Vol. 758 Thursday No. 85 15 January 2015

PARLIAMENTARY DEBATES (HANSARD) HOUSE OF LORDS OFFICIAL REPORT

ORDER OF BUSINESS

Questions HIV...... 891 Personal Independence Payments ...... 893 United States: Haggis Ban...... 896 Milk Production...... 897 Business of the House Timing of Debates...... 900 Natural Environment Motion to Take Note...... 901 NHS: Accident and Emergency Services Question for Short Debate...... 934 Mental Health Motion to Take Note...... 948 Insurance Bill [HL] Third Reading...... 980 Developing World: Maternal and Neonatal Mortality Question for Short Debate...... 980

Grand Committee Cadet Units in Schools Question for Short Debate...... GC 235 Criminal Bar: Funding Question for Short Debate...... GC 249 Property Boundaries Question for Short Debate...... GC 262 Chancel Repairs Question for Short Debate...... GC 273 London Health Commission: Smoking Question for Short Debate...... GC 288

Written Statements...... WS 83 Written Answers ...... WA 257

£4·00 Lords wishing to be supplied with these Daily Reports should give notice to this effect to the Printed Paper Office. No proofs of Daily Reports are provided. Corrections for the bound volume which Lords wish to suggest to the report of their speeches should be clearly indicated in a copy of the Daily Report, which, with the column numbers concerned shown on the front cover, should be sent to the Editor of Debates, House of Lords, within 14 days of the date of the Daily Report. This issue of the Official Report is also available on the Internet at www.publications.parliament.uk/pa/ld201415/ldhansrd/index/150115.html

PRICES AND SUBSCRIPTION RATES DAILY PARTS Single copies: Commons, £5; Lords £4 Annual subscriptions: Commons, £865; Lords £600 LORDS VOLUME INDEX obtainable on standing order only. Details available on request. BOUND VOLUMES OF DEBATES are issued periodically during the session. Single copies: Commons, £105; Lords, £60 (£100 for a two-volume edition). Standing orders will be accepted. THE INDEX to each Bound Volume of House of Commons Debates is published separately at £9·00 and can be supplied to standing order. All prices are inclusive of postage.

The first time a Member speaks to a new piece of parliamentary business, the following abbreviations are used to show their party affiliation: Abbreviation Party/Group CB Cross Bench Con Conservative Con Ind Conservative Independent DUP Democratic Unionist Party GP Green Party Ind Lab Independent Labour Ind LD Independent Liberal Democrat Ind SD Independent Social Democrat Lab Labour Lab Ind Labour Independent LD Liberal Democrat LD Ind Liberal Democrat Independent Non-afl Non-affiliated PC Plaid Cymru UKIP UK Independence Party UUP Ulster Unionist Party

No party affiliation is given for Members serving the House in a formal capacity, the Lords spiritual, Members on leave of absence or Members who are otherwise disqualified from sitting in the House. © Parliamentary Copyright House of Lords 2015, this publication may be reproduced under the terms of the Open Parliament licence, which is published at www.parliament.uk/site-information/copyright/. 891 HIV[15 JANUARY 2015] HIV 892

symptoms. My department was pleased to fund the House of Lords Medical Foundation for AIDS and Sexual Health’s HIV testing in primary care project that provides a Thursday, 15 January 2015. web-based interactive resource for GPs in primary care to help make testing easier in GP surgeries. 11 am Prayers—read by the Lord Bishop of Lichfield. Baroness McIntosh of Hudnall (Lab): My Lords, does the Minister agree that one of the biggest disincentives to testing is the amount of stigma that still remains HIV against those who are known to have HIV? Alongside Question encouraging people to have tests, can he say what Public Health England is doing to combat that stigma? 11.06 am Asked by Lord Fowler Earl Howe: The noble Baroness is absolutely right. To ask Her Majesty’s Government what estimate If we were to single out three things that are important they have made of the proportion of people living in this context, they would be prevention, testing and with HIV who are undiagnosed. tackling stigma and discrimination. The NHS, local authorities, government, community and faith groups, The Parliamentary Under-Secretary of State, Department the media and individuals themselves all have a part to of Health (Earl Howe) (Con): My Lords, Public Health play in eliminating HIV-related stigma. Our framework England estimates that in 2013 107,800 people were for sexual health improvement is clear that action living with HIV in the United Kingdom. Of these, needs to continue to eradicate prejudice based on 24%, some 26,100, down from 25% in 2012, were sexual orientation. That depends on building an open undiagnosed and unaware of their infection. Early and honest culture where everyone can make informed diagnosis is important to ensure people can get early decisions and responsible choices about relationships. treatment and to prevent them infecting others. Baroness Gardner of Parkes (Con): My Lords, is it Lord Fowler (Con): My Lords, surely we cannot not a fact that there has been a great change in ever eradicate HIV in Britain, which currently is costing attitudes about HIV, and not only because of the the health service something like £650 million a year, treatments that are now available? I recall the days when there are at any one time, as my noble friend has when people went into a hospice because it was a just said, 26,000 people who have contracted HIV but terminal condition. I have sat on various inquiries and are undiagnosed and untested and can obviously spread know that people used to hide—in the fridge, for example the infection further. Will my noble friend consider —any evidence that they had HIV because they were setting up a working party to report on how testing in frightened of other people knowing. Because that no this country can be improved, which would be of longer applies, there is a great opportunity for people benefit to those people affected and also to the benefit to have testing without any embarrassment at all. of the public generally. Earl Howe: My noble friend is right. I think that we Earl Howe: I will gladly take that suggestion from have come a long way since my noble friend Lord Fowler my noble friend away and give it consideration and I was Secretary of State, when stigma and discrimination am grateful to him for it. The position on testing is, were very apparent in virtually all sections of society. however, quite encouraging. We have seen more than We do not see that so much now, I am glad to say, as 1 million HIV tests in sexual health clinics in 2013, evidenced by the fact that we are reporting a continuing which is up 5% from the previous year, and that is only reduction in late diagnosis. It was down to 42% last in sexual health clinics. As my noble friend knows, year from 47% in 2012, and that is a key indicator in there are other routes to testing through GP surgeries, this context. self-sampling kits and so on. Additional testing is vital if we are going to make sufficient inroads into diagnosing this condition. Lord Collins of Highbury (Lab): My Lords, the UK is a leading supporter of research and development Baroness Barker (LD): My Lords, the organisation into universal prevention methods, including HIV Halve It reported in a survey last year that one-third microbiocides and vaccines. With 19 million people of GPs who are in high-prevalence HIV areas were globally remaining unaware of their HIV status today, unaware that that is where they worked and consequently will the noble Earl tell us how the Department of were not testing people for HIV routinely. Can the Health is working with the Department for International Government work with Public Health England and Development to support this research and development the RCGP to remedy that? work?

Earl Howe: My Lords, I pay tribute to the work of Earl Howe: My Lords, in November 2013 DfID the Halve It coalition in raising awareness about the conducted a review of our 2011 HIV position paper. importance of increasing HIV testing. My noble friend The review paper highlighted three areas of particular is right that apart from ignorance often GPs are focus in the international context. They were to identify reluctant to discuss HIV testing or are unaware of the the key affected populations—girls and women—and importance of early diagnosis and possible indicator the integration of HIV responses into the wider health 893 HIV[LORDS] Personal Independence Payments 894

[EARL HOWE] purpose, yet the Government are still rolling out the system, as well as broader development priorities. scheme. Is it not right for them to stop the rollout until That of course includes tackling stigma and the the system is working, to assess the negative impact on unacceptable things that we see in certain overseas hundreds and thousands of handicapped disabled people, countries, including discriminatory legislation. and to make sure that it is fit for purpose before they proceed? Lord Patel (CB): My Lords, did the Minister refer to 26,000 people being undiagnosed? What is that Lord Bourne of Aberystwyth: My Lords, I dispute number based on? those figures. The backlog stands at 107,000 at the moment, and 65,000 claims are being processed every Earl Howe: My Lords, these figures inevitably have month. Help is available in other areas—such as JSA, to be estimates but they rely on data from three ESA, local authority help and NHS help—for those who surveys that measure undiagnosed HIV infection among are awaiting an assessment. The system is not failing; sexual health clinic attendees, pregnant women and it is succeeding, and the backlog is being cleared. people who inject drugs. Comprehensive clinical data from sexual health clinics relating to patients newly diagnosed with HIV are also used to infer the risk of Baroness Eaton (Con): May I ask the Minister what undiagnosed infection. assessment Her Majesty’s Government have made of the recent report from the all-party parliamentary inquiry into hunger and food poverty? Lord McConnell of Glenscorrodale (Lab): My Lords, moving the focus from sub-Saharan Africa, where we have been so focused over recent years, is the Minister Lord Bourne of Aberystwyth: My Lords, the Government aware of the increase in the incidence of HIV/AIDS in have looked closely at the all-party parliamentary group’s south-east Asia? Are the Government looking at advice report on food banks and food poverty. It is a complex to British tourists travelling to that area in the light of issue; there is no doubt about that. We have, of course, this increase in the incidence? identified ways in which we can further publicise hardship payments, and we are doing that. We are also looking, with food retailers, at how we can ensure that food Earl Howe: My Lords, I believe I am right in saying waste is minimised. The private sector has a role to that there is advice on the FCO website for tourists to play there. that part of the world. However, if I may, I will write to the noble Lord with details of the factors that obtain in south-east Asia. Lord Touhig (Lab): My Lords, many claimants with autism lack insight into their own condition, and a family member or companion can help fill in the gaps Personal Independence Payments during the PIP interview. But the National Autistic Question Society, of which I am a vice-president, tells me that a number of assessors are refusing to allow that. Will 11.14 am the Minister look into this? It is discrimination. Will he ensure that people who are autistic are not adversely Asked by Lord Dubs affected by this attitude? To ask Her Majesty’s Government what steps they are taking to ensure that people facing delays Lord Bourne of Aberystwyth: The noble Lord does in receiving personal independence payments do notable work in the area of autism, as is well known. not endure financial hardship. The guidelines on the medical assessments related to PIP indicate that all these conditions should be taken Lord Bourne of Aberystwyth (Con): My Lords, personal account of. I have no evidence of this being a particular independence payment is not an income replacement problem, but if the noble Lord would like to write to benefit; it contributes towards the extra costs associated me about it, I will ensure that it is looked at. with disability. Employment support allowance provides financial support for those who are ill or disabled and Baroness Sherlock (Lab): My Lords, last June, Iain unable to work. We appreciate the difficulties associated Duncan Smith told MPs that by the end of 2014 nobody with claims for PIP, and we are absolutely committed would be waiting more than 16 weeks for a PIP to reducing the backlog, and waiting times. Monthly assessment. Can the Minister tell the House precisely clearances have quadrupled over the past year, and the when that target will be met? I do not believe that it backlog is falling. All successful new PIP claims are was met by the end of 2014. As the target was only for backdated. when people would get an assessment, can he also tell the House how long people will have to wait to get a Lord Dubs (Lab): I thank the Minister for that final decision, and their money? He seemed to be reply, but will he nevertheless confirm that, as recently reassuring the House that people would get their as last month, some 670,000 people had registered for money backdated when they eventually got it, but is it PIP but 300,000 people were still waiting for their not the case that, even though PIP is backdated, claim to be processed, some of whom had been waiting passported benefits such as blue badges and carer’s for six months or longer? The system is not fit for allowance are not? 895 Personal Independence Payments[15 JANUARY 2015] United States: Haggis Ban 896

Lord Bourne of Aberystwyth: The noble Baroness United States: Haggis Ban has asked a range of questions, and if I fail to answer Question all of them now, no doubt we can speak later. We are clearing the backlog and, as she will know, there has 11.21 am been significant progress. I shall repeat the figures: the Asked by Lord McColl of Dulwich backlog is coming down and we are clearing 65,000 To ask Her Majesty’s Government what steps claims a month. The Minister in another place, Mark they are taking to persuade the United States to lift Harper, will report on progress to the Work and its ban on the import of haggis. Pensions Select Committee on 28 January. The rate of clearances is improving month on month, and the The Parliamentary Under-Secretary of State, Department number of outstanding cases in the system has been for Environment, Food and Rural Affairs (Lord De Mauley) falling significantly. (Con): My Lords, the United States Food and Drug Administration does not allow animal lungs in products Lord Hylton (CB): Last year, food banks served for human consumption. My right honourable friend 500,000 people in six months. If people cannot even the former Secretary of State Owen Paterson lobbied afford food, does that not show that there is acute the US authorities during his visit in the summer, and financial hardship? Will the Government therefore try we continue to encourage them to adjust their ban on to reduce the number of people suffering sanctions haggis containing sheep lungs as part of the wider and make sure that sanctions last for the minimum European Union negotiations on lifting the transmissible possible period? spongiform encephalopathy restrictions on EU lamb. Lord McColl of Dulwich (Con): I thank the noble Lord Bourne of Aberystwyth: The noble Lord draws Lord for his usual courteous and informative reply. Is attention to the important role that food banks are he aware that the United States Government are depriving fulfilling. Food banks have existed for well over a 24 million American Scots of this wholesome food, decade throughout western Europe, the USA and which satisfies hunger very much more than the junk Canada. The reasons for using food banks are many food the Americans consume? It would help to deal and complex, and I pay tribute to what they are doing. with the greatest epidemic they have—the obesity As I say, to address some of the concerns we are epidemic, which is killing millions, costing billions of publicising much more the possibility of early payment dollars, and for which the cure is free. Will the Minister of hardship benefit and so on, and we are working encourage the Government to redouble their efforts to with food retailers on food waste. persuade the American Government to have much freer trade and lift the 1971 ban on the wholesome Lord German (LD): My Lords— haggis? Lord De Mauley: Well, my Lords, there is quite a lot Lord McFall of Alcluith (Lab): My Lords— in that. Perhaps it would help if I explained that two hurdles are involved in what the noble Lord proposes. We have to get over, first, the US restrictions on the The Lord Privy Seal (Baroness Stowell of Beeston) import of lamb. We are working with the US authorities (Con): My Lords, we have heard from several Peers towards achieving approval to lift those restrictions from the Labour Benches on this Question and we with, I think, good prospects. Secondly, there is the have not yet heard from a Liberal Democrat Member. US’s unwillingness to recognise animal lungs as an acceptable foodstuff. In this regard the most promising Lord German: My Lords, the loss of a Motability avenue in the short term is the production of haggis car can mean the loss of independence for a disabled omitting the inclusion of lung—and the Scottish person. Is my noble friend confident that the personal Government recognise this. independence payment assessors are prompting claimants as to whether they can walk more than 20 metres Lord Purvis of Tweed (LD): My Lords, I appreciate safely to an acceptable standard repeatedly and in a that not everyone fully understands the haggis. Once reasonable time, which are the crucial criteria put into for a Burns supper in Germany, Burns’s, statute by this House? Unless these criteria are followed, “Great chieftain o’ the puddin-race!”, thousands of disabled people will not be eligible for a was translated into German and then retranslated Motability car and those being retested may lose their back as, “Mighty Führer of the sausage people”. Will car and their independence. the Minister make sure that this ridiculous ban comes to an end? If it is not too late, I see that the Prime Minister is with President Obama today, so can my Lord Bourne of Aberystwyth: My noble friend raises noble friend send an urgent message to make sure important issues on the subject of Motability cars. It is that this visit is a triumph by having a private word worth noting that the Motability payment will continue with the President to make sure that the ban is now while it is being reassessed. Those four criteria are looked lifted? at very closely. The legislation requires the assessors to consider whether a claimant can carry out each activity Lord De Mauley: Unfortunately, I cannot guarantee reliably. They will do that by means of observation, a rapid resolution of the problem, but I hope I have discussion and medical evidence—often just on the made clear that we are working extremely hard towards basis of medical evidence. I am satisfied that those it. Promoting food and drink exports more generally is criteria are being followed. a key government priority. We are working hard to 897 United States: Haggis Ban[LORDS] Milk Production 898

[LORD DE MAULEY] that we can guarantee the long-term viability of our champion UK food and drink overseas with, I think, dairy industry and also ensure that the prices of milk considerable success. My right honourable friend the reflect the costs of production? Secretary of State is currently in China doing just that. Lord De Mauley: My Lords, to address the short-term Lord Winston (Lab): My Lords, I confess to being a problem, my honourable friend George Eustice, the little surprised that one of the most senior qualified farms Minister, yesterday held a farming resilience medical practitioners in the Chamber is asking this summit precisely so that this subject could be a central Question, seeing that there is a questionable issue focus. Noble Lords may also have seen that DairyCo about haggis—which I, personally, find a revolting has offered advice and assistance to farmers in cash-flow food. Would not charity be better at home? If haggis planning and volatility management. Other actions in does indeed deal with obesity, perhaps we should hand include investigating whether the seasonal cyclicality promote it a little in Glasgow. of prices lends itself to the use of futures markets to smooth the price curve, and we are putting pressure on Lord De Mauley: My Lords, what a good idea. As the Commissioner to accelerate the improvement of the noble Lord does not appear to like the taste of the, country-of-origin labelling. “Great chieftain o’ the pudding-race”, I recommend a large tot of whisky. Lord Wigley (PC): Does the Minister accept that there is a need for long-term stability for the dairy sector to Lord Forsyth of Drumlean (Con): My Lords, given flourish, and that a price below 29 pence a litre at farm the seriousness of this matter, should the Government gate, which was the average price in November, is not not consider appointing a special envoy with energy sustainable? Does he accept that action needs to be and imagination to go to the United States and stay taken? Does he believe that the steps to which he there until this matter is resolved? Could I suggest that referred with regard to co-operation with our European Alex Salmond is currently looking for work? partners in dairy matters on the question of labelling is enough to deliver what is needed for that stability? Lord De Mauley: My Lords, I was going to say that it is a question of priorities, but that is an eminently Lord De Mauley: I certainly agree with the first half sensible suggestion. of what the noble Lord has said. I am not suggesting Lord Cormack (Con): My Lords, what is served at that the work on labelling is by any means the only the British embassy on Burns Night? tool. That is why, as I have said, we are looking at the use of futures markets, because there is evidence of a Lord De Mauley: What else, my Lords? Haggis. seasonal cyclicality of milk prices. At certain times of the year a crunch tends to be worse, and such crunches can be foreseen, so we want to smooth that curve. But Milk Production crucial is our work on exports, and noble Lords will be Question interested to know that exports to non-EU markets of dairy products are up by 47% year on year. 11.26 am Asked by The Lord Bishop of St Albans The Earl of Shrewsbury (Con): My Lords, is it not To ask Her Majesty’s Government what steps the case that one of the ways forward could be the they are taking to ensure the long-term sustainability model used by Tesco which has a margin-plus deal of milk production in the United Kingdom. with farmers where at least farmers have an idea of what the future looks like and they get a decent price The Parliamentary Under-Secretary of State, Department for their milk? for Environment, Food and Rural Affairs (Lord De Mauley) (Con): My Lords, we share farmers’ concerns over the Lord De Mauley: Yes, my Lords. Certainly, innovative pressures on milk prices caused by the volatility of the deals such as that are of real value to farmers. Sadly, global market and we are working closely with industry. not all farmers are able to negotiate those deals, but It is important to remember that the long-term prospects we are working with them, as I have said, on various are good, with exports at record levels. We are helping ways to resolve the problem. the dairy industry take advantage of opportunities such as opening new export markets and pushing for Lord Curry of Kirkharle (CB): My Lords, as the better country of origin labelling for British dairy Minister knows, I was at the summit yesterday hosted products. by his colleague George Eustice. While the long-term prospects for the dairy sector would appear to be The Lord Bishop of St Albans: I thank the Minister good, what is also clear is that volatility is now an for his Answer. Does he agree that, should we lose any ongoing feature of global trading. I am concerned, as of our capacity to produce milk due to the very low is the right reverend Prelate, about the long-term prices of imported milk at the moment, the nature of sustainability of the British dairy industry and the fact the dairy industry is such that you cannot quickly and that we may lose market share. I understand that the efficiently turn it back on again when another shortage Irish Government have introduced five-year tax averaging occurs—as there clearly will be at some point? What for businesses, which has existed in Denmark for a are Her Majesty’s Government doing to draw together long time. Would the Minister consider approaching dairy farmers, processors and, above all, retailers so the Treasury to see whether that might be possible? 899 Milk Production[15 JANUARY 2015] Business of the House 900

Lord De Mauley: My Lords, I am very happy to Commission recommended the creation of the GCA take that back. and limited its jurisdiction to the relationships between those 10 largest supermarkets and their direct suppliers. Baroness Miller of Chilthorne Domer (LD): My Any change to that would require primary legislation. Lords— It is a little premature to take the next step, because there is a mechanism in place for conducting a review and the first one of those is set for 31 March 2016. Lord Berkeley (Lab): My Lords— Baroness O’Cathain (Con): My Lords, the Question Baroness Miller of Chilthorne Domer: This side. talks about the sustainability of the dairy industry. I This side. am sure my noble friend is aware that the milk cheque is one of the most important ways of keeping agriculture The Lord Privy Seal (Baroness Stowell of Beeston) going in this country. The number of dairy farmers (Con): Order. We need less of the shouting of “This has reduced from 30,000 about 15 years ago to 10,000 side, this side” during Question Time. If we are going now. It seems that people are giving up. Can we to follow the convention of sides, which is not the only impress this point on the Treasury, or whoever, and convention we follow at Question Time, it is the turn particularly on the retailers? Instead of having five of the Labour Benches, so we should hear from the private planes—in the case of one of our leading noble Lord, Lord Berkeley. retailers—could not the retailers consider the future of agriculture in terms of the food supply to them in this Lord Berkeley: I am grateful to the noble Baroness. country? Does the Minister agree that one way of reducing the cost of production would be to introduce mega-dairies Lord De Mauley: My Lords, my noble friend, as and very big units in the way that has been done for always, puts her finger on a key part of the problem. I poultry and pigs? Does he have a view on that and have outlined a number of measures that we are what sort of size would the Government welcome? taking. I can also add to that the use of the RDP—the Rural Development Programme—to foster improvement of competitiveness and profitability, for example, by Lord De Mauley: Certainly, my Lords, some producers increased emphasis on value-added products, such as are able to produce milk at a much lower rate—I met a cheese and yoghurt. I think that is really important to farmer the other day who claimed to be producing our market. Once again I have to come back to you on milk in the mid-teens. We do not have strong views on the real importance of our work on exports. the size of units of farms. What matters is stockmanship. Baroness McIntosh of Hudnall (Lab): Does the Baroness Miller of Chilthorne Domer: My Lords, Minister agree that cash flow, which he touched on in does my noble friend agree that milk coming from an earlier answer, is a critical matter, both for farmers grass-fed cows kept out of doors is of a superior and co-operatives? Can he say whether he feels that nutritional quality? Further, will he say how important the banks are playing their part in sustaining the that is to the look of the countryside in all those areas farming industry by supporting them through volatility dependent on tourism? Does he think that that would in cash flow? be answered by large industrial units? Lord De Mauley: The noble Baroness is absolutely Lord De Mauley: My Lords, there is a strong case right. Cash flow is crucial. You can be as profitable as for extensive farming. We see it in this country and you like, but if you have no money in the bank, you some farmers are practising it very profitably. It depends cannot pay the bills. The noble Baroness is alluding to to a large extent on the part of the country—on the the cash-flow problems that face not only farmers but rainfall, the quality of the grass and so forth. As I have co-operatives. First Milk is a co-operative, wholly said before, we think that there is a place for various owned by farmers, and it is in the interests of farmers different types of farming. that it should survive and thrive. Work such as that being done by Dairy UK, which I referred to earlier, Lord Trees (CB): My Lords, notwithstanding the on helping farmers with cash flow is really important. voluntary codes by Tesco and so forth referred to Some of the banks are doing similar work. earlier, which are to be commended, they apply only to a minority of dairy farmers. Is there not a case for Business of the House extending the Groceries Code to primary producers of such vital products as milk? Most dairy farms are not Timing of Debates protected under the code because they do not directly supply retailers; they supply processors. 11.36 am Moved by Baroness Stowell of Beeston Lord De Mauley: I have considered that point carefully, That the debates on the Motions in the names of my Lords. The scope of the Groceries Code Adjudicator Baroness Bakewell of Hardington Mandeville and is based on a report from the Competition Commission, Baroness Tyler of Enfield set down for today shall which found that the most significant problems in the each be limited to 2½ hours. area were experienced by direct suppliers to the UK’s 10 largest supermarkets. As a result, the Competition Motion agreed. 901 Natural Environment[LORDS] Natural Environment 902

Natural Environment legal targets for biodiversity, clean air and clean water, Motion to Take Note and will establish a natural capital committee in law. The country must also move towards becoming a 11.37 am zero-waste Britain. It is essential to reuse all our scarce resources and create a circular economy. It is not Moved by Baroness Bakewell of Hardington Mandeville enough just to talk about this; we need to set binding targets, with a clear action plan to reduce waste and That this House takes note of the natural end landfill. Our island must not be allowed to sink environment and the case for reducing polluting under the weight of the rubbish we produce. A green emissions, improving green transport and protecting transport Bill will set clear targets for when we will see wildlife and green spaces. petrol and diesel-driven cars banned from using our roads and for rail electrification, as well as promoting Baroness Bakewell of Hardington Mandeville (LD): cycling, walking and public transport. Other colleagues My Lords, I am delighted to be able to lead the debate will talk about our green transport policies and no this morning. This is a very wide-ranging topic and doubt share some excellent examples of good practice. one which can cause strong views to be taken on An energy saving and renewable heat Bill will help to differing sides of the argument. However, the debate is reduce energy bills by bringing in tough new energy really about planning for the future. How do we maintain efficiency standards and boosting renewable heat and our green environment for future generations and how district heating programmes. I shall give examples of do we put in place the infrastructure to make the best this later in my speech. use of green technology as it becomes available? The zero-carbon Britain Bill will include a new Some believe that the effects of climate change are legally binding target for zero-carbon Britain by 2050, with us. Others believe that it is all part of the natural to be monitored and audited by the Committee on cyclical process of the earth and can point to events in Climate Change. It is also important that we look not history which mirror our current predicaments. There just at measures to prevent climate change but at how are those taking part in the debate whose credentials we protect our natural environment, for example by are excellent and far outweigh my own interest in this establishing an office for accelerated low-carbon innovation matter. I look forward to hearing from them and also to support the fast-tracking of less mature but key to the maiden speech of my noble friend Lord Callanan. green technologies, including tidal and wave power, On an almost weekly basis, we can see examples of such as the Wave Hub off the coast of Cornwall, global natural disasters on our television screens; whether sponsored by the previous regional development agency. excessive flood waters, extreme droughts or the melting In addition, we should look at a renewable heat route of the Arctic polar ice cap. Last winter saw unprecedented to modern district heating, ultra-low emission vehicles, rain falling on Britain, resulting in distressing floods energy storage and CCS—carbon capture and storage—as in Somerset, on the land around the Thames and in well as continuing to apply emissions performance many other areas. In 2010 the country suffered an standards to existing coal plants from 2025 to guarantee extreme cold spell around Christmas, with large areas that unabated coal generation ceases and to stimulate of the country under snow. Temperatures were recorded innovation in CCS. It will be important to extend full at RNAS Yeovilton of minus 17 degrees centigrade. borrowing powers to the Green Investment Bank to During this period, despite the central heating and the boost further investment in low-carbon technologies. Aga being left on, I suffered a burst pipe in the roof. The nature Bill will include measures to identify Gallons of water descended through our cottage, bringing those natural resources that we are harvesting at an lath and plaster ceilings down and flooding the downstairs unsustainable level, for example peat and wood. The to a depth of three inches, so I have every sympathy peat industry has long been established in Somerset. with those who were flooded last winter. My saving Measures are already present to protect the environment, grace was that the water in my home was clean and not but these need strengthening to safeguard it for future foul, smelly and muddy water brought by rainwater generations. In order to protect the environment it will flooding. We were in temporary accommodation for be necessary to increase the penalties for the enforcement six months. Many of those flooded last winter are still and punishment of environment crime, such as deliberate out of their homes. I therefore have first-hand experience water pollution, and wildlife crime. The proceeds from of the extreme effects of changes of weather. these increased penalties should be used to fund the The Climate Change Act 2008 has shown the benefits National Wildlife Crime Unit and the sector of the of a clear legislative framework to meet the country’s Environment Agency which tackles pollution-related carbon emission reduction target. I am delighted that crime. my right honourable friend Ed Davey, the Secretary of State, has led the way on these issues. The green Everyone enjoys the country’s forests and it is important agenda has long been dear to the heart of Liberal to provide continued support for British forests by Democrats, and we have plans in the next Parliament placing them in a trust to safeguard them against to take this further by setting legislative frameworks future potential sales. This is included in the coalition’s on five green laws. forthcoming draft forestry Bill. It is essential for the country to have a zero-carbon Green accessible spaces are much valued by local Britain Bill. This will toughen up climate change targets communities and introducing a new designation of in the light of experience and be coupled with a global national nature parks is one way of protecting this climate change treaty to ensure that the mechanisms valuable asset for future generations. The right to are in place to meet targets. A nature Bill will introduce roam is similarly valued by residents; thus including 903 Natural Environment[15 JANUARY 2015] Natural Environment 904 the national forests and other publicly owned land, products. In addition, new heat-saving regulations will while examining the viability of opening up inaccessible apply. For example, when people change their heating habitats that are in private ownership, is also key to system, other low-cost heat-saving investment would the nature Bill. It is important to examine how we put become mandatory. in place the infrastructure we need to build a low-carbon, Ensuring that everyone, including those on very green future. low incomes, is helped to reduce their energy costs is I turn to the zero-waste Britain Bill. In south Somerset essential. There will be new, long-term legal targets for we are proud of our recycling collections. Waste lorries assisting domestic homes, starting with social housing come every week to collect separated, recyclable plastic, and then moving to privately rented and then owner- cardboard, glass, tin and foil. Putrescent waste is also occupier homes. In the south Somerset area, the housing collected weekly to go to on-farm composting. The providers already take steps to ensure that their homes residual waste is collected fortnightly. The vast majority are energy efficient, both as new build and as retrofit. of residents are happy with the arrangement and They know that if their tenants are able to reduce know they are contributing to reducing landfill. energy bills they are more likely to be able to afford Nevertheless, this is a drop in the ocean and it will be rent, buy food and live fulfilled lives. It is important necessary to do more countrywide. We will commission that we have flexibility in all things. On zero-carbon a Stern report on reducing the UK’s consumption of housing, if a developer is not able to make a home fit natural resources in order to facilitate the circular the zero-carbon standard, does the Minister agree that economy, facilitating waste minimisation and ensuring allowable solutions should include an obligation to that only non-recyclable waste is incinerated. We will retrofit another house? also argue for faster development of EU sustainable The coalition Government have already set out that design and production standards. Coupled with this, fuel-poor homes would have to meet the band C the banning of biodegradable waste from landfill by minimum standard by 2030 regardless of tenure, with 2020 will be key. relevant government and industry subsidy and support. As the House already knows, we will bring in the We are currently consulting on setting a standard for 5p plastic bag charge announced in this Parliament. privately rented homes for 2018 and beyond. Liberal Consumers will pay for each new single-use plastic Democrats would propose that this standard should carrier bag they use at the point of sale. After be band C by 2030. We would also consult on setting a administrative costs have been met, the supermarkets standard of band C for social homes by 2025. The will donate the remaining money to charity. We will clear aspiration would be for owner-occupier homes scrap all the exemptions, such as for SMEs and paper, to be band C by 2035. In all cases the standard would, associated with this ban. as far as reasonably practicable, be subject to testing—your Lordships would expect nothing less—as it is recognised I turn finally to an energy saving and renewable that some homes cannot be brought up to band C at a heat Bill which invests in the future. Measures included reasonable cost. in this Bill will be low-carbon infrastructure investment in, for example, heat networks, energy storage systems, I am pleased to be able to report that, earlier this hydrogen distribution and carbon disposal systems. week, Wiltshire Council passed a motion proposed by These will be classified as utilities for infrastructure Liberal Democrat councillors to reduce energy development purposes. A new legal framework will be consumption by creating a Wiltshire energy efficiency set up to require all relevant regulators to facilitate the board, with the remit to work with partners across the development of deep geothermal heat, large-scale heat county to develop a joint strategy to achieve increased pumps and waste industrial heat and energy storage energy savings, and the consequential economic savings systems. Ofgem’s remit and powers will be revised to to match, and then to exceed the south-west average. enable it to regulate all heat forms and heat networks The motion was supported locally by my colleague so that it can provide, for example, protections for heat Duncan Hames MP from the other place. network and heating oil customers. There will be new I am also pleased to be able to tell the House about efficiency incentives to help people cut their energy an energy society which has been set up in south bills permanently. For example, the vast majority will Somerset—the south Somerset energy society. It is in be able to cut their council tax bill when they invest in embryonic form but is applying for a rural community energy-saving home improvements. energy grant to start its feasibility study. This society, working on a similar model to that used by the Plymouth I am sure that many of your Lordships live in areas energy society, hopes to raise share capital for its where there are listed properties, some with thatched investments in businesses, schools and community facilities roofs and mullioned windows. It is extremely difficult to enable it to access cheaper energy. I am sure that for home owners or landlords of such properties to there are many similar examples throughout the country improve their energy efficiency without putting in of local initiatives striving to cut energy costs. I look double-glazing and others measures not permitted by forward to the contributions of other noble Lords, conservation officers. Does the Minister have any solutions and I beg to move. to offer for these properties? New energy efficiency regulations will come into 11.53 am place, for example when people make certain home improvements requiring planning permission. They The Earl of Selborne (Con): My Lords, the whole must also include energy-saving improvements and House will be grateful to my noble friend Lady Bakewell new higher energy-efficiency standards within building of Hardington Mandeville for giving us an opportunity regulations for lighting, motors and cooling and ventilation to hold what I predict will be a wide-ranging debate on 905 Natural Environment[LORDS] Natural Environment 906

[THE EARL OF SELBORNE] In reference to the Clear Air Act, while cleaner air the natural environment. I would like to look at the can be described as a success story, it remains at the implications of environmental change in the widest regional level a serious issue, especially in urban areas. sense, not just climate change, remembering of course Ambient air quality has improved but diffuse sources that the United Kingdom’s natural environment is the of atmospheric pollution remain a challenge. As our product of centuries of management. Whether it is Motion today identifies, transport is a major source of agricultural land, woodland, forest, heaths, moors, pollutants, as are power generation and industrial coasts, green spaces or urban areas, all are products of emissions. Air quality needs to go up the environmental our management. The only area of wilderness in the agenda. The Government could lead the way in raising United Kingdom is perhaps the flow country of Caithness the priority attached to air quality in all government and Sutherland, an area of blanket bog. If we look at departments. In another place the Environmental Audit the steady loss of biodiversity in most habitats, it is Committee calculated that poor air quality will reduce evident that we have much to do to stabilise wildlife average life expectancy in this country by an average populations. of seven to eight months, and that up to 50,000 people a year may die prematurely because of poor air quality. Increasingly, we are recognising the importance of protecting ecosystem services on which we ultimately On our record on national biodiversity loss, there is depend, whether for food production, flood prevention, good news. Some species have done really rather well. pollination of crops, air purification, raw materials There is the reintroduction of the red kite, a bird with recycling and much else. The United Kingdom National which we are now all familiar; at one time, it was Ecosystem Assessment was carried out between mid-2009 isolated in Wales. There are also buzzards, deer, badgers, and early 2011. It was the first analysis of the United otters and some non-specialist butterflies, for example. Kingdom’s natural environment in terms of the benefits They have all expanded their range. These tend to be that it provides to society and its continuing prosperity. generalist species. The specialist species have done far This assessment should set the agenda for future less well. Since 1995, 70% of butterfly species, 50% of consideration as to how we monitor, conserve and bird species and 28% of plant species have declined in enhance ecosystem services. abundance. Those are sobering figures and need to be considered against a background of some over-optimistic A particularly interesting issue, although it is difficult targets to which we have signed up, at national and to grapple with, is the extent to which we rely on or international levels. As a result of the Earth Summit in could benefit from the correlation between human Rio de Janeiro, we became a signatory to the Convention health and the environment. It is a statement of the on Biological Diversity. There were also Millennium obvious to say that we benefit from a contact with Development Goal 7.B and the EU targets for 2010. nature, but it is not easy to measure the relationship All have been a history of failure to meet targets. They between green space and the health of population had good intentions, but without thinking through levels. Here, if anywhere, is an area where much more how we might reduce our impacts we will never meet research is needed on the positive aspects. There is these targets. At present we are signed up to the Aichi much research on the negative consequences: t is easy targets, which were set in Japan, for 2020, but it would to demonstrate that degraded and contaminated be a brave person who predicted that we were going to environments impact adversely on our health, particularly meet them. our mental health. The key to this will be when we ultimately work out how we determine the ownership and distribution of Another aspect that states the obvious and of which property rights for natural capital assets, which is a we are all well aware is that since the Second World War highly contentious issue but one on which the Natural there has been a dramatic change in United Kingdom Capital Committee, which provides advice to government land use. It is because our national priorities changed on the state of England’s natural capital, is giving with the intensification of agriculture, urbanisation advice. If we could get into our national consciousness and transport development. Some 90% of semi-natural and the balance sheets of each and every company in vegetation has been converted to arable use. Youcannot the country an assessment of what impact for better or change the use of land without dramatic and major worse they are making on our natural capital, it would impacts on ecosystems, and therefore the delivery of be something of a game-changer. There would be ecosystem services. Unless you are very careful you lasting benefits to the United Kingdom if we could will cause the disruption of flood regimes, river basins demonstrate the value to society of our natural capital and coastal wetlands. These are the issues with which and reward those who protect and enhance the desired we must deal. They are related not just to climate ecosystem services. This does not have to be done with change but also to land use and the impacts of an new subsidies or grants from government; it can be expanding economy, which of course we welcome. done by adjusting the tax system to reward those who It is easy to cast gloom and doom over the natural are looking after future generations. environment, but we should also remember some positive I return to transport, which is mentioned in the aspects during the period since the war, about which I Motion. My second game-changer would be to look at have been talking. There are the Clean Air Act 1956, the development of hydrogen. We are already there: the Wildlife and Countryside Act 1981, and EU directives we have cars, buses and boats fuelled by hydrogen. The such as the 1979 birds directive and 1992 habitats problem is, of course, the high cost of fuel cells and directive. These have all played an important role in the absence of a refuelling infrastructure. The Government helping us to take our responsibilities more seriously recently announced an £11 million investment in United and with a degree of continuity. Kingdom hydrogen vehicle infrastructure and £2 million 907 Natural Environment[15 JANUARY 2015] Natural Environment 908 of funding for public sector hydrogen vehicles. I think every month, or India where the explicit objective of it is quite realistic to think that in 10 years’ time the new Government’s policy is to exploit to the full hydrogen will be competitive in price with petrol and India’s domestic coal resources—most of which are diesel. It will certainly reduce pollutants in the air and, lignite, the worst form of coal. It is also true within provided the electricity which produces the hydrogen Europe, where Polish and German lignite is now being is from renewable sources, it will make a contribution used to a greater degree: even green Germany is opening to a reduction in greenhouse gases. There is a challenge: new coal-fired power stations. if in the run-up to the general election any political In aggregate, the global subsidies for coal far outweigh party can commit itself to travel only by hydrogen-fuelled those for renewables or nuclear energy. The markets vehicles, it will be doing us a service. and, in some cases, government policy, are moving in the wrong direction. Over the years, the UK Government 12.01 pm have, commendably, taken the lead in both establishing Lord Whitty (Lab): My Lords, I, too, thank the targets and introducing policies designed to offset this. noble Baroness for initiating this very wide-ranging However, most of those policies have not delivered to debate. I thank her also for giving us a quick preview the extent that they should. The noble Baroness mentioned of what would be the Queen’s Speech of a Liberal issues of energy efficiency in residential and other Democrat Government—some of which sounds vaguely property, but so far the measures are faltering. The attractive, and I might support it. ECO is not working as it should, nor is the Green The title of this debate ranges from the very local to Deal, and take-up of the RHI is very limited. A report the international, and we do not know where to begin. which I was partly responsible for found that there are The noble Baroness began, as I rather suspected she very few pressures in the commercial and industrial might, with the situation in Somerset and the Somerset sectors for increasing the environmental efficiency—and levels and the disastrous, distressful floods. There was therefore the energy use—of commercial buildings, old a terrible impact on both the people there and the and new. environment. However, as the noble Earl, Lord Selborne, As the noble Baroness said, we need intensified said, the key thing about the Somerset levels is that they policies in all of these areas. We also need them on are not, in a strict sense, a natural environment. They land management: how we use land and water. We have been created by manmade measures over the need to plant more, appropriate trees on many of our centuries: intricate water management, successive different hillsides; we need more effective water management by forms of farming putting pressure on the system, catchment; we need to reform the abstraction regime deforestation, local pollarding of trees and so forth, for water in our uplands. We cannot defer this, as we and ever-changing farming practices. They all put have done for many years. Some of these interventions, pressure on the system. All those efforts gave an and some on the energy side, will be seen by some as economic base to the area and the landscape that we detrimental to the natural environment, but that will love, but the levels are not a natural environment. only be in the short term. In the long term, they will They need to be protected, but we need a different protect our natural environment. system of human management for such areas. The storms of last year which caused the floods in I am not saying that we should give up trying to Somerset and elsewhere were a unique event and were mitigate the rise in carbon and greenhouse gas emissions. unprecedented in their form. While one cannot ascribe That objective is still there, but we need to recognise any individual extreme weather event to climate change, that a significant rise in global temperatures—probably climate change means that we are going to get more of over two degrees—is now almost inevitable. We therefore them. The likelihood is therefore that the UK and the need to look at adaptation in the way that we have world will face greater storms, floods, droughts and looked at attempts to mitigate. On the mitigation side, other disasters, and we need human management to the Climate Change Committee has indicated that the deal with that. In order to protect our environment, next Budget will require us to cut, between now and we need a change in intervention. As in 19th century 2025, by another 28%. We succeeded in meeting the Sicily, unless there is change, things cannot remain the first budget targets only because of the recession. The same. We therefore need to recognise that the challenge underlying change is nowhere near close to achieving of global climate change will mean a lot of new, local those ends. That means that even in the UK—which is interventions. I do not want to be too despondent, but leading in this area—we are not likely to make our the world has largely failed on climate change. The contribution to reducing carbon. conference in Paris this year may be the last-chance We therefore need to focus as well on mitigation. That saloon to stop average global temperatures going over will need capital expenditure by both public and private the 2% level. sectors. We know that the way in which projects are There are some fairly worrying indications. The fall assessed in the private sector tends to focus on the in the oil price means that people and markets are short term. We know that the immediate fiscal problem switching back to fossil fuels. The development of with regard to public expenditure is limiting the amount shale gas and shale oil has displaced coal in America. of public investment in things such as flood defence, On balance, this is a positive thing, but it has reduced resilience of infrastructure and the whole area of the price of coal, which is being exported to markets at protection of our countryside. Unless we put the money a low cost, as is US oil. The net result is that the price in and give some priority to that form of investment, of fossil fuels, relative to nuclear and renewables, is we will neither protect what we call our natural changing. The problem is not just in places like China, environment nor avoid the major problems that are where coal-fired power stations are coming on stream facing us through the process of climate change. 909 Natural Environment[LORDS] Natural Environment 910

