Grand Committee

Thursday 23rd February 2023

(1 year, 2 months ago)

Grand Committee
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Thursday 23 February 2023

Arrangement of Business

Thursday 23rd February 2023

(1 year, 2 months ago)

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Announcement
13:00
Baroness Healy of Primrose Hill Portrait The Deputy Chairman of Committees (Baroness Healy of Primrose Hill) (Lab)
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My Lords, if there is a Division in the Chamber while we are sitting, this Committee will adjourn as soon as the Division Bells are rung and resume after 10 minutes.

Police and Crime Panels

Thursday 23rd February 2023

(1 year, 2 months ago)

Grand Committee
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Question for Short Debate
13:00
Asked by
Lord Bach Portrait Lord Bach
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To ask His Majesty’s Government what plans they have to change the (1) structure, (2) purpose, and (3) powers, of Police and Crime Panels.

Lord Bach Portrait Lord Bach (Lab)
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My Lords, I begin by thanking other speakers in this short debate. I also thank the House of Lords Library for its useful and well-written background paper and for its extra help to me with the regulations since 2011.

I should remind the Committee that I was the elected police and crime commissioner for Leicester, Leicestershire and Rutland between 2016 and 2021, the only Member of your Lordships’ House so far to serve in that capacity. Whether I am gamekeeper turned poacher or vice versa I shall leave to noble Lords to decide.

No one can have been present in the Chamber during the past few months who does not understand that there is genuine concern about the accountability of police and crime commissioners in general. Of course, they face the ultimate accountability, which is to go before the electorate every four years—actually, five between 2016 and 2021 because of Covid and three between 2021 and 2024. However, given the continuous lack of public knowledge—or is it interest?—about police and crime commissioners, in spite of increasing turnouts in each of the three elections so far, is that sufficient accountability?

The Government have turned down the notion of recall, although it exists of course for Members of Parliament. I can see why. Small turnouts at elections do not bode well for interest in any recall petition.

The other means of scrutiny, and a very important one, is police and crime panels, which were set up by the Police Reform and Social Responsibility Act 2011 and exist in all police force areas except the Met. Their structure, purpose and powers are set out in some detail in Sections 28 to 30 of the Act, and particularly in Schedule 6. There have also been statutory instruments since. His Majesty’s Government have recently reviewed the role of police and crime panels and say that any necessary legislation will have to await parliamentary time.

In general, the Home Office review has given police and crime panels a clean bill of health. This debate gives the Minister an opportunity to set out what happens next and perhaps when. Speaking from my own experience in Leicestershire, there were 15 members of the panel, which is a typical number: a chair, effectively chosen by the county council, and 12 members from the other local authorities—two from unitary authorities, four from Leicester City Council, one from Rutland County Council, and one each from the remaining six districts. Very importantly, there were two independent members, making 15 members in all. Of those with political affiliations, eight and then seven were Conservatives, four were Labour, and one then two were Liberal Democrats. I cannot say hand on heart that I looked forward with pleasure to panel meetings—that would be rather spoiling the purpose of the exercise—and I suspect that every police and crime commissioner feels now as I used to. I have to say, however, that I was treated at all times with critical respect by the chair, who was of a different political persuasion from me, and the panel. In my view, they fulfilled their statutory functions under Section 28(2) of the Act—namely,

“supporting the effective exercise of the functions of the police and crime commissioner for that police area”.

My officials and I were tested and questioned on many issues. Although I was always relieved at the end, I really could not complain.

With some reluctance, I have to say that in my personal opinion the system has not worked so well with my successor, certainly until recently. There may be many reasons for this, but one that I believe has been influential is that the new chair of the panel, a very senior and distinguished councillor in her own right, seems on occasions to have gone too far in protecting my successor from the legitimate questions and comments of the panel. Of course, I realise that this is a difficult area of judgment. It is as important not to let the police and crime commissioner be unfairly treated as it is to allow him or her to be challenged. In my view the balance has been wrong, sometimes markedly so.

I am happy to say that very recently the chair has acted, in my view, correctly and with considerable strength in insisting that the latest interim chief executive—there were six in 19 months, there is now a seventh, and there will perhaps soon be an eighth—be brought before the panel, as the Act insists that it should be, a request that the police and crime commissioner declined. She was right to do so, and I commend her on it. She will no doubt insist that both the new interim chief executive and the interim chief financial officer, who has been in place for 15 months, are brought before the panel urgently.

What changes do the Government intend to make to the structure, purpose and powers of police and crime panels? Before I finish what I have to say, I will suggest three areas in which reform is perhaps called for.

First, it would be a sensible move to ensure that the chair of the panel, a very significant and powerful role, should never be from the same political party as the police and crime commissioner. If one party dominates the panel because of control of local authorities in the area, one of the independent members should have that role. I dare say that this proposal may well be unpopular with members of all political parties, including my own, but I believe it a practical and proper step to ensure the balance that is so vital. The Minister answered my Oral Question on this matter on 31 October last year by saying that he would happily take it back as part of the ongoing assessment. It is now four months later and I ask him for His Majesty’s Government’s response.

Secondly, and this fits in with the Government’s own view, there needs to be more emphasis on the importance of the role of the independent members, involving training, their role on the panel and their selection. Panels should not be political bunfights—it is too important for that—and powerful independents can help to prevent that.

Thirdly and finally is the vexed issue of complaints/allegations concerning police and crime commissioners. Under Section 30 of the Act, a panel can suspend—must suspend, really—a police and crime commissioner if they face a serious criminal charge with a maximum of more than two years’ imprisonment. But under Schedule 7, other complaints should allow panels

“to engage in informal resolution of such complaints.”

An important statutory instrument of 2012, the next year, deals in some detail with complaints. For me, and I think for a lot of panels too, the overall effect is too vague and unsatisfactory given that the Home Office certainly will not get involved in any dispute of this kind.

What if—this is entirely hypothetical—there are many complaints about a police and crime commissioner that do not allege criminal activity but are important and widespread? What is the panel’s role? Should its process be increased beyond informal resolution? If so, to what extent? Do the present regulations and the Act work in practice? After all, that is what matters. Have the Government considered this issue in enough detail? I ask the Minister to ask what their conclusions are. It seems to me that this is an important, living issue that could touch on any police and crime panel and on which they would welcome an answer.

13:10
Lord Lexden Portrait Lord Lexden (Con)
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My Lords, the noble Lord, Lord Bach, has done us a great service in bringing this subject forward for debate and introducing the debate so thoroughly, drawing on his own, if I may say so, impressive experience as a police and crime commissioner.

It would be hard to overestimate the importance of the place occupied by police and crime panels in the new system—a system that is still controversial and not much loved 11 years on—whose success depends on the performance of elected police and crime commissioners, all of whom are now party politicians. Are we satisfied that we are sufficiently well served by having party politicians rather than distinguished independent figures at the helm of the new system? The advantages are not exactly overwhelming, as the long-running crises in Leicester and Cleveland—along with the noble Lord, Lord Bach, I have drawn your Lordships’ attention to them many times—plainly show.

It falls to the police and crime panels to try to deal with these crisis-ridden party politicians on behalf of their communities between elections, in which, sadly, too few people take part. In order to exercise their crucial role, the panels have been given in statute the power to require commissioners to provide information and answer questions. Alas, not all commissioners understand that the information that they provide and the answers to questions that they give need to be accurate, intelligible and free from any form of censorship so that the panels can fulfil their duties and serve their communities fully.

The Leicester and Cleveland commissioners seem incapable of coming up to the standards that are required. I have no idea whether those two individuals are typical of police and crime commissioners as a whole. It does not really matter. Every single commissioner should provide their panel with full, clear and truthful information as the legal obligations to which they are subject require. To do otherwise is to obstruct the panel in the performance of its duties—an offence that surely ought to merit removal from office.

The Cleveland police and crime panel is being obstructed through the denial of full, frank and clear information. Its members have rightly been seeking an explanation from its commissioners as to why Mike Veale, one of the most notorious discredited ex-police chiefs in the country, has not yet been brought to answer the charges against him at the gross misconduct hearing that the Cleveland commissioner announced in August 2021. In November last year, the commissioner was asked by members of the panel about the cause of the extraordinary delay. He replied:

“I cannot share that with you. If I told you and that is then in the public domain, that then compromises something else, which potentially compromises something else.”


Earlier this month, the panel tried again. It found the commissioner in an indignant mood, following comments made in your Lordships’ House. He said:

“Someone in the Lords also said I should just hurry up and I have asked him for some clarity on how he believes I should be hurrying up, given the legal complexity. I can’t say any more.”


It was, I think, my noble friend the Minister who urged him to move a little faster after a delay of some 18 months. No doubt the Minister will tell us when he comes to reply how he has assisted the commissioner in his quest for clarity, but how ridiculous and insulting it is for the commissioner to tell the Cleveland panel that legal complexity justifies endless delay.

The Independent Office for Police Conduct set out the case against the notorious Veale in a report following a two-year inquiry. The report, which has never been published, went to the Cleveland commissioner two years ago, so four years have passed without this case of gross misconduct being brought to even the start of the legal process that is required. What exactly is legally complex about the contents of the IOPC report? The panel is entitled to an answer; it is being withheld. Without an answer, the panel would be forgiven for thinking that there is no complexity and that it is being given fake information by a commissioner who wants to shield and suppress the evidence against Veale.

Someone called a legally qualified chair will preside over the misconduct hearing if it ever takes place. That worries the Cleveland panel, which this month expressed fears that the hearing may run out of time, allowing Veale, a man dogged by scandal since his vendetta against Sir Edward Heath a few years ago, to escape justice. Has a chair even been appointed in Cleveland? No one knows. If there is a chair, their name is being kept a closely guarded secret.

When asked in the House earlier this month why the chair in this case, if there is one, was allowed to remain anonymous, the Minister said he did not know. Yesterday, in a Written Answer, he told me:

“There are no provisions in legislation which entitle legally qualified chairs of police misconduct hearings to remain anonymous.”


Yet neither the Cleveland Police and Crime Panel nor anyone else has been told the identity of the chair in this case. Perhaps at the end of this debate the Minister will tell us why the Home Office is content to see the law flouted in Cleveland by the very person charged with upholding it. Or is the reality that there is no chair—no chair has been appointed and there is no name to reveal?

The Home Office might usefully reflect on the conclusions of a recent report produced by the think tank Policy Exchange on the role of these chairs. It found that:

“Having been introduced with the aim of increasing the public’s confidence in the police misconduct process, the experiment is having the opposite effect.”


It certainly is in Cleveland. The Home Office has reacted to events in Cleveland with weary indifference. It does not seem to care. It takes no action. It maintains that it has no powers whatever, even to make representations, let alone intervene. That is the most tragic aspect of this sorry saga. Is the Home Office really so utterly powerless? It is a point on which independent legal judgment could be usefully brought to bear, but if it needs powers, it should seek them swiftly—urgently—through regulations.

13:18
Baroness Harris of Richmond Portrait Baroness Harris of Richmond (LD) [V]
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My Lords, the small number of Members taking part in this debate probably shows the general lack of interest in this quite vital role of scrutiny of our police service. That is very sad.

I too thank the noble Lord, Lord Bach, for initiating this debate. He was an excellent police and crime commissioner for his area, and I commend him. Would that I could say the same about lots of other PCCs, which is, sadly, what I predicted when the Bill that created them went through. To help the scrutiny of those PCCs, we need much better governance from their panels.

I am most grateful for the help given to me in preparing for this debate by the Library’s excellent briefing and by former academics from Portsmouth University, notably Barry Loveday, the prolific writer on so many policing matters, and Dr Roy Bailey, who has written specifically on PCPs and who very generously sent me his doctoral thesis on this subject to guide me.

Let me share some of those findings with your Lordships. First, there was a general and almost unanimous call for urgent reform of the current governance model. Some 92% overall of clerks, PCCs and panel members agreed that some change was necessary. Why? Because they felt there was little role clarity; they have insufficient powers and inadequate resourcing. To illustrate that, let me tell you what happened in North Yorkshire—and here I refer to my interests in the register on policing matters. Our first PCC was accused of serious bullying. The panel looked into this and concluded that there was indeed good evidence to show that this was the case. Unfortunately, as we have heard from the noble Lord, Lord Bach, they could not do anything about it. The general public got to hear of it, of course, and in effect made their feelings known, so the PCC decided that she really ought to resign. The second PCC—another Conservative placeman without any experience of policing—had to resign because of appalling remarks he made in public about how women should behave, in the aftermath of Sarah Everard’s dreadful murder. We are now on to our third PCC. She does her best, but thinks she has direction and control of the chief constable—a mistake made all too often, I fear.

I go back to the evidence gathered in the thesis. There was a clear feeling that there was a big turnover of members, especially councillors; they needed additional powers, training and better management as well as political influence. What are the Government doing to address that? Panels are unable to select their councillor members. I recall this well in the old police authority model, when it seemed that group leaders would send us the councillors who caused them too much trouble. It appears that panels have the same problem. Independent members, on the other hand, are generally much more engaged and probably have better skill sets, having been chosen through a rigorous selection process. They are also, mainly, politically neutral.

