Covid-19: International Response

Lord Turnberg Excerpts

Monday 18th May 2020 Lords Chamber

[Lord Turnberg (Lab)]

My Lords, it is clear that in tackling a global pandemic, we need a global response. However, I want to raise a different international issue that is a little nearer to home and a little narrower, because nowhere do we see the international dimension more clearly than in our own National Health Service. Some 28% of our medical staff and 13% of all NHS workers come from other countries. Many of them are from black and minority ethnic groups, so they are particularly vulnerable, more so than many others. Yet they do such a wonderful job that every Thursday evening we come out and clap for them. Given that, it might be thought that we treat them well, but I fear that that is not entirely the case.

The Royal College of Physicians tells us that not only do people from abroad have to pay the punitive costs of visas, which might be expected, they also have to pay a £400 a year immigration health surcharge for each family member to help pay towards the costs of the National Health Service. They are being asked to pay for the healthcare that they themselves are providing for us, and that health surcharge is shortly to rise to £624 a year. This is a ludicrous situation where up to a quarter of our doctors are being asked to pay for the care that they are giving to the rest of us. I ask the Minister to press her colleagues in the Department for Health and Social Care to rescind this tax which these incredibly valuable staff are being asked to pay.

Terrorism Act 2000 (Proscribed Organisations) (Amendment) Order 2019

Lord Turnberg Excerpts

Thursday 28th February 2019 Lords Chamber

[Baroness Deech (CB)]

It is welcome but belated that this order should be passed. While we have listened to the reservations expressed by the Labour Party and the Lib Dems, it remains the fact, as I am sure they will agree, that if more has come out about a situation, and maybe we were misled or not given the full facts a while ago, it is right to take that step now.

Imagine, if you can, an organisation that marched through London and actively promoted an ideology that—forgive my words—black people should be killed and their lands restored to colonialist oppressors. You would have no doubt or hesitation about banning it. Well, a group called National Action did just that, and it was recently banned—so this is not a new move. That organisation said that non-whites and “sub-humans”—which it implied was the right word—should not be tolerated.

The Mayor of London supports this ban. We should be tough on terrorism and the causes of terrorism. There is no division between the political and military wings of Hezbollah. In fact, little stickers saying “We are the political wing” have been put on the flags carried by these people as they march, precisely in order to exploit that. They have said, “Each of us is a combat soldier. The story of ‘military wing’ and ‘political wing’ is the work of the British”.

The right to peaceful protest, which we uphold, does not extend to the violent and the threatening and the racist. Countries with which we have close relations, including Canada, Holland, France, New Zealand and even Bahrain, all ban Hezbollah. This of course will not stop the necessary co-operation with the Lebanon Government.

The organisation that I hope we will ban today fights for Assad. This is not just a Jewish issue, as has been implied. The beliefs that this organisation expresses are a harbinger of what is to come if you are western. The anti-Semitism is the tip of the iceberg. The organisation expresses a group of beliefs that everything western is wrong, everything white is wrong, everything that might be stigmatised as colonialist is wrong, and war must be fought to bring everyone to heel.

Hezbollah has said:

“Until Israel ceases to exist and the last Jew in the world has been eliminated,”


it will continue to fight. It has said:

“If Jews all gather in Israel it will save us the trouble of going after them worldwide”.


We cannot possibly go along with allowing such an organisation to march through London.

Hezbollah is a partner to Iran, for which cause it engages in money laundering, arms sales and drugs smuggling. It is implicated in the Yemen disaster. It has prolonged the Syrian conflict. It has carried out attacks all over Europe. Classifying Hezbollah as “terrorist” would stop it using our banks to transfer money around the world. What it does fits precisely Section 3(5) of the Terrorism Act 2000. It has been involved in Iranian-directed bombings that have killed more than 1,000 UK and US servicemen in Iraq and Afghanistan. What has changed in the last year is increasing revelation of this and increasing fear. It is by no means a partisan move. I hope that this House will wholeheartedly support the Motion.

