Equality: Pay and Opportunities
Baroness Northover Excerpts(14 years ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Northover
My Lords, the Government are committed to making full use of the skills and experience that women bring to our economy. We are increasing flexibility in the workplace and extending help with childcare. We are supporting women’s enterprise through identifying and training 5,000 business mentors. We are encouraging greater transparency on gender equality in the workplace and, with the noble Lord, Lord Davies of Abersoch, we are helping more women reach the boardrooms of our leading companies.
Baroness Prosser
I thank the noble Baroness for that reply. Does she agree that as the reasons for the continuing gender pay and opportunities gap are many and various, the solutions must be multilayered as well? Can she tell the House about any proposals the Government may have to address the unaffordability of childcare, the paucity of good quality part-time employment and the training needs of women working below their capacity?
Baroness Northover
I pay tribute to the noble Baroness for her work in this area and for chairing the Women and Work Commission and its later update, which is an impressive piece of work. She will be aware that the trend is in the right direction. It is very marked. If you look at 1970, there was a 38.2 per cent gender pay gap and in 2011 it was 9.2 per cent. But we cannot be complacent and the issues that she has flagged up rightly identify some of the challenges that face women in work.
Under the universal credit, we will be extending the amount of support to childcare for those working less than 16 hours a week—so those working part-time—and that should assist 80,000 families. We are extending the right to request flexible working to employees. It is also extremely important to note that there are many more apprenticeships, often being taken up by women in later life so that they can more easily get back into work if they have taken time out.
Baroness Kramer
My Lords, my noble friend will be aware that students taking maths at A-level almost always go on to higher education and earn something like £17,000 more a year than their counterparts. That is true also for those taking subjects such as physics and engineering. What are we doing today to try to persuade girls that they can choose this route, which would very quickly close a great deal of the earnings gap?
Baroness Northover
My noble friend is absolutely right. Gender stereotyping in schools has tended in the past to direct girls way from the areas that she is talking about. The new National Careers Service will encourage girls and young women to challenge those stereotypes and encourage them to choose from the broadest possible career options. That includes providing good information, which girls, certainly from my experience, are very interested in, about the wide range of career opportunities that studying science and maths can lead to.
Baroness Pitkeathley
My Lords, does the Minister agree that, with the demographics of an ageing population, the provision of elder care and care for disabled people is just as important, if not more important, than the provision of childcare in enabling people to return or stay in the workforce? What provisions are the Government making to help people with caring responsibilities enter or remain in the workforce?
Baroness Northover
The noble Baroness is absolutely right. We often debate how we can better develop the support of social care. I look forward to future debates this year on that area, as she knows. She is quite right that many people find themselves trapped in a situation where they are responsible both for the care of children and for elder care. That means that it is extremely important that our extension of the right to request flexible working for all employees—men and women, as we seek to share that responsibility—is taken forward. It is very important that this does not simply fall on women. At the moment, many men support their parents as well, so I hope that this is something that will move forward steadily.
Baroness Howe of Idlicote
My Lords, does the Minister agree that one of the most important issues is to ensure that men have equal access to flexible and part-time working and that that is seen as important in all the firms that employ men? That is one of the gaps that still exist. I also congratulate the Government on the progress—there are visible signs of progress—in opportunities and on pay. This Government have done a fair amount to increase that and the previous Government did a great deal to start the climb.
Baroness Northover
I am very grateful to the noble Baroness for those comments and I also pay tribute to the previous Government for their work in that area. It is indeed extremely important to extend flexible working to make sure that both sexes take full advantage of that and play their part—whether looking after children or helping with elder care, as we have just discussed.
Lord Boswell of Aynho
My Lords, while in no sense seeking to denigrate the importance of equality legislation, where we must not take our foot off the pedal, will my noble friend agree that it is time to trumpet the positive benefits to companies and organisations of a workforce and decision-makers who are diverse in experience and attitudes? More wisdom will come out of that diversity than out of a monolithic offer.
Baroness Northover
I could not agree more with my noble friend. That was emphasised in the debate on women last week. I note that 24 per cent of all appointments to FTSE 100 boards are now women, up from 13 per cent the previous year. That is one area where it is extremely important to carry through the points that my noble friend made.
Lord Dannatt
My Lords, on this day when we focus on women and are mindful of the loss of six soldiers in Afghanistan, bringing the number who have lost their lives in that campaign to 404, will the Minister and the whole House join in paying tribute to women— mothers, daughters, girlfriends and wives—who are at home while their men are on the front line? We must also bear in mind that some of those on the front line are women. We pay tribute to women who serve at home by supporting those who are on the front line on this day when we focus on women in particular.
Baroness Northover
I am very happy to pay tribute to the men and women who serve for us on the front line and their families at home—their partners, wives and husbands, and their children.
Sahel
Baroness Northover Excerpts(14 years, 1 month ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord McConnell of Glenscorrodale
To ask Her Majesty’s Government what action they will take to help prevent the famine and food shortages predicted in the Sahel region.
Baroness Northover
My Lords, the rapid response of UK humanitarian aid to mitigate the impact of the crisis in the Sahel will reach 68,000 children in Niger, Chad and Mali, and provide livestock support for 30,000 families. The Government are also lobbying other donors to provide funds to help ward off a disaster.
Lord McConnell of Glenscorrodale
I thank the Minister for her Answer. The European Union said yesterday that alarm bells are ringing in this area, with 12 million people potentially affected by food shortages and five countries having already declared an emergency, including four of the poorest countries in the world. Just last month Oxfam and Save the Children reported on the recent famine in east Africa. In their report they said that it was important to manage the risks, not the crisis, and to pre-empt famine more quickly rather than react afterwards. Have the Government learnt some of those lessons, and will they lobby internationally for action to ensure that the international community reacts more quickly in this case than it did in the east over the past 18 months?
Baroness Northover
The international community is, I think, indeed learning these extremely important lessons about acting quickly. The severity of the problem is recognised and the early warning systems that were in place have picked up the absolute necessity of acting rapidly to try to deal with this crisis. The early mobilisation of funds is happening and it is encouraging to see that shift, although we should not be complacent.
Lord King of Bridgwater
My Lords, does my noble friend agree that that region is, unfortunately, becoming an extremely dangerous area? It includes mercenary elements who worked for Colonel Gaddafi and are now operating in the region. Significant elements of al-Qaeda and associated bodies may have moved to the region, and the very serious terrorist attacks in northern Nigeria are not unconnected with some of the problems there. Is the African Union considering how it will tackle the humanitarian situation? The security issues there are critical.
Baroness Northover
The noble Lord is right: the fighting in the region has been exacerbated by the cash, weapons and soldiers that have come from Libya following the fall of Gaddafi, overlaying this humanitarian crisis and making it much more dangerous for people to be working in the area. It is therefore extremely important, as the United Nations analysed recently, that a vacuum is not created for others to come into. The international community is acutely aware of that and the AU is being given technical support.
Lord Avebury
My Lords, what response has there been to the appeal by the International Development Secretary to take steps in addition to those that have already been taken by the Government of this country and by the European Union to avert the possibility that 6.8 million people in the Sahel may starve? Are any steps being taken by the international community to bring to an end the conflict in northern Mali that has led to the displacement of some 50,000 people in an area where, according to the ICRC, there is a threat of a major crisis of food availability after a very poor rainy season?
Baroness Northover
The international community is acutely aware of all the problems right across the region. One of the lessons from west Africa has been, as the crises that have happened there and across the region generally have shown, that you have to pick up the early warning signs of increasing food prices as well as food shortages. The displacement of people from Libya, as I just mentioned, and problems spilling over from Nigeria contribute to this problem. I am pleased to say that the EU is very much taking a lead in this area. The meeting yesterday shows that there is a lot to be done but there are encouraging signs that actions are being taken.
Baroness Kinnock of Holyhead
My Lords, the Minister has acknowledged that the struggling countries of the Sahel are now facing the fallout from the crisis in Libya. Hundreds of thousands of migrants have returned from Libya; communities have lost the income from remittances on which they depended; and huge caches of very sophisticated weapons, which were previously in the Libyan arsenal, are now flowing into the Sahel in the hands of ex-combatants. Would the Minister clearly outline the involvement of the UK, together with the EU and, very importantly, with the UN and regional bodies, in the efforts that need to be made to deal with this growing humanitarian and security problem?
Baroness Northover
This is currently very high on the UK’s agenda and those of the EU and the UN. There will shortly be a debate on this in the UN, as the noble Baroness probably knows. I spoke to relevant officials this morning and I can assure the noble Baroness that they are acutely aware of the problem of the weapons there. As she says, people have come back who are no longer sending remittances home and themselves need to be supported.
Lord Alton of Liverpool
My Lords, the Minister has given the House the welcome news that the British Government are providing 68,000 children with food aid. Did she see UNICEF’s report last week, which said that 1 million children in the Sahel region are at risk of immediate malnutrition? How are we directing our aid, particularly towards the children who are at risk at this time?
Baroness Northover
UNICEF is supported by DfID, as the noble Lord knows. As I mentioned, the United Kingdom is working bilaterally but it is also working multilaterally through the EU and a number of NGOs, and is acutely aware that there are 1 million children at risk.
Gaza
Baroness Northover Excerpts(14 years, 1 month ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Warner
To ask Her Majesty’s Government what contact they have had with the Government of Israel regarding the effect of Israel’s blockade of Gaza on children’s health.
Baroness Northover
My Lords, the UK Government are very concerned about the impact of movement and access restrictions on the health of children in Gaza. We regularly press the Israeli authorities on the need to ease restrictions and to address the humanitarian situation. My right honourable friend the Secretary of State for International Development raised these issues during his recent visit.
Lord Warner
My Lords, I am grateful to the Minister for her reply. Is she aware that only 5 per cent of the water coming out of Gazan children’s taps is drinkable and the rest is not? Gastroenteritis is endemic among children in Gaza, about 70 per cent of whom are anaemic. Is she also aware that doctors working in the main hospital claim that about 500 people have died as a result of the shortage of basic medication, many of whom are children? Can we not approach the Israeli Government with a greater sense of urgency to secure a change in the situation of these children who are being collectively punished?
Baroness Northover
I have been replying to the noble Lord on the issue of water so I am extremely well aware of the situation. We are very concerned about the situation in Gaza and it is a tragedy that people are living in such circumstances. Thirty-eight per cent of Gazans live in poverty, 66 per cent depend on food aid, and, indeed, 90 per cent of mains water is unfit to drink. We are pressing the Israeli authorities all the time to try to address these problems.
Lord Avebury
My Lords, last week representations about this were made even by the UN Secretary-General, which demonstrates once again the futility of all efforts by the international community to alleviate, let alone to resolve, the humanitarian crisis in Gaza. Can my noble friend tell the House what replies we have received to our repeated representations to the Israeli Government? In particular, will the Israelis facilitate the onward delivery of $1.5 million-worth of medical supplies which were landed in the port of Ashdod by a Turkish aid agency last Saturday?
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.
Baroness Deech
Is the Minister aware that around 300 Questions have been tabled during this Session on Israel, Gaza and the associated areas, with, sadly, little effect? We have had only around 20 Questions on Iran, 30 on Syria and only one relating to the Arab spring. Is the Minister confident that this House is seeing the widespread crises throughout the Middle East in perspective and that British representations on Gaza are set in the context of the whole area? I find it very odd—maybe other Members do as well—that we have not had a debate on the Arab spring.
Baroness Northover
The noble Baroness is right to flag up problems in other areas across the region. All these issues need to be addressed, and of course what happens between the Israelis and the Palestinians also plays out in those other areas. It is extremely important that we seize these issues right across the region.
Lord Eden of Winton
My Lords, in her reply my noble friend referred to representations that the British Government have been making to the Government of Israel on this issue. That frequently is the form of reply which is given on many other issues relating to Gaza and Israel. Does Israel give assurances in response to those representations, and do Her Majesty’s Government ever follow up any undertaking given by the Government of Israel? When are we going to have any positive action to redress this wrongdoing?
Baroness Northover
The noble Lord is right: there is a lot of communication all the time. There have been some shifts—some of the restrictions on crossings have been lifted to some extent—but it is nowhere near what is required. Therefore, constant pressure is needed. However, I come back to one of my original points. It is necessary for both sides to see that it is in their long-term interest to find a political solution. It is only when we get people on to that path that we will start to crack some of the other problems.
Lord Davies of Stamford
My Lords, is there not a ready solution available to hand? All that needs to happen in order for the remaining restrictions to be lifted is for the Hamas regime in Gaza to accept and adopt the quartet conditions; to accept existing agreements, including the Oslo accords; to recognise the state of Israel, and to abjure violence. Do the Government think that any of those suggestions are unreasonable; and if not, even though we do not have any relations with the Hamas regime directly, will they find a way of communicating that thought to it?
