, rather than a custodial punishment imposed in a criminal court. In other words, our starting point and our hope would be that as this child develops, because they are children and are still developing, they would come to a point where they would truly know what they had done and truly be enabled to live a different life.
Forgiveness is never just wiping the slate clean, as if a human being were simply a vessel to be emptied or, for that matter, something to be discarded or excluded—nor does forgiveness fail to take crime seriously. Instead, by holding and nurturing someone within a new set of relationships, it means believing that the future can be different. It is for that different future for children who offend that I support the Bill and hope that it is taken forward.
Baroness Massey of Darwen (Lab)
My Lords, I very much admire the noble Lord, Lord Dholakia, for his persistence with this Bill, which I support strongly. It has been very refreshing to hear, from all sides of the House, support for the Bill and sympathy for the approach of looking at children as children who need welfare, common sense and reason rather than just punishment. I welcome the very powerful speeches.
When distinguished organisations such as the Youth Justice Board, the Children’s Rights Alliance for England, the Prison Reform Trust, the Centre for Social Justice, the Howard League and others say that it is time for reform in this direction, we ought to listen. Children are not naturally psychopaths or criminals—they are children first. The noble Lord, Lord Cormack, pointed out very movingly that much happens in children’s lives which needs to be counteracted. Let us not blame the children and rush to prosecution, but remember that the welfare of the child is paramount, as the Convention on the Rights of the Child states. The noble Earl, Lord Listowel, mentioned the All-Party Parliamentary Group for Children, which I chaired, and I remember that we had discussions on the age of criminal responsibility as part of two of our inquiries. Those principles have not changed.
Let us look at the level of youth custody in England and Wales. We lock up more children than any other country in Europe. The earlier a child is drawn into the system, the greater the chance that they will reoffend. A low age of criminal responsibility indicates a society that views young people as criminals, and this has become self-reinforcing. The issue of problematic behaviour is a welfare and educational issue, not a criminal justice issue. Other countries look for alternatives to prosecution. In France there is educational intervention, and proceedings do not take place if it succeeds. In Italy, pre-trial supervision is used and, where it is successful, prosecution does not ensue.
When a young person is involved in criminal activities, we should be asking how and why the young person has fallen through the net—not criminalising them. I believe that our duty as a society is to safeguard and promote children in need, with a clear focus on the best interests of the child. The criminal justice system is not the starting point for this.
The noble Lord, Lord Ahmad, for whom I have enormous respect, stated in the 2013-14 Session, in responding to the noble Lord, Lord Dholakia, on an identical Bill, that the Government had no plans to raise the age of criminal responsibility. He supported this by saying that the Government believe that children aged 10 were,
“able to differentiate between bad behaviour and serious wrongdoing and should therefore be held accountable for their actions”.—[Official Report, 8/11/13; col. 487.]
I do hope we have moved on from that stance.
We have heard the phrase “tough on crime”. That slogan should be tempered by common sense. Locking up young people is tough not only on young people but on the police, on the court system and on parents. Money is being spent on dealing with young children in ways that are not only counterproductive but expensive.
A 10 year-old, under our current system, could be tried in a Crown Court and may be given a custodial sentence equivalent to that available in the case of an adult. Similarly, a child of that age who is co-accused with an adult will be subject to trial in an adult venue. As other noble Lords have said, these arrangements have been criticised by the United Nations Committee on the Rights of the Child, which says that our rules are not compatible with our obligations under international standards of juvenile justice.
The situation is described by the Youth Justice Board as “illogical” and “damaging”. I really cannot accept the argument that children of 10 can necessarily distinguish between bad behaviour and serious wrongdoing. Criminalising a young person will not automatically ensure that they think about their behaviour. In fact, criminalisation may lead to worse behaviour, rather than an improvement, as others have said.
A later age of responsibility can improve the lives of thousands of children and also prevent thousands of children ending up in the youth justice system. It should be noted that one-third of all children who enter the youth justice system reoffend within 12 months. What is the cost of all this not only in human lives but in money? I do not know. Maybe the Minister does.
The Children’s Rights Alliance for England argues for an approach to youth justice in which under-18s in conflict with the law are dealt with under a system that is completely separate and distinct from that for adults: an approach which is child-centred, complies with children’s rights standards and focuses on rehabilitation, education and proportionality. I agree.