12.10 pm However, I would agree that putting the work of the Natural Capital Committee on a statutory basis is one Baroness Miller of Chilthorne Domer (LD): My of the most important steps that we can take now, Lords, my noble friend, whom I congratulate on securing because its work values the synergies that we find this debate, outlined the proposed nature Bill in her between, for example, farming benefiting wildlife, clean admirably comprehensive introduction. I shall concentrate water and more absorbent soil, as well as more interesting my remarks on green space, which, as the noble Lord, landscapes. We have found that there are lots of indicators Lord Whitty, pointed out, is not necessarily a natural of the health of an ecosystem: pollinators, for example, environment as we might have found 2,000 years ago—that which is an issue that we have debated in your Lordships’ exists probably nowhere in the UK. There are wilderness Chamber before, frogs and farmland birds. The areas or wilder areas, as in the national parks, but Government are committed to reversing the long-term much green space is what we share with other species. decline in the UK farmland bird indicator, which is With the decline in biodiversity that has tracked the made up of 19 species. Noble Lords will be aware of whole of my lifetime, through the 20th century, there the different reasons for that decline, particularly different has been an increasing pressure on all the places where farming methods. other species lived, to the point when they often ended up with nowhere to live and breed. I would particularly like to mention one initiative from LEAF—Linking Environment and Farming—that Successive Governments this century have made is important in helping to reverse this decline. It is some very good efforts, and I commend the Labour starting its big farmland bird count within the next Government, when the noble Lord, Lord Whitty, was month and will involve farmers. It is looking at what a Minister, for the Countryside and Rights of Way can be achieved by the adoption of simple management Act, because there is nothing like getting the public techniques to improve habitats and bird numbers and involved in being a major part of the protection of includes information on bird identification, because it green spaces. One of the major steps for this Government is not a given that every land manager can identify all was the report from John Lawton, Making Space for the species. There is much work to be done. The mistle Nature, which talked about protecting what we have, thrush and the yellowhammer have declined enormously the SSSIs and the EU habitats, which of course we are since the 1970s here in England, but oddly in Scotland, obliged to protect. In mentioning the EU habitats, I that decline has now reversed and the populations are say to noble Lords who are Eurosceptics that without becoming much healthier. Perhaps there is something the EU’s input into areas such as water pollution and that we can learn from Scotland. protection of species we would be in a much worse To conclude, I would like to talk about bats, which place than we are in now. The EU can claim enormous are the subject of a Private Member’s Bill in the other credit for turning around what was a pretty grim place on Friday of this week. The Bat Habitats Regulation picture in the 1960s and 1970s. Bill is sadly geared toward preventing bats from living We should expand and join up these spaces for in churches. There have been many claims that bats are nature with wildlife corridors. That was Sir John Lawton’s contributing to a health hazard—which Public Health contention. The babies that came out of that report England denies—but why do bats need special protection were the nature improvement areas, of which there are in the first place? It is easy to kill a whole roost of bats, currently 12—and that is a start. In their assessment of and people have often had a prejudice against them. 2013, the Government found that each pound invested They, perhaps more than any other species, have suffered by the Government results in nearly £6.80 of additional from declining habitats, with barn conversions and so support from communities, businesses and individuals. on. The Bill, which perhaps will come before your It is actually very good value. However, there is still a Lordships’ House, refers to enhancing the protection tremendous amount more that can be done. One area available for bat habitats in the non-built environment. that has been overlooked until now is local wildlife That is all very well, but then it refers to limiting the sites, which are important havens, identified and selected protection available for bat habitats in the built locally for their high-nature conservation value and environment, with great public support from the people on whose “located inside a building used for public worship”. doorsteps they are. The Wildlife Trusts, which I must That is a very dangerous precedent. Anyone who does commend for their work, because their mission is to not like bats can claim that people are gathering to connect the public with wildlife and to protect that worship. I hope the right reverend Prelate will take this wildlife, produced a report entitled, Secret Spaces: the up, as I think it is a very sad comment on the churches’ Status of Local Wildlife Sites 2014. It found enormous attitude towards wildlife. There is a simple solution: if pressures on those sites. It may surprise your Lordships bat faeces are falling in an embarrassing place, you to know that, although they are recognised within the simply need to nail a board under that, as many planning system, local wildlife sites are not protected people have learnt to do in their own homes. by law. That was one of the recommendations—that greater protection should be given to them—that Professor Sir John Lawton came out with. It would be one thing 12.18 pm at the top of my list of things to be done. Lord Callanan (Con) (Maiden Speech): My Lords, I Of course, we have had lots of strategies beyond the join in the congratulations to the noble Baroness, ones that I have mentioned. We had a biodiversity Lady Bakewell, on securing this debate today on such strategy from Defra in 2011 and the important natural an important subject, giving me the opportunity to environment White Paper, as well as the work on eco- make my maiden contribution to the debates in this systems services, all of which are important contributions. House. I begin by thanking noble Lords on all sides 911 Natural Environment[15 JANUARY 2015] Natural Environment 912 for being so helpful and welcoming, and for so politely Both Houses of Parliament are woefully short of people pointing out my many mistakes so far, the most serious with technical knowledge in the various engineering of which was rising to leave the Chamber when the Lord fields. Secondly, he comes from the north-east. One Speaker was on her feet. I shall not be doing that again. has only to sit and listen to recent introductions to Let me particularly thank my two sponsors, my notice how many come from Greater London. This House noble friends Lord Bates and Lord Inglewood. I first is very short of people who have a regional perspective met my noble friend Lord Bates 30 years ago; we both on things. To this particular House he brings a third attended the same Gateshead comprehensive school quality: he must feel a lot younger than he did before and joined Gateshead Young Conservatives at about he came here, being surrounded by so many more the same time. I do not know what prompted him to mature people. do so: Gateshead was hardly then, or even now, a I will concentrate my remarks on two or three things. hotbed of Conservatism; but in my case, the late Lady First is the question of emissions. Emissions in town Thatcher was entirely responsible for my decision to and city centres concern me greatly. A lot of work is join the party. I am profoundly sorry that I never had being done on the Euro 5 and Euro 6 engines, to which the privilege of serving in this House alongside her. the noble Lord, Lord Callanan, referred. However, a After that, the political careers of my noble friend great deal of the pollution in our towns and cities Lord Bates and I went in different directions. I served comes from the refrigeration and cooling units on on Tyne and Wear County Council, Gateshead Council lorries that deliver food and other perishables to shops and then in the European Parliament; he, of course, and airports. These refrigeration engines, which are served in the other place. I am also grateful to him for diesel-powered, do not have the means to send their one other thing—for leaving the title of our home exhaust through the exhaust cleaning system of the ward, Low Fell, for me to take. engine. Youmight clean up the engine that is propelling I was proud to represent the north-east of England the lorry, but you have an extremely polluting cooling in the European Parliament for 15 years, where for system attached. part of that time I also served alongside my noble I am aware from a letter I received from the Minister friend Lord Inglewood, who represented the north-west. this morning that there is work going on in Europe on We often travelled to Brussels and Strasbourg together non-road mobile machinery mechanisms, but there is and spent many a happy hour debating the latest a solution to the problem I have outlined. It is to use political scandals in the departure lounge of Newcastle compressed air or compressed nitrogen engines to run Airport. the cooling units that are so prevalent in the traffic of In the European Parliament our speeches are often today. The plethora of delivery vehicles running round time-limited to two minutes, or sometimes even one, from various shops, delivering goods to your home, is so I am delighted to be in a Parliament where one all very well but the vehicles bring a lot of pollution sometimes gets the opportunity to speak for what with them and this is scarcely recognised. Can the seems like an eternity of eight minutes. I sincerely Minister say whether this non-road mobile machinery hope that noble Lords will not wish, at the end of my includes supplementary engines mounted on the road contribution, that I had spoken for only one minute. vehicles? I am not sure that it does. The happier news Another great advantage of this House is that all the is that there is a technical solution. It is a British debates are—ostensibly, at least—in the same language. solution that has been developed and is going through, Turning to the subject of today’s debate, for most of I think, the advanced stage of trails. If it is adopted—I my time in the European Parliament I served as am not an engineer and cannot comment on the Conservative environment spokesman and worked on technology—it will make a huge contribution to cleaning many of the emissions and climate change directives, up the air in cities. I know there is debate about the including the Euro 5 and Euro 6 engine standards and effects of climate change but there is no debate about the emissions trading system in all its many complicated the health hazards of vehicle emissions. incarnations. I know that a maiden speech is not the The second thing I would like to ask the Minister time to burden your Lordships with some of the concerns low emission zones. There are low emission complicated detail of such directives, so I will merely zones in a few places and I have noticed that the Mayor say that I always took the view that our environmental of London intends to make the City—or the whole of ambition should not be achieved at the expense of London, actually—a low emission zone by 2020. It is damaging the competitiveness of some of our excellent important to give people fair warning of these things. British and European manufacturing industries. Up to a few years ago, they had been encouraged to I am fortunate to come from the north-east, a part buy diesel cars. Suddenly to reverse that and say that of England with many economic difficulties, but also these cars will now be prohibited is very hard, but if blessed with some of the most beautiful countryside you give notice people can adjust. They sell and buy and magnificent natural environments in our nation. I cars and adjustments can be made, as they have had to sincerely hope to use my time in this House to contribute be made to buses. I have been involved in the bus in some small way to help to resolve the former and to industry, as I think is fairly well known. sustain the latter. I put this point and to some extent I turn to the remarks of the noble Lord, Lord Callanan, about the 12.22 pm competitiveness of British industry. There is a lack of Lord Bradshaw (LD): My Lords, we were very glad inventiveness and a lack of capacity to ensure that to hear from the noble Lord, Lord Callanan. He good ideas are developed here and exported around brings two things with him. First, he is an engineer. the world because they are seen to be necessary and 913 Natural Environment[LORDS] Natural Environment 914

[LORD BRADSHAW] which is a member of TDAG. The group contains the good value. The point about stimulating research, widest possible spectrum of organisations concerned innovation and development here is one that I have with these issues, from local authorities to landscape heard echoed round this Chamber on many occasions, architects, from civil engineers to nurserymen, and from but it is absolutely important for industries in the area banks to the Forestry Commission—too many to mention from which the noble Lord, Lord Callanan, comes. but all with the same aim: to get more healthy trees in I will not keep noble Lords any longer but I will be our cities and thus improve the health of those who pleased to give the Minister the information I have on live there. air engines, and I would be glad to send it to anybody TDAG has produced two excellent publications: else who is interested. Trees in the Townscape and, last October, Trees in Hard Landscapes: A Guide for Delivery, which I am sure the 12.28 pm Minister will be aware of, since his colleague, the noble Lord Framlingham (Con): My Lords, I add my Baroness, Lady Kramer, wrote the foreword for it. I congratulations to the noble Lord, Lord Callanan, on urge him, if he is not already doing so, to lend his weight his excellent maiden speech and I am sure we look to the distribution of these guides, or more particularly forward to further contributions from him. their contents, so as to co-ordinate and encourage the most enlightened and best practice everywhere. I am extremely grateful to the noble Baroness, Lady Bakewell, for obtaining this debate today which allows We must use all the experience available to us, me to talk about one of my favourite topics: trees, together with our imaginations, to break new ground particularly ones in urban areas in what are currently and to break out of our sometimes routine thought called hard landscapes. Trees are like the humble bee. processes. Many years ago on a lecture tour in the They do a massive job in the environment and are taken United States, I found myself in Philadelphia. In those for granted by most people, yet without them our very days, Ginkgo biloba, the maidenhair tree, was relatively survival would be threatened. I remind you what an rare in the United Kingdom. To my astonishment, in incredible job trees do. They look attractive. They take Philadelphia it was used as a street tree. It was everywhere. in our waste carbon dioxide and give us in return precious If it was an ideal street tree there, why not here? That oxygen. They provide shelter and are barriers to both is a lesson I have never forgotten. I believe it is now pollution and noise. They help to cool the urban called “thinking outside the box”. environment and manage storm-water run-off. They It is not just housing, office or town-centre develop- have been shown to have a positive effect on the nation’s ments that present challenges and opportunities. What health. In short, they are quite simply indispensible. about business parks, industrial sites, motorway and Yet the question that I want to pose is: are we railway embankments, and roundabouts? Opportunities making the most of this incredible asset? We use trees abound not always with big trees but sometimes with to adorn and enhance our finest buildings and to hide small trees, shrubs and low-maintenance ground cover, and camouflage our ugliest. When applying for planning but always with a mixture of experience and imagination permission, architects embellish their drawings with to produce the best possible use of the ground available pictures of mature trees, yet so often, when the for the maximum effect. development takes place, for reasons of finance or I should like to deal briefly with two other important inadequate aftercare the trees as envisaged never appear. topics: tree importation and woodland protection. It must be obvious from what I have said already Following the importation of ash dieback from Europe, that what is needed is a nationally co-ordinated approach there was a call, including one from me, for a reduction to the design and management of hard landscapes. in the number of imported trees and for much more This would ensure the maximum and most imaginative reliance on home-grown stock to reduce the ever present use of trees and guarantee both their planting and and very real danger to our tree population. Sadly, figures their aftercare—to decide not just what type of tree to that I obtained through a Written Question show that plant but to take into consideration its ultimate size, in the last planting season we imported more trees crown spread, root spread, disease resistance, the soil than ever. I acknowledge that this is not a simple matter. type in which it will flourish and its proximity to It involves long-term planning, with appropriate underground utilities, as well as things such as its leaf commitments and contracts. But trees are a long-term drop, fruit production and aftercare needs, and 1,001 business, and getting it wrong again would be disastrous. other issues. Perhaps a quarantine system is the answer, at least Clearly the Government have a role to play in this, in the short term. A company called Barcham Trees, although I am not quite sure which department it based in East Anglia, has introduced its own quarantine currently comes under. However, help is also at hand system. It says that it will not import trees and sell to in the form of an organisation called TDAG, the Trees customers for immediate planting, and that, and Design Action Group. This organisation, now a “All imported trees will be held on the nursery for one full charity, was formed in 2007 with the ambition to growing season during which time they will be subjected to create a very broad network of expertise across the rigorous inspection for pest and disease. This includes systematic built and natural environment, sharing a common and regular DEFRA visits”. understanding that trees have a major role to play in I do not know whether other companies are doing the health of our cities. this, but if it is not already happening, perhaps the Perhaps I should declare an interest—one that is Minister could look into the merits of that system. not in any way financial. Many years ago, I was for Audit trails for trees are also important, so that trees some time the president of the Arboricultural Association, sold by any particular nursery can be easily traced. 915 Natural Environment[15 JANUARY 2015] Natural Environment 916

Caring for existing trees is vital, not just in urban local population. Because we have been able to maintain areas but in woodlands too, particularly ancient an agency service where the district council carries out woodlands. Houses can be demolished and rebuilt in a the rights of way service on behalf of the county council, matter of months, but an invaluable ancient woodland, with subsidy from the county council but topped up if lost, is lost for ever. The Woodland Trust tells me by the district council, we have the highest standard of that it is currently fighting 400 cases where woodlands service in the county and our paths are in the best are under threat. I know the Minister has a great condition of any in the county. But the county council, interest in woodland, and I urge him to do all he can like all other local authorities, has been under pressure to preserve it wherever possible. and put forward a proposal to stop the agency and We must care for all our trees, old and new. I would significantly reduce the service. We had some fairly say to the Minister, who I am sure loves his trees, vigorous and interesting discussions and I am pleased “Don’t listen to those who say you never see the results to say that we came to a compromise. We have been of tree planting in your lifetime”. Trees make their able to fight off the idea that because our footpaths presence felt in a few short years, and what better are in the best condition of any in the county we do legacy could a Minister leave than to have significantly not need to do much to them for the next few years—until, increased the nation’s tree cover, particularly in our presumably, they get back to the mediocre standard of towns and cities? other areas. This is the kind of debate that is happening on so 12.36 pm many services in local government at the moment, and the rights of way service is not in any way immune. I Lord Greaves (LD): My Lords, I, too, thank my want to ask the Minister a question, which I am sure noble friend Lady Bakewell of Hardington Mandeville he will not be able to answer today, but perhaps he can for introducing this debate and setting out so eloquently dig out what information the Government have and the nature of a nature Bill, which the Liberal Democrats write to me and other Members. What impact have the would like to introduce in the next Parliament. I look cuts already had on rights of way and countryside forward to working closely with the noble Lord, Lord access services throughout England? Do the Government Whitty, when that Bill comes forward. I should remind know what the situation is so far, to provide a baseline the House of my registered interests as a councillor from which to go forward? and as an active member of various access organisations. The second area I want to talk about is referred to I shall talk first about the “natural environment” part in my noble friend’s Motion as “protecting green of the Motion, and particularly about access to the spaces”. I particularly want to talk about urban green natural environment. In the nearly 15 years for which I spaces. The promotion of new urban green spaces is have been a Member of your Lordships’ House, the something for which the Liberal Democrats, in particular, number of occasions on which we as a House have have been pressing for a number of years. The proposal contributed to the extension of people’s ability to for a new designation under the planning system first access the natural environment has been a great pleasure appeared in the Liberal Democrat manifesto at the last to me. The very first Bill that I was really involved with general election. That led to a number of references to was the Countryside and Rights of Way Bill in 2000, urban green spaces in the coalition agreement, a copy for which the noble Lord, Lord Whitty, was responsible of which I have with me. It is an historic document that in this House. That set a pattern that we have followed no one seems to pay much attention to any more, which since. is an interesting lesson for the future. Coalition agreements However, there is now a real threat to vital countryside at the beginning of a five-year Parliament are regarded and rights of way services—the access services provided as being extremely important for a while, fairly important by local authorities—as a result of the cuts, many of for two or three years, and then forgotten. them drastic, that local authorities are having to cope I have a copy of the agreement, which is still on with. Many of them see the rights of way staff and various websites, including the government website. services as not being part of their core service. This Under the heading, “Environment, food and rural really began to bite last year, when some authorities affairs”, the coalition agreement states: were even proposing to close down the service altogether. “We will introduce measures to protect wildlife and promote I do not think that they can do that, because it is a green spaces and wildlife corridors in order to halt the loss of statutory service, but many authorities are subjecting habitats and restore biodiversity”. their services to cuts. We do not know yet what will be Under the section on “Communities and local the effect of the current round of local authority government”, it says: budget making for 2015-16, but it seems that further cutbacks in many areas are inevitable. “We will maintain the Green Belt, Sites of Special Scientific Interest … and other environmental protections, and create a new Some of the more flexible, and perhaps enlightened, designation—similar to SSSIs—to protect green areas of particular authorities have been able to make a link with the new importance to local communities”. health and well-being boards and their public health The results of this appear in paragraph 76 of the functions, and use a certain amount of public health National Planning Policy Framework, which is a document money for the promotion and support of active outdoor that people pay rather more attention to nowadays recreation. Clearly, that is to be welcomed. But the than they do to the coalition agreement. It states: pressures are everywhere. In my own local authority of “Local communities through local and neighbourhood plans Pendle in Lancashire, we have one of the densest should be able to identify for special protection green areas of networks of public footpaths in the country, which are particular importance to them. By designating land as Local Green vital to tourism, local recreation and the health of the Space local communities will be able to rule out new development 917 Natural Environment[LORDS] Natural Environment 918

[LORD GREAVES] work is done on this problem across government. The other than in very special circumstances. Identifying land as Local Department of Energy and Climate Change is, of Green Space should therefore be consistent with the local planning course, interested in climate change but not sufficiently of sustainable development and complement investment in sufficient in emissions. The Department for Environment, Food homes, jobs and other essential services. Local Green Spaces should only be designated when a plan is prepared or reviewed, and Rural Affairs, the Department of Health, the and be capable of enduring beyond the end of the plan period”. Department for Transport, the Department for Business, It was clearly intended that these new local green spaces Innovation and Skills and the Department for Education should be an important part of the planning system. are all responsible in part for emissions. I have another question which the Minister will not Lung diseases are strongly correlated with poverty. be able to answer today, but perhaps the Government There are rich people who die of lung diseases, but they can tell us what information they have. To what extent die mainly of heart problems. It is poorer people who is this actually happening in all the local plans that smoke too much and live in areas where they suffer local authorities have been producing and taking to from bad air quality—and many from tuberculosis. inspection and adoption within the past two or three The climate change problem has been regarded as so years? I have a sense that this has been a bit of a damp important that we put every effort into reducing CO2 squib in many cases and that local authorities have not emissions. Many car manufacturers switched to diesel really grasped this new ability to, in effect, declare new in whole or in part, and we now have extra nitric oxide parkland in parts of their areas, particularly their and nitrogen dioxide in the air. Perhaps it is fair to say urban areas. This is something that our party will that Britain is doing quite well on global warming, want to continue to stress and to press for and perhaps better than the world generally, but are more people give greater prominence to in future. I have run out of going to die of lung poisoning as a result of some of time so I will say no more. those changes? So, the level of emissions in the UK is having a very harmful effect on both the environment and on human 12.46 pm health. While much is known about CO2 and its impact Lord Borwick (Con): My Lords, I declare my interests on the environment, there is far less awareness of the as they appear in the register, particularly that I am a harm to public health caused by particulate matter in trustee of the British Lung Foundation. I welcome the air. Exposure to these poisonous particulates can this debate, as all too often the push to reduce emissions lead to inflammation of the airways, and cardiovascular and improve our green spaces means that we spend a and respiratory illness. In April 2014, a Public Health lot of money on the wrong things. The result is more England report found that approximately 29,000 deaths regulations and higher taxes, which push up the cost per year in the UK could be attributed to man-made of living. The hardest hit are often the poor and the particulate matter pollution. Air pollution is also expected elderly, who spend more of their incomes on electricity to reduce the life expectancy of everyone in the UK by and gas. Indeed, taxes can make up 15% to 20% of the six months. cost of power to a household. If we are trying to reduce We know that the noxious villain of NOx is the car emissions and improve air quality, we have to think of exhaust, and what do we do with our car exhausts? We other ways of doing it than imposing new or higher taxes. cover them in shiny plating to make them look attractive However, none of those points detracts from the and stick them out the back of the car, where the fact that we need to reduce emissions, improve green pedestrian or cyclist can breathe the fumes. There is an spaces, protect wildlife and think about how we travel old-established saying in management that if you do in the future. It is very important that Parliament stays not look at a problem, you will not solve it, and we ahead of changes and developments in this issue. That place the exhaust in the one place that the driver can is why I have proposed to the Chairman of Committees never see directly, so he cannot tell if his engine is the creation of an ad hoc committee on air pollution. misbehaving. What would happen if we required that From the great stink of 1858 to the great smog of 1952, exhausts finished in the front of the car, so that the population growth and industrialisation have reduced driver could see them? I bet they would be cleaned up the quality of the air in the UK, especially in big cities. rather quickly. What, furthermore, if we required that The Clean Air Act 1956 was perhaps the earliest exhausts finished on the inside of the car? If I have to significant attempt to enshrine in law the protection of breathe in his poisonous exhaust fumes, why does the air quality. Now that science is delivering more local driver not have to breathe them in? knowledge on air pollution, we have to be aware and Roadside emissions are a particular problem in preparing for the pressures that that will bring. urban areas of the UK. The index level for PM2.5 in Within a short time, we will be able to get a smartphone London this morning is 67. Yesterday it peaked at 85. app to tell us the levels of air pollution within a local London’s Marylebone Road had the highest concentration area, measured from space. This means that your of PM2.5 in the whole of Europe in 2012, with a sat-nav directions might include the option of the concentration of almost 94 micrograms per cubic metre quickest route, the shortest route and, in the future, of air. Furthermore, the UK has failed to meet its the cleanest route. When citizens get the knowledge recent EU air quality target for NO2—and the annual that their home area has bad air pollution, they are average for NO2 was exceeded in 38 out of 43 air quality going to demand that the Government do something zones. The health benefits in improving air quality are about it. Individuals tend to think—probably rightly—that clear, so I ask my noble friend, when will the Government they cannot improve air quality through their own actions respond to the recommendations presented by the alone. The same can arguably be said for government Environmental Audit Committee report of the other departments. That is why it is vital that collaborative place published shortly before Christmas? 919 Natural Environment[15 JANUARY 2015] Natural Environment 920

New technologies will provide the key to improving the moment, local authorities are required to run. I air quality and developing greener transport. When I have it on good authority that, before the London was a manufacturer of London taxis, I sold thousands Olympics, the Mayor of London covered up the stations of diesel engines. But after that, I spent a fortune on that were reading a bit high. Otherwise, the Olympics trying to make electric vehicles work, and every penny would have been performed allegedly in an atmosphere I made from diesel engine taxis was spent twice over that was worse than that of Beijing four years previously. on electric trucks. I started an electric truck business Whether that is true, I do not know. and sold about 400 vehicles worldwide, and I was Of course, it is much easier to deal with the problem grateful to UPS, FedEx and Tesco for buying the first by removing the evidence. I think it is extraordinary ones. This was a great product which worked really that Defra wants to remove the requirement for local well, but to get consumers to change to electric vehicles authorities to keep maintaining such measuring points. is a huge leap, and we were just too early. It is going to be very easy for a future Government to When I was trying to sell zero-emission vehicles, I say, “Well, there is no evidence of air pollution”. The thought of a single product which I believe every noble Lord may be right that we will be able to measure British consumer would applaud. Particularly in these it on our mobile phones. However, at the moment, election days, I think British people want to find a having some official statistics is extremely important, zero-emission politician. because it is easy to say, “Well, there is no evidence, therefore we don’t need to tackle the problem”. Are 12.53 pm the Government really allowing 55,000, or whatever the number is, premature deaths to continue because they Lord Berkeley (Lab): My Lords, I welcome participating will not only not ban diesels in the worst polluting in this debate and listening to what I think is the start areas but now want to remove the source of evidence of the Liberal Democrat manifesto from the noble Lord, as to where they should act? Lord Greaves, and the noble Baroness. I also welcome another engineer to the House of Lords in the shape My second example is railways—no great surprise of the noble Lord, Lord Callanan. I welcome his there—an environmentally friendly type of transport speech. There are not many of us and he has added and probably the best one, apart from walking and quite a high percentage because of that. cycling, if people feel the need to move around. The The noble Baroness and my noble friend Lord issue of nimbyism is, I am afraid, as rife as ever. We Whitty made a powerful case for change, which I fully have seen it in all the debates on High Speed 2. People support. I want to outline some of the difficulties that even complain when the railway is in a tunnel, under- we will have in achieving it, especially when people ground, two or three miles from their house; they say have the time, energy and resources to fight for or it will still affect them. against it. Sometimes, of course, even those who are in I have heard a more recent example in Bath, which I favour of a particular green or environmental initiative think is more serious. Noble Lords will know that the actually spend more time fighting each other than Great Western railway is being electrified. When you achieving their objective. are putting wires above the trains, you need extra I will give two examples. First, I will say a little height, which means that you either lower the tracks more about air pollution, on which the noble Lord, or you raise the bridges. There is a very famous tunnel, Lord Borwick, gave us some very interesting data. The which Brunel built, called Box tunnel, where the tracks noble Earl, Lord Selborne, and the noble Lord, Lord have to be lowered to get the wires in. The problem is Bradshaw, also mentioned this. We started off with a that there are bats in the tunnel. I love bats and have Question on 6 January which I put down about many friends who love bats. They seem to have survived the premature deaths caused by nitrous oxide and the and prospered in this tunnel for 150 years or so, even PM2.5 from diesel engines. We can all disagree on the when 125 miles per hour trains are rushing through exact number of people who may have died prematurely every 15 or 30 minutes. nationwide. The figure I cited was 55,000 people The only time that Network Rail is allowed to lower nationwide, with an average loss of life expectancy of the tracks in this tunnel is in July and August, due more than 10 years. Other people have different figures, to the bat breeding season or something—it will do a but I do not think it really matters. We can go on lot of other work at the same time, which I could discussing the figures ad nauseam, but I think we all explain but will not now. That means that the railway agree that the figure is very high and it could be reduced. through Bath has to be closed for two months in the Again supporting the statement by the noble Lord, summer. Bath, as we all know, is a World Heritage Site Lord Borwick, Dr David Carslaw, who is a highly and summer is a good time of the year for tourists respected scientist, has said that the pollution in Oxford from around the world to come to Bath. However, Street is the highest in the world. That is a pretty because there are no trains, and Network Rail obviously challenging statement to make. I suspect he is right. finds it necessary to help move passengers around, it has to use buses. I am told that there will be 200 buses The NO2 annual concentrations and the hourly exceedances in Brixton Road may exceed those in Oxford going in and out of Bath for two months in July and Street in 2014. It is easy just to talk about London, but August. I think the problem is just as bad in many other cities. We have to have a specially designed catenary because The easy solution is to get rid of the polluting it is a World Heritage Site. We have to drop the track, diesels, as the noble Lord has said. But how are we which may end up on an old Roman ruin, which will going to know where the problem is? The solution, of probably close the line for another six months while course, is by the network of measuring stations that, at the archaeologists dig. The question is: what price 921 Natural Environment[LORDS] Natural Environment 922

[LORD BERKELEY] a valuable contribution to awareness of energy use progress? This is one of the reasons why the cost of and to future energy use within those communities, electrification has doubled around there. It is not Network and has motivated much more learning about how Rail’s fault, because it has been told to do it this way, people, within their communities, can make real changes. but one rather thinks that if the people of Bath and The council also started a green volunteer scheme, the people who are requiring all these changes do not which links organisations with would-be volunteers. want electrification, we should give them a steam train In conjunction with that, we set up an annual award instead. We can let the people of Bristol get to London scheme to recognise volunteering across the city, so on the other route through Bristol Parkway and have a that individuals and community groups that use volunteers chuff-chuff between Bristol, Bath and Chippenham. and companies which support volunteering from their They can pollute their town with smoke instead. Is it staff can be accredited, acknowledged and thanked. really justified for the bats, which clearly have to be Local sustainable food, and educating people about protected to the extent that they can have a tunnel dug local food, has moved quickly up the agenda in recent up only in August, although they survive all the rest of years, with the Green Capital year being a catalyst for the year round with all this noise going through? many local food projects being instigated in Bristol—I It is a question of what price we pay for progress, a hope that many of your Lordships have heard about debate that we will continue to have for a long time. the food programme that comes from Bristol and There is an added cost and there are a lot of people some of the very innovative projects that we have who feel very strongly about this, but we have to have a there. One example is the Severn Project, which works balance. I hope in the future we will get a better balance. with socially excluded individuals to reduce anti-social behaviour by using the production of food as a vehicle to provide education, training and employment. The 1.02 pm organisation has a temporary lease on a derelict area Baroness Janke (LD): My Lords, coming from Bristol, of land near the station that is earmarked for development. I would not dream of speaking for colleagues in Bath, Despite the site being severely contaminated, the project but we have always had a great aspiration for this has installed polytunnels and put down membranes to improvement and I certainly add my support to it. bring in compost to grow salad crops, which are then It is a great pleasure to speak in this debate as a sold on to local restaurants and businesses in the city. former leader of Bristol, which is the 2015 European Another unique feature is the Bristol pound, which Green Capital. The Green Capital bid was based on I think is the UK’s first citywide local currency, the all-party support. Bristol’s success in winning has led first to have electronic accounts managed by a regulated to greater developments on the green agenda—which financial institution and the first that can be used to is of course, as my noble friend Lady Bakewell said, a pay some local taxes. It was set up by a community key Liberal Democrat priority, whether nationally or group and supported initially by a small grant from locally. One of the success criteria in the Green Capital Bristol City Council. It has now grown thanks to EU award is the need to demonstrate ways that achievements funding and other sources, and nearly 1,000 traders in have been made to help other cities and communities the city accept the currency. For people who do not reach key European targets in carbon reduction, energy quite understand how this contributes, it is a way of conservation and increasing the use of renewable energy. boosting independent producers and creating local Bristol has the lowest carbon emissions of any of the sustainability within the local economy. core cities and has achieved a reduction of 20% per There is still a great deal to be done in relation to person over the period from 2005 to 2012. our international competitors. However, to make real Strategic leadership has been important, and the progress it is important to change hearts and minds council leadership has been acknowledged for establishing and to involve all the people and communities, groups some key strategic projects such as a comprehensive and enthusiasts, wherever they are. With strong local programme of energy efficiency, a successful bid for and national leaderships, we can harness the energy of the cycling city and, of course, the local energy supply individuals and groups and achieve immense benefits company. The energy efficiency project has insulated in terms of the quality of the environment, as well as 30,000 homes. As a result of the cycling city project, reduction of emissions, generation of green energy we have three times the number of cyclists as the core and conservation of energy—all of which bring huge city average. The city council has taken a strong lead in benefits in terms not only of the quality of life but of exploiting its own energy through solar panels and the the health and well-being of people and communities. wind turbines at Avonmouth, enabling the establishment of the energy supply company. 1.08 pm However, it is important that people from all sections Lord Smith of Finsbury (Non-Afl): My Lords, I join of our communities can contribute to these targets in thanking the noble Baroness, Lady Bakewell, and and to achieving a greater quality of environment. We congratulating her on initiating this debate. Her Motion have to change hearts and minds as well as providing does a crucially important thing, because it helpfully strategic leadership. There have been some innovative links the challenge and impact of global climate change and energetic projects in the city, some of which I with the importance of the local environment that we would like to tell your Lordships about. In some of the all live, work and play in. It is a hugely important link poorest areas of the city, we have a project called to make. smart metering, which enables people to measure energy Climate change is of course very much with us. usage using the wi-fi hotspots that we have created Thirteen of the 14 warmest years on record globally there and by using recycled computers. This has made have happened in the 21st century. The sea level rise 923 Natural Environment[15 JANUARY 2015] Natural Environment 924 over the last two decades across the world has been habitats directive and the water framework directive 3.2 millimetres per year—nearly twice the average rate that have provided the underpinning for a lot of the for the 20th century. Here in the UK, we have, as the environmental protection that we need and value in noble Baroness alluded to, experienced extreme weather this country. events over the last couple of years. I lived through the This brings me back to those links between the last winter as chairman of the Environment Agency. It enormous issue of climate change and our own local was a traumatic period, especially for those people environment. Why is it that the environment rates so who were tragically affected by the flooding that occurred. low among current public political concerns? Surely it That was a result of the biggest surge in the North Sea is because we tend to speak of it in abstract terms. that we have seen in 60 years. There were violent However, when you ask people about their own, personal, storms over the course of Christmas and the new year, local patch of environment, they become really passionate and the wettest January and February we have ever about it. Their own piece of green space and the river experienced in 250 years had an extreme impact on at the bottom of their town are bits of the environment people with businesses around the country. that they really value. We need to ensure that we link It is not just flooding. We are seeing more extremes the value placed on those with the big, global issues of weather, both floods and droughts. In March 2012, that we also need to address. when we were facing the imminent prospect of serious The Royal Society for the Protection of Birds does this drought, the River South Tyne was running at 28% of rather powerfully and brilliantly. I sometimes remind its normal flow level for that time of year. Three my former political colleagues that the RSPB has more months later, in June 2012, it was running at 406%. We than twice as many members as all the political parties are increasingly experiencing these extreme weather in Britain put together. They do something that is very patterns. Over the last 30 years river temperatures radical and progressive. They take people and say, “You across England have risen, on average, by 0.6 degrees. are interested in something very small, very fragile—a We are seeing an impact on species too. The vendace, dipper. If you are interested in a dipper, you need to which is a very beautiful coldwater fish, has lived in understand about what happens to its habitat, to the the Lake District for centuries. We have now had rivers, hedgerows and fields. If you want to understand to move them to higher lochs in Scotland in order to about what happens to those, you need to understand ensure they have the cold water that they depend on. about the planning and development pressures, about Damsel-flies are now being found 40 or 50 miles agricultural production and what is happening to it further north than ever before. They are moving with and about the framework of local plans that decide the temperature. All this shows something of the impact what should happen to landscape and habitat. Then that a changing climate is having on habitats, species, you need to understand the national framework that the nature of our countryside, the quality of our rivers operates to determine and protect all this, what the and on the fate of the environment around us. European Union is up to and the international agreements that are reached in places such as Kyoto, Lima and, The importance of that natural environment needs hopefully, Paris”. Before you know where you are, you to be emphasised again and again. I am delighted that have taken people from something very tiny—a dipper—to the Government have realised some of this. The natural an understanding of the global forces that shape the environment White Paper and the establishment of importance of our environment. It is an understanding the Natural Capital Committee are welcome initiatives. of how everything, from top to bottom, is interlinked. The environment is not just something for us to wonder That is the realisation we need to capture. This debate at, to enjoy, to find pleasure and to seek recreation in. has helped us to do precisely that. It is also part of the natural capital on which we all depend. It is a resource, an essential part of our 1.16 pm economic and social life. It is something we cannot do without and that we endanger at our peril. Baroness Ludford (LD): My Lords, I, too, congratulate my noble friend Lady Bakewell on introducing this Yet do we fully understand the importance of this debate. I will follow other noble Lords in concentrating natural bank of capital when we make decisions about on air pollution, especially from vehicles. what happens to our landscape, green spaces, trees and rivers? When we think about how we address the As another former Member of the European growing impact and prospect of climate change? I fear Parliament, it is a pleasure to welcome my noble that, too often, we do not. The noble Lord, Lord friend Lord Callanan. We will both have to get used to Framlingham, talked movingly about the importance calling each other that. of trees. I could say exactly the same thing about our I, too, am grateful for the recent Environmental rivers. They are, of course, a source of life. They provide Audit Committee report in another place. As time is us all with water, but they also sustain industry, irrigate short, I would just urge noble Lords to read it. I broadly crops and permit agriculture in places where it would agree with it. It is nearly 60 years since the Clean Air otherwise be impossible. They are also an ecological Act and more than 40 years since the Control of resource—a place for insects, fish and water-bank Pollution Act. I was, briefly, a very junior civil servant mammals—and we need to look after our rivers in and worked on drafting the latter. It is a scandal that, order to sustain it. This includes responding effectively all these decades later, we are not dealing with what to floods and droughts in order to protect not just our has become the number one environmental health water supplies but this rich diversity of habitat, too. challenge. It is estimated to cause 29,000 premature Let no one tell me that European intervention has deaths a year in this country and 7 million or 8 million nothing to offer, when it is precisely things such as the worldwide. It is not just diesel exhaust but air pollution 925 Natural Environment[LORDS] Natural Environment 926

[BARONESS LUDFORD] way past time for a radical change in policy direction. as a whole that is classed as carcinogenic by the World That will mean giving attention to the fiscal and other Health Organization. London seems to have the highest frameworks—such as fuel duty, vehicle excise duty monitored nitrogen dioxide levels in the world—three and so on—under which people have been encouraged times WHO limits, especially on Oxford Street and to go for diesel. I do not own a car but sheepishly Marylebone Road. admit that, as a member of a car club called Zipcar, I Quite rightly, there has been great emphasis on carbon find myself involuntarily driving cars with diesel engines. dioxide limits in the tackling of climate change—no I do not drive frequently but when I do, the engines one, certainly not a Liberal Democrat, would quarrel always seem to be diesel. Can my noble friend say with that. However, there has been an overlooking of what the Government are doing to remove the loopholes the problems and challenges of air pollution. I agree whereby diesel particle filters are removed after being with the noble Earl, Lord Selborne, that it needs to go factory fitted? People are apparently managing to very fast up the policy and political agenda. I applaud remove them through these loopholes, so I would very the Healthy Air Campaign, which is run by a group of much welcome a specific answer on that. We need to non-governmental organisations, and also Living Streets, aim for the adoption of zero-carbon technology in which emphasises how tackling air pollution can make motor vehicles and in London. Liberal Democrats life much pleasanter and safer for pedestrians. propose having a big switch to 100% electric buses, Liberal Democrats have long championed the need taxis and vans. We regard the Mayor of London’s to tackle air pollution as well as climate change. ambitions for the ultra-low emission zone as lacking Perhaps I may quote from a document which is both urgency and stringency. We need to go much headed “Localised Air Pollution”. It says that, “There further and much faster. is increasing evidence that many people in the UK We work in a European context because air pollution become exposed to concentrations of pollution above does not recognise national boundaries. The coalition World Health Organization guidelines as the result of agreement pledged compliance with EU clean air laws emissions from road vehicles. This includes ground- but the UK is massively in breach of these laws and is level ozone, which is a problem in both rural and thus subject to legal action. We are 20 to 25 years late urban areas, nitrogen dioxide at urban sites, PM10s in the schedule. My noble friend Lord Callanan and I —the fine particulate emissions from diesel engines”. are not quite on the same page on this matter. He says That was in a Liberal Democrat policy paper of that air quality rules must not impede economic growth 20 years ago. The working group was chaired by my but that is a false choice. I also venture to suggest that now noble friend Lord Bradshaw. My noble friend the engineering companies of the north-east could Lord Tyler was also a member of that group. So, we make big business out of clean technology. are not Johnny-come-latelys when it comes to My last question to the Minister is therefore to ask tackling air pollution. whether he will update us on the Government’s efforts I congratulate the successive holders of the post of to ensure that the EU’s ambitions for clean air will Secretary of State for Energy and Climate Change in continue and to dissuade the Commission from the current Government. I believe that they have been withdrawing its proposals for new air quality directives. more active than their counterparts at Defra in dealing Unfortunately, I believe that there is a lack of consensus with air pollution and that there has been some in the European Parliament to pass a resolution now complacency at Defra on the issue. One of the most to urge the Commission not to withdraw these measures. urgent requirements is to update the air quality strategy It was disappointing that the Environment Secretary in this country. We need a holistic approach and a was not a signatory of a letter from the national clear demarcation of responsibilities and resources as Environment Ministers to the Commission President between central government departments and between urging against withdrawal. Will my noble friend tell us central and local government. One rather simple thing whether the Government are determined to press forward that could be done is to incorporate pollution warnings to meet EU laws? into weather forecasts as happens with pollen counts. There seems to be a curious contrast in those things. 1.25 pm The planning framework needs to place much more Lord Grantchester (Lab): My Lords, this has been a emphasis on air quality matters. Locating schools and wide-ranging debate, covering many aspects of our new homes away from main roads is one example. modern environment and touching on the policies of Although I cannot enumerate all the issues that many government departments. I thank the noble need attention, one of them, of course, is airport Baroness, Lady Bakewell, for introducing the it and construction. We need explicit air quality objectives declare my interest as a farmer, and my previous for the current Airports Commission appraisal framework. experiences of being involved along the food supply Liberal Democrats believe, of course, that aviation chain with various organisations. expansion must not further damage health. That is the The noble Baroness, Lady Bakewell, was quite right reason for our negative response to suggestions to to frame the debate around climate change. In the UK, build new airports, particularly in the south-east. As the most significant impacts of climate change are likely others have said—including, I think, the noble Lord, to be further increases in the frequency and severity of Lord Berkeley—we must not allow the Red Tape extreme weather, heat waves and drought, as well as Challenge to undermine local air quality monitoring. storms and flooding. How we respond and adapt to As others have also said—I will not dwell on this—the this is critical. The sixth annual report to Parliament main problem is diesel engines. Although there were of the Committee on Climate Change scoped out the undoubtedly good reasons for encouraging diesel, it is progress towards meeting carbon budgets and emission 927 Natural Environment[15 JANUARY 2015] Natural Environment 928 reduction targets, and reflected on the progress across to deal with flooding and the national resilience forums? the main government departments of energy, local In addition, does he agree that the Government should government, transport, business and the environment, bring forward the reform of the water abstraction as well as in the Treasury and the devolved regime to encourage water efficiency and protect the Administrations. This throws up a clear challenge for environment? joined-up action and co-ordination. The warning is The noble Earl, Lord Selborne, raised the issue of clear: the committee considers that the underlying air quality, which was further taken up by the noble pace of emissions reduction, allowing for the impacts Lord, Lord Borwick, my noble friend Lord Berkeley of the recession through the first carbon budget period and the noble Baroness, Lady Ludford. Air pollution and in 2013, is insufficient to meet future carbon in our towns and cities causes 29,000 people in the UK targets and budgets. to die prematurely. Rather than simply devolving the Meeting the legislated fourth carbon budget in the responsibility to local authorities, making them liable 2020s to reduce emissions by a further 31%—that is, to million-pound fines for exceeding EU air pollution by 50% from the 1990 levels—will require further limits, what are the Government doing to devolve the strengthening of policies, which speakers throughout power to local authorities willing to take action against the debate have highlighted. On the energy front, there this public health crisis? are the policies for energy efficiency and power The next Labour Government will deliver a national decarbonisation; on the transport side, it is those for framework for low emission zones to enable local the electrification of transport; on local government authorities to tackle the problem by encouraging cleaner, policies, they are for infrastructure and green spaces; greener and less polluting vehicles. Currently there is and on Treasury policies, they are for financial incentives no such framework, despite the majority of councils across other departments’ policies. calling for one. The next Labour Government will devolve the power, not just the responsibility, to take In the Minister’s own Department for Environment, action against air pollution to local authorities. Can Food and Rural Affairs, it is therefore extremely the Minister update the House on discussions with the disappointing that the Government’s failure to get to EU Commission and other Governments to ensure grips with the increasing threat of climate change is that the EU delivers a widely reformed, tougher clean putting more homes at risk from flooding. I am sure air package? that the Minister will be regretting the previous Secretary Transport-vehicle emissions are clearly critical in of State’s removal of “preparing for and responding this regard. I certainly enjoyed the maiden contribution to flood risk” from the department’s list of priorities from the noble Lord, Lord Callanan, and hearing of and the consequential ideological cutting of the budget. his experiences drafting EU emissions standards, which Since 2010, the Government have cut the Environment I agree should not be set so that they damage British Agency’s flood defence budget by £138 million, a 21% interests. The theme of further encouragement of good reduction. It was especially instructive to hear from British innovation and development was taken up by the noble Lord, Lord Smith, about his experiences at the noble Lord, Lord Bradshaw. the Environment Agency. Biodiversity and the importance of trees and wildlife The next Labour Government will reinstate flood were also key themes throughout the debate. Again, protection as a core departmental responsibility and clearly the Minister’s department has struggled to establish an independent national infrastructure provide the required leadership. The noble Lord, Lord commission to identify the UK’s long-term infrastructure Framlingham, highlighted the role of trees. Can the needs, including on flood defences. The next Labour Minister update the House on the protections that his Government will also introduce a new national adaptation Government are now taking following the importation plan across government to ensure that all sectors of last year of diseased stock with ash dieback? the economy are adapting to climate change. This will On wildlife protection, can the Minister update the build on the work on the adaptation sub-committee of House on legislation on the control of trade in endangered the Committee on Climate Change, whose 2014 report species? It is now nearly a year since his department underlined the importance of infrastructure resilience, conducted consultations. Does the Minister have any the risks to businesses, well-being and public health, timing for when his department will bring forward and emergency planning—especially in this area of measures to combat wildlife crime? Does his department flood risk. have any plan to publish the report of the National The Government should introduce without further Wildlife Crime Unit? delay the Flood and Water Management Act’s provisions The noble Lord, Lord Greaves, was keen to understand to require sustainable drainage in new development, how to understand how cuts at Defra have undermined as recommended by the Pitt review. They should also key services. He mentioned footpaths and green spaces. now evaluate whether local flood risk management With important considerations of environmental concerns arrangements are in place across the country, in line across government departments, how is the Minister’s with this review. The adaptation sub-committee found department co-ordinating scarce resources so that the that some funding provided by Defra to lead local public purse can be leveraged to meet important flood authorities is being diverted to other council considerations, as has been debated today? services. Statutory local flood-risk management strategies have yet to be published in many areas. Will the 1.33 pm Minister initiate and publish an assessment on local The Parliamentary Under-Secretary of State, Department action plans? Does he also regret the abolition of the for Environment, Food and Rural Affairs (Lord De Mauley) Cabinet committee on improving the country’s ability (Con): My Lords, I thank my noble friend Lady Bakewell 929 Natural Environment[LORDS] Natural Environment 930