Baroness Northover
The noble Lord’s premise of a simple route rather defies the current situation. We welcome the reconciliation between the Palestinians, Hamas and Fatah, which we are monitoring very closely, and we welcome the moves towards elections. However, as the noble Lord and others will know, you have to take a balanced approach and recognise that one side will feel that you are not being fair if you demand X of them, and the other side likewise. That is why it is extremely important to try to bring the parties together and to seek a political solution which is in everybody’s best interests.
Legal Aid, Sentencing and Punishment of Offenders Bill
Baroness Northover Excerpts(14 years, 1 month ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Bach
My Lords, in many of his amendments I agree with the noble Lord, Lord Ramsbotham, and I hope to do so later this evening, but on my understanding of his argument here I find it difficult to accept the amendment on behalf of the Opposition.
I shall make a general point. This is not a government amendment—but when there are government amendments dealing with a different Act, as in the case of this Bill, where we are amending the Criminal Justice Act 2003, Keeling schedules, which set out what the amended 2003 Act would look like if we passed this legislation, are incredibly helpful. Indeed, when we were in government, the opposition on all sides used to ask us where the Keeling schedules were—and they were often there. In this Bill, later on tonight or whenever we reach the 17th group, there are very helpful Keeling schedules in important government amendments. But they do not exist elsewhere, as far as I can see, although the Minister has been helpful in writing to noble Lords about government amendments. There is a value in having Keeling schedules in that the House can understand what is being amended.
The Criminal Justice Act 2003 states:
“If it is proved to the satisfaction of a magistrates' court before which an offender appears or is brought under paragraph 7 that he has failed without reasonable excuse to comply with any of the requirements of the community order, the court must deal with him in respect of the failure in any one of the following ways”.
The Bill changes that “must” to “may”. The following ways include,
“amending the terms of the community order so as to impose more onerous requirements”,
and,
“where the community order was made by a magistrates' court, by dealing with him, for the offence in respect of which the order was made, in any way in which the court could deal with him if he had just been convicted by it of the offence”.
I know that the noble Lord has no objection to those provisions, as amended by this Bill. It is sub-paragraph (1)(c) that his complaint is with. That sub-paragraph is not just about a breach. It refers to,
“where—
(i) the community order was made by a magistrates’ court,
(ii) the offence in respect of which the order was made was not an offence punishable by imprisonment”—
that is the noble Lord’s point. It goes on to refer to,
“(iii) the offender is aged 18 or over, and
(iv) the offender”—
and these are the crucial words—
“has wilfully and persistently failed to comply with the requirements of the order … by dealing with him, in respect of that offence, by imposing a sentence of imprisonment for a term not exceeding”,
six months.
Provided that the Bill reads “may” rather than “must”, I can see nothing wrong with that. The danger is that someone who is given a community service order for an offence for which there is no imprisonment can get away for ever in breaching community service orders to the extent that he wilfully and persistently fails to comply, and the court will never have the power to deprive that person of their liberty. I agree with the Minister’s point from earlier that if community orders are to succeed—we want them to succeed because they are vital—they must be, in the words of the noble Baroness, Lady Linklater, “robust” community orders. There must be something there, eventually, if someone wilfully and persistently fails to comply with them. It is not just a breach in sub-paragraph (1)(c), but a wilful and persistent failure to comply, which is a step beyond a breach. Clearly, it is more than one breach; one breach would not be enough. Two might be—three might well be. In those circumstances, my case—I may be wrong about this—is that if we agree to these amendments, the result would be that someone who was given a community order for an offence that was not in itself subject to imprisonment could never be sent to prison, however wilfully and persistently he failed to comply with it. On this issue, which I concede is not a major one, I do not agree with the noble Lord, Lord Ramsbotham.
Baroness Northover
My Lords, I thank the noble Lord, Lord Bach, for his support on this, the first group of amendments that I am dealing with on this Bill. That is extremely welcome. Maybe the issue to which he refers rather reflects upon the quantity of legislation that this House has dealt with over a number of years. I absolutely take his point about the need for clarity and for linking Bills one to another.
I will seek to clarify what we understand these two amendments would do and why we resist them. They would repeal some of the provisions giving powers to both magistrates’ courts and the Crown Court to deal with breach of a community order. The provisions that the amendments propose to repeal give the courts the power to imprison offenders for serious breach of community orders which have been imposed for offences which do not carry imprisonment. Noble Lords agree on that.
As it so happens, community orders cannot currently be imposed for offences which do not carry imprisonment, so these provisions may appear to be redundant and I can appreciate why the noble Lord, Lord Ramsbotham, might have tabled these amendments. However, they were certainly needed in the past and it was only in 2008 that the community order stopped being available for non-imprisonable offences. Before then, a community sentence could be imposed for a non-imprisonable offence. When that happened, these provisions were the only way that a breach could be dealt with—by sending the offender to prison—so however serious the breach, there would have been no custodial disposal without these measures. As I have noted, since 2008 there has on the face of it been no further need for them to remain on the statute book because they are, in practice, no longer necessary.
However, it is not quite as straightforward as that, complex though that may seem. There is an unimplemented provision in Section 151 of the Criminal Justice Act 2003 which, if it were commenced, would allow the courts to impose a community order on a persistent offender, in the way that the noble Lord, Lord Bach, has spelt out, who has at least three previous fines, even if the offence they committed was not serious enough to cross the community sentence threshold. If that provision in Section 151 were to be implemented, it would become possible once more for a community order to be imposed for an offence which did not carry imprisonment.
It follows that we would therefore need the provisions which the noble Lord’s amendments would repeal to ensure that a persistent offender who gets a community order because they have received at least three fines could be penalised by imprisonment in case of breach. Effectively, these two measures go together. While we retain the sentencing power, even if it is not in force, we also need the breach power. I should perhaps say that we have no intention at present to implement the sentencing power but, as I have explained, while this is still an option, we need the breach power against the possibility that it might happen in the future.
Lord Bach
I follow the noble Baroness’s argument, which she has made very clearly. Indeed, I was not aware that the law was changed in 2008 so that non-imprisonable offences could not receive a community order, but I see the noble Baroness's way around that. However, to describe it as a breach power seems to be wrong on the basis of how the 2003 Act is phrased. It refers to a person who,
“wilfully and persistently failed to comply”.
In one sense, that is about a breach but not a breach on one occasion. It is the court having to find that there has been a wilful and persistent failure to comply and I hate to see that lessened to a mere breach, if I may call it that.
Baroness Northover
I heard what the noble Lord said and was very interested in the points that he made. Perhaps it is best if I come back to him to clarify that point. In the mean time, I hope that after this incredibly clear explanation—
Lord Carlile of Berriew
My noble friend will recall that it was part of the vaunt of the coalition that the statute book would be tidied up so that there were far fewer redundant statutes. There are in fact hundreds and hundreds, possibly thousands, of redundant statutory provisions—I have a book of them upstairs by my desk. Given that this has not been brought into force now for nine years, in the spirit of clear statute-making would it not be better simply to repeal the original provision and, if the Government wished to have something like it in the future, to introduce that in a proper way in a Bill?
Baroness Northover
My Lords, that is exactly what I asked and I was assured that in fact the Government wanted to keep the possibility of this being implemented. We therefore need to make sure that it is, as it were, complete.
Lord Carlile of Berriew
My noble friend clearly did not understand what I was suggesting: that it is, to put it plainly, senseless to have something on the statute book nine years after it was enacted, with absolutely no intention of bringing it into force.
Lord Carlile of Berriew
No, this provision is from 2003 and it has not been brought into force for nine years. Is the right answer to this not to repeal the 2003 provision in question? If the Government then have some constructive suggestions for imposing imprisonment, if it be merited, on people who have been given a community sentence, why do we not start again with those provisions? In reality, my noble friend is not going to suggest for one moment that the Government will bring this redundant provision into force.
Baroness Northover
I assure my noble friend that in fact I understood him very clearly the first time. I asked, as this was introduced in 2003, changed in 2008 but not complete, why we would not seek to repeal it. However, I was told that the Government wish to retain this, in the possibility that it might be implemented—although with no intention of doing that at the moment. I fully support what he says about trying to rationalise legislation in all areas, and I worked very hard on the companies legislation, the first elements of which were finally rationalised relatively recently, after 100 years. I realise that these things can take a long time, but I take very much the point that legislation needs clarity. However, I hope that in this instance the noble Lord, Lord Ramsbotham, will understand what I am arguing here and be willing to withdraw his amendment.
Lord Avebury
May I ask my noble friend what may be a naive question? If the provision to which this is attached has not been brought into force but the Government require it to remain on the statute book in case it is necessary at some future date, why is the provision that we are discussing not also subject to a statutory instrument to bring it into force at the same time?
Baroness Northover
In answer to my noble friend, I expect that it will be necessary that this is in legislation, whereas the implementing would not require further legislation. This is therefore a time to tidy up something which was left untidy.
Lord Ramsbotham
My Lords, I am grateful to the Minister for that response and intrigued with the points made by the noble Lord, Lord Bach. I am grateful to him for those and for the intervention of the noble Lord, Lord Carlile. As I rather suspected, this simple amendment has disclosed that there is a need to examine the clarity of the legislation regarding breach, while absolutely accepting the problems faced by magistrates. I very deliberately did not include “wilfully and persistently” regarding a breach, because that was not what I was after. Wilful and persistent was covered deliberately by the noble Baroness, Lady Linklater, in her contribution.
There is merit in doing this, though; as I said, we are talking about the sentences but we must also consider what is going to happen to the person who has committed the breach and what the impact will be on the prison service. In our overcrowded prisons, there are currently vast numbers of people serving sentences for a breach since the 2003 Act. It was a small number before but it has become large, and there is nothing meaningful that can be done with them. That really is a waste of time and money, accepting that the magistrates have to do something. This should be thought through, which I hope is what the Minister will take away from this short debate. I beg leave to withdraw the amendment.
Baroness Northover
My Lords, Clauses 67 and 75 would enable a court to impose longer curfew requirements as part of a community order, a suspended sentence order or a youth rehabilitation order. The clauses would allow the court to impose a curfew of up to 16 hours a day for a duration of up to 12 months. Enabling the courts to impose longer curfews in this way will make the community order capable of being more punitive and attractive as a suitable disposal for more serious offenders, possibly some who might otherwise have gone to prison. It will also increase the confidence of the public, who too often see community sentences as insufficiently demanding. No doubt these issues will be much debated in this House, but I am very glad that noble Lords support the principle of doing what we can to keep people out of prison. We all know the drivers of that.
We believe that increasing the maximum number of hours of curfew per day will give the courts more scope to use community orders imaginatively to punish offenders, protect the public and encourage compliance.
Lord Beecham
Wherein lies the imaginative use of these orders? Where is the imagination?
Baroness Northover
Perhaps we should leave that to those who are curfewed. For example, a curfew period of 16 hours will enable courts to curfew offenders for 12 hours overnight, as often happens now, but also to add a further period. This is designed to ensure that the offender is at home immediately before a community pay-back session to increase the likelihood of their turning up on time. More seriously, that illustrates the point that I just made about how this could be teamed with something else that the court wishes to achieve. If the curfew is timed so that the person will be at home before the community pay-back session, that is an imaginative way of using it. A young person attending school will need less restriction during the school week but could have their movements more tightly restricted at weekends, when they are at greatest risk of reoffending. That is another point.
I am aware that the Prison Reform Trust does not share this view and believes that the courts already have sufficient flexibility to impose curfews. I know that this belief has been endorsed by the Bar Council. Both have commented on their particular concerns about the impact of these changes on children. While I understand these concerns, it should be remembered that the new curfew limits are maxima. They will be imposed only where such a requirement is, as the law requires, the most suitable for the offender and where the sentence is proportionate to the seriousness of the offence. In respect of under-18s, we expect the longer curfews to be used sparingly and that courts will take their age into account. It will be the court that decides whether and how to use this option.
My noble friend Lady Linklater makes the case for when lengthy curfews would be disproportionate. Doubtless the court would see that in the relevant cases. The kind of aspects that my noble friend mentioned would be raised in court and taken into consideration.
Compliance with curfew is normally monitored electronically through the offender wearing a tag. This will not change. Indeed, we are exploring ways of making more use of electronic monitoring as the technology becomes more sophisticated and robust. None of the existing safeguards will change. Courts will still be required by law to ensure that the restrictions on liberty imposed by any community order are commensurate with the seriousness of the offence, so longer curfews may be more suitable for more serious offenders. It will remain the case that before imposing a curfew requirement, the court will have to consider what the effect of the curfew might be on the person themselves and their individual needs and circumstances and on other people living at the curfew address. With longer curfews being available, it will be even more important that the courts take account of the needs and views of the family members before setting the curfew hours. Youth offending teams will assess the suitability of the home address for curfew purposes. They will make a recommendation to the court on what length of curfew is appropriate. We would expect that any longer length and duration of curfew would be focused on older children where the alternative might be custody.