As the noble Lord, Lord Dholakia, said, the UN Convention on the Rights of the Child requires that states should establish an age below which children are presumed,
“not to have the capacity to infringe the penal law”.
Does the Minister have any evidence that a low age of criminal responsibility reduces crime? I very much doubt it. What the low age may do is criminalise children for minor offences which they will probably never commit again. Most children grow out of things, and bad behaviour is quite normal, as the right reverend Prelate indicated. The human brain is not fully developed in its capacity for cognitive and emotional functioning and abstract thought until young adulthood.
Our Government have to respond to the UN Committee on the Rights of the Child this year. The UN committee may well again recommend that the UK Government raise the age of criminal responsibility for children. I have not heard of any movement on the part of the Government to do so. Will the Minister say if their response is being considered and what the response will say? Perhaps he will write to me and other noble Lords to set out the Government’s approach. I hope that we will get some reassurance today on this important issue.
Lord Brown of Eaton-under-Heywood (CB)
My Lords, I join other noble Lords in congratulating the noble Lord, Lord Dholakia, on his persistence in advancing this worthy cause, to which I add my support.
First, I shall give a very brisk canter through the history of this question. Before 1933, the age of criminal responsibility was in fact seven. You were deemed to be what was called doli incapax—incapable of evil—until the age of seven; for the next seven years of your life— seven to 14—you were presumed to be doli incapax. The Children and Young Persons Act 1933 increased the age from seven to eight, therefore leaving a presumption from eight to 14. Thirty years then passed until 1963 when eight was increased to 10 and 10 to 14 became the age of presumed doli incapax. Thirty-five years then passed until the Crime and Disorder Act 1998 which abolished the presumption of not being criminally responsible and left it to the prosecution to prove criminal responsibility for that 10 to 14 group. The prosecution would seek to prove it by showing that the defendant knew his conduct was seriously wrong and therefore criminal as opposed to merely naughty.
That position, however, remained unclear for about a decade from the 1998 Act because it was thought by some that instead of the presumption having been abolished in respect of the 10 to 14 year-olds, it had merely been reversed. In this Chamber in 2009, in a case to which I was party, R v JTB—we sat in the February recess in 2009 at this end of the Chamber, at the Bar of the House—we decided, not as a matter of policy but as a matter of statutory construction of the 1998 Act, that indeed it had been abolished. Therefore, as we all now know, today if you are under 10 you cannot be convicted of a crime, but once you have reached the age of 10 then your particular age, whether you are 10, 11, 12, 13 or whatever, as a matter of strict law becomes entirely irrelevant except in so far as it would bear on the court’s assessment of how reasonably you had behaved if, for example, you were running a defence of self-defence, or if some question of subjective recklessness, foresight or intention—something of that sort—were involved. But the earlier all-important question between the ages of 10 and 14 of whether you knew what you were doing was seriously wrong was no longer being asked.
Enough of the history. As the noble Lord, Lord Dholakia, has explained, internationally, even indeed within the UK, 10 is among the very youngest ages of criminal responsibility. Surely the critical question must be how as a society we deal with these youngsters to address their misconduct and wrongdoing. The word “criminality” would of course beg the very question. As I understand the position, the substantive disposal of these cases of wrongdoing—of a child in, say, the age group 10 to 12, which is that which we are focusing on today—really is substantially the same whether they are above or below the age of criminal responsibility. I repeat “the substantive disposal” because that is of course a very different question from whether one reaches that by way of the criminal justice system and through the criminal courts or by what is essentially a corrective welfare process. Obviously, whichever side of the line they are, these children will if strictly necessary be detained securely, but generally of course they will be subject to the sorts of welfare programmes that have been outlined by others today.
I shall make a very brief digression in parenthesis if I may. The GOV.UK website states that children under 10 who break the law but of course cannot be charged with a criminal offence can be given either a local child curfew or a child safety order. Actually, as the Library helpfully pointed out to me yesterday, having done a little research on it, local child curfews, introduced in 1998, were in fact repealed by the Policing and Crime Act 2009. One notes that the website perhaps needs correction.