[Lord Turnberg (Lab)]

My Lords, I strongly support the Government on this order.

There can be little doubt that Hezbollah has completely taken over control of Lebanon. It is certainly in the Parliament but it is also in the military—it is everywhere—and Lebanon and its Government can do little without Hezbollah. The deputy secretary-general of Hezbollah, Naim Qassem, has repeatedly said that the political and the military wings are as one—they are not distinct. There is little doubt too that Hezbollah is funded and supported by Iran and represents an outpost of that country, with its Shia expansionist policies, and that those policies are not only anti-Israel and anti-Zionist but anti-Semitic; wherever Jews exist, one just needs to see the sorts of terrorist attacks Hezbollah has made on Jewish installations around the world. It is not just Jews—they have attacked and killed British troops in Syria, as well as the poor Syrians.

It is not only Israel that has worries in the Middle East; Saudi Arabia, Jordan and Egypt are all extremely worried about Hezbollah’s activities, and we have a good example in Yemen, where it has a role too. Its interests have nothing to do with the plight of Palestinians. They are just pawns in their game, and if a peaceful resolution and a two-state solution eventually emerge, which we would all like to see, it will not stop Iran and Hezbollah in their anti-Semitic activities.

Against this background, it is impossible to believe that the so-called political wing of Hezbollah was unaware of what goes on. How can the political wing not be pulling the strings with Iran to produce 150,000 or more missiles and rockets in southern Lebanon, and digging six tunnels under the border with Israel? How can that possibly be thought of as a purely defensive action? Both wings are as one, both should be proscribed, and I hope we agree.

[Lord Polak (Con)]

I refer the House to my registered interests. I commend the Government on this important decision—it is the right one, and long overdue.

On 22 June 2017, after the al-Quds rally, where those yellow flags with the AK-47 were on the streets of London, I said in your Lordships’ House that separating Hezbollah into its military and political wings is an untenable and artificial exercise. The US, Canada, the Arab League and the Gulf Cooperation Council designate Hezbollah in its entirety—what do we know better than them? I asked whether it was not time that the UK demonstrated its commitment to combating extremism by joining our allies in proscribing Hezbollah in its entirety. I also wrote to the Home Secretary in those terms at the time. Some noble Lords talked about Australia; I noted in the press only today that the Australian Foreign Minister in London was interested in following what we are trying to do here today.

What has changed? Of course, I do not speak for the Government themselves. That question was asked by the Labour and Liberal Democrat Front-Bench spokesmen during the debate in the other place on Tuesday, and today in your Lordships’ House. However, those asking the question were all seeking an answer from the Government about the behaviour of Hezbollah. What had it done—what terror atrocities had it masterminded to change the Government’s position and proscribe it in full?

Hezbollah has always been consistent and has not changed at all. It does not recognise the artificial exercise of a division between the military and political; it never has. When Members ask what has changed, they seem to want to discover a smoking gun. It is apparent that some would have preferred to continue to separate the so-called two distinct parts of Hezbollah, appeasing Hezbollah as if it was our friend. Very few of us would call Hezbollah our friend.

Over the years, the main reason given for this ludicrous position was to maintain our relationship with and support for the Lebanese Government and to be able to continue to provide the necessary aid to Lebanon, because, as has been said, Hezbollah had members elected to the Lebanese Government. That was the reason given, but I assert that it was an excuse to do nothing, not a reason. Many other countries that have proscribed Hezbollah in full have connections with and work with the Lebanese Government without any problem whatever. It was an excuse, not a reason.

As an aside, my response to Hezbollah’s role in Lebanon is very clear and was mentioned by the noble Lord, Lord Turnberg. It does indeed play a significant role in Lebanon: it has 150,000 rockets and missiles embedded in south Lebanon, facing Israel.

There is a simple and clear answer to the question, “What has changed?” In my view, the change is as refreshing as it is important. The change is in the Home Secretary, the Foreign Secretary and the Defence Secretary. We have Ministers of integrity, with the courage to ask questions and seek explanations on advice they receive.