The point was made that longer curfews would interfere with work and children’s education. The law requires that all community order requirements, including curfews, should, as far as possible, avoid interfering with an offender’s work and education. I hope that that will reassure people. We believe that giving courts the power to impose longer curfews will contribute to realising the aim of making non-custodial sentences tougher and more demanding. In doing so, we hope that they will command greater confidence among sentencers and the public.
Baroness Linklater of Butterstone
I thank everybody who has participated in the debate. Consensus on this issue has broken out loudly and strongly with one unfortunate exception. I understand entirely where my noble friend is coming from and I do not envy her taking that position. Graphic arguments have been put forward regarding the reality of the lives of the people we are discussing. I respectfully suggest that the people who have framed these conditions have not been able to imagine what it is like to be in a house you cannot bear to be in for 12 hours a day for up to a year. Some sort of assessment by the Government in advance of imposing such restrictions on people who are already in trouble might be a good idea. Perhaps some sort of evaluation is in place that could be looked at. I do not know whether that is the case. Of course, it is a good idea to find alternatives to custody and for more serious offending but not, I suggest, if it hastens the route to custody. I cannot imagine how this measure will not lead to more reoffending. If there are more serious offenders around, it will simply result in more serious offending because these sanctions will be almost impossibly difficult to adhere to.
Once again, I thank everybody who has participated in the debate. I say to my noble friend that I hope that the arguments that have been made this evening will be taken away and considered very carefully before we come back to the matter on Report.
Baroness Northover
Baroness Northover
My Lords, the amendments in this group are minor, technical amendments to ensure that the extent of court-imposed foreign travel prohibitions includes territories as well as countries. I beg to move.
Lord Bach
Whenever I was sitting where the noble Baroness is sitting now and I began my speech on government amendments by saying that they were minor and technical, those sitting opposite me used to look doubly hard at those amendments to see whether they really were minor and technical. I am not saying that I have looked doubly hard at these amendments but they are clearly minor and technical and we have no objection to them.
Baroness Northover
Lord Bach
My Lords, the problems of drugs in this country are always in the news. The arguments about whether they should be legal, illegal or somewhere in between are a constant source of debate among talking heads—quite rightly too, as it is a very serious problem and issue. By comparison, the issues of alcoholism and too much consumption of alcohol have always taken, certainly in recent times, very much a second place in discussion. Of course, if we read our local newspapers, we will see one such case after another—often they are minor, but sometimes they are very serious, which I shall talk about in a moment. We hear of X being found drunk and disorderly at the very bottom end of it, or of criminal damage or damage to a person. Every week countless cases are there to be recorded by any enterprising journalist who goes along to the local magistrates’ court. It is a wonder that, over many years, we have allowed this imbalance to grow—as the noble Lord, Lord Carlile, emphasised—in our discussion of drugs and alcohol. Alcohol when misused is a drug. There is no question or doubt about that.
We have heard some extraordinarily impressive speeches in a very impressive debate. From the opposition Front Bench we welcome the amendment and will support it all the way. I can be brief, as I know that people are waiting for other business to begin, but the facts are truly terrifying. There are 1.2 million alcohol-related violent incidents a year, including about half of all violent crimes. There are 360,000 incidents of domestic violence, a third of which are linked to alcohol misuse. There are all those arrests for drunkenness and disorder. The noble Lord, Lord Carlile, talked about medium and serious crime. There are 530 drink-driving deaths—what a waste that is. There is also the appalling statistic that 58 per cent of rapists reported drinking, no doubt to excess, beforehand. They are horrifying figures for a civilised society and more needs to be done.
We are living in a time of austerity—it does not matter whose fault it is for these purposes—when more people are unemployed and people are probably poorer than they were. The figures for relationship breakdown are not exactly encouraging. Those are all factors that have been associated in the past with heavy drinking. We cannot be careless about the issue now. The cost each year is absolutely huge—£8 billion to £13 billion a year, as estimated by the Home Office in 2010. We have heard about the National Health Service and the ridiculous amount of money that it has to spend on people who constantly get drunk and then get hurt.
Of course I claim that the previous Government did useful and good things in this field, and no doubt the Government before that one did too, but that is no argument in itself. We have to do more and we have to take slight risks. We have to do more than we would otherwise think of doing. It is not a matter for some bureaucracy to decide that we can move forward on this step but not that one. This suggestion has been well discussed by the noble Baroness, Lady Finlay, and her supporters, and I pay special tribute to the noble Baroness, Lady Newlove, who speaks with such effect on all these matters. The argument has been so one-sided that is very hard to see any argument at all against the Government supporting, at least in principle, what has been suggested. I hope that they will support the amendment. We certainly support it—it would be a crying shame not to. It is, after all, a pilot that is being proposed. It is not a dramatic implementation across the country all in one go. A pilot has been proposed and I cannot think of one argument against adopting it.
Baroness Northover
My Lords, in responding to these amendments I am aware that these proposals were discussed previously in the Police Reform and Social Responsibility Act last year. I am very glad to say that we very much support the principle of the intention of the noble Baroness and other noble Lords who have contributed to this debate. It is very clear that alcohol-related offending causes a great deal of harm and there is an undeniable logic in tackling alcohol-related offending by preventing an offender from participating in the activity that has given rise to or exacerbated their criminal conduct.
The noble Baroness makes a very cogent case, and we all know how very damaging the abuse of alcohol can be. I can therefore confirm to the Committee that the Government will shortly be establishing two pilot schemes to test the principles and effect of enforced sobriety schemes as part of our effort to tackle and reduce alcohol-related crime, drawing on the success of similar schemes that have been trialled in the United States.
At the time of the policing Bill, the Government committed to testing sobriety schemes as part of conditional cautions within existing legislation. Since then, the Ministry of Justice and the Home Office have developed further proposals to pilot sobriety as part of community orders within the existing law. There will be two pilots using tags and breathalysers because it is extremely important to assess the practical advantages and disadvantages of schemes such as this. The conditional caution pilot will focus upon offenders who commit high-volume alcohol-related offences, such as drunk and disorderly, common assault and criminal damage. Offenders will face the tough choice of accepting sobriety conditions or facing prosecution and the prospect of receiving a drinking banning order on conviction. Anyone failing to comply with these conditions would be prosecuted for the original offence.
The second pilot will test sobriety as part of community orders, which will target a range of more serious offences where alcohol is a contributing factor. We will be looking at making use of the latest technology through which to monitor an offender’s compliance with the terms of the sobriety requirements. Breach procedures will exist as they currently do. We will set out further details of these pilots in the Government’s forthcoming alcohol strategy.
We want to hear the views of the judiciary, professionals within the criminal justice system and the public on the proposals. We will therefore be consulting in parallel with the pilot schemes to ensure that we give full consideration to the purpose, effect and benefit of sobriety schemes as we develop work further. The noble Baroness, Lady Finlay, as a medical scientist, knows how important it is to evaluate evidence. In her introductory remarks, she flagged up some of the complexities in this area. It is extremely important that we learn from these pilots in order that we can take forward what works best.
Alongside this we are taking a range of other measures to tackle alcohol-related offending. Pricing is one crucial lever for tackling alcohol misuse and its associated crime and health harms. I have just mentioned that the Government’s alcohol strategy will be set out shortly. We are also rebalancing the Licensing Act in favour of communities by giving greater powers to police and licensing officers to tackle irresponsible businesses. We are also strengthening violence reduction programmes to incorporate a greater emphasis on tackling the impact of alcohol and drugs and gathering evidence from drinking banning orders that are being piloted in 50 areas across England and Wales.
The noble Baroness has done a great deal to bring this issue to the Government’s attention, and I congratulate her for it, but as I have said, it is extremely important that we are certain of the effectiveness of this policy before it is put in statute, which is why I am very glad that we can take forward the pilots under current legislation so that the practical aspects can be properly assessed. There are some concerns not about the principles of the amendment but about the design of some of the elements. We feel that some safeguards are not quite as they should be.
The noble Baroness mentioned questions over the tagging equipment. It will be assessed, but I flag up that in 45 states in the United States it has been used for more than 5,000 offenders and has the confidence of the US judiciary and so on. There are a number of things that I can write to the noble Baroness about in regard to that, but as the noble Lord, Lord Harris, said, there are different views on some of the equipment which are slightly at variance with what the noble Baroness said. That shows how important it is to pilot and to see how these various approaches work.
Baroness Finlay of Llandaff
I will be grateful if the Minister will tell the Committee under exactly which parts of current legislation these pilots can be conducted. The legal advice that I have had is that it is only low-level offences. I have also been advised that breathalysers cannot be used under current legislation, so it would be helpful if she could specify which legislation they would be used under. Will she tell the Committee whether devices that detect alcohol in sweat are Home Office-approved and, if they are not, when she anticipates that approval will come through so that the pilots can start? Where will these pilots be conducted? When will they start? For how long will they be conducted? Who is funding them? Without that information, it is very difficult to accept at face value what sounds like a great idea, but we have heard it before, last summer, and I am afraid that no action has been seen since then.
I agree that alcohol does not cause domestic violence but I would be grateful if the Minister could tell us why alcohol-fuelled domestic violence is fundamentally different from other forms of domestic violence. Perhaps it is because it is witnessed by children in the family, who will bear those scars for their whole lives; at least if there is a drunken brawl out in the streets at midnight, it is not witnessed by children where their parent is being seriously injured. Therefore, I also ask for an explanation of why the Government have decided to downgrade the importance of domestic violence, which has extremely long-term effects.
Baroness Northover
I have to dispute what the noble Baroness says about downgrading the importance of domestic violence—we have not. It is because we recognise that it is a very complex and dangerous form of violence that we are separating it out from the assessment of the practicalities of this scheme in these pilots. It is something that has to be addressed across the board and in a much more complex way than whether or not you breathalyse or tag somebody and decide whether or not they have breached various conditions.
The noble Baroness has made her case extremely clear. We absolutely accept the principles. We are taking this forward in the pilots that I have mentioned. I realise there is another debate coming on. I am very happy to engage with her, as is my noble friend Lord McNally, and give her the answers to all the questions she has raised. I will not detain everybody at this point, and I hope that she will be prepared to work with us to take this further forward. As my noble friend Lord Carlile said, this is a very intractable, long-standing problem, but anything we can do to try to resolve the elements that we can, we should do; that comes overwhelmingly from people in this debate. We are taking forward these pilots—I give her that commitment—and let us discuss the details after the sitting.
Baroness Finlay of Llandaff
I am grateful to the Minister for having responded in that way, for offering to meet me and work through all the details. I am also extremely grateful for the support that I have had from all sides of the House, unequivocally. I make it clear that I am not against the tagging process; I am not against anything that deals with this problem effectively. What I am worried about is that if these schemes are not approved this problem will be kicked into touch for yet longer, as the noble Lord, Lord Carlile, said, and we just cannot do that. Like others, I also pay particular tribute to the noble Baroness, Lady Newlove, who has spoken movingly and has committed her life to trying to bring some good out of the tragedy that she personally suffered.
With that, I will not press my amendment tonight, but I look forward to further discussions, and I must warn the Government that if I do not get satisfactory answers I intend to bring this back on Report.
Legal Aid, Sentencing and Punishment of Offenders Bill
Baroness Northover Excerpts(14 years, 1 month ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Bach
My Lords, one of the advantages of these debates is that we will hear proposals for new ways to divert people from custody. Any amendment that carries the names of both noble Lords, Lord Adebowale and Lord Ramsbotham, needs careful and sympathetic attention because both their histories in helping particularly young people who find themselves in potential conflict with the criminal justice system are proud records, and they have a lot to teach us. We are sympathetic to the idea behind this amendment, not least because of its reported success in the pilot areas where it has been tried out.
Noble Lords will know that Section 177 of the Criminal Justice Act 2003 includes a series of requirements for persons aged 18 or over who are convicted of an offence. Those requirements include,
“(e) a curfew requirement … (k) a supervision requirement”,
and the list goes all the way to paragraph (l). There are all sorts of different requirements, and there has been no reticence to acknowledge that divergence from custody and the treatment of the underlying issues—whether they be mental health or socioeconomic—are important and can be more effective than custody. It is not legislators who have been afraid of proposing alternative measures.