Today, though, that is essentially by the way. Altogether more important are child safety orders and, if necessary, care proceedings and orders under the Children Act. Surely our central focus should therefore be on refining and extending the presently available welfare programmes and corrective steps, rather than on criminalising youngsters. The real and compelling reason to raise the age of criminal responsibility, as so many others have tellingly observed today, is to delay for that much longer actually criminalising these very young people. They are still developing as individuals, developing their identities and self-esteem, and if society—represented here, of course, by the criminal justice system it operates—characterises and brands them as criminals, unfortunately, that is how they will come to identify themselves. Alas, that makes it all the more likely—statistics bear this out—that they will thereafter indeed develop into criminals, perhaps career criminals. Surely we must strive to avoid that, above all. In short, we should keep these youngsters out of the criminal courts, protecting against the early acquisition of a criminal record which then will remain with them for ever.
Is the future of this issue to be regarded as settled for all time by that tragic, ghastly and appalling case of Jamie Bulger, which of course we all still remember so vividly? For my part, I fervently hope not and I wish the Bill well.
Baroness McIntosh of Hudnall (Lab)
My Lords, I am very grateful for the opportunity to speak briefly in the gap, and I will be brief, pausing only to say in passing that I have listened carefully to the debate, having had no thought of speaking in it, and am entirely supportive of the Bill that the noble Lord, Lord Dholakia, has brought before the House.
I will pick up on one thing that came out of the speech made by the noble Lord, Lord McNally. He referred to his experience of having made what seemed to me, as he reported it, an entirely reasonable proposition in respect of the age of criminal responsibility, then subsequently found that the parents—or at any rate he referred to the mother—of Jamie Bulger had been contacted and asked whether she agreed that the age should be lowered such that his killers would, as I think the noble Lord reported it, “get away with it”. That anecdote—I do not mean to trivialise it by calling it an anecdote but it is an anecdote in the sense that it is the noble Lord’s recollection—rather points at something that I fear may be behind the kind of reaction we have had so far from government to the proposal, which has been supported all around the House and by everybody who has spoken so far in this debate, that the age of criminal responsibility should be raised. Politicians inevitably have that fear—that if they do something which appears to be liberal, they will be hounded for it and held to account in an entirely unhelpful and irresponsible way.
I do not underestimate the fear that politicians have of being held to account by, as it were, the Daily Mail. However, is not the job of politics not just to follow public opinion as represented by the press but to lead it? When an issue of this kind is so unanimously held up as requiring reform as it has been today, and clearly is so viewed in wider society, it is important that politicians grow a backbone. I therefore address my remarks both to the Minister when he comes to reply and to my noble friend on the Opposition Front Bench, to ask them to consider that it is their responsibility to listen to the evidence and to make decisions that are clearly in the interests of the children whose lives we wish to protect, and not to be too frightened to make decisions, which may indeed result in the kind of press coverage that people do not like to get, but are none the less the right decisions.
Lord Bach (Lab)
My Lords, I congratulate the noble Lord, Lord Dholakia, on bringing his Bill back before the House and on his persistence in a cause that he believes in passionately. I value my personal friendship with the noble Lord and admire him for his great knowledge and expertise in this vital area.
We very much support the Bill having a Second Reading today and that this debate—and it is a debate—should continue in a proper manner. Today, I cannot give my party’s full support to the noble Lord’s proposal, but I hope that he bears my words very carefully in mind. We are obviously considering policy on a whole range of issues—that happens after a general election defeat—and it applies here as it applies elsewhere. Although I cannot promise him full support on principle, I want him to watch this space closely.
A very strong and powerful case for reform has been made around the House. Sometimes in debates of this kind in the House I have been on the side of all those who have supported a particular project. It is a very comforting and enjoyable position to be in. I have also been in the position that the Minister might be in today—I am looking forward to hearing what he has to say—of being the only person to resist what seems a very powerful argument made in different ways around the House. I am not as enthusiastic or sure about my own position as practically all those who have spoken. I do not think it is cowardice for people who make laws to bear in mind that issues of this kind raise very powerful and genuine emotions and feelings, often from victims and their relatives. Frankly, it is not the duty of Parliament to ignore those feelings, saying that they can just be dismissed and that we know better. I wanted to get that off my chest. I had to say that in government and I say it in opposition, too. There is a real need for a continuous public debate on this far-from-straightforward issue.
Many who took part in the last debate will remember the contribution of the noble Lord, Lord Ramsbotham, who referred to the Bulger case. What he had to say was as powerful then as it is today. All I can say is that my party will play its full part in the discussion that follows. For me, an equally, if not more, important issue than the age of criminal responsibility is how the system deals with these children, whether they are prosecuted or not.
