House of Lords: Labour Peers’ Working Group Report

Baroness Northover Excerpts

Thursday 19th June 2014 Lords Chamber

[Lord Richard]

I stand where I was and nothing has caused me to modify my views. I believe in an elected House. I believe that in the long term it will be seen as not only right but inevitable. There is a fairly obvious lacuna in the report that I should point out, which is that it calls for progress and reform as part of the process—progress towards what? What is the end of the process? The answer can be only an elected and reformed second Chamber. If that is the ultimate aim, viewed in that context the report is indeed useful. If viewed as an end in itself, the report is not.

Since we are talking about Labour Party views, we should be clear about what the Labour Party commitment was at the previous election—and indeed, I hope, remains. We set it out very clearly in our manifesto. With the leave of the House, I will quote it:

“We will ensure that the hereditary principle is removed from the House of Lords. Further democratic reform”—

the House will note these words—

“to create a fully elected Second Chamber will then be achieved in stages. At the end of the next Parliament one third of the House of Lords will be elected; a further one third of members will be elected at the general election after that. Until the final stage, the representation of all groups should be maintained in equal proportions to now. We will consult widely on these proposals, and on an open-list proportional representation electoral system for the Second Chamber, before putting them to the people in a referendum”.

That seems perfectly clear. I would be very disappointed indeed if at the next general election we were not equally forthright.

Moreover, in considering the whole issue yet again, one should not forget that when the House of Lords Reform Bill was debated in the House of Commons, it was passed by a majority of no less than 338, which in anyone’s figures is a pretty hefty majority.

The Labour Party voted very firmly in favour of giving the Bill a Second Reading. Again, we should look at the arithmetic. Of Conservative MPs, 193 voted in favour of a Second Reading, 89 voted against. As far as the Labour Party was concerned, 202 were in favour, 26 against. The Liberal Democrats scored 53 in favour and zero against. I hope that there is no suggestion that as a party we should resile from the principles of the position that we took in the House of Commons. One of the dangers in this whole argument is that the House of Lords will come to the conclusion that it is in favour of a non-elected House and the House of Commons will come to the conclusion that it is in favour of an elected House. That is an unhealthy result to look forward to.

Having said all that, however, I want to look at the common ground between us on the report. The report says that the House of Lords should have 450 Members and be smaller than the House of Commons. I totally agree with that. It says that the hereditary principle should be ended and that all remaining hereditary peerages should be abolished. I totally agree with that. It says that no political party or coalition of parties should seek a Lords majority. I agree. All Peers should be working Peers. I certainly agree with that. The House of Lords Appointments Commission should be established in statute. I agree with that. Attendance should be set at an average of three-fifths of Lords sitting days. That seems to me to be unexceptionable. Disqualification from the Lords should be in line with such arrangements as apply in the Commons. All legislation should start in the Commons. The ceremonial wearing of robes should end. The role of the Lord Speaker should be reviewed. With all of that, I think I could agree. I am bound to say that that is a substantial measure of agreement on any view of this issue. I am sure that it goes rather too far for many people on the other side of the House.

Finally, the report calls for a constitutional commission to consider Britain's evolving constitutional settlement as a whole. This will apparently include devolution, the outcome of the Scottish referendum and questions concerning English governance—whatever that may mean—including regional government. It says that all those provide the context within which wider questions of the place of the second Chamber within the constitution will fall to be determined. These questions are apparently to include the functions and composition of the House, including the question of election, the relationship with the House of Commons, the implications for the formation of Governments, legislative activity, scrutiny of the Executive and representation of the people.

I have to say that is one of the longest and least mowable pieces of grass that I have seen cultivated into which a political football can be successfully kicked. The agenda is enormous and the idea that you could produce results on that in 24 months is, with great respect to the authors of the report, somewhat fanciful.