One of the problems is the availability of schemes which are often administered by local authorities, the probation services, youth offending teams or other diverse, multi-departmental agencies. The idea for a new community supervision requirement seems an amalgamation in one sense of powers (e) and (k) from the list that I read out earlier—but probably because it is a combination of the two, it is the stronger for it. It is a recognition that, in that transition to adulthood, a community sentence that helps to socialise people to realise that what they are doing is wrong can be a powerful and tough sentence.
There are two elements to the amendment that I want to touch on briefly. As has already been said, there is a growing recognition that there is not a cut-off point at 18 for beginning crime or carrying on with crime. The years between 14 and 24 are generally considered prime offending years, with delinquent behaviour tending to start in early teenage and tailing off at age 21 to 24. Perhaps these things are not entirely surprising; but because of them, it seems sensible to choose the ages between 18 and 25 for this new requirement. We are sympathetic to the amendment. If it has been as successful as has been claimed in the debate, the Government should be sympathetic, too. I look forward to hearing from the noble Baroness.
Baroness Northover
My Lords, I thank the noble Lords for their amendment. Young adult offenders are a particularly difficult group and outcomes are not always as we would wish. I have a great deal of sympathy with the intentions here.
The amendment proposes a new requirement of the adult community order called,
“an intensive community supervision requirement”,
available for offenders aged 18 to 24. It is clearly intended to mirror the intensive rehabilitation order available for juveniles. I agree that we need to reduce the level of reoffending by young adult offenders and that more intensive engagement may very well have a role to play. However, we need to find ways of achieving this without further complicating the legislative framework and constraining how the needs of this age group will be addressed.
Affordability is, of course, critical. If we were to create extra burdens through statute by delivering intensive interventions, supervision and surveillance to this age group, the Government would not have the resources to deliver what we prescribed. We want to see more effective and efficient use of resources, with payment by results and competition being used to secure improved outcomes for 18 to 24 year-olds and other offenders. A range of interventions may be used to achieve these outcomes, and we wish to avoid prescribing which approach must be used with different age groups.
I heard about the problems at Isis, and the MoJ will be commenting in due course. I also note what noble Lords have said about intensive alternatives to custody. The Green Paper Breaking the Cycle said that the Government were looking at how the IAC principles could be extended nationally. The analysis of the reoffending rates of offenders who took part in the IAC pilots is under way at the moment. We will write to noble Lords as soon as the results are available. I hope that is useful to noble Lords.
The spirit of the amendment ties in very well with work that we are already doing to improve community sentences generally. In addition to provisions in the Bill to strengthen community sentences, we want to deliver a step change in the way they operate. They must address the problems that have caused the offending behaviour in the first place: the drug abuse, alcoholism and mental health problems that noble Lords have referred to. They must also punish properly and send a clear message to society that wrongdoing will not be tolerated. We are hoping to provide sentences with a much improved community sentence offering a robust and credible punishment to deal with both young and old offenders. To this end, we are currently conducting a review of adult community sentences and hope to publish a consultation document shortly. I encourage noble Lords to feed into that. In the light of my comments, I hope the noble Lord will accept that this is not a necessary step to take at this stage and will accordingly withdraw his amendment.
Lord Adebowale
Has there been any cost comparison between the IAC model and the cost of keeping a young person in prison and the concomitant cost of recidivism? The Minister seemed to imply that there is a cost implication in the IAC. Has any work been done on the comparison?
Baroness Northover
We are acutely aware of the cost of keeping people in prison. Obviously it is not only for cost reasons that you try to keep people out of prison, but given that it is a costly route, other measures can be measured against it.
Lord Adebowale
I am not quite sure that that is the answer. Like many noble Lords who have amendments to this Bill, I feel that we have not hit pay dirt here. We have what I, and I think many others, consider to be an excuse remover in terms of the IAC model and the leadership required, which my noble friend Lord Ramsbotham mentioned in his speech. I look forward to further conversations with the Minister on this issue. I do not feel it will go away and I do not want to be here in a couple of years’ time making the same speech as recidivism goes through the roof. However, if the Minister is open to a conversation with me and my noble friend Lord Ramsbotham on that matter, I beg leave to withdraw the amendment.
Lord Bach
My Lords, our time in government retreats into the mists of time day by day, month by month, and my memory fails. I certainly am not in a position to answer the specific question that the noble Lord asks, but to say that there were not concerns about the probation service at the time would be to tell an untruth. Some of the cuts that our Government felt were necessary to make—as do the present Government, too—related to the probation service. One of the achievements of my then ministerial colleague, the honourable Maria Eagle, was to make sure that the cuts were not so great as originally planned and that the probation service had some extra resources that it was not expecting. However, I have to concede that it was not a period, particularly in the latter years, when the probation service was getting as much money as it needed to deal with the problem.
On costs, I think that the noble Lord’s noble friend Lady Linklater had it right, as did the noble Baroness, Lady Howe. Comparing costs is very difficult throughout the Bill, not least in this particular area. I am sorry that I cannot help the noble Lord with more detail.
Baroness Northover
My Lords, I was very struck by the noble Lord, Lord Ramsbotham, dividing things between those which were desirable and those which were essential, and pointing to the need to prioritise. It has struck me that this Bill is above all about prioritising. It would be wonderful to be in government when there was a great deal of money to lubricate things but, even when that is the case, not all problems are corrected. We have just heard of an earlier period where, certainly during the early years, there was much more money to lubricate things yet problems persisted.
Lord Beecham
My Lords, the Minister regaled us earlier with some literary allusions, and Dickens featured largely in those. I would like to follow his example—something which I am not always disposed to do, but on this occasion I will—by making another literary allusion to the famous Sherlock Holmes story concerning the dog that barked in the night. Watson pointed out that the dog did not bark and Holmes said that that was the mystery. The mystery about restorative justice is that it is not yet in the Bill. I hope that as a result of tonight’s deliberations and following the line of thinking of the noble Lord, Lord Carlile, the Bill will include references to restorative justice for precisely the reason that he gave—namely, it would send a very clear signal of the Government’s expressed intent to promote restorative justice.
As has been indicated already, restorative justice has been around for a considerable time and has proved successful. Some 85 per cent of victims who have been through the process are satisfied with it. That is a very high proportion, particularly in these circumstances. The Home Office estimates that restorative justice has reduced reoffending by some 14 per cent. Again, that is a very significant reduction. To follow again the point made by the noble Lord, Lord Carlile, financial savings can be made in this respect. The Restorative Justice Council estimates—presumably on the basis of an equivalent 14 per cent reduction in reoffending—that in the case of adult offenders something like £185 million would be saved simply as a result of the reduction in offending quite apart from other savings that might arise. Therefore, we are talking about significant figures and a significant impact.
Mention of the adult aspect of this matter encourages me to endorse very strongly the reference of the noble and learned Lord, Lord Woolf, to the need to spread the concept across the age range. At the moment, it is mainly concentrated on children and young offenders. Only 1 per cent of adult offenders go through a restorative justice process. Expanding that would be significant and would lead, in the view of the Restorative Justice Council, to the savings that I have mentioned.
The Government have expressed their enthusiasm not only through the Minister’s words but in the Green Paper, Breaking the Cycle, which was published some 14 or 15 months ago. That document contains positive references to restorative justice, describing it as a,
“well established concept in youth justice”,
but pointing out that,
“restorative justice for adults is sometimes viewed as an afterthought to sentencing”.
The Green Paper went on to say that the Government were looking at how they might change that, whereby in appropriate cases restorative justice became,
“a fundamental part of the sentencing process”.
The paper stated that this was,
“likely to involve using restorative approaches as a better alternative to formal criminal justice action for low level offenders where the offender and victim agree the outcome”,
including apologising, replacing items or making good damage and so on.
The Green Paper continued:
“Secondly, in instances where a court case is likely to lead to a fine or community sentence, [the Government] will explore how it could best be used at the charging stage”.
“At the charging stage” goes beyond the amendments before us, and it is an interesting concept. The Government said that they would explore how best it could be used then, and pointed out that, if used, restorative justice,
“would be delivered as part of an out-of-court disposal, for example as a condition attached to a conditional caution”.
Again, a variety of action might be agreed—paying compensation to the victim or making good the offence in other ways. I do not know whether the Government have pursued that to any significant extent. Perhaps the noble Baroness who is to reply to the debate might comment on that. If not, she might follow up the point made at paragraph 80 of the Green Paper to see exactly how far the Government have gone. There is considerable potential in all this, and the amendments certainly should assist the process.
Restorative justice is usually discussed in terms of the face-to-face encounter between victim and offender, and that is perhaps the most obvious use of the term. However, it can be used in the broader sense of what is sometimes also called justice reinvestment—that is to say, in schemes such as community payback, whereby instead of individual reparation the offender is putting something back into the community, and not necessarily into the community that has suffered directly from his or her depredations, but into the community generally.
There have been some encouraging schemes around this concept. In my part of the world, two schemes in particular stand out that involve the successful restoration by offenders of two Victorian parks—Albert Park in Middlesbrough and Saltwell Park in Gateshead—where in both cases mainly young offenders worked under supervision and made a significant contribution to a local amenity as part of their punishment. The process had two effects: first, it of course gave the community an asset; but, secondly, it gave the offenders a skill and an experience of useful employment. Restorative justice can be applicable in that wider concept. In my own ward of Newcastle City Council there is a church with a large graveyard in which many local dignitaries of the 19th century are buried. It was in a poor state and there is now an ongoing restoration scheme that is facilitated in part by a group of offenders on a community payback scheme. That is another good example of restorative justice in that broader sense.
Both approaches to restorative justice are potentially valuable. I hope that the Government—in addition to endorsing the concept, as I am sure the Minister will—will ensure that the concept is enshrined in statute to give an impulse to its spread in practice, particularly but not exclusively among adult offenders. This would also ensure that the good intentions of the Green Paper, with which we on the opposition Benches certainly agree, were translated into reality at both individual and community levels.
I congratulate noble Lords who brought this matter forward in these amendments. I hope the Government see their way to accepting these amendments and, arguably, to expanding them in the way that the Green Paper appeared to advocate.
Baroness Northover
My Lords, where but in the Lords would we be having such a wonderful debate, run through with humanity, after 10 o’clock at night?
I acknowledge noble Lords’ support for the principle of restorative justice. The Government are indeed committed to delivering greater use of restorative practices across the criminal justice system. It is one of our key priorities. For example, we have already begun providing more than £1 million-worth of funding to youth offending teams, probation trusts and prisons for restorative justice training and practice standards, and we are currently setting up neighbourhood justice panels based on restorative principles. It is excellent to have noble Lords’ support for restorative justice. However, the Government believe that the amendments are unnecessary, although we are sympathetic to the intentions behind them.
On the amendments in the name of the noble Lord, Lord, Lord Ponsonby, as I think he realises from what he said in his speech, a court already has sufficient powers under the existing requirements of the youth rehabilitation order and community order to make restorative justice activity a formal part of those orders. The activity requirement allows the court to consider the use of restorative justice where it has been advised that the victim and offender have agreed to take part and provision is in place to deliver such a requirement. The amendments make no provision for ensuring that both the offender and the victim are completely prepared to participate in a restorative justice process. That is crucial to the restorative ethos and to prevent victimisation, but I understand what the noble Lord is aiming at.
Turning to Amendment 172DAA in the name of the noble and learned Lord, Lord Woolf, the courts already have powers to adjourn sentencing for the provision of restorative justice to be undertaken if they believe it will inform the sentencing process. I hope that the noble and learned Lord will be reassured that the Government are looking at taking that process further to allow for restorative outcomes to help inform the courts as to what appropriate sentence should be handed down.
However, the amendments do not contain sufficient safeguards to prevent the ineffective use of remand resources to adjourn sentencing and hold offenders in custody in cases where the victim does not want to participate. The amendments also do not seek to impose a restriction on the length of remand, which poses additional risks not only to delay in court time but also around the proportionality of remanding an offender in custody for a significant length of time without sentencing.
Therefore it is much better for the courts to retain discretion to decide when and in what circumstances restorative justice can be effectively undertaken, although we understand people's concern to ensure that it is high on the agenda. In practice, that would most likely need to be in cases where the court has already been notified of the willingness of both the victim and the offender to participate in the restorative justice process.
As I mentioned, it is crucial that the victim should have the opportunity to consider and undertake restorative justice if they so wish, and the offender must also be completely willing to participate—which the proposed new clause does not provide for. Any circumstances in which the offender is not completely prepared to participate in restorative justice—which cannot be signalled simply by a guilty plea—presents serious risks for the victim being revictimised because the offender is falsely or forcibly engaged in the process.