[LORD DE MAULEY] heavily in measures to improve it. We have committed of Hardington Mandeville for raising a range of important £2 billion to increase the uptake of ultra-low emission matters today. I warmly welcome the chance to discuss vehicles, sustainable travel and green transport initiatives. the importance of our natural environment, and the Overall, air quality has improved significantly in recent need to reduce emissions, improve green transport and decades and the UK currently meets the EU limits for protect wildlife and green spaces. almost all pollutants—though of course we recognise Most people agree that the environment is important that more needs to be done. for its own sake. In addition to this intrinsic value, we We are also taking action for England’s wildlife recognise that the environment provides a range of through our biodiversity 2020 strategy. For example, essential services to society. We all rely on it for our since 2010 we have set in hand the creation of nearly clean air, water, food, energy, opportunities for recreation, 150,000 acres of wildlife habitat, such as field margins, and for the contribution that it makes to our well-being. wetlands and woodlands. As part of our strategy, we We are deeply committed to improving our natural have established a new, more joined-up approach environment. We have set out that we want ours to be to conservation—to which my noble friend Lady Miller of the first generation that leaves the natural environment Chilthorne Domer referred—through the 12 government- of England in a better state than when we inherited it. funded nature improvement areas, which are now starting We know that our environmental goals are challenging to deliver real improvements on the ground. and long term, and that they cannot be achieved easily Earlier, I mentioned the essential services that nature or overnight. Furthermore, government cannot do provides. One important example, to which I have this alone. We need individuals, businesses, farmers, already briefly referred, is pollinators. We are taking land managers, community groups and NGOs to work action to support bees and other pollinators through together. We have put in place an ambitious programme our National Pollinator Strategy, launched in November. of environmental policies to protect the environment The strategy includes actions to improve habitats for for future generations, including bringing forward the pollinators across all land uses in England, enhance first White Paper on the natural environment in 20 years. our response to pests and diseases, and improve our This has a strong focus on changing how we view the evidence base, particularly on the current status of natural environment and on taking better account in pollinators and trends. We have also established a decision-making of the many benefits that nature local green-space designation within the planning regime provides to people. We have already implemented the to enable communities to identify green areas of particular majority of the White Paper’s commitments, putting importance to them for special protection. My noble in place foundations for the longer term. friend Lord Greaves referred to that. We are making progress in many areas. For example, our rivers and coastal bathing waters are getting cleaner. I will now address some of the matters raised by Background concentrations of key air pollutants, such noble Lords during the debate. My noble friend Lady as nitrogen dioxide and particulate matter, halved in Bakewell spoke of allowable solutions and zero-carbon the 20 years up to 2012. We have introduced marine homes. The Government consider that retrofitting existing plans for the first time and greatly increased the network properties with energy-efficiency measures could indeed of marine- protected areas. We have supported the be an allowable solution that housebuilders can support planting of more than 8 million trees, and woodland in order to contribute to the zero-carbon homes target cover is at its highest level in 700 years. We have also that will be introduced from 2016. New homes from recently published our pollinator strategy. Looking 2016 will still have to meet minimum energy performance ahead, we will be investing more than £3 billion from requirements, which will be more demanding than 2014 to 2020 to deliver environmental benefits through those currently required by building regulations. the new Rural Development Programme for England. The noble Baroness spoke about energy efficiency This is in fact a larger share of the overall budget than and listed buildings, particularly those with thatched previously. roofs and those unable to take double glazing. Green My noble friend Lady Bakewell raised the need to Deal assessors are trained to assess the energy efficiency reduce emissions, about which we can all strongly agree. needs of all property types and to make recommendations The UK is committed under the Climate Change Act suited to the building, including listed buildings or to cut emissions by 80% by 2050 and the Government those with a thatched roof. If a Green Deal plan is put take this extremely seriously. We want to make sure in place, there are specific requirements within the that the UK makes a cost-effective transition to that code of practice for Green Deal providers to ensure target. We were pleased to be able to announce in that the energy-efficient measures are suitable for older February last year that the UK had met the first or traditional-style buildings. carbon budget for the period 2008 to 2012. Furthermore, My noble friend Lord Selborne mentioned the Aichi the latest published projections show that the UK is targets for biodiversity, which form part of the Convention on track to meet the next two carbon budgets, up to on Biological Diversity strategic plan agreed in 2010. 2022. The Act has helped drive the UK to reduce The UK has reported to the convention on its emissions by almost a quarter since 1990. The Climate implementation of this plan. The report set out that Change Act was the first of its kind. Almost 500 climate we are making progress in most areas of the five laws have now been passed in 66 of the largest emitting strategic goals of the plan with substantial progress in countries around the world. some areas. My noble friend asked about the Natural My noble friend Lady Bakewell also mentioned Capital Committee, which we established to advise us green transport. It is well recognised that air quality on the sustainable use of natural assets and on our can affect people’s health, which is why we are investing priorities for action to improve and protect nature. It 931 Natural Environment[15 JANUARY 2015] Natural Environment 932 is intended to support a transformation in the way we England’s forests, based around the core hierarchy of view and value our natural assets. Its third report is protecting, improving and expanding our national due on 27 January. The Government will consider it woodland resources. We have made plant health one carefully when it is received before deciding on their of Defra’s highest priorities and taken steps to improve response. biosecurity through, for example, our biosecurity strategy My noble friend spoke about hydrogen in the context and our tree health action plan as well as our plant of transport. We are technology neutral, and we believe health risk register, which now assesses upwards of that hydrogen fuel cell vehicles have a potential role to 700 pests and pathogens. We have also worked hard on play alongside battery electric vehicles and plug-in enhanced contingency planning. We have supported vehicles. In October, we launched the hydrogen technology the planting of more than 8 million trees, 1 million of advancement programme which will see investment them in urban areas, and England now has 10% woodland from government and industry in new and upgraded cover—the highest level in 700 years. hydrogen refuelling stations and support the deployment The noble Lord, Lord Greaves, asked about local of hydrogen fuel cell electric vehicles in public sector green space. The important thing is that it is for fleets. My noble friend Lord Callanan, whose maiden communities to decide. It would typically be land that speech we all enjoyed so much, will be pleased that is in reasonably close proximity to the community it these will contribute to growth and exports in those serves, is local in character and holds a particular areas. significance for that community—for example, because My noble friend Lady Miller and the noble Lord, of its beauty, historic significance, recreational value, Lord Berkeley, spoke about bats. What is needed is for tranquillity or richness in wildlife. Local green spaces wildlife and humans to be able to exist in harmony. It should be designated when a local or neighbourhood is about balance. I am unconvinced that the Private plan is prepared, and they are potentially a very powerful Member’s Bill that my noble friend referred to will tool for communities. Many communities that are achieve that. She will be pleased to hear that we have preparing neighbourhood plans are seeking to designate worked closely with the churches. I visited a church in green or open areas of significance to them as local Norfolk where the damage was very extensive indeed. green space. I am pleased that we have been making important The noble Lord also spoke of the impact of local progress with equipment using light and sound to authority budgets on rights of way. It is the responsibility move bats to places where they do less damage. I will of local authorities to complete maps of rights of way. look at the railway problem that the noble Lord, Lord Through the Deregulation Bill, we are introducing a Berkeley, raised. streamlined process for recording them to reduce the My noble friend Lord Bradshaw was one of several burden on local authorities in managing this work. noble Lords who focused on air pollution. He is right My noble friend Lord Borwick spoke of the effect that emissions from small diesel engines of the type of air pollution on lungs. Evidence linking air pollution used to power mobile refrigeration units are not currently with adverse effects on the respiratory and cardiovascular regulated. The European Commission recently published systems continues to accumulate, and the review by a proposal to revise the legislation related to exhaust the World Health Organization also notes emerging emissions from engines used to power small diesel evidence suggesting a possible association with adverse engines of this type. That proposal, if adopted, would effects on other body systems, including the endocrine bring those engines into scope. The revision is currently system and the nervous system. The World Health in the early stages of negotiation in the Council and Organization has concluded that the evidence suggests we are considering the proposal, but the general consensus that ambient concentrations of nitrogen dioxide have among member states is favourable towards it. My direct effects, particularly on respiratory outcomes. noble friend’s solution is interesting. It is primarily for My noble friend asked when we will respond to the industry to take forward, but I would be very interested Economic Affairs Committee report. I anticipate that, to see the papers he offered. in line with the usual timetable, we will be responding My noble friend and the noble Lord, Lord in February. I can confirm that of course my department Grantchester, raised the matter of low emission zones. works very closely with the Department for Transport, We are working with local authorities on the feasibility the Department of Health, the Department for and design of such zones and have provided guidance, Communities and Local Government, the Department such as on what vehicles should be covered and what of Energy and Climate Change and Public Health emission standards they should meet. So far, London, England on air quality. Oxford, Norwich and Brighton have introduced low The noble Lord, Lord Berkeley, suggested an emission zones. While the main reason for poor air interpretation of the proposals that could lead to a quality is vehicle pollution, sources vary from place to downgrading of the local air quality monitoring network. place, so measures need to be tailored to local The aim of our review is to reduce administrative circumstances. My noble friend raised a point about burdens to free local authority time and resources so adequate notice, and I take it. that they can focus on taking action to address air My noble friend Lord Framlingham and the noble quality. It is important that the consultation proposes Lord, Lord Whitty, spoke about trees. As my noble the removal of the requirement in regulations for local friend kindly acknowledged, I share his passion for authorities to report on four pollutants that have been trees. I should perhaps declare an interest as I planted well within limits for many years, and monitoring 50,000 of them in 2004-05. The forestry and woodlands them will remain at national level. The second part policy statement sets out our vision for the future of contains a number of proposals to do with improvements 933 Natural Environment[LORDS] NHS: Accident and Emergency Services 934

[LORD DE MAULEY] make that happen. In particular, I congratulate the to guidance and includes proposals to streamline the noble Lord, Lord Callanan, on his maiden speech, local air quality management reporting system for and I look forward to his contributions in future. local authorities. I was particularly heartened by the speeches about My noble friend Lady Janke spoke of her pride at trees and to hear about the TDAG. I will look further Bristol having been awarded the title of the European into that organisation. A lot of noble Lords spoke Green Capital of the year. It is the first UK city to about air pollution: trees are essential in helping us have this title. I share her pride in that. It recognises deal with air quality. I will not mention every speaker that great city’s environmental performance and vision. by name or go through all their speeches because we We are pleased to be supporting Bristol as the European would be here for ever, but I thank everyone for taking Green Capital with some extra funding to be invested part. in a range of projects that will help Bristol remain at the centre of green investment and urban sustainability. Motion agreed. We wish Bristol every success with the year’s programme of activities. My noble friend Lady Ludford raised a number of NHS: Accident and Emergency Services suggestions for Defra, and I will raise them with my Question for Short Debate honourable friend Dan Rogerson, the Minister responsible. We are very keen to work in partnership with local 1.53 pm authorities and the Commission to avoid any prospect of fines levied from the infraction that she referred to. Asked by The Lord Bishop of St Albans The main reason for not achieving limit values for To ask Her Majesty’s Government what is their nitrogen dioxide is the failure of EU emission standards assessment of the pressures facing accident and for diesel engines to deliver the expected emission emergency services. reductions in real-world driving conditions, and the Commission acknowledges that. The increase in the number of diesel cars has, of The Lord Bishop of St Albans: My Lords, I come to course, exacerbated the problem. All member states, this debate not as a doctor with specialist medical including the UK, are facing difficulties in addressing knowledge nor with any special insights into the complex air pollution. In 2012, 17 out of 27 member states processes which hospital managers have to manage. I were non-compliant with the annual mean nitrogen approach it as someone from an institution, the church, dioxide limit value. We are compliant with EU legislation which has been concerned for healing, in its broadest for nearly all air pollutants, although we still face a sense, from its very foundation and I live opposite significant challenge in meeting the nitrogen dioxide what is left of the great medieval monastery of St Albans, limit and we are working very hard on that. which for centuries was a centre of healing, with its infirmary and herbarium. In my present role, I have The noble Lord, Lord Grantchester, should know regular contact with the hospitals across Hertfordshire, that defence against floods is alive and well among Bedfordshire, Luton and Barnet, which make up the Defra’s strategic priorities. That is why we have introduced diocese of St Albans. an unprecedented six-year plan, to which more than £2 billion has been pledged. I also come as someone who has received the benefits of A&E departments in my own family. Not many If I have not been able to address noble Lords’ years ago, my eldest nephew was diagnosed with a points and questions I will, of course, write to them. brain tumour and had to have serious surgery on We remain deeply committed to improving our natural several occasions. Sadly, he has since died from the environment, which is a vital foundation to both our tumour. About five years ago, he and all the extended economy and our future well-being. We know that our family were staying with me for Christmas and, in the environmental goals and ambitions are challenging early hours of Boxing Day, he had a fit. I remember and long-term. We also know that there is much more vividly the intense panic as we were all roused out of to be done and that it will require support from others, sleep to find what was going on; as we waited anxiously not just government. We have put an ambitious for the ambulance, willing it to come because we all programme of environmental policies in place to protect felt so helpless; as he was rushed into Watford General the environment for future generations and we will Hospital A&E department. What a relief it was, in continue to strive, with a wide range of people and that terrible time, to feel there were people around organisations, to ensure that it is achieved. who knew what they were doing. I am well aware from talking to doctors and nurses and visiting hospitals 1.51 pm that the widespread coverage in the media about A&E Baroness Bakewell of Hardington Mandeville: My departments has not only been frustrating for many of Lords, I thank my noble friend for his very comprehensive those front-line people but profoundly demoralising. I reply. There was a great deal of detail in his response pay tribute to all who work in such departments and to Members’ questions. I also thank all those who thank them for their tireless service, not least those in have taken part in this very wide-ranging debate. I Watford General Hospital. have been very heartened that we all seem to be on the The House will be aware that pressures on A&E same page, even if we are covering slightly different services have been mounting over a number of years. subjects. Everyone seems to agree that we need to do While the NHS always faces pressures in the winter, something about climate change and work together to these have been compounded by our ageing population. 935 NHS: Accident and Emergency Services[15 JANUARY 2015] NHS: Accident and Emergency Services 936

We now have 350,000 more over-75s than four years from GPs willing to short cut protocols have resulted ago. This rise has occurred simultaneously with a in increased numbers of patients presenting for treatment. significant increase in A&E attendances and a greater Some 20% of A&E patients decide to attend a day in level of sickness among those who arrive, leading to advance, the majority do not consider going first to an increase in emergency admissions of nearly 6% on their GPs, and 80% fail to make use of advice services last year. In my own diocese, the A&E departments are such as NHS Direct. While there has been a change in facing these challenges with varying degrees of success. people’s expectations and preparedness to wait for an For the week of 5 January, Watford General Hospital appointment with their GP, we must not overstate the fell below the Government’s target of 95% of patients extent to which A&E services are being clogged up by seen in four hours, while Luton and Dunstable University misuse. The vast majority of A&E users are not Hospital exceeded this target, in line with its track inappropriate attenders; that is to say, they should be record as one of the top 10 trusts in the country. within the health service. What is causing this? Attendances are up, but the Recently, some pilot projects have begun to change problems go much deeper. Reports have emerged of the range of services available in A&E departments. people in some places having difficulty getting For example, some GPs co-locate in emergency appointments with their GPs. There have been discussions departments as primary care physicians while others about changes in social care leaving some elderly and locate out-of-hours GP services adjacent to A&E frail people without the necessary support. There are departments. Other GP practices have supplemented staff shortages and recruitment difficulties in A&E NHS Direct with their own telephone consultation units. Many in your Lordships’ House will be aware of services, enabling patients to speak with their own A&E’s three main areas of activity: triage, treatment doctors. There is growing evidence over the past decade and referral. Problems tend to arise in bottlenecks at that these approaches relieve pressure on A&E staff the triage and referral stages. Effective triage is and enable efficient triaging at the front door. Similarly, compromised by the presence of patients whose needs pilot projects that locate acute medical and surgical do not fit the current services offered in A&E departments. staff in or approximate to A&E departments at peak Until quite recently, these individuals were often referred times have enabled improved patient flow as additional to as “inappropriate attenders”, but current research diagnostic expertise has resulted in inappropriate suggests that it is not the patients who are inappropriate, admissions to acute wards being minimised. Co-location but the services that emergency departments provide. of acute assessment units has also enabled patients to Estimates vary that between 15% and 40% of patients be monitored and assessed without them either remaining require services other than those offered by an emergency in A&E or by being admitted to acute wards. These department and it is the presence of these patients that approaches require strong leadership, close co-operation creates part of the bottleneck at the triage stage. among health professionals, focus on patient care and strategic implementation. What more can be done to At the other end, efficient referral after treatment is enable every hospital to have its own 24-hour GP compromised by problems in bed allocation in acute practice? medical and surgical wards as well as by accessing Ultimately, resolving the current and on-going A&E appropriate services. In many cases, A&E doctors crisis involves a systematic change to the ways in which admit patients for further diagnostic tests or when the health and social care are organised. Access to good additional expertise of medical or surgical staff is social and community care can relieve pressure on required. Around 20% of referrals from A&E to acute GPs, enabling them to play a greater, proactive role in wards involve patients whose conditions could be treated emergency medicine. Allied with a willingness to break appropriately by their GPs or in the community. Up to down barriers within hospitals between emergency 40% of patients referred to acute wards are discharged departments and acute wards, strain on A&E staff can within a few hours of admission. The Department of be alleviated and patient experience improved. I hope Health says that the effective management of the flow that this debate will play a small part in exploring the of patients through the health system is at the heart of complex reasons for the current problems and help us reducing unnecessary emergency admissions and in addressing the challenges facing A&E departments managing those patients who are admitted. The problem today. is how to identify how this can best be done. Much of the debate in the other place has, not 2.03 pm surprisingly, been highly politicised because we are Lord McColl of Dulwich (Con): My Lords, I thank approaching an election. I hope that, in this debate, the right reverend Prelate for initiating this important this House can stand back and take a more dispassionate debate. He has set exactly the right tone—let us keep view, drawing especially on the huge knowledge and petty party politics out of this and concentrate on the experience of some noble Lords who have intimate, patients. It is important to stress that the staff in A&E personal working experience in the National Health departments—nurses, doctors and administrators—are Service. I hope that we can set this debate in a slightly doing a very good job indeed under difficult circumstances. wider and longer term context. Certainly, it needs to Having worked a lot myself in accident and emergency be set against the background that A&E services across departments, I know only too well how difficult it is. Europe are facing similar challenges. Patients come in, one is not sure what is going wrong Until recently, some emphasis has been placed on with them, and it takes a little while to sort them out. attempts to demagnetise emergency departments, even There were some political shenanigans some years though it has long been established that this tactic ago when there were complaints about people waiting meets with little success. Both self-referrals and referrals on trolleys far too long in casualty. I produced a paper 937 NHS: Accident and Emergency Services[LORDS] NHS: Accident and Emergency Services 938

[LORD MCCOLL OF DULWICH] facing accident and emergency services, but the current when I worked in No. 10 entitled Off Your Trolley. The pressures on them are exacerbated by a consistent failure answer was that if you are really ill and they do not to properly support people with long-term conditions know what is wrong with you, stay in the casualty such as Parkinson’s, both before and after hospital department where all the expertise is—the expert admission. equipment and the doctors and nurses—until an accurate In 2012-13, people with Parkinson’s had more than diagnosis has been made. If it worries people that they 65,000 unplanned or emergency admissions to hospital, are on trolleys, they should take the wheels off after often due to falls, infections or cognitive issues. In 20 minutes and the trolleys will then constitute a bed, England, those over 65 with Parkinson’s are three so people will not fuss about it. times more likely to have an unplanned admission to Things have improved enormously in this service hospital than other people of the same age. In addition from the days when I first worked in casualty.I remember to creating serious pressures on already overstretched once going through the accident and emergency hospitals, this costs the NHS around £177 million department of a hospital that shall be nameless, where each year. However, with proper support at an early there was a man groaning on a trolley. I went up to him stage, many of these admissions could be avoided. and asked how he was, and he said, “I’m in terrible pain in my shoulder, it’s dislocated, I’ve been here for Giving people with Parkinson’s the right information three hours and I have not seen anyone”. I said, “I and equipment can often help them to manage their could put you in a very comfortable position where condition, rather than relying on accident and emergency you’d be free of pain. Would you like that? I’m not services once they reach crisis point. Services such as working in the department, but we can get on and do physiotherapy, dietician support or falls prevention it”. So I put him on his face with his arm hanging over are also a great help in averting health crises, yet access the side of the trolley and the moment when he was in to these services remains inconsistent. Good quality that position he said, “Ah, I’m free of pain”. I said, early intervention would significantly reduce the high “Now you’re free of pain, the muscles will relax and the number of people with Parkinson’s coming into accident thing may go back on its own, without any anaesthetic—so and emergency departments in the first place, thereby you go off to sleep and I’ll come back in half an hour relieving some of the pressures that hospitals are now and see how things are”. When I came back, he was facing. sound asleep and snoring, so I crept up on him and There is also an urgent need to improve care for very gently manipulated the arm. Suddenly, clunk, it people with Parkinson’s once they are admitted to went back—and he woke up and said, “Oh, it’s gone hospital, in order to reduce both avoidable harm and back”. I said, “Yes, you can go home now, but perhaps the length of time they are required to stay. Patients we ought to tell somebody what we’ve been doing”. with this condition currently spend around 75% longer Things are much better than that now, because we in hospitals than others of a similar age, equating to have rapid assessment. Somebody senior goes around more than 128,000 excess bed-days a year. In 2012-13, the A&E departments, assessing things quickly, so these excess days cost the NHS more than £20 million. that sort of thing no longer happens. A key reason for this is that many people with Parkinson’s There has been an enormous increase in the number who are admitted to hospital often experience serious of people attending, and we do not know why. As we disruption to their medication. Parkinson’s medication do not know why, it is quite wrong to start blaming regimes are often complex, sometimes requiring up to any group of people. It is very demoralising if you are 30 doses at specific points throughout the day. It is a doctor, nurse or administrator working for the NHS vital that people receive their medication on time, and people start attacking and accusing you of this because delays can rapidly worsen their symptoms. We and that when they really do not know the cause of the have discussed many times in your Lordships’ House increase in the work. What is true is that more resources the need for these patients to get their medication on are being put in and more staff are being recruited, time, every time. Anyone with Parkinson’s who does which is good news. But we must stop blaming people not receive their medication on time is put at risk, and and pointing the finger. The blame culture has to go, these incidents can create a vicious cycle of escalating and we have to be more constructive. care needs for patients with Parkinson’s and overwhelming pressures on hospital staff. What is the answer? Preventive medicine is one of the great emphases in the Department of Health, and However, there are a number of straightforward it certainly helps. We have the worst epidemic that we and cost-effective steps that hospitals can take to reduce have had for 95 years in this country—the obesity medication errors and excess bed-days for people with epidemic—and we need to get people thinned down. the condition. They include giving patients the option They have to eat less and take more exercise. We have to administer their own medication, as recommended to improve people’s health, which will tend to reduce under existing guidelines; taking up Parkinson’s UK’s the problem. But we also have to have an alternative training opportunities on the importance of medication way of funding the NHS. timing; and making sure that there is always a supply of Parkinson’s drugs in emergency medication cupboards so that they are easily accessible when someone with 2.07 pm the condition is admitted. Baroness Gale (Lab): My Lords, I, too, thank the I am sure the Minister recognises that there is a right reverend Prelate for bringing this important debate clear link between the lack of adequate support for before us today. I may take a slightly different angle from people with long-term conditions like Parkinson’s, and other noble Lords. We are all aware of the problems the serious pressures being experienced by accident 939 NHS: Accident and Emergency Services[15 JANUARY 2015] NHS: Accident and Emergency Services 940 and emergency services. Taking steps to reduce both Fortunately, I was at home when these events occurred; avoidable admissions and avoidable harm will protect I am grateful for the prompt response of the ambulance individuals, alleviate the strain on hospitals, and benefit paramedics who rushed me to Cheltenham A&E. On our health service as a whole. I hope that the Minister two of these occasions my wife was called out of the will take the opportunity to outline how these problems family room and told to prepare herself for the worst; can be addressed as part of the Government’s wider but thanks to the skill of the truly wonderful doctors response to the current situation. and nurses—and, no doubt, a lot of praying in the family room—I survived. I do not know what the 2.13 pm doctors did: I was out at the time, but I understand Lord Jones of Cheltenham (LD): My Lords, I, too, that a super-dose of frusemide was involved. If the congratulate the right reverend Prelate on securing recent downgrade of Cheltenham A&E had been in this timely and important debate. I should like to focus operation then, it would have taken an extra 15 minutes my remarks on the situation at the Gloucestershire to get me to Gloucestershire Royal. I would probably Hospitals NHS Foundation Trust and the critical incidents not have survived and would not be here now addressing at A&E at Gloucestershire Royal and Cheltenham your Lordships’ House. Therefore, will the Minister General Hospitals. The latest critical incident lasted ask the regulators and the Care Quality Commission for more than a week and was lifted only yesterday. to look into the difficulties in Gloucestershire to give Presumably in that time, hundreds of routine operations answers as to why we have experienced these critical and admissions were cancelled and have stacked up. incident periods? Will he please ask the Gloucestershire This was the second such critical incident at GHT in a Hospitals Trust to reinstate round-the-clock A&E services month and went on longer than those at other trusts in at Cheltenham General Hospital and ensure that it the country. We need to understand why. has the capability to recruit sufficient doctors, nurses and technicians? It is complicated and not simply to do with money. We know that the coalition Government have increased 2.18 pm NHS spending overall from £95 billion in 2010 to £115 billion this year, giving GHT £3.6 million for The Lord Bishop of Ely: My Lords, I am very grateful winter pressure this year; so what are the problems? to the noble Lord, Lord McColl, for reminding me Are too many 111 calls going into A&E? Anecdotal how pleased I was to be off my trolley in February 2013, evidence from local doctors says that they are, and when I was admitted as an emergency patient to certainly the non-medical call-handlers have a naturally Addenbrooke’s Hospital in Cambridge. Were it not for risk-averse system that will direct people to a doctor the skill and dedication of the surgeons and nurses—and when in doubt. The Prime Minister, in response to a the grace of God—I would not be here now. Like the Question from my honourable friend Martin Horwood, right reverend Prelate the Bishop of St Albans, I pay said that only 7% of 111 calls ended in A&E. I believe tribute to the dedication of staff in our hospitals, not that that was a statistic from October; it would be least Addenbrooke’s, from which no one needing helpful if the Minister could tell us whether that is emergency treatment is turned away. increasing and what it has been in the last month or I support the thrust of what the right reverend two. Prelate has already said. The immediate problem for GHT has implemented what is called the UTOPIA Addenbrooke’s recently, in its critical incident over system of routing all unplanned admissions through accident and emergency, was the high intake of unusually A&E. Has this made things worse? The theory is that frail elderly patients in December. They took up more people see a doctor sooner than in direct admission, than 300 of the 700 adult beds available. The number when they have to wait for the next ward round, but in of elderly admissions is bound to double—so the chief practice you need enough capacity in the emergency executive tells me—in the next 20 years. The only department to handle cases, which GHT pretty obviously immediate resolution was provided by a release of does not have. I wonder whether the June 2013 decision funding and access to beds in social care by the county to remove doctor cover from Cheltenham A&E at council. night and route blue-light admissions to Gloucestershire I am pleased to commend the even closer co-operation made matters worse. I understand that these decisions of trusts and social care providers to ease the pressure were made not due to a lack of money, but simply to on A&E and to provide even more joined-up care for the failure to recruit sufficient staff. Is there something the frail and elderly, both in their homes and in wrong with the salary structure within the NHS that nursing environments. The new frailty assessment unit particularly affects Gloucestershire? At night, Cheltenham at Addenbrooke’s seems to me a way ahead in offering General Hospital is now really a minor injuries unit, an overhaul of how hospitals care for the physically although I understand that it still gets help from GPs and mentally frail patients, and how to keep patients in the out-of-hours service based at CGH . in hospital for the shortest possible time by having I have spent more time than I care to remember as a such units next to A&E with a resident multidisciplinary patient in Cheltenham A&E. In January 2000, I was team. there following a sword attack in my constituency office I am also very concerned about the CQC’s report which left my assistant dead and my hands in need of on Hinchingbrooke Hospital in Huntingdon. Without repair with 57 stitches. Then, in 2002, 2003 and 2006 I wanting to support poor performance, Hinchingbrooke’s had three events of flash pulmonary oedema, all at best asset is its dedicated staff. The chaplaincy was one night. This is a deeply unpleasant experience in which department that was praised in the report. I shall visit the heart goes into a ridiculous non-rhythm and stops staff at the weekend with the chaplain. I mention the pumping and one’s lungs quickly fill up with fluid. Hinchingbrooke situation because a longer-term response 941 NHS: Accident and Emergency Services[LORDS] NHS: Accident and Emergency Services 942

[THE LORD BISHOP OF ELY] not emergency vehicles to operate within the meaning to this debate needs to be an urgent approach to even of the various vehicle lighting and construction regulations. closer synchronicity between regional hubs and district A list has been provided of the ambulance services hospitals. This will be one such opportunity. covered that are associated with NHS trusts. Very importantly, alongside having GP services As St John Ambulance vehicles are appropriately available in hospitals, we need to rethink how we recruit constructed, I wonder why they have not been included younger GPs to market towns and semi-rural settings, in the list. Is there any possibility of this being amended? such as most of my diocese. In Ely itself, an older It also has very robust driver training standards and profile of GP practice is desperately seeking younger compliance. St John Ambulance used to be very useful colleagues to take on the profoundly important and and very helpful to the accident and emergency services complex care needs of the very elderly. The experience and it still could be if the exemptions that it and other of Ely is that recruits are not easy to find. When they like-minded organisations used to have for vehicles are found, they do not often stay, because they are not used “for ambulance purposes” were restored. prepared for the multiple and heavy demands placed on GPs providing clinical, social and pastoral care for 2.25 pm elderly patients who are desperate to stay in their own homes, which is much to be commended. We need to Lord Greaves (LD): My Lords, I will follow up the support our GPs, as I know Simon Stevens plans to do remarks that have just been made by the noble Viscount, in his proposed strategy for the future of the NHS. Lord Simon, on ambulance response times. However, this needs to be rooted on the ground in how Pendle Borough Council in Lancashire—I declare younger people are formed and prepared for the reality an interest and remind the House that I am a member of GP ministry among the elderly in our communities. of it—has made full use of its new statutory scrutiny In December, the chief executive of Addenbrooke’s, powers concerning the health service as laid down in the clinical commissioning groups and the county the Health and Social Care Act. A meeting of its council presented improvement plans to Simon Stevens health scrutiny panel this week received evidence from and the chief executive of Monitor. Here was an councillors and members of the public. For Pendle as opportunity to pool together the most effective joint a whole, in the three months at the end of last year the services and investment in a lively, real and continuous number of ambulances arriving within eight minutes approach, beyond any change of Government, to how was only just over half, at 55.7%. However, in the West we unite our health services properly to get beyond Craven area of Pendle—the towns of Barnoldswick immediate crises to a carefully and thoughtful response, and Earby and surrounding villages on what might be particularly for the most elderly members of our called the Lancashire-Yorkshire border country—it communities. was 10.7%, which is clearly not satisfactory. Evidence was also received from members of the 2.22 pm public on 999 calls that on at least two occasions, on Viscount Simon (Lab): My Lords, in opening the 17 November and 14 December, 999 calls were put debate the right reverend Prelate mentioned people through to the ambulance service, but then went on to having to wait in ambulances outside A&E departments, an answering machine. Clearly that is totally unsatisfactory. in addition to which some patients have to wait at I wonder whether the Minister will have a quiet word home for ambulances to arrive because ambulances and find out whether something is seriously wrong in are not available. I wonder how many patients’ conditions, this part of the North West Ambulance Service. when they arrive seriously ill at hospital, have worsened The rest of what I want to say comes from a due to the delay. hands-on account by a worker at a Greater Manchester Until recently St John Ambulance could provide a hospital who works nights in A&E, which I have very rapid response to patients where and when required, kindly been supplied by UNISON North West. I thus keeping conventional ambulances free for other would like to read out the account that this worker has work. It could also provide immediate life-saving provided, which shows the pressure that workers such intervention in more serious incidents where ambulances as this are under. The account says: were delayed in reaching the patient and when it was “We work as a team—there are doctors, nurses, mental health nearer. It was able to use blue lights and sirens. It could specialists, radiologists. It’s challenging and rewarding work. Staff also use motorcycle units when required, in addition work 12 hour shifts and rarely get to take their scheduled breaks. I to which motorcycles were used to transport emergency just have to grab something to eat and keep going. equipment, medicines or other parts very urgently. We never know what we’re going to encounter … but some things are predictable … a lot of alcohol-related cases up until However, following a judgment handed down in the about 3am. From 5am we begin to get broken hip or fractured Court of Appeal last March, all response services not neck cases where elderly people have had a fall. These are often involving a conventional ambulance have ceased. The people in care homes who are having ‘unwitnessed falls’ when judgment has also applied to many other operating they get up. I think that if there were enough staff in care homes response cars, support vehicles, emergency equipment some of these accidents would never happen. tenders and the like. Consequently, they can no longer Sometimes people come in with minor ailments like colds exceed speed limits, go through red lights or do anything because they can’t get a GP appointment … But our main problem is that we don’t have enough capacity for people who else that they used to do under an exemption. A special really need to be admitted. order under Section 44 of the Road Traffic Act 1988 We see most patients within 4 hours. If they need to be refers to the use of sirens and lights. It runs from admitted they should then go to the MAU (Medical Assessment 6 June 2014 until 5 June 2016 and permits vehicles Unit) for the first 24 hours, but sometimes there isn’t space … We constructed for medical response emergencies that are have some bays on A&E where people can wait on trolley beds, 943 NHS: Accident and Emergency Services[15 JANUARY 2015] NHS: Accident and Emergency Services 944 but if we have too many then patients can have to wait for 2 or with it and keep within our targets. There is no doubt 3 hours on corridors. Ambulance paramedics help to provide the that something has happened. I have no doubt that the care that patients need while they wait, but it is a frustration to us restructuring has had an impact. The one thing that is that they are not being treated in the right environment. Detaining the paramedics also has a knock-on effect for the time it takes to missing above all else at the moment is someone being respond to new emergency calls. in charge locally. There is no one single person in a When MAU is full, the registrar will come to A&E and health and care system you can go to and say, “You discharge people when they can. This can be a problem and we are in charge. You are responsible”. We desperately can sometimes see the same people in A&E the next night and need to get that local leadership back. even the night after that. On the 111 issue, which the noble Lord, Lord Jones, If they need to be admitted and there is no room in MAU, patients raised, are the Government going to undertake a review might be moved out of MAU after less than 24 hours. Other patients who are sleeping on wards can be moved during the night of it? Has the noble Earl seen the evidence given to make space for them to be accommodated. It can be that yesterday by Cliff Mann, the president of the College people end up on a ward that is not best placed to meet their needs. of Emergency Medicine, when he said that the “absurd” We are struggling to provide the level of care that we want to 111 helpline is to blame for overloading A&E with because we don’t have enough capacity. We want to provide the patients? best but the service is always stretched … We feel that we have to I also pull up the point made by the noble Lord, work flat out all the time just to keep things going … I sometimes can see that staff are so stressed that they should really be off Lord Greaves, about the ambulance service. Is the work, but they won’t take time off as they know that will make Minister as alarmed as I am by reports today of things even worse for their colleagues”. ambulance staff from the East of England Ambulance In a sense, that shows the strength of what is Service leaving the dead body of a man on the floor traditionally known as the public service ethos but so they could finish their shift on time and indeed the really it indicates that it is not just when the four hour report yesterday of staff there on their own volition target is being breached that these kinds of stressful apparently not following procedures in relation to situations and pressures exist, but week-in, week-out the maximum call-out times? What is going on in the through the year, as many of us know from the experience East of England Ambulance Service? We need an of the people we speak to. external review of it. On ambulance services I also ask the Minister about the policy of some services very insensitively called “drop and run” where patients are 2.31 pm left at the door of A&E without a proper handing over Lord Hunt of Kings Heath (Lab): My Lords, this to A&E staff after a certain time limit of 30 to has been an excellent debate. I congratulate the right 45 minutes. reverend Prelate for his very penetrating analysis of On the weekly A&E data, one trust last week hit the challenges facing the NHS at the moment. only 53.7% against the 95% target. What impact does Like other noble Lords, I pay tribute to staff in the the noble Earl think that will have on mortality rates? emergency services, indeed in the whole of the health Is monitoring going on to see what impact that is and social care system, for the way that they are having on safety and quality? responding to the enormous pressure. The noble Lord, Finally, does the noble Earl agree that there are all Lord Greaves, really put his finger on it when he sorts of issues such as 111, primary care and people’s talked about some of the pressures. We know that predilection to come through the door more often junior hospital doctors are at the moment not being because A&E is a place where they are going to get attracted into emergency departments. Can the noble high-quality care from a lot of staff which is not Earl tell me whether the Government have a strategy available out of hours elsewhere? However, when it for finding ways in which we can both encourage new comes down to it one single issue is clearly responsible doctors into emergency departments and also relieve for most of our problems—the swingeing cuts made some of the pressure on them so that they do not burn by the Government to local authorities and the impact out and find it overwhelming when they face situations on social care. The real issue is that patients cannot be as they do today? Will he also respond to my noble discharged into the community because the community friend Lord Simon on the contribution of St John facilities have gone. What is the noble Earl going to do Ambulance and other services like it? about that? On the actual pressures, my noble friend Lady Gale spoke very eloquently about the pressures in relation to people with Parkinson’s. The right reverend Prelate 2.36 pm the Bishop of Ely talked about the doubling of admissions The Parliamentary Under-Secretary of State, Department over 20 years. Can the noble Earl say what the Government of Health (Earl Howe) (Con): My Lords, I very much expect in relation to flows of patients through hospitals welcome the opportunity to debate this important through A&E? He will know that the five year plans of issue and I pay tribute to the right reverend Prelate the NHS trusts and foundation trusts are all predicated on Bishop of St Albans for introducing it so admirably. reducing capacity on the basis that something will The NHS is facing unprecedented demand with record happen elsewhere so that patients no longer need to go numbers of people attending A&E and the ambulance to hospital. There is very little sign that that is going to services providing record numbers of emergency journeys. happen, and I would like to hear what the noble Earl Despite this, the NHS is still providing high-quality has to say about that. care, and alongside the right reverend Prelate the Bishop I understand the point about politics. I gently point of St Albans and other noble Lords, I place on the out to the House that this yearly increase is nothing record my thanks to all NHS staff for their hard work new. In the previous Government we managed to cope in responding to this challenging time. 945 NHS: Accident and Emergency Services[LORDS] NHS: Accident and Emergency Services 946

