House of Lords: Reform

Lord Hill of Oareford Excerpts

Wednesday 6th February 2013 Lords Chamber

[Lord Howarth of Newport]

To ask Her Majesty’s Government whether they intend to proceed with any reforms to the composition of the House of Lords.

[The Chancellor of the Duchy of Lancaster (Lord Hill of Oareford)]

My Lords, as noble Lords know, the Government have no further plans for legislation to reform this House in this Parliament.

[Lord Howarth of Newport]

My Lords, given that the House of Commons has made it absolutely clear that it will not tolerate the challenge to its primacy of an elected second Chamber, given the Deputy Prime Minister’s sensible acknowledgement that the best is the enemy of the good and given the undesirability in the interests of good government that the question of Lords reform should overshadow the next Parliament, will Ministers introduce legislation in this Parliament to enable us to resolve the issues of how Members are to be appointed to the House of Lords, the future size of the House, how the balance between the political parties, the Cross Benches and the Lords spiritual is to be determined, the future of hereditary membership and life peerages, and provision for retirement and disqualification, all of which need to be resolved and upon which sufficient consensus could be achieved?

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[Lord Hill of Oareford]

Having picked my way around this landscape over the past few weeks and having had the chance to talk to and understand the concerns of many noble Lords, I am not sure that it would be as easy to secure consensus as the noble Lord, Lord Howarth of Newport, suggests. He is clearly a great optimist if he believes that that is the case not only in this House but between this House and the other place. I obviously understand the points that many noble Lords raised about some of these issues that we discuss but, in the light of last year’s debate and the views that the Deputy Prime Minister has made clear, there is no prospect of further legislation for those issues that would require legislation.

[Lord Laming]

Bearing in mind the financial situation and the concerns expressed all round about the impact of that on the poorest people in our society, does the Leader of the House agree that it would not enhance the reputation of this House for public funds to be used to encourage people to give up the privilege of serving in this House?

[Lord Hill of Oareford]

I agree personally and in principle with the point raised by the noble Lord, Lord Laming. When the rest of the country is facing huge economic challenges, as the noble Lord said, to spend taxpayers’ money in such a way would be difficult, but I also agree with the underlying point of principle, which is that it is an honour and a privilege to serve in this House, and the idea that if one ceased to want to fulfil that honour and privilege, one would need to be compensated financially, sits oddly with the principle it serves.

[Lord Forsyth of Drumlean]

My Lords, in his role as Leader of the House and as the representative of this House in Cabinet, will my noble friend take the opportunity to draw to the attention of the Prime Minister the article in today’s Times by the Lord Speaker, and impress on him that it represents the feelings of the vast majority of people in this House? Further, will he talk to the Deputy Prime Minister and say to him that his refusal to allow the Steel Bill to go forward is unacceptable, given the strength of feeling shown in both Houses about the size of the Houses of Parliament and the importance of getting value for taxpayers’ money?

[Lord Hill of Oareford]

My Lords, I am sure that all the points that have been raised in this debate are being seen by my colleagues in the Cabinet, including by my right honourable friends the Prime Minister and the Deputy Prime Minister. I understand the points raised about the size of this House. It is important to have the ability to refresh the House, bring in new talent and draw on the expertise for which this House is rightly renowned. One of the reasons why I was particularly keen to do this job is because I saw as a Minister the difference between this House and another place in terms of the quality of the scrutiny that this House provides, and it is extremely important that we should carry on having the Members to enable us to do so.

[Baroness Hayman]

My Lords, will the Leader reconsider the pessimism implicit in his original reply? It is intolerable that the failure of the Government’s plans for an elected House should stand in the way of progress on a reform agenda that is widely supported and which is urgently needed for the reputation of this House. The noble Lord could do the House a great service by championing that reform agenda, as the noble Lord, Lord Forsyth, said. Will he undertake so to do?

[Lord Hill of Oareford]

My Lords, I hope that I can always be a champion of this House, about which I feel extremely strongly. On the point about me being a pessimist, I like to think that I am an optimist. I am optimistic about this House, about its future and about the contribution that it makes to our national debate. I have, though, to be realistic about the consequence of the debate and the votes that took place. We know that the other place said at some point that it was in favour of an elected House; it did not then will the means for that to happen. Given where we got to last October, I am not a pessimist but I am realistic.

[Lord Steel of Aikwood]

Is the Leader of the House aware that following consultations with the Chief Whip, and as he rightly advised me, I postponed the Motion that I was to bring forward stopping further introductions until 28 February, which is the day before my Bill is next due to be blocked by the government Whips in the House of Commons. It would helpful if he, I and others could use the intervening time to try to persuade the powers that be at the other end that this is really a housekeeping measure purely affecting the Lords that we would like them to be nice enough to send back to us.

[Lord Hill of Oareford]

I understand that point. I have great respect for the noble Lord, Lord Steel, and am glad that I have already had the chance to discuss his proposals with him and others. I would be happy to do so again. He, I am sure, can use his powers of persuasion with colleagues in his own party, including the Deputy Prime Minister. I know that he will try and we will then see how we get on.

[Lord Hunt of Kings Heath]

My Lords, I would like to take him back to his first Answer. He suggested that it would be difficult to get a consensus in your Lordships’ House on interim changes. Why does he not put it to the test? There are various groups meeting at the moment in this House discussing these matters. There is a great deal of consensus. Why does he not call those groups together, or have a Leader’s Group, to see if we can make progress when there is a clear and huge majority of your Lordships’ House in favour of making sensible interim changes?

[Lord Hill of Oareford]

Again, the noble Lord says there is a lot of consensus around this. The conversations I have had with people so far do not bear out that optimistic gloss. I am keen to talk to Members of this House who have views, and that is something I will continue to do.

Mid Staffordshire Foundation Trust Inquiry

Lord Hill of Oareford Excerpts

Wednesday 6th February 2013 Lords Chamber

[The Chancellor of the Duchy of Lancaster (Lord Hill of Oareford)]

My Lords—

[Lord Campbell-Savours]

My Lords, will the Minister make it clear that brief interventions are required? Otherwise not everyone will be heard.

[Earl Attlee]

The noble Lord has taken the words out of my mouth.

[Lord Hill of Oareford]

My Lords, with the leave of the House I will now repeat a Statement made earlier in another place by my right honourable friend the Prime Minister. The Statement is as follows:

“Today Robert Francis has published the report of the public inquiry into the Mid Staffordshire NHS Foundation Trust.

Mr Speaker, I have a deep affection for our National Health Service. I will never forget all of the things doctors and nurses have done for my family in times of pain and difficulty. I love our NHS. I think it is a fantastic institution and a great organisation that says a huge amount about our country and who we are. I always want to think the best about it. I have huge admiration for the doctors, nurses and other health workers who dedicate their lives to caring for our loved ones.

Nevertheless, we do them—and the whole reputation of our NHS—a grave disservice if we fail to speak out when things go wrong. What happened at Mid Staffordshire NHS Foundation Trust between 2005 and 2009 was not just wrong, it was truly dreadful. Hundreds of people suffered from the most appalling neglect and mistreatment. There were patients so desperate for water that they were drinking from dirty flower vases. Many were given the wrong medication, treated roughly, or left to wet themselves and then to lie in urine for days. Relatives were ignored or even reproached when they pointed out the most basic things which could have saved their loved ones from horrific pain or even death. We can only begin to imagine the suffering endured by those whose trust in our health service was betrayed at their most vulnerable moment. That is why I believe it is right to make this Statement today.

There was a healthcare commission investigation in 2000; a first independent inquiry from Robert Francis in February 2010; and, long before that, the testimony of bereaved relatives such as Julie Bailey and the Cure the NHS campaign. They all laid bare the most despicable catalogue of clinical and managerial failures at the trust. But even after these reports, some really important questions remained unanswered. How were these appalling events allowed to happen and how were they allowed to continue for so long? Why were so many bereaved families and whistleblowers who spoke out ignored for so long? Could something like this ever happen again? These were basic questions about wider failures in the system—not just at the hospital but right across the NHS, including its regulators and the Department of Health. That is why the families called for this public inquiry and that is why this Government granted one. I am sure that the whole House will want to join with me in expressing our thanks to Robert Francis and his entire team for all their work over the past three years.