When I chaired my police authority, over 20 years ago now, I brought in specialist trainers to help us to understand what our responsibilities were. They were invaluable—on the few occasions we were able to use them, mainly because we had the Police Federation breathing down our neck, telling us this was its money that we were using. Will the Government undertake to help panels to get the training that they need to fulfil their important role?

So it is today that policing panels need the ability to understand their role and proactive scrutiny programme. This is almost impossible for them with their present funding arrangements. Panels tend to meet only four times a year. How can they undertake scrutiny of the PCC in the months when there is no meeting? What is the PCC doing? Monitoring and assessment should be ongoing for all panel members. I take what the noble Lord, Lord Bach, said very much to heart: it is not a very comfortable place to be when you are being scrutinised, as I was when I was chair of my police authority. Nevertheless, it is vital that it is done. Does the Minister agree?

As the noble Lord, Lord Bach, referred to, in many areas there is little or no political opposition on the panels, which is entirely wrong. It is like policing oneself and there should be a concerted effort to engage membership from opposition parties. Again, the Government must address this area. Are there any plans to do so?

PCCs and PCPs should collaborate better. At the moment they are set up to be in conflict but, as we have heard, a good PCC should enable a well-briefed and knowledgeable panel to scrutinise their work and to work together for the benefit of their community.

In conclusion, I reiterate the belief that there must be radical reform of the current governance model—a model, incidentally, that the Liberal Democrats insisted be included in what became the Police Reform and Social Responsibility Act. Indeed, I may even have done that personally; I did everything I possibly could to scupper that Bill. Had we not insisted on this inclusion there would have been absolutely no scrutiny of PCCs at all, and we all know what problems have arisen from their introduction. At the moment, there are six forces under special measures as it is.

There is a risk of panel members becoming disillusioned because of their perceived impotence and low status. They have no power. It is high time that we gave them some.

13:26
Baroness Wilcox of Newport Portrait Baroness Wilcox of Newport (Lab)
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I thank my noble friend Lord Bach for bringing this important topic of debate here today. The tripartite structure of police accountability, whereby the governance of policing was until 2012 a responsibility shared between the Home Secretary, chief constable and the relevant police authority, was disassembled by the Police Reform and Social Responsibility Act 2011, following widespread criticism. The deficiencies of the tripartite structure were inflamed by the strong and persistent criticisms directed at police authorities, widely considered the weakest link.

It was noted at the time that one major reason why police and crime commissioners were established was to create greater engagement with the public, and stronger accountability and transparency within our local policing systems. So the Home Secretary has retreated from day-to-day policing matters, leaving responsibility for police governance and accountability between the PCC, PCP and chief constable. Every PCC, PCP and chief constable in each police area in Wales and England is required to have an effective, constructive working relationship.

In carrying out their functions, PCCs are required to have regard for the views of local people within their policing area. They are also required to issue a police and crime plan and keep it under review. In forming this plan, the PCC is also required to take account of a number of issues, including consultation with the chief constable, while taking regard of any report or recommendation from the PCP. The PCC holds the chief constable to account not only for the exercise of their functions but for eight specified criteria.

Updated guidance was produced for police, fire and crime panels in January this year. Within its focus was a commitment to strengthen the accountability of police and crime commissioners and expand their role, together with the need for better guidance and training for panels, which policing stakeholders have regularly highlighted as an important area to address and a weakness within the structure.

One always hopes that training will help by enabling panels to perform their role more effectively, but also by providing constructive support and that very important challenge to PCCs: acting as the critical friend where needed. Panels have a pivotal role in the current model of police accountability, as they are solely responsible for supporting, scrutinising, providing and maintaining a regular check and balance.

The critical friend role is increasingly important, and the statutory role of panel members—to scrutinise decisions and actions taken by the PCC, review the plan and annual report, resolve non-criminal complaints about the conduct of the commissioner, and make recommendations to the commissioner as needed—is extremely important. I recognise that very many panel members across the UK take their roles seriously, as indeed did my former colleagues at Newport City Council who served diligently as panel members for the Gwent PCP, working with the Gwent commissioner, Jeff Cuthbert, and the excellent chief constable, Pam Kelly. However, there are significant concerns that the critical friend aspect and the holding to account need to be strengthened.

Given the key role of PCPs, a number of reports and reviews have questioned their effectiveness. The House of Commons Home Affairs Committee in 2014 noted that there was no national standard as to how PCPs work and warned that some members struggled to understand their powers and role. Indeed, in my reading for today’s debate, some were highlighted as powerless and compared to a “crocodile with rubber teeth”.

PCPs are nothing more than a symbolic function if they do not properly discharge their scrutiny role. If commissioners are not benefiting from scrutiny by PCPs, there may be limited accountability between elections, as current governance arrangements make PCPs exclusively responsible for scrutinising and providing checks and balances. That may cause unintended consequences, such as in the exercise of accountability, with the governance of policing reactive to the one-to-one accountability relationship between commissioners and chief constables. That one-to-one is problematic, possibly unpredictable and, in the absence of panels being effective and credible, potentially unproductive.

I turn to another issue already mentioned by noble Lords: the low turnout in police and crime commissioner elections. It is a concern and demonstrates that the remit is not being totally fulfilled by commitment from and with the wider public. In 2012, turnout was 15.1%; it went up in 2016 to 27.4%; and in 2021 it was 33.9%. It is going in the right direction but is woefully short of democratic engagement. What are the Government doing to ensure that the system of police and crime commissioners and the panels which hold them to account have the democratic endorsement of the public?

My noble friend Lord Bach has asked some searching and probing questions today, but I will add to them a little. Will the Minister address the ongoing concern about party politics getting in the way of scrutiny? Can he answer on how many panel chairs are of the same political party as the commissioners whom they must hold to account? The Government brought in guidance last spring to create better accountability for the panels. Can the Government say yet whether this has had any impact on their functioning, or whether the Government plan to report back on its implementation?

13:33
Lord Sharpe of Epsom Portrait The Parliamentary Under-Secretary of State, Home Office (Lord Sharpe of Epsom) (Con)
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My Lords, I thank all noble Lords for their contributions, and I particularly congratulate the noble Lord, Lord Bach, on securing this important debate. I know that this topic has long been of interest to him, and a wide range of views have been expressed on a variety of issues related to the roles and responsibilities of police and crime panels this afternoon.

I am grateful to the noble Baroness, Lady Harris, for reminding us that this was a coalition policy and that panels were a Lib Dem idea because it gives me a rare opportunity to congratulate the Lib Dems on a good idea.

I echo the comments of the noble Lord, Lord Bach, that it is vital that policing remains transparent and accountable to the public. Since their introduction in 2012, police and crime commissioners have brought real local accountability to how chief constables and their forces perform, ensuring that the public have a stronger voice in policing. In stark contrast to the invisible and unaccountable police authorities that preceded them, PCCs operate in the full gaze of the media and must justify their record via the ballot box, as the noble Lord knows.

I will digress briefly to look into the old police authority model because, to quote some of the remarks of the noble Baroness, Lady Wilcox, I believe that they were short of democratic accountability too. Police authorities consisted of 17 members, nine of whom were elected members drawn from the local authority or authorities for the force area, and reflected the political make-up of those authorities. The remaining eight members were called independent members and were appointed from the local community for fixed terms of four years by the police authority itself. They were drawn from a long list of applications submitted by the elected members and magistrates to the Home Office and that committee then appointed the independent members from a shortlist returned by the Home Office. At least three of the members were magistrates and there was no difference in power and responsibility between the different types of members. The chair was appointed by the authorities themselves. I am afraid that that is also very short of democratic engagement, it certainly lacks accountability and there is not much transparency.

Over their term of office, the decisions and actions of a PCC are subject to a holistic system of checks and balances. The most visible mechanism for scrutiny is the police area’s police and crime panel. PCCs are also subject to investigation by the Independent Office of Police Conduct in cases of serious misconduct, the oversight of their monitoring officer in preventing unlawful action or expenditure, and statutory requirements on transparency imposed by the specified information order. Panels are a vital part of that police governance model. They ensure that PCCs are scrutinised effectively and remain accountable for their decisions to those who elected them.



I will begin by explaining, for clarity, the existing structure, purpose and powers of police and crime panels, which for ease I will refer to simply as “panels”.

The noble Lord, Lord Bach, and the noble Baroness, Lady Wilcox, asked about the chair and political neutrality. They can be independent; they are not always, but they are expected to act with neutrality. Unfortunately, I do not have the statistics about political affiliations requested by the noble Baroness, so will write.

In each force area outside of London, panels have a wide-ranging remit to scrutinise the actions and decisions of their PCC, providing support and challenge, and acting, again to quote the noble Baroness, as a critical friend.

Panels have specific powers of veto over chief constable appointments and precept setting. They also have oversight of the PCC’s key documents, decisions and reports, requiring the PCC to provide information and answer any questions which the panel considers necessary. Additionally, panels have specific powers to review the PCC’s proposed appointment of senior staff—a subject to which I will return. They also play a direct role in handling complaints made about the conduct of a PCC, including responsibility for resolving complaints of a non-criminal nature.

A key function of panels is also to provide transparency, enabling the public to effectively hold PCCs to account. Panels must make information available to the public by publishing all reports and recommendations made to the relevant PCC. In most cases, panels are required to conduct their meetings where members of the public can attend or watch via webcast. Each panel is also required to maintain rules of procedure, which will usually make provisions about how questions or statements can be submitted by members of the public. I note with interest the comments of the noble Lord, Lord Bach, on the panel hearings that he faced, which I think vindicate their effectiveness.

On the question asked by the noble Lord, Lord Bach, noble Lords will, I hope, be aware of the Government’s two-part review to strengthen the accountability and expand the role of PCCs, and to help PCCs to deliver effective police forces that can cut crime and protect their communities. Both parts of the review looked specifically at sharpening the transparency and accountability of PCCs, as well as ensuring that they have the necessary tools and levers to be strong local leaders in the fight against crime and anti-social behaviour. As part of this, the review examined whether police and crime panels have the right skills, tools, and powers to scrutinise PCCs and provide constructive support and challenge.

The review concluded that panels have the appropriate powers at their disposal, agreed by Parliament, to scrutinise PCCs effectively and shine a light on progress against local police and crime plans. However, the consistency and quality of scrutiny can vary, and the review made several recommendations to improve the scrutiny of PCCs, primarily by supporting panels to perform their role more effectively and improving panels’ understanding of their powers and responsibilities.

In line with those recommendations, and in consultation with both the Local Government Association and the Welsh Local Government Association, we have already taken steps to improve and strengthen the scrutiny of PCCs by: issuing new guidance and best practice guides in May 2022 to sharpen panels’ understanding of their roles and responsibilities; hosting a series of webinars with panel chairs, members and supporting officers to deliver foundational learning on scrutiny best practice, which we have published on the Home Office’s YouTube platform; and issuing additional guidance to aid the recruitment and retention of independent panel members, who provide valuable additional skills, diversity and expertise for PCC scrutiny. That was issued in January.

Furthermore, in line with one of the recommendations brought forward through part 2 of the review, we have begun a fundamental assessment of the panel support model to further improve the professionalism, quality and consistency of support provided to panels by local authorities. This work will seek to address what we heard during the review’s call for evidence, which pointed towards variation in the level of full-time, dedicated resource given to panels by host local authorities.

The delivery of all these measures will help to ensure that PCCs put the law-abiding majority who voted for them at the centre of their decision-making. Noble Lords will see that we are already taking a number of steps to improve the scrutiny of panels. For that reason, the Government currently have no plans to change the structure, purpose and powers of panels.

The noble Lord, Lord Bach, asked about the powers of police and crime panels to scrutinise senior appointments made by the PCC. Other noble Lords alluded to that. He will know that PCCs are required by legislation to notify the panel when proposing appointments to senior positions in their office, including those of chief executive, chief finance officer, and deputy PCC. The legislation provides that the same appointment procedures and scrutiny processes also apply to the roles of acting chief executive or acting chief finance officer.

To execute scrutiny duties, the panel must then hold a confirmation hearing and produce a report and recommendation on whether it supports the proposed senior appointment. The panel must do so within three weeks of receiving notification from the PCC of the proposed appointment. The confirmation hearing must be held in public and the proposed candidate must be requested to attend.

In the case of Leicestershire, to which the noble Lord, Lord Bach, referred, we are advised from discussions between officials and supporting officers from the Leicestershire panel that the PCC intends to notify the panel that a new interim chief executive of the OPCC has been installed, and that this interim appointment will undergo the appropriate scrutiny process and confirmation hearing at the next panel meeting, which is due to take place on 6 March. That is therefore in accordance with the legislation, and I hope that satisfies the noble Lord. I say on the record that the Government expect, in the strongest possible terms, that PCCs appointing to senior positions in their offices follow the process clearly set out in legislation.

