Serious Crime Bill [HL]

Baroness Finlay of Llandaff Excerpts

Tuesday 28th October 2014 Lords Chamber

[Baroness Brinton (LD)]

My Lords, when I was chair of education in Cambridgeshire some 20 years ago, it was brought home to me very starkly how the lack of mandatory reporting had allowed a caretaker to abuse children in a school over a 16-year period. It was not taken seriously at any point over that time when parents, or even some of the children, reported concerns. Had that system been in place—even the first report—the head would have been under a requirement to force a proper inquiry. As a result, this man’s actions would have been curtailed and a large number of children would not have been subsequently abused.

Even though that happened some time ago, the problem still continues. We have heard from the right reverend Prelate the Bishop of Durham about some of the larger cases at the moment. I should have declared an interest: I am a trustee of UNICEF. I echo the point of the right reverend Prelate that if we are talking about mandatory reporting for female genital mutilation, which is a form of child abuse, we should also be considering it for wider child abuse as well.

Another point that has been raised outside the Chamber refers to concerns felt mainly by professional psychotherapists about an exemption in their treatment of perpetrators of child abuse, or would-be perpetrators, under the normal terms of confidentiality if there is a requirement to report. The exemption is in proposed paragraph (8) of the amendment. It quite specifically says that it is possible for a person to have that exemption. We need to reassure professionals that important work such as that should be one of the few exemptions allowed to continue without further report to the law.

I want to raise a more topical concern. Much has been said about the Jay report and what has been happening in Rotherham and subsequently in Sheffield and other places. I am very concerned that yesterday UKIP published a photograph showing a young girl who might be deemed to be a victim of abuse while the headline said something like, “1400 reasons why you should not vote Labour in the PCC election” .

Frankly, UKIP’s hypocrisy is breathtaking. Its record on tackling serious child abuse is disgraceful. The only record of the noble Lord, Lord Pearson of Rannoch, asking Questions about child abuse is on 13 October this year, after the by-election was called, and he has been in this House since 1990. Even that Question was focused entirely on the UKIP obsession with Muslims, ignoring the fact that child abuse happens in all areas of the country and is not exclusive to any culture, community, race or religion.

However, it is not just UKIP in the Lords. In the European Parliament, its Members abstained in a vote to strengthen legislation about sexual abuse and the sexual exploitation of children and child pornography. Further, UKIP’s candidate in the Croydon North election in 2012, Winston McKenzie, said that gay adoption was child abuse. Gordon Gillick, a UKIP Cambridgeshire councillor, told a meeting of some children in care that they were takers from the system and wanted to know what they would give back to society. As we have heard, many children in care are the most vulnerable to grooming and abuse.

We need to have an honest and open debate about child abuse but it is completely inappropriate for a party that has not taken it seriously, even within its own actions when it threw out a paedophile and allowed that person to come back to receptions, particularly those with young UKIP members. We need to make sure that UKIP—it offers a policy of making sure that children are safe—can deliver that by having safe policies itself. I do not believe that the evidence is there.

Finally, I am also grateful for our discussions with the Minister on this. I hope that he will be able to offer reassurance to those of us who want a public debate and public consultation about the mandatory reporting of child abuse. I look forward to his response.

[Baroness Finlay of Llandaff (CB)]

My Lords, I have put my name to the amendment and support it strongly. Current child protection systems, which rely upon voluntary reporting, simply are not seen to be working effectively. There is ongoing underreporting of suspicions of abuse or neglect by professionals working with children. Why might this be? It is worth looking at previous studies, which have suggested that barriers to reporting include the professionals’ own values and attitudes—for example, over the acceptability of physical punishment—and confusion over the thresholds for reporting. Professionals may be worried about issues of confidentiality and the potential impact on their relationship with the child and the family.

The current position for someone reporting is that they may, in effect, feel that they are being a whistleblower on a situation that they feel uncomfortable about. Professionals may fear the consequences and the potential impact on their reputation, leading to further hesitation. Reporting a suspicion that turns out to be unsubstantiated should not be a disciplinary matter for professionals, however distressing for those involved. There is a balance of harms here, and the need to protect vulnerable children should be paramount.

