Violent Crime

Baroness Healy of Primrose Hill Excerpts

Thursday 29th November 2018 Lords Chamber

[Baroness Healy of Primrose Hill (Lab)]

My Lords, I congratulate my noble friend Lord Harris of Haringey on securing this important debate on the recent increase in violent crime.

London has seen a tragic number of young men killed in knife crime in the last year, and the death toll keeps rising. The cross-party Youth Violence Commission, chaired by my colleague in another place Vicky Foxcroft, published its interim report this July, and I wish to highlight some of its key findings. It suggests that preventing youth violence will require a strategic approach, involving almost every part of Whitehall and the wider government machine. The report states that successful implementation at the local level will also need to involve deep and extensive collaboration with schools, youth workers, police officers and faith and community leaders, as well as parents and individuals, in the creation of a safer, fairer and more positive future for young people.

The Government’s Serious Violence Strategy has been welcomed by the commission for its recognition of the impact on young people of childhood trauma and adverse experiences, the importance of early intervention and preventing violence later in life, and the need for greater integration of services, which is often known as the public health approach. However, concern has been expressed that the strategy lacks sufficient resources. Some £40 million of public funds may not be adequate. The shadow Home Secretary said that,

“in the past 12 months the police recorded almost 40,000 knife crime offences and well over 6,000 firearms offences; the funding allocated to discourage, prevent, divert and detect serious weapons-related violent crimes is therefore just a few hundred pounds for each offence”.—[Official Report, 22/5/18; col. 750.]


The Mayor of London’s strategy on knife crime recognises that effective school and after-school programmes, youth provision and summer activities are critical to deal with some of the factors such as poverty, unemployment and educational failure that result in young people becoming involved in crime. There is no quick fix to youth violence; the root causes are complex, including childhood trauma, undiagnosed and untreated mental health issues, inadequate state provision, deficient parental support, poverty and social inequality.

Research has shown that young people carry knives for self-defence and protection, but some carry to commit crime and must be apprehended. Some join gangs for a sense of belonging. Work needs to be done on intelligent monitoring of gangs by the police, with more resources allocated. There is a need for cross-party support to tackle the long-term nature of this epidemic. I welcome the Government’s decision not to focus solely on law enforcement—especially stop and search—but to encourage partnerships across education, health, social services, housing, youth and victim services.

Early intervention is key, and a successful youth violence reduction strategy will, over time, shift and concentrate resources on prevention activities. But aspirations cannot be fulfilled without long-term funding by the Government. Noble Lords have already spoken of the decline in children and youth services, as well as community policing, and lack of support for parents; austerity has caused much distress to communities and families.

The Centre for Crime and Justice Studies argued this week that:

“Interventions which do not seek to address wider social issues such as inequality, deprivation, poor mental health and drug addiction are unlikely to provide long-lasting solutions to knife violence”.


The Mayor of London is lobbying for more resources for the police, and for local government to receive help to reinstate and expand youth services. He has allocated serious funding for the Young Londoners Fund, as already mentioned. The commission found a clear link between school exclusions and vulnerability or propensity to youth violence; excluded children are more likely to be groomed by gangs to be runners in the county lines drug supply chains.

The Local Government Association has also warned that,

“the targeting of young people excluded from secondary schools is a major feature in the profile of ‘county lines’… In some areas, PRUs become the arena for gang rivalries … where already vulnerable young people get first hand exposure to and experience of crime”.

As the 2017 IPPR report on the link between school exclusion and social exclusion found:

“Excluded children are the most vulnerable: twice as likely to be in the care of the state, four times more likely to have grown up in poverty, seven times more likely to have a special educational need and 10 times more likely to suffer recognised mental health problems”.


The commission’s Safer Lives survey of over 2,000 young people found that drug markets generate violence and create a crime hierarchy where our most vulnerable young people are groomed to enter the lower levels of drug distribution. The damaging lack of trust between the police and some communities must also be addressed. The reduction in community policing must be reversed. Walls of silence will not help police to find the perpetrators, and young people must be listened to with respect. As the commission says:

“Any future violence reduction strategy will have to place a premium on establishing trust and mutual respect”.


We can be quick to blame society’s ills on social media, but the commission found it not to be a root cause of youth violence though it can be a factor in escalating and inciting violence; internet giants should take some responsibility for what they allow to be platformed, as the noble Baroness, Lady Bertin, said. The Mayor of London’s strategy rightly involves working with social media organisations to ensure that online videos which glorify knife crime are quickly taken down.