My noble friend Lord Lexden referenced Mike Veale and that hearing. The law is not being flouted. Arrangements concerning the establishment of a misconduct hearing are a matter for PCCs. My noble friend is quite right that I asked for speed in answer to a previous question, but I meant it in very much a generic sense. It is in everybody’s interest that these misconduct hearings are concluded as quickly as possible. I should have said that the Cleveland PCC has no power over the legally qualified chair, who must commence a hearing within 100 days of an officer being provided a notice referring them to proceedings, but may extend this period where they consider that it is in the interests of justice to do so. Decisions made within a hearing are done so independently of PCCs as well as government. There is no indifference on the part of the Home Office.

Lord Lexden Portrait Lord Lexden (Con)
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Could my noble friend comment as to whether a chair has actually been appointed in Cleveland? If an appointment has been made then, as the Written Answer sent to me yesterday clearly states, the name must be made public. The only way in which the Cleveland police and crime commissioner can be within the law is if a chair has not actually been appointed. If no chair has been appointed then the situation is even worse.

Lord Sharpe of Epsom Portrait Lord Sharpe of Epsom (Con)
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My Lords, I shall come on to the answer to that question in a second. As I say, the Government take the accountability of the police very seriously and will continue to do so. There is no indifference on the Home Office’s part in this situation.

In recent months, I have been asked on a number of occasions about the lack of apparent progress in this particular misconduct hearing. I have variously been accused, largely by members of my own party, of incompetence and impotence, among other things. However, the legally qualified chair has the right to extend the 100-day period if it is in the interests of justice to do so. If I were to comment further on this specific case and its delay—I could but I will not—that would, I believe, be genuinely incompetent because it could well prove prejudicial to the interests of justice. I am sure that no noble Lords want to see justice prejudiced, so I am afraid that my answer to any future questions or continuing questions in this debate will remain the same.

I happen to have a copy of the Written Answer that I sent to my noble friend Lord Lexden yesterday. Let me read it out for the record:

“Arrangements concerning the establishment of misconduct hearings are a matter for Police and Crime Commissioners (PCC), and the management of the hearing itself is the responsibility of the independent Legally Qualified Chair (LQC) in charge of it. Decisions made concerning a hearing are done so independently of PCCs as well as Government and the Home Secretary has no powers to make directions in relation to those hearings. Given the independence of PCCs and LQCs, it would be inappropriate for the Government to seek to influence those decisions.”


Anonymity is not a legal requirement. However, as I have just explained, the Home Secretary has no power to intervene in these circumstances. The legally qualified chair in Cleveland has taken decisions for very good reasons; I will leave it there as there is nothing more I can say.

I will move on to the PCC review recommendation to undertake an assessment of the panel’s support model, which obviously formed the basis of a number of good points that were made, in particular by the noble Baronesses, Lady Wilcox and Lady Harris, and the noble Lord, Lord Bach. Following a commitment arising from part 2 of the PCC review, we have begun a fundamental assessment of the panel support model to further improve the professionalism, quality and consistency of support provided to panels. I must stress that this work is tightly focused on the role of democratic support officers, who sit within a host local authority and provide policy, professional and administrative support to ensure that panels effectively discharge their statutory functions to scrutinise PCCs.

To progress this work, we are undertaking some analysis of a regional model for panel support, along with consideration of improvements to the current model and exploring other potential ways to achieve our aims. A range of options will be designed and assessed before further advice is sought from Ministers to agree any next steps.

The recommendations on PCC complaints were referred to by the noble Lord, Lord Bach, and my noble friend Lord Lexden. I must say that I find it disappointing that my noble friend has not investigated the quality of other PCCs more generally; had he done so, he would have found that they are consistently excellent across the country.

Although our announcement of the PCC review recommendations did not make specific recommendations on the PCC complaints system, we are still committed to developing reforms in this area. This includes ensuring clarity on what constitutes misconduct or a breach of expected standards by PCCs; deciding which body is best placed to handle certain types of complaints; ensuring that the system does not give rise to vexatious complaints; and ensuring the effective handling of criminal allegations against PCCs.

We need a system which is open, transparent and fair for all parties when handling complaints. While we develop the reforms in this area, we have taken interim steps to assist, which includes publishing guidance to strengthen the quality and consistency of scrutiny by panels and more clearly explaining their roles and responsibilities. In handling complaints about PCCs, panels must refer serious complaints and conduct matters to the IOPC. Additionally, panels are responsible for resolving non-serious—that is, non-criminal—complaints made about a PCC’s conduct when in office. Ultimate responsibility for handling any non-criminal complaints they have received remains with the panel, and they retain the ability to seek an informal resolution of a non-criminal complaint if they consider it necessary.

We consider the PCC model more democratic than the predecessor model of police authorities, as I hope I have explained. PCCs are directly elected by the communities they serve and are held to account at the ballot box; this democratic power did not exist before PCCs were introduced in 2012. The Government are committed to strengthening and expanding their role. We have taken steps to do so through the implementation of recommendations from the PCC review, and we are continuing to work closely with sector partners to implement all the recommendations.

I thank noble Lords for raising this debate. I am pleased that I have had the opportunity to update the House on the progress that we are making to strengthen and improve scrutiny arrangements. The Government believe that panels have sufficient powers and the right structure to carry out their vital role of scrutinising PCCs, and the Government are committed to delivering the PCC review recommendations in full to sharpen quality, consistency and professionalisation of panels. PCCs play a vital role in holding the chief constable to account and keeping our communities safe. The public deserve visible and accountable local policing leaders who are properly scrutinised and held accountable on the issues that matter most to them.

As a final postscript, the consultation on LQCs and the dismissal process remains open. If noble Lords have strong opinions on this, I suggest that they submit them to the consultation.

13:50
Sitting suspended.

Healthcare in Rural Areas

Thursday 23rd February 2023

(1 year, 2 months ago)

Grand Committee
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Question for Short Debate
14:01
Asked by
Baroness McIntosh of Pickering Portrait Baroness McIntosh of Pickering
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To ask His Majesty’s Government what plans they have for the delivery of health care in rural areas.

Baroness McIntosh of Pickering Portrait Baroness McIntosh of Pickering (Con)
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My Lords, I am delighted and grateful to have secured this debate this afternoon and I look forward to contributions from other noble Lords across the Committee, especially my noble friend Lord Evans in summing up. I draw attention to my entry in the register, my work with the Dispensing Doctors’ Association based at Kirkbymoorside in North Yorkshire, and to the fact that I am a proud daughter and sister of dispensing doctors. I also sit on the Rural Affairs Group of the Church of England General Synod.

I pay tribute to all those who deliver health and social care in rural areas: doctors, nurses, carers, pharmacies, paramedics, and community hospitals—where they still exist, such as St Monica’s in Easingwold and Malton Community Hospital. I thank all those in the NHS for their help with my recent injury, from the accident and emergency department through to orthopaedics. I am hugely grateful for the care provided.

One-fifth of the population live in remote, rural and coastal communities. This amounts to 9 million people, more than the population of Greater London, yet at present there is a stark disparity in the care and services available. Undoubtedly, the cost and challenges of delivering healthcare in a rural area are markedly greater than those in urban areas, and I question the extent to which this is reflected in current policy decision-making. For example, is the policy tool of rural-proofing used by the department and NHS England? There was a very useful report on this by a committee of this House chaired by the noble Lord, Lord Cameron of Dillington, in 2016. I have not yet seen any evidence that those recommendations have been acted on.

Similarly, last year the All-Party Group on Rural Health and Social Care published a report that has a wealth of recommendations on how to improve the provision of services to patients. It has to be asked: why have the Government failed to act on any of its recommendations?

In the past, rurality and sparsity of population used to be reflected as criteria in health spending, but that is no longer the case. Many remote, rural and coastal GP practices are permitted to dispense medicines to their patients for the simple reason that there is no community pharmacy within a reasonable distance. The department’s cost of service inquiry from 2010 demonstrates that the income from dispensing cross-subsidises the general practitioner service.

Dispensing practices are under the same cost pressures as their community pharmacy colleagues, buying their medicines in the same marketplace. Despite this, the recent changes to the system of drug reimbursement in pharmacies have not been reflected in the dispensing doctor contract. A recent example was the spike in chickenpox cases, where penicillin was to be issued to all children, but my understanding is that rural practices were not properly reimbursed for the cost. I hope that my noble friend Lord Evans will take this opportunity to revisit that.

In addition, there are barriers such as poor connectivity for both broadband and mobile signals. How widely is it known that electronic prescription services cannot be delivered in rural areas by dispensing doctors for this very reason? Similarly, remote consultations to patients and other telehealth innovations are unable to be delivered. I was disappointed that in the exchange at Oral Questions earlier today my noble friend Lord Markham seemed unaware of this problem in remote rural areas. The problem is seen not just in health. When we have the influx of population in all the beauty spots represented by the Members of the Committee today, tourists often rely on mobile signals if their car breaks down or if they are involved in an accident. This needs to be addressed as a matter of urgency. I applaud the investment that the Government have made and the work of local authorities such as North Yorkshire County Council and others, but it is the last 3%, 4% or 5% of deeply rural, remote and isolated areas where we have not yet got full connectivity either for mobile phones or broadband.

I am grateful to Alzheimer’s UK for alerting me to the clear irregularities of dementia diagnosis in rural areas, with the consequential effect on the care and support that families can access. I therefore urge my noble friend to level the rates of dementia diagnosis across rural areas, allowing those living there faster and more equal access to the essential care and support that they and their families desperately need.

I want to raise the role of NHS England in this regard, which is clearly undermining the role of GPs and demoralising practitioners and therefore patients. The level of micromanagement is breathtaking. It has removed all the regular interface that GPs would normally have with patients in rural areas—and, I accept, in other areas as well. You can no longer access minor injuries treatment; you can no longer have your ears dewaxed; you can no longer have a routine check-up in the way a GP used to give before, giving the GP the opportunity to question patients about their general health and mental welfare.

NHS England has been asked to focus on a one-size-fits-all solution, oblivious to the fact that what may work in an urban area is totally inappropriate and cannot necessarily be delivered in a rural one, across a highly isolated, sparsely populated, deeply rural area with, in addition, many elderly patients with a number of comorbidities. This level of micromanaging is inappropriate and must cease, and clinicians must be allowed to decide on treatment.

At its inception in 1948, the NHS was set up to be universally available to everyone, free at the point of delivery and based on clinical need and not the ability to pay. My father was one of the very first practitioners, commencing his practice in 1948.

Equality of access was reflected in the more recent NHS constitution. As I referred to earlier, the APPG report on rural health called for levelling up between rural and urban areas and removing impediments in rural areas such as lack of workforce capacity and poorer access through inadequate transport, leading to the inequalities of outcomes for patients which it identified.

I regret that, at the moment, the Government seem blind to the challenges of delivering healthcare in rural as opposed to urban areas. I hope that the contract about to be negotiated will provide an opportunity to revisit this issue and ensure both that there is a better balance between primary and secondary care spending and that rural areas are identified as a priority. I urge my noble friend the Minister to use his good offices, through today’s debate, to address the issues before us; to ensure delivery of universal healthcare across the country, delivering in rural as well as urban areas; and to reduce the health inequalities for those of us who live in rural areas. I beg to move.

14:10
Lord Bishop of St Albans Portrait The Lord Bishop of St Albans
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My Lords, I thank the noble Baroness, Lady McIntosh, for obtaining this debate. She is a powerful champion for these issues; we are grateful that she continues to raise them. I also add my thanks to and appreciation of all those who work on the front line in our rural areas. They often have to drive huge distances, sometimes along quite difficult roads; it is not always easy and is certainly not always as wonderful as our memories of remote rural areas from our holidays. I declare my interest as president of the Rural Coalition.

Although many people in this country dream of retreating to the rural idyll that is deeply embedded in the English psyche, they do not always realise that, if their dream comes true, they may face many challenges in living in rural areas: poor access to banks and cash; patchy broadband; sporadic mobile signal; virtually non-existent public transport; and little childcare. Then, of course, there is the topic we are exploring today: the stresses on the healthcare system, which is primarily and unsurprisingly designed for an urban context. Rurality faces a unique challenge in the delivery of healthcare, demanding that the Government adopt a clear strategy for improvement. I welcome His Majesty’s Government’s promise to rural-proof our healthcare system; my hope is that that promise will be able to deliver what is needed.

Rural areas are home to significantly older populations than those in towns and cities, with a quarter of England’s rural population aged over 65—and that figure is due to rise. An older population exacerbates the difficulties of delivering healthcare in rural areas because those people are much more likely to require higher levels of intervention and support. Although many rural areas have a strong sense of community—it is often much stronger than in urban areas—there is nevertheless the challenge of isolation. More than 1 million older people in England suffer from persistent, chronic loneliness as they are cut off from wider society. As a consequence, rural areas face a significantly higher rate of hospital admissions for alcohol-related harm and self-harm. Put simply, mental health issues are exacerbated in rural areas.

Fortunately, in many rural areas, such as some of the villages and communities in Bedfordshire and Hertfordshire that I serve in my diocese, there are all sorts of active churches and charities working on the ground. They visit the lonely and offer support and practical help. However, they are not in a position to offer the professional care that is required. We therefore need the Government to develop and fund a comprehensive, universal rural healthcare strategy that is fit for the future. The Rural Services Network has found that rural residents receive 14% per head less in social care support overall. I therefore ask the Minister what assessment he has made of the gap in social care funding between our urban and our rural areas. Will His Majesty’s Government take any steps to close it?