Sometimes, policy can drift and we can find ourselves in a time warp where policy remains unchanged as if we are in a fantasy land, rather than facing up to reality. Our policy on proscribing Hezbollah was in such a time warp, until the change was made by Sajid Javid, Jeremy Hunt and Gavin Williamson. They should be praised for making this important change. This legislation is important as it shows the rest of the world that the UK is a safe country to do business with and supports the global economy by mitigating terrorist risks. In our constant fight against terror, they have ensured that our Government are in the right place. This gives me great hope for Britain’s future post Brexit as a world leader in a turbulent and dangerous world.

Gaza: Reconstruction

Lord Turnberg Excerpts

Wednesday 29th October 2014 Lords Chamber

[Lord Turnberg (Lab)]

My Lords, it is clear that we need to get much building material into Gaza to help rebuild all those destroyed homes, but is the noble Baroness aware of the statement made by the Hamas spokesman last week? He said that the avowed intention of Hamas is to start rebuilding the tunnels into Israel immediately. Is there any way of preventing this?

[Baroness Northover]

We urge restraint, as we always do, on both sides. Peace is in the interest of both sides—of the Palestinians and the Israelis.

Israel and Palestine: Humanitarian Aid

Lord Turnberg Excerpts

Thursday 24th July 2014 Lords Chamber

[Baroness Northover]

My noble friend is absolutely right about the commitment that the UK Government have made. We are the third biggest donor to UNWRA’s general fund, which supports the majority of the Gazan population. Given the rapidly declining situation, we have made more than £5 million available in emergency support. This includes £2 million in new funding to help UNWRA provide immediate emergency assistance for more than 100,000 people. We are also bringing forward £3 million in funding to help the ICRC respond to the worsening situation. We are also working very closely with others to encourage them to engage and support as well in this dire situation.

[Lord Turnberg (Lab)]

My Lords, the tragedy that is occurring in this terrible carnage in Gaza can be stopped immediately if Hamas stops firing its missiles that it is storing in UN schools and hospitals. However, my question is: what conversations have the Government had with the Government of Qatar about the funding that they have been giving to Hamas to build tunnels into Israel and to buy missiles from Iran, instead of using that money for infrastructure and aid?

[Baroness Northover]

We urge all in the region to be restrained. There is massive civilian casualty resulting from the conflict there, as the noble Lord will be well aware. We would impress on everybody in this situation to draw back. We need an immediate ceasefire. It was appalling to hear this morning our noble colleague, Valerie Amos, saying that a child an hour is being killed.

West Bank

Lord Turnberg Excerpts

Tuesday 3rd July 2012 Lords Chamber

[Lord Turnberg]

My Lords, I too am grateful to the noble Baroness, Lady Brinton, for introducing this debate. I should express my interest as a member of the Labour Friends of Israel. It is obvious to anyone who has looked at the condition of the Palestinian water supply and the terrible state of the sewage disposal facilities, particularly in Gaza, that the situation there is increasingly intolerable. Noble Lords have spoken eloquently about these difficulties, and I resonate in particular to the analysis made by the noble Lord, Lord Alderdice, and not least that of the noble Lord, Lord Wright, who it always seems to be my problem and privilege to follow. I differ hardly at all in my recognition of the problems for the Palestinians, but I differ in my view of the causes and possible cures. The prime cause, of course, is the stand-off between Israel and the Palestinians, and the cure for the water conditions would follow a peace treaty, but we are where we are.

I shall start with Gaza because that is where the problems are undoubtedly most acute. According to the United Nations, Gaza has a desperate shortage of pure drinking water. Between 90% and 95% of Gazan water is polluted and a threat to health. If ever a place desperately needed a desalination plant, Gaza is it. Recently, UNICEF came in with a plan to do just that, but it came up against a Hamas Administration that, I am afraid, put their politics ahead of their population’s health. UNICEF wanted to purchase at favourable rates all the equipment that it would need from Israel because Israel has all the necessary expertise in desalination that could be wished for. Moreover, Israel was ready to help. But unfortunately all hell broke out. Hamas absolutely forbade any Israeli involvement. The Palestinian contractors’ union condemned UNICEF and announced a boycott of the agency, which then had to shut down its offices.