Interestingly, the commission found that debates around the potential impact of drill music on youth violence, already mentioned by my noble friend Lord Harris, are in the main a distraction from understanding and tackling the real root causes. Some projects that help young people to have a sense of their own self-worth by encouraging them to learn to record and produce the music that the media like to condemn are, sadly, under threat because of cuts to youth services.

It is now time for us all to come together to effectively tackle this tragic epidemic of knife violence by long-term investment in our young generation.

International Women’s Day: Progress on Global Gender Equality

Baroness Healy of Primrose Hill Excerpts

Thursday 8th March 2018 Lords Chamber

[Baroness Healy of Primrose Hill (Lab)]

My Lords, I welcome this debate marking International Women’s Day, and thank the Minister for initiating it. I celebrate, as other noble Lords do, the centenary of women’s suffrage this year. Celebration, however, must not mask the plight of too many women internationally and here in the UK.

To this end, I wish to raise the situation of detained women in Yarl’s Wood, some of whom are currently on hunger strike. Although campaigners have welcomed improvement in conditions at Yarl’s Wood since the implementation of the adults at risk policy, which should mean that survivors of sexual and gender-based violence would not normally be detained and that the routine detention of pregnant women would be ended, there are still concerns for detained women.

Today sees a lobby of Parliament by refugee and migrant women under the banner of All Women Count, which calls for safety, dignity and liberty for all women regardless of status in the UK. The Government currently lock up 1,600 asylum-seeking women every year. Critics of the use of detention say it is unfair to deprive a person of their liberty for administrative convenience; that detention is costly, ineffective and harmful; and that there are better alternatives.

Of particular concern, highlighted by noble Lords last week, is that indefinite detention is harmful to detainees’ mental health and well-being. Safeguards to protect detainees and prevent inappropriate cases from being detained are insufficient and ineffective. As my noble friend Lady Lister of Burtersett said,

“the point about indefinite detention is not that the person is never released; it is that they do not know when they will be released … this has a devastating impact on mental health”.—[Official Report, 27/2/18; col. 587.]

All these concerns are still being played out at Yarl’s Wood, according to the campaign group Women for Refugee Women, to which I owe my thanks for this briefing. Last year, this group conducted interviews with 26 women who have claimed asylum and been detained since the adults at risk policy came into force and, alarmingly, found that survivors of sexual and gender-based violence are still routinely detained. Many had experience of domestic violence, forced marriage, female genital mutilation and forced prostitution and trafficking. Many had been detained for long periods even when their mental and physical health had deteriorated. Women reported feeling suicidal, and two had attempted suicide while in detention.

I recognise that the Government argue that the purpose of detention is to enable swift removal, but there are too many examples of women incarcerated for long periods. Home Office statistics show that, in 2017, 43% of asylum-seeking women leaving detention had been detained for 29 days or more. Although the number of pregnant women detained has fallen since the 72-hour time limit came into force, it is still the case that the majority of pregnant women are subsequently released to continue with their claims, so their detention serves no purpose. Fewer than 20% of pregnant women who are detained are removed from the UK.

Women for Refugee Women has raised a number of concerns about how the new approach is actually working, despite the good intentions following the Shaw review. There is no screening process that actively identifies whether someone is vulnerable or at risk before they are detained, so survivors of sexual and gender-based violence are going into detention before any attempt has been made to find out about their previous experiences. Survivors of sexual and gender-based violence are not believed when they disclose their previous experiences and find it difficult to obtain supporting evidence that the Home Office will accept. Women are not automatically informed about rule 35 reports—medical reports prepared by doctors working in detention centres—which the Home Office will accept as evidence. Even then, women with this legitimate evidence have remained in detention.

Her Majesty’s Chief Inspector of Prisons report on Yarl’s Wood, published in November 2017, noted “significant improvements” since its last inspection in 2015, but raised concerns about rule 35:

“There were unacceptable delays in the Rule 35 process. The quality of reports was generally poor. They were vague, lacked detail and did not adequately address symptoms of post-traumatic stress disorder. In some cases the Home Office refused without explanation to accept rape as torture. Detention had been maintained in most cases that we looked at without addressing the exceptional circumstances for doing so. In several cases, detention was maintained despite the acceptance of professional evidence of torture”.