I should like noble Lords to think for a moment of the situation of a GP who is seeing people on 10-minute appointments, and who may know a family, see a child, have some concerns but be unable to put a finger on it. At the moment, the hesitation to report remains there. Other pressures of work come in. I must declare an interest here. When I was a GP, I looked after children in a children’s home and became convinced that something was not right. I went to the authority in whose area I was working but we did not get anything specific to happen. I would go out to the children’s home whenever there was a request for an appointment so that I would see the children on their own territory. I tried to see the children on their own when they were referred for a sore throat, sore ear or whatever. I had this nagging suspicion that something was wrong but I could not pin it down anywhere. All that I can say is that the Christmas after my suspicions began to become aroused the children themselves burnt the home down, which confirmed to me that my index of suspicion was right. However, I had no clear evidence on which to report that abuse was going on, although I was suspicious. I would have welcomed having to report that suspicion because it would have allowed me the freedom to state, “I have a really uncomfortable feeling here”, without feeling that I had to accrue the evidence.

That is my personal experience and where I have come from with it. That is why I stand separately from my professional body, the BMA, which has reservations about this amendment. It is concerned that a degree of professional discretion is required to ensure that doctors can take account of an individual’s circumstances and always act to ensure the protection of a patient. My experience suggests that that is incredibly difficult.

Queen’s Speech

Baroness Finlay of Llandaff Excerpts

Monday 9th June 2014 Lords Chamber

[Baroness Finlay of Llandaff (CB)]

My Lords, like others I wish to focus on the protection of children and our duty to the most vulnerable in our society. The legislation on all child abuse, including female genital mutilation and slavery, must be as strong as possible if it is to be truly effective in improving the lot of children in our society. As the noble Baroness, Lady Walmsley, so strongly pointed out, shamefully we have turned a blind eye to the most vulnerable far too often. We must respect and legally enforce the rights of children and stamp out cruelty because all too often cruelty breeds cruelty. I hope the Government will support the online safety Bill brought forward by my noble friend Lady Howe of Idlicote.

Others have addressed health issues. I agree with noble Lords who have called for the awaited Bill to modernise the regulation of health and social care professions to better protect the patients and improve care delivery. Will the Government, following this debate, bring it forward for scrutiny? It is a Bill that this House would look at very thoroughly.

Let me turn to legislation that remains uncompleted. This year the clear will of both Houses was to introduce standardised packaging of cigarettes and tobacco products. As Sir Cyril Chantler’s independent review of the evidence supported this, where are the draft regulations for consultation, for notification to the European Union and then to be laid before Parliament for debate? As the noble Lords, Lord Ribeiro, and Lord Faulkner of Worcester have highlighted, if the Government drag their feet, time will play into the hands of the tobacco tycoons.

In November last year the Government amended the Energy Bill to include audible carbon monoxide alarms in a review of the private rented sector. Each year, carbon monoxide kills about 40 people in England and Wales. At least five of those who died last year were young campers and holidaymakers. Regulations are needed now to prevent yet more totally avoidable young people’s deaths over the summer.

Finally, I am glad that England is following Wales’s lead on tackling the environmental damage from plastic bags. Legislation in Wales has decreased the number of plastic bags in retail by more than 76%, but I am concerned that, without tackling all types of bags in all settings, England may see a mushrooming of paper-based bags and so-called exemptions rather than rejoice in reusable bags as we do at home in Wales.

Wales looks forward to hosting the NATO summit in September. In the mean time, I am sure that this House will carefully scrutinise all legislation affecting Wales.

Immigration Bill

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Wednesday 12th March 2014 Lords Chamber

[Baroness Meacher (CB)]

In moving Amendment 62, I shall speak also to Amendment 62A. The purpose of Amendment 62 is to ensure that treatment for any injury resulting from domestic abuse or female genital mutilation is exempted from NHS charges even if the victim does not have permanent leave to remain, or indeed if her immigration status is not clear. I should explain at the outset that these are probing amendments and I understand from the Minister that these matters will be dealt with by the Department of Health in regulations. Having said that, this amendment provides an opportunity for this House to try to influence those regulations. I think that I am right that there will be no further opportunity to do that.