It is not just social care that suffers from lower levels of funding. The Rural Services Network also noted that the NHS receives less funding per resident in rural areas despite the unique challenges that they face. With an older population, higher levels of mental health problems, issues with connectivity and poor access to services, it is clear that those areas need more support, not less. As His Majesty’s Government rightly noted in their report on rural-proofing England, we need to pursue innovative solutions to those challenges. Just throwing money at them is not enough to tackle the structural issues that we face; we need to bring all the parties together to work out how we can address them.

Improving rural infrastructure will help people to get the help they need. Going to the doctor or the pharmacy should not be a difficult task, but currently many people rely on expensive transport or on taxis, and it is not easy.

Finally, it is important that we work to recruit and retain a workforce of healthcare professionals in those areas. Those who work on the front line know that this is not easy. Life in the city has its benefits: higher wages, greater access to services and a faster pace of life. It would be helpful if programmes to help people return to work were as flexible as possible and part-time jobs were available. What are the Government doing to attract carers to work in rural areas and, indeed, ensure that they want to stay there?

I look forward to hearing from the Minister the plans His Majesty’s Government have to support this vital part of our healthcare system.

14:16
Baroness Bennett of Manor Castle Portrait Baroness Bennett of Manor Castle (GP)
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My Lords, I thank the noble Baroness, Lady McIntosh of Pickering, for securing this debate and for overcoming her injury to make it in today. I put this issue of rural healthcare out to Green councillors around England. What I got back could be described only as a flood of concern.

We have heard an overview from the first two speakers. I will narrow down largely to one county, Shropshire, which is one of the most rural counties in England, with a population of 323,000, around a quarter of whom live in Shrewsbury. The rest are widely dispersed across small market towns and rural areas. As the right reverend Prelate noted, 23% of the population are over the age of 65, compared with the English average of 18.5%.

Public transport is often simply non-existent. The NHS’s own figures state that 45,000 people live 30 minutes or more away from a GP practice by public transport. It is clear that access has got dramatically worse in recent years.

Rural healthcare is often seen as inefficient. In Shropshire, it is centralised at either the Royal Shrewsbury Hospital or Telford’s Princess Royal Hospital. This is undoubtedly cheaper for the NHS, but the cost is transferred to individuals, who might simply not be able to bear that cost or might encounter barriers they simply cannot overcome. Cost, age, disability and a lack of transport lead to people either seeking healthcare later, which greatly increases costs to the NHS in the long run, or simply deciding to go without, with significant social, personal and economic impacts.

In many cases, services have simply disappeared. Cardiology outpatient appointments, including diagnostic tests, used to be available in Shrewsbury, but recently there were centralised to Telford. That is an hour’s drive from Ludlow or Bishop’s Castle. By public transport, you need two trains, a bus and a hearty wish of good luck.

Another issue is midwife-led maternity units. There used to be a network of five of those. Closure was first mooted in spring 2016, with cost explicitly cited as the issue. There was then a period of short-term closures, often at extremely short notice—as little as two hours—so women would find out on the day they were giving birth that their expected plan for birth simply could not be followed through. It is not that there has been no reaction to this; there were very strong protests against these closures in Ludlow, Bridgnorth and Oswestry. Although the MLUs remain open as a base for antenatal and postnatal care, there is no out-of-hours service, so if a patient finds themselves with unexpected bleeding or reduced foetal movement at night, they very often have no chance to get care. You might say, “Take a taxi”, but in many rural areas there simply is no taxi available to take. So that is the reality in Shropshire.

I have just one more point to make in that area about community hospitals. We see repeated attacks on the whole concept of community hospitals, and we have seen cutbacks and further cutbacks, but there needs to be a vision for such hospitals—that is, a strategy of how they can best be used for local people and the local healthcare system, taking medium acuity patients to relieve some of the enormous pressures that the acute hospitals are experiencing and, of course, making sure that people can visit patients and that patients can remain in and be part of their communities. It is suggested that Shropshire could become a centre for training and education for rural healthcare, perhaps teaming up with Keele University to offer better services to meet local needs.

I just want to branch out briefly into a couple of other areas. We are focused on healthcare but, of course, health and social care are closely interrelated elements. I heard from a councillor in north Somerset about the huge issue in very rural areas of simply finding a carer who is available to provide care in a small village. If someone needs that care and there is one person available, it means that the patient has absolutely no choice at all in terms of the carer they receive; if it is not working out very well, there is simply no other option available.

Finally, another terribly important issue is that of the shortage of dental care. I should declare my position as a vice-president of the Local Government Association because I will refer to recent LGA analysis that shows that rural and deprived communities particular suffer from a lack of dental provision. In comparing data from January 2022 for the bottom 20 areas, a year on, we can see that only one of them had seen improvements; all the others are going backwards. Meanwhile, the areas with the best access to dental care are seeing more and more dentists opening up and offering NHS services. So we are seeing a huge displacement of services to areas where there is relatively little need, but we are not seeing services coming into the areas where they are needed. Of course, what that means is that people either forgo dental treatment or resort to DIY dentistry. That is hideous in terms of pain but also in terms of the final cost of treatment that will need to be provided by the NHS. Indeed, if the Government will not listen to any other arguments, we can again come back to the issue of economic costs. We are looking for workers but those workers are all too often too ill to be available for work.

14:22
Lord Mann Portrait Lord Mann (Non-Afl)
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My Lords, the Minister was nobbut a lad when I last lived in a city but I do not buy this idea that there is some kind of clash for resource between urban and rural and that rural areas somehow get the worst of it. Having been a parliamentary representative and therefore also having an obligation to live in London, I know that access to services in London is significantly worse than I have ever seen in any rural area.

I think that the issue is different. I have specific questions relating to dispensing pharmacies. I recall the 2008 consultation by the then Government, when I personally put in more than 50% of the national responses and turned over the Government to allow the system, which was crudely a subsidy of local GP services—in particular, therefore, of smaller ones in more rural areas—to maintain the dispensing. That subsidy was critical to the maintenance of the GP practice; that was my argument to the Minister of the day. It was not particularly about convenience, although there are marginal arguments there; it was about the maintenance of GP practices. Have the Government any intention of watering that down or moving away from it in any way, or does that remain guaranteed as a principle that they will actually enshrine further rather than cut away from?

My second point for the Minister is the one that I find the most unfathomable. Let me take the example of stroke care. I live in an area that is generally described as a former coal-mining area; it is not one of the wealthiest areas. Statistics can be used in many ways but, in many of the rural areas that I once represented and where I live, there is no longevity of life. Where is the use of technology?

Let us take Iceland as an example—one that I have cited repeatedly over the years to local health services in the north Midlands and South Yorkshire. Iceland has the best outcomes for stroke care in the world, by quite a degree. I do not know how many noble Lords have had the opportunity to visit Iceland but, if they have not been, they can envisage that it is incredibly rural: it takes a day to get the whole way round it. There is one main hospital, in Reykjavik. What happens when someone has a stroke? You are not going to get, in a golden hour, from any rural part of Iceland into the capital city and the hospital—it is not possible—so they use online consultation. The specialist in Reykjavik, who is available 24 hours a day and is doubtless at home, is there on the computer. This has been the system for the past 20 years. They diagnose on whether to thrombolyse and a skilled, but not particularly highly skilled, nurse of some kind then does the thrombolysis, if that is determined as the outcome. More people live; indeed, all people who have a stroke have a better outcome.

If that can be done in such a rural situation, with one hospital, why are we not doing the same in so many different areas? Let us take me as an example. I may not be a typical patient but I am not that atypical of the people the NHS is a bit worried about and advises, “Make sure you’re looking after yourself. Make sure there’s early diagnosis, otherwise you might be up for a bad time and you’re going to cost us a lot”. I am more than happy to have a face-to-face discussion. I would prefer to be able to speak to a specialist in Sheffield or London—or, frankly, in Tokyo or New York—if that is what is determined rather than having to book to see a generalist GP who can then only refer me on and try to get me to a specialist, about whom the GP may or may not have specialist knowledge about whether they are any good. That is not a coherent system.

We are not using technology in the health service. It is obvious to me that rural communities could be the biggest beneficiaries. I accept that there are issues with broadband in some areas but, frankly, even recent Governments have managed to move us on somewhat in relation to that. It would be a game-changer. If I needed to speak to my local GP, I would be happy to do it face to face, but I suspect that this would be more efficient for them. I am not saying that it should be a system for everybody, that everyone would be comfortable or want to do it or that, in every scenario, I or the medical practitioner would feel that it was appropriate, but does the Minister think that we could do far more in resource to move this forward in the next year or two?

14:28
Lord Bishop of Exeter Portrait The Lord Bishop of Exeter
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My Lords, I begin by thanking the noble Baroness, Lady McIntosh, for securing this important debate. We all acknowledge that the NHS is operating under enormous pressure at the present time. Perhaps inevitably, publicity focuses on our inner cities but, as we have been hearing this afternoon, rural communities are also pinch points. My own county of Devon has the second-oldest population in the country. We should not underestimate the challenge, both logistical and financial, of delivering healthcare to an ageing population, particularly in coastal communities and remote rural areas.

In his 2021 report on coastal communities and their patchy provision of medical services, the Chief Medical Officer for England observed that some

“of the most beautiful … and historically important places”,

including in the south-west region,

“have some of the worst health outcomes in England, with low life expectancy and high rates of many major diseases”.

As we heard in the Chamber this morning, patients experience difficulty in accessing physiotherapy following strokes and operations. This is exacerbated in rural areas by poor and non-existent public transport. In parts of the south-west, we are finding it difficult to recruit GPs and I encourage His Majesty’s Government to think outside the box and consider adopting a salaried approach to recruitment, rather than a partner approach.

Age UK estimates that each day a medically fit patient occupies an NHS bed costs three times as much as if they were to be cared for in a nursing home. Given the age demographic of shire counties, you do not have to be a brilliant mathematician to realise that the NHS and care services are under huge pressure in rural areas. Our ageing population, with increasing levels of frailty and multimorbidity, is generating increased demand for social care at a time when capacity in the sector is shrinking, not expanding. We need to face the fact that successive Governments of all complexions have failed to grapple with the social care problem. Social care is the responsibility of local authorities but over the last 10 years it has been subject to severe cuts, so what is to be done?

One reason is that it is hard to recruit carers following a patient’s discharge from hospital because of zero-hour contracts that do not allow for transport time between sites. Devon is a massive county and it may take an hour, without pay, for a carer to travel between visits. As a result, admissions to care homes may be the only viable option, although it is the least attractive. This leads me to say two things: first, there has got to be a better deal for unpaid carers. Secondly, there is an urgent need to transform what is a low-paid, low-status workforce in the care sector into a viable and noble career.

Last month saw the publication of the report by the commission of my most reverend friends the Archbishops of Canterbury and York on social care. Entitled Care and Support Reimagined, the report identifies a pressing need for a new national care covenant that would set out the respective rights and responsibilities of national and local government, communities, families and citizens. “Covenant” has strong biblical overtones, and the commission chose it in preference to “contract” because the health of a nation is dependent on the underlying principles and values that shape a society.

The report also points to a malaise at the heart of the NHS that needs to be addressed. The greatest resource the NHS has is its staff: people matter. The unpalatable fact is that good, capable and experienced staff are leaving the NHS in droves. It takes years to train doctors and nurses, and even longer for a qualified medic to accumulate the experience that is the prerequisite of good healthcare. Older and experienced staff are burnt out and retiring early. The loss of their expertise is a national tragedy that could have been avoided. Many are exhausted by the obligation to record unnecessary data and navigate a health system that has become byzantine in its complexity. They find themselves servicing the system rather than the patient. If we are to secure a more effective delivery of healthcare in our rural areas, we need to address these challenges and, above all, give energy to raising the morale of our hard-pressed NHS and social care staff.

14:34
Lord Allan of Hallam Portrait Lord Allan of Hallam (LD)
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My Lords, we too are grateful to the noble Baroness for creating this opportunity. All health and social care services are under strain, but there are particular challenges in rural areas and it is worth some time to focus on those. I will touch on four important topics: staffing, structure, transport and digital.

On staffing, there are issues with shortages everywhere but an especial challenge with trying to attract qualified staff into rural areas. The right reverend Prelate the Bishop of Exeter referred to the idea of salaried GPs, which is one way to attract people in; it would be interesting to hear the Minister’s views on that. Another approach that I understand can work quite well is to train staff in situ—in other words, to train up people already living in those rural areas, rather than seeking to bring people in from outside.

The Times tells us that the Government are going all out on trying to come up with what are effectively apprenticeship schemes for nurses and doctors to take people already in the profession to the next level. Is that something that the Minister thinks could be particularly important for rural areas, where we have staff with some skills but can train them up to be fully qualified nurses and doctors? Of course, that would require us not to insist that they move out of those rural areas for the training; we should be willing to deliver it where they already are. Additional training is a long-term fix, and I hope the Minister will also be able to offer some shorter-term government initiatives to make sure that we can create attractive options for qualified nursing and NHS staff, in particular doctors, to move into rural areas.

