(3 months, 2 weeks ago)
Lords ChamberMy Lords, the Government are working as closely as possible with the judiciary to reduce the backlog in the Crown Court as early as possible.
My Lords, more prisons are now in special measures than have been for some years, including flagship prisons such as Wandsworth. Reports on how they got into this position mention low morale, drug use, violence and some terrorist elements exercising control over prisons. While having sympathy with the Government in so far as they do not, in and of themselves, determine how many people are in prison, I ask: have we not reached the point where the system is in part broken? Therefore, we need a radical appraisal of how it is going to continue. With so many significant prisons now in special measures, it is perfectly clear that something is radically wrong with the whole system.
My Lords, there are certainly problems in some prisons, but the overall picture is by no means as painted. We have had major refurbishments at sites including HMP Birmingham, HMP Liverpool and HMP Norwich. Your Lordships may have seen the picture of Liverpool the other day in the papers. It was a most impressive refurbishment. Constructions of new houseblocks at four prisons are going on; we have opened HMP Fosse Way and HMP Five Wells. I would encourage noble Lords to visit those very modern and effective prisons. We now have outline planning permission for two more.
(2 years, 10 months ago)
Lords ChamberMy Lords, we are privileged to be in a position to have this debate, express the views of our conscience and have them listened to with respect. Sadly, this is something very rare in our community and we should cherish it.
We are legislators. Therefore, we have our personal belief systems—I was encouraged by the letter from the faith leaders which expresses my opinion—but we have to legislate not only for those who share our faith, but for those who have no faith and those who have other views. We have to look at things in the round. However, having participated in the previous debate in this House on this Bill, I believe the one glaring omission in our discussions is the huge impact of changing the relationship between the medical profession and the public, on which this legislation would have a negative effect.
We seem to have a rose-tinted view of what is going on and what is likely to happen in the NHS if this legislation were to be enacted. Patients sometimes have more than one condition. They are served by numerous medical teams and consultants. Therefore it is hard to understand which medical consultant would make a judgment. Could they make a judgment? The medical profession cannot predict accurately the time of a person’s death. We have been telling stories; I will tell one. Earlier this year, a very good friend of my family was sent home in the late spring and given seven days to live. This week, she entertained members of my family in her own home and is hoping to do so again next week. We simply do not know.
As has been said in this debate, between one-quarter and one-third of the population wait for more than 12 months to see a specialist or a consultant. Where are these people coming from to make these judgments? After all the years of trying, which I absolutely respect, none of us knows what our end will be, but after all these years of this legislation—or versions of it—coming to this House, no solution has been found or mechanism put in place significantly to deal with these issues. They are just not there because in many cases it is impossible. If the Bill goes forward to further stages, it will be subject to a massive number of amendments. I oppose the principle of the Bill, which is what we are supposed to be debating today, because of my personal belief system, but I understand that the views of others have to be taken into account.
(8 years, 1 month ago)
Lords ChamberIt is very difficult to refuse the noble Lord anything. I will, of course, speak to my ministerial colleague and try to ensure that appropriate meetings take place when they can.
My Lords, is the Minister aware that the Channel Islands and the Isle of Man have specific relations with the Irish Republic through our treaties that were developed as part of the peace process in 1998, and that those relationships would need to be dealt with separately, as well as the relationships with the rest of the European Union? Are the Government aware of the significance and sensitivity of these relationships, and that they should be preserved at all costs?
The noble Lord identifies one of an immensely complicated set of relationships which need to be considered in the renegotiation. I accept that this is a matter that ought to be communicated to those with responsibility for the negotiations.
(9 years, 2 months ago)
Lords ChamberMy Lords, it is interesting where the applause for that comment came from. At this late stage in the evening, it is hard to say things that are unique, but I welcome the noble Lord, Lord Dunlop, to the Front Bench, with the unbounded enthusiasm that we will no doubt knock out of him as time goes on.
The noble Lord, Lord Norton of Louth, pointed out that this year we will have a Scotland Bill, a Wales Bill and a Northern Ireland Bill. If that sounds familiar, it is because last year we had a Scotland Bill, a Wales Bill and a Northern Ireland Bill. It is immediately obvious to everybody that we have a Lego kind of constitution, which we are putting bits into and pulling bits out of as we go along, and there appears to be no overarching plan. This is very disturbing.