The inquiry finds that the appalling suffering at Mid-Staffordshire hospital was primarily caused by a “serious failure” on the part of the trust board, which failed to listen to patients and staff and failed to tackle what Robert Francis calls “an insidious negative culture involving a tolerance of poor standards and a disengagement from managerial and leadership responsibilities”. But the inquiry finds that the failure went far wider. The primary care trust assumed that others were taking responsibility and so made little attempt to collect proper information on the quality of care.

The strategic health authority was “far too remote from the patients it was there to serve, and it failed to be sufficiently sensitive to signs that patients might be at risk”. Regulators, including Monitor and the then Healthcare Commission, failed to protect patients from substandard care. Too many doctors “kept their heads down” instead of speaking out when things went wrong. The Royal College of Nursing was “ineffective both as a professional representative organisation and as a trade union”, and the Department of Health too remote from the reality of the services that they oversee.

The way Robert Francis chronicles the evidence of systemic failure means we cannot say with confidence that failings of care are limited to one hospital. But let us also be clear about what the report does not say. Francis does not blame any specific policy; he does not blame the previous Secretary of State for Health; and he says we should not seek scapegoats. Looking beyond the specific failures that he catalogues so clearly, I believe we can identify in the report three fundamental problems with the culture of our National Health Service.

The first is a focus on finance and figures at the expense of patient care; Francis says that explicitly. This was underpinned by a preoccupation with a narrow set of top-down targets pursued in the case of Mid Staffordshire to the exclusion of patient safety or listening to what patients, relatives—and indeed many staff—were saying.

Secondly, there was an attitude that patient care was always someone else’s problem. In short, no one was accountable. Thirdly, he talks about defensiveness and complacency. Instead of facing up to and acting on data which should have implied a real cause for concern, Francis finds, all too often, a culture of explaining only the positives rather than any critical analysis. Put simply, managers were suppressing inconvenient facts in favour of looking for comfort in positive information.

That is one of the most disturbing findings. It is bad enough that terrible things happened at that hospital, but this inquiry is telling us is that there was a manifest failure to act on the data available not just at the hospital but more widely. As Francis says:

“In the end, the truth was uncovered … mainly because of the persistent complaints made by a determined group of patients and those close to them”.

The anger of the families is completely understandable. Every honourable Member in this House would be angry—furious—if their mother or father were treated in this way, and rightly so.

The previous Government commissioned the first report from Robert Francis and, when he saw that report, the former Secretary of State, now the shadow Health Secretary, was right to apologise for what went wrong. This public inquiry not only repeats earlier findings but also shows wider systemic failings, so I would like to go further as Prime Minister and apologise to the families of all those who have suffered for the way that the system allowed such horrific abuse to go unchecked and unchallenged for so long. On behalf of the Government—and indeed our country—I am truly sorry.

Since the problems at Mid Staffordshire Hospital first came to light, a number of important steps have been taken. The previous Government set up the National Quality Board and the quality accounts system. This Government have put compassion ahead of process-driven bureaucratic targets and put quality of care on a par with quality of treatment. We have set that out explicitly in the mandate of the NHS Commissioning Board, together with a new vision for compassionate nursing. We have introduced a tough new programme for tracking and eliminating falls, pressure sores and hospital infections, and we have demanded nursing rounds every hour, in every ward of every hospital.

However, it is clear that we need to do more. We will study every one of the 290 recommendations in today’s report and respond in detail next month, but the recommendations include the three core areas—patient care, accountability and defeating complacency—on which I believe we should make more immediate progress. Let me say a word about each.

The first is how we put patient care ahead of finances. Today, when a hospital fails financially, its chair can be dismissed and the board suspended, but failures in care rarely carry such consequences. That is not right. We will create a single failure regime where the suspension of the board can be triggered by failures in care as well as failures in finance, and we will put the voice of patients and staff at the heart of the way that hospitals go about their work.

In Mid Staffordshire, as far back as 2006, there was a survey in which only about a quarter of staff said that they would actually want one of their own relatives to use the hospital they worked in. During the following two years, bereaved relatives produced case after dreadful case and campaign after chilling campaign, but those voices and horrific cases were ignored. Indeed, the hospital was upgraded to foundation trust status during that period. We need the words of patients and front-line staff to ring through the boardrooms of hospitals and beyond to the regulators and the Department of Health itself.

From this year every patient, every carer, every member of staff will be given the opportunity to say whether they would recommend their hospital to their friends or family. This will be published and the board will be held to account for its response. Put simply, where a significant proportion of patients or staff raise serious concerns about what is happening in a hospital, immediate inspection will result and suspension of the hospital board may well follow.

Quality of care means not accepting that bed sores and hospital infections are somehow occupational hazards and that a little of them is somehow okay. They are not okay. They are unacceptable—full stop, end of story. That is what zero harm means. I have asked Don Berwick—who has advised President Obama on this issue—to make zero harm a reality in our NHS.

Francis makes other recommendations. Today, you can give hands-on care in a hospital ward with no training at all. Francis says that that is wrong, and I agree. Some simple but profound things need to happen in our NHS and our hospitals. Nurses should be hired and promoted on the basis of having compassion as a vocation, not just academic qualifications. We need a style of leadership from senior nurses which means that poor practice is not tolerated and is driven off the wards. Another issue is whether pay should be linked to quality of care rather than just time served at a hospital. I favour this approach.

Secondly, there is accountability and transparency. The first Francis report set out clearly what happened within Stafford hospital. It should have led to those responsible being brought to book by the board, the regulators, the professional bodies—and, yes, even by the courts. But this did not happen.

Most people will want to know why on earth not. We expect hospitals to take disciplinary action against staff who abuse their patients. We expect professional regulators to strike off doctors and nurses who seriously breach their professional codes, and, yes, we expect the justice system to prosecute those suspected of criminal acts, whether they take place in a hospital or anywhere else. In Stafford, these expectations were badly let down. The system failed. That is one of the main reasons we needed this inquiry.

Now that the recommendations about systemic failure are public, the regulatory bodies in particular have difficult questions to answer. The Nursing and Midwifery Council and the General Medical Council need to explain why, so far, no one has been struck off. The Secretary of State for Health has today invited them to explain what steps they will take to strengthen their systems of accountability in the light of this report, and we will ask the Law Commission to advise on sweeping away the Nursing and Midwifery Council’s outdated and inflexible decision-making processes.

The Health and Safety Executive also needs to explain its decisions not to prosecute in specific cases. Indeed, Robert Francis makes a strong argument that the executive is too distant from hospitals and not the right organisation to be focusing on healthcare and criminal prosecutions in such cases. We will look closely at his recommendation to transfer the right to conduct criminal prosecutions from the Health and Safety Executive to the Care Quality Commission.

Thirdly, we must purge the culture of complacency that is undermining care in our country. This requires a clear view about what is acceptable and what is not. In our schools, we have a clear system of deciding whether a school has the right culture and whether it is succeeding or failing. It is a system based on the judgment of independent experts, who walk the corridors of the school and analyse more than just statistics. The public therefore know which schools near them are outstanding and which are failing. They have a right to know the same about our hospitals. We need a hospital inspection regime that does not just look at numerical targets but examines the quality of care and makes an open, public and explicit judgment.

So I have asked the Care Quality Commission to create a new post—a Chief Inspector of Hospitals—to take personal responsibility for this task. I want the new inspections regime to start this autumn. We will look at the law to make sure that the inspector’s judgment is about whether a hospital is clean, safe and caring, rather than just an exercise in bureaucratic box-ticking. In the mean time, I have asked the NHS Medical Director—Professor Sir Bruce Keogh—to conduct an immediate investigation into care at hospitals with the highest mortality rates and to check that urgent remedial action is being taken.

Complacency in the system has meant that all too often, patient complaints have been ignored. I am today asking the honourable Member for Cynon Valley and the Chief Executive of South Tees Hospitals NHS Foundation Trust, Tricia Hart, specifically to advise how hospitals in the NHS should handle complaints better in future.