I see no reason why the reform of this House should have to wait for the resolution of all the problems related to the British constitution. I am very strongly in favour of a long look at the relationship between the devolved Administrations and the centre. I am strongly in favour of taking a long look at the possibilities of regionalisation for England, but I am very much against using the constitutional commission as the excuse for continued inaction on the central issue of the reform of this House.

I am conscious of the time, but I have two other points that I want to make. I will do so very briefly. Looking at the history of this country, we see that many of the great constitutional advances that have been made have been made not by consensus but very much in its absence. If we go back to the 17th century—let alone Magna Carta, that was hardly consensual—and the disputes between Parliament and the Crown, to the Great Reform Bill, or to the Parliament Act 1911, none of them was consensual. They all took place because the Government decided that that is what was right and that was what they were going to do. I would wish future Governments to do that too.

[Baroness Northover (LD)]

My Lords, I remind noble Lords that we are in a time-limited debate. When the clock reaches eight, noble Lords have had eight minutes.

--- Later in debate ---

[Lord Hunt of Kings Heath (Lab)]

My Lords, I wonder if the noble Lord will give way on that point. He is really rather glossing over some of the difficulties of the 2012 Bill relating to the respective powers of the two Chambers. Surely in those Parliaments where there are two elected Chambers—

[Baroness Northover]

My Lords, I will let the noble Lord continue, but I remind the House that noble Lords who have signed up for this all have an opportunity to put their case. They should therefore be chary of eating into the time of other people.

[Lord Campbell-Savours]

It is a debate.

[Baroness Northover]

Noble Lords will have their time. I will let the noble Lord continue his point, but I point out that noble Lords will have their opportunities later on to make the case that they wish to make and that they should be chary of eating into other people’s time.

[Lord Hunt of Kings Heath]

My Lords, with the greatest respect, it is not in the noble Baroness’s gift to either let me intervene or not. The noble Lord is clearly well able to debate and wants to do so. The only point that I want to put to him is this: in those places where there are two elected Chambers, there tends to be a written constitution. Is that not really at heart the problem—that no one has yet resolved the balance of power between the two elected Chambers in the UK?

UK National Action Plan on Women, Peace and Security

Baroness Northover Excerpts

Monday 24th February 2014 Lords Chamber

[Baroness Northover (LD)]

My Lords, I, too, thank the noble Baroness, Lady Prosser, for securing this important debate and for her tireless work in this area. I thank her and other speakers for the tributes they paid to the Government on the work that has been done, and note the comments about progress that is yet to come.

The noble Baroness, Lady Prosser, is right to say that the powerlessness of women is at the root of this problem, which is why the education of women, ensuring that they are independent, have bank accounts and participate at all levels of society is key. As she said that, I found myself thinking about groups that I met in India over the past few days. I could see that DfID’s support for women and girls was transformational, but also how far we have to go. It is in the light of this that we need to assess what is happening in terms of women, peace and security.

We firmly share the view so powerfully expressed in this debate that women must be at the heart of peace and security. They are central to efforts to prevent violent conflict overseas and to build strong societies yet too often, as speakers have said, women and girls are excluded from peace processes and continue to be especially vulnerable to violence, with dreadful consequences.

The UN estimates that at least one out of every three women around the world has been beaten, coerced into sex, or otherwise abused in their lifetime. Although women and children represent 90% of casualties of conflict, only 8% of participants in peace negotiations have been women. Of nearly 600 peace agreements signed between 1990 and 2010, only 16% contained references to women. Looking more widely, women are too often marginalised in society generally. For example, they account for only 21% of parliamentarians globally, and would not be at that level but for quotas.

There is international consensus on what needs to be done. The UN Security Council set this out in 2000, in its Resolution 1325, and in the six resolutions since mentioned by the noble Baroness, Lady Prosser. The council called for action under four pillars: women’s participation in building peace; preventing conflict and preventing violence against women and girls; protecting them; and making them central to the provision of humanitarian relief and a society’s recovery from conflict.