[EARL HOWE] Implementation of the urgent and emergency care Winter is always challenging and this year it comes review will include enhancing NHS 111 so that it becomes on top of a general increase in A&E attendances. In the smart call to make, offering a 24-hour, personalised 2013-14 these were up one-third on 2003-04. So far priority contact service. The service will have access to this year, A&E attendances have been higher than in people’s medical history and allow them to speak any year since 2010 with, on average, almost 3,500 more directly to a nurse, doctor or other healthcare professional people a day attending. This has led to an increase in if that is the help and advice that they need. NHS emergency admissions of nearly 6% on last year. The 111 will also be able to directly book a telephone noble Lord, Lord Hunt, said that this was nothing call-back service. new. I have to tell him that it is. It is about the double Another key aspect of improving services outside the trend of increase that we have seen in recent years. hospitals is providing seven-day access as a matter of There is no single cause of the increase in A&E course. Currently, not all services are delivered at attendances. Healthcare is a system and problems that weekends, and sometimes staff cannot get the advice arise in one part of the system will impact elsewhere. and decisions that they need from more senior colleagues Commissioners and providers need to look at what is on Saturdays or Sundays. Delivering the vision of happening not just in hospitals but more widely, and seven-day services could improve the clinical outcome address the issues that are most salient in the particular for patients. NHS England is therefore working with area. That is what they have done in drawing up local NHS employers and staff to develop plans on how plans to spend the £700 million of additional support seven-day services can be delivered. This should improve mentioned by my noble friend Lord McColl that the outcomes and experiences for patients as well. Government have made available to the NHS so it can ensure urgent and emergency care services are sustainable I should like to move on to the better care fund. For year round and ready for the pressures of winter. In the first time, this Government will join up health and addition to providing more staff and beds, the money social care services through the £5.3 billion better care has funded local initiatives including: local information fund. I can say to the noble Baroness, Lady Gale, in campaigns so people are better informed on where and particular, and to the right reverend Prelate the Bishop how to access the services they need; seven-day pharmacy of Ely that the vast majority of this money is being services; enhanced NHS 111 and GP out-of-hours services; spent on social care and out-of-hospital community and schemes to help people recover in the comfort of health services. These aim to keep people—especially their own home after surgery. Some £50 million of the the frail elderly—out of hospital and, if they have to winter money was specifically to support ambulance trusts. be admitted to hospital, support them to leave safely as soon as they are well enough to do so. I have set out what the Government have done in response to the immediate winter pressures. However, Underlying the new approach are improvements in we recognise fully that we require system-level change seven-day working across health and social care to to ensure that services can be delivered on a long-term help quicker, more appropriate discharge from hospital. sustainable basis. I will now set out our longer-term One of the metrics for the fund is the number of people plans to achieve this goal. The right reverend Prelate supported to remain at home at least three months the Bishop of St Albans called for a systematic review after discharge from hospital. Plans project that over and that is already under way. NHS England’s urgent two years, the number of older people supported to and emergency care review should improve access to, remain at home at least three months after discharge and the availability of, services outside hospitals. This from hospital will increase by 33.7%. That will be will involve providing consistent and same-day access good for those patients but it will also save a great deal to primary and community services. of money. Schemes in plans typically focus on things such as increasing capacity in reablement or intermediate The vision for the review is simple. For people with care services, or multidisciplinary emergency response urgent but non-life-threatening needs, the NHS must teams, which focus on avoiding unnecessary admissions provide highly responsive, effective and personalised to hospital. services outside hospital and deliver care in or as close to people’s homes as possible, minimising disruption I now turn to our plans for access to primary care. and inconvenience for patients and their families. For We are offering 7.5 million more people extra evening people with more serious or life-threatening emergency and weekend appointments, as well as e-mail and Skype needs, the NHS should ensure that they are treated in consultations, through the Prime Minister’s Challenge centres with the very best expertise and facilities in Fund, and by 2020 we will offer seven-day GP services order to maximise their chances of survival and a to everyone in England. We have announced a £1 billion good recovery. If the NHS gets the first part right, it primary and community care infrastructure fund, which will relieve pressure on hospital-based emergency services, will improve access for millions more people through so that the focus can be on delivering excellent care. introducing new models of care and improving estates NHS 111 plays an important role in ensuring that and infrastructure—including, I am sure, GPs’ surgeries. people get access to the right care when they need it. There are now more than 1,000 more GPs working Only around 8% of calls handled by NHS 111 result in and training in the NHS compared with the position advice to attend A&E. In November the figure was in in September 2010, and there are 40 million more fact 6%. Moreover, 30% of callers say that they would appointments every year than there were in 2008-09. have attended A&E if NHS 111 had not been available. I turn to some of the questions that were asked That indicates that NHS 111 is instrumental in diverting during the debate and, as usual, I shall write to noble people from A&E rather than adding to those attending. Lords whose questions I cannot answer today. The noble It is a myth that NHS 111 makes matters worse. Lord, Lord Hunt, made me prick up my ears when he 947 NHS: Accident and Emergency Services[15 JANUARY 2015] Mental Health 948 said that the problem is that no one is actually in Mental Health charge of the system. I contend that the system is now Motion to Take Note more co-ordinated than it has ever been with the system resilience groups that we see in every single 2.49 pm area of the health service. These groups comprise Moved by Baroness Tyler of Enfield commissioners, acute providers, social care and all the players in the system so that they can genuinely co-ordinate That this House takes note of mental health care their actions and assess the risks and priorities that provision. they need to address. Baroness Tyler of Enfield (LD): My Lords, I am The right reverend Prelate the Bishop of St Albans delighted to have secured this debate, and with it such said that people are turning up at A&E when they an array of knowledgeable and, I know, passionate could go elsewhere, and he is absolutely right about speakers. I am particularly looking forward to hearing that. The urgent and emergency care review that I the maiden speech of my noble friend Lord Suri. For referred to noted that it had been estimated that about too long, the subject of mental health has been ignored, one-quarter of A&E attendees could have been treated marginalised or left to the realm of social experiment elsewhere. A number of local areas are taking action or institutional stigma. Why does this matter? Just as to make people aware of the range of different urgent we all have physical health, we all have mental health. and emergency care services that are available and the Mental health problems affect one in four people in circumstances in which they should be used, as well as any given year, and the numbers continue to rise. In the alternatives, such as pharmacies, that are open to 2013, referrals to community mental health teams people. were up by 13%, and up by 16% for crisis services. As a consequence, services are often unable to cope, and The right reverend Prelate also asked about staffing, people are not getting the support they need. especially doctors—a point also raised by the noble While 75% of people with a physical health condition Lord, Lord Hunt. Compared with last year, more than get treatment, just 65% of people with psychotic disorders, 260 more new doctors will be available in A&E. That and a mere 25% of those with depression and anxiety, is good news. It includes British trainees but also successfully access treatment. John Lucas, a campaigner senior staff from other countries, including India, the for the mental health charity Mind, has been diagnosed UAE, Egypt and Malaysia. with both mental and physical health conditions, and speaks compellingly about the discrepancy between A number of noble Lords, including the right reverend the care people receive for mental and physical health Prelate the Bishop of St Albans, called for more problems. He asks: collocation of services. I fully agree with the wisdom “Why does the NHS pull out all stops to stop me dying of of that suggestion. As part of the urgent and emergency physical health problems but does not care if I die of mental care review, NHS England is supporting the collocation health problems?”. of community-based urgent care services in co-ordinated Importantly, mental health problems are estimated urgent care centres. He may like to know that 112 out to cost the country £105 billion a year through lost of 143 NHS hospitals already have GPs working in, or working days, benefits, lost tax receipts and the cost of collocated with, A&E departments. treatment. So there is also a very strong economic case for investing in well-being, resilience and mental health. My time is nearly up but I want to touch briefly on It is therefore highly appropriate that this debate takes ambulances. The department is working closely with place at a time when, although a lot of progress has NHS England, Monitor and the NHS Trust Development been made, there is still much more to be done. We Authority to improve performance, and the Government need to ensure that mental health services are equipped have provided an extra £50 million of funding to to respond to people with all sorts of mental health ambulance services. However, these services are facing needs, ranging from preventive work and early intervention unprecedented levels of demand, with an additional through to crisis care. We need to make sure that 2,000 emergency journeys a day. Despite that, they are people who need mental health services, like those still providing high-quality care. We have introduced who use physical health services, can access care quickly, the ability to fine providers where handover delays at and have choices about what kind of care they receive. hospitals are unacceptable. Since then, those delays have gone down markedly. This Parliament has seen real progress in mental health at national policy level. We have made real I will respond to my noble friend Lord Greaves strides in awareness and public attitudes towards mental about the North West Ambulance Service, and I will health. I pay tribute to my right honourable friends also respond on the incident of the dead body, which Paul Burstow and Norman Lamb for all that they the noble Lord, Lord Hunt, mentioned in relation to have done in this area. Specifically, the cross-government the East of England Ambulance Service. strategy No Health Without Mental Health marked a breakthrough moment for mental health, and led the My time is up but I hope that noble Lords have way for the commitment to parity of esteem between been able to glean from what I have said that there is a physical and mental health which is now enshrined in great deal going on. We are gripping the issue. There is legislation and in the Government’s mandate to the NHS. no one cause of the increasing pressure on A&E, but What has happened as a result? Last year, building we have comprehensive plans, which I have just covered on the £400 million investment in talking therapies, in some detail, to relieve the pressure that we are the introduction of the first ever access and waiting currently seeing on our A&E services. time standards for talking therapies and early intervention 949 Mental Health[LORDS] Mental Health 950

[BARONESS TYLER OF ENFIELD] Even when people receive care, it is not always helpful. in psychosis, backed up by additional cash, was a When we are unwell we are often told to see our GP in welcome and long overdue step towards achieving the first instance, and 90% of people with mental parity of access to treatment for people with mental health problems are treated in primary care. But GPs health problems. The mental health crisis care concordat themselves admit they do not always have the training should ensure that no one is left without support in a they need to support people with mental health problems. mental health crisis. I think all primary care services urgently need GPs All localities have made declarations about working and practice nurses with the confidence and expertise together across agencies to improve crisis care, and progress to improve people’s experience of primary care. is already happening on the ground. For example, in Evidence shows that a choice of care improves Birmingham there has been a marked reduction in the treatment outcomes, but people often do not receive use of police custody as a place of safety. I am sure we the type of care they want. Talking therapy is the can all agree that a police cell can never be an appropriate preferred choice of a majority of people with mental environment for someone in a mental health crisis. health problems, but only one in seven receive it. That Of course, good mental health care is not just about is why I would like to see the right for patients to treatment, but about empowering people to lead better choose the type of treatment they receive enshrined in lives. Recognising this, we now have more peer support the NHS constitution—and for those who would rather workers in mental health trusts, and some 30 recovery have talking therapies than medication, there should colleges in place, to help people with mental health be a choice of evidence-based therapies available, backed problems develop and achieve their own goals for up by high-quality information. recovery. I suspect that we can all agree that children and We have seen a real sea-change in the way people young people’s mental health services are a matter of think about mental health. The MPs who participated real concern. Some 10% of children aged five to 15 have in that famous debate in the House of Commons, and a mental health problem, yet funding for CAMHS has spoke so openly and movingly of their own mental fallen by over 6% in real terms since 2010, and the health experiences, deserve much praise. Noble Lords commissioning of these services is far too fragmented, in this House have also been open about their experiences. resulting in too many children and young people falling The courage of those in such positions in being open through the cracks. Too often they are taken hundreds about their own mental health problems has undoubtedly of miles away from their home for treatment, or are raised the profile of mental health in Parliament—and, admitted to adult wards. The Government are committed I hope, made it easier for others to speak out. Meanwhile, to fund more children’s beds, which is welcome, and the Time to Change programme, England’s biggest have invested £150 million to improve support for anti-stigma programme, run jointly by the charities eating disorders. We eagerly await the report of the Mind and Rethink Mental Illness, is making a real Children and Young People’s Mental Health and impact both on public understanding and, perhaps more Wellbeing Taskforce—a very long title. Can the Minister importantly, on people’s experiences of discrimination. say when that is likely to be published? However, I am a realist, and despite this commendable progress, there is still a long way to go to achieve Of course, children’s mental health begins at birth. genuine parity for mental health in the NHS, and an It is critical to children’s mental health and resilience equal chance in life for people with mental health that they develop a secure relationship with their problems. After generations of missed opportunities, I primary care giver—but are we doing enough to support guess this is inevitable. So what are the remaining new mothers who develop mental health problems barriers that need addressing? To put it bluntly, funding during their pregnancy? More than one in 10 women for mental health services has faced disproportionate will experience mental health difficulties during and cuts compared with other services. Mental health services after pregnancy, which often go unrecognised and have always been known as a Cinderella service because untreated. According to the National Childbirth Trust, of their chronic underfunding, and mental health only 3% of CCGs report having a perinatal mental receives only 13% of NHS health expenditure, despite health strategy. I suggest that we could improve mothers’ making up 23% of what is called the burden of disease. access to mental health support by committing to Austerity has hit mental health services particularly including measurable objectives in the NHS mandate. hard. Mental health has seen real-terms cuts three years What else could and should be done? Schools have in a row. At the same time, demand is rising. By 2030 a golden opportunity to protect and promote children’s there will be approximately 2 million more adults with mental health and emotional well-being, at the same mental health problems in the UK than there are today. time as helping them achieve good educational outcomes. Early intervention services are often the first target I would like the next Government to commit to raising for cuts, but surely this is a false economy, because awareness of mental health and well-being among young people’s problems then get worse, and they need more people by ensuring that mental health and emotional intensive and costly support. With their new public well-being form part of an enhanced and mandatory health responsibilities, local authorities have a real part of the curriculum for all schools, irrespective of opportunity to prevent mental health problems developing their status. Yes, PSHE will be central to this, but such in their communities. It is encouraging that some an approach needs to be embedded in the mainstream 35 authorities now have a mental health champion. of the curriculum and the whole ethos of the school. However, research suggests that on average, councils As counselling can be an effective early intervention for are spending only 1.5% of their ring-fenced public young people experiencing mental health problems, and health budget on mental health. improve students’ attendance, attainment and behaviour, 951 Mental Health[15 JANUARY 2015] Mental Health 952

I would like to see all children in England having to ensure that mental health services for children and access to counselling, as children in Wales and Northern adults receive their fair share of funding and that Ireland do. metal health services see real-terms increases in investment People with mental health problems also face difficulties in each year of the next Parliament. finding and keeping employment—2.3 million people To conclude, much progress has been made in mental with a mental health condition are out of work. Almost health over this Parliament. The next Government—of half of those receiving employment and support allowance whatever complexion or, indeed, combination—have a are claiming primarily because of mental health problems, real opportunity to build on this momentum and yet research shows that the vast majority want to transform the way in which we approach mental health work. It is clear that back-to-work schemes have little in this country. It will take strong and courageous understanding of people with mental health problems leadership both politically and from within the NHS, and often assume that they lack motivation and willingness but the prize in terms of the nation’s well-being could to work. What we need is personalised and specialist be immense. I very much look forward to hearing what support to help them back into work, designed around other noble Lords have to say on the matter. I beg to the specific needs of people with mental health problems. move. Finally, parity of esteem needs to be genuinely inclusive and work for all, including those who find 3.02 pm themselves excluded or marginalised from society—those Lord Goodlad (Con): My Lords, I congratulate my who are isolated or that third of people living with a noble friend Lady Tyler on securing this debate and on long-term physical condition who also have a mental her and very wise words. health problem. Certain black and minority ethnic I speak from the perspective of one whose home for groups and people with multiple and complex needs the first 14 years of my life was a mental illness are often overlooked. People with a dual diagnosis—for hospital: the Lawn in Lincoln—founded by the Willis example, those who have been diagnosed with a drug family in 1819, following the successful treatment of and alcohol problem as well as with another mental King George III—of which my late father was for illness—are often denied access to mental health care many years the medical superintendent. People have on the ground that their substance abuse makes treatment said to me, “What an unusual upbringing that must impossible. When they are in crisis, they are more have been”—to which my only reply is, in the spirit of likely to be taken to a police cell than a health setting. Elvis Presley, “She’s a distant cousin but she ain’t too It should not have to be that way. distant with me”. An unusual upbringing it may have Charities working together as part of the Make Every been, but it was not unusual for me. As I look back on Adult Matter coalition, which I chair, have shown that those years, the memories of friendships with patients by effective joint working, better care can be achieved and staff remain with me as if it was yesterday. I see for people with complex needs. I am pleased that the that part of my life through rose-coloured spectacles. Department of Health is currently reviewing the 2002 My father wanted me to follow in his footsteps, as for guidance on dual diagnosis and hope that the continued some years did I. When that was not to be, grudgingly rollout of liaison and diversion schemes will also start he said that my upbringing had been as good a preparation to address the issue of drug and alcohol abuse. as any for life in the other place. The next Parliament should set out an ambitious To be serious, much has changed since those days, agenda for mental health. What should it be? Here is most of it for the better. Public attitudes toward my starter for 10: mental health is not just a health issue. mental health have changed enormously, led I like to Therefore, we need a truly cross-governmental mental think by government and parliamentary action, and health and well-being strategy embracing issues such certainly reflected in Westminster today. There is a as employment, welfare, policing and criminal justice, limited amount that the Government can do to influence housing, education and planning, as well as seeing public attitudes, and there is regrettably a very long Public Health England lead with the establishment of way to go. In many ways, although progress has been a national well-being programme championing preventive made over the past 50 years, the glass is at least half action. To lead this charge I would like to see a dedicated empty. One in four adults during their life is traumatised Minister for mental health with a cross-government by anxiety, depression, OCD, schizophrenia, dementia remit and, indeed, the Secretary of State for Health or another mental health condition. reporting annually to Parliament on progress towards The report of the noble Lord, Lord Layard, published achieving parity of esteem between mental and physical by the LSE, sets out some stark evidence. Mental health. illness is now nearly half of all ill health suffered by Next, we should rewrite the current system which people under 65 and it is more disabling than most discriminates against mental health and leads to physical disease. Yet only a quarter of those involved institutional bias, including: making the NHS constitution are in any form of treatment. The report of the noble fairer; introducing a wider range of access and waiting- Lord, Lord Layard, also pointed out that 23% of all ill time standards, along with entitlement to NICE-approved health in the UK—the largest single cause of disability—is treatments for mental health problems; revising payment mental ill health, yet only 11% of England’s annual systems to put mental and physical health on an equal secondary care health budget is spent on mental health footing; and better aligned NHS public health and services. social care outcomes frameworks which put much My noble friend set out some of the costs—£100 billion greater emphasis on mental health. Finally, and perhaps a year, including 70 million lost working days, additional most importantly, we should rebalance the NHS budget welfare benefits, lost tax receipts and the cost of treating 953 Mental Health[LORDS] Mental Health 954

[LORD GOODLAD] The exact causes of schizophrenia psychoses are avoidable illness. No price can be put on the suffering unknown. They are among the commonest and most of those involved. Most of the millions of people serious mental health conditions. Only one in 10 people suffering from depression, and children with behaviour who are diagnosed with schizophrenia is in work. problems, received no treatment, despite NICE’s Stigma still attaches to the condition. The human cost recommendations. I hope that the Minister will be able is colossal, the financial cost in terms of resources to indicate how she thinks local authorities and clinical used is enormous and the distress to sufferers and commissioning groups will deal with mental health their families is inconceivable. Schizophrenia affects care commissioning plans in the future. about one person in 100 at some point in their life. It is estimated that it costs the UK taxpayers about £2 billion There is, of course, support for the glass half full a year in care and treatment, together with the vast view of the situation. Premature death of people with personal cost, both financial and in terms of suffering, serious mental illness has declined, although it is still for patients and family members. The global drugs bill too high, particularly for schizophrenia sufferers—20 years. alone is estimated to be £12.5 billion a year, not The quality of life of many mentally ill people has including hospital stays. improved, as has the experience of healthcare. The Royal College of General Practitioners has committed So where are we now? Last year the Harvard Gazette to making improved care for people with mental health published an article saying that there had been little problems a training priority. I well remember as a innovation in drug development for the treatment of child accompanying my father in his car as we followed schizophrenia in more than 60 years. It went on to the tail lights of general practitioners in rural Lincolnshire report on efforts to identify, on domiciliary visits. Perhaps this will not have to “more than 100 locations in the human genome associated with happen so much in future, and reference to community the risk of developing schizophrenia”. health teams will be quicker. The hope is that this might lead to the development of new drugs. Despite the pressing need for treatment, I do not doubt the good intentions of the Government medications currently on the market treat only one of and I pay tribute to the recent work of Jeremy Hunt, the symptoms of the disorder—psychosis—and do Norman Lamb and Simon Stevens. The Government not address the debilitating cognitive symptoms. Treatment have legislated for the first time for parity of esteem options are limited because the biological mechanisms between physical and mental health. The intention is underlying the illness have not been understood. The that most patients needing a talking therapy will be sole drug target for existing treatment was found guaranteed treatment within six weeks, with a maximum serendipitously, and no medications with fundamentally wait of 18 weeks, and that patients experiencing their new mechanisms of action have been developed since first episodes of psychosis will receive treatment within the 1950s. two weeks. Let us hope that these aspirations result in action—fine words butter no parsnips. Great work is going on in the United States, financed by foundations and philanthropic donations, and there The children and young people’s mental health and is an international project on genomes. On this side of well-being task force has been established. The mental the Atlantic, mental health has always been a poor health crisis concordat has been signed by 20 national relation in the charitable sector, with the exceptions of organisations. The Government have announced that Alzheimer’s and autism. Mental health charities will everyone who receives mental health care should have not, in the foreseeable future, be able to compete with a named, accountable clinician. Mental health has physical health charities, such as those devoted to now been made part of the new national measure of cancer. That puts the Government in the firing line. well-being so that it is more likely to be taken into The Institute of Psychiatry at King’s College London account when government departments are developing has been given £5 million for a project, but nothing and implementing policy. will come from that, I understand, for a decade. So there we are: little progress over 60 years. My late father was one of the pioneers of day care. I am not sure that, seeing the outcome of care in the I hope that the Minister will give me some comfort community in some of our inner cities, despite the deep that the Government understand the urgency of further commitment of carers, social workers and health workers, research into the causes of schizophrenia psychoses he would be convinced that an adequate solution has and the crucial role of the Government and the NHS been found. What is required is a holistic approach, in promoting it. Mental health has been described, co-ordinating social care, general practice, liaison with justification, as the Cinderella of the NHS—but psychiatric and mental health specialist organisations, let us remember with hope that Cinderella hadahappy housing and education authorities and prisons. What ending. we need is not just talk in Whitehall but action. 3.13 pm The Health and Social Care Act for the first time in statute places a duty on the NHS to promote research. Lord Storey (LD): My Lords, I am very grateful to It is in the context of research that I turn to schizophrenia. my noble friend Lady Tyler for securing this debate. I pay tribute to the work of charities such as Rethink, With three children in every classroom experiencing Mind and SANE—Schizophrenia, A National Emergency mental health problems, teachers need the right training —founded and so ably run for many years by Marjorie and support to identify issues early and ensure that Wallace, and of which I was a director for some time. young people get the help that they need to recover There is now a schizophrenia audit, and depressing and thrive. I would like to use my time to focus on reading it will make. mental health care and support in schools and on the 955 Mental Health[15 JANUARY 2015] Mental Health 956 creation of an ethos that does not ignore mental tackle the underlying causes and contributory factors health problems but has the readily available resources of mental illness. In doing this, we can help pave the and support to help children and young people proactively. way for improved physical and mental health for our Making such support available and accessible will not children and, further still, support opportunities for only be life changing for the pupil but head off later all young people to learn effectively. problems and lead to later savings in human and We all believe that education and care for young financial costs. people should provide the best start in life for every child, A recent survey by CentreForum, as part of its regardless of their background, their living circumstances mental health commission, concluded that 54% of or the socioeconomic status of their parents. Over the head teachers found, years, we have seen that early years and childhood “mental health services ineffective in supporting pupils”, experiences can have profound and long-lasting while, at the same time, mental health issues are on the consequences for an individual’s health. We know that rise in schools. Confidence in child and adolescent mental the life chances of a child are greatly influenced between health services, or CAMHS, was even lower among the ages of three and five, and that their future chances head teachers at pupil referral units, at 37%, and at are often predicated on their development in the first special educational needs schools, at 43%. Sixty-five five years of life. If undiagnosed, mental health problems per cent of schools do not assess the severity of mental can continue to affect young people throughout their health needs among their pupils, yet where such screening life, affecting their personal development, educational tools are available 85% of schools reported it to be attainment and overall well-being. effective. During my time as a head teacher, it was often clear As the Deputy Prime Minister rightly said, to see that children from disadvantaged backgrounds were arriving at school, on their very first day, already “Schools would never ignore a child with a physical health problem, so the same should be true of mental ill health too”. a few steps behind their more fortunate peers. This had severe implications for their learning capacity, He went on to say: their ability to interact with classmates and even their “Early intervention is crucial in tackling mental health problems”. literacy and numeracy attainment levels. While we So early identification and the provision of effective tend to presume that such disadvantage is primarily support systems are paramount in dealing with mental caused by social and material circumstances such as health problems. However, two-thirds of local authorities poverty, family structure and demographics, all too have cut their child and adolescent mental health often we neglect the role that mental health plays in services, and, unfortunately, the largest cuts have been child well-being. Yet around one in 10 of the nation’s to early intervention services. children are affected by mental health issues, with significantly higher levels evident in certain groups of We need to provide alternative solutions which benefit young people. families and young people affected by mental health problems and which take into account the existing Many education providers, parents and children responsibilities of teachers. For example, the Well alike find themselves confronted with the challenging Centre in Streatham, south London, provides drop-in realities that are presented by mental health care provision, one-to-one counselling, structured therapy, peer group and teachers are increasingly placed under considerable work and digital services. Since CAMHS budgets have pressure to take responsibility for such demands. It is been reduced, we must look to investing in alternatives, vital that education, youth services and healthcare such as linking up schools with these youth health providers have the capacity to work together in identifying centres in order to reach out to young people who may mental health problems at the earliest possible point, not have the confidence to ask for themselves. in order to offer early diagnosis and professional, collaborative support. As a Government, we have been successful in introducing free childcare for increasing numbers of Furthermore, early diagnosis and support for affected disadvantaged children, implementing education, health children and families can significantly reduce costs to and care plans to enable quality and consistency for all society in the long term, as well as empowering those young people with special educational needs and providing who are affected to help themselves. Targeted interventions for further integration of crucial services that affect and the provision of integrated services at an early age the well-being of children from birth throughout their are key strategies that have been proven to help reduce education. However, mental health care for under-25s low educational attainment, unemployment, crime, still makes up only 6% of the overall NHS mental and anti-social behaviour in the long run. The benefits health care budget. We must therefore continue to of interventions during the early years of childhood work towards preventing the suffering of those children are therefore realised both in the short term and over with emotional, behavioural and psychological problems. the entire life course of the child. As such, we should I believe this can be achieved by creating the conditions see the provision of mental health care in the foundational that allow for early diagnosis. It can also be achieved years as a valuable investment. by addressing the factors that can contribute to the We need to look specifically at the treatment of stigmas surrounding mental health and maintaining mental health for young people, and make sure that high standards of mental health services for every this treatment is accessible to high-risk groups. We child and family. It is our responsibility to enable every need to ensure that there are flexible, sustainable and child to receive the best possible start in life. The only workable plans in place for young people affected by way that we can safeguard this right is by ensuring that emotional illness from birth, and that care continues education and healthcare services are equipped to to be accessible throughout their lives. 957 Mental Health[LORDS] Mental Health 958

[LORD STOREY] accessories boutique as customers would not be Finally, we need to cut right to the core of the issue, forthcoming. Instead, my wife was recruited and she and act on the advice of medical professionals who ran our boutique full time while I ventured onwards emphasise the influence of perinatal mental health on looking for further trading opportunities. a child’s upbringing. If mental health problems are We were determined to stand on our own feet and identified and treated quickly, efficiently and effectively, to earn our living without committing to the state for many of these serious long-term human and economic benefits. In 1977, I established a wholesale fashion costs can ultimately be avoided. jewelry and accessories business, and through its success I thank noble Lords her#e for their dedication in I built up a sound property portfolio. The company is debating the importance of mental health care provision, still trading strongly. and urge us all to consider further investment and Through my selfless and entrepreneurial approach accessibility in services for young people, as a crucial to business, I have always remained actively involved way in which we can prevent emotional disturbances with many charities, social action projects and social from affecting the life chances of children from all initiatives. This is in keeping with my firm belief that walks of life. It is reassuring to see the progress that we people should contribute back to society to help others have made in firmly placing mental health care provision in less fortunate positions. Service to charitable and on the agenda, and I look forward to seeing the voluntary works has always been deeply rooted in my Government, local authorities, trained professionals, ethos on life. Service to mankind and praying for the and parents continuing to uphold the highest standard welfare of all is one of the principal pillars of the Sikh of care for young people. religion. As Dame Sue Bailey, chair of the Children and I have been treading on this noble road to serve Young People’s Mental Health Coalition said: others from a very young age. Over the years I have “School is a critical environment where young people should championed community work and have held posts be able to flourish across all domains of their lives. The gaps and concerns this report so clearly identifies reinforce the need to including justice of the peace, general commissioner provide young people with the help, support and self-empowerment of income tax, serving on the Middlesex Probation to develop and maintain resilience to stay mentally healthy in Committee and the Home Office Advisory Council on order to achieve and develop to their full potential”. Race Relations, being a member of the board of I say, “Hear, hear”. visitors of HM Prison Pentonville and mentor to the Prince’s Trust youth business trust. 3.22 pm I thank my noble friend Lady Tyler of Enfield for putting down the Motion for today’s debate on the Lord Suri (Con) (Maiden Speech): My Lords, I importance of mental health care provision. Good would like to thank all noble Lords on all sides of the mental health, as well as good physical health, is House and the staff of this House for their immense essential in enabling us to contribute to the socioeconomics kindness and friendliness in making me so welcome to of society. The relevance of today’s debate endorses this honourable establishment, navigating me through over five decades of my contributing to the community, the protocols and giving me advice and guidance to voluntary services and charities, starting in Kenya and enable me to fulfill my new role in this House. In continued in Britain with unremitting devotion. particular, I would like to express my heartfelt gratitude and thanks to my supporters, my noble friends Lord During my involvement as a voluntary associate at Popat and Lord Leigh of Hurley, for introducing me HM Prison Wormwood Scrubs, prior to commencing to your Lordships’ House. my voluntary career in probation and magistracy, it Little did I know back in 1974 when I emigrated was evident that poor mental health and the lack of from Kenya to the UK that I would be bestowed with mental health care provision hindered people from this great honour to work alongside your Lordships to making the journey to recovery. I would like to share continue contributing towards building a cohesive with your Lordships a particular case where I supported multicultural society in this country. I am humbled to a fellow Sikh who was imprisoned for having committed join this House and family, which strives to represent murder. This individual, who I will call Tej, which is the diversity of the population in this great nation. I not his real name, was further isolated in this environment am the second turbaned Sikh who has been elevated to through lack of communication, as he was not literate the upper House. This great British institution has and unable to converse in English. Tej was fluent in his taken a praiseworthy step by bringing into its fold mother tongue Punjabi, which limited his interactions people of different faiths. and intensified his isolation and sense of hopelessness, contributing to his depression and placing him at a I have spent all my working life as a businessman, high risk of suicide. with a career that started in Kenya as an importer of educational supplies. This was the start of my liaisons Through my weekly visits, we established a rapport. with United Kingdom, dealing with long-established Over time, Tej was persuaded to join literacy classes in British publishers. In 1974, having decided to migrate the prison, which reduced some of the isolation and with my family to the United Kingdom, I pursued my frequency of suicidal thoughts. Through continual business ambitions and challenged myself to a new support, Tej was transferred to a prison nearer to his business venture. I decided to enter into the fashion home town in order to rebuild his relationship with his accessories trade, and much to my disbelief I encountered family, who had severed all links with him. a harsh reality not previously experienced. The estate My work within the prison environment led me to agents who offered me business premises to rent strongly visiting the young people at Feltham young offender advised me not to be the front man in a fashion institution. These young men were institutionalised as 959 Mental Health[15 JANUARY 2015] Mental Health 960 a result of their criminal activities, with an outlook of Much has been said in the past two years about parity further poor outcomes in the future, and once again of esteem. It has almost become a slogan. Whenever the state of their mental health contributed to the anybody speaks about mental health, whether they sense of despair and low aspirations. It could be said work in the mental health field or in health services that the young people were like tender green shoots waiting generally, they talk about parity of esteem. It means to be trained along a framework that would build on different things to different people, but it probably means their aspirations. They would acquire new skills and nothing at all to the public, the patients and their families. knowledge through education, which would be utilised Turning the slogan into the practicality of what it in a productive way to reduce the cost to society. should be will make the families and patients feel what It has been important to me to have put my business parity of esteem for mental health is. skills into the field and mentored young people through The duty to ensure parity of esteem was enshrined the Prince’s Trust youth business trust, sharing my in the Health and Social Care Act 2012, by securing knowledge and experience of starting businesses, thereby improvement, giving them the tools to take the first steps in building “in the physical and mental health of the people of England, a new life and contributing to their community but and … the prevention, diagnosis and treatment of physical and also to the economy of the country. mental illness”. Education has a multidimensional impact on every This duty provided a legal backing for the commitment member of society and should be for all to take on to parity of esteem within the Government’s 2011 board as a lifelong journey of learning, discovery and mental health strategy, No Health Without Mental character building. In 1956, I had the privilege of Health. However, parity of esteem in mental health meeting the President of the Republic of India at that refers to a broad range of issues which reflect the role time, Mr Sarvepalli Radhakrishnan, who was visiting of mental health across all the different areas of our Kenya to open the Mahatma Gandhi academy. In his lives. “Parity” therefore refers not only to equivalent speech, he emphasized that, although he was an academic, levels of funding for mental health but to a whole range philosopher and statesman, he still considered that the of areas which affect our mental health—in and out of world was his school. This analogy has influenced my mental health services. Furthermore, parity of esteem thinking on education, which has brought me here needs to address “parity within parity”. By that, I today. I am sure that the provision of mental health mean the inequalities within mental health in terms services will remain high on the agenda of this House. both of the differential prevalence of mental ill health within marginalised groups and of achieving fair and 3.31 pm equal access to services. Lord Patel (CB): My Lords, it is a great pleasure on Parity of esteem and its applications may come in behalf of the whole House to congratulate the noble different forms. When we look at parity between physical Lord, Lord Suri, on his maiden speech. As he mentioned, and mental health, we see a persistent mortality gap he is the second Sikh to enter the House of Lords. He between people with a diagnosis of bipolar disorder or has also represented 450,000 Sikhs through his honorary schizophrenia and the general population, as has already secretaryship of the Sikh forum. No doubt, he brings been mentioned. Measuring the parity gap may focus his experience and wisdom from that time of representing on the excess mortality that patients with mental ill Sikhs who contribute so widely to this society. He health suffer. They die 15 to 20 years earlier than those who evaluated the many contributions he has made to the do not have mental ill health. The parity measurement wider society in faith and commerce. He has also been gap may also refer to the burden of disease. One-quarter a magistrate for over a decade, so he has many talents. of the NHS disease burden and disability is due to Today he has demonstrated his commitment to mental mental health. health and his experiences in supporting prisoners. We The parity gap can also be measured by the treatment welcome him to the House and look forward to hearing gap; that is, the number of people who may have a from him on many occasions. condition, but do not get the treatment for it. It is as I am going to concentrate mainly on what parity of low for common mental disorders as 24%, compared esteem means. I declare two interests. I am an honorary to 85% for a broken hip. The parity gap in treatment is fellow of the Royal College of Psychiatrists, not because therefore considerable. I have contributed much to mental health but for In cases such as schizophrenia, the gap in the reasons I do not understand. The second is why I am general population is widening among certain groups. interested in parity of esteem. Some noble Lords will Problems such as diagnostic overshadowing mean that remember that, during the debate on the Health and the physical health needs of people with mental health Social Care Bill 2012, I spoke on an amendment to problems are not sufficiently investigated. Only recently give mental health parity of esteem. I was the third have waiting time targets been introduced for psychological name on the amendment. The first name was that of therapies, already mentioned, in contrast to long-standing the noble and learned Lord, Lord Mackay of Clashfern, physical health waiting times. In mental health, we and the second was that of the noble Baroness, Lady currently see one in 10 people waiting up to a year to Hollins, one of the most respected psychiatrists in the receive treatment, particularly for psychological therapies. land. Neither of them could attend that day and it was It is still hard to get the full range of NICE-recommended by chance that I called a vote which was won by four psychological therapies—only 15% of people are offered votes. Parity of esteem is now in the statute because of the full choice of approved therapies. those four votes and the fact that the other place did Mental health must also have an equal footing with not overturn it, presumably because of the wisdom of physical health in public health strategies. There is the coalition Government—I emphasise coalition. clear evidence and a convincing economic case for 961 Mental Health[LORDS] Mental Health 962

[LORD PATEL] opportunity also to congratulate my noble friend Lord investing in public mental health. Parity in funding Suri on a very fine contribution to this debate. I am has already been mentioned. Mental health has been aware of the considerable expertise that lies within historically underfunded compared to physical health. your Lordships’ House on the issue of mental health, At present mental health accounts for only 13% of so it is with some humility that I approach the subject—but NHS spend on health, despite accounting for 23% of also with a conviction that there are neglected issues, the burden of disease. Mental ill health is also the and it is at these that I will pitch my comments. single largest cause of disability in the UK. Investment in mental health research is key to advancing parity of My overriding concern is with the drivers of our treatment for mental health. high levels of mental disease—I use that term deliberately. When a nation as great as ours has prevalence rates of Despite mental health problems affecting one in one in six adults at any one time suffering profound four of us, funding for mental health stands at less mental distress, as well as one in 10 children and young than 6% of all health research funding. A commitment people, this surely reveals an underlying and widespread to parity in funding must be consistent across government societal dis-ease. Mental illness does not just happen: and health services. In 2014 Monitor announced a very often there are preventable causes, and this is where funding decision to cut mental health services by 20% a new wave of public health effort needs to focus. more than NHS hospital trusts. I know that Ministers did not approve of that, or like it, but none the less, the We have just heard from the noble Lord, Lord funding was cut. Reports found that 77% of clinical Patel, that mental health is the single largest cause of commissioning groups have frozen or cut their children disability in the UK. It is responsible for a quarter of and adolescent mental health services budget between the disease burden and 13% of the NHS budget. 2013-14 and 2014-15, alongside 60% of local authorities Although that disparity will, I am sure, be the concern in England having cut or frozen their budgets since 2012. of others here today, I would ask us simply to pause Mental health services must see real-terms funding for a moment and consider how much is already being increases to be equipped to meet increasing demand spent, and how much human misery it represents, and unmet needs for both adults and children. Parity rather than simply asking for more money. Moreover, within mental health is essential to ensure that anyone it is a fraction of the overall cost to society, estimated who experiences a mental health problem has fair and by the Centre for Mental Health at £105 billion every equal access to treatment, especially among marginalised year. We simply cannot afford these eye-watering costs groups. This includes adapting services to make sure and loss of human potential, so I emphasise the that they are inclusive of all. There are no hard-to-reach importance not just of treating mental illness but of people—there are only hard-to-reach services. preventing it from occurring—or recurring. One way to address this is through the coproduction It is now widely accepted that we need to adopt a of services. Outcomes for people with complex needs bio-psycho-social model to understand the causes of and from minority-ethnic communities are unacceptably poor mental health. To put it more simply, it is not just poor. This also means that mental health services should about genetic predisposition, it is also about the kinds be appropriate for people across the life course, from of families and communities people grow up and live children to later life. Young people need to be given in, the character of schools and workplaces, and societal the skills to address life’s challenges with the confidence attitudes. If we are serious about preventing mental to manage their well-being, and older people need dis-ease, we have to step back and ask some fundamental services that are accessible and appropriate. Health and searching questions about the kind of society we inequality increases the likelihood of experiencing want our children and grandchildren to be born into, mental ill health, and addressing inequalities can promote grow up in and grow old in. First and foremost, it the population’s mental health. should be one where the unique human worth of every Parity and stigma is another issue, which some noble individual is appreciated and which places a very high Lords have already mentioned. Nine out of 10 people premium on relationships. With this as a backdrop, I with a mental health problem experience stigma and will now unpack what is meant by a bio-psycho-social discrimination. It is essential that the work of the model, highlight key issues in these three areas where Time to Change programme continues to improve we need to see profound cultural change and recommend public and professional attitudes to mental health. It how this might be achieved. is essential to eradicate the stigma surrounding mental health in professional health settings, as stigma affects First, in terms of biological drivers, drug misuse the esteem in which professionals are held. can be both a cause and effect of mental illness. I have two questions for the Minister. First, what The British Journal of Psychiatry reports that 80% of steps are the Government taking to reduce the imbalance first-episode psychiatric disorders, schizophrenia or in the provision of publicly funded research into mental schizophrenia-like illnesses occur in either heavy or health? Secondly, what are the Government’s plans to dependent cannabis users. Individuals using cannabis ensure that mental health services are appropriate for are doubling their risk of developing schizophrenia. people across the life course? This undeniable risk to mental health is why I am so strongly opposed to legalising cannabis. We need to send a clear and unambiguous signal to our young 3.42 pm people that drug use, which many of them think is Lord Farmer (Con): My Lords, once again the noble somewhat cool, is strongly implicated in the development Baroness, Lady Tyler, has secured a debate of vital of mental health problems—which everyone would national importance, for which I thank her. I take this agree are deeply uncool. 963 Mental Health[15 JANUARY 2015] Mental Health 964