Clause 34 defines for the first time the term “ordinarily resident”. If the person is not ordinarily resident they may be charged for health treatment. If they have paid the surcharge they should be covered for health services but many other people are already living in this country—I understand in the realm of about half a million—who have not paid the surcharge and are eligible for NHS charges. Further, Clause 34 brings ordinary residents into line with permanent residents. That means that instead of being here with a visa for a settled purpose such as a job, a university course or to reunite with a spouse for a minimum of one year, an immigrant will need to be here for a minimum of five years in most cases before they are fully covered for healthcare. This is why Amendment 62 is important and relevant to health charges, as I understand it.

In his letter of 12 March, the noble Lord, Lord Taylor, said that short-term visitors and those without lawful immigration status will,

“continue to be liable to pay overseas visitor charges for secondary care treatment under NHS regulations”.

This is similar to the letter from the Minister for health quality, who said that,

“illegal non-EEA migrants and short-term visitors (under 6 months) will continue to be liable to NHS treatment charges as they are now”.

I am told that this is not precisely the case, as the National AIDS Trust’s excellent briefing points out. In fact, the Government plan to introduce new charges for primary care, apart from GP and nurse consultations, and for A&E services for this group and for any migrant who cannot show that they have paid the levy. The need to assess patient entitlement in primary care or A&E would be an unhelpful distraction in an emergency situation. This might be done after someone receives treatment—but that, too, is an alarming position for someone who may have little or no money.

In his subsequent note and his latest briefing, the Minister gave assurances about a number of vulnerable groups who will not be subject to the surcharge or charges for treatment under the NHS charging regulations. There is no mention of the victims of domestic violence or FGM in relation to either. Do the Minister and his colleague, the Minister for Health, intend to exclude these two groups from the surcharge and, in the case of those already here without permanent residence, from NHS charges? If not, it is a matter of great concern that the moral and humanitarian case previously accepted concerning these groups appears to have been set aside.

As to the practical difficulties in determining who the exemptions for domestic abuse and FGM would apply to, I understand that medical checks would be needed if these groups are to be exempt from the surcharge. I appreciate that could be problematic in the circumstances, but in the case of NHS charges for failed asylum seekers, irregular or undocumented migrants, short-term visitors and others without permanent residence, does the Minister not agree that if a patient in any of these groups has been domestically abused or damaged by FGM, they should not be charged for treatment? It would be helpful to have clarification on this point on the Floor of the House, if the Minister is able to give it, albeit that such provisions would ultimately be made in Department of Health regulations.

If irregular migrants and refused asylum seekers who would not have paid the surcharge cannot access primary care services, apart from GP and nurse consultations to address comparatively minor health problems, they will eventually present elsewhere—probably at an A&E department—at much greater cost, as I referred to in relation to an earlier amendment.

A different but important point is whether the NHS will be expected to report back to the Home Office if a patient’s migration status requires them to be charged for NHS services. There is a concern about this in view of the comment of the Home Office Permanent Secretary to the Home Affairs Select Committee that the Home Office intends,

“to improve its radar screen into the NHS”.

I find that rather chilling. If it became known that a visit to the doctor could lead to a report to the Home Office, people could be deterred from seeking healthcare. Can the Minister assure the House that this will not be the case?

The Government have previously recognised the important role of the NHS in identifying victims of abuse and helping them to recognise, consider and exercise their option to escape from that abuse. Also, in the case of FGM—where we have not had a single prosecution—the NHS is seen as probably the best hope of identifying perpetrators and providing evidence to support the prosecution case. I look forward to hearing the Minister’s view on that.

On Amendment 62A, the Government have agreed that no charge will be made for health services to victims of human trafficking. I am dealing with this issue separately because, in a sense, these people are in a different situation. The aim of the amendment is to put this commitment in the Bill and to require the Government to produce a strategy and procedures to ensure that the victims of human trafficking are promptly and effectively identified for the purposes of the clause. This is a probing amendment which I hope the Minister can endorse, thus assuring the House that there will be regulations in place to achieve its aims so that victims receive the necessary medical treatment. The UK would thus satisfy our international obligations.