The UK can be pleased with how far we have come across government to put women and girls at the centre of policy. As my noble friend Lady Jenkin mentioned, my right honourable friend the Foreign Secretary is leading an international effort to shatter a culture of impunity for sexual violence in conflict, building global momentum and taking practical action on the ground, including deploying experts to help in countries ranging from the DRC to Syria, and from Bosnia to Mali. The Global Summit to End Sexual Violence in Conflict, to which noble Lords referred, will take place in June, and 140 countries, international organisations and members of civil society will come together to discuss and agree what more we can do to tackle these terrible crimes. I will take back my noble friend Lady Falkner’s suggestion about the All-Party Group on UN Women.

My noble friend Lady Falkner flagged up those countries that do not have national action plans. I assure her that we are working bilaterally with such countries on security and justice reform, preventing violence against women and girls, empowerment, and tackling violence against women and girls in humanitarian settings. We are certainly encouraging those various countries to take that forward.

The noble Baroness, Lady Kinnock, mentioned Syrian women’s participation, and she will have noted that my right honourable friend the Foreign Secretary has been urging that women are included in the discussions on Syria’s future, and we will continue to do so.

The Department for International Development, as many noble Lords will know, works very hard to try to prevent violence against women and girls. Its strategic vision for girls and women promotes women and girls’ health and rights, and their access to economic resources and education—very much building upon the ideas that the noble Baroness, Lady Prosser, outlined. It builds women’s political and civil participation and puts women’s and girls’ needs at the centre of our humanitarian response. It makes the policy arguments, including at the UN Commission on the Status of Women and in the debate about what follows the 2015 millennium development goals. Noble Lords will know that the United Kingdom is pushing hard for a stand-alone goal on gender. My honourable friend Lynne Featherstone is the Government’s champion on tackling violence against women and girls, and has led groundbreaking work in this area, including on tackling FGM.

A number of noble Lords mentioned the Ministry of Defence. Its goals cover personnel, training and operations, as noble Lords will know. It regularly reviews the employability of women in the Armed Forces and aims to ensure that gender is understood in all that the MoD does. The noble Baronesses, Lady Kinnock and Lady Thornton, flagged up this area in particular. The MoD constantly reviews training and includes sexual violence scenarios in pre-deployment. Operational planning for new theatres will take into consideration tackling sexual violence. NATO has carried out a lot of work towards integrating UN Security Council Resolution 1325 and gender perspectives into its command structure. This is a template that the Ministry of Defence can apply. We are also looking at the example set by Canada in terms of training overseas, and are seeking to see whether that can be brought into the way in which we do things through the Ministry of Defence. In terms of senior leadership, which the noble Baroness, Lady Kinnock, mentioned, we have, according to this note here, two female air vice-marshals in the Ministry of Defence, so we are making some progress but are acutely aware of the challenges that the MoD faces. I am sure that her comments will be taken note of.

Action at home is equally important, whether through the Home Office’s work to end violence against women and girls or the Government’s agenda to see women play a greater role in public life. We want women to represent half of new public appointees by the end of this Parliament, and we have reached a figure of 45%.

The noble Baroness, Lady Prosser, raised the subject of quotas and whether negotiation and mediation teams will be at least 30% female. The Government are reluctant to set a specific figure on women’s representation, but we are pushing hard to improve numbers. I am sure that this will be kept under review.

The UN Security Council calls for member states to deliver on all four pillars through national action plans. The UK adopted its first such plan in 2006 and we will soon, as noble Lords mentioned, launch our third plan, for the next three years. My noble friend Lady Hodgson is right that this needs to be strategic and joined up across government for it to have its best effect. I read with enormous interest the independent review of the previous national action plan, which makes this point very clearly.