Similarly, I consider it highly appropriate for the about them. Morgan and Fearon, researchers at the Government to fund information campaigns such as Institute of Psychiatry, found that family breakdown Time to Change, which the noble Lord, Lord Patel, and early separation from a parent had a clear effect just referred to, which address the stigma of mental ill on rates of psychosis in the African-Caribbean population, health. This deters many people from coming forward where there is a higher likelihood of growing up without for treatment when problems are at an earlier and both birth parents. Insights such as these make it even possibly more manageable stage. Stigma has to be seen more imperative that we address family instability, alongside the second area of social factors, which which affects poor communities of whatever ethnicity include isolation and loneliness, unsupportive and hostile particularly badly. communities, poor housing, inadequate healthcare, Honesty requires us to admit that one’s birth family financial poverty and sexual or racial discrimination. can be at the root of mental health problems. The first The risk of psychosis among Black African-Caribbean onset of mental health problems is commonly in childhood groups is seven times higher than among the general or adolescence. Half of all lifetime cases have started population. They are more than twice as likely to commit by the age of 14. A prevention agenda has to make suicide and three times more likely to be admitted to parenting support a major priority. There is a great hospital. They are more than 40% more likely to be prize in helping families repair and its members become sectioned—in other words, detained without their consent a resource to each other. Families can also be at the under mental health legislation. heart of the solution. Recent polling found that more than half the people with mental health difficulties Prevention of hospitalisation is a worthy goal for received “a lot” of help and support from their families. financial as well as therapeutic reasons. I will describe This was more than those who cited their GPs and how voluntary sector organisations can do just that. three times as many as those citing psychiatrists. We Recent polling found that, of those with experience of urgently need better family functioning to be included hospitalisation, more than half did not feel the settings in the national Public Health Outcomes Framework. and facilities aided recovery; 44% felt that the treatment This would mean that local authorities had to ensure they received was fairly or very ineffective; and 14% felt that couple support and family therapy were offered very unsafe. People who feel unsafe in hospitals are as standard—for example, in the family hubs for which not necessarily simply nervous types. I have heard how I am pleased to hear there is growing cross-party returning soldiers with post-traumatic stress disorder support. consider UK hospital settings more dangerous than the Iraq or Afghanistan front line. It should not be There must also be greater recognition of the role possible to spend one’s days in a mental health ward, that supportive communities can play because not hunched up on the floor against the wall, alone with everyone lives in a family. The black-led churches are one’s troubling thoughts, while nurses busy themselves on the front line of preventing mental ill health. with bureaucratic tasks. One study found that only Organisations such as the African Caribbean Community 16% of patients’ time was passed in what is loosely Initiative in Wolverhampton are helping to keep many termed “therapeutic interaction”. The remaining 84% black people out of hospital by inspiring confidence in was characterised by a distinct lack of purpose. mental health professionals that their patients are safe in their hands. I understand how much pressure mental health professionals are under. The Mental Health Act That is what we all need for well-being and good Commission found that nurses were unhappy about mental health—reliable relationships, whether in families, being too busy to develop therapeutic rapport with the workplace, healthcare settings, faith communities patients. The commission concluded that all hospital or during our retirement years. The Government have wards caring for detained patients should ensure that a clear role to play by pursuing policies that will they have “protected engagement time” with nursing strengthen rather than undermine these relationships staff. I endorse that recommendation. Everyone needs and the innate desire and ability that people have to to feel that they are significant, that they are worth look out for one another. I am my brother’s keeper. spending time over and that they belong. This leads me to a third category of psychological 3.54 pm factors. These include insecure attachment to parents Lord Addington (LD): My Lords, the first and very in infancy, sexual or physical abuse in childhood, pleasant duty that falls to me today is to welcome inadequate, neglectful or abusive parenting and being from these Benches—from this part of the coalition—the bullied or harassed—in other words, continually feeling noble Lord, Lord Suri. A good start has been made unsafe. This is possible even in the workplace, because and we look forward to what is to follow. of one’s own line manager. Bereavement, lack of any When I put my name down to speak in this debate, close confiding relationships and family breakdown it was because of something which is blindingly obvious are also factors. I keep promising myself that I shall give to somebody such as me who has dealt with disabilities a speech in your Lordships’ House in which I do not for many years. Somebody who is disabled is likely to mention family breakdown. It is getting very difficult undergo slightly more stress than somebody who is to do that because of its myriad, knock-on effects. not. Stress seems to be one of the key factors, whether There is a strong evidence base about the impact on it comes from family, or social background. With a child of losing one parent, which sadly goes beyond disability—that is, not being able to function—there is the financial or emotional and reaches into the heart going to be more stress and there are probably going of this debate. According to Professor Richard Whitfield, to be slightly more mental health problems there. It is for a child to surface, somebody needs to be crazy a little bit of a no-brainer. 965 Mental Health[LORDS] Mental Health 966

[LORD ADDINGTON] them and getting the system to recognise them. I do However, many of the speeches today have touched not say that the Department of Health is going to upon that. I always regard people as being a cocktail become any worse but without training, without pushing of a series of events, circumstances and chance and all to make sure that it is kept under surveillance to do so, these things come together in individual people, making it will not be any better. That is because it will think—and them slightly more likely to go in certain directions or it may be right—that it has enough to do as it is in react in certain ways. If you are a person with a disability, dealing with the duties in front of it. That will be so who struggles to access certain parts of society or to unless you place a duty on that department to become communicate, or to achieve as your peers would, it is aware or find out and make sure that, when it does an almost dead cert that you will be slightly more not, it must report back the reason why. That is both vulnerable and there is a slightly higher probability to reinforce the fact that it is a duty and so that the that mental health problems will occur in your life. systems are in place to make sure that it does not Virtually all the reading I have done backs this up, and happen again. If we do not undertake this type of everyone who has spoken to me has said so. activity, we will reinforce this cycle of people who are On the issue of dyslexia—the noble Lord, Lord underachieving. Farmer, might have said that he always talks about We will not address the selfish interest of society family breakdown; I am trying to find a subject where properly unless we become aware of this. We will have I cannot find an aspect on dyslexia and my connection a whole section of our society who we are encouraging to it and I have failed so far—it is well known that by saying, “Youshould go out to work and become fully dyslexics get slightly more stressed in the classroom active”. Indeed, we are making that a legal duty; all and that mental health problems will be that little bit Governments in the last few years have done this, saying, more common among them. However, they are not “You should get out and earn. We don’t want you the only group. When it comes to autism, 70% of sitting at home”. But unless we make sure that they young autistics are reckoned to have a mental health are supported the whole way round they are going to problem. That 70% equates to 1% of the population. fail in this, effectively because they have no option. The on-costs of not dealing with this in the best way are massive. To deal with just those two groups at first, If we look at other areas where bad mental health is most of those have economic capacity and the capacity prevalent and disabilities, often hidden, are common, to work, but that will be greatly reduced by not giving we could look at prisons. I thought that I might say a them support and help throughout. By not taking few things on that, but I looked at the speakers list, action, we are effectively creating that little bit more of and then across the Chamber, and saw the noble Lord, a burden or drag on society and making people’s lives Lord Ramsbotham. Whether or not he chooses to more unpleasant. take a bite out of this particular apple today, I will always defer to him on that issue, but we should look All those whom I have spoken to in this field say to the examples of how we get such “co-morbidity”, that there is one problem that the medical world—and, which I think is the correct term here—personally, I indeed, the rest of the world—has in dealing with this. think the word means that you are dying twice and When they see a person who has a disability, whether quickly, so perhaps we should say “co-occurrence”. obvious or hidden, they tend to see the disability first For an example of where co-occurrence leads to failure rather than think about what might be going on and expense, you need look no further than prisons. behind it. I remember that we had a long debate in this This is particularly true of conditions such as autism Chamber about how the deaf, or British Sign Language and other hidden disabilities. In all the cases at which I users, access the health service. How much more difficult have looked, not looking at the whole person or beyond is it for a doctor or a professional to establish that the initial aspect will lead you into trouble. mental health provision is required when they cannot understand the person, who has to be translated through I am in grave danger of reciting all the facts that I somebody else? There are sometimes difficulties there, have about the problems in these areas, such as that so how do we address this? people with a learning disability were traditionally If we are serious about taking this very sensible and seen as not being worth indulging with a talking cure good step forward of giving parity to those with —because it would not do them any good because you mental and physical health problems, the first thing we cannot help them anyway. However, they can become must do is surely to ensure that all those in the health more independent and they can get out there. Unless service are at least aware that this possibility is there. I we address the idea that we give all groups in this am talking about everybody not becoming expert and sector as much help as we can, we will fail. In failing, trained but being aware that there might be a problem, we pass on costs to society and to those in families which they should assess and move on from. A degree who end up looking after these people. of awareness can be achieved fairly easily, simply by Carers have a high occurrence of mental health stating, “By the way, in certain groups certain types of problems. They are under stress. We must start to cut conditions are more frequently occurring”. Once again, this Gordian knot or break the circle—the clichés roll that is a no-brainer, but what is required to move you on—and address this by saying that you must look for on? this problem, think of a strategy and get into the system Regarding the education sector, my noble friend some awareness of those who are using it. We must Lord Storey mentioned how the Department for also make sure that the medical profession is prepared Education deals with mental health. In education, we to take advice on this subject from outside. Unless we have for a long time dealt with special educational needs, do these things we will not ultimately get the full but most of the problem that we have is in identifying benefits of a very sensible strategy. We must exercise 967 Mental Health[15 JANUARY 2015] Mental Health 968 our peripheral vision and think laterally on this, because means that there is something wrong. If you can identify it will touch every aspect of society. If we do not, the it and do something about it, that could mitigate the strategy will not work. bad behaviour or whatever it was that led them to commit their crime. It has always seemed to me that 4.02 pm the proper assessment of whatever mental health problems people come in with has been sadly missing. It has Lord Ramsbotham (CB): My Lords, like other noble always been said that treatment in prisons should be Lords, I congratulate the noble Baroness, Lady Tyler, the equivalent of treatment in the NHS, but unless the on obtaining this debate and for the way in which she assessment is right, you will get no treatment that is introduced it. I also echo her tributes to the Ministers worth the name. The importance of partnership in Paul Burstow and Norman Lamb for their work in the that is that time in prison is when various organisations mental health post. I agree entirely with her call for a could get to grips with whatever physical or mental cross-government mental health and well-being strategy, health problems a person has and use the time to which has been long needed. advantage. That must be a public health benefit when When I saw the list of speakers, I knew that I did people are released. not need to say anything about learning difficulties An improvement that came from the Health and and disabilities, as the noble Lord, Lord Addington, Social Care Act was placing commissioning for offender was there. Every time he stands up I realise that we are services under NHS England. Having heard about it, I listening to someone who not only uses his experience looked forward to the development of local health wisely, but is worth listening to because of the practical and well-being boards on which I hoped the criminal things that he always adds. I also welcome the noble justice system would be properly represented. However, Lord, Lord Suri. I was very glad to hear him concentrate I am concerned about the inconsistency of these boards, on elements of the criminal justice system, particularly and it worries me that they meet only quarterly. If they Feltham. Not surprisingly, that is what I propose to do are to help the criminal justice system in particular, as well: concentrate on the criminal justice system. meetings need to be more frequent and consistency Before I do, I declare two interests, first as vice-president between what happens in one health and well-being of the Centre for Mental Health, which has done a board area and another needs to be developed. great deal of work in the reissuing, in particular, of Having said that, like the noble Lord, Lord Goodlad, carefully researched reports, which have provided everyone I welcome the foundation of the mental health and with a great deal information on the whole system and well-being task force. It is a healthy development in the problems within it. Secondly, I am chairman of the this area. I particularly welcome its children and young Criminal Justice and Acquired Brain Injury Interest people sub-committee. The five all-party groups that Group. This is doing a great deal of practical work, are studying children and young people’s mental health and showing up some of the shortcomings in the and emotional well-being are going to meet the sub- criminal justice system in identifying and assessing the committee. That is particularly relevant for one of my problems that people have, and what needs to be done current concerns, which is that I do not think that all is about them. well within the criminal justice system. I am currently Echoing the noble Lord, Lord Goodlad, I should very concerned that due attention is not being paid to explain that I was fortunate enough before becoming the mental health needs of detained children. That is Chief Inspector of Prisons to chair the hospital at confirmed by the proposal to build a secure college for Hillingdon, which had a very large and extremely well 320 of them under the age of 18 in which the emphasis run mental health unit. The director said, “You must is to be on education which, it is alleged, is the key to a train as a lay assessor or otherwise you’re no use to reduction in reoffending. What is being proposed is this hospital”. I am extremely glad that he did because totally at variance with the advice of those who have he gave me an insight on which I have based all my any experience of the characteristics, problems and subsequent experiences. needs of the children who will be sent there. The scant When I took over as chief inspector in 1995, I was acceptance of this advice is reflected in the insistence extremely alarmed to find that healthcare in prisons by the Secretary of State for Justice that educational was not the responsibility of the National Health outcomes are more important than the selection of Service. It seemed utterly absurd because people came suitable staff. How wrong he is: staff are absolutely from the NHS and went to the NHS. The staff were key to anything that is done. not NHS-trained, and I discovered that only 10% of I have two other concerns. One is purely to do with medical officers in prisons were qualified to act as GPs the criminal justice system and the other with the in the National Health Service. I set out to try to do linkage between that system and people outside it with something about it. That aim was achieved in 2003, mental health problems. My first concern is probation. eight years later. I was very glad that we had quicker- There are 200,000 people currently serving community minded people acting for the country during the Second orders. Only 20% of CCGs believe it is their area World War. team’s role to commission healthcare for those on Fairly soon after that, in 1998, the Office for National probation. We have just got that figure through the Statistics published psychiatric morbidity figures for Freedom of Information Act. Only 1% of CCGs are all our prisons. It produced the figure that the noble currently directly funding general healthcare in probation; Lord, Lord Addington, cited: 70% of prisoners have 40% have nothing to do with it; the remainder have one or more identifiable personality disorders. That does some association with it. Only 6% of mental health not mean that they are certifiable under the Mental trusts provide services for probation and the majority Health Act, although at least 500 a year are, but it of that takes the form of a half-day advice clinic once 969 Mental Health[LORDS] Mental Health 970

[LORD RAMSBOTHAM] our clients have served custodial sentences and been in a week. That is wholly inadequate and something must constant trouble with the police. When they are referred be done, somehow, to connect the Ministry of Justice and to us, the Nelson Trust can be their last chance to the Department of Health to improve support for those avoid a prison sentence. on probation, who have exactly the same characteristics We have heard from the noble Lord, Lord as the Office for National Statistics showed in 1998 for Ramsbotham, about the importance of looking after those in prisons. people with these problems in our society. In July 2014, My second concern is employment, which is absolutely Theresa May delivered a speech outlining the importance key to the rehabilitation of any offender but is also of ensuring that people with mental health problems crucial to the future well-being of people with mental are identified and diverted from the criminal justice health problems. Last week, I attended the launch of a system into appropriate healthcare and support service report by the Mental Illness and Employment Task providers. The psycho-educational group programme and Finish Group, which addressed the serious inequality at the Nelson Trust responds to these difficulties along of employment outcomes for people with and without with emotional and practical support not only to the mental health problems. It is a very good report and client but, more often than not, treating the whole Norman Lamb spoke extremely well at its launch. I family.This brings huge financial savings to the community welcome the recent introduction of CCG outcome and treats the multiple problems that mental health indicators on employment rates for people with mental can bring under one roof. The centres are closely illness because this will, at least, draw the facts to involved with the police, probation and healthcare people’s attention. I welcome the Commissioning for professionals, magistrates and housing providers. Quality Innovation targets for supporting adults who In Cambridgeshire, our police and crime commissioner, are in contact with mental health services. This is an Sir Graham Bright, facilitated a Cambridgeshire and unresearched area and we need to do much more if we Peterborough mental health crisis care concordat. This are really going to provide mental health services in landmark agreement sets out how agencies that deal this country that are worth the name. with people suffering from mental health problems will work together to support those experiencing a 4.13 pm mental health crisis. Improved information-sharing, Baroness Chisholm of Owlpen (Con): I thank the prevention and early intervention were just some of noble Baroness, Lady Tyler, for initiating today’s debate the commitments made in the declaration. and join your Lordships in congratulating my noble Those are just two examples of joined-up thinking friend Lord Suri on his maiden speech. which has brought a difference in these communities In my lifetime, mental health services have gone to both those suffering from mental health problems through a radical transformation, perhaps more than and the professionals who come into contact with any other part of the health system. When I started them. Implementing known good practice that already nursing, people with mental health problems were exists provides good integrated mental health care, usually treated in large institutions. Today, as your saves time and money and expedites the care that can Lordships know, care is focused mainly in the community. be available. The King’s Fund stated in September 2014: Multidisciplinary teams care for people in their own “Cultural change is as important as funding in transforming homes. Admissions are in small specialist units and for mental health”. those requiring long-term care there are small residential How true this statement is. units. This is, of course, the way forward, but unlike most other health complaints, mental health has its Mental health still carries a stigma, yet one in three own very special problems. When those with mental of us will come into contact with mental health problems health issues suffer an episode, they require immediate in our lifetime. It can affect people of any age, any attention. An appointment one week or even a few socioeconomic group and is hugely destructive not days later can be too late and lead to disastrous only to those suffering mental health issues but to consequences. Acute in-patient service provision has their families as well. We are at ease discussing other remained a challenge throughout the country, as has health issues, quite often intimate ones, but will rarely community care. With people being treated mainly in discuss mental health issues. This must change; mental the community, the number of in-care beds has decreased, health should be treated as a core public health issue causing an increased number of out-of-area placements so that it will be as normal for everyone to look after at substantial cost to authorities and with lengthy their mental health as it is to look after their physical travel, leading to extra cost to clients and their families. health. The public health workforce must see mental But there is good practice going on that is making a health as one of its core responsibilities. The voice of considerable difference in certain areas and I would the mental health community is finally being listened like to share two of these with your Lordships today. to and, as we are seeing today, the issues are being I am closely involved with a charity called the debated, but collaboration between commissioners, Nelson Trust which has facilitated two women’s centres, providers, service users, academics and clinicians and in Gloucester and Swindon, treating clients with substance the justice system is still too rare. abuse. As the Corston report stated, more often than Mental health cannot be considered in isolation and not these women have a history of mental health can rarely be separated from physical health. Therefore, issues. The women whom we are seeing at the centres as with most practices within the NHS, it requires a are those who have suffered trauma in their life, leading joined-up approach involving multiple stakeholder groups. to depression, self-harming and personality disorders, A reduction in the number of people across the UK and this in turn has led to substance misuse. Many of developing mental health disorders is surely the only 971 Mental Health[15 JANUARY 2015] Mental Health 972 way that mental health services will adequately cope traditional ways of working are simply not working. It with future demand. The case for more preventive is understandable that many of these people feel excluded work is therefore undeniable. and without hope. The conventional services are not Arguably, the onus today is on GPs to run initial addressing their needs but are being used in an ineffective care and give treatment, instead of referring patients and costly way. People with long-standing mental on to the appropriate professional. However, as one health needs are not well served by repeatedly ending noble Lord has stated, some GPs have said that they up in A&E or in police custody. As many experts have felt out of their depth. Is this partly due to the downplayed said, the services provided for those with multiple and role of psychiatric social workers, daycare workers complex needs have to change. Indeed, the noble and community psychiatric nurses? Could an acute Lord, Lord Patel, said today that it is the services that episode be avoided if respite or suitable community are hard to reach. care were more readily available when someone felt an I would like to highlight one project today that is episode building up, thereby saving considerable frustration particularly focused on this area of need; it is called and a feeling of helplessness for the client, as well as the Golden Key project. The idea is that this golden saving the considerable resources required for treating key will unlock services. It consists of a partnership an episode once it reaches crisis proportions? board, resulting from a Big Lottery Fund bid by a These are an inadequate few words on a massive consortium of agencies working with Bristol City subject that affects people from birth to death, leaving Council. The project helps people to drive their own in its wake a feeling of helplessness, fear, frustration recovery by providing support, by reconfiguring services, and loneliness among all those it touches. We must feel and by enlisting the help of people who have had the confident that, when seeking help for mental health experience of living through similar issues and who problems, the appropriate healthcare experts will be have come through it to regain their own lives. immediately available to give us the appropriate treatment The project is at an early stage. As I said, it is run and care in the appropriate place. by a broadly based partnership on which the full range of interested groups are represented, including 4.21 pm agencies that provide services, commissioners, clinical commissioning groups, peer mentors who have real Baroness Janke (LD): My Lords, I, too, am grateful experience, business, and city leaders who are championing to the noble Baroness, Lady Tyler, for initiating this this project. Key elements include a group of debate. I shall focus on the significant numbers of 300 individuals who sign up to the project “walking people with multiple and complex needs. They might the journey” with a lead co-ordinator at a pace that is be street drinkers, homeless people, an aging drug-using right for them. At the heart of the scheme are the peer population; people with wide-ranging mental health mentors, who bring their own lived experience to issues, including complex trauma histories; many women support, and to inspire hope. Golden Key agencies trapped in the sex industry with significant multiple and services are pledged to work together to make needs; and young people, including 16 to 17 year-olds. services accessible and sympathetic to needs. They might be individuals with serious health-related Innovative aspects of this project include small needs and long-term conditions who have a range of personal budgets that encourage staff and their customers complex needs, some of whom are at the end of their to think carefully about which practical measures lives, as well as increasing numbers of people who are might create early successes. There is a “telling your unable to be housed due to the complexity of their story once” website, with access controlled by the client, needs and the risks associated with their behaviour. so that people do not have to repeat their personal These people often have at least three of the four information and story. One symptom of the current needs areas: mental ill heath, homelessness, drug and service is that an individual seeking support may have alcohol misuse, and offending. They are also likely to to tell his or her story to a range of different agencies. have other significant factors such as: poor physical This website tries to bring services together and shape health, including long-term conditions; experience of them to the individual who needs them. There will be a complex trauma in childhood or early years; and psychologically informed environments approach to experience of domestic abuse. This group is often the deliver more effective services through a deeper farthest away from services or only comes into contact understanding of clients’ needs. There will also be with services when in crisis; they perhaps come into training and action learning to embed change. contact with the police, A&E or mental health crisis Very many of us are aware of this complex area of teams. In addition, gaps in services, or the way that need and care about these most deprived and excluded services are provided, can mean that, in the worst people. It is essential that these people’s acute need is cases, help is not available, or that people are passed fully recognised and that we look at ways of building round the system, having to deal with several different on national and international examples of good practice. agencies—or, worse still, that they get into the revolving- Through this, we must find ways of unlocking the door syndrome where they are constantly repeating future for a group of people who often do not believe their experiences and not receiving the support to ever that they have one. move forward. Mental health needs in this area are often undiagnosed, 4.27 pm undisclosed, untreated, masked and compounded by other needs. It is an area where people have problems Lord Bradley (Lab): My Lords, I also congratulate that are often considered too entrenched or too complex the noble Baroness, Lady Tyler of Enfield, on securing and they have no one to turn to. It is an area where this very important debate and on her very effective 973 Mental Health[LORDS] Mental Health 974

[LORD BRADLEY] adolescent mental health services. This must be completed and wide-ranging opening contribution to it. I also to ensure that we have genuine parity of access to mental congratulate the noble Lord, Lord Suri, on his excellent health care, as we do to urgent and elective care for a maiden speech. He will clearly be a very welcome range of physical illnesses. There must also be comparable addition to your Lordships’ House. entitlement to NICE-approved interventions to ensure Mental health has rightly risen up the political that there is no compromise on quality.Such entitlements agenda significantly in recent years. It is timely to take are essential to delivering parity of esteem. However, I stock of the current issues and policy developments noted carefully the views of the noble Lord, Lord that have taken place during this Parliament. I declare Patel, on that point. my interest as a trustee of the excellent Centre for Secondly, on mental health care funding, data suggest, Mental Health, which undertakes superb work in this as we have heard, that NHS spending on mental health area. services has fallen in real terms each year from 2011 to Let us first consider further some background facts date. This is putting services under great pressure, and figures. I make no apologies for repeating what leading to disinvestment in effective interventions such many noble Lords have already mentioned. Mental as crisis resolution and home treatment, and placing health problems affect 23% of the population at any extra pressure on hospital beds. It is even leading to one time, the most prevalent of which are depression bed closures where there is often already underprovision. and anxiety at 17% of the total. As we have heard, the Local campaigns, such as those in Waveney and other economic and social costs of mental ill health are areas of the country, have been initiated to protect estimated to be £105 billion annually. As the NHS Five vital local mental health services. I would be grateful Year Forward View points out, this is roughly the cost for the Minister’s views on that situation, as well as for of the entire NHS budget. Mental ill health accounts his view on the Royal College of Nursing’s view that there for 23% of all ill health—more than heart disease, are now 3,300 fewer posts in mental health nursing cancer and diabetes—and causes as much ill health and 1,500 fewer beds than in 2010. Planning guidance among working-age people as all physical illness combined. recently published by NHS England asked CCGs to Some 10% of children aged five to 15 have a mental secure real-terms increases in mental health spending health problem. Three-quarters of people with depression for 2015-16. It is vital that this is implemented and receive no treatment at all. A third of people with a that accurate records are kept of spending on mental long-term physical illness also have a mental health health services for adults and children. problem. This costs the NHS an extra £10 billion in extra prescriptions, hospital admissions and more Thirdly, on crisis care, the crisis care concordat was expensive treatments. published a year ago, as we have heard, and is welcome. As we have heard, nine out of 10 prisoners have a It sets out the standards expected in all local areas. mental health problem, and mental health research The deadline for localities to produce crisis care funding—as we have heard again—is appallingly low. declarations has now passed. These should be followed As the organisation MQ points out, the scale of mental up with local action plans to implement agreed measures. health research is not proportionate to the burden of The tracking map shows that all areas have now made disease. The spend on mental health research is just declarations but that few have action plans to go with 5.5% of the total research spend in the UK, despite them. It is unclear how local organisations will be held the fact that mental health problems, as we have accountable for achieving progress and how it will be heard, affect around one-quarter of the population in monitored. I hope the Minister will be able to elaborate any one year. MQ further points out that a major on that point. challenge in the mental health funding landscape is Next comes liaison and diversion, in which I have a that, in contrast to the other major health conditions, particular interest. NHS England recently announced public funding of mental health research is virtually the expansion of the national programme of liaison non-existent. For every £1 that the Government spend and diversion services to cover half the population of on cancer research, the general public invest £2.75; for England. This is welcomed but we must ensure that it heart and circulatory problems it is £1.35. For mental is extended nationwide by the committed-to date of health research, the figure is 0.003p. I am not arguing 2017. However, there is also a need for CCGs and against such public investment in other disease groups; other commissioners to commission services to which I am simply putting mental health research in that people can be diverted to make the investment in such broader context. Like the noble Lord, Lord Patel, I services as effective as possible. I hope that the Minister look forward to the Minister’s response on that point. can reassure us on that point as well. Against that backdrop, what have been some of the key policy pledges made by the Government on behalf Finally,on employment, the Government have recognised of those suffering with mental health problems, and that the Work Programme is not offering adequate what appears to be the current position on each? First, help to people with mental health problems, and they there are new access standards for mental health, have invested in a pilot to trial the adaptation of the which are clearly welcome. Announced in October 2014, individual placement and support approach for people they include, from April 2015, waiting-time standards with common mental health problems. This work needs for improved access to psychological services, and to inform the future of the Work Programme. I also early intervention in psychosis services. The Department commend the report that has been mentioned, published of Health’s five-year plan to improve access to mental on Tuesday, on addressing the serious inequality of health care pledged to follow this up with further employment outcomes. It makes very clear recommendations standards, for example in urgent care and in child and on how to improve employment opportunities for people 975 Mental Health[15 JANUARY 2015] Mental Health 976 with severe mental health problems, such as schizophrenia, some point in their life. Mental health problems are about which the noble Lord, Lord Goodlad, spoke so the single largest cause of disability in the UK, contributing eloquently earlier. up to 22.8% of the total burden, compared to 15.9% In spite of those initiatives, which are clearly welcomed, for cancers and 16.2% for cardiovascular diseases. It is there remain many weaknesses and concerns. We have estimated that the wider economic costs of mental already talked about the real-terms reduction in funding illness in England are, according to anyone’s figures—and and about the fact that people with mental health we have heard several this afternoon—enormous. problems have been adversely affected by continued The noble Lords, Lord Patel and Lord Goodlad, weaknesses in the work capability assessment and, in raised the issue of parity of esteem. This has been a some cases, by the use the benefit sanctions. We have game-changing issue. The Government’s commitment heard about schools being given little support in promoting to prioritising mental health is encapsulated in the mental health and the removal of well-being from principle of parity of esteem—equal priority for mental Ofsted inspections. We have also heard of the major and physical health—which was set out in our 2011 concerns in children’s mental health services, which mental health strategy, No Health Without Mental have experienced particularly large cuts. Last year, Health. This commitment to parity was made explicit two-thirds of councils and three-quarters of CCGs in the Health and Social Care Act 2012. Many noble cut or froze CAMHS spending. A recent Parliamentary Lords here will remember that vote well and many will Answer showed that the aggregate PCT/CCG expenditure be grateful for it. on CAMHS fell in real terms from £758 million in The 2014-15 mandate to the NHS sets an explicit 2008-09 to £717 million in 2012-13, and I suspect that target for NHS England to make measurable progress it has continued to fall. The position is exacerbated by to ensure that, cuts in youth services, many of which have a positive “everyone who needs it has timely access to evidence-based impact on well-being and prevent the emergence of services”. later problems. My noble friend Lady Janke referred to the challenges Finally, what should be done to ensure that these posed by those who only attend emergency and crisis situations are addressed? This afternoon we have heard services. In October 2014, NHS England set out its many good examples of new initiatives. We must continue vision on the future of the NHS in its Five Year to explore ways of making the NHS constitution Forward View. This recognises that, fairer, including a wider range of access standards and entitlements to NICE-approved interventions. We must “the NHS must drive towards an equal response to mental and physical health, and towards the two being treated together”. consider revising payment systems for all mental health services to put mental and physical health on an equal As part of that commitment, for the first time ever, footing. We must ensure that the NHS, public health waiting time standards will be introduced in mental and social care outcomes frameworks and the quality health services in 2015-16. My noble friend Lady Tyler and outcomes framework for GPs properly represent referred to these. They will include: 75% of people mental health priorities. We must invest in cost-effective referred to the Improving Access to Psychological interventions—which are currently undermined by a Therapies programme will be treated within six weeks postcode lottery—for, for example, perinatal mental of referral, and 95% will be treated within 18 weeks of health care and parenting programmes, and, crucially, referral; and at least 50% of patients experiencing a we need early intervention in psychosis and individual first episode of psychosis will be treated with a NICE- placement and support. approved care package within two weeks of referral. My time is almost up but that list is not exhaustive. On the subject of child and adolescent mental The quality of this debate shows how many initiatives health services, my noble friend Lord Addington spoke people understand and want to progress through the movingly about the fact that, if people are different, development of mental health services. Whether we mental health problems can follow them. He spoke are talking about adults or children, they need and about dyslexia, dyspraxia and autism. It is estimated deserve that support, and I hope that this high-quality that 50% of mental illness in adult life begins before debate will help to progress that agenda. the age of 15 and that 75% of mental illness in adults starts before the age of 18. Early intervention is known to reduce not only the incidence, duration and severity 4.39 pm of lifelong mental health problems, but also the cost of Baroness Jolly (LD): My Lords, I thank my noble friend mental health problems to the economy. We will invest Lady Tyler for tabling the Motion for this excellent £30 million a year over the next five years to improve debate. It has really been a series of mini-debates. We services for young people with mental health problems. have had experts of all sorts bringing their experience We are also investing £54 million over the period 2011 to bear on subjects such as parity of esteem, maternal to 2015-16 in the Children and Young People’s IAPT health, dual diagnosis, children and young people, programme, to transform child and adolescent mental prisons and public health, to name but a few. health services. In August we set up the Children and Mental illness can emerge at any age and can have YoungPeople’s Mental Health and Wellbeing Taskforce, highly significant impacts across much of the life to focus on innovative solutions to improve outcomes course for the individual, their family and the community. for children and young people’s mental health. It will The noble Lords, Lord Goodlad, Lord Farmer and Lord report to Ministers in spring this year. Bradley, among others, have outlined some statistics—and My noble friend Lord Storey brought his experience I have some more. We know that at least one in four as a head teacher to the debate. I can tell him that I people will experience a mental health problem at have recently spoken to the Care Minister, Norman 977 Mental Health[LORDS] Mental Health 978

[BARONESS JOLLY] and well-being boards. These were set up locally to Lamb, on the issues that he mentioned, about how meet local needs, so the frequency of their meetings things will work and the work that will be going on will be determined locally, not nationally. with the Department of Health to try to nail some of On mental health information, the lack of mental those problems. health data is an issue that goes to the heart of equal Mental health crisis care is crucial. People in mental priority for services. We do not have the same level of health crisis need speedy access to safe and compassionate information on mental health services as we do for care in the right environment. My noble friend Lady Janke physical health. Information that has proved so critical gave us an example of a multidisciplinary, multiagency in driving improvement and service change in the rest approach in Bristol—the Golden Key approach. We of the NHS is either absent or incomplete for mental know that an effective response can often prevent an health. We are driving forward plans to address gaps in in-patient admission, which is disruptive to an individual’s mental health information on prevalence, waiting times life and their well-being, as well as costly to the taxpayer. and access, outcomes, spend, uses of out-of-area It can also help to avoid totally unacceptable admissions placements and restraint. To further the parity agenda, a long way away from people’s homes. The first national data from across the health and care system has, for crisis care concordat was published in February 2014 the first time, been brought together on the NHS Choices to improve service responses to people in mental health website. Key in this is the inclusion of a specific crisis and, in particular, to keep people in mental distress mental health section. This level of data will help to who have committed no crime out of police cells. facilitate evidence-based decision-making, drive up The concordat—the noble Baroness, Lady Chisholm quality and standards and ensure genuine accountability of Owlpen, spoke about the Cambridge one—is a for the services provided. It will, in time, create the national commitment for agencies to work together to most transparent mental healthcare system in the world. support people in crisis to find the support that they need. The noble Lord, Lord Goodlad, raised the issue of schizophrenia and questioned why little progress had The 2014-15 mandate to NHS England specifies been made on schizophrenia research. More than that NHS England must make rapid progress, working £400 million is being invested over the spending review with clinical commissioning groups and other period to make choices of psychological therapies commissioners, to help to deliver on the shared goal to available for those who need it. We are investing in have, improving provision, including for those with severe “crisis services that, for an individual, are at all times as accessible, mental health conditions. responsive and high quality as other health emergency services”. That picks up on the question asked by the noble Data are also vital to research, helping us to provide Lord, Lord Patel. I can report that, as of 22 December the evidence that we need to transform services. Investment 2014, every local community now has its own local in mental health research by the National Institute for crisis care declaration in place. Local action plans, Health Research—the NIHR—has nearly doubled in most of which are expected in the first quarter of the past four years, from £40 million in 2009-10 to 2015, will make sure that improved crisis care is embedded £72 million in 2013-14, and we will continue to support in services for years to come. I have too many responses the work of the NIHR and the network of specialist to contain in this speech, so I will use this opportunity clinical research facilities in the NHS. in answer to the noble Lord’s question on how these From September 2014, more than 800,000 people will be followed up and monitored to say that that will with the most complex physical and mental healthcare go out in a letter that I shall send to all Peers. needs are benefiting from the Proactive Care Programme. On offender health, my noble friend Lord Suri This is being delivered through an enhanced service to brought up the important issue of mental health in the GP contract. Many of these people will have prisons. I congratulate him on his maiden speech and complex physical and mental health needs and this look forward greatly to his work in your Lordships’ initiative will ensure that they get personalised, joined-up House. I can assure the noble Lord, Lord Ramsbotham, care and support, tailored to their needs. that the NHS provides treatment and care according NHS England is working with commissioners to to clinical need, so offenders, irrespective of gender, make mental health a bigger priority, with better should receive the same range and quality of treatment integration of physical and mental healthcare in primary and services as anyone else. Offenders within the criminal care and, indeed, in all settings. Improving the diagnosis justice system—whether in the community or outside— of mental illness is one of four national goals for with mental health needs should have their treatment 2014-15. Providers will be rewarded for better assessing delivered in the most appropriate setting, whether in and treating the mental and physical needs of their prison or in the community. We should listen to his service users. wise words on the issue of young offenders’ mental health. We have committed £25 million to introduce a The issue of training for GPs was raised. The Royal new standard service specification of liaison and diversion College of General Practitioners has a programme services in England to identify and assess the health around training. However, there are two issues: one is issues and vulnerabilities of all offenders when they the training of new GPs before they go out and first enter the criminal justice system. Prison healthcare practise; the other is the ongoing training of GPs in all has improved significantly since the NHS first became the new developments. The noble Lord, Lord Bradley, responsible for commissioning it in 2006 and it continues raised the issue of the mental health workforce. Health to improve. But we should not be complacent. The Education England has increased training places for noble Lord, Lord Ramsbotham, also mentioned health mental health nurses by 3.2% for 2015-16. 979 Mental Health[15 JANUARY 2015] Maternal and Neonatal Mortality 980

As for mental health unemployment, getting people 4.57 pm back to work is a priority for the Government. Jointly Baroness Tyler of Enfield: My Lords, this has been with the Department for Work and Pensions, we an excellent debate drawing on the wealth of expertise, commissioned external policy advice from RAND knowledge and first-hand experience of all the speakers. Europe on how we can achieve better outcomes for I thank all noble Lords who spoke and especially people with common mental health problems. Based commend my noble friend Lord Suri for his excellent on the recommendations put forward this year, we are maiden speech. I also thank the many local health taking forward a number of feasibility pilots to explore organisations that provided me with briefing; I particularly the most promising and evidence-based approaches. thank Mind for its help. My noble friend Lord Addington addressed the I do not think that anyone who listened to the issue of ensuring awareness among healthcare debate this afternoon could be in any doubt about the professionals of potentially vulnerable groups. As the strength of feeling on this issue, the importance of mandate to NHS England makes clear, mental health to the country’s well-being or indeed the “everyone who needs it should have timely access to evidence-based scale of the challenges ahead. Those challenges are for services”, central government, but also for the NHS, local councils, including people with autism and learning disability. the voluntary sector, communities and, indeed, families. In line with the Equality Act, we expect all service I leave noble Lords with one thought: many speakers providers to make reasonable adjustments so that this afternoon, myself included, talked about or implied disabled people are not placed at a disadvantage compared that the problem was around the issue of institutional with non-disabled people. bias against mental health within the NHS. I feel that My noble friend Lady Tyler raised the issue of that sort of culture has started to change, given that Time To Change, the country’s largest anti-stigma and one quarter of the population in this country experience anti-discrimination mental health campaign—indeed, mental health problems at one time or another, a several other noble Lords mentioned it—which the quarter of all managers in senior leadership positions department currently funds by up to £4 million a year. have a mental health background and a quarter of all Between December 2012 and December 2013, we have the thinking and doing time in the NHS is spent on seen a 20% decrease in the number of life areas in mental health. which people experience discrimination. On discrimination for black and minority ethnic patients, this Government Motion agreed. are committed to tackling inequalities in access to mental health services. The commitment to reduce inequalities is in our action plan, Closing the Gap. The Insurance Bill [HL] 2014-15 mandate to NHS England makes it clear that Third Reading everyone should have access to the mental health services that they need. 4.58 pm On the issue of mental health and perinatal health Bill passed and sent to the Commons. for mothers, the mandate to NHS England includes an objective for NHS England to work with partner Developing World: Maternal and Neonatal organisations to reduce the incidence and the impact of post-natal depression through earlier diagnosis and Mortality better intervention and support. Question for Short Debate On the budget, mental health funding is not ring-fenced. However, we expect commissioners to demonstrate 5pm parity of esteem when agreeing financial statements. Asked by Baroness Hayman Aggregate CCG expenditure is not yet available for 2013-14, but NHS England advises that total mental To ask Her Majesty’s Government what progress health spending in 2013-14 was £11.3 billion with an has been made in reducing maternal and neonatal estimated £11.6 billion planned for the following year—an mortality in the developing world; and what plans increase of £302 million. they have to build on this work post-2015. There are many other issues that I will write to noble Lords about. I am proud of the Government’s Baroness Hayman (CB): My Lords, I am grateful record on mental health, of the role of my honourable for the opportunity to introduce this debate, and delighted friends Paul Burstow and Norman Lamb in the other that noble Lords from all Benches of your Lordships’ place and of the commitment and leadership of the House are planning to contribute on this important DPM. But as the noble Baroness, Lady Tyler, has issue. I declare my interests in health and development, highlighted, there is still more to be done. I would not particularly my chairmanship of the external advisory want to suggest any complacency on the part of the group of the Centre for Maternal and Newborn Health Government on this vital issue. I feel confident that, at the Liverpool School of Tropical Medicine. whatever May brings us, Members of your Lordships’ It was in this role that last year I visited Zimbabwe House will keep the feet of the new Government well and saw for myself the power of the Making it Happen and truly to the fire on issues of mental health. I programme run by the centre in 11 countries, supported particularly thank the noble Lord, Lord Farmer, and by DfID. I saw UK volunteers, an obstetrician and a the noble Baroness, Lady Tyler, for giving us some midwife, together with Zimbabwean master trainers ideas for the new Government to start with. who had been through the course before, supported by 981 Maternal and Neonatal Mortality[LORDS] Maternal and Neonatal Mortality 982

[BARONESS HAYMAN] figures, and which need the greatest improvements, are the country’s Ministry of Health, running the course ones that have seen the least change in their statistics. I for Zimbabwean health workers, giving them the skills ask the Minister to address the issue of how, post-2015, to save the lives of mothers and babies and to pass on we attend to the unfinished business in the millennium those skills to their colleagues to ensure sustainability development goals and ensure that we do not take our and improved services countrywide. eye off the ball in these hugely important areas where I will step back from the specific to address the we need to make sustained efforts in order to continue scale of the problem. The statistics are chilling. Some with the progress made so far. 300,000 women die every year; 800 women die every I have not said a lot so far about the causes of day in pregnancy and childbirth; 50 will die in the course maternal and newborn mortality, and how this terrible of this short debate. There are an estimated 2.6 million toll of death and suffering can be reduced. That is stillbirths and 3 million neonatal deaths every year; partly because when I asked a local expert for help in half of those neonatal deaths occur in the first 24 hours preparing for this debate and what she thought I of life. A child dies somewhere in the world every five ought to stress and what ought to be said, she shrugged seconds, overwhelmingly of preventable causes. her shoulders and said, “There is nothing new to say. These maternal and neonatal deaths are not evenly We know what the issues are and we know how they distributed. The maternal mortality ratio shows the can be addressed. What are needed are the resources highest discrepancy: the greatest gap between high and the political will to do it”. and low income settings of all international health You can go through the list of causes of maternal indicators. In the UK, the maternal mortality ratio is and newborn death: poor nutrition, existing medical eight per 100,000. In Sierra Leone, it is 110 per 100,000. conditions—which are often the diseases of the poor, That is the last figure that we have; I hate to think such as malaria—unsafe abortions, infections, eclampsia, what the figure will be for the last 12 months when the haemorrhage and obstruction in labour. The last three ravages of Ebola have put into abeyance the most of these can be addressed by specific programmes of basic health services that were available in the past. maternity care, but the first are much wider issues The average for neonatal mortality in developed countries relating to water and sanitation, education for girls, an is 3.7 per 1,000 live births; in southern Africa and end to child marriage, immunisation programmes, and south-east Asia it is 10 times that; 99% of all maternal access to family planning and antenatal intra-partum deaths and 98% of all neonatal deaths occur in low or and post-partum care from trained and skilled birth middle-income countries. attendants. That is where programmes such as Making a Difference can have profound effects: in the first Within developing countries there are wide variations, phase of those programmes, maternal death rates in with the poorest, the youngest, the least educated, and areas where they had been implemented reduced by as the rural women most at risk. The deaths are not the much as 50%. The decision we have to make globally is end of the story. For every woman who dies in childbirth, about the priority that we give to the quality of women’s it is estimated that 20 to 30 live but suffer lifelong lives and the numbers of women’s deaths. morbidity such as fistula. The health and survival of babies is dependent on the health and survival of In the early 17th century, Joseph Hall, who was mothers, not only in the quality of antenatal, intra-partum then Bishop of Exeter, wrote: and post-partum care, but evidenced by the fact—I “Death borders upon our birth, and our cradle stands in the have lost the reference for this statistic, but I am sure grave”. someone will tell me—that a motherless child is 10 times That is no longer true in this country. It need no more likely to die in the first two years of its life than a longer be true in the developing world. But to stop it child who has a mother to care for them. being the reality for millions in that world, we have to put the resources and the priority into work to reduce It was the recognition of this tsunami of suffering maternal and neonatal deaths. and the obstacle to development that the figures represent—because we all know how crucial women Lord Bourne of Aberystwyth (Con): As the debate are to development—that led to the introduction of gets under way, I respectfully remind noble Lords that millennium development goals 4 and 5, of reducing this is a time-limited debate. child deaths by two-thirds and maternal deaths by 75% by 2015. When the Minister comes to answer the 5.09 pm question posed in the title of this debate, I am certain Baroness Hodgson of Abinger (Con): My Lords, that she will outline the considerable progress that has nearly every minute of every day a woman dies from been made since 1990. complications in pregnancy and childbirth. Yesterday I pay tribute to the work that has been done in 800 women across the world died; 800 will die today developing countries by DfID and other international and every day until the end of the year and into next. agencies in just about halving those deaths. The figures On average, 9,000 babies will die at birth or in the first have been helped of course by the progress in other week of life each day of this year too. In this day and MDGs, for example in relation to HIV/AIDS and age these are truly shocking figures. malaria, and perhaps point us again, looking forward, I congratulate the noble Baroness, Lady Hayman, to the importance of joined-up healthcare and healthcare on having secured this debate which encompasses two for all. of the most important millennium development goals—to However, it is disappointing that the progress that reduce child mortality and to improve maternal health. has been made has, again, not been evenly distributed, Of course, these two goals go hand in hand and I am and that some of the countries that have the worst heartened that the title of this debate recognises it. 983 Maternal and Neonatal Mortality[15 JANUARY 2015] Maternal and Neonatal Mortality 984