The convention that has been lobbied for is one model. I think that my noble friend Lord Trimble and I are the only Members of this House who were members of an elected constitutional convention. That happened many years ago and was a great success, was it not? It took another 20-something years to get to the point where we had an agreement. However, whether it is a convention or a commission or the Lord Chancellor appoints an advisory group or whatever—I would not be precious over the methodology—we need to have constitutional coherence in our policies in this country, which unfortunately is missing. We understand the vagaries of the political process and why it is the way it is. Things have happened—Macmillan famously commented, “Events, dear boy, events”—and we have been reacting to events. We are not directing events, we are not controlling events, and we are sadly not influencing events, which is a matter of grave concern.
I shall turn briefly to the devolution side of things, because obviously we watch with very great concern what is going on in Scotland. I have no doubt that in his demure, quiet and diplomatic fashion the noble Lord, Lord Foulkes of Cumnock, who follows me, will have a word or two to say on that. I believe that we are in severe difficulties, because ironically Nicola Sturgeon said that if a referendum were held on the European Union, all parts of the United Kingdom would have to tick the box to say yes. I did not see her go on to say that in the European Union if decisions had to be taken every part of the European Union would have to tick the box, because that is a totally different argument. We are not dealing properly with the Scottish question. We got so many things wrong. The question was wrong, the timing was wrong and the campaign was wrong. Everything was wrong, and we are reeling from that. As many Scottish noble Lords have said, we need to rethink our position.
My part of the country is Northern Ireland. As one of those who were able to assist my noble friend Lord Trimble in getting the devolution settlement in 1998, I am deeply disappointed at the way things have gone. I always felt that we could use the devolved Administration to do something different on behalf of the people. We are gradually reaching the tipping point where if things go on as they are at Stormont, one will be unable to say that it is helping the people of Northern Ireland. We are very close to that.
One of the reasons, and a mistake that we are making in devolution generally, is the idea of “legislate and forget”: in other words, we draw up a piece of legislation, devolve the issue and Westminster walks away. That is a mistake. It was made in 1921. If Westminster had kept an active interest in what was happening in Northern Ireland and if it keeps an active interest in Scotland and Wales, we will avoid problems. “Legislate and forget” does not work. It merely reinforces what I have said before in this House: that devolved Administrations become ATM machines, the local politicians spend the money, and if there is not enough of it the evil legislators in London are responsible. We are not linking this Parliament to the money and to the people there. I am for devolution, but it has to be within a context and not simply, “Hand over and then forget about it”. That would be a mistake.
Sadly, we are now facing another crisis at home. We have a Bill which the Minister has announced to implement the Stormont House agreement. As we stand here tonight, there is no Stormont House agreement. I hope that will change tomorrow when the leaders meet the Secretary of State and the Irish Government, and I wish them well, but I fear another press-gang coming along looking for more money. That is the mechanism that Sinn Fein has used to disguise the fact that what it is really doing in reneging from the Stormont House agreement is trying to protect its electoral interest in the Republic of Ireland next year, and it is prepared to sacrifice the interests of ordinary working people in Northern Ireland. We are losing at least £2 million a week, which is being taken out of our budget because of the failure to implement the agreement, and not only that: we are losing far more in what could flow from the Stormont House agreement. Hundreds of millions of pounds are being lost.
It is not purely down to the welfare issue. Sadly, I have to say, it is down to gross financial mismanagement by Stormont over a number of years. It was given its budget for the year ending March this year in October 2010, and this year’s budget in June 2013. Until the crisis last autumn, no action was taken to get the expenditure to meet the budget. For the first time since 1921, Stormont was about to default and had to go to the Treasury to get this Wonga loan to try to bail it out for this financial year, otherwise it would have defaulted. Now it is back in another mess. Not only is it not fully implementing the welfare but it is now borrowing hundreds of millions of pounds to pay off 20,000 workers, when it should have been gradually running the thing down over a period of years at effectively no cost because it would have been natural wastage. The reductions it is asking the Civil Service to make have not been made. It keeps asking it do more but then puts forward schemes to pay its employees off. It is paying them off, but at the moment it is only being allowed to borrow the money to do that. Now, because of the Stormont House agreement, it is not able to do that, so all those people have applied for a scheme that is currently endangered.
The voluntary and community sector is in an even worse position: some of the people have not had money for months because nobody knows what the budget is. That sector is doing such good work. It makes up 5% of the Northern Ireland economy and represents some of the most vulnerable people, yet it is living from hand to mouth. Some of the people who work for those organisations are in tears because they do not know what their future is and the money is locked up. That is not good governance.