This episode is just one example of why it has been so difficult for Israel to influence the development of clean water and a proper sewage disposal system in Gaza, both of which have been Gaza’s own responsibility since 1995. Hamas just will not have anything to do with Israel, even when it offers to help. If it is said that Israel has prevented the transfer of necessary materials, while that may have been true, it is no longer the case. All the pipes, pumps and chemicals that are needed for water purification are now going across.

On the West Bank the situation is far from perfect, but it is much better than in Gaza. My figures—we all have different statistics, of course—suggest that 95% of the population is connected to a clean water supply and that the people have access to almost as much water as the Israelis. We can argue about the data. The problem in the West Bank is again one of a lack of willingness on the part of the Palestinians to collaborate on water and sewage projects with the Israelis. From what I hear, the relevant experts in water treatment meet and talk on friendly terms, but any agreements reached are quashed by the politicians. I fear that the Palestinian Authority is at least as much to blame as the Israelis. It does not want to be seen to be collaborating with the enemy in Israel.

A couple of years ago, Israel agreed to an American proposal to hold joint hydrological workshops with the Palestinians, but again that has been put on hold by the Palestinians. Water and sewage management in the small area of land in which Israel, the West Bank and Jordan sit closely together demands a co-ordinated approach on which they all work together. Placing all the blame on Israel or on any one of those countries is unhelpful. We in the UK must focus hard on how to get the parties together, if not in a total peace agreement —that is probably asking too much—at least on water, which is vital to them all.

In debates on the Middle East in your Lordships’ House I always try to bring out the possibility of what we in the UK might usefully do that is positive, rather than the usual constant carping and criticism. In that light, will the Minister consider inviting representatives with expertise in water management from those countries to meet on the neutral ground of the UK, where, perhaps, they can work something out far away from the scenes of conflict?

West Bank and Gaza

Lord Turnberg Excerpts

Tuesday 29th May 2012 Lords Chamber

[Baroness Northover]

My Lords, the Government have not only maintained aid but increased it. I am sure that the noble Baroness will be pleased to know that. On aid to the Occupied Territories, the EU has sustained its level of aid, as has the United Kingdom. We make it extremely clear that demolitions do not help take things forward. It is extremely important for the future of Israel and of the Palestinians that they seek a negotiated settlement. Anything that stands in the way of that, including demolitions, is a mark against it and does not help the process.

[Lord Turnberg]

My Lords, is the noble Baroness aware of the many UK charities that support Palestinians? I will give three examples. Olive Tree supports young Palestinian and Israeli students to come to City University for three years. The Building Bridges programme brings doctors from Palestine and Israel to the UK to train at the Royal Free Hospital. On a personal note, the Daniel Turnberg fellowship that my wife and I run provides research fellowships for Palestinians to come to the UK. There are many more; is the noble Baroness aware of them?

[Baroness Northover]

I am indeed aware of them—not least the one set up in memory of the noble Lord’s son. I commend him and others who put their efforts into these organisations. They are extremely important and we encourage them to develop further.

Gaza

Lord Turnberg Excerpts

Wednesday 8th February 2012 Lords Chamber

[Baroness Northover]

My Lords, the important thing is to seek a political resolution. It is only following that that some of these problems will properly be addressed. My noble friend is right to highlight some of the problems that are occurring at the moment. We have to emphasise yet again that it is in Israel’s future interest to make sure that these problems are properly addressed and that it will never be secure while this situation continues.

[Lord Turnberg]

My Lords, is the Minister aware that medical supplies for Gaza are shipped by Israel to the Ministry of Health in the West Bank, which then has to deliver them to Gaza? There is considerable mistrust and poor communication between the two ministries of health, and that is one of the main causes of the delay in the transfer of medical supplies. Is she aware of that?