According to the Catholic Bishops’ Conference, the UK Human Trafficking Centre shows that more than half—54%—of trafficking victims were not recorded by the national referral mechanism in 2011. UKHTC notes that people who have been trafficked are often treated as irregular or illegal migrants. They may, of course, have been given false, stolen or genuine but fraudulently obtained identity documents. They will most likely then be treated as immigration offenders despite not acting under their own volition. This is quite understandable but it will need attention to avoid this kind of thing happening.

As the Bill is currently worded, these victims would not be exempt from the charges for health services if they are in one of these obscure groups. Also understandably, people who have been trafficked and coerced into criminal activities are often treated as offenders rather than victims. They are unlikely to benefit from exemption from health charges. A 2013 report by Anti-Slavery International highlighted a lack of awareness of trafficking indicators among authorities. If these victims are not identified, they are likely to get a criminal record, go missing, be deported and be retrafficked. They become victims a second time round.

All this will increase the fear of victims and their suspicion of the authorities. Help with later investigations is less likely to be forthcoming. At the moment, the authorities rely on those who are trafficked to disclose their status quickly or face detention—and, for obvious reasons, often that does not happen. If not identified immediately on arrival, trafficking victims are unlikely to be identified subsequently, and hence the importance of subsection (2) of the amendment. There is a need for,

“a strategy and procedures to ensure that victims of human trafficking are promptly and effectively identified”.

We are particularly concerned about trafficked children. I understand that at the moment social workers receive no mandatory training in identifying a trafficked child. We know that in the context of the draft Modern Slavery Bill there is a commitment to roll out specialist training and other measures. Can the Minister give the Committee a commitment that rigorous enforcement of health charges will not be introduced until the safeguards associated with the Modern Slavery Bill are rolled out?

Let us get things in the right order. Does the Minister agree that before the planned safeguards are introduced, they will be put before the modern slavery commissioner, who is to be appointed under the modern slavery legislation? Indeed, to clarify these matters, can he provide the Committee with information about the planned timing of the introduction of the new enforcement rules for health charges and of the implementation of proposals in relation to the Modern Slavery Bill? I beg to move.

[Baroness Finlay of Llandaff (CB)]

My Lords, my noble friend Lady Meacher has introduced this group of amendments with great clarity. I have added my name to Amendment 62 and I will speak to Amendment 64. Other Peers who have added their name send their apologies for not speaking at this late hour. I do not want to add much more to what has been said about domestic abuse and female genital mutilation except to say that I have a major concern as to how this will actually work in practice unless these groups are exempt.

What happens if a girl comes into the country, her status is not established, and she has infected wounds? What happens to the girl who has been mutilated and has urinary and voiding difficulties or suffers chronic pain? What happens during pregnancy, when delivery can be incredibly complicated? If it is not properly managed, a woman may literally burst because scar tissue is not elastic. We recognise FGM as an absolutely awful form of abuse and it is shameful that there have not been prosecutions already. If we put these women into the charging category, we will almost reverse the message we have sent to society about this terrible act.

The other problem arises with domestic abuse. If a woman arrives at A&E with severe facial injuries including fractures to the bones of her face or her chest wall, they may be life-threatening. If her ribs have been stoved in, it may be a life-threatening injury such as a pneumothorax and treatment will have to begin straightaway. Emergency service personnel are going to be put into a terribly difficult position. Another problem is that, in the societies from which many of these women come, sadly they are not afforded the rights they have in our society, and they are not given the respect they deserve. I am fearful that there may be a tendency to blame the woman if attempts to stay fail because she is a burden on the man, thus making it more difficult for him to stay.

Amendment 64 is about people who are released from detention. Currently, people can receive treatment while they are being held in an immigration detention centre and the course of treatment will be ongoing when they leave, but this may not be the case in the future. The consequences will be particularly acute in the area of mental health. It is well documented that the experience of an immigration detention centre is damaging to the mental health of many detainees. Without ongoing support, those mental health problems will be exacerbated rather than ameliorated at the point of release. The problem we are faced with is where to set the boundary and how it will actually be implemented.

These are probing amendments, but when regulations come before the House we will not be able to amend them. We will be faced with either accepting or rejecting them. That is why we need to tease out these issues very carefully at this stage.