Will the Minister assure the House that the inspector’s recommendation is being implemented? That is:

“Rule 35 assessments should be completed within 24 hours. Reports should provide clear, objective and detailed professional assessments, including on evidence of PTSD. Responses should be prompt. Where professional evidence of torture is accepted, the exceptional reasons leading to the decision to maintain detention should be provided in detail. Rape should be considered a form of torture for the purposes of Rule 35”.


HMIP noted that just a third of all rule 35 reports submitted by doctors working in Yarl’s Wood in the six months prior to its last inspection had resulted in the woman concerned being released. Overall, it found that vulnerable women were still being detained,

“despite professional evidence of torture, rape and trafficking, and in greater numbers than we have seen at previous inspections”.

As a result, it concluded that,

“the effectiveness of the adults at risk policy, which is intended to reduce the detention of vulnerable people, was questionable”.

It is surely wrong that those whose mental and physical health are clearly deteriorating while in detention should remain without hope. Home Office statistics show that, in 2017, 85% of asylum-seeking women released from detention were released back into the community to continue with their asylum claim. So their detention appeared to serve no purpose.

Campaigners are calling for a proactive screening process to ensure survivors of sexual and gender-based violence are identified before detention. There should be an absolute exclusion on the detention of pregnant women. There should be a 28-day time limit on immigration detention. Community-based alternatives for immigration detention, focused on support and engagement, are more effective and less expensive than detention.

Good practice has been demonstrated by the family returns process, implemented in 2011, following the welcome pledge to end the detention of children, which has reduced by 96%. The Government should do more to move away from the detention model and into community-based alternatives. Perhaps the new review by Stephen Shaw to assess progress against the key recommendations for action in his previous report, Review into the Welfare in Detention of Vulnerable Persons, will encourage the Government to be braver.

Tuberculosis

Baroness Healy of Primrose Hill Excerpts

Monday 8th December 2014 Grand Committee

[Baroness Healy of Primrose Hill (Lab)]

My Lords, I congratulate my noble friend Lord Collins of Highbury on securing this debate on a subject so important to a world which contains an estimated 35 million people living with HIV.

Today’s debate is focused on investment in research and development in global health, in particular to develop new tools and treatments for TB. I welcome the fact that the TB Alliance has four combinations of drugs in late-stage development and will soon launch a trial of a combination of drugs suitable for those who are co-infected with TB and HIV. More people living with HIV die from TB than any other coinfection, but the first new drug available for TB in 50 years, Bedaquiline, is still not reaching the 1 million people who may need it because of its high price, as the noble Lord, Lord Lexden, mentioned.

The Doha declaration of 2001 must continue to be enforced and respected by all countries to ensure that public health is prioritised over profits. Currently, a number of free trade agreements are causing concern. Most, if not all, FTAs involving the EU or the USA contain provisions on intellectual property rights that are TRIPS-plus and have the potential or likely effect of hampering or preventing the use of one or more TRIPS flexibilities—TRIPS being Trade Related Aspects of Intellectual Property Agreements. Where there is a public health imperative, countries can issue a compulsory licence to a generic manufacturer on payment of a royalty to the owner of the patent.

We need to examine the role of the pharmaceutical companies as part of the debate. In 2002, the world watched as 39 pharmaceutical companies took the South African Government to court. Their complaint was that the Government, under the presidency of Nelson Mandela, had passed legislation paving the way for the purchase of cheap anti-HIV drugs from India to tackle the worst HIV epidemic in the world. By buying those cheap drugs, the companies claimed, the South African Government would be breaching their intellectual property rights. Thankfully, the case was eventually dropped, but the issue of intellectual property rights in that context remains controversial.

In 2003, the Labour Government launched a commission to explore the relationship between IP and development. They published a landmark document recognising the enormous impact of intellectual property legislation on international development. The commission recommended that further research be carried out, and the Labour Government led the way by supporting the establishment of the World Health Organization’s Commission on Intellectual Property Rights, Innovation and Public Health. The commission sought to create global consensus around research and development for global health, and led to a series of reform proposals. Progress on these reforms has stalled and has been pushed back to 2016, as my noble friend has already highlighted, but the progress of diseases such as HIV and TB has not stalled, and the time wasted in coming forward with new research and possible vaccines sees 2.7 million people die from these two diseases alone every year.