[Baroness Northover]

I am aware of that. The noble Lord is right that the division between Gaza and the West Bank, both geographically and politically, is indeed playing a part here. We urge all sides to co-operate together to ensure that medicines get across and do get into Gaza.

International Development

Lord Turnberg Excerpts

Monday 21st November 2011 Lords Chamber

[Baroness Northover]

My Lords, we are currently piloting the International Citizen Service, which is giving more than 1,000 young people from all backgrounds the opportunity to spend three months doing voluntary work overseas. This will make a real difference to some of the world’s poorest people, while developing skills that will be invaluable as they seek employment in the future. Our intention is to scale up this programme so that 7,000 young people will benefit over the next three years.

[Lord Turnberg]

My Lords, is the Minister aware that in the Palestinian West Bank territories many textbooks contain all sorts of anti-Semitic and anti-Christian remarks and incitements to violence? Is that not something that DfID should pay attention to in its funding arrangements?

[Baroness Northover]

The noble Lord is right that some of these textbooks include things that we would certainly not wish to see within them. There is no doubt about that. With his work in the area, he knows how difficult it is to bring together groups that come from opposing positions. Sometimes it is extremely important to try to take forward the bigger picture and ensure that the Israeli side has security and that the Palestinian side has some kind of hope. That has to be the focus of DfID in supporting those who are in poverty in whatever situation they may be living.

Health and Social Care Bill

Lord Turnberg Excerpts

Wednesday 16th November 2011 Lords Chamber

In addition, advisory committees breed. It is absolutely extraordinary. Yes, you want to keep the good ones. There are others that I have set up and given a time limit to complete a task within two or three years. Then you try to get rid of them. It is so difficult, because they get dug in, they love the work they are doing and many get paid for it. In the end, they become not so much a help but more of a nuisance. So I have some reservations, but when we get to the debate on Public Health England we will see how some of this knits together.

[Lord Turnberg]

My Lords, I am also pleased that public health receives such a high profile in this Bill. I speak to Amendment 60B and one or two others in this group. There seem to be several aspects to the public health parts of this Bill being probed by these amendments. However there is one area of public health that might fall between too many bodies and where we might usefully explore how we can arrange for them to be better co-ordinated. The area is child and maternity services.

As I understand it, local authorities will be responsible for child public health services; the Commissioning Board for health visitors and immunisation services; and clinical commissioning groups for child health and maternity services. That will require all sorts of collaborations to be set up, and that is always a recipe for some problems. I hope that the noble Lord can give us an idea of how these sets of services can be rationalised in some way.

I shall now speak to Amendment 62 and some others. Clause 8 describes the Secretary of State’s duty to protect the public’s health. It details a number of specific responsibilities which, it so happens, are currently undertaken by the Health Protection Agency. I would like to comment on them. I have extolled the virtues of the HPA on a number of occasions, having observed it closely as the chairman of its predecessor, the PHLS, some years ago. Incidentally, the hero of the noble Baroness, Lady Cumberlege, is an employee of the Health Protection Agency. It is a remarkable organisation and the envy of the world. It jumps on outbreaks of infection very rapidly and has prevented many an epidemic. There are many examples of that.

I reiterate this because the HPA is to be swept up into a new arrangement, as we have heard, much more directly under the influence of the Secretary of State. Thank goodness it will not be within the Department of Health, but it will be very close to it. My fear is that we will weaken something of great value to the country. I have some specific questions for the noble Earl.