I have talked today about some of the systemic failures, but at the heart of any system are the people who work in it and the values and vocation that they hold. As Francis says early on in his report, and it is worth me quoting in full:

‘Healthcare is not an activity short of systems intended to maintain and improve standards, regulate the conduct of staff, and report and scrutinise performance. Continuous efforts have been made to refine and improve the way these work. Yet none of them, from local groups to the national regulators, from local councillors to the Secretary of State, appreciated the scale of the deficiencies at Stafford and, therefore, over a period of years did anything effective to stop them’.

What makes our National Health Service special is the very simple principle that the moment you are injured or fall ill, the moment something happens to someone you love, you know that whoever you are, wherever you are from, whatever is wrong, however much you have in the bank, there is a place you can go where people will look after you and do everything they can to make things right again. The shocking truth is that this precious principle of British life was broken in Mid Staffordshire. We would not be here today without the tireless campaigning of the families who suffered so terribly, and I am sure that the whole House will join with me in paying tribute to their incredible courage and determination over these long and painful years.

When I met Julie Bailey and the families again on Monday, she said to me that she wanted the legacy of their loved ones to be an NHS safe for everyone. That is the legacy that together we must secure. I commend this Statement to the House”.

My Lords, that concludes the Statement.

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[Lord Hill of Oareford]

My Lords, I am grateful for the way in which the noble Lord, Lord Hunt of Kings Heath, put his questions and responded. I agree with what he said at the outset about the NHS representing the best values of our country, his important point that these awful things are not typical of everything that goes on, and that there are many hundreds of thousands of people delivering great care. He is right to remind us of that but also right to be clear, as he was, that together we need to face up to the problems that this extremely important report from Mr Francis has uncovered. I also take the noble Lord’s point, which the Francis report mentions, about the dangers of over-frequent reorganisation. All parties need to be conscious of that, and I think that all politicians are sometimes guilty of it. One of the great lessons of all systems is that the simpler and more stable one can keep them, the better the framework in which people have to operate.

I agree with the noble Lord about the importance of patients having a strong and independent voice. I think that is the way he put it. I certainly know from the world of education that it is hugely important to find ways to ensure that parents and those who care and have to use the services can plug into the system and can help to hold those services to account, and the findings in the Francis report underline the effort that we need to make to ensure that that happens.

On the noble Lord’s specific question about Healthwatch, I know that my noble friend Lord Howe spoke yesterday evening about some of the ways in which we are trying to strengthen the role and voice of patients and the public through local Healthwatch. We are determined to ensure that local Healthwatch can act as an independent and powerful voice for patients in local areas, and we are creating Healthwatch England so that there is a national voice for patients as well. I agree with him about the importance of that.

I also agree with the noble Lord’s emphasis on having compassion at the heart of medicine. Again, that point came out of the Francis report.

On the question of skills, numbers and finances, the noble Lord is right to say that that question was put to my right honourable friend the Prime Minister by the Leader of the Opposition earlier on. My right honourable friend said that he believes that the resources that are going into the health service, which are increasing, are in place. I agree that we have to ensure that every ward has the right mix and number of doctors, nurses and healthcare assistants so that staff have the time and the skills to ensure that they are providing safe and effective care. I believe that the recent nursing vision, Compassion in Practice, set out new measures to help to ensure that locally, but I know that my right honourable friend the Health Secretary will study the report to see whether there are other steps that may need to be taken.

On the subject of the chief inspector, again there is an analogy with schools. Having a figure that we can identify as a champion of standards is going to be a good step forward. He or she will be part of the CQC. The precise process by which they operate will need to be sorted out in detail over the days and weeks to come, but obviously we will share that with the noble Lord and other interested Peers.

On the noble Lord’s question about the National Patient Safety Agency, I understand that that was merged into the Commissioning Board to try to make safety integral to the commissioning of care. We need to ensure that happens.

On the merging of Monitor and the CQC, another important question, the noble Lord asked for reassurance that a decision on that has not already been taken. I can say to him that it has not. We have already made clear that we aim to create more generally a single failure regime under which organisations can be held accountable for failures in care, as well as with their finances. Francis’s recommendation to merge those two organisations is one that we will consider. There are clearly questions about the balance between making sure that quality is high and money.

On the noble Lord’s important question about the registration and training of healthcare assistants, we are certainly committed to supporting healthcare assistants and support workers to provide proper, compassionate and safe care. We will take Francis’s recommendations seriously, but the report in another place also points out, rightly, that compulsory statutory regulation does not necessarily prevent poor care, and that cultural issues—one of the recurring themes of the report—are indeed central.

The noble Lord asked about the effect on the quality of care of the process of moving to foundation trust status. Like the previous Government, we believe that foundation trusts can make our hospitals more accountable and responsible and better able to take decisions. However, the move to trust status for Mid Staffs was at the expense of patient care, and that was clearly wrong. I agree with the noble Lord that it is a move that must not be rushed and that patient care must come first. In answer to his question: yes, there will be no pressure. The essential requirement is that they be ready.

In response to the noble Lord’s question about targets, I accept—and this is clearly the case in all sorts of areas—that there is a place for sensible targets. We also know and accept that if we have the wrong targets, or too many of them, there is sometimes the danger of perverse incentives and confusion as well. As the noble Lord said, getting that balance right is extremely important.

On integrated services, it is important to make sure that we are able to look across the piece, and that there are not the barriers that he described. Of course I recognise the amount of interest in the subject. I know how much expertise there is here, and I am very happy to see whether we can find an opportunity for a fuller debate through the usual channels, which I think would be well received by noble Lords.

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[Baroness Jolly]

My Lords, we, too, welcome the Francis report, and the many recommendations that we believe will strengthen the whole NHS. In particular, we welcome Francis’s recommendation of a statutory duty of candour: the duty of a clinician to explain and apologise when things go wrong. When and how does my noble friend see this being implemented?

[Lord Hill of Oareford]

As my noble friend said, Robert Francis certainly recommended a statutory duty of candour, and my right honourable friend the Secretary of State will give full consideration to that. So far, he has said that he will work through all 290 recommendations in the report, and that the Government aim to give an initial response within a month. Precisely what the timeframe will be on all these elements, I cannot say. As my noble friend will know, in the interim we created legally binding rules that require the NHS Commissioning Board to insert a contractual duty of candour into the NHS standard contract in 2013-14. That means that NHS hospitals will be required contractually to tell patients when they have been significantly harmed by a patient-safety incident during their care. Otherwise, I take my noble friend’s point on board.

[Lord Campbell-Savours]

My Lords, the Statement says:

“every carer, every member of staff will be given the opportunity to say whether they would recommend their hospital to their friends or family. This will be published … where a significant proportion of patients or staff raise serious concerns about what is happening in a hospital immediate inspection will result and suspension of the hospital board may well follow”.

That is a very radical proposal. My question is very simple: will a member of staff making such a report have their name published, or will their contribution be anonymous? If it is not anonymous, this system will not work.

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[Lord Hill of Oareford]

I understand the noble Lord’s point. Like many things in this report, we will need to consider exactly how the details of the system will work. Generally, on whistleblowing and giving people the opportunity to make their views known, we have already taken steps to try to protect and support whistleblowers. We are funding a helpline to support them, we are embedding rights in their employment contracts, and we are issuing new guidance. We will be studying the report to see whether there are any further procedural or legal measures, and I hope that we will be able to provide more information to the noble Lord in due course.

[Baroness Knight of Collingtree]

My Lords, would that it were only the Mid Staffordshire hospital that was guilty of the kind of wrongdoing that we have been talking about tonight. My noble friend has made a wonderful, genuinely caring, speech about what has been happening and his determination to stop it. However, I feel very strongly about this, because I have tried for years and years, from 2002 onwards, to bring cases to this House. We should sometimes listen to people, here and in the other House, who bring cases before their House to be considered.