On structure, I know that the Government’s response to everything is integrated care boards, and I expect we will hear that again today. It is interesting that many of the integrated care boards combine rural and urban areas. The noble Lord, Lord Mann, pointed out that there are challenges in both, and we should not necessarily see it as one against the other. I can certainly see that integrated care boards could work in both directions. It could be that by combining those areas you get a particular focus on the rural areas and much better integration of centres that tend to be in the more populated urban areas with need in the rural areas. Equally, it could work the other way; an integrated care board could look at impact on population and think, “We’ll put all the resources into the most densely populated area”. In that context, I wonder whether the Government are carrying out monitoring and research for these integrated care boards, which are a new creature, to understand the impact they are having on rural areas and whether they achieve some positive benefit in bringing together people across a community.

The third area is transport, mentioned by the right reverend Prelate the Bishop of St Albans and the noble Baroness, Lady Bennett, who said that taxis are not always there for patients. Certainly, if you have a medical emergency at the time of the school run, in most rural communities you will find that the taxi or the two taxis in your town or village are already fully booked. There are real issues for patients, but I will focus on the issues for staff and the calculation of travel times for them. As I understand it, health and care staff in the most sparsely populated areas can spend 10 times as many hours on travel as those in the most urban areas. That means that you cannot look after the same number of people with the same number of staff, because the ratio of travel hours versus treatment hours is very different.

The right reverend Prelate the Bishop of Exeter raised the issue of care staff on zero-hours contracts, and that is very relevant. I would be interested to hear what the Minister thinks of the proposal we have put forward that there should be a higher minimum wage for care staff, above the current national minimum wage. Care staff need something more to attract them into the profession. That also means looking at their contracts and making sure that travel time in rural areas is not something they have to absorb but something they are reimbursed for.

Another part of the solution to travel time is to look at where services are delivered, with more local clinics and more diagnostic centres. A lot could be done around bringing services to people rather than necessarily making people go to the services, but that has limits. It is certainly a solution when somebody needs to be on site—when they are producing blood samples or need scanning equipment that can be only in a fixed setting—but, as the noble Lord, Lord Mann, reminded us helpfully with that illustration from Iceland, other services can be delivered entirely remotely.

That brings me to my final point, where I want to touch on digital. There are a couple of issues here. First, Iceland’s system works because it has fully digitised its electronic health records. In the United Kingdom, we still have a real patchwork. To be able to deliver proper, effective digital services, we need a fully electronic national health record. However, we are some way off. I hope that the Minister can talk a little about our ambitions in that direction.

Secondly, on connectivity, again, it is about looking at specific locations. We should not generalise. We should look at specific locations and be prepared to invest where a location is missing the connectivity it needs.

Finally, I turn to digital health skills. Again, one of the differentiators for Iceland, a country I also love, is that it has invested in such skills; I learned this from a friend who is a Pirate Party MP, which says something about Iceland’s approach to digital. People understand how to use these technologies and interpret the results. Again, I hope that the Minister will have something to say about digital health skills. I emphasise the “health” part of that; digital is important but there is something specific about teaching people to use applications to do remote consultations.

14:40
Baroness Merron Portrait Baroness Merron (Lab)
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My Lords, I start by congratulating the noble Baroness, Lady McIntosh, on giving us this opportunity to debate what I believe is a very important matter: equality of access to healthcare. I listened closely to the noble Lord, Lord Mann, as I always do, but for me this is not about rural versus urban. It is about saying that no one thing fits everybody. The health service is not one size fits all.

There are a lot of givens in respect of rural, remote and coastal areas; we heard them outlined today. The Nuffield Trust, which produced an important report after the pandemic, has said that the problems in healthcare were made worse by the pandemic but that it also threw up some new problems. We heard about a number of them today. Like other noble Lords, the right reverend Prelate the Bishop of Exeter talked about workforce challenges, including difficulties with recruitment and retention, higher overall staff costs and the larger distances that people need to travel. There is a high amount of unproductive healthcare time as staff must travel. That is not going to change, because the nature of the areas is based on the distance between them. This matter must be addressed, but the way we address it is not a given. There are challenges relating to the size of areas, such as difficulties in realising economies of scale and access to certain resources—such as telecommunications, training and consultancy—being more expensive or difficult.

It is worth saying that, for all those givens, it was shown just before Christmas that people in certain rural areas are waiting almost three times longer for emergency ambulances than those in urban areas. I make that point in the context of the number of debates we have had in the Chamber about the inadequacy of response times in respect of ambulances across the country. Yet we have a particular issue in rural areas, with an ageing and older population. For example, the longest wait for an ambulance was registered in Cornwall at just over an hour and 41 minutes, whereas—this is the important point—two years previously the equivalent figure was 32 minutes. That begs the question as to why it has gotten so much worse, especially in rural areas; the Minister may be able to assist us on that.

The noble Lord, Lord Mann, expanded on the point that I made earlier today in my Oral Question about access to GP appointments. I want to emphasise that choice is so important. Here is an opportunity in rural areas because one cannot necessarily just wander down the street or get a bus to a GP practice. The Government are going to have to be much more creative. In so doing, they can embrace this and provide choice for people on how they wish to have their consultation.

I want to say one word about the Answer given to me earlier today; perhaps the Minister here can assist. The Minister in the Chamber made an assumption about people being able to use smartphones. I accept that many of us can, but there is a whole swathe of the population for whom this is just not going to happen, which adds to their distress and discomfort. Perhaps the Minister here could assist in this regard.

I want to refer to the matter of dispensing doctors. I am grateful to the Dispensing Doctors’ Association for its briefing, because it threw up a lot of whys for me. I want to put those whys to the Minister. Dispensing doctors are NHS GPs who can dispense medicines in designated rural areas where a community pharmacy is not economically viable. This seems a good thing to me. They account for some 15% of all prescriptions dispensed. We know that pharmacies now provide more clinical services to their patients, such as hospital discharge planning and medicine use reviews. Again, that is a good thing, but such services are not available for rural patients who use dispensing practices. Why not? Can this be addressed?

Similarly, the electronic prescription service is not available for dispensing patients. This builds on the point made by the noble Lord, Lord Allan, about the whole system, to which the right reverend Prelate the Bishop of St Albans also referred. The EPS is not designed with dispensing practices in scope. Can the Minister confirm that, as the NHS moves towards ever more integrated IT solutions, it will be possible for a hospital consultant to send a prescription to a patient who receives their medication from a dispensing practice, which is not currently the case?

It has been said that rural residents are paying more, receiving fewer services and earning less on average than those in urban areas, and that this is inequitable. That is indeed the case. I hope that the Minister can help us today.

14:47
Lord Evans of Rainow Portrait Lord Evans of Rainow (Con)
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I thank the Committee, noble Lords and noble Baronesses for their contributions to this debate. I know that this topic raises great interest across your Lordships’ House. I also congratulate my noble friend Lady McIntosh of Pickering on bringing forward this debate and on her work not just in this House but over many years as the Member of Parliament for the wonderful constituency of Thirsk and Malton.

I recognise many of the challenges of delivering healthcare in rural areas, including the distinct health and care needs of rural populations and the challenges of access, distance and ensuring a sufficient workforce to enable safe and sustainable services. As a resident of a rural area myself—Rainow—I am no stranger to the challenge of people having to travel further to access healthcare, or their difficulties in relying on rural transport networks to reach the care that they need. However, I assure my noble friend that this Government are, and will remain, committed to improving the health service in rural areas, as we are committed to improving it across England.

First, I can give my noble friend an assurance that we are in full agreement that the NHS needs to be flexible enough to respond to the particular needs of the various rural areas in England. That is why we passed the Health and Care Act 2022, which embeds the principle of joint working right at the heart of the system, promoting integration and allowing local areas the flexibility to design services that are right for them.

Integrated care boards and integrated care partnerships give local areas forums through which to design innovative care models, bring together health and social care and prioritise their resources to ensure they best align with the needs of their area. We are also enabling the NHS to establish place-based structures covering smaller areas than the ICS—for example, covering a local authority footprint or, in some cases, even smaller subdivisions for those larger county areas.

By establishing these models for the NHS to follow we have set the framework, but we have left it to individual areas to tailor the specific details. That is the right approach because, as established in this debate, local areas know better than Ministers in Whitehall how best to organise themselves to design and deliver the best possible care for patients. While we can guide and hold accountable, it is right that we also protect that local flexibility.

I share noble Lords’ passion on internet connectivity. We recognise that some rural areas may have greater challenges accessing the internet than others. I assure the Committee that the Government are taking action to improve broadband and mobile phone connectivity in rural and hard-to-reach parts of the UK. More than 73% of premises in the UK can now access gigabit-capable broadband, which is a huge leap forward from January 2019, when coverage was just 6%. This will only get better.

To help drive this rollout further, we are awarding a series of contracts to suppliers to deliver gigabit-capable connectivity in areas to which the market will not go without subsidy. We have already awarded six contracts and, in total, have made almost £1 billion of funding available through our live contracts and procurements, covering up to 681,000 premises—two-thirds of a million homes. This can be a solution for those hard-to-reach communities on a case-by-case basis. However, we recognise that connectivity remains limited in some areas at this time. As such, digital approaches to health and care should always be only one part of a multipronged offering reinforced with the right support, including face-to-face meetings and visits for those who struggle to access digital services.

The Government recognise the important work done by dispensing practices. This is reflected in the five-year GP contract framework we agreed with the British Medical Association in 2019, underpinned by a record-level addition of £4.5 billion for primary and community care by 2023-24, as part of the NHS long-term plan. This money will help ensure that dispensing practices can continue to provide patients and communities with the prescriptions that they need and to which they are entitled.

I would like to address the important topic of dementia, which my noble friend specifically raised. I assure your Lordships that the Government and the NHS are committed to tackling dementia head-on. On 24 January this year, the Government announced that they will publish a major conditions strategy covering six conditions including dementia. An interim report on the major conditions strategy will be published in the summer. Only in December, the recovery of the dementia diagnosis rate to the national ambition of 66% was included in the NHS priorities and operational planning guidance. This reinforces the importance of dementia as a key priority for the NHS and provides a clear direction to those with responsibility for planning healthcare to make sure that they deliver timely diagnosis.

What is more, work is under way to investigate underlying variation in dementia diagnosis rates. This includes the assessment of underlying population characteristics such as rurality, ethnicity and age. The aim of this work is to provide the context for variation and, in doing so, enable targeted support at local levels to improve diagnosis. This is important work and that discovery must be undertaken to learn how we can make things better for patients in rural areas.

I turn briefly to resources, which many Members have mentioned today. As noble Lords will know, it is vital that we allocate resources in a fair way. NHS England is responsible for funding allocations to integrated care boards. This process is independent of government, and NHS England takes advice on the underlying formula from the independent Advisory Committee on Resource Allocation. That formula takes into account various factors including population, age and deprivation.

In 2019-20, the Advisory Committee on Resource Allocation introduced a new element to the formula to better reflect needs in some rural, coastal and remote areas that, on average, tend to have older populations. NHS England is now using this formula and making allocations accordingly. However, we recognise that some systems are significantly above or below the target of where their allocations should be, so NHS England has a programme in place to manage convergence over several years.

I will now answer some of the specific questions that noble Lords asked. The right reverend Prelate the Bishop of Exeter mentioned social care. The Government have read the archbishops’ report with great interest. We have already committed to publishing a plan for adult social care by spring 2023, which will build on progress so far. We will consider the report as part of that work. The noble Baroness, Lady Bennett, and the right reverend Prelate the Bishop of St Albans also mentioned social care. The Government are putting £2.8 billion next year into additional funding. In spring 2023, the Government will publish a plan for adult social care system reform.

The noble Baroness, Lady Bennett, also mentioned dental care in Shropshire. I am sorry that I am not quite familiar with dental care there—in Cheshire, perhaps, but not Shropshire. The Government put £50 million into funding for NHS dentistry in 2021-22. We acknowledge that some areas are experiencing recruitment issues, and we are actively considering what measures can incentivise dentists to work in more rural areas. We know that we can go further, however, and our priority is to improve access to rural dentistry.

In response to the noble Lord, Lord Mann, I have not been to Iceland, but I hope to one day. He made a very powerful point. We have increased significantly—by 50%—the money going into virtual ward beds. By the end of this year, 100,000 people will be able to have consultations through the virtual ward system. It is a way forward but, as he said, we need digital connectivity for that to be effective.

In response to the noble Lord, Lord Allan, electronic patient records are close to my heart. Our digital health and social care plan sets out a commitment to ensure that all trusts have electronic patient records. NHSE will produce a digital work plan by the autumn. I will take a keen interest in that, as I am sure he will too. The noble Lord also mentioned the correct apprenticeships for key priority areas. The Government are working on that so that it mirrors the local population apprenticeships as a good way for young people to get into the health service.

In response to the noble Baroness, Lady Merron, iPhones are popular with all ages, but I take the point that this is not for everyone. I went to a 102 year-old’s birthday lunch; he took a photograph on an iPhone and texted it to me. There is hope for us all but she made a good point: digital technology is not for everybody.