The challenge for the next plan is to bring together all the work that we do—we recognise that—and to ensure that we deliver both globally and on the ground and test our plans against what those in this field are saying to us. We will bring under one framework our work on the Preventing Sexual Violence Initiative, the strategic vision for girls and women and the call to action on protecting women in emergencies, as well as our work at the UN Security Council and at the Commission on the Status of Women. I hope that this reassures noble Lords, including the noble Baroness, Lady Kinnock, that that is the approach that we are taking. My noble friend Lady Hodgson asked about the review of the national action plan and whether it will continue to be reviewed annually and reported to Parliament. We will continue to report annually on this, as well as to hold frequent meetings about it.

We are also learning from what appears to be working. DfID has a fund of, I think, £25 million—I do not have the exact figure in front of me—which is a research and innovation fund. My noble friend Lady Falkner asked about what we were learning; that fund is seeking to analyse what works and, therefore, what should be taken forward further. We are seeking to bring all this together; I think that that is vital. We will deliver multilaterally, through the United Nations, NATO and the European Union and now also in partnership with the African Union. We will put in place stringent monitoring and evaluation to assess the impact and outcomes of our actions and to capture the changes that our national action plan will make for girls and women on the ground. We will integrate women, peace and security issues into the work of the new Conflict, Stability and Security Fund. I hope that that reassures the noble Baroness, Lady Kinnock.

I can reassure the noble Baroness, Lady Prosser, that there will be central guidance from the fund on women, peace and security, although our conclusion is that a ring-fenced allocation would in fact encourage programme designers to take a compartmentalised approach to women. We think that it is extremely important, as that review indicates, to look at this strategically and make sure that it runs right through all the various programmes, but I understand people’s concern and the necessity to make sure that is does indeed run though every programme.

We will also be consulting both in the UK and on the ground and we take very seriously the Associate Parliamentary Group on Women, Peace and Security and Gender Action for Peace and Security. They were instrumental in delivering a successful workshop at our embassy in Kabul in December and will remain invaluable as we plan and carry out more workshops before April. We continue to be very engaged as far as the position of women in Afghanistan is concerned.

As we prepare to adopt and implement a new national action plan, we can be proud of what we have achieved but we recognise that we have much more to do and that we need impact that helps to shift general attitudes in society, protects women and girls and secures a better place for them in delivering peace and security. What lies behind all this, as noble Lords have made clear, is gender inequality. They are right that addressing this is fundamental to ensuring that women and girls are at the heart of all that we do, everywhere and in everything.

[Lord Wallace of Saltaire (LD)]

My Lords, we began this debate by having 62 minutes for a 60-minute debate, including the intervention in the gap. Thanks to the immense self-discipline of speakers—in particular, that of the opposition final speaker—we have now ended with three minutes to spare. Therefore, I beg to move that the House do adjourn during pleasure until 8.47 pm.

Crime: Sexual Violence

Baroness Northover Excerpts

Wednesday 6th March 2013 Lords Chamber

[Baroness Northover]

My Lords, I, too, thank the right reverend Prelate the Bishop of Wakefield for securing this extremely important and timely debate. In this week of International Women’s Day, I am glad that we have this focus tonight and that so many noble Lords chose to contribute, albeit briefly.

The statistics on violence against women and girls are shocking. Globally, one in three women is beaten or sexually abused in her lifetime. In conflict and post-conflict situations, sexual violence can be even more widespread, as the noble Lord, Lord Parekh, pointed out. As the noble Baroness, Lady Eaton, the noble Lord, Lord Collins, and others have said, women and girls are the poorest and most marginal in society, with the least power. In conflicts, they are the most vulnerable. As the noble Lord, Lord McConnell, the noble Baroness, Lady Tonge, and others have pointed out, we also see rape being used as a weapon against the woman, her family, her community and her society. However, as the right reverend Prelate says, and my noble friend Lord Hodgson emphasised, we also see sexual violence against men and boys used to degrade and destroy. We see that now in Syria. The noble Lord, Lord Sheikh, rightly emphasised the stigma of rape.