As many Members know, I produced a long document of 26 cases of the various bad treatment of patients. I went to endless trouble to make absolutely certain that every fact I put forward was correct, and that each patient for whom I pleaded had given me full permission to raise his or her case. The noble Lord, Lord Hunt, might remember the occasion when I went to him with a long and detailed dossier of these cases. It was certainly not his fault, but a number of those 26 cases were never investigated at all, and I never got an answer. I even tried to get through this House a parents’ protection Bill, which was quietly squashed at the time. My plea to my noble friend is that he also lets Members of Parliament, in one House or the other, be heard. They do not raise cases for fun but because of their feeling for the patients or relatives who have contacted them. I ask him please to listen in future, because what they say is of crucial importance.

[Lord Hill of Oareford]

I very much agree with the broad point that my noble friend is making. One of the recurring themes of the report is that whomever complaints came from—family or whoever—they were not being listened to. I am sure that my noble friend will have noted the part of my right honourable friend the Prime Minister’s Statement that announced that there will be a complaints review, which will be jointly led by Ann Clwyd MP—that makes the point about Parliament being involved in this process—and Professor Tricia Hart, chief executive of South Tees Hospitals NHS Foundation Trust. We need to make sure that we have these proper mechanisms and that where there are concerns, they are raised and listened to.

[Baroness Emerton]

The report calls for NICE to devise tools to calculate safe staffing levels, which have already been mentioned this evening. The evidence is growing. A group of senior nurses has come together to collect the evidence. The evidence base determines that safe and cost-effective care is determined by the safe levels of trained staff—registered nurses—to support workers. Will the noble Lord the Leader of the House be taking from this report that NICE will be devising tools to determine safe staffing levels as an urgent requirement because until we get them right, we are not going to see safe care delivery?

On the registration of support workers, one reads in the report that patients were suffering appalling neglect and mistreatment. Hundreds of people suffered from being given the wrong drugs because support workers were not trained. Please will the noble Lord take away the recommendation on the registration of support workers as a matter of urgency?

[Lord Hill of Oareford]

As I think I said in my earlier response to the noble Lord, Lord Hunt of Kings Heath, the registration of support workers is something that the Government will consider as part of their response to the Francis recommendations. We need to have well trained staff at all levels.

On the noble Baroness’s other point about ratios, I am sure that my colleagues in the Department of Health will reflect on what she said. Ultimately, decisions about staffing levels and so on need to be made locally, but I know that as part of this whole debate the department will be thinking in every way it can to try to make sure that all these sensible points are acted upon.

[Baroness Williams of Crosby]

My Lords—

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[Lord Harris of Haringey]

The noble Lord the Leader of the House has referred to the fact that there is now to be a contractual obligation of candour on healthcare organisations. Presumably Robert Francis was aware of that in framing his recommendations, feels that it is inadequate and is advocating a statutory duty of candour, which, so far, the Government have resisted. I hope that policy will change. The noble Lord the Leader of the House also talked about the importance of an independent voice for patients. Given the suggestion that has been made about merging Monitor and the CQC, will he accept that it is therefore inappropriate that Healthwatch England, the national voice of patients, should be subordinate to that monster new body? Secondly, does he also accept that it is inappropriate, if you are to have an independent voice, that local Healthwatch is subordinate to local authorities, some of the organisations that they are supposed to monitor?

[Lord Hill of Oareford]

On the duty of candour, I said in my response to the noble Lord’s noble friend that the suggestion about a statutory duty of candour is something that the Government will consider in their response to Francis. I pointed out that there is already a contractual duty in place, but I understand the point that he makes.

So far as Healthwatch England is concerned, I understand that that was debated at length. My noble friend Lord Howe is sitting here, and I am sure he will have heard the points that the noble Lord has made.

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Baroness Williams of Crosby: I have much to comment about on this front, and I am going to finish my sentence. We all need to be responsible and accountable for making sure that no Mid Staffs ever happens again. That means that we may not pass the burden of responsibility to and fro. We all have to accept our common responsibility, and if that means abandoning party statements, so much the better.

[Lord Hill of Oareford]

I agree about the theme, which I think we have all accepted, that there is a common responsibility. One of the themes of the report is that we should not seek to single out individuals or particular organisations for risk of not seeing the bigger picture which, as my noble friend said, is that there is a common responsibility.

[Lord Cormack]

My Lords, for some 35 years, my constituents in South Staffordshire had good healthcare from Stafford hospitals. It was only in this very bad period that we had these appalling stories, and we all feel ashamed. It is important to recognise that there was good healthcare before, and there must be after. In that context, will my noble friend assure me that all those appointed to boards of hospitals will receive adequate training about what their true responsibilities and powers are?

[Lord Hill of Oareford]

That is an extremely important point, and it is part of what the Government need to do in their response in ensuring that boards accept their responsibility and understand what it is. It is not just to do with running hospitals economically and efficiently; above all, it is to do with patient care.

[Lord Patel]

My Lords, I have questions relating to two areas in the Statement on which a decision has already been made. The first relates to the Prime Minister asking Sir Don Berwick to advise on zero harm. The noble Lord the Leader of the House did not answer the question asked by the noble Lord, Lord Hunt, about whether it is now the Government’s intention to re-establish the National Patient Safety Agency. I declare an interest as I was chairman of the National Patient Safety Agency for four years. I have worked with Sir Don Berwick in my hospital. The implementation of zero harm is possible in patient care in certain areas, but to implement it requires an organisation in every hospital and a national organisation to monitor it. How is it intended that that will happen? The second decision was to ask Sir Bruce Keogh, the medical director, immediately to investigate hospitals that have high mortality rates. That implies that we know which hospitals they are. Will the noble Lord the Leader comment on that? I hope that investigation will also include all higher mortality rates including still births, neonatal deaths and infant deaths.

[Lord Hill of Oareford]

My Lords, perhaps I responded elliptically to the noble Lord’s first point about whether we had plans to reintroduce the agency by saying that it had been merged. We do not have plans to reintroduce it. On his second question about Sir Don Berwick, it is for him now to work out how he will carry out his review and come back to us with his recommendations. On his third question about the immediate inquiry being carried out by Sir Bruce, mortality rates are the factor he will take into account in identifying the cases that would most benefit from his urgent attention.

[Lord Willis of Knaresborough]

My Lords—

--- Later in debate ---

[Lord Wills]

My Lords, I welcome the Minister’s emphasis on the importance of involving patients and their relatives more centrally in decisions about their own care. Does the Minister think that principle should be extended throughout the NHS, including the new policy on value-based pricing for new medicines?

[Lord Hill of Oareford]

I certainly take the point that that principle is one we need to apply in our response. As regards the specific question, my noble friend Lord Howe will follow up with the noble Lord.

[Lord Willis of Knaresborough]

My Lords, Francis quite rightly recognises the contribution made by healthcare support workers. He makes seven recommendations about how they should be included within a reinvigorated National Health Service. The report makes the claim that healthcare support workers have to be properly trained to appropriate standards. I want to ask the Leader of the House two questions. First, will those standards be set independently, by the NMC or another body, and not the department? Secondly, will he guarantee to the House tonight that, whatever those standards are, the training will be mandatory, not an optional extra?

[Lord Hill of Oareford]

My Lords, at the moment I cannot give the specific assurance my noble friend would like because the Secretary of State for Health has to look at all the recommendations, working out how to respond to them and the most sensible way forward. However, it is clear that the standards would need to carry weight and be recognised as doing so. I know my right honourable friend the Secretary of State will reflect on that and that my noble friend Lord Howe will have heard the points the noble Lord has made.

[Baroness Masham of Ilton]

My Lords, can the Leader assure me that there will not be bullying and that there will be kindness? Kindness does not cost money. Nurses should be kind and treat patients with dignity.

[Lord Hill of Oareford]

My Lords, I could not agree more. One of the things that are most distressing when one strips away everything to do with structures is the lack of common humanity. That is the most extraordinary thing. I agree very much with the noble Baroness about the importance of compassion.

Business of the House

Lord Hill of Oareford Excerpts

Thursday 31st January 2013 Lords Chamber

Moved by

[Lord Hill of Oareford]

That Standing Order 40(5) (Arrangement of the order paper) be suspended from Thursday 7 February until the end of the session.