Before I close, I pay tribute to the NHS and social care services across England for their work. They deliver excellent care now and did so throughout the pandemic. The country is rightly proud of them. We absolutely recognise the importance of ensuring that the challenges faced by rural areas are given due diligence and consideration. These areas face a different range of challenges from those of the NHS in more urban or suburban areas and it is right that we give the systems the flexibility to respond to them.

I hope that I have given my noble friend some reassurance that the current system works. I also hope that she has a speedy recovery from her damaged leg.

14:58
Sitting suspended.

British-Iranian Relations

Thursday 23rd February 2023

(1 year, 2 months ago)

Grand Committee
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Question for Short Debate
15:01
Asked by
Lord Alton of Liverpool Portrait Lord Alton of Liverpool
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To ask His Majesty’s Government what their priorities are in respect of the conduct of British-Iranian relations.

Lord Alton of Liverpool Portrait Lord Alton of Liverpool (CB)
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My Lords, in thanking all noble Lords who are to speak today, I wish that more time was available for an extended parliamentary debate. I should also record for the sake of transparency that the noble Lord, Lord Polak, and I are both sanctioned by the Iranian regime.

Key issues that the Committee will want the Minister to address include Iran’s reported ability to have enriched uranium to levels just short of the threshold for making a nuclear bomb. We will want to hear about its supply of drones to Putin for his use in the illegal war in Ukraine and its support for regional proxies destabilising the region—not least for the Houthis in Yemen, where an estimated 150,000 people have been killed in the war, including 10,000 children. We will want to hear about the malign activities of Iran’s Islamic Revolutionary Guard Corps, inside and outside Iran, and the continued lamentable and dismal failure to proscribe it; about abductions and extrajudicial killings, including of UK citizens, and the increasing use of the death penalty; about the decision this week of the independent TV station Iran International to leave London because of threats to its staff, along with similar, systematic targeting of BBC Persian staff and their families; about the shocking ill-timed cuts to the BBC Persian services when widespread protests are sweeping the country, heroically initiated by defiant women, and when the need for the flow of reliable news rather than propaganda has never been greater. We will also hear about the systematic abuse of human rights, not least for political and religious beliefs, including those of Baha’is and Christians whose beliefs do not conform to those of Iran’s repressive theocratic regime.

I turn first to nuclear proliferation. The inspectors for the International Atomic Energy Agency say that levels of enriched uranium at Iran’s nuclear sites are now just 6% below the threshold for a nuclear weapon. In a week during which North Korea launched an intercontinental ballistic missile, it was disturbing to read that their brothers in arms in Iran are also developing comparable technology, with direct application to intermediate and intercontinental-range ballistic missiles.

Back in 2021 in the integrated review, the United Kingdom asserted that with its allies it would

“hold Iran to account for its nuclear activity”.

I would be grateful if the Minister could tell us when the update of the review will be completed and explain what we mean by accountability, how we intend to respond to these most recent developments, and what it meant when we said we remain

“open to talks on a more comprehensive nuclear and regional deal”

—not least in the context of President Biden’s reported remarks that the JCPOA is dead.

In any event, why should we believe anything this regime says or promises? It told the world that its centrifuges could enrich uranium only to a 60% level of purity. As its total enrichment of uranium stockpiles now exceeds JCPOA limits by at least 18 times, it is patently clear that this is not a regime whose word counts for anything.

The risks to world peace, including an existential risk to the State of Israel, are obvious. On 12 September, Israel’s Defence Minister Benny Gantz displayed a map depicting the Syrian location of 10

“production facilities for mid- and long-range, precise missiles and weapons”

that Iran had

“provided to Hezbollah and Iranian proxies.”

In commenting on that, can the Minister also tell us how we have responded to Iran’s provision of unmanned aerial vehicles, Mohajer-6 drones and Shahed 131 and 136 drones, which target civilians and civilian infrastructure in Ukraine, aiding and abetting Putin’s brutal war crimes, in which Iran is now implicated and complicit and for which it should be held to account and ultimately prosecuted?

An Iranian delegation was in Moscow last month discussing building a factory to mass-manufacture drones. Are we seized of the urgency in recognising the deepening military and economic ties between Russia, Iran and the PRC on everything from satellites to grain, drones and joint military exercises in the Gulf? As for the axis with Putin, it was reported in the Guardian last week that:

“The Iranian Revolutionary Guards Corps (IRGC) has been at the forefront of the growing bond, with senior leaders, Khalil Mohammad Zadeh, Suleiman Hamidi and Ali Shamkhani, playing central roles in the drone exports to Russia.”


How effective does the Minister believe that the more than 50 sanctions designations imposed because of military support for Putin or as a consequence of human rights violations have been? Are we considering further sanctions? Beyond sanctions, is it correct that the FCDO has blocked a Home Office attempt to proscribe the IRGC? Is that because of German reluctance to do the same? As I asked in the House on 18 January following the execution of Alireza Akbari, what has to happen and what further evidence is needed before it is proscribed?

Such executions and death penalties are not new in Iran. It has long ranked among the world’s top executioners, often on the back of hasty sham trials. In 2021 it executed 314 people, 20% more than in 2020. Estimates differ for 2022, but dozens are facing protest-related executions. Perhaps the Minister can give us the FCDO estimates, including the numbers of children who have been executed. As for the sham trials and what passes for justice, Tara Sepehri Far of Human Rights Watch says:

“Defendants are systematically deprived of access to lawyers … are subjected to tortured and coerced confessions and then rushed to the gallows.”


Not that we should be surprised, given the role of President Ebrahim Raisi in 1988 in the massacre of 30,000 political prisoners, predominantly from Mrs Rajavi’s pro-democracy resistance.

Executions have been used to try to frighten people who have been protesting since the death in September of 22 year-old Mahsa Jina Amini while in the custody of the nation’s morality police—the spark that ignited a nationwide revolt against the theocratic regime, in many cases led by young women, turning on its head the stereotype about the nature of opposition within Iran. Mahsa had been arrested for “improperly” wearing her hijab and, according to her family and local media, severely beaten. She died three days later while still in police custody. Protests then erupted across Iran, led by women who tore off their hijabs, cut their hair and adopted a rallying cry of “Women, life, freedom”. How bitterly ironic that Iran, until it was expelled in December, had a place on the United Nations women’s committee. According to the UN human rights office, protesters are facing the so-called crime of “waging war against God” or “moharebeh” and “corruption on earth”.

Agnès Callamard of Amnesty International says:

“The Iranian authorities knowingly decided to harm or kill people who took to the streets to express their anger at decades of repression and injustice.”


She said that

“countless more face being killed, maimed, tortured, sexually assaulted, or thrown behind bars”

and that the international community

“needs to go beyond mere statements of condemnation”.

The sheer courage is striking. Reports of what happened to Mahsa Amini emerged in part thanks to reporters Niloofar Hamedi and Elahe Mohammadi, whom the Iranian regime then subsequently jailed. These brave young women could now themselves face the death penalty. But their journalism is not a crime. By the end of 2022, there were 363 known cases of detained journalists. Article 19 is abused every day in Iran; as it tops the world’s league of executioners, Iran also tops the league for jailing journalists.

That takes me to the BBC. I sometimes wonder whether Ministers truly understand the smart power of the BBC World Service. Certainly, the Iranian regime must do so, or it would not be threatening BBC journalists and their families. Following the debate that I secured on cuts to the BBC’s global news services, and a meeting along with the noble Baroness, Lady Browning, with the FCDO Minister David Rutley this week, I met Liliane Landor, the director of the BBC World Service. On each occasion, I raised my concerns about the despicable treatment of BBC Persian journalists, which is of a piece with the driving out of Iran International from London. I have also contested the FCDO’s shocking decision to cut the BBC Persian radio service. BBC services being cut does exactly what the regime wants the FCDO and the BBC to do and, in the scheme of things, it makes very small savings. I know that my noble friend Lady Coussins will return to that issue.

In summary, 1.6 million Iranians still get their news via radio, and dictators can far more easily close down internet services. Long-term funding of the BBC World Service must be addressed, but in the short term the Persian radio service should not be allowed to close. Its voice and the voices of those who want to see the emergence of a more just and democratic society based on the rule of law must not be silenced. In this debate, we must reiterate our support and raise our voices for the people of Iran.

15:11
Lord McColl of Dulwich Portrait Lord McColl of Dulwich (Con)
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My Lords, for many years I have been associated directly and indirectly with Iran. I have visited many Iranian cities and have a great affection and respect for the Iranian people. I am very keen to try to help them in getting them medicines, essential equipment and other humanitarian help. It is my understanding that the acute lack of essential food and health commodities in Iran is in great part due to the gap between the Iranian and international banking systems. This is reflected by Iran’s non-adherence to recommendations of the Financial Action Task Force, which is one of the main obstacles preventing the Iranian banking system joining the global banking community.

As it appears unlikely that this problem can be resolved in the short term, the need seems obvious for an approved secure banking channel to be established for the uninterrupted supply of essential goods to the Iranian population, regardless of the international political environment. Multiple solutions have been proposed over recent years that have not gained much traction or success. However, I am aware of a Swiss proposal, initiated by a former senior United States oversight official in the Washington area and his Swiss-based colleague, which has received the preliminary blessing from the relevant US department that handles such issues. Would the Minister agree to sit down with me and the sponsors of the Swiss proposal to understand its merits? My understanding is that this proposal could easily incorporate other interested actors, such as Qatar, to which an invitation has already been extended to participate, and would be operational in a matter of days, provided that appropriate approvals are received. This could mean the possibility of delivering medicines and other essential goods during the Iranian new year period that starts next month, which would make an immediate and meaningful impact.

15:14
Lord Dholakia Portrait Lord Dholakia (LD)
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My Lords, I thank the noble Lord, Lord Alton of Liverpool, for this debate.

The United States Government classify the Islamic Republic of Iran as the foremost state sponsor of terrorism, alleging that Iran provides a range of support, including finance, training and equipment, to terrorist groups around the world. How else can we explain the use of Iranians drones in Ukraine or the security of some of the countries in the Middle East?

In recent days, we have seen a democratic revolution fully supported by the Iranian people. This is a revolution against the mullahs, the likes of which we have never seen before. More than 750 people have been killed, according to the Iranian opposition People’s Mujaheddin Organisation of Iran. I have seen similar evidence of the attacks on resistance fighters in Camp Ashraf, where they had sought shelter. I have seen video evidence of the hanging of women and children on cranes in Tehran. There is one change in the protest marches that are now taking place: it is a revolution carried out mostly by Iranian women.

Democratic rule is perfectly possible in Iran. Mrs Maryam Rajavi leads the pro-democracy Iranian opposition coalition, which has produced a 10-point plan and has widespread support in both Houses of the UK Parliament, as well as in Parliaments in many parts of the world. She mentions the rule of law and proper fair elections as essentials. Briefly, she talks of establishing a democratic, secular and a non-nuclear republic. I make a plea to our Minister: invite Mrs Rajavi to London to meet our Government and Iranians living in the United Kingdom.

15:16
Lord Polak Portrait Lord Polak (Con)
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My Lords, the people of Iran are entitled to have good relations with the people of the United Kingdom. However, I would argue that the current Government of Iran are absolutely not entitled to have good relations with His Majesty’s Government.

I commend my friend Hillel Neuer, who is the indefatigable executive director of UN Watch, a human rights NGO based in Geneva. He has been holding the Iranian regime to account; indeed, he headed the campaign to remove Iran from the UN Commission on the Status of Women in 2022. I thank my noble friend the Minister for taking such a strong lead on that issue. I hope he will forgive me for not having enough time to list all the reasons why the Islamic Revolutionary Guard Corps should be proscribed as a terror group; perhaps I could just ask him in his response to furnish the Committee with the reasons why the Government have not done so.

Hillel is rightly campaigning for UN delegations to walk out in protest when the Iranian Foreign Minister addresses the UN Human Rights Council next Monday, on 27 February. Global figures have joined that campaign, including Masih Alinejad, the exiled Iranian women’s rights activist whom the regime attempted to assassinate in New York last summer. I urge my noble friend the Minister to lead once again and take a strong stance against a regime that tortures, kills and hangs its own people. If we stand for the protection of human rights as we say we do, my noble friend should stand up and leave the room when the Iranian Foreign Minister begins to speak.

15:18
Baroness Cox Portrait Baroness Cox (CB)
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My Lords, I also congratulate my noble friend Lord Alton on achieving this very important debate.

I will use the short time available to give a personal message from Christian Iranian asylum seekers based near my home in Witney, who have become friends. These are their words, not mine:

“Our Iranian friends are losing their lives for the simplest human rights of a person. At the risk of making their voice known to the world, they have come to the streets and they only protested. But the answer to their protest was gunshots, prison and execution. In the last four months, more than 1,000 people have been killed in Iran. Many of their bodies have not been handed over to their families; many have been executed and several hundred innocent children have died. Now, we have only one request to the British people: please help us so that the voice of the people of Iran is heard because, in our country, there is nothing but oppression, torture and imprisonment; the oppression of women; and shutting the mouths of young people. My country smells of blood—the smell of the blood of my brothers and sisters, who only wanted nothing but the cry of freedom in the street.”