First, is it expected that all the current functions of the HPA will be taken on board, or are we to lose some? The list is pretty comprehensive but it may leave things out. If so, what would be lost and what would be preserved? Secondly, is it intended that all the staff will move across? They currently work as a very efficient and effective team—a lean, mean team—and any break-up will have an effect. Thirdly, is funding to be affected in the changeover? Will the new organisation have access to external research grant income? That is very important if it is to keep ahead of the infections, which keep changing every day. I have mentioned this before and the noble Earl has responded, but I should like him to respond again more forcefully on whether the organisation will have access to the Wellcome Trust grants, the Medical Research Council and others outside of the NIHR. One of the duties of the Secretary of State is to take steps that include,

“the conduct of research or such other steps as the Secretary of State considers appropriate”.

Finally, will the body have the degree of independence that will allow it to give advice to the Secretary of State unfettered by Civil Service restrictions?

I hope that the noble Earl can help us with these questions, because there is considerable unease in the HPA at the moment.

[Lord Ribeiro]

My Lords, I should like to speak very strongly in support of Amendment 65 in the name of the noble Lord, Lord Warner. Were the noble Lord, Lord Patel, here today, I am sure that he would also speak strongly in support of it because he raised the issue of patient records yesterday when we had a meeting with Professor Steve Field of the Future Forum. We were discussing information provision for patients and the use of computer records. He said that for many years when working in maternity he had given patients their own notes, and in all that time he could remember only two occasions on which the notes had gone missing. On one occasion, the patient reported that a dog had eaten the notes and, on the other, the notes were left on a bus and shredded, someone having recognised that they were important. Therefore, only two sets of notes were lost over a period of some 20 years. Patients are perfectly capable of looking after their own notes. When I was a surgeon in Ghana in 1974 it was certainly quite common for patients to come to the clinic with their notes, which often would otherwise have been lost.

The final message that came through was that we have spent billions of pounds on creating paperless records and computer records and are about to spend even more. The information that we were given yesterday at the Future Forum was that we should be looking at what can be done locally, bearing in mind that GPs have a computerised system of records. We heard another anecdote about an old lady who went to the out-patients’ clinic for her appointment and the consultant said, “I’m terribly sorry but we’ve lost your notes today”. She put her hand into her handbag and came out with a memory stick, saying, “Doctor, it’s all on here”.

I hope that the Minister will take note of Amendment 65 because I feel that it may well stimulate us to look again at patient records and the use of technology. We are, after all, in the 21st century and, although paper records are wonderful for us to have as a tactile instrument, they do not always contain the information that we need.

--- Later in debate ---

[Lord Brooke of Alverthorpe]

My Lords, I hope that the noble Earl will accept these amendments. In many respects they are very modest. I have grave doubts about the extent to which we will be able to influence the course of events in this arena with the changes that we have before us. I am grateful to him for responding in his long letter of 20 October to all of us who raised a variety of questions at Second Reading. He endeavoured to address some of the topics that I had raised on alcohol, labelling, licensing and so on. However, I still believe that ultimately the major issues on alcohol policy will need to be addressed at the centre.

One can do nothing about the cost of alcohol at local level. It must be done centrally. That is being addressed—but inadequately. The marketing of alcohol is something over which local authorities and well-being boards will have no control whatever. The drinks industry is increasingly marketing on the internet and targeting youngsters, particularly in the social networking sphere. I heard recently that one-third of young girls aged 13 to 16 surveyed in Essex are suffering blackouts from excessive drinking. If they continue to drink like that, they will not be ill immediately—they will have good fun and games—but within 10 years, when they get to their late 20s, they will have real problems. What will health and well-being boards be able to do about that? I have been pestering the noble Earl on the labelling issue for quite some time. Nothing can be done about that at local level.

There is one issue that we could have done something about at local level, but we missed our chance. The noble Lord, Lord Clement-Jones, will recall that when we debated the Police and Social Responsibility Bill, we addressed the freedom that people now have to issue licences on a much more liberal basis than used to be the case—we now have a proliferation of off-licences everywhere—but were unable to effect any changes that would have given local authorities greater powers to limit the way in which licences are granted locally. Again, nothing can be done by health and well-being boards.