[Baroness Cumberlege (Con)]

My Lords, I shall speak to Amendment 66A on behalf of the noble Baroness, Lady Masham of Ilton, who sadly has another commitment that she has to honour this evening. Successive Governments have very good track records in safeguarding the public’s health. When I was a Minister, I was deeply involved in the Health of the Nation strategy, which was lauded at the time by the World Health Organisation as a model for other countries to follow. Since then, through the Labour Government and now our present Government, we have concentrated on looking after the public’s health. Indeed, Ministers were saying only in November last year that nothing will be done to worsen public health. Two years ago, this Government extended free treatment regardless of immigration status to include treatment for HIV infection. As was said at the time:

“Reducing transmission will reduce the risk of new infections in the wider UK population and … reduce … NHS costs”.—[Official Report, 29/2/12; col. 1397.]

They have confirmed that treatment for communicable diseases and sexually transmitted infections will remain free to all.

These are really welcome and important commitments but we have to be very careful that this proud record is not undermined by what we are now doing. Many noble Lords, I know, have a crystal-clear understanding of the Bill, as the noble Baroness, Lady Meacher, has explained to us this evening, but I would like to clarify some issues. First, who is actually going to be affected by these charges? I look to my noble friend to provide the clarity that I seek.

Immigration Bill

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Monday 10th March 2014 Lords Chamber

[Lord Harries of Pentregarth (CB)]

My Lords, I have listened carefully to the debate and support the general thrust of all the amendments. However, like the noble Baroness, Lady Masham, I am not clear which of the amendments particularly meets the bill. I hope the Government will indicate not only whether they are receptive to the general thrust but which amendments are particularly inadequate. I hope the Minister will address the question posed by the noble Baroness, Lady Tonge, of what exactly is meant by the phrase “health tourism”. What is the evidence that it exists?

[Baroness Finlay of Llandaff (CB)]

My Lords, this has been an important debate and I declare all my health interests. In speaking briefly, I will not reiterate the points made by the noble Baroness, Lady Cumberlege, and my noble friend Lord Patel but they are incredibly important.

When the Minister comes to reply, perhaps he will give the figures in respect of the actual cost of antenatal care versus the actual cost of complications. Let us not forget that a massive haemorrhage in labour or a massive problem with obstructive labour will cost a great deal of money in emergency treatment when, if they had been picked up much earlier with a simple ultrasound examination, the problems could have been avoided. Will the Minister give the costs and the research evidence behind the reason for the Government not exempting pregnancy and children? Will he say what discussions the Government have had with the royal medical colleges and the Royal College of Midwives, in particular, over the background to this measure and its implementation? For doctors, nurses and midwives trying to implement it on the ground it will be a nightmare.

What do the Government intend to do to monitor the effects of the measure—in other words, how will they audit it—when and if they proceed to implement the Bill as it is currently drafted? Will that audit include a cost of the complications that would have been avoided in the event that pregnant women had had appropriate antenatal care?

There is a great deal of evidence behind this. From all the amendments that have been tabled today it seems evident that a consolidated and focused amendment will be brought back on Report. Like others who have spoken, I believe it would be most sensible for the Government to listen today and take the evidence on board, rather than push the House to determine its view.

Anti-social Behaviour, Crime and Policing Bill

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Tuesday 14th January 2014 Lords Chamber

[Lord Rosser]

My Lords, this amendment was also moved by my noble friend Baroness Thornton in Committee, so I do not intend to repeat all the points that were so powerfully made at that time. Needless to say, we were not happy at the Government’s response, which was basically that, because the measures proposed in this amendment would not solve all the problems in relation to young people in the purchasing of tobacco products, it should not be adopted. The amendment has the support of the Association of Convenience of Stores, which represents 33,500 stores, the majority of which sell tobacco products. The ACS welcomes these proposals as a further measure to help to restrict youth access to tobacco products.

It is illegal to sell tobacco products to anyone under the age of 18, but it is not an offence for someone to buy tobacco products on behalf of a minor. There is, thus, a gap in the legislation which this amendment seeks to close to bring the position more into line with the provisions of the Licensing Act 2003, which has made it an offence to proxy purchase alcohol. Proxy purchasing is one means by which young people gain access to tobacco products. A recent survey has shown that, in 2012, 8% of pupils had asked somebody to buy cigarettes on their behalf and nine out of 10 were successful at least once. We are not saying that tobacco proxy sales are the only means by which children receive their supply of cigarettes—there is a variety of means for this—but we are saying that it is one of the predominant ways, hence this amendment.