There has been improvement. Since 1990, maternal Harmful traditional practices such as FGM and mortality has declined by nearly half. Although progress early marriage, all too prevalent in some developing has been made in all developing regions, as we have countries, also contribute to maternal and child mortality. already heard, there are vast geographical disparities Lack of adequate nutrition can also be a cause. Lack and it is now estimated that 99% of maternal deaths of gender equality impacts, too. For example, there occur in developing countries. In 2013, the maternal are clear connections between women’s lack of access mortality ratio in developing countries was 230 per to education and reproductive rights and health. In 100,000 live births, compared to 16 per 100,000 in the some countries, girls commonly have to leave school developed world. For example, one woman in 30,000 due to pregnancy or for early marriage—that is, if they dies as a result of pregnancy and childbirth in Sweden, have attended school at all. I recently visited Mali, whereas in Afghanistan it is about one in six. So many which has one of the highest child marriage rates in of these deaths are preventable. These women will not the world. Half of the girls there will be married before have had the pain relief and epidurals that we have come they are 18. In addition to greater vulnerability to to expect here. Many will have had to endure many hours domestic violence and the contracting of diseases, these of excruciating and unbearable pain before they die. child brides are more likely to bear children before Neonatal mortality rates have also declined significantly they are physically ready, thus exposing them to extreme over the past 20 years, but to have between 3 million risk. Newborn baby deaths are also 50% higher when and 4 million babies a year currently dying is truly born to those under 20. appalling Cocooned in the Palace of Westminster, we Women need to be empowered in a wider cultural might find these overwhelming impersonal statistics sense by having control over their sexual and reproductive numbing, but we should remember that each and every activity. It is estimated that 215 million women in the one of these deaths is a devastating tragedy for those developing world want to delay or avoid pregnancy, involved. It is a tragedy for the children who lose a with as many as 50% of pregnancies being unplanned mother—and children who have lost their mothers are and 25% unwanted. Having to have baby after baby 10 times more likely to die prematurely—and a tragedy wears a woman out, with each pregnancy multiplying for the mother who loses a baby. In the West these her chance of dying from complications. It is estimated losses are mercifully rare but, having lost a baby at that a third of these deaths could be avoided if women birth myself, I know personally that it is a very hard had access to contraception services, which would thing ever to come to terms with. help avert unintended and closely spaced pregnancies For every woman who dies, at least 20 more suffer and reduce instances of unsafe abortions. This is complications which may leave them with lifelong because one-quarter of all pregnancies end in abortion crippling disability and pain. Lack of obstetric care and 19 million of those abortions are unsafe, resulting may result in fistula, resulting in them being shunned in 68,000 deaths per year and many women suffering by their families and the community. Traumatic births complications and infections. So the provision of proper can cause postnatal depression—something rarely contraception is crucial in improving reproductive health mentioned in the context of developing countries. and tackling maternal mortality. Today in the UK, 10% to 20% of women develop a I particularly welcome the debate today, as in spite mental illness during pregnancy or within the first of the improvement of the last 20 years the situation is year after having a baby. With the right help, women still unacceptable. We need to be resolute in tackling can recover but, without that help, they may never be the causes in developing countries because we still able to function properly again. For a baby, even slight have a long way to go until every woman and child oxygen deprivation at birth may cause life-changing across the world receives the care that we, in the damage—either physical or mental. western world, take for granted. Many of these deaths are avoidable but, to ensure the fundamental well-being and survival of both mothers 5.16 pm and babies, every woman needs access to a trained Baroness Kinnock of Holyhead (Lab): My Lords, I, doctor or midwife. In countries such as Afghanistan, too, thank the noble Baroness, Lady Hayman, for only 14% of births are attended by a health worker. introducing this debate and for doing so in such a Every year, across the world, 46 million babies are compelling and expert way. delivered without any skilled assistance. In large parts of the world, poverty means that I have seen the challenges from my visits to various great numbers of women die from a lack of family countries. For example, I remember visiting the district planning, an inability to negotiate the number and hospital in Koinadugu in Northern Province, Sierra spacing of children, the lack of money to pay for Leone a few years ago. There was only one doctor in skilled birth attendance or emergency obstetric care, the hospital, who was also the district health administrator. and violence. In spite of some welcome progress, it is He explained that some of the villages in the district clear that MDG 5, on reducing maternal mortality were 100 miles away from the hospital and there were and achieving universal access to reproductive health, no roads. Although there was a system of outlying is far from being fulfilled. However, as affirmed by the clinics, none had doctors and most had no trained nurses UN Commission on the Status of Women,the elimination either. The radio system to them from the hospital was of preventable maternal mortality is possible in the broken. There are similar tales in many other developing next decade but it will, clearly, require a major scaling-up countries. So it is not just about ensuring that there are of our efforts. Does the Minister agree that sexual and enough doctors and midwives in these countries; it is reproductive healthcare for women and girls should be also about ensuring that the medical care that is so a specific priority, separated from maternal health, so vitally needed can be reached. that its allocation and impact can be properly measured? 985 Maternal and Neonatal Mortality[LORDS] Maternal and Neonatal Mortality 986

[BARONESS KINNOCK OF HOLYHEAD] discriminatory norms. Religious, cultural and social Is the Minister aware that around only 1% of ODA is barriers impose overt discrimination that stands in the currently allocated to family planning? way of women’s freedom to choose. DfID has also committed to, One hundred and ninety-three Governments are currently gearing up for the UN discussion, at September’s “enable 10 million more women to access family planning (of which 1 million will be girls aged 15-19)”. annual meeting, on priorities for the next decade and a half. Currently, there are 17 goals and 169 targets. However, How confident is the Minister that this objective can be we can safely say that there will be a stand-alone goal met, since only 4,966,000 have been reached to date? on gender equality, women’s rights and empowerment. Does the Minister agree that, as DfID spending on This will include universal access to sexual and humanitarian assistance is increasing, it is vital that a reproductive health, and rights to be mainstreamed comprehensive package is offered in emergency settings, across all other goals. The task is to prevent an estimated such as conflicts and disasters, and that this should 640,000 newborn deaths and 150,000 maternal deaths include access to sexual and reproductive health? each year, which will result in 600,000 children having The UN high-level panel established to prepare the to grow up without a mother. When motherless children post-2015 agenda for action estimates that 800 women are 10 times more likely to die within two years of die every day from complications related to pregnancy their mother’s death, the urgency is graphically obvious. and childbirth and, according to the WHO, 99% of To achieve such advances we will indeed need political those maternal deaths occur in developing countries. leadership. When fundamental rights are upheld, women, In addition, medical experts testify that, globally, every girls and young people can thrive. They can gain year there are about 80 million unplanned pregnancies education, get better jobs with better wages and therefore and 20 million unsafe abortions with the result that, as reach their full potential. That objective is essential Marie Stopes International points out: and, I believe, achievable. It will serve every interest. It “Worldwide, one woman dies every 11 minutes from an unsafe must gain active support. The British Government abortion”. have a duty to take the lead in that mission. Unsafe abortion is a major cause of maternal mortality 5.23 pm and remains a major public health and human rights concern. Being able to make an informed choice and Lord Patel (CB): My Lords, I join the noble Baroness, take control of your own reproductive health is surely Lady Hayman, in the tribute that she paid to DfID for a basic right. Does the Minister agree with the view the work that it has done and continues to support in that Governments and donors need to prioritise what areas of reducing maternal and child mortality. I women want, rather than what they feel most comfortable emphasise that in the hope that DfID will not now with doing and providing? Such a change is urgent. I stop but put extra vigour in joining other partners in remember talking to Beth outside her home in rural delivery until we achieve the goals. Tanzania. Such were the perils of childbirth that before As has already been said, the statistics—which will she went into labour she would say goodbye to her be cited by others—are horrendous. A woman giving children. Giving life should surely not mean taking life should neither die nor go through childbirth only such a risk. to have the heartbreak of losing her child at birth or in A post-2015 assessment says that aiming to reduce infancy. The noble Baroness, Lady Hodgson, described newborn mortality by 70% will prevent 2 million child her experiences, which I well understand. Yet for many deaths every year. Such evidence highlights the urgent mothers and their children this is a reality. Three hundred need to provide expectant mothers with nutrients, thousand women die every year during pregnancy. For protection against disease, nursing care, clean water children, the statistics are worse. There are 131 million and hygiene facilities. All these initiatives can save births a year; of these, 6.3 million children die before precious lives and are taken for granted in the developed the age of five. That is 17,000 deaths of children every world. No girl should die giving birth and no child day. One million babies are stillborn. Two million die should die because its mother is too young. Each year in the first week of life, and for 1 million babies the around 1 million babies born to adolescent girls die day of their birth is the day of their death. While progress before their first birthday. in reducing maternal and infant deaths has been significant over the past two decades, many millions continue to These issues go beyond family planning. Campaigns die, and 223 million children under five died between and condom distribution are irrelevant to women and 1990 and 2013. Four out of five deaths of children girls who simply do not have the power to make the aged under five occur in sub-Saharan Africa. decisions. A country’s current status and future prospects While the number of deaths of children under five are clearly illuminated by examining, for instance, the has declined, the decline in the number deaths around lifetime risk of maternal death, the percentage of women birth and in the first month of life is not so striking. using modern contraceptives, women’s literacy rate, Neonatal deaths now account for 44% of deaths of their participation in national growth and the enrolment children under five. There has been no noticeable of girls in school. reduction in neonatal deaths. Some interventions focused The reality is that gender inequality remains a on the 24 hours after birth hold great potential for major propellant of poverty and women’s marginalisation, reducing maternal and neonatal deaths. We know the and a basic cause of underdevelopment. Faced with causes of death and how to prevent them, but we have that reality, it is clear that little will change until the not succeeded in delivering health interventions widely underlying root causes of discrimination are plainly and consistently throughout the world or in developing and publicly identified as gender inequality and pervasive, sustainable health systems. 987 Maternal and Neonatal Mortality[15 JANUARY 2015] Maternal and Neonatal Mortality 988

Two-thirds of neonatal deaths occur in 10 countries, India is twinned with our diocese in an ecumenical link. and 48%—nearly half—occur in four countries: India, I work with people in a number of Indian communities China, Nigeria and Pakistan. Two-thirds occur in only where this issue is enormous. In 2012, one-third of two countries, India and Nigeria, and both of them global neonatal deaths happened in India. The highest are capable of developing health systems that would rate of first-day mortality is in India. That is the context stop them, so what must we do to encourage them to in which we are working with our partners, through strengthen their health systems? whose eyes we discern some factors. The causes of neonatal deaths are pre-term births, The first, as other noble Lords have said, is poverty. complications at birth, infections and sepsis and congenital People just do not have the means to call medical help abnormalities. Basic, cost-effective care in the first hour and there is no local infrastructure available anyway even after birth results in significant reductions in maternal if they could. That kind of poverty is a major factor. and neonatal mortality. For example, breastfeeding in The second factor is the lack of education about basic the first hour of life reduces deaths by 40%, yet only hygiene. I visited slums in Calcutta with the Cathedral 50% of newborns are breastfed in the first hour of life, Relief Service, which trains very young girls of 10 to particularly in vulnerable parts of the world. Skilled 12 to wander in and out of people’s houses, giving attendants at birth and the use of a maternal and good advice about hygiene and childcare. This helps neonatal checklist which includes simple tasks, such as families learn good practice in an unthreatening way cord care, dramatically reduces neonatal mortality, yet and will produce a new generation of young mothers 44% of women in some countries do not have skilled with those skills. This is a practical, grass-roots response. attendants, and even when there are attendants at birth, simple interventions are not delivered. For example, My colleagues in India would say that the third only 10% of babies delivered by skilled attendants factor is that a lack of respect for women and girls is received seven key neonatal interventions, so we must behind these terrible statistics. The attitude so often is ask why, even when there are skilled attendants, they that this is their role—illness is not taken seriously—and do not happen. Hence, we have developed a checklist their job is to run the household. New mothers are for maternal and child health at the time of birth to try expected just to get up and carry on with things. to make sure that those interventions, including Fourthly, in the urban areas, the issue is not so much a breastfeeding, can be delivered. matter of the infrastructure being hundreds of miles away but that whole families live on pavements and The charity, SafeHands, of which I am a patron, as give birth there. I was in Calcutta in December and is the noble Baroness, Lady Kennedy of The Shaws, who saw families living in the street with no resources, is not in her place, tries to use education using visual cutting the cord with an ordinary knife because that media in rural villages in Ethiopia and other countries was all that was at hand. to deliver messages about the importance of basic care and attendants at birth, which can have dramatic effects. That was a snapshot of some of my experiences; what What of the future? The world needs to fulfil the are the responses? I work with ISPCK—the Indian promise made to the children of this world in 2000. version of the publishing house—and the Cathedral The MDG 4 target will not be met in 2015. At the Relief Service in Calcutta. As the noble Baroness, Lady current rate, it will not be met until 2026. We need a Kinnock, was hinting, they say that the key is to have new commitment, not just the targets of 2015, even if strong, empowered women. Research by the Cathedral we could meet them in 2026. We need a new commitment Relief Service in Calcutta shows that 63% of pregnant to children going beyond MDG 4 that by 2035 every women in the slums are anaemic. That is an appalling country will see a neonatal death rate of 10 per 1,000 starting place. I visited a slum where they had just births and a stillbirth rate of 10 per 1,000 births. The invented a green goo to give to people to build up their challenge could be 20 by 2035, to mothers and their resources—I had to taste it, and it was a really testing babies underpinned by helping to establish sustainable moment in intercultural activity. People have to take health systems. this kind of local initiative to build, literally, physically The UK Government have done so much to advance strong women. these causes and lead the world. What commitment Women have to be empowered, too, and many will they make beyond 2015 towards efforts to reduce people in development know that it is by building up maternal and childhood deaths? women that families survive and have structure and leadership. We spend a lot of time in our diocese 5.30 pm raising funds to create around providing sewing machines The Lord Bishop of Derby: My Lords, I too for women so that the family has a livelihood. This congratulate the noble Baroness, Lady Hayman, on year, we are raising funds to create businesses for securing this debate and on introducing it with such recycling in Delhi, where all the waste from industrialising expertise and such a challenging sense of the statistics. India needs dealing with. It is only by giving women Millennium development goals 4 and 5 are not being that kind of strength and security that they will be able met and, as other speakers have said, the consequences to deal with some of the issues about family planning are horrendous. My contribution will be from my own and their self-respect and standing in the community. experience working with people at the grass roots, and Other things that we do with our partners include I will then tease out what the implications of that running education and immunisation programmes, as experience should be. well as doing home visits. We show films in the slums, I work in the diocese of Derby, in England, and we and some villages have health days, when volunteers are twinned with the Church of North India, which go out and gather people around. So what are the extends from Calcutta to Mumbai—the whole of north implications that I am learning? The key one is partnership. 989 Maternal and Neonatal Mortality[LORDS] Maternal and Neonatal Mortality 990

[THE LORD BISHOP OF DERBY] look after them in their old age and they need people There is a partnership between the people of Derbyshire to work in the fields. They’ve got to have big families—you and people in the slums and rural areas of India mustn’t prevent them from doing that”. We have all around this issue, which provides practical help and been working hard in this Government, and in DfID tries to empower women and provide infrastructure. in particular, to convince those Members that that is I am privileged to be a trustee of Christian Aid, no longer the truth. which specialises in partnership working with local We have heard a lot of statistics, and I welcome their agencies. We work in Kenya, Malawi and Bangalore, repetition; we should have them fixed in our head. But in India, and there are lots of stories that I could in fact maternal mortality is reducing—there is some tell—like the ones from Derbyshire—of partnership good news. It has reduced by some 50% in the past working. Most exciting is our partnership at the moment 20 years; now around 250,000 women die per annum. with DfID. The Minister came to the Christian Aid That is still far too many, but it is reducing. With that carol service and launched a match funding scheme figure goes the estimate that 2 million neonatal deaths for a project in Kenya on this very topic. We should occur per annum—and we know that they are linked. congratulate the Government on their approach to partnering with organisations such as Christian Aid, We must also remember, as all Members have pointed which have a lot of expertise on the ground and out, that it is not just maternal deaths. They hide the grass-roots connections and can deliver real change. I fact that maternal morbidity and terrible conditions am proud of the way that our Government are investing after childbirth, such as fistula—of which I know the in that. Clearly, we can always do more and clearly we noble Lord, Lord Patel, has had such experience and need millennium development goals that will challenge on which he has done so much incredible work—are the Government more, but I record on behalf of also very important and account for millions of women Christian Aid our positive experience of working with being unable to take proper part in family life and DfID and what a good job comes out of it. look after their families properly because of childbirth. All are due to lack of proper medical and obstetric I finish with two questions for the Minister. If care and to other factors such as too-early marriage, developing countries need encouragement to ensure child marriage, forced marriage, violence in marriage—but provision for maternal healthcare, what can the most of all, in my view, they are due to a lack of family Government do to up their game about partnership planning, which enables women to control their own with those who have grass-roots contacts? That is bodies and voluntarily space the number of children where we need to operate—with those who are excluded that they have. at grass-roots level. We need to connect with those people. How can the Government up their game, We know that more than 2 million women in working in partnership and investing their funds, while developing countries would use birth control entirely using their influence with other Governments for grass- voluntarily if they had access to it. That is a fact. It roots activities? has been disregarded in the past, but thanks to the Secondly, we all know that a lot of problems in efforts of parliamentarians here, Governments such as developing countries are caused by the unsatisfactory our own, and the Bill and Melinda Gates Foundation, tax base. So much of what could be raised by taxation a great effort is now being made to get family planning to provide money for health and other infrastructure supplies out to those women who need them. is shifted out of the country by the way that corporations In 2012, our own Government—and I am very proud operate financially. Both the Prime Minister and the to mention and applaud this—held a great family Chancellor have spoken out against this practice, planning summit. Pledges were made from all over the commendably, and we have had debates in this House world and progress has been made. Since then, 8.4 million about it. I would be interested to know what the more women are now able to control the number of Minister thinks about the part that getting a better tax children that they have: that is in a report from the structure in developing countries plays if we are to organisation Family Planning 2020, which was set up equip people in their own places to take up this work to monitor the pledges given at the summit and see and meet the challenge. that they were being delivered. This is all happening despite tradition, despite their religion, despite all the 5.38 pm excuses given in the past—especially the one that we Baroness Tonge (Ind LD): My Lords, I, too, thank need children to look after us in or old age. I am the noble Baroness, Lady Hayman, for bringing this constantly telling my children that. matter to the attention of the House. As chair of the I hope that our colleagues in both Houses will take All-Party Parliamentary Group on Population, note and realise that maternal health—and family Development and Reproductive Health and president planning in particular—is the way to sustainable develop of the European forum of the same name, it is a -ment. The World Bank, no less, has pointed out that subject that has occupied most of my waking hours in sustainable development and a steady rise in a country’s the last few years. Indeed, sexual and reproductive GNP follow a reduction in family size or fertility rate health occupied the whole of my professional life in that country. We know now that it is not the other before I was elected to the other place. way around. Sexual and reproductive health and rights, I am constantly dismayed when I talk to colleagues including family planning, are essential for sustainable about maternal mortality and family sizes. I get back development. We are pretty sure, too, that fewer people the same old mantra. “Oh”, they say, “we can’t do will mean less environmental degradation; my all-party anything about it—people in developing countries group is doing an investigation into this subject at the need big families because they have to have people to moment. 991 Maternal and Neonatal Mortality[15 JANUARY 2015] Maternal and Neonatal Mortality 992

There are other advantages for us, too, when this special conferences this year alone to deal with FGM happens. Less international aid will be required in the and sexual violence in conflict—will insist, at the final long term; there will be bigger markets for our goods, conference in September at the UN on the post-MDG if that interests noble Lords; and—dare I say it—there agenda, that these issues will be dealt with in full. will be less migration from those countries for a better Sexual and reproductive health and rights are human life in the West. Let us say that loud and clear: if they rights. We talk about the empowerment of women do not listen to our arguments on maternal health and very glibly, but we cannot ensure that until we allow reproductive health and rights, tell them that; tell that women to have control over their own bodies. We to UKIP and tell those people who disregard the simply cannot. Women all over the world are depending importance of international development. on us to release them from the position to which they I am still concerned that this message is not being are condemned. We must not let them down. taken as seriously as it should be by the United Nations body deciding on the action needed after 2015, as was 5.48 pm touched upon by the noble Baroness, Lady Kinnock. At that time, the millennium development goals should Lord Alton of Liverpool (CB): My Lords, we are all have been achieved. We know that MDG5 on maternal greatly indebted to my noble friend Lady Hayman for mortality will not be achieved: there is not a hope. instigating this debate and for the way that she introduced The European forum of which I am the president—I it. As she told us, my noble friend is chair of the want to tell your Lordships about this—has Members external advisory group of the Liverpool School of of Parliament from 25 countries in Europe and beyond. Tropical Medicine’s Centre for Maternal and Newborn It includes members from Russia and Turkey; it is not Health. Her work for the school has given it very great just the European Union. We liaise with, and have encouragement. For more than 30 years I have been encouraged the formation of, similar parliamentary privileged to be associated with the work of the school groups to ours and similar forums in Australasia and and serve as an honorary vice-president. The centre Africa. All those parliamentarians all over the world designs and implements innovative healthcare packages, are having meetings and making declarations on the and offers unique expertise in research and in developing very things we have been talking about this afternoon— evaluation frameworks. It works collaboratively and impressing on their Governments, when they go back strategically with Governments and global agencies, home from their meetings, that this is the line that they saving the lives of women in countless countries, along must take, both in their own country and internationally. with the lives of their babies. The international parliamentary conference on the Professor Nynke van den Broek, who is head of the implementation of all these declarations, meetings Centre for Maternal and Newborn Health, graphically and forums that have taken place among parliamentarians sets out the scale of the challenges that face developing was held in Stockholm earlier this year. Some of us countries in reducing maternal and neonatal mortality. went from our all-party group. This conference agreed She says that an estimated 300,000 women die each that sexual and reproductive health and rights—remember year from complications in pregnancy and childbirth all those elements—should be high on the list for the and—as the noble Baroness, Lady Tonge, said a few post-millennium goals agenda. That was only after moments ago—this represents a decline. The school lobbying the office of the UN Secretary-General after says it is about 45% overall since 1990. However, this an unsatisfactory interim report was published that should not lead us to any kind of complacency because did not mention sexual rights or sexual health. It it still equates to a woman dying every 90 seconds or mentioned just reproductive health. 800 women a day. There are also at least 2.6 million stillbirths every year and an additional 2.9 million We finally got some movement. We lobbied, and neonatal deaths. At least 43% of deaths in children the parliamentarians got together and wrote letters under five occur in the first month of life. and started making a fuss about this, after all our The World Health Organization says that 99% of efforts. I am glad to say that last week we heard from all maternal deaths occur in developing countries. the Secretary-General’s office that the final version of Inevitably, this loss of life is at its most acute in rural what is called the synthesis report—sorry about the areas and—as the right reverend Prelate the Bishop of terminology; it is not mine—which was released on Derby said—in poorer communities. UNICEF reminds Christmas Day, of all days, included the words, us that more than 50% of women still deliver without “women’s sexual and reproductive health and reproductive rights”. the assistance of skilled health personnel, with 80% of That has moved us forward quite a bit: it is mentioned, maternal deaths caused by direct obstetric causes. that is good, they are looking at it. However, the word Pivotal to addressing this shocking and avoidable loss “rights” still applies only to “reproduction” and not to of life is the challenge of improving the health and “sexual”, which means that there is disagreement and nutrition of mothers and providing access to good-quality concern about a woman’s right to safe abortion, which support services for mothers-to-be and newborns, before was mentioned by several speakers. Even after rape, and after birth. we are still unsure whether women can get a safe At a personal level, two decades ago I was struck by abortion. There is no protection against FGM, for what a difference those factors could make. While example. So we must keep putting on the pressure. working in Namibia, my sister gave birth to my niece I am sorry, I have nearly finished. I fully understand at 32 weeks’ gestation. My niece weighed less than two that these are sensitive issues and I hope that the Minister pounds and no baby as small as that had previously can tell us that our Government—who have worked so survived in Namibia. I was told that important to her hard on these issues in the last five years and held two survival was her mother’s breast milk and the antibodies 993 Maternal and Neonatal Mortality[LORDS] Maternal and Neonatal Mortality 994

[LORD ALTON OF LIVERPOOL] As my noble friend Lord Patel reminded us, two it contains, but obviously she was too small to be able countries stand out: Nigeria and India. India accounts to suckle. There was no electric breast pump available for 17% and Nigeria 14% of the total. The right at the hospital. I was able to buy one and ship it out. reverend Prelate told us of his experiences in India. It How different the outcome would have been if she had is one of the world’s greatest nations, yet in its treatment been living in the bush or a remote village without of women, from conception to death, India justifies its access to resources. That is surely the challenge we title as the land of paradoxes. A 2012 report by the have to address. United Nations Department of Economic and Social Consider this tale of two countries: 2013 data highlight Affairs found that the ratio of boy to girl deaths is UK maternal mortality rates as standing at eight severely skewed. Between 2000 and 2010, 100 girls deaths in every 100,000, with three neonatal deaths for aged one to five died for every 56 boys. Putting that into every 100,000 live births. By contrast, in Zimbabwe— plain language, an Indian baby girl is almost twice as visited by my noble friend—there are 470 maternal likely as an Indian boy to die before the age of five, and deaths in every 100,000 and 39 neonatal deaths for the problem seems to be getting worse. In 1961, 976 girls every 100,000. The vast majority of stillbirths, newborn were born for every 1,000 boys, and in 2011 that number deaths and maternal deaths occur around the time of was 914. The horror stories that have filled Indian papers, birth and in developing countries. Ultimately, the health describing bodies of baby girls decomposing in heaps and survival of babies depends on the health and by refuse pits or being discovered in their scores in survival of mothers and that requires resources. rubbish bins, should rouse our consciences, and I should like to hear from the Minister when we last raised this It has, of course, been crucial that millennium issue with the Government of India. development goals 4 and 5 have helped to shape the Another country that stands out and, because of agenda for action to improve these health indicators. Ebola, is much on our minds is Sierra Leone. It is That progress has been made is borne out in the report estimated to have the highest ratio of maternal deaths, Financing Global Health 2013 from the Institute for with 1,100 per 100,000 live births. This estimate was made Health Metrics and Evaluation. It noted a welcome in 2013 and the situation then was bad enough, but increase of nearly 18% in development assistance for obviously, with the inevitable decline in the infrastructure maternal, newborn and child health. Although I join in Sierra Leone today, the situation is getting worse. I others in congratulating DfID on the role it has played hope that the Minister will be able to say something in this, nevertheless the spending per live birth remained about that. at just £32 per child. Are we involved in the formulation of new development Even where death does not occur, failure to provide goals to ensure continued global advocacy and to resources and care at this crucial moment in a woman’s ensure that action is under way? A proposed new goal life can have, as we have heard, long-term consequences. is universal health coverage. Surely a universal gold For each maternal death, an estimated 20 to 30 women standard, strengthening health systems worldwide and live but suffer lifelong morbidity including a fistula, ensuring that care for mothers and babies is available, which my noble friend Lord Patel has done so much accessible and affordable, is one that the United Kingdom work to tackle and was mentioned by my noble friend should be championing. Lady Hayman. In addition, there is chronic infection, As we look at best and worst practice, do we ask anaemia and infertility.The Liverpool School of Tropical what was done well, what was not done well, how care Medicine is currently working with the World Health can be improved in the future and how much involvement Organization to develop new tools to provide more there is of users and providers? Are we working to see detailed data—something that DfID might want to the better development of perinatal audit and cause support. classification for maternal deaths, and the introduction Improving the availability and quality of data helps of an urgently needed system to identify the cause of, to capture and understand the reasons for maternal and contributing factors to, stillbirth? I hope that my and neonatal deaths, and to develop the necessary noble friend’s initiative today will help us to achieve initiatives to prevent deaths. Digging deeper into the some of those life-saving objectives. I am indebted to currently available statistics, it starts to become clear her for giving us the opportunity to contribute to this where we should concentrate our resources and our debate. efforts. Baseline surveys under the Liverpool School-led and DfID-funded Making it Happen programme show 5.57 pm that across 11 countries early newborn care packages are simply not consistently available. Out of 749 hospitals Lord Collins of Highbury (Lab): My Lords, I, too, and health centres, only 173 were able to provide the thank the noble Baroness, Lady Hayman, for initiating required emergency obstetric care package, which is this important debate. 23.1% or less than one in four. A study of reasons for As we have heard, the UN estimates that over the unavailability of the care package shows that in 17% past two decades the under-five mortality rate has to 75% of cases there was lack of functioning equipment; almost halved; and the number of deaths of children in 13% to 17% of cases the reason was lack of a staff under five is being reduced faster than at any time in cadre—doctors or senior midwives—able to lead the team the past two decades, partly due to increased access to or provide the more technical aspects of care; and in vaccination against deadly childhood diseases. As we 2% there was a reported lack of drugs. Not surprisingly, have heard, the number of women dying in pregnancy then, sub-Saharan Africa accounts for 62% of all and childbirth has also been cut by almost half in the maternal deaths, followed by south Asia with 24%. same period. 995 Maternal and Neonatal Mortality[15 JANUARY 2015] Maternal and Neonatal Mortality 996

However, as we heard from the noble Baroness, of affordable essential commodities, medicines and Lady Hayman, this progress has not been even because vaccines, providing equitable access to universal health women, adolescents and children from poor and care, are critical. Proven strategies to improve maternal marginalised communities are being left behind. Noble and newborn health include increasing access to quality Lords have referred to the fact that nearly 800 women care in pregnancy and childbirth, including emergency die every day in pregnancy and childbirth, and HIV/AIDS obstetric and newborn care, reproductive healthcare remains the leading cause of death for women aged and information, family planning services and, most between 15 and 44. importantly, safe abortion. With little control over their lives, millions of adolescent Poor nutrition is an underlying factor in almost girls are forced into early marriage, putting them at half of all child deaths under the age of five. The UK risk of complications from pregnancy and HIV at a Government are a leader in the fight against hunger young age. Faced with an unintended pregnancy, many and under-nutrition, but can the Minister assure the women and girls resort to unsafe abortion, which House that all bilateral maternal and child health accounts for 13% of all maternal deaths; and for every programmes include a strong nutrition component? woman who dies, 20 others suffer illness, injury or The next Labour Government will put universal health disability. coverage at the heart of the global development agenda. As we have heard, mothers and babies face the Universal health coverage affirms the right of every greatest risks in sub-Saharan Africa, which accounts person to have the opportunity for the highest standard for 62% of all maternal deaths, followed by south of health, without suffering financial hardship or poverty Asia, with 24%. As the noble Lord, Lord Patel, said, as a result. It does not just help improve health outcomes, two countries account for one-third of all maternal but would help reduce inequality and stop 100 million deaths: India, with 17%, and Nigeria, with 14%. It is people a year falling into poverty. Health and economic worth repeating these statistics, because those are countries development are interdependent. Healthy populations that we now consider middle-income countries, which are more productive. do not need development support. But inequality there It is clear from this and other recent debates in this is growing rather than diminishing. Chamber that universal healthcare will make countries more resilient to humanitarian disasters and outbreaks The noble Baroness, Lady Hayman, highlighted the of disease. The ability of Nigeria, which has a relatively maternal mortality ratio, showing the highest discrepancy strong healthcare system, to contain and beat the Ebola of all health indicators—the gap between high and virus this year sharply contrasts with the experience of low-income settings. Sierra Leone has been mentioned: Sierra Leone and Liberia, whose health systems were it is estimated to have the highest MMR, at 1,100 per weak. Universal healthcare is a clear and quantifiable 100,000 live births—and as we have heard, this estimate goal. Will the Minister commit the Government to it is from 2013, before the Ebola epidemic. There is in considering the language of the health goal in the emerging evidence that as a result of the Ebola epidemic SDGs when negotiations start in New York next week? more maternal deaths are occurring, both as a result What is her department doing to ensure that the next of the virus and as a result of lack of availability of development framework is ambitious and trans- routine care, with the focus on care for patients with formational to end all preventable, maternal, child and Ebola and the collapse of existing health systems—which newborn deaths? were, as we have heard, incredibly weak already. I do not know how many noble Lords heard the BBC’s As we have heard from my noble friend Lady excellent report yesterday highlighting the additional Kinnock, addressing the underlying causes of ill health risks to healthcare workers treating pregnant women and mortality is also critical. As we heard from the with Ebola. It was a shocking story. right reverend Prelate the Bishop of Derby, this means investing in women’s empowerment, girls’ education, We have heard about millennium development goal 5a, preventing gender-based violence and ensuring access to reduce maternal mortality by 75% between 1990 and to clean water and sanitation. Will the Minister highlight 2015: 11 countries are “on track” to meet it, 63 countries what the UK Government are planning and doing to are “making progress”, and 13 are “not on track”. Factors address these underlying causes? associated with making progress include leadership, working in partnership, using evidence, and being 6.06 pm innovative and able to adapt using both long and The Parliamentary Under-Secretary of State, Department short-term strategies. for International Development (Baroness Northover) Maternal and newborn health are closely linked. As (LD): My Lords, like other noble Lords, I pay tribute we have heard, motherless children are up to 10 times to the noble Baroness, Lady Hayman, for securing more likely to die within two years of their mother’s today’s debate, and for her long-standing commitment death. More than 6 million children under five died to maternal and neonatal health. I commend the other last year, primarily from complications of prematurity contributions we have heard today, which, as ever in and birth, pneumonia, malaria and diarrhoea, with your Lordships’ House, have ranged very widely. I also under-nutrition a major factor. The survival rate of thank noble Lords for their tributes to DfID for our the most vulnerable children—newborns—is improving work. We have heard the devastating figures, and as my too slowly: 44% of deaths under the age of five occur noble friend Lady Hodgson pointed out, a human face in the first month. was given to those figures. As we have heard, nearly all maternal, child and The noble Baroness, Lady Hayman, my noble friend newborn deaths are preventable. Strong health systems, Lady Hodgson, the noble Baroness, Lady Kinnock, with sufficient skilled health workers and reliable supplies the right reverend Prelate, the noble Baroness, Lady 997 Maternal and Neonatal Mortality[LORDS] Maternal and Neonatal Mortality 998

[BARONESS NORTHOVER] they need when they need them. They include better Tonge and now the noble Lord, Lord Collins, have all nutrition, access to education and access to clean pointed out that this relates fundamentally to the rights water and sanitation. The United Kingdom has a of women and their unequal status, unequal access to strong track record of working to improve maternal nutrition and education and being forced into early and newborn health—and I thank noble Lords again marriage—we have heard the range of challenges. for their tributes. In 2010, we made commitments to Gender inequality is key. save 50,000 maternal lives and 250,000 newborn lives This is a very timely debate, coming right at the by the end of 2015, and we intend to meet them. We start of 2015, the final year of the millennium development have already exceeded our target for maternal lives goals and the year in which new goals will be agreed at saved through a combination of increased investments the UN in September. Globally, as the noble Baronesses, in family planning, skilled birth attendants and making Lady Hayman and Lady Tonge, said, we have made health systems stronger—all issues that noble Lords significant progress in reducing maternal mortality. addressed. A number of noble Lords emphasised family The maternal mortality ratio dropped by 45% between planning, and we share their view that this is crucial, 1990 and 2013. Each region of the world has seen which is why we emphasised it at the London summit significant improvement, though none, as noble Lords in 2012. A recent report shows that we are broadly on pointed out, has yet reached the goal of a 75% reduction track to meet our commitments. Nevertheless, we are in mortality. not complacent; we know how extremely important These improvements have been driven largely by that issue is. more women having access to skilled birth attendants— I agree with the noble Baroness, Lady Kinnock, nearly 70% of births now take place with a skilled that we need to make sure that we have adequate attendant. I note what the noble Baroness, Lady Tonge, funding for sexual and reproductive health and that and the noble Lord, Lord Alton, said about the high that includes funding from the country Governments level of maternal morbidity. I pay tribute to the All-Party themselves. The summit was encouraging, and I hope Parliamentary Group on Population, Development that the noble Baroness was able to see the commitments and Reproductive Health for its outstanding report, that came forward. We need to make sure that those Better off Dead?, as well as to the work on fistula by are delivered. We agree that it is vital that girls and the noble Lord, Lord Patel. It is not just a matter of women should be able to access comprehensive packages physical morbidity. As my noble friend Lady Hodgson of sexual and reproductive health. pointed out, the mental health of mothers is key. I hope that my noble friend will be pleased to note that Ensuring that the post-2015 development agenda mental health is included in the targets for the SDGs continues to advance the social, economic and political proposed by the open working group. empowerment and human rights of girls and women remains a top priority for the United Kingdom, and The noble Baroness, Lady Hayman, noted the number we will continue to work tirelessly to ensure that the of neonatal deaths and that it had not moved in the final framework advances the needs of girls and women. direction that maternal mortality had. The MDGs did The noble Baroness, Lady Kinnock, mentioned prioritising not include targets for newborns; consequently, they what women want in terms of safe abortion. Where received less attention and less progress has been made. girls and women have taken the decision to terminate The noble Lord, Lord Patel, in particular emphasised a pregnancy, our aim is to ensure that they do not put how much more we still need to do. Nearly 3 million their own lives at risk. Improving access to safe abortion newborns still die every year, accounting for around saves maternal lives and reduces maternal ill health; I 44% of all deaths of children under five, and 1 million stress that very strongly. of these die on their first day of life, as noble Lords noted. Eighty-five per cent of newborn deaths result Beyond international targets, we know what is needed from three preventable causes, as the noble Lord, Lord on the ground. We need to see high-quality reproductive Patel, and other noble Lords pointed out. midwifery and emergency obstetric services being delivered The noble Lord, Lord Patel, emphasised the high through well functioning health systems. There is much incidence of neonatal deaths in a few countries, identifying more that we need to do. Most of these deaths are particularly large numbers in the populous countries preventable. We must ensure that clear targets for of India and Nigeria—the noble Lords, Lord Collins improved sexual and reproductive health and rights and Lord Alton, made reference to that as well. As the are included to prevent maternal and newborn deaths. noble Lord, Lord Patel, noted, it is shocking to see the They must be secured in a post-2015 framework. We proportion of babies not breastfed in the first 24 hours. are working extremely hard on this and anything that I was shocked when I visited India early last year to noble Lords can do working with southern voices in discover that this was indeed widespread. I can assure these next crucial months is vital. the noble Lords, Lord Patel and Lord Alton, that My noble friend Lady Tonge mentioned the omission prioritising women and girls and seeking to address of “sexual rights” from the UN Secretary-General’s neonatal health is uppermost in our discussions in recent synthesis report. This report is one of many inputs India. My right honourable friend Lynne Featherstone into the process. We still wish to see the full sexual and has been to India this week as a champion to combat reproductive health and rights package reflected in the violence against women and girls, so it is very high in final framework. We need to ensure that women can the Government’s priorities. access contraceptives if they wish to prevent pregnancy As noble Lords made clear, faster progress in these and, if they become pregnant, have access to skilled crucial areas will be achieved only when girls and health workers who have the right drugs and equipment women are able to access the care and services that at the right time in the right place to be able to respond 999 Maternal and Neonatal Mortality[15 JANUARY 2015] Maternal and Neonatal Mortality 1000 to complications during pregnancy and childbirth. I We need to continue to work on the social determinants was very moved at the Christian Aid carol service to of health, such as poverty, better nutrition, education, hear some of the stories from Kenya. and so forth, as I have said. Crucially, as noble Lords have made clear, we need the empowerment of girls We need health financing systems that mean women and women, to enable them to have voice, choice and do not have to make choices between accessing care control within their households, their wider communities and feeding their families. I agree with the right reverend and across their nations. Noble Lords have made a Prelate in terms of finance that a sustainable solution powerful case for that. That means working at every can come only when countries finance their own healthcare level. I agree with the right reverend Prelate that that adequately. He is absolutely right that tax reform is a clearly involves working at community level and we key part of that. have our aid-matching system as one of the key mechanisms for that. There are others in our portfolio We need supporting information systems that tell of support for civil society. us whether our efforts are working and how and where All this is doubly important when we are talking, as to improve them, ideally taking advantage of new noble Lords have, of the hardest-to-reach groups: the technologies, as the noble Lords, Lord Alton, Lord youngest, the poorest, the most geographically isolated Collins and others mentioned. All this is why universal and those affected by conflict—those left behind by health coverage must be an important part of the the progress towards the current MDGs. That is why post-2015 agenda. Strong health systems are vital. It is the new set needs to ensure that they leave no one because Sierra Leone and Liberia have fragile health behind. More rapidly declining rates of maternal and systems as fragile countries that the Ebola epidemic newborn deaths will tell us when we are getting this was able to take hold. That is why we are involved in right. such countries and why such health strengthening has received 20% of DfID’s budget. House adjourned at 6.19 pm.