[Lord Steel of Aikwood]

My Lords, perhaps I may ask a couple of questions about this Motion, because it refers to starting next Thursday, 7 February. As noble Lords may be aware, I have tabled a Motion, which appears at the top of the Order Paper for debate that day, that,

“this House resolves that no introductions of new Peers shall take place until the recommendations in paragraphs 36, 47, 57, 63, and 67 of the First Report of the Leader’s Group on Members Leaving the House, chaired by Lord Hunt of Wirral (HL Paper 83, session 2010–12), have been implemented”.

We have just passed the second anniversary of the publication of this unanimous, all-party report. Nothing has been done about it and there is an increasing concern about overcrowding in this Chamber, which is why I have tabled my Motion. Can the Leader assure me that if we pass the Motion before us, my debate will not be gazumped and we shall have the chance to discuss it next Thursday morning?

Secondly, is the noble Lord aware that the Bill that passed through this House which would give effect to that report is in the Commons and has been taken up by our colleague, the Conservative MP Eleanor Laing? Last Friday she tried to get a formal Second Reading of that Bill so that it could come back here, but it was objected to by the Government Whips in the normal way. She is going to try again tomorrow, and of course, if the Government Whips do not object and she gets a formal reading, the Bill next Thursday would be unnecessary.

[Lord Forsyth of Drumlean]

My Lords, further to the point made by my noble friend, I understand that the Chief Secretary to the Treasury has suggested that this House should find economies of at least 2% in its budget. That seems to be inconsistent with proposals to add to the burdens on the House by appointing more Peers. This is not the moment to debate the issue, but would it not be appropriate for the Procedure Committee of this House to look at how the rate at which introductions are made is consistent with the resources available to us and the demands being placed on us by the Treasury to reduce the burden on the taxpayer, with which I very much agree?

[The Chancellor of the Duchy of Lancaster (Lord Hill of Oareford)]

My Lords, first, I should say to my noble friend Lord Steel of Aikwood that I am well aware of the concerns he has expressed for a long time on this issue. Indeed, I was glad to have the opportunity to discuss them with him soon after I took over this post. If the House will allow me, I should say for the record that I am slightly disappointed that, in bringing forward his Motion, my noble friend did not discuss it with my noble friend the Chief Whip in the way that convention suggests. It is important that we observe the conventions because that is how this House operates. I feel that I should bring that to the attention of the House.

On the matters raised by my noble friend Lord Forsyth, we will be discussing those next week and I am sure that we will have a good opportunity to hear a range of views from all sides of the House. On the Government’s position generally on this important issue, that has not changed since the last time it was discussed in this House in terms of both future legislation and the position regarding the appointment of new Peers. As it has always been, it is for the Prime Minister to make recommendations to Her Majesty the Queen. That is how it has always been done in this House by both parties and how it was done with great vigour by Mr Blair. It is the situation that exists now.

[Lord Pearson of Rannoch]

My Lords, can the noble Lord tell us where the Prime Minister and the Government stand on their commitment to ensure that membership of your Lordships’ House more accurately reflects the votes cast in the previous general election? Does the noble Lord agree that that would give my party, the UK Independence Party, no fewer than 24 Peers, whereas at the moment we have three? Does the Prime Minister stand by this commitment or has he abandoned it?

[Lord Hill of Oareford]

My Lords, I think we all feel that the value we get from the noble Lord, Lord Pearson of Rannoch, is worth at least 24 Peers. The position taken by the Government on this is set out clearly and has not changed. The Government’s view is that we should work over time more accurately to reflect the balance of Peers.

[Lord Forsyth of Drumlean]

My Lords, I do not wish to detain the House, but further to the point made by the Leader of the House, there is a distinction between the prerogative power to appoint Members to this place and the rate at which they can be introduced. I think that my noble friend’s Motion was about having a debate that takes account of the resource constraints upon this House and the proposals that are now in the other place which would enable a sensible accommodation to be reached. However, it would be useful if, before next week, we had something from the Procedure Committee to indicate what the constraints are so that we can have a more informed debate.

[Lord Hill of Oareford]

I am sure that the Chairman of Committees will have heard that point. More generally on this debate, my noble friend says that he does not want to delay the House. We will be discussing it next week and I am sure that there will be plenty of opportunity to consider this and all the other points that noble Lords want to raise then.

[Lord Grocott]

My Lords, would we not have a more informed debate if a Government Minister was able to answer a question that I and, I am sure, others have repeatedly put in Written Questions and elsewhere: what precisely in terms of numbers is the coalition commitment to establishing the party strengths in this House on the basis of the last general result? What does that mean in terms of numbers for each of the three parties? Although the Leader of the House dealt with the question put by the noble Lord, Lord Pearson, very effectively in parliamentary terms, he did not actually answer the question, which was a valid one. If the Government are committed to their repeatedly stated objective of reflecting the last election results, surely we are entitled to know precisely in numbers, including the total number, what that would occasion. If we do not know the numbers, it is very difficult to have an informed debate.

--- Later in debate ---

[Baroness Deech]

My Lords, does the Minister appreciate the illogicality of the proposition that has been put forward? There are nearly 200 Cross-Bench Peers in this House who are independent minded, as the Minister will know, who may vote one way or the other. It would make more sense for the parties to try to win over, by logical arguments, the votes of the Cross-Bench Peers rather than striving to pack the House with Members already committed to one side or the other.

[Lord Hill of Oareford]

My Lords, I believe in deferred gratification, and I am prepared to defer some more gratification until next week when we have the debate. In the past nine minutes, we have had a good illustration of the range of views on retirement in this House. I would not want to personalise the very fair general point made by my noble friend Lord Tyler in the way that he did. However, it is true that that scheme is available for any Member of Your Lordships’ House who would like to take a permanent leave of absence. I can refer any noble Lords who might be interested in looking at it to page 22 of the new Companion. In the conversations that I have had about retirement, the views expressed to me in the Corridors and around the place have tended to be affected by the age of the noble Lord to whom I have been speaking—and the age of retirement suggested is normally a couple of years above the age of the particular noble Lord to whom I am speaking.

The point raised by the noble Lord, Lord Hunt of Kings Heath, about membership representation on particular Benches was a slight case of pots and kettles, if I may say so. I think that he conveniently forgot the important contribution made in this House by Cross-Benchers when he looked at his percentages. The noble Baroness, Lady Deech, rightly reminds us of the extremely important contribution that the Cross-Benchers make at all times.

On the specific point of numbers, the noble Lord, Lord Grocott, knows probably better than I—since he is a great expert on all these matters—the form of words that the coalition Government set out. No precise figure has been set but the general intention is clear.

Motion agreed.

Business of the House

Lord Hill of Oareford Excerpts

Thursday 31st January 2013 Lords Chamber

Moved by

[Lord Hill of Oareford]

That Standing Order 46 (No two stages of a Bill to be taken on one day) be dispensed with to allow the HGV Road User Levy Bill to be taken through all its remaining stages on Thursday 7 February.

Motion agreed.

Business of the House

Lord Hill of Oareford Excerpts

Thursday 31st January 2013 Lords Chamber

Moved by

[Lord Hill of Oareford]

That the debate on the motion in the name of Baroness Noakes set down for today shall be limited to three hours and that in the name of Lord MacGregor of Pulham Market to two hours.

[Lord Hannay of Chiswick]

I wonder if I can put a couple of questions to the Leader of the House about these time limits that he is proposing to have today. I know it is early days in his tenure of his present post, but does he not recognise that the business managers are imposing limits today which are severely testing the sense of humour of Back-Benchers to a point of destruction? Does he not also recognise that he is moving these time limits pretty close to the time limits imposed in the European Parliament—not an example normally thought good for emulating by this House? Finally, does he not recognise that there could be occasions when the national interest—and I think the two items on the Order Paper today are genuinely of national importance—does not require the House to rise at a fixed time on a Thursday evening?

[The Chancellor of the Duchy of Lancaster (Lord Hill of Oareford)]

My Lords, the House has taken the decision over time as to how long it wants to set aside for debates. I take the point about the importance of some of the issues being discussed this afternoon, and the number of speakers who have signed up to discuss Europe is an indication of the great deal of interest that there is in that subject. If there is appetite for a debate of that nature, my noble friend the Chief Whip is always available to discuss that, and one could have a discussion through the usual channels as to whether we could make more time available.