As noble Lords have already emphasised, intellectual property is not, in itself, a bad thing, but IP is designed to incentivise innovation by helping innovators to make a profit on the products they invent. Companies will concentrate on developing drugs to address the illnesses besetting the developed West more quickly than addressing the needs of the developing world, as my noble friend Lord Collins has already mentioned. The disparity in wealth between high- and low-income countries means that the markets which offer greatest returns are those in the developed countries. The pharmaceutical companies predominantly invest in developing products with the greatest potential to generate sales in high-income countries, and price their products accordingly.

The establishment of the Medicines Patent Pool—MPP—in 2010 to address intellectual property barriers to generic production is of course welcome and is already making a difference, but there is still a time lag from the period when a licence is agreed, given the two to three years it takes for a generic manufacturer to develop a new drug. More pharmaceutical companies need to be encouraged to sign up and there is still a need for greater investment in R&D.

The Government need to show the same leadership as the previous Labour Government did in this field by commissioning a new report to examine the differences in overall costs between a commercially driven model of development and models that are open access and do not include IP protection, so that global solutions can be found to global health problems. The aim of such a study would be for the UK Government to find the most effective ways of creating incentives to encourage investment in R&D, and to look at the benefits and challenges with different approaches to drug development.

As my noble friend Lord Collins highlighted, there is a concern about this Government’s reduction of funding into research and development around a vaccine for AIDS by more than 80% for the period 2013 to 2018. The new grant for the next five years has been reduced to only £5 million—one-eighth of its previous level. Does the Minister support the recommendations in the report launched by the All-Party Parliamentary Group on HIV and AIDS, Access Denied, to carry out an inquiry into alternative models of research and development investment which separate the cost of R&D from the demands of profitability? As my noble friend Lord Collins has already mentioned, a new global research and development fund could reward all who contribute to it, and the UK Government could negotiate with the pharmaceutical industry and civil society to create a research and development treaty to provide the framework for such a fund. Notably, the report calls on,

“the UK government, the pharmaceutical industry and multilateral organisations to work together to make second and third-line ARV drugs available and affordable to all, including marginalised populations and people living”,

in middle-income countries. The report also says:

“DFID should lead the way in harnessing donor support for the Global Fund to cover the cost burden of the increased numbers of people (28.6 million) now eligible for ARV treatment under WHO guidelines”.

Most importantly, Access Denied suggests that,

“DFID should use its leverage as a donor to ensure multilateral institutions such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, WTO, WHO, World Intellectual Property Organization (WIPO) and UNITAID are doing enough to bring prices down. It must use its voice to demonstrate leadership on this issue”.

HIV and AIDS in the UK

Baroness Healy of Primrose Hill Excerpts

Thursday 1st December 2011 Lords Chamber

[Baroness Healy of Primrose Hill]

First, I congratulate the noble Lord, Lord Fowler, on securing this important debate on World Aids Day and must say how privileged I was to have served on the Select Committee that was so expertly chaired by him.

The report calls for urgent action by the Government and I wish to highlight two recommendations in particular. Recommendation 72 states:

“HIV awareness should be incorporated into wider national sexual health campaigns, both to promote public health and to prevent stigmatisation of groups at highest risk of infection. We recommend that there should be a presumption in favour of including HIV prevention in all sexual health campaigns commissioned by the Department of Health”.

Recommendation 139 states:

“Ensuring that as many young people as possible can access good quality SRE”—

sex and relationship education—

“is crucial. We recommend that the Government’s internal review of PSHE”—

personal, social, health and economic education—

“considers the issue of access to SRE as a central theme. Teaching on the biological and social aspects of HIV and AIDS should be integrated into SRE”.

The report makes it clear that although there is a widespread assumption that the danger has gone away, nothing could be further from the truth. Thousands of people are still being infected every year and the number of those diagnosed with HIV continues to grow relentlessly. Next year it is estimated that there will be 100,000 people with HIV in the UK. Although medical advances have ensured much better treatment and enabled those diagnosed with the illness to live much longer thankfully, serious medical and mental health problems remain for many with HIV.

As the report states:

“Patients can now live with HIV, but all those infected would prefer to be without a disease, which can still cut short life and cast a shadow over their everyday living”.