How do we break the silence on this and change behaviours? Unless we do, we undermine the likelihood of peaceful resolutions. We know that sexual violence causes huge physical and psychological trauma. My noble friend Lady Hamwee referred to that. But it also exacerbates ethnic, sectarian and other divisions, further entrenches conflict and undermines efforts to restore peace and stability. It reduces progress towards the millennium development goals and represents one of the most serious forms of human rights violation or abuse. For all these reasons, tackling violence against women and girls is central to the Government’s work overseas. We agree with the noble Lord, Lord McConnell, that women and girls must continue to be at the heart of whatever replaces the MDGs.

This year, 2013, is a hugely important year for this agenda. We are working hard with other Governments to ensure that this year’s UN Commission on the Status of Women, whose focus is on violence against women and girls, is a success and agrees a set of robust global standards to protect women and girls from discrimination and violence. My honourable friend Lynne Featherstone is leading the UK delegation. We also want to see women and girls at the heart of the new millennium development goal framework to be published later this year. Their inclusion is critical to achieving our goal of ending extreme poverty.

This year will also see greater government action to address the use of sexual violence in conflict as we further develop and implement the Foreign Secretary’s preventing sexual violence initiative, to which noble Lords have referred. In our own lifetimes, millions of women, men, and children have endured this horror, including in the Democratic Republic of Congo, to which noble Lords have referred, in South Sudan, in Colombia, as the noble Baroness, Lady Coussins, said, in Bosnia and in Syria. The truth today, as the right reverend Prelate pointed out, is that the perpetrators of these appalling, life-shattering crimes more often than not go unpunished.

We believe that more must be done to combat the use of sexual violence in conflict. We want the international community to address the culture of impunity that has been allowed to develop for these crimes and to increase the number of perpetrators brought to justice, both internationally and nationally. As other noble Lords have mentioned, the Foreign Secretary has placed this issue at the top of the G8 agenda for 2013. We want G8 Foreign Ministers at their April meeting to speak out against those who use sexual violence in conflict and to declare that rape and serious sexual violence amount to grave breaches of the Geneva Conventions. This is a very significant step in the development of international humanitarian law. Declaring that serious sexual violence and rape amount to grave breaches sends the message that these crimes are to be treated in the same way as the most serious category of war crimes. I can therefore reassure my noble friends Lady Tonge and Lord Alderdice that these crimes will become the most serious category of war crime in international law. I can also assure my noble friend Lord Alderdice that they can be taken to the International Criminal Court. Consultation with prosecutors at the ICC has clearly identified that a lack of clarity over investigations and collection of evidence led to the low number of prosecutions in the ICC and other international tribunals. The protocol will directly address this.

We are also proposing a set of practical G8 commitments that, taken together, will promote justice and accountability and provide greater support to victims. I hope that my noble friend Lady Hamwee, the noble Lords, Lord Parekh and Lord Judd, and others will welcome them. These commitments are, first, to improve investigations and the documentation of sexual violence in conflict, including through endorsing a new international protocol; secondly, to provide greater support and assistance to survivors, including child survivors, of sexual violence, so that they can rebuild their lives and attain justice for what they have endured; thirdly, as the noble Baroness, Lady O’Loan, emphasised, to ensure that the response to sexual and gender-based violence is fully integrated into wider peace and security efforts; and fourthly, to improve international co-ordination, including through the UN, because a co-operative approach to addressing sexual violence will have a much greater long-term impact.

To underpin these international efforts, the Government have established a new specialist UK team of experts, to which the noble Lord, Lord Sheikh, referred, who can be deployed to conflict areas to help local authorities and organisations address sexual violence. This team has already been deployed to the Syrian border to help train local health professionals. In answer to the right reverend Prelate, we aim to work with, and support, those who can document these abuses in that area. We also plan to deploy the team to at least five other countries this year. It will go to Libya, to support survivors of sexual violence committed during the revolution; to South Sudan, to work alongside the UN and the Government to strengthen local justice; to eastern DRC, to help doctors and lawyers to investigate crimes against the hundreds of women and girls who are raped each month; to Bosnia-Herzegovina, to help courts and prosecutors address the backlog of war crimes cases; and to Mali, to provide human rights training to the Malian armed forces on preventing and responding to sexual violence. As the noble Baroness, Lady O’Loan, emphasised, in order to address these issues, we need first the law to protect and then we need to work with those who can help to ensure the implementation of those laws: the police, the judges, civil society and the media.