GC 235 Cadet Units in Schools[15 JANUARY 2015] Cadet Units in Schools GC 236

It was with pleasure, therefore, that I received a Grand Committee letter on 10 December from the noble Lord, Lord Astor of Hever, from the MoD, which said that those Thursday, 15 January 2015. proposals would not go forward and that funding as currently conceived would continue and would extend 1pm to the new school cadets. That was very good news indeed, as was the news that I heard later that the schools expansion programme was on time and back on track and that we have about 60 new schools ready Cadet Units in Schools to open their cadet corps in September, with another Question for Short Debate 50-odd in the pipeline. That was good news, as was the Asked by Lord Lingfield cadet bursary fund, of which I know that the Minister is himself a great supporter. That is meant to support To ask Her Majesty’s Government what plans the expansion of cadets, and to raise £8 million over they have to promote more cadet units in schools. the next four years. I would be grateful if the Minister would indicate, when he replies, where that fund is and the prognosis for the future. Baroness Garden of Frognal (LD): My Lords, will If last July’s proposals were indeed misconceived, Members making speeches limited to four minutes the MoD was right to subject cadet funding to some please sit down as soon as the clock reads four, and scrutiny.That was absolutely proper. Cadets cost annually preferably a few seconds before. Thank you. about £160 million, of which £28 million is spent on school cadets, with the rest going on cadets in the Lord Lingfield (Con): My Lords, I begin by declaring community—the Army Cadet Force, the Air Training an interest as the chairman of a charity, CVQO, the Corps and the Sea Cadets. We have to ask ourselves: Cadet Vocational Qualification Organisation, an are they worth it? Are those sums of money justified? appointment in which I was proud to succeed Admiral In my view, they certainly are. West—the noble Lord, Lord West of Spithead. The Not very long ago, I was speaking at a national Combined Cadet Force has a long and honourable competition to a young man from one of our northern history. It finds its roots in the rifle volunteer battalions cities. He was badged as a guardsman and dressed in for home defence which, in the early 1860s, acquired the scarlet of a drum major. It became clear during some school units. They numbered 90 by the beginning our conversation that he had left school with just one of the Great War. By 1938, that number had doubled. poor GCSE and had had a little intermittent work During the Second World War, Royal Navy and RAF since, cleaning cars. It was also clear that his cadet sections were added, and shortly after the war they unit—with its regular attendance, discipline, uniform, were combined into the Combined Cadet Force. Her and its opportunity for leadership skills and for taking Majesty the Queen became its Captain General early BTEC and other qualifications, which he had started in her reign. Today, we have about 46,000 cadets in 260 to do—was the only way that he could show any schools and there are about 2,800 adult instructors self-worth at all and gain any self-esteem. He said to and officers me, “If it hadn’t been for the cadets, it would be drugs In 2008, I and other supporters of cadets—I was an and trouble for me”, and he was beginning to do well. honorary colonel at the time—were very pleased indeed Stories such as that are legion, and they tend to when Gordon Brown revealed his plans to increase the suggest that every penny we spend on cadets is worth number of cadet units in state secondary schools. In while and could save money in other areas of public May last year, David Cameron announced the cadet expenditure. My own organisation, the CVQO, puts expansion programme, which was planned to deliver thousands of cadets each year through BTECs and another 100 cadet school units by September this year. other similar diplomas. They acquire at the same time It was with dismay, therefore, that we received the those life competences of punctuality and a can-do news in July that the MoD proposed that funding as it attitude. They are most likely then to go into work and currently happens should cease and that, indeed— on to higher vocational qualifications. They are less presumably to pay for those new units to be created—the likely to be NEETs or benefit claimants, or indeed to cadet grant should end next September; that the year encounter the youth justice system. It is also not too after that, remuneration for cadet officers and other far-fetched to say that the NHS saves money from adults should end; and that the year after that, a cadets, because they tend to be healthier, fitter and less government charge of £75 per cadet should be made obese. Certainly, they make good recruits to the Armed and should double the year after that. Forces, in both the Regular Forces and the Reserve The consultation which followed suggested that Forces. There is also some indication that in later lives about 60% of schools with cadet corps would not be they are more inclined towards volunteering in their able to continue them, leading to a loss of probably communities. However, all that is anecdotal. We seriously half to two-thirds of the current number of cadets. It require a study of the social impact of cadets and of was clear that the department had failed to take into their value for money. I very much hope that the account the fact that schools already contribute Minister will indicate whether such a study might be considerable resources to cadets and that further funds possible. from their general expenditure would not be possible. Finally, I mention another excellent government That was not where the Prime Minister’s initiative was scheme, the military ethos in schools programme, in meant to lead. which my own organisation, among many others, takes GC 237 Cadet Units in Schools[LORDS] Cadet Units in Schools GC 238

[LORD LINGFIELD] also commanded his civil service unit to be present. part. Typically, some dozen young pupils are selected Outreach is a generous gift from the Army. It reaches in each school. They tend to be those who are having out to the young underprivileged and offers a way problems with discipline and have low achievement. forward to boys and girls in our high schools, who, for They benefit enormously from the cadet-type work example, may have encountered the police and the that they do, supervised by cadet instructors, which is magistrates’ youth court. They then do very well on usually part-time. Their schools are hugely supportive the course. Time is of the essence, so I shall sit down. of this and report better attendance among those pupils, improved self-worth and an increase in levels of 1.15 pm literacy and numeracy. Finally, cadets were created some 150 years ago Lord Burnett (LD): My Lords, I congratulate my with the object of making better soldiers. Today, the noble friend Lord Lingfield on securing this debate object is to make them better citizens, and long may and for the wholehearted support he gives to the they be enabled to do so. cadets. I also thank my noble friend Lord Astor of Hever for his great support for the cadets. 1.10 pm Life is full of coincidences. I was up on Dartmoor Lord Jones (Lab): My Lords, in a very long public last Saturday. I spend a great deal of time there; not, I life, most of it in these two Houses, I have not encountered hasten to add, in the prison, though I have been there better provision for youth than that proffered by the a few times—I made guest appearances only. While up nation’scadet force associations. From my own observations, on Dartmoor I came across 60 cadets who were learning I can say that what is done by the Army for young to do a six mile or so advance to contact in hostile women and men is magnificent. They are provided conditions, on hostile terrain and in hostile weather. It with excellent opportunities, facilities, training and was raining and very cold. They were in cold-weather mentoring. There are many successes and Wales is a clothing, though their instructor, I am proud to say, determined partner in this success. I attend cadet camps Corporal Credicutt of the Royal Marines, was in throughout the length and breadth of England and see shirt-sleeve order: noble Lords must remember that it these achievements. The Committee owes the noble was not quite freezing. Corporal Credicutt had come Lord, Lord Lingfield, a debt of gratitude for securing up from Commando Training Centre Royal Marines this debate. I sincerely support him wholeheartedly. He to instruct the cadets. has made the case for cadet units in our schools and defended them. I thank him for his insightful, loyal These 60 or so cadets were from Tavistock and two and committed remarks. other units. They need not have come; they were all I also acknowledge the professionalism of Brigadier volunteers, all dedicated and enthusiastic. They were David Short, the ACFA chief executive officer, for his giving up their free time to learn leadership skills, élan, vigour, experience and enthusiasm. I do not say how to work together in adversity and many other that for nothing, as he commanded Apache attack lessons, including initiative and self-discipline. I was helicopters in British squadrons. We are in good hands. immensely impressed and proud of them. I believe, as I declare my interests as president of the Army my noble friend Lord Lingfield said, that other Cadet Forces Association Wales, as president of the departments of state should contribute to the cost of training ship “Tuscan”, and my very long-standing the cadets. association with 2247 Squadron ATC, both of the It is a shame that we have only four minutes in latter in Flintshire. I have seen a lot of them. which to speak, but I also want to thank Lieutenant In Wales we have a leadership team dedicated to the General Sir Robert Fulton, a former commandant-general best interests of the cadets. I offer praise to Colonel of the Royal Marines, a corps in which I had the Commandant AVJones in Clwyd and Gwynedd, covering honour to serve, for briefing me. I congratulate the the communities of the Snowdonian massif and industrial Ministry of Defence and our Secretary of State on north-east Wales. I also praise Colonel Commandant recognising the importance of the cadets. He saw them David Hammond, a very distinguished professional at first hand when the Royal Marines Cadets were at soldier, who leads over the seascapes of Dyfed and the Buckingham Palace last summer. The year 2014 was city of Swansea, and Colonel Commandant Rob Hughes, the 350th anniversary of the formation of the Royal who copes with the vast interior of Powys and the Marines. Due to the tireless work and commitment of eastern valleys of Gwent. Our splendid chairman is many, particularly Colonel Cautley of the Royal Marines Colonel John Brunt, himself a former commandant. Reserve, Her Majesty the Queen last year instructed The colonel of cadets is the ubiquitous Colonel Mike that henceforth all cadets who are entitled to wear the Mullis. We recently welcomed our new secretary, Colonel Royal Marine uniform will be called Royal Marines Naysmith, saying goodbye to a wonderful secretary of Cadets. Some 500 or so Royal Marines Cadets and 10 years—Major John Carter, to whom I owe a great instructors marched behind the band of Her Majesty’s deal. This team faces up very boldly to the constant Royal Marines from Horse Guards to the gardens of challenges of distance, climate and topography. We Buckingham Palace, where his Royal Highness Prince are a very varied people in Wales with distinctive Philip, the Duke of Edinburgh, took the salute. I shall approaches, but I think that the movement is a splendid end by reading an excerpt from his Royal Highness’s success in my homeland. address. He said of the Royal Marines Cadets: I place on record my thanks to the right honourable “They have a very special reputation of their own which Secretary of State Iain Duncan Smith for receiving my reflects the reputation and achievement of Her Majesty’s Corps deputation concerning the outreach programme. He of Royal Marines”. GC 239 Cadet Units in Schools[15 JANUARY 2015] Cadet Units in Schools GC 240

1.18 pm When I took over as Chief Inspector of Prisons in 1995, very soon afterwards the then Home Secretary Lord Freeman (Con): My Lords, like my noble told me that he wanted to impose what he called a friend Lord Lingfield, I am a very strong supporter of “boot camp regime” based on what he had seen in the cadet forces. We need more cadet units and I am America. He thought that the only place where he very grateful for and appreciative of the efforts taken might find that was in the military prison at Colchester. by the Ministry of Defence and, in particular, by my I told him that that military prison was not a prison—it noble friend Lord Astor to ensure that we are on an was the Military Corrective Training Centre and that upward and, I hope, sustainable track in supporting it had two parts: one was a sort of resettlement prison, more cadet units. My experience, like that of many of returning people to civilian life, and the other gave a your Lordships, was at school, having served in the second start to people who had made a bad start in Combined Cadet Force. Then it was compulsory. I am their careers. They therefore did basic training again, not in favour of compulsion, but everyone was in full which resulted in an 84% success rate. Indeed, the uniform and received weapon training. That is very MCTC counts 11 regimental sergeant majors among expensive, partly because of the cost of provision of its successors. armouries, let alone safety; those were the days. Today there are many fewer combined cadet forces and, One of the very interesting facts about the population clearly, cost is a factor. So I ally myself behind those, of the MCTC was that virtually none of the people and with those, who call for a further expansion and I who came through that programme had ever been in am delighted at the support that has been given. the cadets. Having been in a regiment which strongly supported the cadets and indeed welcomed people I will very briefly mention one initiative which I am with cadet experience because they had had, as it were, associated with: the military ethos in schools programme. a flying start to their regimental career, I was very That involves former military personnel—who I am interested in that. Therefore one of the things I hoped told are already in 460 schools throughout the United was that, as a result of the experience of sending Kingdom—explaining the ethos of the military and young offenders to the MCTC—where they grew up explaining and using the discipline and determination amazingly and responded to military discipline in a that is expressed so well by many in our Armed Forces, way which was immediately recognised by their parents, helping to improve not only the self-discipline but the quite apart from their instructors—perhaps a cadet ambitions of more than 16,000 children. I thank Her force might be formed in a young offender institution. Majesty’s Government for their continuing support Indeed, one was started at Feltham. It has not taken for that programme. off as well as it might, but I suspect that that is as Finally, I will touch on the connection I have, partly much because of lack of encouragement rather than because I have served as president of the Council of lack of opportunity. the Reserve Forces and Cadets Association. At the Recently, there was the idea of setting up, for instance, time I served in that association it had 50,000 reservists. a secure foundation, which is a local area responsibility Today we have an ambition to get back to something in a one-hour radius by public transport for young like 30,000, which is a very tall order. I hope that offenders. Incidentally, all the local councils, in seeking increasing the activities and numbers of school cadet what the place should do, all wished a cadet force to be forces will feed through to participation in our Reserve part of the curriculum because of what it offered the Forces in later life. It is vital that we have 30,000 young people. Therefore, my plea to the Minister is reservists as soon as possible, because our Regular that he should contact his colleagues in the Ministry Forces are being reduced significantly. Initiatives taken of Justice, commend to them that the military ethos in at school, and school cadet forces, can help. schools programme should be extended to young offender institutions, because it clearly works, and do all that he can to encourage this. You never know, out of the 1.21 pm youth justice system we might rescue some people for Lord Ramsbotham (CB): My Lords, I, too, congratulate the Armed Forces, quite apart from anything else, and the noble Lord, Lord Lingfield, and thank him for nothing has a better track record of dealing with obtaining this debate. I also congratulate him on his young people and building up their self-esteem than leadership of the CVQO, which I know is much the cadet force. appreciated. 1.25 pm I make no apologies for diverting slightly, but the noble Lord mentioned the youth justice system. Recently Baroness Seccombe (Con): My Lords, I add my the Secretary of State for Justice announced that he congratulations to my noble friend for giving us this wants to put education at the heart of the youth opportunity to debate this important issue. First, I justice system. I therefore feel that there is a connection want to declare an interest as my son is chairman of between the subject of this debate and what is wanted the West Midlands Reserve Forces’ and Cadets’ in the youth justice system. I will explain some of the Association. things that have happened in the past which give me When I was at school I was a Sea Ranger, which encouragement to speak like this. Before I do so, I join was odd as I lived in the centre of England as far away the salute to the noble Lord, Lord Astor, for all he has from the coast as you could be. We were instructed by done, and say how welcome that letter was. I cannot a retired naval officer who was a great believer in the believe that it resulted from anything other than a power of marching and all its intricate moves. I loved great deal of work on his behalf, so I thank him for it and could see that we all gained from working that. together with great precision. We were the best and GC 241 Cadet Units in Schools[LORDS] Cadet Units in Schools GC 242

[BARONESS SECCOMBE] George Washington said: proudest of anyone as we marched along The Mall for “Discipline is the soul of an army”, the then Princess Elizabeth. Noble Lords may question and that one of its outworkings was “esteem for all”. what this has got to do with the subject. All I know is Words such as “discipline” and “respect” have formed that I benefited from it and it was all that was on offer a common refrain in this debate and that is as it at the time. We had to spend two hours each day in should be. While the Army Cadet Force is very deliberately some form of sporting activity. Children do not have a youth organisation, and not some junior version of that chance today but now they have this splendid the Army Reserve, it does share some common genes opportunity through membership of a cadet detachment with military service—genes which we would do well to combine active involvement while developing important to encourage throughout society. life skills. I believe in today’s hazardous world it is really important that young people learn more about People like to complain about the young. It is the the military and voluntary ethos. The cadet expansion natural order of things and has been ever thus. Every scheme gives that opportunity to learn about self-discipline, generation has shaken its head disdainfully at the teamwork, punctuality and self-confidence—all so useful prevailing trends of youth culture. Punks, mods, rockers throughout life. and even the flappers of the 1920s have all been cited as evidence of moral rot. In the 21st century our The cadet movement has always been part of life in terminology is less gracious and headline writers are independent schools, so I was delighted when last year never happier than when writing about the “feral the Government agreed, at last, to fund a scheme with youth” running amok across society. £1 million added to the £10 million already pledged to Clearly, young people are not undermining the help state schools cover the setting-up and running fabric of society but I do think that the very nature of costs of 100 new cadet units within a year. The sum is modern society is helping to undermine the prevalence being matched by the private sector. I understand that of characteristics that are for the common good. Today’s the initiative is going well and I agree with my noble society is more atomised and less community-orientated friend that it would be good to have an update from than at any time I can recall. The ties of tradition, the Minister. It seems to me that this would be a family and religion have loosened. We live in an instant principled cause to motivate charities and philanthropists age and are prone to live in the moment and for the in generous donations as well as then following up moment. We are less patient, less thrifty, less structured, with interest. Of course, in any exercise of this kind so less active and more self-centred—and that applies to much must depend on head teachers. They are the the not so young as well as to the young. We live in an ones who must first excite the students and the parents era of dichotomy, where medical advances that would on the benefits of the cadet experience and then drive have seemed beyond possibility to the post-war generation the project forward. They must explain what will be are accompanied by the plague of obesity. In our gained by being part of a team, developing particularly relative culture of plenty we have all become concerned self-confidence and self-discipline. This will be important with rights rather than duties. We have never had as the students face all the new challenges that this will more, but are we really more content or happier? offer them. They will be able to go on expeditions, do activities such as sailing, and develop skills in advanced Frankly, “discipline” and “self-reliance” are not the first aid and, most importantly, leadership. Other critical watchwords of modern Britain’s zeitgeist. You could individuals are the adult volunteers who, I understand, almost say that they are countercultural. That is why I are coming forward in encouraging numbers. Perhaps have no hesitation in supporting the Motion of the the Minister could update us on this also. noble Lord, Lord Lingfield, to encourage more cadet units in schools. In an age where virtuous and liberating I believe that, whether participation in the scheme characteristics, such as self-control, hard work, leads to a life in the services or not, these young people camaraderie and discipline are hard-pressed, we should will enter adulthood as well rounded citizens. They encourage activities, especially among our youth, which will have had invaluable experience to test themselves help push back against the prevailing headwinds. in many ways and will emerge more self-confident and, I believe, more understanding, ready to take their Cadet units build self-confidence, they prepare people place in society. I am sure we all wish we could have for work, they teach respect for the self and for others, had the opportunity in our own school days. they encourage fitness, and, as has been mentioned, the financial cost of involvement is minimal. Sometimes 1.29 pm you do not have to reinvent the wheel to solve a problem. School cadet units are an excellent outlet for Lord Rogan (UUP): My Lords, through my 12 to 18 year-olds, and many more of them should involvement in politics and with a personal interest, I have the opportunity to get involved. have had the good fortune to spend time with the men and women of our Armed Forces. I know that the 1.34 pm noble Lord, Lord Burnett, is especially pleased that some of that time was spent with his Royal Marines. I Lord Lexden (Con): My Lords, this is indeed a most have had the privilege of watching the modern Army valuable debate, for which we are indebted to my noble at work. As an honorary colonel of a signals regiment, friend Lord Lingfield. Sadly, my career in the school I have come to greatly admire the character of those cadet force long ago was an utterly inglorious episode, who serve. I have listened to many tales from serving all details of which must be suppressed. soldiers about what the Army has done for them—how I have nothing but praise for the Government’s it shaped and moulded their character and gave them plans—now well advanced—to enable more maintained the skills to fulfil their potential. schools to establish cadet units. A number of those GC 243 Cadet Units in Schools[15 JANUARY 2015] Cadet Units in Schools GC 244 schools already have them but, like the excellent state physical risks as adult TA soldiers. Yes, risks were boarding schools, they are among the nation’s best taken because military exercises are inherently hazardous, kept secrets. Their ranks should be swelled, and now even though we try to reduce the risk as much as they will be. possible. I hope that the Committee will agree that it The increase in the number of cadet units is surely was worth taking those modest and controlled risks. to be welcomed on two grounds above all. First, it will In my career, one thing led to another. Being a confer benefits on many more youngsters, assisting the cadet led me to the TA, a point made by my noble shaping of responsible character and the provision of friend, Lord Freeman. For me, the TA involved logistics otherwise unattainable opportunities. Secondly, it will and leadership, and that led me to running an NGO in assist the national interest. Our defence in the years Rwanda. That meant that I had utility to the regular ahead will rest on the Territorial Army to a much army for peacekeeping operations in the Balkans and, greater extent than in the recent past. The expansion of course, that I had utility to your Lordships’ House. of cadet units will help furnish the recruits that the TA Of course, this argument that one thing leads to will need. another is not unique to someone with the privileged I have just one principal objective in this short background which I have. It applies to everyone, no debate: to advocate greater collaboration between matter what their background. independent and maintained schools. I should add There is one problem I would like to draw to the that I have long been associated with the independent attention of the Committee and the Ministers. I sector of education. Collaboration is already flourishing understand that the maximum age of cadets was 18 and in a number of places. The head of an independent a half, but it has been reduced to 18. Apparently, the school in York wrote recently that it has, reason is that adults are not allowed to share “pupils from a neighbouring state school training alongside our accommodation with cadets, and I can understand the cadets every week”. reason for that. Noble Lords might think that this is a Another head teacher in Cheltenham described how a small change, but an attractive activity for cadets is contingent formed recently in a nearby academy has target rifle shooting, and competitions are held nationally been developed in partnership with his school’s CCF, and internationally. The problem is that other nations “using our experience and resources, and they are bringing some can field a team with cadets aged up to 19, and it is superb talents to the team”. difficult for 18 year-olds to compete with a 19 year-old I am sure that the Minister will agree that such partnership because at that age an extra year of maturity, concentration ventures should be encouraged throughout the country. and everything else makes a significant difference. This is, of course, a matter for both Ministers—my Of course, not all independent schools have attained noble friend Lord Nash for education, and my noble the highest standards throughout their histories. One friend Lord Astor of Hever, who I am sure we are all school magazine reported on 3 May 1888: grateful to see in his place. A touch of ministerial “The majority think it monstrous if they are obliged to attend direction in order to allow cadets at the age of 18 and twenty drills in the summer term. The consequence is that whenever a half might be worth thinking about. It would be the corps makes its appearance the drilling is bad, the marching is extremely beneficial with negligible risk attached. slovenly, and it becomes the laughing stock of the school”. The school in question was Harrow, and its cadet force When I was in the CCF in the 1970s, many teachers was about to secure a new recruit: Winston Churchill. had military experience, and some had operational He swiftly transformed it, making it what would today experience in the Second World War. Two challenges be called a model of good practice. It was therefore so now arise: first, the lack of military experience of the very appropriate that contingents of cadets were prominent instructors, which is not necessarily a huge problem; at his state funeral 50 years ago this month. We can be and secondly, an increasing requirement for adult sure that he would have been much in favour of the instructors to be course trained. As ever, some of this expansion of the number of cadet units which is now is sensible. For instance, I would take my wife walking taking place. He always said that the opportunities on Snowden but I would not take a group of cadets or available to the few in public schools should be extended adult soldiers there because I am not qualified by throughout the nation. training or experience. Simply, I do not know what I am doing. However, an instructor may have a qualification 1.37 pm but not the right one. In other words, he knows what he is doing but does not have the right piece of paper. I Earl Attlee (Con): My Lords, I am grateful to my understand that the cadet movement is facing increased noble friend Lord Lingfield for introducing this Question bureaucratic demands. I hope that the Ministers can for Short Debate about cadets. On the point about have a look at that. recruitment, I point out that the cadets are a youth movement, and the cadet force is worthwhile even if the Armed Forces get no recruits from it. We would 1.41 pm just need to find another way of funding the cadets. Baroness King of Bow (Lab): My Lords, I congratulate I started my military involvement with Stowe School the noble Lord, Lord Lingfield, on securing this debate. CCF and, as I observed at Second Reading of the Even more important than that is securing the funding Social Action, Responsibility and Heroism Bill, in the that he outlined, and I am therefore particularly glad mid-1970s I was allowed to do things as a cadet that to be able to congratulate him and his colleagues who would be absolutely out of the question now. For have worked on this issue and secured the funding instance, I was allowed to go off on my own on a TA stream. In a moment, I should like to ask the Minister internal security exercise, and I took exactly the same a few questions about how far the funding will reach. GC 245 Cadet Units in Schools[LORDS] Cadet Units in Schools GC 246

[BARONESS KING OF BOW] Vocational Qualification Organisation and the fine First, however, I should say that it is encouraging work that it does to ensure that the skills gained that both Labour and Conservative Prime Ministers through cadet forces are recognised. I would also like have given their personal backing to the cadet forces. to thank all noble Lords for their valuable contributions It is also encouraging, as the noble Lord, Lord Lexden, today. outlined, that partnerships between schools are in As part of driving education reforms to address our place to help strengthen and expand the cadet forces. slide down international league tables, we need to After all, the cadets, when one looks at what they equip our young people with the character, grit and actually do, are one of the most—possibly the most— determination that they need to make their own way in fantastic youth service we have in this country. The life. We need to give them the opportunities to develop service they provide is extraordinary. The skills and the leadership, team working and other social skills training on offer are second to none, and then there that are so vital to employers. As we have heard, many are all the other things being done—not just allowing of our most respected independent and some state young people to jump off mountains or use gliders, schools have for over 100 years looked to military-themed although I would have loved to have had that opportunity activities to give their pupils a sense of discipline, myself. In terms of promoting active citizenship, adventure and achievement. committed citizens with high self-esteem, mentoring, volunteering, fitness, personal and social development, Such life-changing experiences should not be the and leadership skills—who would have thought that preserve only of the fortunate. It is young people in the noble Earl, Lord Attlee, would have ended up in schools in the most disadvantaged communities who Rwanda—all these extras that one gets from this funding most need greater strength of character to cope with makes it extremely well spent. In particular, the the challenge they face to succeed in life. Contrast the employment skills around punctuality, reliability and organisation, routine, structure and discipline that discipline are extremely important. come from a service life with the chaotic home lives The other area that we should dwell on was touched which, sadly, so many of our children and young upon by the noble Lord, Lord Ramsbotham—the people experience today, with no structure or routine youth justice system. I was struck by his comments. As and a background that is literally scatty, with poor my noble friend Lord Jones said, the cadet force is, eating and sleeping habits, and so on. above all else in some senses, an outreach programme One of the charities I was actively involved in that connects young people to the Army, although, as before I took this job looks after boys on the edge of we have heard, it is not a formal Army organisation. I exclusion. Virtually all of those would be in a single-parent commend my noble friend and others who have spoken situation. We surveyed these parents to ask whether on their long association with the cadets and the any of them had systems or routines at home for times military. It is really important for young people to for eating, homework, television or sleeping, or times have a positive experience of authority at an early age. that they had to be in by. More than 80% of parents I cannot underline enough how important that is for replied that they had none; but more than 80% also young people who come from areas such as the one in replied that they would love to hear about such a which I live in Tower Hamlets, for example. I know system if somebody could explain it to them. That that the first words that a police officer said to me were shows the chaos in many of our homes today. very derogatory and included my skin colour. I remember The other important thing that the forces can bring thinking, “I’m not that black and, anyway, why is he to schools is men. Of course, women forces personnel saying that?”. The cadets offer the exact opposite are extremely good role models, particularly for girls approach and avenue for young people to come into in schools; but sadly a large proportion of young contact with authority and we cannot underestimate people today are brought up in what we politely call how important that is. single-parent households, which almost certainly normally I have a couple of questions. First, I understand means a single mother. Some 27% of primary schools that there are 3,280 cadet units across the UK, but have no male teachers in them at all; only 15% of only 10% of those are in state schools, which is why primary school teachers are male, though there has this programme seeks to increase the numbers. I assume been a 10% increase under this Government; and only that the 60 new cadet units that are to open this 4% of teaching assistants in primary schools are male. September are all in state schools. I would like clarification, This means that many children have a total absence of although I believe that they are. Secondly, is the male role models in their lives, which can be just as Department for Education encouraging schools to damaging for girls as for boys. If a girl has never collaborate in a more concrete way, so that a relatively experienced the love of a man, the dangers that this small network within the state sector can reach further? can represent in her teenage years in terms of unsuitable The Government’s website mentions that the cadets relationships and teenage pregnancy are clear. can promote social mobility. That is yet another reason As an important strand of our work to raise standards to support cadets in schools, both now and in the for all in the English education system, this Government future. want to see as many pupils as possible benefiting from the same quality of life-changing military activity 1.45 pm offered in many of the best independent and state The Parliamentary Under-Secretary of State for Schools schools in the country. That is why we have put in (Lord Nash) (Con): My Lords, I thank my noble friend place such an ambitious programme to expand school- Lord Lingfield for securing this important debate. I based cadet units. Starting from a base of 190 independent pay tribute to him in his role as chairman of the Cadet school units and 66 state school units, the MoD and GC 247 Cadet Units in Schools[15 JANUARY 2015] Cadet Units in Schools GC 248

DfE have been working closely together since 2012 My noble friend Lady Seccombe is correct to say towards our shared ambition of adding 100 new cadet that adult volunteers are another critical factor in the units by this September. I am pleased to confirm that, success of a unit. This is why round 1 of the cadet despite pressures on funding, the Government have bursary fund has had a specific focus on supporting committed the necessary money. As a former police the cost of specialised instructors, and offering incentives cadet myself, I am delighted that state schools across or supply cover for volunteers and staff. I record my the country are eager to embrace this opportunity for thanks to all those schools with established cadet units their pupils. To date, 65 new units in state schools have which have partnered with a state school to enable already been approved and opened, and we are actively them to offer the cadet experience to their pupils, to working with a further 54 schools towards approval which my noble friend Lord Lexden referred. This is over the next nine months. We have also had interest particularly valuable where new schools have no prior from a further 77 schools. Many head teachers can military experience and helps to transfer important already give testimony to the positive impact of their skills. To date, 23 of the 65 state schools approved to cadet unit on attendance, behaviour and discipline, on establish cadet units under our cadet expansion educational engagement and attainment, and on the programme are benefiting from such a partnership, relationship between staff and students. As my noble and many existing units are willing to enter into such friend Lady Seccombe has highlighted, head teachers partnerships. Those who have grown up through the have a vital role to play in exciting parents, pupils and cadet force are themselves ideally placed to inspire and staff about the benefits of a cadet unit. support cadet units and are those who become volunteers themselves when they reach the age of 18. The Government believe in the important societal benefits of cadet units as well as other military ethos My noble friend Lord Attlee talked about the benefits programmes such as the excellent SkillForce, of which of risk taking. I have a poem on the wall of my office my noble friend Lord Freeman is chairman. I pay which talks about just those benefits, but he did note tribute to his work in this regard. These benefits are a some implications in the fact that young people can significant driver for our continued investment in cadets. remain cadets only until their 18th birthday. While I They have been clearly articulated today by my noble acknowledge these points, child protection and friends Lord Lingfield and Lady Seccombe, by the safeguarding must be our highest priority, but I will noble Lord, Lord Jones, and in studies undertaken by look at this further and discuss it with my noble friend the University of Southampton. I hope that my noble Lord Astor. I would like to see many more state friend Lord Lingfield will be pleased to hear that my schools including the running of their cadet unit within department has commissioned research to further the employment contracts of their staff, but there is strengthen the evidence base for these benefits. When also an important role for adults from outside the that work reports in May this year, my expectation is school community. The MoD includes information on that it will support further expansion in the number of becoming a cadet force adult volunteer in its resettlement cadet units in schools by convincing more head teachers support for those leaving the services and is looking at and others about the benefits. In addition, officials are how to encourage better integration between reservists also currently considering the feasibility of a further and cadet units. in-depth cost-benefit analysis of the value for money The noble Lord, Lord Ramsbotham, referred to the of the cadet experience. youth justice system, on which he is of course a Despite the clear benefits, schools can face significant renowned expert, and I will contact colleagues in the challenges and barriers to establishing and running a MoJ and commend to them the military ethos programme cadet unit, particularly in relation to financial and being extended to youth offenders. The noble Lord, human resources. In June last year, the Prime Minister Lord Jones, president of the Army Cadet Force launched the cadet bursary fund, a charitable fund Association Wales, has already highlighted and thanked pump-primed with £1 million of funds from LIBOR those involved in cadet units in Wales. I would like to fines to help schools with the cost of their new units. I give recognition and thanks to all those involved in am delighted to say that, so far, £3.1 million has been running cadet units. They are delivering a truly life- raised, which has enabled the fund to award £2 million changing experience to their pupils. to 46 schools. A further funding round may be launched The Government’s cadet expansion programme is later this spring. However, only £180,000 has been ensuring that 100 more state-funded schools have the raised from private donors, so I would be grateful for opportunity to do the same. The Government welcome any support noble Lords can give directly or indirectly the engagement of forces and ex-forces personnel in in this regard. To support the long-term stability of the school system. We have demonstrated this not only the fund, my department continues to fund a professional in our considerable expansion of the cadet programme fundraising activity. As my noble friend Lord Lingfield but through our engagement with organisations such has mentioned, the MoD has recently announced as SkillForce, Challenger Troop and Commando Joe’s, that rather than proceed with the per-cadet charges and our Troops to Teachers programme. I firmly hope schools were expected to pay, it will find efficiencies that in the coming years we can build on this success and absorb the costs of the first 100 units. This is to give many more children the life chances they excellent news because it levels up the playing field deserve. Again, I thank all noble Lords who participated with schools that already have a cadet unit which in this debate. are not being charged, thus reducing the financial barriers to new schools. I would like to thank my 1.55 pm noble friend Lord Astor for everything he has done in this regard. Sitting suspended. GC 249 Criminal Bar: Funding[LORDS] Criminal Bar: Funding GC 250

Criminal Bar: Funding When Sir Bill visited Crown Court centres and spoke to Crown Court judges who carry out the bulk of Question for Short Debate judicial criminal work at that level, he found that the “main area of concern” was that of, 2pm “relatively inexperienced solicitor advocates being fielded by their Asked by Lord Morris of Aberavon firms (for what were presumed to be commercial reasons) in cases beyond their capacity”. To ask Her Majesty’s Government what assessment Sir Bill described the judges’ views as, they have made of the long-term impact of current “remarkably consistent and strongly expressed”, levels of funding of the criminal Bar. and said that in his view it would be a “mistake to discount them”. Baroness Garden of Frognal (LD): My Lords, as I think I have said enough about the problems. It is this debate is very tight, it will be much appreciated if no surprise that the relations between the defence noble Lords keep to the time that they have been criminal Bar and the ministry have been turbulent. It allocated. was my old friend, Kenneth Clarke MP who, as Lord Chancellor, was one of the first to accept the Chancellor Lord Morris of Aberavon (Lab): My Lords, I am of the Exchequer’s proposals at the beginning of this delighted to initiate this short debate. I have no present Parliament. I do not know what brownie points he got interest to declare save for those on the register. As for being first in the field, but, given the breadth of his Attorney-General, I attended the monthly meetings of responsibilities, it is no surprise that the profession is the Bar Council and, as head of the Bar, I presided reaping the results of his alacrity. over the annual meetings. On one occasion, I even had Only a few weeks ago, your Lordships voted to exercise my casting vote, which pleased exactly 50% overwhelmingly against the limitation of judges’discretion of those attending, but probably not the other 50%. in judicial review cases. I believed, as did the House, It was the Lord Chancellor who told the Commons that in a country that does not have a Bill of Rights Justice Committee: judicial review was one of the bastions of the rule of “It is very important that the independent criminal Bar has a law. An independent Bar, ready and willing to take up good future”. the cudgels on behalf of citizens, is vital to ensure that I have not sought this debate to argue for more money there is no infringement of the rights of the individual. for the profession that I had the privilege to practise in Likewise at the criminal Bar, however odious the case, over a working lifetime; that is for others to argue. My all parties who find themselves before the courts should hope is that, in this short debate, we can get confirmation have proper representation. from the Minister, who understands the profession My experience, like many others, is that from time well, that the Lord Chancellor meant what he said, to time your non-lawyer friends will ask you, “How and that he will spell out his hopes that, in the face of could you represent such an obnoxious individual?”. today’s difficulties, on his watch we will not see the History is littered with such examples. My old friend decimation of a part of a profession that helps to the late Lord Hooson was defence counsel in the underpin our freedoms. moors case. I am sure that he had to explain the role of It was Mr Nicholas Lavender QC, the chairman of counsel many, many times. A more recent example the Bar, who said last year that the Bar was astonished might be the Shipman case. Over the years those of us that, on the Government’s figures and allowing for at the criminal Bar have had similar if less startling inflation, there had been a 37% cut in the funding of experiences. In my own experience it was of the upmost defence advocates’ fees in the Crown Court in six importance in the Broadwater Farm case that the years. He maintained that he was, prosecution was properly probed and challenged at “not aware of any other area of public expenditure where individuals every stage, as it was. One of the important pistons to have been asked to, and have, put up with cuts on this scale”. the effective working of the engine of representation The Bar took unprecedented steps to show how to ensure fairness is the sometimes questioned cab-rank strongly it felt. It was encouraging that the Government rule. decided that there would be no cuts that year in the Against the background of the horrific atrocities in advocates’ graduated fee scheme. Can we be assured France in recent days, the need for representation, as that none will be proposed in immediate future years? in our unhappy years of terrorist activity, will be more The years have resulted in a massive reduction in important than ever. I note and welcome the comments expenditure on Crown Court advocacy. Fortunately, made by the Lord Chancellor in the reply that he gave wise brokering broke the impasse highlighted in the in the House of Commons on 6 January to Jeffrey’s Operation Cotton case. Sir Brian Leveson, on giving criticism and the letter to the chairman of the Bar judgment in that case, said: Council on 22 December. The cab-rank principle has “We have no doubt that it is critical that there remains a been described by many. I like very much the words of thriving cadre of advocates capable of undertaking all types of publicly funded work developing their skills from the straightforward the noble and learned Lord, Lord Hoffmann: work until they are able to undertake the most complex”. “It is a valuable professional ethic of the English Bar that a Sir Bill Jeffrey, who is not a lawyer, was commissioned barrister may not refuse to act for the client on the ground that he disapproves of him or his case. Every barrister not otherwise by the Lord Chancellor to report on the market for engaged is available for hire by any client willing and able to pay criminal advocacy services. He reported that, an appropriate fee. This rule protects barristers against being “the market could scarcely be argued to be operating competitively criticised for giving their services to a client with a bad reputation or in such a way as to optimise quality”. and enables unpopular causes to obtain representation in court”. GC 251 Criminal Bar: Funding[15 JANUARY 2015] Criminal Bar: Funding GC 252

Against this background I wonder if it was the best the criminal Bar? Rather, one has to advise them to use of the funds of the Legal Services Board to steer clear of it and direct them instead to commercial commission two professors to work out the impact of or public law chambers or one of the other Bars. the rule. Sir Sydney Kentridge systematically destroyed Thirdly, even if financial considerations do not the methodology and conclusions of this very academic deflect some of the wealthier among the Bar’s potential rule. The rule with all its practical implications is recruits—those with money, trust-backed grants or ingrained in young barristers from the day they begin family funds—assuredly they put off those who have to practise. The most persuasive evidence comes in a no financial support and are burdened with heavy footnote to Sir Sydney’s opinion: debt. The consequences for the Bar’s commendable “I can say from my own experience that in political trials long-standing efforts to promote diversity and social in South Africa in the apartheid years it was essential and mobility need no emphasis. They are all too obvious. invaluable”. Finally, the young criminal bar is the seed-corn for I would hope for some endorsement in the ringing the next generation of experienced criminal Silks and tones of the Lord Chancellor’s comments which I have justices. It is small wonder that in paragraph 9.11 of already referred to. his report, Sir Bill Jeffrey stated that, “concerns about the future ‘talent pipeline’ for criminal QCs and 2.08 pm judges are not, in my view, fanciful”. Lord Brown of Eaton-under-Heywood (CB): My In the following paragraph, under the heading “How Lords, I begin by congratulating the noble and learned much does this matter?”, he expressed his conclusion. Lord, Lord Morris of Aberavon, on securing this I shall not read that paragraph in full, although I hope debate and opening it so skilfully. He was himself, of that others may do so later in the debate. Put shortly it course, in his time a great ornament of the criminal was, unsurprisingly, Sir Bill’s conclusion that it obviously Bar. He has recounted something of the history of the matters a great deal. It is imperative that any future savage cuts that have already been made over the years Government recognise that they should do nothing to in criminal legal aid funding and there is of course, further imperil the future of the criminal Bar, which is following the election in May, to be another review of truly one of the great assets of our proud legal heritage. the fate of the criminal Bar. I suggest it would be catastrophic if, following this review and in the light of 2.14 pm the Sir Bill Jeffrey report and other reports, further Lord Thomas of Gresford (LD): My Lords, I, too, cuts were to be made. There is time today to make just thank the noble and learned Lord, Lord Morris of four brief points. Aberavon, for introducing this debate. My interests First, of all the specialist Bars, the criminal Bar is are declared. I started off as a salaried partner in a the most important. Of course it does not earn for its small country solicitors’ office in north Wales in 1961 practitioners, or even for the Exchequer, the huge on a salary of £1,000 a year. Despite our limitations, sums earned, for example, by the commercial Bar, the we could provide for our clients the highest quality of companies Bar, the patent Bar or the revenue Bar; representation in criminal cases via the availability of however, the work undertaken by the criminal Bar is legal aid and the existence of a strong and expert the most valuable of all. The outcomes of commercial independent Bar. I could and did instruct on behalf of disputes largely result in book entries—the adjustment legally aided clients Lord Elwyn-Jones, Lord Hooson, of balance sheets—but the administration of criminal Sir Ronald Waterhouse, Sir Robin David and other justice goes to the very heart of the rule of law, and distinguished barristers of the Wales and Chester circuit. directly and immediately impacts on the day-to-day Incidentally, I was present with Lord Hooson on the lives and liberty of all. I quote Geoffrey Cox QC MP last day of the Moors murder trial. I took him for a in a debate more than four years ago: cup of tea afterwards, which he almost certainly needed “The efficient conduct of cases in the courts is the essential after sentencing. pivot around which revolves the entire administration of justice. In every serious criminal case, there was a team on Incompetence and poor quality in the representation of prosecution both the prosecution and the defence side led by or defence will inevitably lead to the failure of justice, prolonged outstanding silks who were capable of guiding the delays, aborted trials, appeals and much greater cost”.—[Official preparation of cases, were accustomed to taking big Report, Commons, 15/9/10; col. 245WH.] decisions and to giving wholly independent advice. In It is all-important to assist the judiciary in its task of those days, there were the resources of time and money achieving justice. That is why the judiciary strongly to ensure that cases were properly prepared and presented traditionally supports a strong criminal Bar. by experienced people, and I believe that the interests Secondly, the criminal Bar has for many years been of justice and of the community were properly served. the poor relation of the various specialist Bars. The I like to think that my own generation at the Bar effect of recent funding cuts is “ruinous”—I quote preserved those traditions and that the quality of what a member of my old chambers said to me yesterday. service in Wales with outstanding advocacy from Gareth Others have spoken of a crisis of confidence in the Williams, Alex Carlile and others has made sure that economic viability and the long-term future of the those traditions continue. Those who have succeeded criminal Bar. Predictably, all this has had a devastating us have struggled with increasing cutbacks. The input effect on the recruitment of real talent to that Bar. The of an experienced solicitor in court disappeared long number of pupillages has fallen, and all this is on top ago, and it is not only on the defence side that standards of the loss of student grants and the increasing levels have slipped. A lack of resources on the prosecution of student debt. How today could one conscientiously side has also increased delays and wasted time and encourage some able and ambitious young graduate to money. GC 253 Criminal Bar: Funding[LORDS] Criminal Bar: Funding GC 254