I have to ask the Minister, and I hope he addresses this in the wind-up, whether more money is going to be paid to the parties, should they come here looking for it, or whether what we have in the Stormont House agreement is a solid figure that has to be stuck to. That is a fundamental question, and if we do not know the answer to that, what happens tomorrow may happen under false pretences. People need to know that and hear that. I hope that it works tomorrow, although I have my doubts.
The point I would like to emphasise and close on is this: we should not turn our backs on the institutions devolved from this Parliament. That was a mistake that was made before, and if we keep on going the way we are going we will repeat the same mistake again. I hope we will not do so, given the Scottish example. We need to fight for the union. We need to sell the case for the union and for togetherness, and to re-establish some British identity. I do not look upon myself as a separate unit that has floated off somewhere else. That is not what the union means to me. The whole purpose of it has to be set out clearly and articulated with some enthusiasm, and not simply left to others to articulate. I therefore ask the Front Bench to bear those things in mind.
Finally, I also ask the Front Bench to pay close attention to my noble friend Lord Bew, who made some excellent points. There are those who are trying to rewrite history. The number of victims whose names we never hear have just as much a case as those who happen to have support groups to push their case. If we go on trying to dig and tear at those scabs for ever, we will never get the peace that we seek and deserve.
(9 years, 7 months ago)
Lords ChamberMy Lords, the point has been made, as though this closes the need for a definition, that a definition in the form DS 1500, which the noble Lord, Lord Warner, and many others have referred to, has already been passed by Parliament. I merely want to say that the need for precision when it is a question of providing social services benefits in cash or in kind is much less demanding than the need for precision when the question is pulling the plug on somebody’s life. Therefore, it is not unreasonable to return to this issue.
My Lords, one is reluctant to become involved in a debate when so many noble Lords with senior medical and legal experience have been putting forward their interpretations. However, I want to deal with a couple of matters. With this amendment, the noble Lord, Lord Carlile, is clearly adding that a medical practitioner will have to have significant knowledge of the patient.
I want to speak on this issue because I feel that the Achilles heel of the whole Bill is that it is built on sand. It works only on the assumption that the medical profession will deliver it, whereas it is obvious to most of us that the vast majority of the medical profession do not want to deliver it. That leads us to what may be the essential contradiction or conflict in the amendment. A number of noble Lords have said that specifying six months would be an overburdensome requirement. Therefore, we have the dilemma that either you have a medical practitioner who knows the patient, knows the condition and knows how that patient is likely to react to certain drugs, or you have a complete stranger who comes in and makes a judgment on the spot, having read a medical file. I fear that a rent-a-doctor procedure will develop and will distil down to those who are prepared to do it, and that, in my view, will create a whole series of new problems.
I want to raise another point regarding these amendments. We talk about having conversations, discussions and processes. I represented an inner-city constituency for more than 25 years and my question is: with whom and at what time are people going to have these discussions, conversations and processes? At the moment, nurses hardly have time to feed patients on their ward, let alone to involve themselves in very complicated and difficult conversations, discussions and processes.
Therefore, looking at the modern-day NHS and all the pressures that it is under, to some extent we are adding a further pressure without the active support and consent of the medical profession. Also—this is the one thing that I worry about more than anything else—we are changing for ever the potential relationship between a doctor and a patient. In an inner-city area, the ordinary person will say, “Oh, here comes Dr Death. How can that person help me on the one hand and put my lights out on another?”. I fear that that is how this will be distilled down to street level.
In the amendment, the noble Lord is clearly trying to put in place the safeguard that the patient will at least be dealt with by somebody who knows him or her. I understand that and accept the rationale for it. However, there are practicalities, which have been raised by others. With inner-city practices, it is hard enough to get the patient to go to a doctor in the first place, but if they think that that doctor could at some point in their lives, as they would say, sign them off, will the amendment achieve the worthy objective for which it is meant?
The word “control” has been used a number of times. I think the noble Baroness, Lady Meacher, and others used it. One can see that people would want to have control over their lives. It could happen to any of us. But in the real world out there, many people who are seriously ill may not have the means. They do not have access to the courts, money or knowledge. Control may be all right for those of us in this House, but it is not always available to the ordinary person in the street. That is where I believe there is a fundamental weakness in this. Without the act of involvement of the medical profession who really want to do something, we are forcing them into a corner. It will inevitably boil down to a handful of doctors who will go around the country signing off people they do not know.