[The Earl of Sandwich]

My Lords, I feel it is an important discussion to have now. For example, can the noble Lord say whether the usual channels have discussed and agreed the principle of a limit on the numbers of speakers, which would surely allow those who have prepared for several weeks for debates to have their say in a reasonable way?

Tourism

Lord Hill of Oareford Excerpts

Wednesday 30th January 2013 Lords Chamber

[Lord Dannatt]

My Lords—

[The Chancellor of the Duchy of Lancaster (Lord Hill of Oareford)]

Cross Bench.

[Lord Dannatt]

My Lords, I declare an interest as Constable of the Tower of London, which received 2.5 million visitors last year, 70% of whom came from overseas. Will the Minister indicate what he is doing to encourage the UK Border Force to present not only a secure but a welcoming entry into this country so that queues and the grumpy attitude seen on some occasions do not deter people from visiting this country and our wonderful attractions?

Business of the House

Lord Hill of Oareford Excerpts

Wednesday 23rd January 2013 Lords Chamber

Moved by

[Lord Hill of Oareford]

That Standing Order 48 (Amendments on Third Reading) be dispensed with today in respect of the Third Reading of the Electoral Registration and Administration Bill.

Motion agreed.

Algeria

Lord Hill of Oareford Excerpts

Monday 21st January 2013 Lords Chamber

[The Chancellor of the Duchy of Lancaster (Lord Hill of Oareford)]

My Lords, with the leave of the House, I shall now repeat a Statement made earlier in another place by my right honourable friend the Prime Minister. The Statement is as follows.

“With permission, Mr Speaker, I would like to update the House on the despicable terrorist attack in Algeria and the tragic events of the past few days. It is with great sadness that I have to confirm that we now know that three British nationals have been killed and that a further three are believed to be dead, as is a Colombian national who was resident in Britain. I am sure the whole House will join me in sending our deepest condolences to the families and friends of all of those who have lost loved ones.

First, let me update the House on developments over the weekend and the steps that we have taken to get survivors home. Then let me begin to set out how I believe we will work with our allies to overcome the terrorist scourge in this region.

The Algerian Prime Minister told me on Saturday afternoon that the Algerian military had completed their offensive and that the terrorist incident was over. Since then, Algerian forces have undertaken a further operation to clear the site of potential explosives and booby traps. This is still being completed and it will allow our embassy-led team to access the site.

It is important to put on record the scale of what happened. There is still some uncertainty around the precise facts but we believe that, in total, some 800 employees were working at the In Amenas site at the time of the attack, about 135 of whom were foreign nationals. More than 40 were taken hostage and at least 12 were killed, with at least a further 20 unaccounted for and feared dead. The Algerian Prime Minister has said today that he believes that 37 foreign hostages were killed. The number of terrorists was more than 30. Most were killed during the incident, but a small number are in Algerian custody.

Our immediate priorities have been the safety of the British nationals involved, the evacuation of the wounded and freed hostages, and the repatriation of those who have tragically been killed. Working closely with BP, and side by side with our US, Japanese and Norwegian partners, a swift international evacuation effort has been completed. The last British flights out on Saturday night brought not only the remaining freed Britons but Germans, Americans, New Zealanders, Croats, Romanians and Portuguese. As of yesterday, all 22 British nationals caught up in the attack who either escaped or were freed had been safely returned to Britain to be debriefed by the police and, of course, to be reunited with their families.

Now, our most vital work is bringing home those who died. An international team of British, American and Norwegian experts is in close co-operation with the Algerian Ministry of Justice, undertaking the task of formally identifying their bodies. We want this process to happen as swiftly as possible but it will involve some intensive forensic and policing work and so may take some time.

Throughout the last five days, the British ambassador to Algeria and staff from across government, and beyond, have been working around the clock to support British citizens and their families. I am sure the House would like to join me in thanking them for their efforts. We should also recognise all that the Algerians have done to confront this dreadful attack. I am sure the House will understand the challenges that Algeria faced in dealing with more than 30 terrorists bent on killing innocent people in a large and extremely remote and dangerous industrial complex. This would have been a most demanding task for security forces anywhere in the world and we should acknowledge the resolve shown by the Algerians in undertaking it. Above all, the responsibility for these deaths lies squarely with the terrorists.

Many questions remain about this whole incident, but one thing is clear. This attack underlines the threat that terrorist groups pose to the countries and peoples of that region and to our citizens, our companies and our interests too. Four years ago, the principal threat from Islamist extremism came from the Afghanistan and Pakistan region. A huge amount has been done to address and reduce the scale of that threat. Whereas at one point three-quarters of the most serious terrorist plots against the UK had links to that region, today this has reduced to less than half. At the same time, al-Qaeda franchises have grown in Yemen, Somalia and parts of north Africa.

The changing nature of the threat we face was highlighted in our national security strategy in 2010 and it shaped the decisions that we made. While of course there were difficult decisions to make, we increased our investment in our Special Forces, cybersecurity and key intelligence capabilities while also increasing our investment in fragile and broken states.

In north Africa, as in Somalia, terrorist activity has been fuelled by hostage ransoms and by wider criminality. To date, the threat it poses has been to those north African states themselves and, of course, to western interests in those states. But as it escalates, it is also becoming a magnet for jihadists from other countries who share this poisonous ideology. Indeed, there are already reports of non-Algerian nationals involved in this attack. More than ever, this evolving threat demands an international response. It must be one that is tough, intelligent, patient and based on strong international partnerships.

First, we should be clear that this murderous violence requires a strong security response. We must be realistic and hard-headed about the threats we face. Our role is to support the Governments of the region in their resolve to combat this menace, as many are doing at great cost. So we will work closely with the Algerian Government to learn the lessons of this attack, and to deepen our security co-operation. We will contribute British intelligence and counterterrorism assets to an international effort to find and dismantle the network that planned and ordered the brutal assault at In Amenas.

We must work right across the region. In Nigeria, we will continue our close security partnership with the Government as they confront Islamist-inspired terrorism. In Libya, we will continue to support the new Government on the urgent priority of building new and effective security forces. In Mali, we will work with the Malians themselves, with their neighbours and with our international allies to prevent a new terrorist haven developing on Europe’s doorstep. We support the French intervention that took place at the request of the Malian Government and we are working to ensure that an African-led military force can, with the appropriate training and support, help to ensure Mali's long-term stability. That support will include the EU training mission that was agreed by EU Foreign Ministers in Brussels last week.

Secondly, our tough security response must be matched by an intelligent political response. Al-Qaeda franchises thrive where there are weak political institutions, political instability and the failure to address long-standing political grievances, so we need a political approach that addresses these issues. We must support effective and accountable government, we must back people in their search for a job and a voice, and we must work with the UN and our international partners to solve long-standing political conflicts and grievances. Thirdly, we must be patient and resolute.

Together with our partners in the region, we are in the midst of a generational struggle against an ideology which is an extreme distortion of the Islamic faith and which holds that mass murder and terror are not only acceptable but necessary. We must tackle this poisonous thinking at home and abroad and resist the ideologues’ attempt to divide the world into a clash of civilisations.

The underlying conflicts and grievances that are exploited by terrorists are in many cases long-standing and deep, and, of course, the building blocks of democracy—the rule of law and the independence of the judiciary, the rights of minorities, free media and association and a proper place in society for the army—are a big part of the solution but all take a long time to put in place. Yet this patient, intelligent but tough approach is the best way to defeat terrorism and to ensure our own security. We must pursue it with an iron resolve, and I will use our chairmanship of the G8 this year to make sure this issue of terrorism and how we respond to it is right at the top of the agenda, where it belongs.

In sum, we must frustrate the terrorists with our security, we must beat them militarily, we must address the poisonous narrative they feed on, we must close down the ungoverned space in which they thrive and we must deal with the grievances they use to garner support. We must demonstrate the same resolve and purpose that previous generations have shown when dealing with these issues in this House and in the country. I commend this Statement to the House”.