Issues were raised in Committee by my noble friend Lady Crawley concerning the need for proper enforcement and adequate surveillance if moves were made to tackle proxy sales of tobacco. That comes down to providing adequate resources, including for local authority trading standards organisations. However, we are talking about sales that adversely affect the health of young people and we should be prepared to act, as they have in Scotland, where there is an offence of proxy selling tobacco. That has the support of the Tobacco Manufacturers’ Association, which has said:

“Scotland introduced regulation criminalising the proxy purchasing of cigarettes, where adults purchase cigarettes on behalf of children in April 2011. The TMA and its members supports this legislation. Proxy purchasing was identified in NHS data as one of the most common sources of tobacco for young people”.

The Minister said in Committee that the Government had an open door on this issue, and my noble friend Lady Thornton invited them to think further on this matter before Report stage, which we are at today. I hope that the Minister will be in a position to give a more positive response to this amendment than he was able to do in Committee. I beg to move.

[Baroness Finlay of Llandaff (CB)]

My Lords, my name is added to this amendment, which I feel is very important. We know that when young people start smoking, their addiction potential and the long-term harms are very great. There is good evidence that children get cigarettes by proxy either, particularly in the case of younger children, by stealing from their own families or by purchasing single cigarettes from other children at school. However, a cohort in the older, middle-teens bracket seems to obtain cigarettes more through proxy purchasing. Quite often, with a very small incentive added to the cost of the cigarettes, they use a drug abuser or somebody else to do the purchasing for them. The retailers—the small shops—which sell cigarettes find themselves in a really difficult position. Rightly, they are not allowed in law to sell directly to the youngster, yet they are aware that there is no lever in terms of proxy purchasing, although it is they who would be prosecuted rather than the person doing the proxy purchasing.

It is important to bring the law into line with legislation on alcohol purchasing. The harms from tobacco are in a different group from those relating to alcohol, but they should not be underestimated.

[Lord Faulkner of Worcester (Lab)]

My Lords, I intervene only briefly. This is the first occasion on which I have spoken on an amendment supported by the Tobacco Manufacturers’ Association.

It seems to me self-evident that the arguments made by my noble friend Lord Rosser and the noble Baroness, Lady Finlay, just make so much sense. It is entirely sensible to bring the law into line with that governing the proxy sale of alcohol and to follow the practice which has been adopted in Scotland with regard to the proxy purchase of tobacco. Persuading young people not to smoke is something to which we in this House have devoted a lot of attention. When we return to the Children and Families Bill at the end of the month, we will have an opportunity to do something on the standard packaging of cigarettes and on smoking in cars where children are present. This is also an important measure, which will make it more difficult for youngsters to start—and thus become addicted to—this terrible, dangerous habit.

Alcohol: Late Night Drinking

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Wednesday 16th October 2013 Lords Chamber

[Lord Taylor of Holbeach]

I cannot promise to accept opposition amendments to the Bill, but I am sure that noble Lords will consider all amendments that are tabled. However, I can assure the noble Baroness that this is an important piece of legislation, and I hope she recognises that the measures being introduced by the Government are designed to tackle the anti-social elements that drinking can cause.

[Baroness Finlay of Llandaff (CB)]

My Lords, do the Government recognise that the current below-cost sales of alcohol are responsible for at least 900 major crimes per year? Do they also recognise that the introduction of minimum pricing, on top of banning low-cost sales, would probably cut out 32,000 crimes per year? When are the Government going to revise their policy on minimum pricing and below-cost sales?

Alcohol: Minimum Pricing

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Wednesday 10th July 2013 Lords Chamber

[Lord Taylor of Holbeach]

I can certainly counter that allegation. The response will be a comprehensive review of alcohol and the way in which we tackle alcohol abuse in this country, and it will be available in due course.

[Baroness Finlay of Llandaff]

When do the Government plan to start to pilot sobriety schemes as a way of reducing reoffending rates among those whose crimes have been alcohol-fuelled?