Our plans for the initiative have been developed in consultation with UN agencies, other international bodies, NGOs, and—I can also reassure the right reverend Prelate—representatives from faith groups. These groups have a particular role, not least because of their ability to reach out across communities. We want to continue to work closely with them as we challenge the myths and stigma associated with victims of sexual violence.

There were a number of questions. My noble friend Lady Tonge asked about the proposals we brought forward earlier this year in terms of international humanitarian law. In conflict situations, even if it is contrary to national law, abortion care can be offered where its denial would amount to torture or cruel treatment. We need now to focus very much on bringing our international partners with us on this. We are very forward-looking on this, as we have been in the area of safe abortion as well, and it is extremely important that we take others with us. However, if the noble Baroness has any evidence that UK aid is not being used appropriately and is not reaching women, will she please let us have those details?

The noble Baroness, Lady Coussins, asked about Columbia. PSVI is working in partnership with the UN special representative’s office and its team is leading on these issues in Columbia. We support that. I will be very happy to provide further details for the noble Baroness.

My noble friend Lord Hussain spoke about the abuse of human rights in Kashmir. I hear what he has to say in this regard, and we welcome the invitation by the Indian Government to the UN special rapporteur, who is to look in detail at those allegations. We are not willing to put up with abuse of human rights, wherever it happens in the world.

The noble Lord, Lord Collins, asked about funding. I will be very happy to spell this out further in writing. The G8 commitments are essentially very practical, but groundbreaking. By working with our international partners we have moved this forward in a very significant way, and we now need to take our international partners with us so that we can ensure that this is as effective as it needs to be. It needs to be done right across the international spectrum.

Tackling the impunity of those responsible for sexual violence is essential for any conflict or post-conflict society seeking to come to terms with past abuses. It is also essential to prevent their recurrence. This is an absolutely key year as we seek to take this forward. This is the year to ensure that we make the difference for those who are at risk of this horrific form of abuse.

[Lord Wallace of Saltaire]

My Lords, as several of the final speeches were shorter than time allowed for, and as one speaker withdrew at the last minute, we have now come rather short of our time limit. I thank everyone for their indulgence at the unpleasant roles that Whips have to play, and I suggest that the House should now adjourn until 9.36 pm.

PACE Trial: Chronic Fatigue Syndrome/Myalgic Encephalomyelitis

Baroness Northover Excerpts

Wednesday 6th February 2013 Grand Committee

[Baroness Northover]

My Lords, I thank the noble Countess for initiating this debate. I apologise for the fact that my noble friend Lord Howe cannot be here, as he is in the Chamber making the Mid Staffs Statement. I, too, am a last-minute replacement.

I know that the noble Countess has a particular and personal interest in the subject and I pay tribute to the way in which she continues to raise issues of concern in your Lordships’ House, as well as her unswerving commitment to improving the experience of people living with CFS/ME. I recognise how distressing and debilitating the condition can be for individuals, their carers and their families. Equally, I recognise the difficulties that many patients face in getting the treatment and care they need to help them manage their illness and, where they can, make a recovery; we have heard that this afternoon. I am sure that we all agree that the most important thing is to ensure that patients receive the treatment and care that they need.

At this point it is worth acknowledging that, while many patients feel let down by the system, many patients have had a positive experience and have worked with health and social care professionals to manage their care effectively. It is also important to acknowledge that doctors and other professionals working in this field are highly committed to providing the best possible care for their patients. We want to see people with CFS/ME being listened to when it comes to decisions about what type of treatment and care may best meet their individual needs and, across the country, many doctors are working with their patients to achieve this. I hear what my noble friend Lord Alderdice says on this.