We have heard a great deal about the potential of this approach, which is of course very encouraging. Before we can make any determination as to whether further, specific legislation is necessary for restorative justice, we must make significant steps to build capacity to deliver it. Once we have begun to make greater strides in embedding restorative justice across the system and helping areas to put necessary provisions in place, we will reflect carefully both on whether to widen the application of restorative justice using the law and on how to do so, if it proves necessary to take this approach. Although I understand noble Lords’ enthusiasm to enshrine this now in statute, there is work to do before we reach such a stage—persuasive though noble Lords undoubtedly are, and we certainly agree with their principles. Although we share a common interest in the increased use of restorative justice, at this stage I nevertheless urge the noble Lord to withdraw his amendment.
Lord Thomas of Gresford
I support the noble and learned Lord. I was surprised to hear the Minister say that it is very important that the victim should consent. Amendment 177DAA states that,
“the court may remand the case in order that the victim shall be offered the opportunity to participate”.
It does not say in any sense that this will be imposed on the defendant.
Baroness Northover
I refer noble Lords back to the concluding remarks that I made. I fully understand that amendments may not be phrased quite as we might wish but I hope that I addressed the principles. We are very supportive of restorative justice. I gave reasons why we feel that we want to take this further forward and see it in practice before building it into statute. My noble friend Lord Carlile anticipated that I might say something like that, and I expect that the opposition Front Bench thought likewise. We can continue to discuss this. We accept the principles and wish to take it further forward. Whether that means that it will go into statute is another matter. I hope that on that basis the noble and learned Lord will withdraw his amendment.
Lord Woolf
Taking into account what has just been said in coming to my conclusion, at this stage I beg leave to withdraw the amendment.
Baroness Northover
My Lords, I have listened carefully to the case made by the noble Baroness, Lady Lister, in support of this amendment. I am also aware of the arguments made by Citizens Advice and the Z2K Trust. There are essentially two issues as regards the amendment. The first relates to the current law relating to the power to withdraw warrants for non-payment of fines, which has not been particularly explored in these discussions but to which I will return.
The second relates to the practice of bailiffs enforcing those warrants particularly against fine defaulters, especially those who may be considered to be particularly vulnerable. I understand the concerns that many people have about bailiffs enforcing warrants. However, many people are concerned at the level of fines that remain unpaid. There is a balance to be struck between the need to have an effective way to collect unpaid fines, and therefore to enforce the orders of the court, and the need to allow for some flexibility in the treatment of fine defaulters.
The national standards for enforcement agents were revised last month. They set out specific standards—for example, for dealing with vulnerable and socially excluded people—and I hope that the noble Baroness has seen them. It includes a list of those who may be potentially vulnerable, including the elderly or people with a disability or where someone has a difficulty in understanding English. In addition, the contracts with bailiffs include several conditions relating to their behaviour and treatment of vulnerable people. The Government remain of the view that the national standards, guidance and contractual arrangements are the best and most effective way to ensure the appropriate use of enforcement powers.
With regard to the first issue under the amendment, which relates to the legal powers to suspend or withdraw warrants, the Government think that this area deserves further consideration. We do not think that there is any doubt that a court has the power to suspend a warrant that it issues but there is at least an ambiguity about the question of whether a court or a fines officer can withdraw or suspend a warrant issued by a fines officer. I am willing therefore to take away these points and to consider whether there is a need for a change to the primary legislation and whether that change can be made in this Bill or at a later stage. In the light of that, I hope that the noble Baroness will withdraw her amendment.
Baroness Lister of Burtersett
My Lords, I thank the noble Lord, Lord Thomas of Gresford, for his support and for another cautionary tale that he related to good effect. I would remind noble Lords of the very strong language he used. He talked about “confusion” and people being “bullied” and that it is a “disgrace”. I think that those words are warranted. I also thank the Minister for her response, in particular for leaving open the door on the second part. In taking away these issues, I wonder whether she would be willing to commit to meeting with the Zaccheus 2000 Trust and Citizens Advice to talk through the possibilities. The question is: if not in this Bill, in which one? It seems that we have an opportunity here and the Minister has shown an openness of mind that perhaps there is a case for clarifying this in law. I hope that the noble Baroness will seriously consider it for this Bill because another opportunity may not come up for some time. In the mean time, we may see other cases of people being bullied or rebuked and very vulnerable citizens being put into difficult situations. I do not think we should delay when we have an opportunity in this Bill. However, given what the Minister has said and the lateness of the hour, I beg leave to withdraw the amendment.
Developing Countries: Free and Fair Elections
Baroness Northover Excerpts(14 years, 2 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord McConnell of Glenscorrodale
To ask Her Majesty’s Government whether they consider the conduct of free and fair elections to be a prerequisite for United Kingdom aid to developing countries.
Baroness Northover
The Government have committed to support at least 13 countries to hold free and fair elections by 2015. Elections are not a prerequisite for aid, but we provide direct support only for Governments who share our commitment to poverty reduction, human rights, public financial management and accountability to citizens. Where democratic norms are not respected, we ensure that those in need receive essential assistance by working outside Governments.
Lord McConnell of Glenscorrodale
My Lords, I thank the noble Baroness for her Answer. The Government will be aware of the continuing concern about the organisation of the recent elections in the Democratic Republic of Congo. The UK Government are significantly increasing aid to the DRC over this year, next year and the year after. Will the Government, as part of the discussion on that bilateral aid, insist on lessons being learnt in that country, which suffers from some of the worst poverty and violence in the world, to ensure that future elections are more reliable and more transparent and that the results are trusted by more of the population?
Baroness Northover
I have read the noble Lord’s blog on his experiences in the DRC as an election monitor and I give him credit for going out there to do that. He noted how enthusiastically people voted, but that is balanced against problems in the election. We are monitoring the situation. We expect the full results of the DRC National Assembly elections are to be published shortly. Some problems have been flagged up and we seek that the DRC electoral commission investigates all of them. We are extremely well aware of the problems in the DRC. It was flagged up to me, for example, that it is the worst place in the world to be a woman. The noble Lord will be extremely familiar with the problems and we are well aware of them.
Lord Chidgey
I want to press my noble friend a little further on the issue of the DRC. I, too, had the opportunity to visit the country a few months ago before the elections, but the issues that were obvious then are still obvious today. Is my noble friend familiar with the DfID report, Electoral Assistance and Politics: Lessons for International Support, which states:
“Delivering free, fair and credible elections is … a considerable but important challenge, logistically, financially and politically”?
As my noble friend rightly says, the electoral commission has postponed issuing the results of the legislative elections yet again. The international election experts have left the country—frankly, I think, in disgust because they cannot get access to the election data—and the diaspora from the Congo, particularly in this country, are traumatised by the continuing fraud in elections in their home country. What will DfID do to try to make some sense of it all?
Baroness Northover
The first thing that I would emphasise is perhaps a sense of humility. If noble Lords bear in mind how long it took us to democratise from 1832 to 1929—in terms of the franchise for women—it is not surprising that, in some of these fragile states, it takes a long time to ensure that the elections are carried out fairly. Positive accounts are coming from the DRC about the elections, as the account of the noble Lord, Lord McConnell, bears out. As I said, various concerns are being monitored, particularly by the United States. We are in close contact. My noble friend Lord Howell answered on this subject the other day and the Minister for Africa is also pressing on the matter. We share those concerns and we are taking this forward, but we need to bear in mind the difficulties.
Lord Alton of Liverpool
My Lords, reverting to the specific Question asked by the noble Lord, Lord McConnell, about the DRC and the outcome of the elections, if the delegation that has been in London this week from opposition parties in the DRC is right and it is found that the elections have been entirely gerrymandered, will Her Majesty’s Government refuse to recognise the legitimacy of President Kabila and his Government? What about the opposition parties and their leaders who have been imprisoned in the DRC since the election and the closure of their television and radio stations and other media outlets? What have the Government to say about that?
Baroness Northover
One has to bear in mind the interests of all involved. It is striking that none of the observation missions—again, I make reference to the one that noble Lord, Lord McConnell, was on—judged that the overall result of the presidential election would have been changed by the irregularities that have been flagged up. However, it is clearly essential that the DRC electoral commission takes the necessary steps to investigate and address all reported irregularities.
Lord Foulkes of Cumnock
Will the Minister join me in commending the work of the Westminster Foundation for Democracy in promoting free and fair elections? I declare an interest as one of the Labour governors of the WFD. She will be aware that the foundation has put forward a business plan to the Department for International Development so that we can develop our work in the Middle East, north Africa and in other parts of Africa. We are still awaiting—for some time now—a response from DfID. Can she give an assurance that it will come in the very near future?
Baroness Northover
As the noble Lord clearly knows, the department is discussing with the Westminster Foundation for Democracy, which has done excellent work right across the world, how to take forward the work that DfID wants to encourage in supporting elections and everything that goes into making those elections work. That includes making sure that civil society is developed, that political parties are encouraged and that there is some basis on which these elections can work more effectively.
Health: Tropical Diseases
Baroness Northover Excerpts(14 years, 2 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Hayman
To ask Her Majesty’s Government what international support they expect to receive for the new Department for International Development initiative to combat neglected tropical diseases announced on 21 January.
Baroness Northover
The Government have just announced a fivefold increase in support for neglected tropical diseases. This will help to protect more than 140 million people worldwide. It will strengthen the UK’s partnerships with the World Health Organisation, foundations such as the Bill & Melinda Gates Foundation, the Carter Center, other donors, pharmaceutical companies that are making drug donations, the endemic countries and non-governmental organisations.
Baroness Hayman
I welcome that very positive response from the Minister and the Government’s initiative in this field. I should declare a non-financial interest as a trustee of the Sabin Vaccine Institute, which works to develop new vaccines for diseases such as human hook worm and on mass drug administration programmes.
Does the Minister agree that diseases such as guinea worm, river blindness and schistosomiasis not only devastate the health, education and employment prospects of hundreds of millions of the world’s poorest people but impede progress towards the achievement of the millennium development goals? Given that eradication is a real possibility and that intervention is so cost-effective, will the Government do all they can to ensure that generous donors, such as the Bill & Melinda Gates Foundation, and other countries continue their efforts so that we can rid the world of these truly awful diseases?
Baroness Northover
The noble Baroness is absolutely right. I pay tribute to her and to her husband Martin Hayman for all that they have done in this field. When this announcement was made, my honourable friend Stephen O’Brien said:
“British support will take the neglected out of neglected tropical diseases”.
That is clearly critical. The noble Baroness is absolutely right: these are devastating diseases. The United Kingdom can help gear up what is happening elsewhere. The Bill & Melinda Gates Foundation has been remarkable in what it has managed to achieve, as has the Carter Center. The possible elimination of guinea worm by 2015 would be the second human disease that we have managed to eliminate.
Baroness Kinnock of Holyhead
Does the Minister agree that the distribution of drugs and the setting up of treatment programmes present a huge challenge in many of the countries where these neglected tropical diseases are endemic, where health systems are already struggling to provide even the most basic services? Would she also agree that a further challenge comes from meeting requirements to regulate a range of what will be new medical products and to evaluate their safety, their efficacy and their quality in very particular conditions, for instance in Africa? Will the Minister assure the House that funding will be provided to support efforts to strengthen health systems and to build capacity to regulate the new drugs?
Baroness Northover
I can give the noble Baroness that assurance. She will know that there is a conference on Monday that will be attended by Bill Gates and many organisations, including the WHO. This will doubtless be part of what they will be considering.
Lord McColl of Dulwich
Would my noble friend agree that this Government’s policy of increasing aid to developing countries is just and admirable and so is the method of giving aid on condition that it is spent on agreed projects and carried out by reputable NGOs?
Baroness Northover
I thank my noble friend for those comments. I would also point out that British universities, which have a long track record in research on tropical diseases, are also able to take advantage of this so that the work done at Imperial College, the London School of Hygiene and Tropical Medicine and the Liverpool School of Tropical Medicine should also be encouraged.
Lord Walton of Detchant
My Lords, now that smallpox has been eradicated from the world and that the same may soon be true of poliomyelitis and that vaccines for malaria and many other neglected tropical diseases are in an advanced stage of development, this development by government is most welcome. Is the Minister satisfied that there are sufficient training opportunities in tropical medicine in this country to enable doctors to be trained who wish to work in the tropics on the eradication of these diseases?
Baroness Northover
I thank the noble Lord for his comments. The prospects before us are astonishing. I have just mentioned the United Kingdom universities and their research centres. I know that various noble Lords, including the noble Lord, Lord Crisp, are playing a part in trying to ensure just that.
Lord Chidgey
Can my noble friend confirm that the £20 million increase in funding, a fivefold increase, from the UK Government is in fact dependent on finding matching funds? Therefore, can she tell your Lordships’ House what progress has been made in securing those matching funds, and whether this would enable the programme to maintain its dynamicism, which is obviously so important?