My Lords, that concludes the Statement.

--- Later in debate ---

[Lord Hill of Oareford]

My Lords, I am grateful to the noble Baroness the Leader of the Opposition for the support she has given to the Government. I agree very much with her comments and the tone with which she concluded her response. I think all sides of the House would want to align themselves with what she said and the Statement my right honourable friend the Prime Minister made. She was also right, at the beginning of her comments, to emphasise the importance of understanding the nature of this new threat. That is something we very much need to do.

On some of her specific points, it is clear that the Algerian Government found themselves having to deal with an extremely difficult and complicated situation many thousands of miles away from the capital in a very remote part of the world. All of us need to recognise the difficulty they confronted. She asked whether there are lessons we can learn from that. I am sure there are—we always need to learn from events and it is vital that the British Government continue to work closely with the Algerian Government.

With regard to the work of the British Government in the region, all major British companies have now been contacted and have put in place improved security procedures and the consular information has been updated.

The noble Baroness rightly said that we have made clear that there is not a combat role for British troops in Mali but I think we should support the French in taking emergency action. We have, as she knows, already lent them two C-17s and are due to discuss our help to them at the National Security Council tomorrow. In terms of progress on the ground and the involvement of other countries in supporting the effort in Mali, there are some African soldiers on the ground. We hope that more will follow soon. This will be co-ordinated by ECOWAS and the United Nations, but she is absolutely right to say that there is no quick fix for any of this. She said rightly that we believe that this is the work of a number of distinct organisations under the al-Qaeda banner. They are distinct but there are connections between them and we will need to deal with them individually but recognise those commonalities.

In terms of improving the flow of intelligence to the area, the noble Baroness will know that recently, before Christmas, the Prime Minister appointed his own envoy to the Sahel. Discussions at the NSC about the Sahel are continuing. We will need to work with our allies, particularly the French, in making sure that we share all the intelligence that we can.

On the role of the African Union and ECOWAS, we certainly need to help build capacity for the future to deal with those issues. We have stepped up our help to Libya to try to remove weapons from the region. The noble Baroness rightly raised the issue of security on the borders. One of the priorities of all our work in Libya is to try to address that important issue, and working with other countries and the Libyans to make the region more secure. I agree entirely with the noble Baroness’s concluding remarks on the importance of having a great focus on the region. I agree with her remarks about the Arab spring, and the long-term benefit to which that will give rise. There are obviously difficulties through which we need to work, but we need that focus. It is also worth remembering that, in the past, brutal regimes have not made our world any safer.

I am grateful for the noble Baroness’s remarks. We will continue to work on this.

[Lord Chidgey]

My Lords, we support the Prime Minister in the calm and measured response that the Government have given to this crisis. Of course, we join with the Minister, the Prime Minister and the whole House in expressing our sympathy for all those affected, particularly our British families who have lost, or who are still awaiting news of, their loved ones.

We face a serious situation developing in Algeria and throughout the Sahel. The emergence of Islamist groups such as AQIM has been long foreseen. The advent of the Arab spring has unfortunately created an environment, through porous borders and the like, in which extremism can now more readily flourish across the region. What specific measures are the Government taking to ensure that the African nations engaged through the AU, ECOWAS and the UN have full access to effective EU training and support for counterterrorism actions? What measures are the Government taking to develop an international security protocol to protect the personnel and the assets of the companies working in difficult conditions in these remote regions?

Finally, what specific initiatives, and with whom, are the Government taking in the Sahel to enable the underlying economic exclusion—unemployment and poverty— fuelling the unrest to be tackled? I appreciate that at this stage it may be difficult for the Leader to comment in detail, but can he give us some indication of when we might get that sort of specificity?

[Lord Hill of Oareford]

My Lords, I am grateful to my noble friend Lord Chidgey for his support. I will need to follow up some of his specific questions over time. Currently, the broad approach is becoming clear: the need to emphasise the importance of the Sahel and for us to up our efforts in working with a range of interested parties, whether through the EU or with other individual states; to address both the security issue but also the kind of economic issue to which my noble friend refers; and recognising that political and military solutions need to go hand in hand. We must address some of the underlying issues to do with poverty, which act as fuel for people who recruit and feed on those grievances.

[Lord Hannay of Chiswick]

Does the Minister accept the endorsement of what the Prime Minister said: it really is shameful that, at a moment like this, after these horrific events, so many attempts are made to look for people who are responsible other than the terrorists themselves? The events that took place were not provoked by the invasion of Mali. They were not provoked by any behaviour that could possibly be regarded as justifying it; it is right to say that.

Will the Minister also address the need to mount a really successful international operation to restore the sovereignty and territorial integrity of Mali and, hopefully, a properly functioning governance system there? This will not be easy or short. Is any thought being given to a recommendation made by two UN panels that, where the UN asks a sub-regional organisation, such as ECOWAS, to undertake a very tough business like this and where keeping the regional powers in the fore must surely be the right thing to do, the costs should be met under the UN assessed contributions and not simply through having to rely on carrying a hat around, invariably, to the European Union? Why should countries such as Japan, Russia or China not contribute?

That proposal has been made on a number of occasions. I do not think that it has ever yet born fruit. Surely, an operation such as this demonstrates the need to provide ECOWAS, which has no any financial resources of its own, with a proper underpinning for the task we are asking it to undertake.

[Lord Hill of Oareford]

My Lords, first, I very much associate myself with the first comments made by the noble Lord, Lord Hannay, about who was responsible for this attack and with his point about those attempting to say that it is the sensible and appropriate action being taken as regards Mali that has driven this. He is clearly right that there is not that linkage. As far as we can tell, the attack, which was extremely well planned, must have been some time in the making. The idea that it was triggered by recent events in Mali does not seem to make sense.

On his broader point about Mali and how we can take it forward, I listened with great care to what he said. I know that discussions are going on at the UN on precisely those issues. I will follow those points up subsequently.

[Lord Howell of Guildford]

Does my noble friend accept that the emphasis in the Statement on the resolve of the Algerian authorities and Algerian forces in dealing with this horrific situation is extremely welcome? Is he aware of a point that was not made in the Statement but perhaps should have been; namely, that in recent years and months, Algeria has been seeking to move much more closely to the United Kingdom through trade links, business links, links in relation to prison reform and human rights, and through a whole range of other areas, as well as an interest in associating itself in some way with the Commonwealth? In short, Algeria regards Britain as a strong and growing friend. Therefore, it is fully entitled to expect from us not criticism but support and encouragement in dealing with this very difficult situation.

--- Later in debate ---

[Lord Hill of Oareford]

I am grateful for the comments made by my noble friend, to whom I always listen with a great deal of care. His views on these matters are highly respected in this House. It is obviously the case that Algeria over a long time has been dealing with these terrible issues, going back over many years. It is a sovereign country. We should respect the difficult decisions that it had to take. It is also the case that in addressing this horrible situation, Algerians lost their lives and Algeria’s armed forces risked their lives to help free nationals from around the globe. I agree with my noble friend about the importance of us making sure that our relations with Algeria build on the improvements made and become closer, and that people do not rush to condemn it.

[Baroness Symons of Vernham Dean]

My Lords, I am sure we all agree with the noble Lord, Lord Hannay, that the responsibility for this hideous incident lies entirely with the terrorists concerned. I hope that the Leader of the House also agrees that there is a real problem about regional security in that part of north Africa. I want particularly to raise with him the unresolved issue over the western Sahara. In recent years, Morocco has told us over and over again that because of the disputed territory there, the western Sahara is peculiarly vulnerable to al-Qaeda activity, to training camps for terrorists and to other activity of a really appalling nature. Are the United Kingdom Government now prepared to raise this issue again forcefully in the United Nations in order to try to get some proper security into the western Sahara so that that territory cannot be used as a launching pad for this sort of activity in the region in future?

[Lord Hill of Oareford]

I take the points that the noble Baroness makes. The Government, the Foreign Office and the Prime Minister have been aware of the growing threat to which she refers. I will certainly pursue those points, as I know she will. Perhaps we might have a word about it.