I was fortunate enough to be asked by the noble Lord, Lord Carlile of Berriew, to sit on an all-party unofficial committee of both Houses which produced, I believe, a very valuable and serious report on youth offending. It asked what society should do with those who commit offences at a young age, whether or not you call them criminals. The elephant in the room during those discussions and the argument that we did not take on was the age of criminal responsibility. We said, “No, that’s not relevant to what we’re looking at. We’re looking at what happens to those who have clearly committed wrong—and criminal wrong—in those circumstances”. It seemed to us from the powerful evidence that we had that the whole mood had altered from the situation when, for example, I was a very young lawyer doing criminal cases to looking at solutions that were welfare-based rather than punishment-based. That is true whether or not someone is taken to the youth court. Just because criminal responsibility exists for 10 year-olds, that does not mean that a welfare conclusion is not reached, and today it seems that it invariably is. Whether there is then a mismatch as far as the age of responsibility is concerned, I know not. However, I see the power of the arguments that have been made today from around the House suggesting that there may not be enough logic in taking someone to a youth court at a very young age and then coming up with a welfare conclusion.
What we do to prevent children committing offences and making victims’ lives hell—let us not forget that the effect on a victim of an offence committed by an 11 year-old can be every bit as painful for that victim as an offence committed by an adult—is a hugely important part of public policy. It is that issue that the noble Lord, Lord Dholakia, quite rightly keeps raising with us. It is, I think, coming to a time when a conclusion must finally be made.
The point made about international comparisons is very powerful and has to be accepted by the Government, the Opposition and Parliament as a whole.
We do not deny the important principle behind the noble Lord’s Bill. We are delighted to support its Second Reading and hope that it encourages the national debate that we need on such an important and difficult subject. I do not think this is an easy subject, but it is one that the Government and the Opposition are now going to have to grasp.
The Minister of State, Ministry of Justice (Lord Faulks) (Con)
My Lords, I join other noble Lords in congratulating the noble Lord, Lord Dholakia, on introducing this Bill and bringing this important debate to the House. I am grateful to all noble Lords for their contributions today. The debate reflects a long-standing commitment on the part of the noble Lord, and indeed there are many noble Lords who have considerable interest and experience in these matters.
In order to avoid any unnecessary suspense, I should say that the Government have no plans to raise the age of criminal responsibility from 10 to 12. I know this will disappoint the noble Lord, Lord Dholakia—but I hope he will at least be consoled by the fact that he will not have to embrace me, as was suggested by my noble friend Lord Cormack.
Although at the moment we are not able to accept that there should be a change, we none the less share the concern of the noble Lord, as indeed do all noble Lords who spoke, about the proper way to deal with young offenders. The Government believe that children aged 10 and above are, for the most part, able to differentiate between bad behaviour and serious wrongdoing and should therefore be held accountable for their actions. Where a young person commits an offence, it is important they understand that it is a serious matter. The public must also have confidence in the youth justice system and know that offending will be dealt with effectively.
The Jamie Bulger case casts a shadow over all our considerations in this area. That case was, I am glad to say, very unusual. The noble and learned Lord, Lord Brown, referred to the principle of doli incapax. There was a rebuttable presumption in 1993, at the time of the hearing, which was then removed in 1998. The court in that case specifically considered doli incapax and decided that both boys clearly knew that what they had done was wrong, and so the presumption was rebutted.
A number of points were made during the debate about whether or not the full panoply of a trial at the Old Bailey was really appropriate for boys of this age. I entirely understand that point. We have to bear in mind that this was an issue of national concern and, of course, an absolute tragedy for those connected to Jamie Bulger. It is difficult for a country somehow to balance the fact that we are dealing with very young people with, at the same time, acknowledging the seriousness of something of that sort.
Unusually, I agree with the noble Lord, Lord Bach—in two years, it is very rare that we have agreed on anything, at least across the Dispatch Box—that the Government do have a duty to respond to what the public want. With very great respect to the noble Baroness, Lady McIntosh—who is now on the Woolsack: a somewhat different position from when she made the point—they are not simply responding to the Daily Mail, although the Daily Mail clearly has a capacity to influence policy in a number of respects.
The noble Lord, Lord Parekh, made the point that European countries do not share our view about the age of responsibility. Of course, other countries and different states in the United States vary. It is a matter for each country to make its own judgment. It is not simply a question of our following what others say.