The noble Lord made some cogent points in relation to this group of amendments. He made me wonder whether he thinks the solution may be that the discussions could happen earlier but the provision of the assistance to end life should be much later. The timeframe could change. Discussion of whether someone is terminally ill could start much earlier, and could therefore take more time, but the delivery of the lethal drugs could happen much later. For clarity, they are not morphine or heroin. The drugs are a massive overdose of barbiturates, which is completely different and would never be used therapeutically. That is the way that you end people’s lives under the Oregon and other legislation. That might be a solution. I also ask the noble and learned Lord, Lord Falconer of Thoroton, whether he would consider that type of solution in looking again at the clause.
Those are things that we have to probe in Committee. That is what Committee is for. The amendment of the noble Lord, Lord Carlile, has many worthy objectives. If the proposal that the noble Baroness, Lady Finlay, has just enunciated works, and if the professionals who know their business feel that it is more helpful, that is terrific. That is exactly what this Committee is for. I therefore commend what she said.
My Lords, I wanted to make exactly the same point as that made by the noble Baroness, Lady Finlay. I will not repeat it, but I ask my noble and learned friend to consider carefully the point that she just made about the actual timing of giving any drugs that would terminate life.
I wanted to make one other small point about something that the noble Lord, Lord Warner, said earlier about thinking that doctors were overoptimistic about survival rates. My own experience of this, which the noble Lord, Lord Carlile, referred to at the beginning of this debate, was exactly the reverse of that. Right at the beginning of a very late diagnosis of leukaemia, my husband was told that there was only a 20% survival rate for that form of leukaemia and he was unlikely to be in that 20% because of the late diagnosis. Five years later, he received a letter, having gone through the dark hours of the night wanting to end his life in very much the way that the noble Baroness, Lady Campbell, alluded to in others but has obviously steadfastly and gallantly resisted herself. The letter said that, in fact, the survival rate had not been 20%, as he had been advised, but 47%—more than double what the survival rate was meant to be.
I simply make the point that terminal illness is hard to define, whatever we put into legislation. The fact is that medical science is moving fast, particularly in the treatment of cancer. These definitions are enormously difficult and I would ask noble Lords to reflect on the fact that survival rates can be very much higher after a relatively short period of time.
(10 years, 1 month ago)
Lords ChamberMy Lords, sometimes we perhaps overestimate our ability to bring about events. Everybody wants to see suffering diminished, but this House cannot end suffering. We cannot bring an end to suffering; we cannot bring an end to poverty. Therefore, what is it that we are trying to do? We are trying to help; we are trying to bring, I suspect, the best that we can do in the legislative framework to help the human condition. But we are requiring a specific group of people to do it in this Bill. We are requiring the medical profession in the broadest sense to be the people who implement what is proposed in the Bill.
Two weeks ago today, I had the privilege of attending a graduation ceremony, at which my daughter was graduating in medicine, along with 300 other students. It was a great privilege to see those young people, who had put five years of their lives behind the idea that they could go out into the world to help and bring healing to many people for the rest of their lives. Those people have not been taught or trained in how to bring life to an end.
I come from a region where we have seen the long-term consequences of asking a group of people to do a specific job, such as protect the community. Many years later—and we shall see this with our troops in Afghanistan—those people began to show the symptoms of post-traumatic stress. I fear that asking a very small group of our community to carry out something that is almost the very antithesis of what they have been trained for could, in the long term, have serious consequences for those individuals. I just do not believe that it is possible to bring precision, however well meaning it might be, to this situation.
We have 14 days, six months, six days, two doctors and one health professional: what does all that mean? It means that, ultimately, some doctors will specialise in nothing else because so many will not do it. I fear that we have not thought through the consequences for the health professionals who will be at the sharp end of this. However much any of us could face, we do not know what we will face.
It is not only older people who will be affected by the Bill. Many young people will find that they have conditions that become terminal. We must think through what it means for the people we ask to implement this legislation. They will be the people at the sharp end. Have we really thought through the consequences? What will we teach them in university in a few years’ time? What will we be training them for? It will be the opposite of and go against the atmosphere of hope that I was privileged to see two weeks ago. Will we damage that and, ultimately, damage those young people?