[Lord Wright of Richmond]

My Lords, I should perhaps declare an interest as a former non-executive director of BP. I would also like to echo the condolences that have been expressed to the families of all the victims. Does the noble Lord accept that one essential element in confronting Islamic extremism, not only in north Africa but elsewhere, is the unresolved problem of the Middle East peace process? I suggest that we and our partners should make a positive and active attempt to revive the moribund peace process and to work towards—at last—a just and permanent peace settlement for the Palestinians.

[Lord Hill of Oareford]

My Lords, on the noble Lord’s condolences and the role of BP, it has clearly been a very distressing time for BP and all its employees. I think that all noble Lords will endorse the points that were made. On his broader point, yes, that whole issue is one that the Government are very aware of and continue to pursue to try to resolve at every possible opportunity.

[Lord Naseby]

The speed with which the Prime Minister moved in calling COBRA meetings and the Government as a whole moved in bringing back our colleagues who survived is greatly to be welcomed. The Prime Minister mentioned in his Statement that priority will now be given to bringing back the remains of those who have died. To that end, I wonder whether it might not be in the interests of all parties if a senior coroner, or a recently retired coroner, was hastily made one of that team to ensure that, if at all possible, this can be done even more quickly than has ever been achieved before.

[Lord Hill of Oareford]

I am grateful to my noble friend for his comments both about the way in which my right honourable friend the Prime Minister has handled this crisis and also his points about the importance of resolving the problem of repatriating these bodies—which is a deeply distressing thing for all the families concerned—as soon as possible. I know that officials in our embassy and from the police are working closely with the Algerian authorities in the kind of way he describes to resolve it as rapidly as possible.

[Lord Lea of Crondall]

Perhaps I may ask a couple of related questions about African ownership of the solutions. First, for some years I was the secretary of the All-Party Group on Algeria, after Prime Minister Blair and President Bouteflika were starting a new rapprochement. One of the problems, of course, is that they do not have Westminster-style democracy in Algeria. On the other hand, does the noble Lord the Leader of the House agree that we have to have practical, in-depth parliamentary arrangements with Algeria, as we do with Ethiopia or anywhere else where we may not have perfect arrangements? Secondly, is there not scope for giving more congratulations to the African Union on the string of successes it has had right across the tenth parallel from Somalia through to Chad, South Sudan and right the way across? I base this on a talk that I had in Addis two months ago with the executive director for security of the African Union. I think it is fair to say that they are remarkably able people but very badly resourced. We ought to be a little less schizophrenic about letting the African Union take the lead instead of damning it with faint praise for not being as effective as it should be.

[Lord Hill of Oareford]

I agree with both the noble Lord’s points—on the importance of working with Algeria, and having African solutions to problems in Africa.

[Lord Alton of Liverpool]

My Lords, is the Minister aware that two of the fatalities were men from Liverpool? Paul Morgan, the head of security, originated from Aigburth, and was killed while trying to repel the attackers. Garry Barlow, from Allerton, reportedly had Semtex strapped to his chest. Their deaths left their loved ones and the local community utterly devastated. Will the Minister ensure that every practical help is given to these and the other grieving families as they try to come to terms with their loss? As this jihadist contagion threatens other countries, especially Nigeria, will he look again at the proscribing of Boko Haram, which has been responsible for hundreds of deaths, and the need to find political and economic solutions to deter the easy recruitment of the disaffected, as well as the wisdom of supporting militias in places such as Syria, which have links with al-Qaeda, or share jihadist indifference to the slaughter of innocent people?

[Lord Hill of Oareford]

First, I agree very much with the noble Lord how important it is that these poor families have every support that we can give them. I know that through the police and in other ways through our embassy we have been providing as much of that support as we possibly can.

On his broader point about Nigeria, we strongly condemn the violence that there has been in northern Nigeria. We are working with the Nigerian authorities to try to find lasting solutions to that conflict and, through our High Commission in Abuja, we are supporting counterterrorism work and interfaith projects. In November, the terrorist organisation, Ansaru, was proscribed by Her Majesty’s Government, which I hope sent a clear message that we condemn its terrorist activities.

[The Lord Bishop of Ripon and Leeds]

First, I associate these Benches with the sympathy with the relatives of those who have died and who have experienced the nightmare of either knowing that their relatives have died or not knowing what has happened to them. We meet in mourning this afternoon. We also associate ourselves with the thanks to the diplomatic staff, who have done such an excellent job in repatriating those who have died and making sure that the hostages who have been freed have returned home.

I welcome the phrase from the Statement where the Prime Minister speaks of these events as a,

“distortion of the Islamic faith”.

Will the Leader of the House express his support for the vast majority of Muslims, in this country and across the world, who express their own bitter opposition to violence? This is sometimes associated, on the part of terrorist organisations, with allegations of western and Christian aggression. Will he also affirm his support for all that interfaith activity in the cause of peace, which is going to be so crucial to the development of a cultural situation across the world where peace is seen as a crucial part of the future of our world?

[Lord Hill of Oareford]

I am grateful to the right reverend Prelate for the support that he expressed from the Bishops’ Benches for the work of our embassy staff and others who have been dealing with this awful situation. I am very happy to associate myself as strongly as I can with both the statements that he made—that these terrorists and extremist Islamist organisations represent a distortion of the faith, and his view that interfaith work has an important part to play in trying to build understanding and putting these aberrations into their proper context.

[Lord McConnell of Glenscorrodale]

My Lords, I endorse strongly the point made by the noble Lord, Lord Hannay, about the United Nations, but can I also ask the Leader of the House about what role the Government see for the European Union’s External Action Service in this important region? In addition, in relation to the drug trade, while the weapons that are being used may well be coming from Libya and elsewhere, it is absolutely clear that at least part of the finance is coming from the drug trade that comes up through Guinea-Bissau and other failed states from South America, through the Sahel and the Mediterranean and into Europe. Can we have an assurance from the Government that they see this wider picture as including dealing with that key element, which is part of the source of the problem?

[Lord Hill of Oareford]

The noble Lord very accurately reflects the interconnections that exist between criminality, terrorism and all the different factors which come together. As he said, we know how criminal activity is used to fund terrorist activity in a horrible nexus in a number of places. He is right to emphasise that we need to find ways of tackling both strands in the solutions that we develop: both security and military, and political. As far as the EU is concerned, it is one of a number of different bodies with which we need to work to find solutions. The support which it is providing for training in Mali is one example, and there are others too. I agree with the noble Lord that we need to do everything that we can to build on that.

[Lord Elystan-Morgan]

The noble Lord the Leader of the House referred to French intervention in Mali. It is of course accepted that that is not only lawful, but laudable, and historically utterly understandable. Does he agree, however, that in such terrifying circumstances as these, the maximum premium should be placed upon collective responsibility and concerted action? Is he able to say whether the Government of France came to any consideration or discussion on this matter with any country other than Mali, including of course the neighbouring African countries, before sending troops into Mali?

[Lord Hill of Oareford]

I am afraid that I am not able to add a great amount in response to the noble Lord’s question. I know that it is the case, as he has said, that the Malian Government invited the French to undertake that intervention. It was urgent in the circumstances on the ground. If I can find better particulars I will of course pass them on to the noble Lord with great pleasure.

Business of the House

Lord Hill of Oareford Excerpts

Thursday 17th January 2013 Lords Chamber

Moved by

[Lord Hill of Oareford]

That the debate on the motion in the name of Baroness Hollis of Heigham set down for today shall be limited to three hours and that in the name of Lord Smith of Leigh to two hours.

Motion agreed.

Standing Orders (Public Business)

Lord Hill of Oareford Excerpts

Thursday 17th January 2013 Lords Chamber

Moved by

[Lord Hill of Oareford]

That the standing orders relating to public business be amended as follows:

Standing Order 73 (Joint Committee on Statutory Instruments)

In Standing Order 73(1), after “Human Rights Act 1998”, leave out “and”; and after “Regulatory Reform Act 2001” insert “, any draft order laid under or by virtue of section 7 or section 19 of the Localism Act 2011, and any draft order laid under or by virtue of section 5E of the Fire and Rescue Services Act 2004”.

Motion agreed.