It is important to note that serious crimes committed by children are mercifully rare and we do not want to see 10 and 11 year-olds prosecuted for minor offences. Indeed, most such offending will be diverted away from the formal criminal justice system. We have recently invested a significant amount, £3 million over two years, in restorative justice conference facilitator training for youth offending team staff—I know my noble friend Lord Cormack is an enthusiast for restorative justice—and referral order lay panel members to encourage support for and promote greater use of restorative justice conferencing. However, it is important that, where appropriate, serious offences can be prosecuted and the public protected.
The noble Earl, Lord Listowel, who has great knowledge of and concern for the welfare of young people, particularly those who make up much of the prison population—possibly as a result of the care system or the origin of their lives, which cause them to be in the care system—made a point about the expense this caused and asked me to give the costs of the full criminal process compared to more informal disposals. That is a factor but the real costs lie in where someone is sent for punishment. The average price per year in a secure children’s home is £204,000; in a secure training centre it is £163,000; and in an under-18 young offender institution it is £75,000. These are very large sums of money. Fortunately, we do not send nearly as many young people to any of those disposals as we used to. It is very much a punishment of last resort.
Returning to the question of 10 and 11 year-olds, between 2004 and 2014, the number of 10 and 11 year-olds who received a custodial sentence was 12. Maintaining the minimum age of criminal responsibility at 10 does not, however, lead to the prosecution of a large number of 10 and 11 year-olds. In 2014, only 136 10 and 11 year-olds were proceeded against at court compared to 6,860 12 to 14 year-olds, and 65 of those 10 and 11 year-olds were given community sentences. The others were found not guilty, fined or given a conditional or unconditional discharge. Many crimes committed by those aged 10 or over will not result in a prosecution at all.
We are keen to ensure that, whenever possible, children are not prosecuted as research shows that this can be counterproductive, as many noble Lords have said. The principal aim of the youth justice system is to prevent young people offending. We need to keep our focus on that.
Legislation specifically requires courts to have regard to the welfare of under 18s. Section 44 of the Children and Young Persons Act 1933 provides that every court, in dealing with a child or young person who is brought before it, shall have regard to their welfare. This is reinforced by detailed guidance contained in the sentencing guideline Overarching Principles—Sentencing Youths.
Having the age of criminal responsibility set at 10 years allows flexibility to deal with young offenders. If particular needs are identified in a youth offending team’s assessment of a child or young person, the multiagency youth offending team, which includes representatives from health, housing, children’s services and education, can refer the child on to other statutory services, such as children’s services departments and child and adolescent mental health services, for further investigation and support. That support can include addressing attendance and attitude to school, referral to speech and language therapy and, where appropriate, referring parents to parenting courses. A youth caution can also be given for any offence where the young offender admits an offence and there is sufficient evidence for a realistic prospect of conviction, but it is not in the public interest to prosecute.
Youth cautions usefully aim at a proportionate and effective resolution to offending and support the principal statutory aim of the youth justice system of preventing offending by children and young people. Youth conditional cautions require young people to take responsibility for their actions, including by agreeing to conditions that require them to put things right or seek help for their behaviour. The conditions that can be attached must include one or more of the objectives of rehabilitation, reparation and punishment. The rehabilitative conditions may include attending one or more of a range of interventions available to the youth offending team for addressing offending behaviour. Reparation can include apologising, repairing or otherwise making good any damage caused, provided that this is acceptable to the victim. Punitive conditions may include attendance at a specified place to undertake an agreed activity. I should however emphasise that in any case where the police or the CPS are considering offering a youth conditional caution or a second or subsequent youth caution, the case must be referred to the local YOT to provide a check on the appropriateness of the disposal and the interventions that should go alongside. This will all be well known to the noble Lord, Lord McNally, as chair of the Youth Justice Board.
When a young person aged 10 to 17 pleads guilty to an imprisonable offence, is convicted for the first time and does not warrant an absolute discharge, conditional discharge, hospital order or a custodial sentence, the court must give a referral order. A referral order is based on restorative justice principles and may be between three and 12 months in length. The offender is referred to a youth offender panel made up of trained community volunteers and a member of the youth offending team.