Baroness Northover
Yes, the contribution to the Carter Center is based on matched funding, and the conference on Monday will help to take this area forward.
Lord Crisp
My Lords, I declare an interest as chairman of Sightsavers, part of the UK Coalition against Neglected Tropical Diseases. I congratulate the Government on this initiative and on continuing the leading role that the UK plays in development. Does the Minister agree that the Government, national Governments in the affected countries, Sightsavers and others can now plan confidently to eradicate blinding trachoma—it is eminently preventable: we know all the ways to do it and we have the drugs—and that we should be able to do that in the next decade?
Baroness Northover
I certainly hope that that will be the case, and one of the diseases that this new programme will focus on is indeed trachoma.
Niger
Baroness Northover Excerpts(14 years, 2 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Kinnock of Holyhead
To ask Her Majesty’s Government, in the light of the Save the Children and Oxfam report on the crisis in east Africa and the call for early responses to warning signs, what they will do to ensure a similar crisis is averted in Niger.
Baroness Northover
My Lords, the Government are very concerned about the emerging crisis in Niger and have been monitoring the situation closely. The Secretary of State for International Development has announced emergency support to mitigate the impact of the crisis. This will reach 68,000 children in Niger, Chad and Mali and provide livestock support to 30,000 families.
Baroness Kinnock of Holyhead
My Lords, I thank the noble Baroness for her response. The warning signs of looming disaster were there in the Horn of Africa two years ago, but no action was taken and tens of thousands of Somalis starved to death and millions of people in east Africa were affected. Against that background, will the Government give active endorsement to the UN-supported charter to end extreme poverty, which identifies five specific actions that must be taken when we know that a crisis is predicted and preventable? We can and must stop the drought in west Africa and the Sahel turning into a famine. We must say never again and mean it.
Baroness Northover
The noble Baroness is right that we must say never again and mean it, but I dispute that the Department for International Development was not leading on the response in the Horn of Africa. Credit has been given to the UK Government for that. The report from Oxfam and Save the Children to which her Question refers is extremely welcome. It indeed emphasises that the intention is to manage the risk, not the crisis. That is absolutely the right way to go about it: to intervene early and build resilience. That is why the Department for International Development did that in the Horn of Africa and is doing that across the Sahel.
Lord Chidgey
My Lords, is my noble friend aware that in the report, A Dangerous Delay, which has just been issued, Oxfam states that many of its messages chime well with the humanitarian emergency response review chaired by my noble friend Lord Ashdown? Focusing on anticipation of and resilience to natural disasters, what measures have been put in place to co-ordinate cross-departmental and cross-agency efforts through the stabilisation unit and other means?
Baroness Northover
The noble Lord is right that the humanitarian emergency response review made some extremely important recommendations for the anticipation of disasters and building resilience to them. That is being taken forward at the moment. DfID is in the process of developing a humanitarian framework for Africa and a Sahel resilience strategy which will help the UK anticipate and respond strategically to crises across the continent. The building stability overseas unit normally focuses on resilience against conflict issues rather than natural disasters. Nevertheless, the two feed on each other, so there is action that that unit can take as well.
Lord Alton of Liverpool
My Lords, has the Minister seen the reports this week that Boko Haram, the radical Islamist group in Nigeria, has been responsible for a large number of people escaping from the violence there into neighbouring areas in Niger, and that this is both leading to an exodus of refugees, compounding the existing problems in Niger, and preventing food being transported from Nigeria into Niger? Did she see the warning from the European Union earlier this week from Kristalina Georgieva, the commissioner for human aid, that it is a race against time to safeguard the lives of the 5.5 million people who are currently at risk?
Baroness Northover
The noble Lord is right to flag up the problems in the area generally. Indeed, the knock-on effects from the problems in Nigeria are having an effect. So, too, are the returning mercenaries from Libya who instead of sending back remittances now need to be supported in that area. My right honourable friend the Secretary of State today spoke to the Commissioner about the situation in the area and the EU has just doubled its contribution. We are acutely aware of the difficulties of working in this area as it is very unstable.
Lord Richard
Can the noble Baroness give us a figure on what the British contribution has been so far and what she intends it to be in the future?
Baroness Northover
The United Kingdom has just contributed £2 million to this directly in response. It is worth bearing in mind that the United Kingdom is also a major contributor to the UN Central Emergency Response Fund which has just put in £7.9 million, of which £1.9 million was from the United Kingdom. The European Commission contribution, as I have just mentioned, has doubled in the past few days to £105 million and we contribute 17 per cent of that. Maybe the noble Lord would like to do some of the maths. For historic reasons, the French are the leading country in this area, and DfID staff are in France right now seeking to gear up the response.
The Lord Bishop of Liverpool
My Lords, according to the World Health Organisation 40 per cent of the healthcare in Africa is delivered through the churches. Can the Minister say whether the Department for International Development will be working through the churches as part of its response to these crises?
Baroness Northover
The right reverend Prelate is right that the churches are very active in the region and DfID is working with a number of organisations. This is a region where, generally speaking, it is not possible to channel money directly through Governments. Therefore, a number of other organisations are the routes to support in the area.
Lord Boateng
In the light of the Minister’s very helpful answers to previous questions, will she consider how she might co-operate with her colleagues in the Ministry of Defence and the Foreign and Commonwealth Office in seeing how we can better support the African Union and ECOWAS in terms of their peacekeeping or conflict resolution capacity in view of the deteriorating situation in the Sahel involving the Tuareg?
Baroness Northover
The noble Lord is right. In terms of co-operation, the FCO, the MoD and DfID are working very closely together. My noble friend made reference to the building stability overseas unit, which is, as it were, a concrete example of that working together. The support for the African Union is very strong and will continue to be so.
Baroness Tonge
My Lords, some of us may be old enough to remember that in times of plenty the Pharaohs used to build up stores of excess supplies to use in times of famine. I wonder whether the international community has made any progress in pre-empting these crises by making sure that there are stores in strategic parts of the world that are likely to suffer famine in advance of the famine occurring.
Baroness Northover
The World Food Programme and UNICEF are indeed already stockpiling supplies and a lot of work is going into how best to ensure that these crises do not occur. The Question from the noble Baroness, Lady Kinnock, was all about how to pre-empt such crises and develop resilience in an area where already the population is exceptionally vulnerable. A lot of the problems are because of rising food prices rather than necessarily food scarcity. The noble Baroness’s point is well taken.
The Earl of Sandwich
Will the Minister join me in commending BBC correspondent Mike Wooldridge and his colleagues for outstanding coverage of the famine in West Africa? One point that he made, which the noble Baroness mentioned, was that food prices had risen 40 per cent in a single year, out of reach of the local population. What is DfID doing for longer-term sustainability? The noble Baroness mentioned cattle; perhaps she would comment on agriculture as a whole.
Baroness Northover
I am very happy to commend the BBC and its journalists for their brave coverage in these very unstable areas. DfID supports the Comprehensive Africa Agriculture Development Programme, a pilot programme from the World Bank on climate resilience, which is extremely important here, and a global facility for disaster risk reduction. It is also important to emphasise DfID’s support for social protection programmes, and for cash transfers where appropriate, to try to build up these vulnerable communities so that they will be more resilient in circumstances such as this.
Lord Skelmersdale
My Lords, that is all very well, but will the noble Baroness tell me what is being done to extract and preserve water, on which all agriculture and horticulture depend?
EU: Healthcare
Baroness Northover Excerpts(14 years, 2 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Kakkar
My Lords, I am very grateful for the opportunity to introduce this Question for Short Debate on the impact of the European Union on the delivery of healthcare in the United Kingdom—a subject on which I have spoken in your Lordships' House on a number of previous occasions. In doing so, I wish to draw noble Lords’ attention to my entry in the register of interests as a practising surgeon, professor of surgery at University College and active biomedical researcher. I would also like to take this opportunity to thank those noble Lords who have kindly added their names to the speakers list and who will make a contribution to this short, time-limited debate.
The impact of European Union directives and regulation on the delivery of healthcare in our country is an important issue. It is not primarily an issue of politics but of the well-being and safety of patients in our healthcare system. If there have been unintended consequences of the adoption of regulation and directives into domestic legislation, it is important for Governments to recognise this and ensure that appropriate measures are taken to overcome them.
We can consider the impact of legislation from Europe on the delivery of healthcare in our country in three broad areas. The first is directives and regulation that have already been incorporated into the laws of our country. The second concerns how directives and regulation that are under consideration should be incorporated into domestic legislation. The third covers areas of broader concern connected with potential consequences, particularly with regard to European Union competition law and the intended purpose of the Health and Social Care Bill.
As regards the first category, it is well recognised that the European working time regulation has had a detrimental impact on the training of our young doctors, particularly those who are training to pursue careers ultimately as independent practitioners at consultant level in the craft specialties, such as my own of general surgery. A restriction to 48 hours’ working per week has resulted in trainees feeling that they have insufficient experience at the end of their training to be certain that they can perform independent consultant practice in the way that it is envisaged in our country rather than models for the delivery of clinical practice in other European countries, to the extent that there is genuine concern that we may be producing generations of consultants less able to deliver the rigorous and demanding practice that we have always expected and have been fortunate enough to receive in our country.
There is also the question of the additional cost of providing locum cover to ensure that rotas are compliant with a 48-hour working week. In an important piece of work published last year, the Royal College of Surgeons identified an additional £200 million a year cost in providing locums to ensure that rotas were 48-hour compliant after the first year of the introduction of the final European working time regulation.
There has also been considerable concern about the problem of language and competence testing. I think most noble Lords would agree that the same standard should apply to every doctor and healthcare practitioner working in our country with regard to their ability to speak the English language and be able to communicate appropriately with patients. There is no doubt that the ability to communicate is a hugely important part of the delivery of healthcare. Equally, it is only right that patients in our healthcare systems are able to expect that all doctors and other healthcare professionals who have the privilege of treating them in our hospitals and other healthcare environments practise to the same level of competence. At the moment it is impossible for the national regulatory bodies in our country to ensure that doctors who are registered elsewhere in the European Union meet the same standards as we expect of our own graduates or graduates from elsewhere in the world.
There are real concerns that the first year after qualification from medical school—formerly known as the house job year, now known as foundation year 1 —which is an essential part of completing the process for full registration with the General Medical Council, has now been opened up to competition from medical graduates across Europe as part of the free mobility of labour in the European Union. However, this first year of clinical practice remains an important element of ensuring that our young medical graduates can complete their training and can ultimately register to practise in our country. The issue is very simple: if they are unable to take that year, they are unable to fully register and will not be able to practise in our country. This is a huge waste because these talented graduates should remain in our country and serve our nation, ensuring that the debt they have is repaid through practice in the National Health Service. In this year’s round of appointment to that first foundation year, some 52 potential graduates have not been given a foundation year 1 post and some 113 practitioners from the European Union have taken places on those foundation year 1 schemes. How do Her Majesty’s Government propose to ensure that this problem does not result in our graduates being unable to complete that essential first year after they have qualified from medical school?
There are also important concerns about the impact of the European clinical trials directive in terms of reducing the competitiveness of the biomedical science and research science output of our country. It is estimated that in the year 2000, 6 per cent of all patients who entered clinical trials around the world came from our country. Soon after that, in 2003, the clinical trials directive was incorporated into our domestic legislation, and the problems associated with its bureaucracy have resulted in a reduction in this country to just 2 per cent in 2006 and 1.4 per cent in 2010 of the number of patients included in clinical trials around the world.
These are all well proven areas where Her Majesty's Government need to develop a strategy to address the problems that have been experienced. However, there are also important matters relating to directives that are currently being considered by the Department of Health for inclusion in domestic legislation. There is a directive on transplantation which, if incorporated, will add bureaucracy to the delivery of transplantation services in our country, resulting in added cost. Those responsible for the delivery of these services believe that our standards that are highly regarded throughout the world are of sufficient quality and that any potential European directive must not be gold-plated and undermine an already successful service.
With regard to energy efficiency, a directive that is currently under regulation has caused considerable concern to the NHS Federation. This directive requires the building stock of all public bodies, including the National Health Service, to be improved on an annual basis, and for 3 per cent of floor space to be addressed each year. This will cost some £70 million a year, and the NHS, given the severe financial constraints it is facing, can hardly afford this.
Then there is the ongoing concern that European competition law may inadvertently be applied and in some way affect the proposals of Her Majesty's Government in the Health and Social Care Bill. Clinical commissioning groups, in wishing to take forward the development of new services to improve the clinical outcomes and care of our patients, could be disrupted in doing that through the application of European competition law.