[Lord Taylor of Holbeach]

That is an interesting suggestion. I have no information on it but will certainly take it up.

Alcohol Strategy: Role of Drinks Industry

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Tuesday 10th July 2012 Lords Chamber

[Baroness Finlay of Llandaff]

My Lords, I am most grateful to my noble friend Lady Coussins for instigating this important debate. It goes to the heart of where the line is drawn in the relationship between government, all the public health concerns of government, and the drinks industry. There is a fundamental conflict of interest here. The Government pick up the costs, particularly the healthcare and social care costs, of the victims of alcohol abuse. You only have to go into an A&E department at night to see the large numbers there or visit a liver transplant unit.

The other side of this divide—and it is a divide—is that those who work in the drinks industry have a duty to their shareholders to maintain their profits. Therefore, however they work with Government, they are certainly not there to put themselves out of business.

There are some things which the drinks industry can do, and is uniquely placed to do. For instance, training bar staff properly to challenge those who are underaged or who are already intoxicated and wanting to buy more alcohol. That has improved greatly.

The labelling commitments, however, are lagging far behind. Some of us wonder, where are these clear labels? Where are the labels unified on a voluntary basis? There was an attempt to bring in legislation in this House during the term of the previous Government, but that has not come to fruition. The responsibility deal has yet to prove its worth. As has already been said, the BMA felt that it could not carry on. Neither could the Royal College of Physicians, for the same reason. It felt that the voice of the drinks industry was disproportionately strong in the way that the forward path for alcohol control and strategy was being developed.

There has been talk already about unit pricing, but I would ask the Government, what has happened to the question that I raised previously about such pricing being index-linked? As soon as we begin to have inflation the price per unit will become almost insignificant, unless that is priced as a proportion and index-linked as a percentage cost rather than an absolute cost. Indeed, it is worth noting that Scotland has already put up its so-called minimum price.

Some of the advertising we see is very clever. A phrase such as “Why let good times go bad?” has a subtle message behind it: that you have a good time by drinking. There is not a message there that you can have a good time on sparkling water. I am from Wales, and we have some wonderful sparkling water. It comes in blue bottles, called Ty Nant. It is extremely fashionable in Wales.

There is a message that you can have a good time without even having to have a drink. But there is a subtlety behind some of this advertising that is worrying, particularly in the use of social media.

While I applaud the Government for the action that they are taking, I would ask them to take a long hard look at the conflicts of interest that lie inherently in having too close a relationship with the industry, and in not having a high enough profile for the voices of those in public health; in particular, working with local authorities and others to make sure that alcohol control measures are effectively implemented.

We hear a lot about education strategies; I am afraid that the evidence that those have actually altered behaviour is very weak, although there is certainly evidence that they have increased awareness. I am afraid I cannot say that all is going perfectly well. I would like to see a little more separation—not to stop any of the moves, but to try to get clearer labelling in place, and index-linked prices.

Queen’s Speech

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Tuesday 15th May 2012 Lords Chamber

[Baroness Finlay of Llandaff]

My Lords, the Dilnot commission report on the funding of social care states:

“We should be celebrating the fact we are living longer and that younger people with disabilities are leading more independent lives than ever before. But instead we talk about the ‘burden of ageing’ and individuals are living in fear, worrying about meeting their care costs”.

I hope that the draft Bill will allow the Government to take an imaginative and forward-looking approach to the way in which we support those providing care so that we do it in a way that is fit for the modern world in which people now live.

Carers UK, in its report Growing the Care Market, sets out the costs of failures in social care and the economic opportunities of stimulating the care market. It has been estimated that 1 million people have given up work or have reduced working hours in order to care—in other words, about one in six of all carers. Figures published recently from the London School of Economics show that the public spending cost of carers giving up work to care for ill or disabled people is £1.3 billion each year in lost tax revenues and additional welfare payments. That is an enormous cost for not having got the system right.

A Carers UK survey of more than 4,000 carers found that 31% of working-age carers gave up work in order to care or reduced their working hours because local care services were unsuitable—they were too expensive, inflexible, unreliable or of poor quality. The peak age for carers is between 45 and 65, a time when people tend to be at the peak of their careers, their knowledge and their experience. Carers often have multiple responsibilities. If they give up their work to care, their experience is often lost in the long term from the workforce because when they try to return they may have difficulty in regaining a job.