There is no doubt that there is widespread uncertainty surrounding this condition; that has shone through in this debate. There is controversy, disagreement and divided and often polarised opinion about its causes and the best way to treat it. The kind of issues raised by the noble Countess today have surrounded the debate for many years. We have seen how passionate but how often opposed are those seeking to address these problems in the debate this afternoon.

It is an unfortunate fact that despite a great deal of worldwide research—the noble Lord, Lord Winston, made clear how extensive this is—we do not yet know definitively the cause or causes of CFS/ME: whether it is a disease; a condition, as the noble Baroness, Lady Hollins, described it; or a syndrome, as the noble Baroness, Lady Meacher, described it. The noble Lords, Lord Winston and Lord Layard, surely are right that it is concerning if researchers are in any way intimidated as they seek to clarify these problems.

CFS/ME is not alone in being mystifying. We do not know the causes of most cancers and other diseases such as Alzheimer’s. That lack of knowledge, however, has not stopped us from seeking the best forms of treatment. Many of these diseases are treated well even though we do not know their causes. I quite agree that more research is needed. In the mean time, patients want access to the best treatments that are available. So far, the only treatments that seem to have shown any benefit in clinical trials have been cognitive behaviour therapy and graded exercise therapy, but I have heard what noble Lords have said in regard to those.

This brings me to the PACE trial that has prompted today’s debate. The MRC’s decision to fund this trial was based on the fact that there was a lack of high-quality evidence to inform the treatment of CFS/ME and, in particular, on the need to evaluate the treatments that were already in use and for which there was insufficiently strong evidence from randomised controlled trials to support their effectiveness. The decision to fund this trial was based on the MRC’s usual rigorous peer- review process for clinical trials, as noble Lords have emphasised. The experts who reviewed the application were satisfied that the design put forward was of high quality, would provide useful evidence to help doctors and patients decide whether any of the four treatments to be evaluated was likely to be worth pursuing, and would help to inform decisions on the provision of treatment by the NHS. The noble Lord, Lord Winston, and others argued that this was a controlled and rigorous study. All agree that research is needed.

I shall try to address the challenges that were raised by the noble Countess, Lady Mar. She expressed concern about the selection method for participants. I assure her that having neurological symptoms, such as memory difficulties or muscle weakness, did not exclude anyone from taking part in the trial since these symptoms were medically recognised symptoms of the condition. While researchers used the Oxford definition to define the condition in the PACE trial, participants were also assessed to see whether they met the international Centers for Disease Control and Prevention criteria to see whether the effects of treatments were different in those who met this alternative definition. The independent members of the trial steering committee reviewed and agreed the plans for secondary analysis.

The noble Countess, Lady Mar, also expressed concern about the recovery statistics and other areas in relation to the protocol. As for all MRC-funded studies, it is the responsibility of the investigators and the relevant journals, guided by peer reviewers, to determine how findings are published and when. The investigators’ first paper on the outcomes of the PACE study was published in the Lancet in March 2011. A later paper was published in August 2012, which dealt with the cost-effectiveness of the interventions. Further papers will be published, including papers showing a long-term follow-up after two and a half years. The noble Baroness, Lady Hollins, made a very important point about follow-up, and no doubt the MRC will bear that in mind and will look at this debate. Follow-up in all these trials is very important.

The noble Countess, Lady Mar, asked about severely disabled patients being excluded from the trial. Patients had to be able to attend hospital for treatment, but a number needed mobility aids and others received treatment by telephone when they were too unwell to attend a clinic once they had been recruited. She also asked whether the trial data could be reanalysed. As she will know, there are ethical and legal barriers to releasing data to a member of the public without consent when these data contain medical information that might identify the patient. The main outcome data have already been independently analysed by a Cochrane Collaboration group and a paper is being prepared for publication. I know that she will look at that with interest.