In October last year, the Prime Minister indicated that all government departments should look at European regulation to determine how it might be adversely impacting on the work of those departments and the life of our country. There is no doubt that in the area of healthcare, the training of our young doctors, the innovation and delivery of biomedical research, and the delivery of healthcare itself have been detrimentally affected. It is absolutely essential that Her Majesty's Government are sensitive to the concerns—repeated on several occasions by those with responsibility for the delivery of healthcare in our country—and act as a matter of priority.
Baroness Northover
I remind noble Lords that this is a time-limited debate and that all speakers, except for the Minister, have two minutes. When the clock displays two minutes, noble Lords have had their two minutes. I note that we are without at least one speaker in this debate.
Health and Social Care Bill
Baroness Northover Excerpts(14 years, 3 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Hunt of Kings Heath
My Lords, I, too, pay tribute to the noble Baroness, Lady Emerton, for her perseverance and determination in this very important area. Rather like the noble Lord, Lord Alderdice, I am clear that the role of healthcare assistants has to be seen in the context of a much more general debate about nursing care, including the compassion that he talked so eloquently about.
As the noble Baroness said to us rather earlier this afternoon, we had an excellent debate on nursing on 1 December, and we are presented with something of a paradox: on the one hand, we should not ignore the huge advances in the nursing profession over the past 20 years. There has been the move to a graduate profession and nurses have taken on much greater responsibility, including for complex care and specialist care, and I think that, overall, the public have welcomed that increased responsibility. At the same time, there has been real and mounting concern about basic standards of care and issues to do with hygiene, feeding of patients, nutrition, dignity and even face-to-face contact—the kind of compassion that the noble Lord, Lord Alderdice, has just spoken about. We have seen the reports from unannounced visits of various bodies. Recently, the CQC has undertaken important visits to many of our hospitals. There seems to be real evidence and concern about a falling of standards of basic care.
The reasons for that are not clear. It is possible that nurse training is now too focused on academic performance rather than on practical nurse training. It is also at least possible that the drive for specialist nurses and modern matrons has taken from the ward the many experienced nurses who, in retrospect, might be better placed in leading their ward as ward manager or senior sister. What is not in doubt is the need for serious thinking about how we can enhance the overall quality in standards of basic care that nurses give.
That brings us to the role of healthcare assistants. Again, in our debate on 1 December, the noble Earl, Lord Howe, in responding, referred to the concerns that had been expressed about nursing in the acute sector in particular. He said he felt that that,
“related to inappropriate delegation by nurses to healthcare”,
assistants. He continued:
“Wherever there is a multidisciplinary team of regulated professionals and unregulated healthcare workers, appropriate delegation and supervision is vitally important. This is an area ripe for formal review”.
He also said that the Government welcomed,
“the NMC’s plans to update its guidance on delegation”,
and that they have,
“asked Skills for Health and Skills for Care to accelerate production of a code of conduct”.—[Official Report, 1/12/11; col. 419.]
I am sure that those actions by the Government are very generally welcomed. The question before us is whether they are sufficient. From what the noble Baroness, Lady Emerton, has said, it is clear that she does not think that they are. Powerful support for that argument has been received from the Nursing and Midwifery Council, which argues that a system of regulation for healthcare support workers should contain provisions for consistent UK-wide standards of training and practice that would assure the public and employers that they have the knowledge and skills to practice safely. It further suggests a mandatory register to ensure that workers who have been struck off the nursing and midwifery register are not re-employed in a healthcare support role, which has been the subject of some concerns. It is also notable that the House of Commons Health Committee supports mandatory statutory regulation of healthcare assistants, which it believes is the only approach that would maximise public protection.
However, we have heard from my noble friend Lady Pitkeathley, chair of the Council for Healthcare Regulatory Excellence, who has put a different view. It will be interesting to hear the response of the noble Baroness, Lady Emerton, on why she thinks that a voluntary register for healthcare assistants is the way forward. I should like to ask her whether she would support NHS bodies which require healthcare assistants to be voluntarily registered as a condition of employment. If that were the case, what safeguards does she think could be put in place as regards a worker who was dismissed because of poor conduct towards a patient? How could we ensure that in those circumstances that person could not then work in another part of the care sector? That seems to me to go to the heart of the issue of whether a voluntary register could work.
I have no doubt that NHS employers could be encouraged to make it mandatory but the problem with that is that too many people could slip through the net. I would also ask the noble Baroness to respond to my noble friend Lord Warner. I share his view that, clearly, we are crying out for a fundamental review of these issues around nursing quality and care, compassion, and dignity of care being given to patients, and that relationship to healthcare assistants. If the Government are not prepared to move on this and on the point about only going as far as a voluntary register, can they at least give some comfort and assurance that they recognise that this matter needs close attention?
I am not a great believer in royal commissions—I think it was Harold Wilson who said that they could be established in a minute but take years—but there is a strong case for a fundamental review of the nursing profession, embracing healthcare assistants. Would the Government be prepared to give us some comfort on this?
Baroness Northover
My Lords, these amendments seek to extend compulsory statutory regulation to healthcare support workers. I thank noble Lords for the amendments because they raise important issues about the ways in which we assure the quality and safety of those who work in support of our regulated health professionals. The Government are publishing a fact sheet on this issue that will contain further details about their proposals, which I hope will be helpful to noble Lords.
There are more than 200,000 nursing assistants and approximately a further 1 million people working in similar jobs in adult social care in England alone. The majority of support workers give the highest quality of care. However, a minority let patients down. This is rightly a cause for concern, although as a former historian I have to say that I do not fully recognise the notion of everything having been perfect in earlier periods but everything breaking down at this point. One needs only to look at what has been said from Florence Nightingale onwards about what happened during the interwar periods, during times of war and so on. This has always been more varied than perhaps noble Lords are allowing for. Nevertheless, it is extremely important that we try to drive up quality and ensure that quality holds good right across the health service and social care. It is right that there is discussion and debate about the best way of ensuring that high standards of care are delivered at all times.
As the noble Baroness, Lady Pitkeathley, pointed out, there are already existing tiers of regulation that protect patients and service users. Professionals struck off by their regulator or sacked by an employer who pose a risk to vulnerable adults or children should be referred to the Independent Safeguarding Authority, which has been very clear that it expects this to happen. In the same way, employers should make referrals about individuals from unregulated groups where they pose a risk of harm to vulnerable adults or children. Providers and employers also play a key role in ensuring safe, high quality care that patients and service users can be confident in, being both responsible and accountable for the staff they employ. Under the registration requirements of the Care Quality Commission, providers must take steps to ensure that at all times there are sufficient numbers of suitably qualified, skilled and experienced persons employed for the purpose of carrying on any regulated activity.
An individual being on a list does not alter this and would not remove employers’ responsibility to undertake a range of checks on the suitability of any persons who they appoint, including qualifications, relevant registrations, employment history and reference checks to ensure that an individual is competent for a specific role. Equally, appropriate delegation and supervision is a necessity within teams made up of both regulated and unregulated professionals and workers. Guidance by the Nursing and Midwifery Council is being updated so that nursing staff know how to delegate appropriately and safely.
We are not ruling out compulsory statutory regulation for healthcare support workers, but our view is that the case has not yet been made for imposing further compulsory statutory regulation, given the tiers of existing regulation and the duties on regulated professionals. There is no solid evidence that demonstrates that healthcare support workers and adult social care workers should be subject to compulsory statutory regulation. Research by King’s College London concluded that little evidence could be deployed to show that regulation of healthcare support workers would reduce the risk to the public, although it was clear that some healthcare workers were undertaking roles that had traditionally been done by nurses. The point is that quality is not always what is delivered. Therefore, we have to try to tackle that concern and not simply assume that regulation will deal with it. As the noble Baroness, Lady Pitkeathley, mentioned, there are regulated professions which are in some instances letting us down. We must focus on the real problem and figure out ways of tackling it.
The Government’s view is that high standards for healthcare support workers and other professional occupational groups can be assured without imposing compulsory statutory regulation. That is why, in the wider context of supporting providers, we are creating through the Bill a system of external quality assurance for voluntary registers. To pick up the point made by the noble Lord, Lord MacKenzie, there are various examples of voluntary registration for groups of professionals. We are proposing a quality-assured voluntary approach, looking at how those registers are set up and operated and what training is offered and so on. A quality-assured voluntary register will set standards for training, conduct, competence and ethics that all registrants must meet.
Lord Hunt of Kings Heath
My Lords, if the Government are putting so much faith in the quality-assured voluntary register, surely the evidence from King’s College would show that that was not necessary. They cannot have it both ways. Either regulation, and what comes with it, provides advantages or it does not.
Baroness Northover
Regulation and training are often put as two words in one sentence. Regulation may indeed include training; assured voluntary registers may also include training. The noble Baroness, Lady Emerton, talked about that. Perhaps I may come on to it, because it is potentially relevant here.
I am particularly grateful to the noble Baroness for her contribution to this debate, not only today but throughout her time in the House of Lords. We agree that common standards of training are needed for those working in both health and social care, as well as more role-specific training, and that this will lead to a more capable and flexible group of support workers. As we seek to integrate health and social care more effectively, this area deserves a lot of scrutiny.
We expect work on the standards to begin by April 2012 in terms of training, and for them to be agreed ahead of the establishment of voluntary registers for healthcare support workers and adult social care workers, which could be operational from 2013. This will allow unregulated workers to demonstrate that they meet a set of minimum standards for training and are committed to a code of conduct.
Lord Hunt of Kings Heath
My Lords, I still do not understand this. If it is so important that the voluntary registers are established, for the reasons that the Minister has given, why on earth not go the full hog and make registration compulsory? If the Government do not think that it is important, they would not be pursuing the voluntary register approach. However, by taking that approach, they will leave lots of people outside the net.
Baroness Northover
As the noble Baroness, Lady Pitkeathley, and others have indicated, one has to be proportionate about this and not think that simply going down the route of regulation is going to crack it. Nevertheless, training and making sure that people are well prepared for the work that they are doing is clearly of great importance. We would expect a voluntary register, quality assured in the way that I have described, to provide a way for employers to assure what they are offering in terms of staff. There will therefore be greater take-up. Those who are on the quality-assured register will find themselves more employable, which will move things forward. Meanwhile, if, as we continue to debate this, voluntary registration does not seem sufficient and regulation seems the route to go down, the Government do not rule that out. However, it is extremely important to focus on the end point, which is to try to drive up quality, and not simply be deflected by thinking that this would crack it.
I assure noble Lords that we will keep this issue under constant review. We are well aware of people’s concerns and that standards need to be driven up in a much more even way across the board. As I say, we are developing the education and training which I hope will go some way towards this.
Lord Patel
I wish to pick up on one point. Can the noble Baroness reassure us on what it is she will keep under constant review? I understood her to say that the Government will rely on employers to ensure that these support workers have some kind of training. There will be no national training standards and, once the employers are satisfied that these people have some kind of training, they will be entitled to go on a voluntary register. As I understand it, the logical thing here is first to establish a national standard of training; then to ensure that those national standards are implemented; and then to allow people to register. If they register, the next step would be regulation. The first step is not immediate regulation but national standards of training and assessment that those standards are being met, before people can go through any kind of registration. What is the noble Baroness agreeing to keep under review?
Baroness Northover
I should perhaps explain that more precisely. This issue will be constantly under review so that if there are concerns in this area they will be flagged up. The Government will of course continually consider how best to respond and make sure that standards are of the quality that we need. The noble Lord is right: national standards of training are indeed the start. Then people are admitted to a register and so on. A voluntary-assured register would demand that kind of national level of standards in training. I hope that in that regard I can at least reassure the noble Lord.
Lord Warner
One question has puzzled me more and more as the noble Baroness has progressed. My noble friend Lady Pitkeathley laid great stress on the position of the regulated nurses and the fact that they will have to ensure that people working in the healthcare assistant type of roles under their supervision do not take on roles that they are not competent to fulfil. Going back to my description of the way the NHS works in reality, particularly in acute hospitals, there is a constant flow of different people on these wards—regulated and registered staff, agency or bank staff, are there particularly in the evenings, for unsocial hours and at weekends. We have heard a lot about employers. I am still puzzled about how the statutory regulated nurses satisfy themselves about the competence of the healthcare assistants working under their direction. They seem to be the people most exposed—at least theoretically—to cop it from their regulatory body if they have not made extensive inquiries about the competence of these healthcare assistants. How does the noble Baroness square that particular circle if we do not have much knowledge of the training of these people and they have not even registered on a voluntary basis?
Baroness Northover
The noble Lord will be familiar with being on wards at changeover time and when there is a pooling of information about who is on the ward and what the problems are. Issues are flagged up and one team passes information on to the next.
Lord Warner
I have seen changeovers at weekends, when visiting relatives. It is not a pretty sight.