These poignant words provide a painful, powerful endorsement of the purpose of this debate. I hope that the horrific persecution of minorities by the regime in Iran is something that the Minister can address in his reply.

15:20
Lord Bishop of St Albans Portrait The Lord Bishop of St Albans
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My Lords, I thank the noble Lord, Lord Alton, for obtaining this debate, for his superb introductory talk and not least for his powerful call that we should oppose the persecution of Baha’is and Christians. I will raise just two issues in the few moments I have.

First, as we conduct British-Iranian relations, it is vital that we support loudly and clearly those who are demonstrating for their freedoms, in particular those who face the most opposition: the young and the women who are being opposed by their own Government. They are rightly demonstrating for freedom of speech and for their rights to an education and a job.

It is difficult to know exactly how many people have been caught up in the demonstrations although it is widely reported that, so far, between 600 and 800 protesters have been killed, more than 30,000 have been arrested and more than 40 have been executed. Those are probably very modest figures. I echo the question to the Minister from the noble Lord, Lord Alton: what attempts are being made to record the regime’s crimes so that they can be taken to the UN Security Council? What representations have His Majesty’s Government made to the Government of the Islamic Republic of Iran? Does the Minister agree that Supreme Leader Khamenei and President Ebrahim Raisi should be held to account?

Secondly, I want to say just a few words about the vital importance of the BBC Persian service, to which the noble Lord, Lord Alton, referred and which has a weekly estimated audience of 1.6 million people. The BBC Persian radio service costs only around £800,000 a year. It is appalling that BBC Persian staff, especially women journalists, are being targeted. Iranian journalists working here in the UK are finding that their families back in Iran are being threatened and sometimes arrested and interrogated.

Iran has a systematic programme of media censorship. It blocks Facebook, Twitter and YouTube, among other sites, and, at critical times, it shuts down the entire internet. So the only source of independent reporting comes via the radio. The official state media do not report on the demonstrations. If the BBC withdraws its service, as it is reported it will, the media will be delighted that one further voice has been removed. Surely this is the very time when we need to continue to support those who are beleaguered by their own state by ensuring the unbiased reporting of events in that country. Will the Minister make urgent representations on behalf of His Majesty’s Government to reverse this very unfortunate decision about the BBC Persian radio service?

15:23
Lord Hannay of Chiswick Portrait Lord Hannay of Chiswick (CB)
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My Lords, I am delighted to follow the right reverend Prelate and also talk about the matters he talked about. My noble friend Lord Alton’s welcome and timely debate invites us to address the issue of what the Government’s priorities for British-Iranian relations should be. I would have no hesitation in naming the reversal of the lamentable decision to close down the BBC Persian radio service as the short-term top priority.

Why so? First, it would be one of the few actions that our Government could take of their own volition to reach out to Iran’s citizens in a period when they are going through great stresses and difficulties and are deprived of fair and accurate information.

Secondly, although I have listened carefully to the BBC’s and the Government’s explanations justifying the closure of BBC Persian’s radio broadcasts, I find them totally unconvincing. It is true that the radio audience is smaller compared with that of other media channels but, when they are deprived of radio, what alternatives will that audience have that do not put them at increased risk and cost?

Thirdly, and most importantly, why on earth is a step being taken that will only give delight to those who oppress Iranian citizens and deprive them of objective information—a step that they will surely hail as a victory? I very much hope that the Minister will tell us that this regrettable closure will now not proceed and that the cost of maintaining the radio service will be met as an addition to the FCDO’s block grant to the BBC’s overseas services.

In conclusion, I will mention another long-standing priority: the currently stagnant negotiations over Iran’s nuclear programme aimed at reviving the JCPOA. In my view, the Government are to be congratulated on persevering with this effort, unpromising though the present circumstances are. To abandon the JCPOA would merely give pleasure to the hard-liners in Iran who have always sought to undermine it. To abandon it without any alternative course to ensure that Iran does not obtain a nuclear weapon would be folly.

This debate certainly should not pass without paying tribute to the courage and determination of those in Iran who continue to demonstrate their rejection of oppression. Can the Minister say why refugees fleeing Iran are not on the list of those receiving expedited treatment for asylum claims? Surely they should be, irrespective of how they get here.

15:26
Viscount Waverley Portrait Viscount Waverley (CB)
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My Lords, freedom is a precious commodity but nobody knows with any degree of certainty where and when the situation in Iran will finally end. However, its people have sent an indisputable message to the mullahs and the revolutionary guard that enough is enough and their time is up. The people must always come first; the indicators are that the wind is in their sails. Arabian and Middle Eastern near-neighbour states are already pushing back against regime change but now is the time for the Government in London to become more assertive and be on the right side of history by supporting root-and-branch change away from corruption, illegal imprisonment, capital punishment, the confiscation of homes and the pillaging of the wealth of the nation.

Since the regime controls the economy, joining the revolutionary guard is an assured way to advance in a difficult life exacerbated by crippling sanctions. A long-term necessity is that the conditions are such that the economy can be opened up, to the benefit of all. The new generation in the IRGC is far removed from the original purpose of the Islamic revolution; given the incentive to do so, lower ranks could come out as sympathetic to the uprising given that the regime is now recognised as being so unpopular. The flight of capital from the country by senior members of the Government is testament that the end could be near.

However, I make a note of caution: the Islamic Republic has a strong lobby outside Iran, most particularly in Washington. A certain leftist ex-Prime Minister is being groomed to take over the mantle and, if this ploy is successful, will serve as a puppet of the regime by implementing cosmetic change only. The “Woman, Life, Freedom” movement has not yet found a single voice. It should be encouraged to do so post-haste in the same manner as the way in which Khomeini orchestrated the uniting of disparate factions in 1979. There is a consensus in Iran that the West is not doing enough. However, I remain of the belief that the leadership will buckle when faced with continued condemnation and pressure. Frankly, everything hinges on the strategic support that the uprising receives from the United Kingdom Government and others.

I join others in saving my concluding remarks for matters relating to the pending BBC closure. I can do no better than join the dots with what I said the other day in the Chamber:

“Our foreign policy and strategy should deem this an entirely illogical move … closure will send conflicting messages about the support we have in this country for the uprising.”—[Official Report, 21/2/23; col. 1616.]

15:29
Lord Shinkwin Portrait Lord Shinkwin (Con)
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My Lords, it is a pleasure to follow the noble Viscount. I join others in thanking the noble Lord, Lord Alton, for securing this important debate.

Which of us can ever forget the inspiring inauguration of the first black President of the United States only 14 years ago or the soaring rhetoric of that momentous day when, in reference to the unalienable rights enshrined in the American constitution, he declared:

“Today we continue a never-ending journey to bridge the meaning of those words with the realities of our time. For history tells us that while these truths may be self-evident, they’ve never been self-executing”?


How right he was, because passivity never pays. He also said that war does not need to be “perpetual”; again, he was absolutely right, of course. But surely, if the last 14 years teach us anything, it is that vigilance and resolve do need to be exactly that—perpetual—because appeasement always comes at a price, and what a price the world could be about to pay for the audacity to hope that diplomacy would work with a regime so disdainful of any values, any truths, other than what the ayatollahs decree. Whether it is terrorism abroad or even at home against its own people, as we have already heard, the threat to our values is real.

All eyes may be on Ukraine as the criminal invasion by Russia enters its second year on Friday, but the global destabilisation threat posed by Iran is potentially even more dangerous. As we have heard, Iranian nuclear breakout is imminent. That is the new reality of our time, which, sadly, no amount of rhetoric will bridge.

In conclusion, given that global security must be our number one priority, I hope my noble friend the Minister knows that he and the Government can count on the support of many noble Lords when appropriate military action to prevent that threat materialising is taken. For all our sakes, I hope it is taken swiftly.

15:32
Baroness Deech Portrait Baroness Deech (CB)
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My Lords, my noble friend Lord Alton is our moral compass in international affairs, and how fitting is his choice of subject today. This is a regime that has rewarded the attacker of Salman Rushdie and teaches its children to engage with martyrdom and the Islamic revolution and to call for the death of America and Israel.

But the gravest danger is its nuclear programme, in violation of the Joint Comprehensive Plan of Action. It is not joint because the US withdrew; it is not comprehensive because there are loopholes and sunset clauses, such as only a 10-year limit on centrifuges; it is not a plan because there is no strategy to prevent the development of an Iranian bomb; and it is not action because the IAEA cannot monitor or obtain accurate intelligence about Iran’s nuclear activity. It has amounted to a waste of time because Iran has never given up on its plan to develop nuclear weapons, and it seems to us that it is not bound by that agreement. Uranium purified to 84% has reportedly been traced. Even at 60%, there is no peaceful use for that uranium.

If Israel is provoked into a strike, the consequences could be world-threatening. The Government should be insisting on snap-back sanctions, albeit that they too expire in 2025. Iran is in breach of UN Security Council Resolution 2231 by supplying Russia with drones used to attack Ukraine. It is the cause of destabilisation right across the Middle East, supporting Assad, the rebels in Yemen, Hezbollah in Lebanon and Hamas in Gaza. How tragic that Syria appeals for assistance in the aftermath of the earthquake yet is funded for warfare by Iran to the tune of billions.

Unfortunately, snap-back sanctions would not hit Iran’s dealing in oil with China, but sanctions hitting the Iranian people may lead to the day when the Government are finally overthrown due to the miseries inflicted on their own people. Will our Government assure this Committee that the JCPOA is dead and that pre-JCPOA international arms restrictions should be restored? Will they downgrade diplomatic relations and close the Islamic Centre of England, which allegedly in effect represents Iran’s Supreme Leader?

15:34
Baroness Coussins Portrait Baroness Coussins (CB)
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My Lords, I endorse everything that my noble friend Lord Alton said in opening this debate about the treatment of protesters in Iran, especially women and girls. I shall use my time to support and re-emphasise what has already been said so forcefully by other noble Lords about the importance of preserving the BBC Persian radio service and the need to step up our intervention in order to stop the threats, persecution and violence being experienced by its staff in London and their families in Iran.

I know that the Minister has heard it all before—not least from me—but I make no apology for repeating a little of what I said in our debate on the World Service in December because, first, things have got significantly worse and, secondly, there is an immediate window of opportunity to do the right thing and reverse the decision to scrap the BBC Persian radio service on 26 March. I get the overall case for going digital but there are situations in which digital-only cannot be right, and surely this is one of them. The latest review of the BBC World Service asserted that it would

“serve audiences during moments of jeopardy”

and ensure

“access to vital news services, using appropriate broadcast and distribution platforms.”

Jeopardy in Iran includes the internet being restricted or blocked, so reliance on old-school radio may be the best or only way to provide access to those vital news services.

We know from the most recent data that 1.6 million people a week get their news from the Persian radio service—around 8% of its total audience. However, the impact of that service is far more significant than those superficially modest figures suggest because it is the morning radio output that feeds the TV and digital news content. Closing the radio service would mean BBC Persian TV not having any scheduled live news programming for 17 hours a day, creating the space for other, less balanced outlets with rather less palatable values and interests to fill the gap.

As others have asked, why hand the Iranian authorities a gift on a plate? Closing down BBC coverage of what is going on in Iran is exactly what they want. It would be a victory for them but the tragic loss of a lifeline of information and hope to the millions of Iranians who suffer under their regime—and all for the cost saving of only £800,000 a year. Will the Minister commit today to three clear actions: reversing the decision to close the radio service; funding the shortfall; and stepping up the diplomatic measures and the hard measures to protect Persian service staff in London and their families in Iran? This would give the Iranian resistance what they—and, ultimately, we—need and value.

15:38
Lord Purvis of Tweed Portrait Lord Purvis of Tweed (LD)
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My Lords, as always, it is a pleasure to follow my friend, the noble Baroness, Lady Coussins. I endorse all the points that she made and her specific request for information; I hope that the Minister will be able to respond clearly to them.

I commend the noble Lord, Lord Alton, on securing this debate. As he and others have pointed out, we are debating the Government of Iran’s policy and practice of persecution, not the Iranian people—many of whom have humbled us all, including those women and girls who, as many noble Lords have said, have been extraordinarily brave in the face of such persecution. We have seen the death penalty and torture used as a policy of intimidation; that is obvious.

It is welcome that the UN Commission on the Status of Women expelled Iran. However, it was disappointing to see countries on which the UK relies in many aspects of trade and diplomacy abstain from that decision, including those that are part of the Abraham Accords and our Gulf allies. It is also welcome that Iran is now subject to a UN Human Rights Council investigation. Similarly, countries that this country considers close diplomatic allies abstained. What work are we doing with our Gulf allies to ensure that their abstentions become positive votes when it comes to sending signals on human rights and supporting women and girls?

It is also worrying to have heard about Iran’s policy on Russia now, with its drones and diplomacy on arms and fuel, and to have the BRICS countries cited. It is alarming to see the BRICS network becoming a de facto diplomatic network as a cover for Russia. We have seen this from Iran within the recent military exercises but we also saw it with the naval exercises of our allies in South Africa. I hope the Minister can give clarity as to what our diplomatic work is doing to ensure that Iran is isolated, as it should be.