The lack of adequate social care has a knock-on effect on healthcare. Very often, healthcare delivery is suffering because social care cannot be put in place. Patients do not come out of hospital as rapidly as they could because care packages are not in place or have broken down, or the additional supplement in care that they need cannot be provided within the resources of social care delivery. The scheme Employers for Carers, set up through Carers UK, recognises that a good system of care and support should be part of being a good employer. There are some interesting and innovative examples of supporting and providing leave arrangements for the workforce. Centrica British Gas found that special leave arrangements for carers delivers a bottom-line return of about £1 million a year.

There is also interesting experience from abroad. The Work and Care Act in the Netherlands provides a right to various forms of leave for working carers, with paid emergency leave of typically one day, short-term carer’s leave, which is reimbursed at approximately 70% of pay for a maximum of 10 days, and provision for long-term care leave. Poland has provision for short-term leave of up to two weeks a year with financial compensation at 80% of the average monthly wage over the previous 12 months.

In France, family care leave was introduced in 2006. There is an entitlement to unpaid leave if the carer is looking after a disabled relative or dependant. There is another leave option called family solidarity leave, which is available to employees to care for a relative with a life-threatening or terminal illness. There is also the opportunity for leave entitlements based on the working hours reduction, whereby leave can be accumulated over time up to 24 days, which can then be taken later on if people need it to provide care for a family member. In Canada, too, legislation allows carers leave from employment when they are caring for a relative who is terminally ill—this is called compassionate care benefits.

These measures are all operating in different healthcare systems and areas, but it is interesting to see that in different parts of the world the problem of carers and the need for families to be able to provide care has been looked at—and the solutions may in some ways be adaptable to the UK experience. Whatever we do and whatever emerges, it must be portable, so that if a person moves nearer their family their care is not jeopardised, and it must involve the person and their family in the assessment of care and provide information on how the family can access support and help.

Much care is provided through the voluntary sector. I welcome the Government’s statement that they will bring forward legislation that will decrease the burden on charities, enabling them to claim additional payments on small donations, because charities at the moment are finding it difficult to continue to meet their care obligations. That will be an important and positive part. But we also have a large number of unpaid volunteers who provide important care.

On a completely separate note and topic, I commend the Government for facing up to the problem of alcohol abuse and its related economic and social damage to the fabric of society. The proposals on minimum pricing are welcome, but a price that is a permanently fixed tariff will be diminished in effectiveness by inflation over time. I therefore urge the Government to consider a minimum price linked to another independent mark of cost of living expenses, which can then keep pace with alcohol prices over time and is consistent across the four nations of the UK.

At today’s cost of living indices, a 40p minimum unit price is projected to result in 1,180 fewer deaths and 38,000 fewer hospital admissions annually, whereas if it were set at the proposed Scottish level of 50p the projections of benefit rise and are more than doubled to almost 3,000 fewer deaths each year and 92,000 fewer hospital admissions.

Alcohol: Strategy

Baroness Finlay of Llandaff Excerpts

Tuesday 27th March 2012 Lords Chamber

[Lord Henley]

My Lords, minimum unit pricing is just one part of the whole strategy announced by my right honourable friend the Home Secretary in her Statement late last Friday. Unfortunately, I was not able to repeat the Statement in this House because the House was not sitting. There will be other parts of the strategy, and the noble Baroness is right to talk about education and getting the message across. That is something that we will have to consider very carefully. We will consider not just direct education in schools but all other forms of education as part of that process.

[Baroness Finlay of Llandaff]

Do the Government plan to consult on legislative controls for alcohol home delivery services, particularly at night to a party which has run out of alcohol and during the day to those who are already inebriated? I understand that these services do not fall under the current licensing controls.

[Lord Henley]

My understanding is that any sale of alcohol falls under the control of the licensing laws. I appreciate that it is very difficult to deal with these matters, particularly when it comes to home deliveries of pizzas or whatever the noble Baroness is referring to. Again, that is something that we will have to consider if there is evidence of abuse because, as the noble Baroness is right to point out, it is illegal to sell alcohol to those who are inebriated.