I highlight those two recommendations as part of the way forward to help prevent the disease and to increase understanding and tolerance by the public for those who have contracted the virus. The problem of stigma has already been raised by the noble Lord, Lord Fowler. It leads to isolation and fear of getting treatment and possibly prevents people seeking a test in case they are found positive and excluded by their community. Our report argues that the awareness of responsibility and risk must extend to the population as a whole, and general campaigns may be necessary to educate the wider population. Evidence from charities noted by the Select Committee suggests that a general HIV prevention campaign would be valuable. As the report says in paragraph 100:

“Discrimination against those affected by HIV is based, at best, on ignorance and, at worst, on prejudice, and we unreservedly condemn it. This underlines the need for a general public awareness campaign on HIV”.

I am particularly disappointed that the Government have responded to this by saying:

“We do not support the Committee’s recommendations on the need for a national campaign aimed at the general public as there is little evidence that this would be effective”.

I hope they will think further on this and that with the publication of their new sexual health policy framework planned for 2012 they will have reassessed,

“where further work is needed to ensure a strong and sustained response to tackling HIV”.

Complacency is not an option when looking at the scale of infection in the UK. As the report states:

“There has also been a dramatic increase in the yearly number of new HIV diagnoses since the late 1990s. This peaked in 2005, with more than 7,800 new diagnoses ... In 2010, there was a year-on-year increase for the first time since then, with an estimated 6,750 people diagnosed”.

By next year, the report states, and I repeat, that the figure for people living with HIV is likely to be above 100,000.

The need to increase awareness remains, and so does the need to ensure that young people are taught about the illness and how to guard against it. The committee heard evidence of the increase in numbers of young people contracting the virus. The Health Protection Agency report of 6 June 2011 states that,

“a quarter of MSM”—

—men who have sex with men—

“newly diagnosed in 2010 probably acquired their infection 4-5 months prior to diagnosis, with higher recent rates in younger ages”.

According to the HPA, in 2009 10 per cent of diagnoses for HIV were among those aged between 15 and 24 years old. The National AIDS Trust has highlighted that since 2000 new HIV diagnoses among 15 to 24 year-olds have risen by nearly 70 per cent and among young gay men they have more than doubled. As a generation grows up without memories of the widespread health promotion messages of the 1980s, spearheaded by the then Secretary of State, now our formidable chairman of this Select Committee, the noble Lord, Lord Fowler, reliable HIV information for young people remains essential.

Given the lack of either a vaccine or a cure, then,

“prevention is better than cure when there is no cure”,

as Dr John Middleton, vice-president of the UK Faculty of Public Health said. One of the best means of prevention lies in education. Present teaching looks at HIV and AIDS within the science curriculum. However, the separate subject of SRE, with its focus on broader social issues, which can increase levels of safe sexual behaviour according to the Sex Education Forum, should also be considered as part of HIV and AIDS prevention methods. While the report calls for the mandatory teaching of SRE in schools, the Government have indicated that that was,

“not the approach we are taking to education policy”,

and that it was,

“imperative that parents will maintain a right to withdraw their children from SRE lessons”.

Yet a recent survey commissioned by Brook, the charity, found that 43 per cent of young people said that their SRE was unsatisfactory or non-existent. More alarming is the recent Sex Education Forum research, which found that one in four young people did not learn about HIV in school, which was described by a government Minister, Nick Gibb, as “unforgivable”.

The Select Committee report states that,

“ensuring that as many young people as possible can access good quality SRE is crucial”,

and recommends that the internal government review of PSHE considers access to SRE as a central theme. In a report in 2010, Ofsted highlighted SRE as an area for improvement, finding that in a third of schools visited students’ knowledge of SRE was no better than satisfactory. In a previous report, Ofsted expressed concerns about teaching around HIV and stated specifically:

“In particular, schools gave insufficient emphasis to teaching about HIV/AIDS. Despite the fact that it remains a significant health problem, pupils appear to be less concerned about HIV/AIDS than in the past”.

I am pleased to see that the government response to this report states:

“The reviews of the National Curriculum and of PSHE by the Department for Education will take account of the Committee's recommendation”,

but where compulsion is not appropriate I return to the report's call for a national sexual health campaign. We cannot afford to let public awareness of HIV and AIDS fade away, and young people must be given the information either through such a campaign or by better education in schools or preferably both. It will help young people to learn to look after themselves and their health better and to increase their understanding and tolerance of those who live with the illness. The success of the “Don't Die of Ignorance” campaign in the 1980s should serve as a lesson to the Government to ensure that young people do not live in ignorance today.