These are major topics and I wonder how much power there will be to change the course of events. These issues all link to related topics such as obesity and diabetes. It is important that we do not delude ourselves into believing that there will be massive changes without a strong drive from the centre. The nudge-nudge approach will not work with the big drinks industry. Neither, as the noble Baroness, Lady Williams, mentioned this morning, will it work in the context of food, with salt, fats and sugar. These are real problems for people and very little change will be effected at local level; it must all be done centrally.

I come back to the amendments before us. They are very modest and I see no reason why they cannot be accepted. In particular, I will look at the endeavour to achieve change at GP level. Many GPs have been very innovative. Initiatives have been offered to them to effect changes and a number of them have taken up the cudgels and worked adventurously to identify the problems at local level in their communities. Many more have not been doing anything like what should have been done. The Government have declined to accept the screening possibility that was mentioned. Again, I hope that they will be prepared to review their position on that.

Overall, I urge the Government not to reject the modest changes here, but to accept the amendments.

[Lord Turnberg]

My Lords, I should like to speak to the amendments in the name of the noble Baroness, Lady Finlay of Llandaff, and others. I do not think that it is necessary for me to reiterate the dangers of excessive alcohol consumption. The damage done by alcohol is obvious to anyone who visits an A&E department on a Friday or Saturday evening—and indeed, now, almost every evening during the week. It is the cause of more than 1 million admissions a year to hospitals—that is, admissions to hospital beds, not to the A&E department. Liver disease is spiralling out of control. All of this has been described very eloquently by the noble Baronesses, Lady Finlay of Llandaff and Lady Hollins, and other noble Lords.

I want to concentrate on the sort of things that we might be doing—in addition to the things suggested, very modestly, in these amendments—with regard to two aspects, prevention and treatment. It is pretty obvious that the system of voluntary pledges with the alcohol industry does not work. It has not yet worked, and does not look like it ever will. The drinks industry is not in the business of reducing alcohol consumption. We cannot suggest that it is. We have tried the voluntary pledges system, and it is obviously not having an impact.

I agree entirely with my noble friend Lord Brooke of Alverthorpe that we need a national strategy. We cannot rely on local authorities alone. In any national strategy, I fear that we have to focus on the price of alcohol. Our history has shown that every time the price of alcohol goes up, the incidence of liver disease and death from liver death goes down. It is the most effective measure. The Government have suggested that we should look at the minimal unit price, which is the price based on VAT and duty, as the minimal level. That is a pretty pathetic level and it does not work. I am reliably informed by Sir Ian Gilmore, who is a guru on the effects on alcohol, that this price measure affects no more than one in 4,000 drinks that are on sale. You have only to go to the supermarket. It is still possible, for example, to get three litres of 7.5 per cent cider—which is the drink of choice of many—for £2.99, and if you are lucky you can get a two-for-one offer, too. Price is critical. It is clear that the Department of Health is not responsible for pricing, duty and so on, but it must put pressure on for a rise in the price. It is not very popular with journalists, and it is even less popular with politicians. Nevertheless, it is an important measure.

I shall talk about treatment. There is no doubt that the best results from treatment come where there is an integrated team approach to patients suffering from the effects of severe alcohol ingestion. That is a team which combines specialist nurses, specialist doctors, primary care doctors and their team in an integrated way. A good example of that service is the one run by Dr Kieran Moriarty in Bolton. It is a very good system. Unfortunately, there are too few of those sorts of arrangements available. We need many more. They work, because you can actually do something with them. You prevent further damage from alcohol by aborting the effects of alcohol very early on. It works.

There is a lot that is needed, and a lot that can be done. We certainly cannot rely on the drinks industry to put up the price. We have to do something nationally. We have to enhance the alcohol services. I hope we can see some action here. I support these amendments as a first step.

--- Later in debate ---

[Lord Turnberg]

In the review that the Government are undertaking, will they take note of the publication on alcohol by the Academy of Medical Sciences, produced by Sir Michael Marmot two or three years ago? It recommended a whole series of things to do. Unfortunately, the Government of the day sexed it down and we were not able to move much further with it. I hope that this Government will take it into account.