There is a great deal more I could tell the House about, but it is important to stress that in these and other interventions, custody of any sort is always very much the last resort. As the noble and learned Lord, Lord Brown, emphasised, very often the destination, as it were, is one that is reached in the interests of the child whether it comes by welfare provision or via the criminal justice system. Custody is available, admittedly at great expense, for 10 and 11 year-olds only if they commit a grave or serious crime, normally one where an adult would be liable to a maximum penalty of 14 years’ imprisonment or more. A child would only be placed in a secure children’s home with a strong focus on addressing their and their family’s needs as well as the offending behaviour.
Reference was made to the report being produced by Charlie Taylor, who I know is doing an extremely thorough job, as was confirmed by the noble Lord, Lord McNally. He is a former head teacher and an expert in child behaviour. His interim report is due to be published shortly and the final report will follow in the summer. We believe that, partly as a result of the legislation which has been introduced and other steps, this has all contributed to a significant fall in the number of under-18s being dealt with in the criminal justice system. The noble Baroness, Lady Massey, asked about the numbers. The legislative changes are not the only factor, and one clear contributory factor was doing away with the police target introduced under the last Labour Government for offences brought to justice, but which was very sensibly dropped by that Government in 2008. Since youth offending peaked in 2007, proven offences have fallen by 78% and there are 64% fewer young people in custody. At the end of November only 991 under-18s were being held in the youth secure estate. However, we are not complacent. We recognise that there is scope to make the youth justice system better and to improve the experience of young people who the courts consider need to be detained. We will be better informed after Charlie Taylor reports.
In conclusion, the Government believe strongly that the current age of criminal responsibility is appropriate to hold young people to account for their actions if they commit an offence and reflects what is required of our system. We are of course most anxious to ensure public confidence in the youth justice system, and that communities know that young people’s offending will be addressed to counter the negative effects on victims and the community. We must, above all, however, ensure that young people are rehabilitated and educated if we want them to cease their criminal activities.
By bringing back his Bill, the noble Lord, Lord Dholakia, focuses our attention on what we do about young offenders. He reminds us of the causes that often precede their arrival in the criminal court system. He and other noble Lords have emphasised that we must look at the problems that young offenders pose for society, as the right reverend Prelate did, in terms of our responsibility as a society, and we must react to that appropriately. In doing so, he does us and the House a great service. While we do not support the Bill, we very much support many of the expressions of concern for youths and the justice system that we have heard today. This has been a valuable debate and I congratulate the noble Lord and others on bringing these matters to our attention.
Lord Dholakia
My Lords, I am grateful to the Minister for his contribution to the debate and for the observations that he has made. I am of course disappointed that the Government are not prepared to support this very simple measure. I do not wish to take any longer than necessary; many noble Lords have given up considerable time to be present here on a Friday afternoon, so I shall be very brief. I just want to make one or two points.
The noble Lord, Lord Cormack, was absolutely right when he said that we are a civilised society, but we must also accept that in any civilised society, from time to time, there will be heinous and serious crimes and it is how we deal with such crimes that determines how civilised we are. In this respect, if there is one message I would like the Minister to take to the Secretary of State, it is that this time I have the church on my side: God is speaking on my behalf as well, so I hope there will be change at some stage.
My second point was made by the noble Baroness, Lady McIntosh. I appreciate what my friend and colleague the noble Lord, Lord Bach, said: the Labour Party is reviewing this policy and it remains for its membership to influence it and say that there is substance in the arguments that have been put forward.
Let me give the Minister an example. Under the coalition Government, I persisted in bringing forward my Bill on the rehabilitation of offenders. My purpose was very simple. Welfare and rehabilitation go hand in hand on this sort of issue. I was able, with the support of the House of Lords, to discuss it on a number of occasions, but I did not get any support from either the Labour Party or, later, from the coalition. However, I was able to convince my noble friend Lord McNally to fix a meeting with the Secretary of State at that time, Ken Clarke. Together, we sat down and we were able to take forward, under the LAPSO Bill, a number of suggestions that came from my Bill. According to private research that has been carried out, the simple measure to amend the Rehabilitation of Offenders Act that I proposed now benefits more than 750,000 young people in this country. That is a tremendous strength that has come from legislation of this nature. We are not saying that people should not be dealt with or that people’s perception that youngsters will get away is wrong. All we are saying is that there are better ways of dealing with them and I hope we can pursue them.
At this late hour, I thank all noble Lords for their contributions. Sometimes the Government should remember that they assume wrongly that the public are as punitive as they tend to make out. They are not. It is better not to follow newspaper headlines but to see what is right and appropriate as far as the criminal justice system is concerned.