As the noble Lord, Lord Hannay, indicated, it is jarring to see Iranians excluded from the amnesty on irregular routes announced today. Why is this the case? Can the Minister state, in clear terms, what the safe route is for Iranian women to seek asylum in the UK? According to the Government, Iranians were the second highest nationality of those who sought asylum in 2021, with 9,652. What signal are we sending if we have not put in place safe routes for asylum for those who seek refuge in the UK?

Finally, on the point raised so well in the debate with regard to the BBC, on 12 October—over four months ago—I asked an Oral Question in the Chamber in which I sought urgent emergency funding, even if temporary, to secure the future of the BBC Persian radio service. This is now the time to ensure that the people of Iran understand, benefit from and can receive information from an independent, impartial and free media at exactly the time it is being denied to them by their own Government. I hope that our Government can at least provide emergency funding to ensure that that service is not stopped at the end of March.

15:41
Baroness Wheeler Portrait Baroness Wheeler (Lab)
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My Lords, I, too, congratulate the noble Lord, Lord Alton, on securing this timely debate when the spotlight is on British-Iranian relations. We are again seeing a further widespread wave of uprisings across Iran. My noble friend Lord Collins has spoken fervently on a number of occasions on the need for continuing support for the protesters and is sorry not to be here today, due to his role on the Bill currently in the main Chamber. This debate is about priorities for British-Iranian relations, and we have had a number of expert and very moving contributions from all noble Lords on those. I will underline four key issues.

First, the regime’s brutal crackdown against protesters has been an appalling response to extraordinary bravery. Viewed alongside Tehran’s military threat to our allies, through its proxies and arms sales, the UK Government must respond firmly and consistently. As we have heard, the flow of Iranian drones to Russia in support of its illegal war against Ukraine has been a stark warning about the regime’s threat beyond its borders. The continuing presence of the Islamic Revolutionary Guard Corps demonstrates that security threat right here in the UK, along with the chilling MI5 evidence of threats by the Iranian regime to British individuals, including British-Iranian journalists, with at least 15 potential threats on British individuals in the last year alone.

The Intelligence and Security Committee has warned of state-sponsored assassination and is undertaking a report into Iran. Can the Minister confirm that that committee is urgently receiving all the information and support it needs from the Government? The IRGC needs to be a proscribed organisation in the UK, so why have the Government not yet done this?

Secondly, our policy towards Iran must be a reflection of our values, as well as the national interest, and standing up for human rights a priority for Britain’s diplomacy across the region, particularly by standing unequivocally against the death penalty in Iran and calling out the barbaric—and politically motivated—treatment and execution of protesters, including that of British national Alireza Akbari. We also stand with Iranian journalists on freedom of expression, including here in the UK. During questions on Tuesday’s Statement in the House, my noble friend Lord Coaker emphasised, in support of the Government’s Statement, that we must make the UK a safe place for journalists and others speaking the truth to power. We can never allow tyranny or authoritarianism to be exported to the UK. In the light of the summoning of the Iranian chargé d’affaires, can the Minister update us on the meetings and discussions held with Iranian officials and what has been said by Iranians as any possible explanation for their actions?

Thirdly, when the UK pays tribute to the brave protesters, we must also support their demands for the fundamental freedom to live their lives as they choose. My House of Commons colleagues have led the calls for the Government to bring forward extra sanctions against the regime and we welcome the new sanctions, announced earlier this week, in relation to the IRGC. Can the Minister confirm that the FCDO will continue to engage with international partners to ensure our sanctions reflect those of our closest allies?

Finally, on the potential for the JCPOA, I want quickly to stress our view that the Government are right to support a diplomatic solution to address Iran’s nuclear escalation. I look forward to the Minister’s response.

15:45
Lord Ahmad of Wimbledon Portrait The Minister of State, Foreign, Commonwealth and Development Office (Lord Ahmad of Wimbledon) (Con)
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My Lords, as others have, I thank the noble Lord, Lord Alton, and recognise his continued advocacy on important issues of human rights; Iran is no exception. While I recognise the different points raised, both on a personal level and as a Minister, including in my capacity as Minister for Human Rights, I assure all noble Lords, irrespective of their contributions, that the principles they have articulated are very clear to me. While I cannot speak in detail, my advocacy in my capacity as a Minister in private, internal discussions that are taking place will perhaps resonate with noble Lords. I assure noble Lords of my best efforts in this regard.

The debate today has shown that we all recognise, as my noble friend Lord Shinkwin reminded us, that Iran’s reprehensible and abhorrent behaviour has escalated in recent months. It is very clear. Since the start of 2022, there have been 15 credible threats to kill or kidnap British or UK-based individuals by the Iranian regime. I recognise the point made by the noble Lord, Lord Alton, about the sanctioning perpetrated against both him and my noble friend Lord Polak. It is different now—in all my time as a Minister, I have never seen the need to brief all parliamentarians about the risks of the Iranian threat to us here in the United Kingdom. Most recently, we have seen the brazen behaviour of the regime in targeting journalists and their families in the UK.

The noble Baroness, Lady Coussins, raised three important points, which I will come to. On the last of the three, also articulated by the noble Lord, Lord Purvis, I can give that assurance. We work closely with the families of journalists. If noble Lords pick up particular instances or specific areas of concern, they should first be flagged to the police, but if they are also made known to us within government, while we cannot talk in detail, we will seek to ensure that appropriate protections and advice are provided.

Over the last six months, we have seen the regime’s brutal crackdown on protesters fighting for their basic freedoms; many noble Lords referred to this. At the same time, the regime continues to provide support to Russia in its appalling and brutal illegal war. I am sure I speak for all noble Lords in saying that I hope we shall see another vote at the UN General Assembly in favour of Ukraine later today. We have been lobbying hard to ensure that many countries across the region where Iran is based recognise the importance of Iran’s destabilising actions, not just in the region but right here in Europe. As noble Lords also articulated, Iran’s nuclear programme is now more advanced than ever; I will come to that in a moment.

The noble Lord, Lord Dholakia, talked about Iranians in the UK; I recognise the points he made. We take a measured approach in engaging with both Iranian civil society and the diaspora in the UK. We are clear that the choice of Iran’s Government will ultimately be a matter for the Iranian people.

The noble Baroness, Lady Deech, was right to raise concerns about the Islamic Centre of England. On 14 November 2022, the Charity Commission approved and opened a statutory inquiry into the charity due to serious governance concerns that were raised. We are following that very closely. I note the points that the noble Baroness raised.

I will address the repeated threats to UK-based individuals. Over the past year we have seen credible threats, as I have alluded to. These include very real and specific threats towards UK-based journalists working for Iran International. While there has been much speculation, I assure noble Lords that we are working across government—and, as my right honourable friend said in the other place, together with Iran International —to ensure the protection of its activities here and the important work it does. This hostile behaviour is unacceptable and we will not tolerate attempts to threaten, intimidate or harm anyone in the UK. We will also not tolerate direct attacks on media freedom, which are threats to our fundamental values of freedom of expression and the media.

I turn to the BBC Persian service. As the noble Baroness, Lady Coussins, said, I could articulate what I said before about our support for the broader service. I shall be very clear to the noble Lord, Lord Alton, the right reverend Prelate the Bishop of St Albans, the noble Lords, Lord Hannay and Lord Purvis, and the noble Baroness, Lady Coussins. Indeed, more or less all the contributions today have focused on BBC Persian, which is right—and I recognise the valuable service that it provides. I also recognise that we are in a very different phase to where we were when certain decisions were taken, even six to 12 months ago. Therefore, I shall of course take note of the immense strength of feeling, although I cannot give the assurances that the noble Lord, Lord Hannay, seeks at this time. However, I shall take the issue back. As I said, I share many of the concerns that have been raised, and I recognise that, while radio is a small proportion of the service provided by BBC Persian, it is an important service, particularly in the current circumstances.

To turn to some specific actions, on 20 February, my right honourable friend the Foreign Secretary summoned the chargé, Iran’s most senior diplomat in London, to make a formal protest about Iran’s intolerable threats in the UK and to warn against any further activity. The noble Baroness, Lady Wheeler, alluded to this. It shocks me. I have had various conversations with the chargé, and I put it very bluntly to him that they are actually killing their next generation. To put all other issues aside, given some of the people who have been executed, in terms of age and their contributions to Iran, it is shocking to see the regime acting in the way it does. What answer does Iran have? To share the answer, the answer is nothing. How can you respond to that?

I assure all noble Lords that we will continue to work closely with law enforcement to identify, deter and respond to emerging threats. As my right honourable friend the Security Minister made clear earlier this week, we will work closely with our allies in a unified response. The noble Baroness, Lady Wheeler, and the noble Lord, Lord Purvis, also raised those issues. Of course, we are working hand in glove with our allies. This is a threat that is real not just for those in the region but across the world.

To turn to the protests in Iran, the noble Lord, Lord Alton, my noble friend Lord Polak, as well as the noble Baroness, Lady Coussins, and others, raised this issue. I have already alluded to how you deal with a regime that is so brutal to its own people—yet we shall stay focused and work with our allies in this respect. Holding the regime to account was raised by the noble Lord, Lord Alton, and others. Five months have passed since the tragic incident and tragic death of Mahsa Amini, which we have discussed in your Lordships’ House, after she was arrested by Iran’s so-called morality police, which sparked protests in which we have seen brave Iranian people stand up for their basic rights and freedom.

The noble Lord, Lord Alton, asked about specific records. Of course, it is difficult, but we have estimated that more than 500 people have now died and more than 18,000 people have been arrested, with 1,500 injured. Tragically, some of those numbers include about 65 children, if not more. Their demand is a simple one—for a better future—and we stand by that. It is clear that the Iranian people will no longer tolerate the violence and oppression of the regime, which is putting its own interests above theirs. The UK is working in international fora and directly on this issue. On Monday, we sanctioned eight individuals for horrific human rights violations, including the killing of children, and last month we sanctioned the Basij Resistance Force for its brutal repression on the streets of Iran.

My noble friend Lord Polak, rightly, along with the noble Baronesses, Lady Wheeler and Lady Deech, asked about the IRGC. The UK maintains sanctions on over 300 individuals and entities for their roles in Iran’s human rights violations. That includes the IRGC in its entirety. Of course, further sanctions have been imposed on key individuals. I am not going to speculate about our future response, but I have heard again very clearly where noble Lords stand on this. I can share with noble Lords that we are working very closely across government on the issues that noble Lords have raised, particularly in relation to proscription.

On the important issue of human rights more generally, I listened very carefully to the contribution of my noble friend Lord McColl. I reassure him that the sanctions that are imposed—indeed, any sanction imposed on the Iranian regime—have the appropriate carve-outs that allow us to provide that basic humanitarian and medical support that is needed. As we are increasing sanctions, they are being felt by the regime and having an impact. At the moment, it is not the right time to do anything that would seek to alleviate or recognise things beyond humanitarian or medical support.

The noble Lord, Lord Purvis, raised asylum seekers and pathways; I myself have been following this and asked that question. I assure noble Lords that I will follow this up directly with colleagues at the Home Office. Although it is a matter for them, I recognise that Iranians are eligible for the resettlement scheme, for example, which is a global scheme that started in March 2021. The need for safe routes for asylum is crucial; we need to remain focused on that.

The noble Lord, Lord Polak, talked about our human rights work. He will know about the action that we have taken at the CSW; I thank my noble friend in that respect. I assure all noble Lords that we will use the 52nd session of the UN Human Rights Council to make clear our views on Iran’s credibility on human rights issues.

In terms of Iran supporting Russia, the illegal war continues and Iran is profiteering from it. The noble Lord, Lord Purvis, made an important point about BRICS. I assure him that we waste no opportunity in the context of our G7 representations to make clear to countries that perhaps do not share the same view the importance of acting together.

On wider destabilisation, I met the Foreign Minister of Yemen this week and was in the Gulf last week to align ourselves fully in strengthening our alliance against Iran’s destabilising influences. We will continue to work hand in glove.

The nuclear threat is ever increasing. I will write to noble Lords on where we have got to specifically but I assure them that we are watching this continuing threat. It is not in any way a comprehensive deal, as the noble Baroness, Lady Deech, said. The deal has been ready for signing for some months now but Iran has not moved. The challenge on the issue of nuclear enrichment is ever increasing; I particularly appreciate the valuable insights of the noble Lord, Lord Hannay, on this. We will move forward carefully with our partners because the ultimate objective must be that we do not allow Iran to gain nuclear weapons. I will write in further detail on that important point to say exactly where we are.

I welcome this debate. Like the noble Lord, Lord Alton, I recognise that we cannot cover a subject of such gravity in one hour. I spoke to officials earlier today and before this debate; we will look to see whether we can arrange an appropriate briefing at the FCDO, perhaps including colleagues from the Home Office, so that we can give noble Lords a more detailed insight into our current work and, of course, listen to their valuable advice.

Committee adjourned at 3.58 pm.