[Baroness Northover]

I note what the noble Lord has said in regard to his Government. I would be astonished if those working on this strategy were not bearing that in mind, but I will check. I can assure the noble Lord that, in the unlikely event that they are not, I will bring the review to their attention so that they can factor it in.

The noble Lord, Lord Rea, asked whether the current spending on alcohol is included in local authorities’ funding for public health. I can assure him that that is the case and that what is being spent by PCTs on commissioning alcohol services will be reflected in the resources transferred to local authorities.

Amendments 66 and 72 would add,

“providing services for the prevention and treatment of harmful drinking and alcohol dependence”,

to the list of steps that the Secretary of State and local authorities may take under new Sections 2A and 2B. However, the Bill already gives the Secretary of State and local authorities the ability to take appropriate steps to address harmful drinking. The new public health responsibilities in this Bill give local authorities a ring-fenced grant to ensure that local authorities have the resources to deliver their public health responsibilities, including alcohol misuse services. Obviously, there was discussion of that ring-fence grant previously. I think it is a move forward that, instead of public health being part of the overall NHS and subject to being raided, there will be a ring-fenced grant.

Clinical commissioning groups are already under a duty—under Section 3 of the NHS Act, as amended by Clause 10, and under new Section 3A—to commission services as they consider appropriate as part of the health service or to secure improvement in the physical and mental health of their population. Given the scale of the problem, it would be astonishing if that was not part of how they see their responsibility.

I can further reassure your Lordships’ House that the importance of services which reduce alcohol-related harm will not be overlooked. The Secretary of State will set the strategic direction of the NHS through the mandate to the NHS Commissioning Board. This should be the route for highlighting priorities for the health service and I have no doubt that debates in Parliament, such as this, and in the wider sphere will help to influence that.

Amendments 328 and 329 would require joint strategic needs assessments to include an assessment of alcoholism in the local population and the involvement of representatives from alcohol services in the preparation of the joint health and well-being strategy. While we fully support the principle that the joint strategic needs assessments need to be comprehensive, we do not feel that it is necessary to include this amendment in the Bill. The scope of this assessment will naturally include the needs related to harm from alcohol. However, we have retained the power for the Secretary of State to issue guidance on the preparation of the joint strategic needs assessment. We will ensure that it covers the need to consider alcoholism, which I hope will reassure noble Lords.

Amendment 329 would require local authorities and clinical commissioning groups to,

“involve representatives from alcohol services”,

in the preparation of the joint health and well-being strategy. While there is no representative of alcohol services in the local area on the health and well-being board, it would still be able to involve experts as appropriate or invite them to be members of the board. On Amendment 331, which would require health and well-being boards to include,

“a representative from alcohol and drugs service”,

the same point applies: they could be a member of the board or their advice could be sought. The legislation sets out a minimum membership for these boards—

Gaza

Lord Turnberg Excerpts

Monday 13th December 2010 Lords Chamber

[Baroness Verma]

My Lords, I understand the noble Lord’s concerns. We recognise that ordinary Gazans are suffering—indeed, the deterioration of Gaza’s institutions and infrastructure is described by the UN as “de-development”. We continue to call on Israel to implement its 20 June announcement by allowing full exports and movement of people. Ministers have put that to Israel during their recent visits to the region and we are working with our EU partners to agree practical steps to improve access. That is having results, as Israel has agreed to limited exports from early next year. However, it is important that that translates into reality on the ground.

[Lord Turnberg]

My Lords, is the Minister aware that despite the antagonisms between Hamas and Israel, almost 40 per cent of children sitting down with their families in Israeli hospitals are from Gaza? Is she also aware that a number of doctors from Gaza are training in Israel to go back to set up clinics there?

[Baroness Verma]

The noble Lord makes a very valid point. Of course, it is by dialogue and improvement in negotiating across both the occupied Palestinian territories and Israel that we will improve the lot for both sides of the argument.