An often voiced criticism is that the money spent on the PACE trial would have been better spent on research into causes. As the noble Baroness, Lady Meacher, indicated, the two are not mutually exclusive. While understanding the cause of the condition is obviously important, if potential treatments are available, it is equally important to test their effectiveness so that they can be introduced into service. Of relevance to this is that the PACE trial tested adaptive pacing therapy, which had not previously been tested in a large trial and which is supported by patient organisations. Various noble Lords have paid tribute to the quality of the research, even though the noble Countess, Lady Mar, was more sceptical.

As the noble Countess is aware, the findings of the PACE study reflect the recommendations in current NICE guidance. I understand that concerns have been expressed that patients may have their choices about care restricted because the PACE trial supports their non-recommendation by NICE or that patients may be forced into treatments they do not want because they are recommended. I assure noble Lords that clinical guidelines published by NICE help to promote consistency but recognise that patients are individuals who may require different forms of management. Clinicians are therefore free to adapt the guidelines when deciding, in consultation with their patients, the most appropriate treatment. NICE routinely reviews the need to update its guidance in order to take account of the latest available evidence. As the noble Countess is aware, CFS/ME is currently a highlighted area and a high priority for the MRC. The high-quality research stimulated by the MRC’s recent call will add to the future evidence base.

Concern has been expressed that the findings of the trial will be used to reduce the number of people with CFS/ME on state benefits. That was flagged up briefly by noble Lords. I should like to dispel straight away the idea that CFS/ME is not recognised by the Department for Work and Pensions as a potentially serious condition. For example, there are no targets for finding individuals fit for work in the work capability assessment process. The noble Baroness, Lady Meacher, raised this particular issue and asked whether patients who do not comply with the CBT or take the treatment recommended to them might have their benefits withdrawn. I can assure her that that is not the case. Entitlement to employment support allowance is not based on compliance with specific treatments and anyone claiming ESA will undergo the work capability assessment. That assessment is founded on the premise that eligibility should not be based on a person’s condition or the treatment regime for it but, rather, on the way that that condition limits their functional capability. I am happy to flag this debate to the DWP, as the noble Baroness asked me to, in regard to the availability of services.

The noble Baroness also asked me about the NHS Commissioning Board and whether it would give equal weight to a number of other diseases. I can assure her that the mandate to the NHS Commissioning Board will ensure that improvements are made to the quality of life for all people living with long-term conditions, including this one.

The noble Lord, Lord Layard, asked me about specialist treatment provided by PCTs. In the new system, clinical commissioning groups will be responsible for commissioning specialist CFS/ME services. As he knows, they comprise front-line clinicians. We certainly hope that they will therefore have a good understanding of their local communities, including patients with these problems. The NHS Commissioning Board will hold those CCGs accountable for the services that they commission, as well as providing support—for example, through the development of commissioning guides. I understand that Martin McShane, long-term conditions lead at the NHS Commissioning Board, has already met with the CFS/ME patient groups to discuss their concerns. Those discussions will inform the board’s work as things move forward.

The Government’s aim is to help individuals who are suffering from these problems both to receive appropriate treatment and to get back to work where they can do so. They also seek a better understanding of the situation that these individuals are in. The PACE trial was funded to respond to the concerns of patients, carers and doctors that more research into CFS/ME was required. Of course, we all hope that health research results in people becoming healthier and fewer suffering from these kinds of problems. This is obviously a major focus for the MRC in making its individual funding decisions.

In conclusion, I hope that the noble Countess will agree that we are sympathetic to the needs of patients with CFS/ME. I appreciate, as do other noble Lords, her many concerns. I hope that I have reassured her that we are investing in improved services for CFS/ME patients and in an expanded research programme—noble Lords have emphasised the importance of research moving forward in this area—and that this should make a difference to the lives of the many people affected by this condition. That is the Government’s priority.

Committee adjourned at 6.25 pm.