Baroness Northover
I have seen many, many changeovers. The proposal is being brought forward so that registered, regulated nurses have a better idea of when and how to delegate, and that is extremely important for the reasons that the noble Lord has just indicated. As I have indicated, the training and national standards of healthcare workers, to which the noble Lord, Lord Patel, referred, are also important—as is taking that forward so that the registered nurses are aware of the kind of training that those healthcare workers have had. I want to pick up on the case that the noble Baroness, Lady Emerton, mentioned about the healthcare worker who was taking a patient’s blood pressure but did not know what the reading meant. Surely, it was for the person to whom that was reported to take action on the significance of that. That information was to be passed on to somebody else to read, understand and interpret.
Lord MacKenzie of Culkein
But if that healthcare assistant does not have the basic training or an understanding of the reading that she or he has just taken, they may not see the importance of reporting it to another nurse.
Baroness Northover
I am not suggesting that they would. What I am suggesting is that the registered nurse might go and check the chart.
Baroness Emerton
My Lords, perhaps I could be helpful at this stage. I am grateful to noble Lords who have contributed to this debate. A large number of issues have been brought forward; I shall start with the title “nurse”. As noble Lords have mentioned, a person who is nursed—and feels that they have been nursed—experiences care, compassion, respect and dignity. There has been a lot of discussion among the public, and indeed in this House, about registered nurses becoming graduates and whether they will be too posh to wash, to put it colloquially. To me, a nurse who is a graduate would be only too grateful to be able to attend to the basic needs of patients, because that is part of holistic care. When you do various intimate things for patients, you learn a great deal about their condition.
The point that has been raised about the nurse is very important. We talk about support workers but we cannot talk about support nurses, because the term “nurse” is completely left for the statutory requirement of a regulated nurse. We are looking for a support worker who is able to do tasks which they understand, with the skills of the graduate nurse—because by 2013, we will be producing all-graduate nurses—within holistic care. That is the point I was trying to make this morning: it is the holistic care we are looking for in the delivery of care. However, it is not only holistic care in the acute sector; we are looking at the holistic care which is integrated with social care, because we are now looking at patients going into the community. Indeed, people working in the acute sector need to understand that the patients they are discharging are going into the community, which is a different scene and which may require not only a nurse but social care support. Therefore, somewhere in our education we need to bring together a basic core of understanding healthcare, nursing care and social care.
The point that the noble Lord, Lord Warner, made is very important. We need to conduct this review. On the other hand, the research evidence shows us that as regards highly qualified registered staff, the higher the proportion, the less likely it is that patients will have a longer stay in hospital. They will have a better clinical outcome. I hope that the Government are not going to ignore that research. If possible, we should carry out a truly safe cost-benefit analysis into increasing the number of trained staff, seeing where they are needed, rather than having a higher proportion of support workers.
The Royal College of Nursing has been resolute in putting forward the regulation of healthcare support workers because it feels that that is the way to ensure that they are answerable to a registered nurse. We talk about employers but I am not sure who the employers are going to be—social workers, managers or the nursing profession. This whole issue needs to be taken away and looked at, and perhaps we could return to it. I do not know whether these comments are helpful but I feel strongly about this issue, as noble Lords may have gathered. I pass it back to the Minister.
Baroness Northover
I hear what the noble Baroness says. She is extremely well informed, as ever, and I hope that she will continue to engage as we take this forward, as she has done up to now. However, at this point I hope that she will withdraw her amendment.
Baroness Emerton
My Lords, I am prepared to withdraw but we will probably come back to this on Report. I beg leave to withdraw the amendment.
Lord MacKenzie of Culkein
My Lords, I support this group of amendments. I want to make just a couple of points, as I think that most of the others have already been covered.
I am looking at some information sent in an open letter from the Registration Council for Clinical Physiologists to Anne Milton, the Parliamentary Under-Secretary of State in another place. Interestingly, in that open letter the registration council, which operates a voluntary register, takes the view that the council is rather toothless. It says that the professions covered by clinical physiologists will continue to be,
“saddled with a toothless system of voluntary registration, in which those managing the registers are exposed to unacceptable legal risk when attempting to enforce the meagre sanctions at their disposal and maintain professional standards”.
It says it is evident that those administering the current inadequate voluntary registration process are being threatened with civil action by those whom they are forced to reprimand. It is a pretty poor state of affairs when those who are trying to enforce professional standards are themselves threatened with legal action.
I know from talking to people involved with the registration council that people leave the register when disciplinary issues come to the fore. I gather that in one instance a person left the register when faced with discipline, emigrated to Australia, continued to practise and got in trouble there. As I understand it, the Australian statutory body that exists for clinical physiologists was astonished to discover that there was no statutory regulation in force in this country.
I do not think that we can continue with this so-called voluntary system and light touch. We need to do what other countries do and have statutory responsibilities and statutory training and registration for these very important groups of staff.
Baroness Northover
My Lords, these amendments seek to extend compulsory statutory regulation to physicians’ assistants in anaesthesia and clinical physiologists and to make changes to legislation to further provide for the compulsory statutory regulation of clinical physiologists.
I make it clear at the start that healthcare scientists such as clinical physiologists play an important and highly valued role as part of clinical teams, and this is also true of physicians’ assistants. It is a testament to their professionalism that the Department of Health is not aware of any general concerns about the standards of practice of either group. Furthermore, we need to be absolutely clear that the purpose of regulation is to protect the public, not to support the development of a profession.
Given the wider systems of assurance in place such as the Care Quality Commission’s registration requirements, and the vetting and barring scheme, the Government do not consider that the case for compulsory statutory regulation of these groups of healthcare scientists not already subject to regulation, and physicians’ assistants, has been made. However, we agree that there need to be processes to ensure high standards of care, and assured voluntary registration overseen by the Professional Standards Authority for Health and Social Care has the potential to provide this. It will ensure that there are robust standards of conduct and training. It will be open to employers and commissioners to insist on only recruiting staff on voluntary registers. Those doing so would secure many of the benefits of compulsory regulation. Both healthcare scientists and physicians’ assistants already have established voluntary registers and would be well placed to seek accreditation from the authority.
The noble Baroness, Lady Thornton, asked why we were not taking forward the regulation of clinical physiologists as recommended by the Health Professions Council. The recommendations of the Health Professions Council were not based on an assessment of the risk presented by a profession, but rather on whether that profession had already developed processes of assurance which prepared them for professional regulation. There is therefore no evidence that compulsory statutory regulation is necessary to mitigate the risks posed by the professions recommended for such regulation by the Health Professions Council. This is probably why the previous Government did not decide to regulate, although this is an issue that has been flagged up for a number of years. The professions recommended by the Health Professions Council for compulsory statutory regulation will be well placed to join the system of assured voluntary registration that we are proposing.
The noble Baroness, Lady Thornton, asked about research in terms of regulating clinical physiologists. We are not planning on commissioning research into the case for regulating them, but we will review the case for introducing compulsory statutory regulation for clinical physiologists and, obviously, others in the light of experience of assured voluntary registration, and the evidence about risks available.
Baroness Thornton
Perhaps the Minister could tell us what sort of timescale she envisages for this, or whether it will have to wait until an accident happens like the noble Baroness, Lady Finlay, recorded and then the Government will deal with it.
Baroness Northover
The noble Baroness will be fully aware, because she was a health Minister, that if there is no evidence of there being a risk then you do not choose to regulate. That is presumably why the previous Government chose not to.
The noble Baroness, Lady Finlay, flagged up the position of anaesthetists’ assistants. I had interesting discussions yesterday with an anaesthetist and an anaesthetist’s assistant, and it was very enlightening. As the noble Baroness will know, the anaesthetist is of course ultimately responsible. Assistants must always be supervised by a consultant who needs to be available within two minutes. The issue that the noble Baroness raises is one of quality assurance. As she knows, the Royal College of Anaesthetists runs the training and the registration for those assistants. After they have done a science degree, generally it is 27 months of practice. If the Royal College of Anaesthetists judges that that is inadequate, on the basis of the kind of concerns that the noble Baroness raises, then it is clearly for it to say that there are risks, it has encountered risks, and that needs to be addressed. If this system comes under the quality assurance system that I mentioned earlier, there will be another body looking at whether that kind of training, assurance and registration is adequate. However, there have not been cases flagged up as causing concern. I also point out that there are few anaesthetists’ assistants. They are more generally used in other countries, I gather, but not so much in the United Kingdom. The noble Lord, Lord Alderdice, asked why there is not more statutory regulation. In some ways I think I have addressed that. Although compulsory statutory regulation is sometimes necessary, one has to look at the risks and at what is proportionate.
Baroness Thornton
The health Minister Anne Milton said that those professions in which a patient safety case can be made, including that of clinical physiologists, will be considered for statutory regulation subject to a cost-benefit risk analysis. Will the Government carry out that analysis and, if so, when and in what time? I do not particularly want an answer about what my Government may or may not have done or may or may not have decided. The noble Baroness’s own Minister has pronounced on this matter since the general election so it seems to me that she needs to answer the question: when will they do the risk analysis?
Baroness Northover
I have already mentioned to the noble Baroness—she is probably totally familiar with this—that the Department of Health does not have evidence of there being a risk in this regard. Clearly, as I mentioned on the earlier group, these issues will always be kept under review. If the concerns that she has flagged up and if the association, which is particularly encouraging the regulation of clinical physiologists—that is fine; it is all part of professionalisation—flags up particular concerns that emerge from other evidence, then of course the department will take that very seriously. However, things need to be proportionate.
Baroness Finlay of Llandaff
I have listened very carefully to what has been said about the assistants relating to anaesthesia, but I also used the more catch-all phrase about the clinical perfusion scientists. I would be grateful if, after this debate, the noble Baroness would write to me and explain why coroner recommendations in relation to clinical perfusion scientists are not considered to be enough of a risk to take action. If one is trying to assess this on a risk spectrum, it would be helpful to understand why a coroner's decision to recommend that this small, contained group of clinical perfusion scientists should be regulated does not constitute enough of a risk to go down that route to regulate them and to have them on a statutory register.
Baroness Northover
I am very happy to take away what the noble Baroness has said and to discuss the situation further with her.
We expect the assured voluntary registration to be up and running by 2012. Therefore, afterwards that would need to be assessed to see whether anything further is required, as noble Lords have figured might be the case. We are hoping to see how it all works.
The noble Lord, Lord Walton, flagged up various groups which were regulated and he could not quite see why others were not. Given that I used to bump into the noble Lord, Lord Walton, in the Wellcome Library for the History and Understanding of Medicine, I think he will fully understand that the way in which regulation has grown up has not necessarily been logical or consistent. Therefore, I flag up the 2005 Hampton review on regulation which says that it should be proportionate to the risks that it seeks to mitigate and various other provisions. That is what we are seeking to do. Of course, we shall keep under review what we are doing to see whether it is adequate. In the mean time, I hope that the noble Baroness will be willing to withdraw the amendment.
Baroness Thornton
My Lords, I thank the Minister, but this is not yet a satisfactory situation. We might be moving towards one but we are not there by any means. If I were on the register of clinical physiologists I would find it slightly offensive for the Minister to suggest that I was asking for statutory regulation as a kind of professional development of the organisation. Physiologists are very clear in all of their briefings that they think that this is important for patient safety. That is why they want statutory regulation and that is why we need to listen to them very carefully.
Baroness Thornton
I thank the noble Baroness for that. The noble Baroness, Lady Finlay, made a graphic and powerful case. I thank my noble friend Lord Rea, the noble Baroness, Lady Masham, and the noble Lord, Lord Walton, for their support for the amendment. My noble friend Lady Pitkeathley and the Minister are coming at it from a different point of view. It is entirely possible that an arbitrary decision was taken, quite possibly by my Government, that there was enough statutory regulation. It is possible that this Government need to think that that was an arbitrary decision in the history of regulation and that exceptions need to be made.
There are questions about the limits of assured voluntary registration. Do clinical physiologists carry out invasive procedures that could harm patients? Yes, they do. Are clinical physiologists incentivised to join the voluntary register? No, they are not. A small number of NHS and private employers notionally require applicants to be on their register but there is no mandatory requirement for this. Are professionals incentivised to maintain the voluntary register? No, their activities are carried out on a voluntary basis by the chair and other officers. Does the voluntary register empower patients to make formal complaints? No. While the Health Professions Council operates a system whereby anyone can make a complaint about the fitness to practise of a professional on its register, in most instances members of the public are not aware of the existence of voluntary registers. Finally, does the voluntary register have any powers of enforcement? No, it does not. The RCCP operates a disciplinary code and procedure but it cannot protect patients from continuing to be treated by practitioners who have not been registered and who are potentially unfit to practise. I beg leave to withdraw the amendment.