[LORD THOMAS OF GRESFORD] When I look around the area designated in north-east But while there were difficulties in the recent past, Wales, from Llandudno to Llangollen, an hour and a there was nothing on the scale of the cutbacks now half’s travel, and consider that the two custody suites being pursued by the Lord Chancellor. In my view, are at St Asaph and Wrexham, some 35 miles apart, I they will destroy the criminal Bar. Like the noble and find it impossible to conceive that the interests of the learned Lord, Lord Brown, I could not possibly advise public in access to justice, whether in the English or a bright youngster to embark on such a career at the Welsh language, can be served by the wholesale reduction present time. There is nothing in it; there are no of legal aid contracts to two firms of solicitors. The glittering prizes to reward years of study and struggle. knock-on effect on the local Bar in Chester will be Certificates for leading counsel are granted by judges considerable. through gritted teeth, and the fees are a fraction of The response to the original Next Steps consultation what they once were. by Treasury counsel, which conducts the most serious Solicitors concerned in criminal work now have to and complex prosecutions in this country at the Old become solicitor advocates in order to survive financially, Bailey, put the position very well, saying that: and routinely take the work on which entrants to the “skilled and experienced defence advocates, whose capacity and criminal Bar would in former days have depended, ability inspires the confidence of the court, the prosecution and their professional and lay clients … shorten, straighten, sustain and it does not stop there. If leading counsel today has and hasten the trial process: their continued presence is nothing a junior at all, it is like as not a solicitor advocate with less than vital”. a direct financial interest in the instructing firm. This As the noble and learned Lord, Lord Brown, pointed often leads to inexperienced and insufficiently qualified out, our judiciary is largely drawn from experienced persons in that important role. If anyone doubts that, counsel. Destroy the Bar and the whole foundation of I recall a recent case in a court adjoining the one in our judicial system is put at risk. which I was appearing where the solicitor advocate junior applied immediately for an adjournment when he was called upon to cover for his temporarily absent 2.21 pm leader. Lord Judge (CB): My Lords, I declare an interest as Barristers’ fees in the Crown Court account for treasurer of the Middle Temple last year; my intervention around £300 million of the criminal legal aid budget. in this debate reflects that experience. They have been effectively static since 1997, during In some ways what I am going to say is entirely which period retail prices have increased by 54% and repetitious, but it is worth drawing public attention to public sector pay by 49.9%. The average annual payment the fact that for many years now the Inns of Court to criminal barristers made by the Legal Services have been dedicated—that is the word—to ensuring Commission, including all graduated and VHCC cases that no one should be deterred from entering the in the year 2011-12 was £52,000, from which they paid profession of barrister on financial grounds. The fact all their expenses, including up to 20% for chambers’ that they or their families may be financially humble fees. was not to be an obstruction. The end result has been The Next Steps consultation by the Ministry of extremely successful. The way in which the Middle Justice was found to be defective in the High Court on Temple achieved that—the same process applies to all judicial review. That consultation paper was introduced the other Inns—is that the large majority of the money with the following statement by the Minister: we have each year is spent on scholarships. Last year we spent in the region of £900,000, which is much the “This is a comprehensive package of reform, based on extensive biggest expense we have. The objective: to get every consultation. I believe it offers value for the taxpayer, stability for boy or girl of talent who wishes to come to the Bar the professions and access to justice for all”. through the expensive process of getting to the Bar if I absolutely and profoundly disagree. In that paper, no they are good enough to do so. Nowadays we even attempt was made to evaluate the financial consequences have scholarships, chosen on merit, but the funding of the proposed changes. They were said to be “uncertain”. that is provided for the scholarships reflects the financial They are not at all uncertain. They will do significant needs of the individual concerned. harm to the criminal justice system by damaging the The take-up has been very great and very successful. supply and the quality of the criminal advocacy service. My time as treasurer was spent having a good deal of As a result of the judicial review application, last contact with some exceptionally bright young men September the Ministry of Justice was forced to disclose and women who wish to make a career at the Bar. the KPMG report which it had commissioned to However, there is one subject on which it is extremely advise it. Only then did it appear that the ministry had difficult to conduct an exchange with them: what told KPMG to make broad assumptions about cost about crime? These are not greedy young men and savings, profit margins and the availability of investment women; many of them are inspired by a wish to see capital for restructuring businesses which appear to that the administration of justice works and that they have been plucked out of the air and were completely play their part in it as advocates. What about the without evidential foundation. Yet after a further three- possibility of an innocent man being convicted— week consultation forced upon them last September, somebody spending years in custody? What about the the Lord Chancellor persisted in adhering broadly to possibility of a guilty man escaping justice when he his original cuts, and his conclusions are now again richly deserves to be convicted? The same of course subject to renewed judicial review application. Are the applies to women, but there are far fewer women public to be properly served? defendants. This matters, and when you discuss it with GC 255 Criminal Bar: Funding[15 JANUARY 2015] Criminal Bar: Funding GC 256 them, they see the point, but many of them say, happening. I emphasise that this is very much needed, “There is no point—there’s no future in the criminal and it is about time that it was provided. I say that it is Bar. Look at what’s happened to it in the last few about time because I am very conscious that in the years”. report published in the mid-1990s into access to justice If you forget the cuts which have already been for which I was responsible, I emphasised the importance described by noble and learned Lords—and I am not of that technology being provided. Many of my report’s forgetting them—there are no pupillages in criminal recommendations were accepted. When I delivered my chambers, or very few of them, therefore what is the report we were assured by those responsible in the point of even starting to try to find a non-existent then Lord Chancellor’s department—which was the pupillage? Those young men and women have already equivalent of the Ministry of Justice—that this technology committed themselves to the Bar and many of them would be forthcoming. Alas, it was not, and some of will be called. The reality is that in the present climate, the problems of the justice system today are because very few of the very best will do criminal law. of that delay in provision. None the less, it is important that it should be provided now. I suggest to the Committee We are having a debate at the Middle Temple about that the message to draw from those who have spoken whether we are spending our money wisely, as so already in this debate is that we are now in a situation much of it is wasted. So much of it goes to people who in which positive action is needed to improve the in the end cannot find a pupillage or, ultimately, a position of the criminal Bar in particular, not in tenancy. We are looking at the possibility of reducing the interest of the criminal Bar but in the interest of the amount of money that we give to boys and girls to the public. As has been made clear by those who have get them called to the Bar in order to provide more already addressed your Lordships, there is a real need money to support the young men and women who for an efficient and effective criminal Bar if this country have got to the Bar and who have a pupillage in is to continue to ensure the high standards of justice criminal chambers, and who then have a year or two in which are so much a part of this country. criminal chambers in which they hope to make enough just to cover the expenses. We are all still reeling from the events that took place so recently in Paris. I suggest to the Committee That debate will take place, and it will have to that one cause of disaffection of a country’s young is recognise that if we adopt that process it will inevitably that they feel that the society in which they live is not reduce the money available to encourage young men just. Fortunately, in this country most people who and women from a humble financial background to have been brought up here can rejoice in the fact that even try for the Bar. I think that that is a very sad they live in a society that can say it provides justice for possibility. When we are considering the impact of its citizens, but unless something is done to arrest the this, let us be in no doubt that if we do so the pool of present decline of the criminal Bar, I believe that that talent will be reduced and the quality of talent will be will not continue. diminished. The national asset identified by Sir Bill Jeffrey will be dissipated. Being called to the Bar and Although the criminal Bar is the subject of this practicing at the criminal Bar will become a matter of debate, as the noble Lord, Lord Thomas, made clear, means, rather than merit. That is a shocking possibility. it is not only the criminal Bar; the civil solicitors who provide legal advice and assistance up and down the The long-term impact has already been described country are also critically affected. When somebody is by noble and learned Lords. The results in criminal faced with a criminal charge he needs to have ready trials will be affected; trials will take longer; and trials access to someone who can give him, or her, the advice will take longer to come on. That means that defendants that they need. A situation cannot be allowed to arise will wait longer for their trials and witnesses will have in which that is no longer the position. It cannot be to wait longer and longer before they can give their allowed to arise because of those who are entitled to evidence, in many cases in very distressing circumstances. and need advice, but also because an efficient system—one At the same time, the long-term future of our efforts that makes the best use of the limited resources to ensure a more diverse judiciary—that is to say, a available—is made so difficult if those who appear judiciary coming from every element of the citizens of before the court are not of the quality that is required. this country—will be undermined. In 20 years from The problem, which is why I suggest that this is now, young men and young women from a financially such a critical time, is that once we have a slide of the humble background will not be available as candidates sort described it is so much more difficult to restore for judicial appointment. That will be to the public the position that was once there. Things can be done disadvantage. with the resources available now which will at least arrest the decline. I think that when the Minister 2.27 pm comes to reply he should show that the Ministry of Lord Woolf (CB): My Lords, like other members of Justice is aware of the extent of the problem and that my former profession who have addressed the Committee something more than sticking plaster is required. There today, I speak from long experience. I congratulate the needs to be a rethink of the approach to the funding of noble and learned Lord, Lord Morris of Aberavon, on a profession which is of vital importance to this country obtaining this debate. and to every citizen in it. This is a very appropriate time for us to discuss these matters. I was very pleased to read in my Times 2.33 pm today Frances Gibb’s article about what is being done Lord Bach (Lab): My Lords, I congratulate my to provide technology for the courts, and I am very noble and learned friend Lord Morris of Aberavon on glad to be able to say that I am pleased about what is securing the debate. It is an important debate, made GC 257 Criminal Bar: Funding[LORDS] Criminal Bar: Funding GC 258

[LORD BACH] “This matters, because the particular strengths of the English much more significant by the experience and status of and Welsh criminal Bar are a substantial national asset, which those who have chosen to speak. These include two could not easily be replicated. There is also a distinct national interest in having sufficient top-end advocates to undertake the former Lord Chief Justices, one of whom, of course, most complex and serious trials, and senior judges with deep was Master of the Rolls too, one former Supreme criminal experience”. Court judge, one former Attorney-General—my noble It is very hard for anyone to argue with that view. and learned friend Lord Morris of Aberavon himself—and When Her Majesty’s Government did their deal, if I two distinguished and successful silks, if I may call may call it that, with the Bar last spring—agreeing a them that, including the Minister. I practised as a VHCC cut and leaving until after the election a cut in member of the criminal Bar for many years and am the graduated fee, with an agreement to discuss the proud to have done so. Slightly to my surprise, and future of both those causes to be continued until the certainly much more to other people’s surprise, I find summer of 2015—they were following a well trodden myself now in the position of shadow Attorney-General. path in two respects. First, some issues were put into The years I practised in just about covered what I what might crudely be called the long grass to escape describe as the golden years for the criminal Bar. They criticism for actually taking action; and secondly—and were pretty golden, I have to say. There was the more importantly—they actually split the legal profession. emergence of the Crown Court; there was plenty of The solicitor criminal practitioners were offered no work; there were not many members of the criminal equivalent agreement and some would argue that they Bar around; it was pretty well paid; and it was effectively were left hanging out to dry.Cuts have been implemented a monopoly for members of the Bar at that stage. I in that field and the imposition of a new and controversial would argue that that state of affairs has now been system of criminal legal aid is being attempted. Instead over for many years; perhaps 20 or a few more than of talks to determine the future, therefore, we actually 20. The important point to remember is that those have, as we speak this afternoon, solicitor practitioners golden years are not coming back. Any politician of and the Law Society itself traditionally reviewing the any party who says that they are, or hints that they Ministry of Justice in court. To put it mildly, this is a might be, is to be viewed with a healthy degree of deeply unsatisfactory position for our criminal justice scepticism, at the very least—and the criminal Bar was system. To set one branch of the legal profession always very good at being sceptical about pronouncements against another is wrong both in principle and in being made. Therefore, any discussion of the criminal practice, and it does not help either branch or, indeed, Bar has to happen in the context of today rather than the criminal justice system itself. looking back too much at a time that has gone. If my party wins the general election, we will set in As my noble and learned friend Lord Morris pointed train a review of the criminal justice system, concerning out, over a long period the rewards for criminal not just funding but the way the system works for practitioners have without doubt declined sharply. victims, defendants, the general public and, of course, That is due not just to cuts or long rises in fees, practitioners. Obviously, we are not making any promises although, of course, they play an important part in about funding but one thing is clear: there is no future what has happened. As Sir Bill Jeffrey, who has been for the Criminal Bar, the criminal solicitors’ profession quoted already in this debate, concludes in his report or even the criminal justice system itself if the Government of May last year, crime is down, fewer cases reach the of the day play off one branch against another. There Crown Courts and there are more guilty pleas. He are obviously going to be natural tensions between the says: various branches and the Government of the day; that will always happen. But no system will work unless all “There is substantially less work for advocates to do. Its parties, including the Government, work together. character is different, with more straightforward cases and fewer contested trials”. Of course, there are many more solicitor advocates. 2.40 pm Sir Bill goes on to say, The Minister of State, Ministry of Justice (Lord “There are now many more criminal advocates than there is Faulks) (Con): My Lords, I congratulate the noble and work for them to do”. learned Lord, Lord Morris, on bringing forward this He goes on to make proposals for the future, all of debate and on attracting such a very high calibre of which are well thought out, very interesting and should speakers, as was acknowledged by the noble Lord, be considered carefully. My first question to the Minister Lord Bach. A great deal of experience and expertise is this: What can he tell us today about Her Majesty’s has been brought to bear on what is an extremely Government’s response to the Jeffrey report, both in important subject. It is important because it goes general terms and, if possible, in more detail? beyond the interests of the criminal Bar as such and has important ramifications for our country, for our Sir Bill talks about the future of the Bar being less system and for the future. I found very little to disagree clear. He says that there are signs that, away from the with in what was said in the debate. self-employed Bar, the tide may be turning, but he fears that the Bar’s lack of confidence in the future of The criminal advocacy market has changed significantly criminal work, or its unwillingness to adjust to compete over recent years. I am glad that the noble Lord, Lord for it, may become a self-fulfilling prophecy. I think Bach, whom I congratulate on his recent appointment, that the following passage was referred to by the noble acknowledged that we are not going to return to that and learned Lord, Lord Brown. It is worth quoting. It golden age. The reduction in cases going to trial and states: the growing number of advocates, including solicitor GC 259 Criminal Bar: Funding[15 JANUARY 2015] Criminal Bar: Funding GC 260 advocates, have presented particular challenges to the junior part. The consultation paper Transforming Legal future of the independent criminal Bar in its current Aid, published in April 2013, included proposals for form. the graduated fee scheme, which covers most advocacy I note what was said about the judicial review and in the Crown Court, and to reduce fees paid on very the noble Lord, Lord Bach, told us, quite rightly, that high cost cases by 30%. Together, these proposals it is ongoing. It refers to the contract in relation to sought to target the fee reductions at the highest solicitors. It is not appropriate for me to comment on earners; we know that barristers who work on the that in view of the fact that is it ongoing. If one reads most complex, longest-running type of cases receive the Jeffrey report, one can see that it is inevitable that more in fee income than others. Furthermore, the there will be—and there is—a degree of tension between original proposals had the effect of protecting the fee the role of solicitors and the role of barristers in income of the most junior members of the Bar. We providing advocacy services at the Crown Court. That amended our proposals, following consultation, and is one of the challenges that have to be faced in the have amended the very high-cost cases scheme while future: how the public can be best served by preserving still ensuring that the fees were within planned budgets. the roles of both solicitors and criminal advocates. The second consultation, Transforming Legal Aid: One of the Jeffrey recommendations, which I do not Next Steps, published in September 2013, included think anyone would find hard to accept, is the two options. The first was an adjusted version of the improvement in the teaching of advocacy at the solicitor original proposal, and the second was a model based level if solicitors are going to function in the same on that put forward by the Bar Council, which was field as barristers. There is clearly a disparity that based on the CPS payment scheme. The outcome of ought to be remedied. that consultation was that the Government decided to The Government have found it necessary to make implement the CPS-like model. This would still have reforms to the legal aid system. The financial climate the benefit of focusing reductions on the higher earners. and the tackling of the deficit have forced some difficult Following further engagement with the profession decisions on the coalition. It has been important to try in early 2014, the Government announced the deferral to ensure quality public services while balancing the of changes to the advocates graduated fee scheme books. But it is clear, and I am happy to confirm this, until summer 2015, to align with the second fee reduction that the Government want to protect the provision of for litigators. This will allow us to take into account quality advocacy services. We have engaged extensively the outcomes of the review by Sir Bill Jeffrey, as well with the profession. Clearly, some of the engagement as any impact on legal aid spend from falling crime not always been as happily reported as it might have rates, and earlier remuneration changes. been. The current chairman of the Bar has confirmed that the current relationship is a good one and I hope Beyond the review by Sir Bill Jeffrey requested by that the engagement will prove profitable in the future. the Secretary of State, the Lord Chief Justice has asked Sir Brian Leveson to undertake a review of the Certainly, the engagement that took place led to length of criminal proceedings. He has been tasked several adaptations to the original proposals, including with suggesting ways to streamline the trial process, the changes to the graduated fee scheme and the identifying ways to reduce to the minimum the number commission of Sir Bill Jeffrey’s report, to which there of pre-trial hearings that necessitate advocates attending has been much reference. He identified in his report a court. However, the review goes much further and is number of structural problems related to the history likely to produce some real gains in terms of the and development of the criminal Bar. He found that criminal process as a whole. I note that the noble the criminal advocacy market is not working, Lord, Lord Bach, committed his Government—should “competitively or in such a way as to optimise quality”. it be his Government after the election—to look again There are all sorts of reasons for this and time does at criminal procedure. I suspect that whichever not allow me to engage with all of them. The decrease Government come to power will find the report of in the amount of crime is clearly one. There is now a Sir Brian Leveson on criminal procedure a valuable rather unsatisfactory state of affairs whereby fewer basis on which to review this vital part of our system. younger barristers are joining professions. There is a The report will also impact on the further consideration bulge of those in their 40s and 50s. This has significant of the advocates graduate fee scheme. long-term risks, I accept, for the profession in terms We have also recognised the need to regularly monitor of, “Where are we going to get senior barristers from? the criminal legal aid market. That is why the Government Where are we going to get judges with the relevant have committed to publishing regular data reports on experience?”. However, as has been made clear, it is fee payments received by criminal advocates from not obviously attractive for young people to go into public sources. The data gathering collated from the the criminal Bar at the moment. I note what the noble CPS and the Legal Aid Agency will help us to meet the and learned Lord, Lord Judge, said about diverting need to collate more data on the market and facilitate scholarship funds from the Middle Temple; that seems a better understanding of the way in which the market a highly constructive way in which to encourage people is operating. I know how irritating it can be for information through those difficult years. that is only partially accurate about barristers’ fees to The Government recognise that this is a period of be published, which can give a rather misleading picture great transition. They have endeavoured to listen to of what are relatively modest earnings for most barristers. the profession, and care was taken in developing proposals I have conveyed that to officials, who confirm that, in that would minimise the effect of the changes on the fact, much of the information is published as a result particularly vulnerable section of the profession—the of freedom of information requests by journalists, GC 261 Criminal Bar: Funding[LORDS] Property Boundaries GC 262

[LORD FAULKS] The Deputy Chairman of Committees (Lord who are not, of course, terribly interested in providing Skelmersdale) (Con): My Lords, the Committee stands a full and accurate picture, including the facts that adjourned until three o’clock. there are chambers’ expenses and clerks’ fees. The figures may be out of kilter because payment is made 2.54 pm over several years. It is important that the Ministry of Justice should be responsible for accurate figures, so Sitting suspended. that the public appreciates the nature of the payments that are in fact received and gets a real picture of the criminal Bar. Property Boundaries It is undoubtedly true that fees have fallen in real Question for Short Debate terms. It is the Ministry of Justice’s case that they remain reasonable, although I entirely accept that 3pm compared with the other opportunities in the legal profession—at the Bar and elsewhere—they remain Asked by The Earl of Lytton extremely modest. In 2013-14, mean fee payments for barristers doing publicly funded legal aid work was To ask Her Majesty’s Government what proposals £70,200, including VAT and disbursements, and the they have for the settlement of unclear or disputed median was £57,400. In the last financial year, 18% of property boundaries. advocates received less than £10,000, while 25% received more than £100,000. That gives a very rough picture The Earl of Lytton (CB): My Lords, I am most of the range. Those are modest sums. grateful for this opportunity to debate the matter of property boundaries and I thank the Minister both for The Government’s response to Jeffrey is that he his willingness to meet Charlie Elphicke, MP for Dover identifies a number of challenges for the advocacy and Deal, and me on more than one occasion in the market, but he does not in fact put forward any recent past, and for forewarning us of the Government’s positive suggestions, apart from the education factor, scoping study published today. I am also grateful to and not all of his recommendations are for the other noble Lords, particularly noble and learned Government to address—they are largely matters for Lords, who are to speak today. I declare my interest as the professional regulators of both the Bar and the a practising chartered surveyor. I also chair the Boundaries solicitors’ profession. The Lord Chancellor has made and Party Walls Panel of my professional body, the clear that he is committed to working with the profession Royal Institution of Chartered Surveyors. I am very in the first half of this year, and I am sure that any much indebted to the groundwork of Mr Elphicke, future Lord Chancellor will also wish to do so. The who raised the matter in the Commons some time ago. cab rank rule referred to by the noble and learned Although his Bill did not progress, it triggered the Lord, Lord Morris, is a cardinal principle of the Bar. formation of an expert panel of practitioners who Of course, it is subject to exceptions, but as a principle took away the original Bill and have comprehensively it is very important and must be respected in the way revised it. The question now is whether the Government that legal services are provided. are minded to give this some time and support were it We are particularly anxious to ensure that defendants to be formally introduced. are aware of the choices available to them in representation. An eminent boundary surveyor once prefaced a That was a factor identified in the Jeffrey report as an learned treatise by saying that when he met potential unfortunate by-product of the way that cases were clients for the first time, he would advise how very assigned to solicitors, and is something that the expensive boundary disputes can be—so expensive in professional bodies need to look at, because it is in fact that for the money one could purchase a very everybody’s interests that individuals have their best good family holiday in the sun or even construct a opportunity to be represented. swimming pool in the back garden. He would add This is a time of unprecedented change in a context that, fortunately for him, most clients ignored the of continuing financial pressure. I am glad that the advice which is why he had lots of foreign holidays noble Lord, Lord Bach, did not make any extravagant and a large swimming pool. promises as to the future. It is imperative to reform the Although the need for resolving boundary issues is system to adapt it to the modern reality of reduced most evident in the few cases that go to court, this is public funds and greater efficiency. The Ministry of not representative of the whole picture. There is a Justice welcomes the engagement that we have with hierarchy of needs in relation to boundary matters, the Bar on the issue. We are concerned to maintain which could simply be to facilitate voluntary registration those constructive discussions over the coming months. at HM Land Registry, for the purposes of fence erection, At a time of major financial changes which are being because of a wish to transfer a property or sell it free felt by businesses and households across the country, from doubt as to where the boundaries lie, through to the criminal advocacy profession cannot be immune a wish to build or develop land in respect of which the from the Government’s commitment to get better boundary position may be economically important, value. However, while committed to finding savings the purposes contentious and the planning mechanism within the system, we are also committed to maintaining adversarial. Competing interests in land as to extent the high standards of the criminal Bar, which, as many and intensity often breed acrimonious and hotly contested noble Lords pointed out, plays a vital part in our situations, although these remain a minority. However, society. as soon as you raise the issue of a boundary position GC 263 Property Boundaries[15 JANUARY 2015] Property Boundaries GC 264 quite innocently with a neighbour, the balloon often over a number of years and although, as I say, relatively quite literally goes up. Innocent enquiry is fettered few cases get to the courts, those that do are often and the consequences can be very serious, if not ruinously expensive. The problem of costs in the action disastrous. frequently and rapidly outstrips the financial value of the disputed land, which raises the stakes and makes it Much of the problem lies in the distant past. Although ever more difficult for the parties to settle. the paper documents involved with the transaction of land have a long history in this country, actual boundaries Many cases, of course, collapse without getting to are often extremely poorly defined. Maybe in the court simply because one party can no longer afford to 19th century everyone knew where the boundaries of pursue the matter. That is not in the interests of justice Farmer White’s property at Blackacre Farm happened and seems to me to be inherently unsatisfactory. If to lie but later, when it mattered for other reasons, advice as to likely costs is taken on board right at the everybody seemed to have forgotten. Therefore, the start, people often decide simply to accept the fact and legacy of poor descriptions and even worse plans roll over in the face of reality—something sometimes drawn up by feckless trainees in surveyors’ or solicitors’ taken advantage of by aggressive neighbours. Moreover, offices—I used to be one—adds to the problem. in many non-contentious situations where there is just a simple need to know the correct boundary, even More recent data are also at fault. Before the general raising it with a neighbour can be dangerous. As I have use of digital survey techniques, properties were often said, planning applications often give rise to such sold off-plan and the interests of prospective purchasers queries. and their mortgagees registered against a master plan before a dwelling was ever built. However, nobody Unclear boundaries—and, worse, unresolved boundary thought to check the as-built result. The fencing sub- disputes—are, of course, a material barrier to sale. contractor, with his usual incomplete regard for the Nobody wants to buy a property where there is an legality of boundaries, often added to the problems, as unresolved boundary dispute. This can be deployed by I have encountered professionally. Yearsago, I attended unscrupulous owners against their neighbours. Then a meeting of bigwigs to discuss e-conveyancing and there is the mistaken belief that unregistered land is the digitisation of the Land Registry and was unwise somehow ownerless—often aided and abetted by some enough to suggest that this legacy would henceforward unscrupulous companies, it has to be said—and therefore travel at the speed of light and be treated as holy writ up for grabs in some way. That causes problems. thereby. Eyes narrowed perceptibly on the other side Latent uncertainty impedes development or redevelopment of the table. However, I pay tribute to the Land proposals, as well as necessary alterations, adaptations Registry for a remarkable performance in spite of this and even basic maintenance. For instance, I know of backcloth of defective raw data. situations where the ownership and control of historic ditches has importance for the long-term drainage of Land registration works to a general boundaries development sites or for preventing neighbours filling rule that gives an approximate boundary indication them with rubbish or building over them. As the only, except for the very few cases where a formal eminent boundary expert David Powell said in an determined boundary has been registered. The data e-mail to me earlier this week, the visible instances of are plotted on an Ordnance Survey base to either a court cases are believed to be but the tip of a much 1:2500 or a 1:1250 scale, and it has to be noted that OS larger iceberg. plans themselves are expressly not definitive of legal boundaries. Note, too, that for a 1:2500 scale a line Clear boundaries are as essential to property ownership 0.3 millimetres thick on the OS plan equates to and value as permitted use. Owners need to be able to 750 millimetres on the ground, and features closer to rely on where their boundaries are situated and who each other than about 2 metres are not shown as owns a boundary feature or has responsibility for a separate items on the OS plan at all. This begs the hedge, ditch, boundary, retaining wall or roadside question as to what feature or part of it the OS plans embankment. People often assume, erroneously, that were intended to represent. The Land Registry does formal land registration guarantees title; regrettably, it not always hold adequate pre-registration documents does no such thing. The matter is made worse by the and many original documents have either not been law on adverse possession, with its combination of retained or worse—because they are part of social motive and opportunity, and the high costs of resisting history—have been deliberately destroyed. Far from it. everything, of course, is actually registered; much Australia recognised this problem long ago and uninterrupted historic ownership, along with a good although I believe that the matter is dealt with nationally deal of community, parish and highway land, never under something called the Dividing Fences Act, an mind overriding interests of one sort or another, is effective, workable system occurs on a state-by-state simply not registered at all. basis. The noble Baroness, Lady Gardner of Parkes, In many situations, the boundary may be physically who is not able to be here today, was kind enough to self-evident and identifiably long-standing. Some lack obtain for me some information about this. At present, of precision may even be of benefit in allowing a a formal determined boundary can be achieved only degree of flexibility and evolution, especially when by mutual agreement between neighbours. This makes coping with the work of garden fencing contractors. it impractical for cases where it is not in the collective However, in cases of dispute, and especially on tight interests of both owners from the outset. It is certainly urban sites, matters are compounded by a substantial of no use when a dispute has arisen. Land Registry legacy of poor or simply inaccurate title documents. adjudication, as I understand it, generally concerns Boundary disputes have, I believe, been increasing only the accuracy of the register. GC 265 Property Boundaries[LORDS] Property Boundaries GC 266

[THE EARL OF LYTTON] is under the system I was used to in Scotland, and that As properties become more valuable and urban underlines the importance of the issue raised by the space scarcer, the position of boundaries becomes noble Earl. more crucial. I believe that the mark 2 Bill that has Scotland has had a system of recording land tenure been drafted, a copy of which I have circulated and in a public register called the Sasine Register since the placed in the Library, would solve this. I am aware that early 17th century. There were attempts to create a the Minister may feel that it is unnecessary. The same register earlier than that, but the position today is that was said, of course, of the Party Wall etc Bill that I for well over 300 years, every single property in the had the privilege of taking through all its parliamentary country has been the subject of a recorded title, or stages in this House back in the 1990s. The mark 2 Bill more accurately, a registered title, which can be examined can and would be of assistance in removing many by every member of the public on payment of a disputes from the courts and providing better self- suitable fee. It is in the course of being replaced by a regulation and a cost-effective starting point in the modernised system of registration of title, but the event of the court having to intervene. The formula Sasine Register still exists and it is the source from that is proposed would enable the end product to be which the relevant information can be derived when recorded without recourse to conventional litigation. moving to the new system. There is a complete account It would start with a system of notification of a of all deeds, which enables anyone to identify the boundary proposal which, if disputed, would trigger a extent of ownership of any holder of land, and includes dispute resolution procedure. I believe that it is in the all deeds which affect the security of land—the title to public interest and that it would be a good thing for the land—that is, deeds which are in the form of the maintenance of property and the removal of security for debt, deeds that record rights of way, and contention from what should be the peace and tranquillity what in Scotland are called servitude and England of people’s own homes. easements. Everything that affects a title has to go on to the register to be effective at all. It is therefore a very complete record of the present situation of any 3.10 pm landowner’s title. Lord Hope of Craighead (CB): My Lords, I begin Every title that is put on to the register has to have a by congratulating the noble Earl on securing this description. For a long time the practice has been to debate. I put my name down to speak because the describe the property that goes on to the register by issue he has raised is quite an important one and reference to boundaries. The early deeds did that by deserves to be broadened out a bit from the original reference to natural features such as walls and gables. list of speakers, which until recently was only three. Occasionally resort was made to plans, which were Having looked more closely at the subject over the always described as taxative—in other words, they past two or three days, I am not sure that I am all that were made to be definitive as to the extent of the title. well qualified to express an opinion on the point. My Once a title containing the information had been background is that of a lawyer rather than a surveyor, registered, the titles that derived from it simply tended and in this debate we are talking about English law, to refer back to the original deed, so that in practice while my training and experience is largely in Scots one has to search the register quite diligently to find law. One thing I learnt when I came south was that out the limits of where the property lie. The result is Scots law and English law differ most fundamentally that from time to time mistakes occur. Someone sets of all in the area of property law, and it is very difficult out to design a new definition, but has not correctly for a Scots lawyer to understand the details, let alone recorded what was in the earlier deeds from which the the structure, of the way in which English property title is derived. It is in that kind of situation that a law operates. boundary dispute arises. However, I encountered quite a number of boundary Where mistakes of that kind arise there are two disputes when I was in practice at the Bar in Scotland, kinds of problems. First, there is the problem of and even one or two when I was sitting as a Law Lord searching the register and understanding how the titles here in this House and was introduced to, among have been defined. To some extent that is a task for a other things, the wonderful presumption known as the lawyer, given that a lot of work is being done through hedge and ditch presumption, which I very much titles, which only lawyers can really understand. It enjoyed examining. I also encountered a number of may be that measurements and things of that kind are surveyors during the course of my practice, as a result needed, for which a surveyor might be used. However, of which I should say that I have a great deal of there is another aspect of this: in Scotland it is called respect for the noble Earl’s profession. There were positive prescription. The noble Earl referred to adverse many cases on which we worked together as a team, possession and it is the same concept. If somebody although it is fair to say that they were largely in the has occupied land without objection for 10 years—“nec area of valuation for rating rather than surveying in vi, nec clam, nec precario” is the Latin phrase—he has the more strict sense. an absolute right to remain in possession, even if the We are not being asked to consider the law of description in his title conflicts with his neighbour and Scotland today, and in any case I am quite sure that the neighbour can show that actually he ought to have the Minister would not wish to comment on it since it been able to occupy that land himself. If he does not is a devolved matter. However, it may be of interest if I take the initiative within the 10 years, he loses the right sketch in a little the way that issues are apt to arise in to do so. In that sort of situation very difficult issues that jurisdiction. It does tend to show that the problem of fact may arise. The question is whether the present here in England and Wales is much more acute than it possession has been adverse for the necessary period, GC 267 Property Boundaries[15 JANUARY 2015] Property Boundaries GC 268 and in that situation a surveyor, frankly, is not the 3.19 pm person to whom one would turn. It would probably be a solicitor instructing a member of the Bar to prepare Lord Kennedy of Southwark (Lab): My Lords, I and argue the case all the way through. Therefore the start my remarks by thanking and paying tribute to situation is quite complex. In Scotland, these issues the noble Earl, Lord Lytton, for putting down this can arise in various forms, but the basic situation is important question for debate today. In preparing for one of a complete register of all the land and we this debate, I read a number of very useful documents therefore do not have the problem that arises in that gave sensible and practical advice on dealing with England—and, no doubt, in Wales—where a substantial property boundaries. The overriding theme I picked amount of property is not on the register at all. up was the importance of discussion and communication with your neighbour, and of seeking to find a solution What about England and Wales? My noble and on a reasonable basis. The last place that anyone learned friend Lord Brown of Eaton-under-Heywood should want to find themselves in seeking to deal with said to me this morning that the courts would be quite these matters is a court of law. That, in my opinion, is delighted were Mr Elphicke’s draft Bill to be enacted very sensible advice. Every now and again a case is and the courts were relieved of the heavy responsibility, reported in the media in which a boundary dispute got which he described, of having to deal with these cases. completely out of hand, and both sides became involved My own experience as an advocate was that these in expensive litigation which cost far more than the cases were really quite enjoyable and therefore I would worth of the boundary they were actually arguing be rather sad to see them go. There is a difference of about. This is, of course, in addition to the stress and view between counsel and the judge. However, I am anxiety people suffer in dealing with such matters. not absolutely sure that the situation is quite as easy as In his remarks to the Grand Committee, the noble the draft Bill is suggesting or that the public would be Earl highlighted the point that in many cases the well served if the law were to be reformed in the way boundaries for registered and unregistered properties that it proposes. are poorly defined. That is where the problems start. I stress that I do not for a moment doubt that there Relying on the Land Registry against a backdrop of is a problem. Indeed, since the pattern of land-holding Ordnance Survey mapping of the general position of in England and Wales is much less neat and accessible the boundary may not provide the detail required to than it is in Scotland, the problem is indeed acute. But resolve the problem. I am an elected member of Lewisham my impression is that the Land Registry does an Council, and at a recent planning committee meeting excellent job. Having studied its website, it offers much which discussed an application for an extension to a helpful advice and guidance for people who find resident’s house it emerged that most of the garden themselves in dispute, which they would be well advised was actually owned by Lewisham Council, which owned to follow. There is the right that everyone has, under a long strip of land that went through a number of Section 73 of the 2003 Act, to object to an application gardens behind properties. No one seemed to have any for registration. If there is an objection there is a idea why the council owned the land or for how long it tribunal to which the matter can go. No doubt, it will had owned it, but own it it did. It was not a huge take many decades before the system can settle down problem in that case, but it illustrated to me how in to the extent that it has in Scotland; but nevertheless many cases property boundaries can be ill defined the Land Registry is there to improve the situation and which, as the noble Earl said, can bring significant assist the public, as I have attempted to describe. difficulties. Clear boundaries are important, and it is good My main point is that I am not entirely convinced advice to get the boundaries of your property clear that making it compulsory for every such dispute to be with your neighbours. As I said, and as the noble Earl resolved by reference to a panel of surveyors and mentioned earlier, relying on a Land Registry guarantee excluding the courts entirely—as I think the draft Bill of title is not the protection that some people think it seeks to do—is either necessary or desirable. There is. The noble and learned Lord, Lord Hope of Craighead, will be cases where the title deeds alone will provide usefully outlined the position in Scotland. Not for the the answer and it may be that agreements can be first time, we could learn valuable lessons from how reached; but I am not entirely sure that understanding property law operates in Scotland. To resolve any these deeds is within the exclusive competence of a dispute, speaking to your neighbours is of paramount surveyor. There is then the problem of how to deal importance, as is not taking action that would be seen with other evidence about the way the property has as inflammatory, such as submitting a planning application been used, which may be hotly disputed and requires or using any other means to reclaim land. Reaching an analysis, presentation of evidence, cross-examination amicable solution to the dispute is in the interests of of witnesses and so on. There is also the matter of all parties. adverse possession, which could raise very difficult issues. Problems can occur when boundaries are not clear, or have become confused over time. Hedges, fences, While I am absolutely sure that the noble Earl has stone walls or other physical barriers might not be the raised some interesting and important issues, I am not actual boundary at all, but have become seen as the sure that the suggested solution is the right one. I look boundary. As I said earlier, minor disagreements can forward very much to what the Minister has to say in quickly escalate into major disputes involving solicitors his reply and, in due course, to reading the scoping and expensive litigation. When agreement cannot be study that has appeared on my BlackBerry, but which reached between the parties themselves, the objective I have not yet had a chance to read. should be to resolve the dispute at the lowest common GC 269 Property Boundaries[LORDS] Property Boundaries GC 270

[LORD KENNEDY OF SOUTHWARK] I am grateful to him also for acknowledging the fact denominator. For example, that could involve chartered that he, I and Charlie Elphicke, who brought forward land surveyors or chartered surveyors who specialise a Private Member’s Bill, had a number of meetings in in boundary work making an expert determination. which he helpfully outlined of the nature of the problem That could be legally binding on the parties concerned as he sees it, and the possible solution presented by the if they agree that it is to be so. There are a number of Bill. This has been a useful exercise informing the advantages to this method, which is confidential, speedy, ministry and my officials. cost effective and final, but actually this procedure is Property boundary disputes relate to the legal position not very popular or often used. I am not sure why that of a boundary between two properties and the ownership is. Perhaps it is because people are not aware of it, and of the relevant land. There are many millions of by the time that professional people get involved lawyers boundaries between properties in England and Wales. are often needed, as it has come to a court action. This is not a hyperbola—there are 24 million registered As with other disputes it is possible to go through a properties. The vast majority are probably never the process of mediation, by which a settlement is negotiated subject of a dispute. However, as we have correctly between the parties that they can live with. However, heard, where neighbours disagree about the line of the for this to work there has to be a willingness to boundary, the disputes can be very difficult indeed to negotiate. That involves give and take, and being prepared resolve. to enter into the process with an open mind about the discussion and the options for reaching a solution. It We cannot realistically create a world in which is possible that at the end of a mediation process one neighbours do not from time to time fall out over the party will feel that the outcome is unsatisfactory, but if precise position of a boundary. There are all sorts of people enter the process with an open mind it can reasons for the disputes, not all to do with a precise resolve matters. It is also worth noting that the advantages evaluation of the boundary itself. What we can aim to of mediation are that the parties arrive at the agreement do is provide effective ways to resolve the disputes that themselves, and in reaching that agreement hopefully occur. A first step is to try to identify why they seem to get a better understanding of the position of the other be so difficult to resolve. side. It is perhaps regrettable that boundaries are rarely Moving on from these ways of seeking agreement, precisely defined in England and Wales, and the standard people can often find themselves at the land registration of property descriptions in conveyances and the matching service of the Tribunals Service, the county court or of plans to the situation on the ground has historically the High Court, in certain circumstances. All those too often been poor. In addition, boundaries may be options begin to cost quite a lot of money. It does no changed by the application of the principle of adverse good to enter into disputes before courts and tribunals possession, to which there has been reference in this that, in the end, cost more to resolve than the value of debate. Those rules are complicated and the time the land or boundary in question. periods applicable depend on whether the title to the land is registered but, basically, a person can become The Government need to act on this, and the noble the owner of land by uncontested continuous use over Earl, Lord Lytton, has made the case today with a a lengthy period of years. The noble and learned Lord, sensible solution to the problem before us. We need an Lord Hope, correctly referred to the Latin maxim. If effective link between the public and the Land Registry, this happens the line of the legal boundary will change. so that where required the position of boundaries could be formally established and recorded without The fact that adverse possession involved evaluation recourse to litigation of the type I outlined earlier. of the facts is one of the reasons why the Government As the noble Earl suggested, to achieve that there respectfully agree with what the noble and learned should be a system of notification of a boundary Lord, Lord Hope, said about the difficulty in the proposal to neighbours which, if disputed or ignored, otherwise initially attractive solution of having the would trigger a dispute resolution system backed by a matter determined effectively by surveyors. An undesirable requirement to register the outcome with the Land side effect of this lack of precision is that unless a Registry as a formal determined boundary. It would certain give and take is observed between neighbours, be similar to the process that operates under the Party the resultant boundary disputes are often bitter, protracted Wall Act 1996. It would ensure that the vast majority and expensive. On occasions, the costs, as the noble of boundary disputes were removed from the courts, Lord, Lord Kennedy, rightly said, can be out of proportion but without in any way preventing an appeal in appropriate to what is at issue. There are all sorts of reasons for cases. We have only to look at how many party wall this. cases are appealed to the courts to see the effectiveness As we have heard, it was concern about the of such a of measure. disproportionate cost and bitterness of disputes based In conclusion, I again thank the noble Earl for on the experience of his constituents and others that raising this issue and I look forward to the response of prompted Charlie Elphicke to bring forward his Bill. the noble Lord, Lord Faulks. It proposed—if I may condense a 17-clause Bill, which I know has been amended—that disputes relating to the exact location of a boundary between adjoining 3.25 pm properties in England and Wales must be referred to The Minister of State, Ministry of Justice (Lord an independent adjudicator for final determination at Faulks) (Con): My Lords, I, too, am grateful to the the earliest opportunity, subject only to a right of noble Earl for raising this important issue for debate appeal to the county court. In the light of the concerns and for the clear way in which he outlined the problem. raised, the Government decided to carry out an initial GC 271 Property Boundaries[15 JANUARY 2015] Property Boundaries GC 272 scoping study on the issue. The result of the study was the absence of agreement is normally a matter for a published today; it is on the Blackberry of the noble judge, as it determines a person’s legal rights. A surveyor, and learned Lord, Lord Hope, I think the noble Earl no matter how expert in technical issues—I entirely has received it, and if the noble Lord, Lord Kennedy, agree with the noble and learned Lord, Lord Hope, has not received it, he will do so shortly. We have although my own experience with surveyors is that placed a copy in the Library, but I will briefly summarise they very often are extremely expert and supplement its content. the often inadequate understanding that lawyers have of these issues—will not necessarily have the legal The study took the form of interviews with a small expertise to deal with cases that involve more complex number of key stakeholders and the distribution of a legal issues such as adverse possession. Allied to this is questionnaire to 30 organisations with an interest in the fact that, unlike party wall cases, which are essentially land law issues involving boundary disputes. Input based on a mutual need between the owners of the was also received during the period of the study from adjoining properties for work to be done efficiently, a number of individuals who had themselves been boundary disputes are much more likely to produce a involved in such disputes. The study reflects the views “winner” and a “loser”. In addition, as contributors to expressed in the responses received on the nature, this debate have acknowledged, boundary disputes frequency and causes of boundary disputes, the can generate considerable bitterness. effectiveness of the resolution methods, the problems that arise and what could be done to address them. It The combination of these factors means that in our discusses a number of options for legal or procedural view the likelihood of appeals being brought against change. Incidentally, I accept that it is difficult to decisions would be high. It would mean that in many calculate quite how many disputes there are because cases the suggestion would simply add a further layer they can vary between a full-blown boundary dispute to the proceedings, which would add to the costs which reaches the High Court and even beyond, to an rather than reduce them. In some cases the early initial disagreement which may be relatively easily appointment of experts could itself front-load costs resolved, and there are very many steps along the way. where the dispute might have been resolved in other ways, and, perhaps, permit stronger and legally astute Boundary disputes can be mediated by a range of parties to steal an advantage over more easygoing methods, either through the county court or the land neighbours. That does not mean that the Government registration division of the Property Chamber of the are in any way complacent about the problems that First-tier Tribunal, as part of legal proceedings or can arise in boundary disputes, or about the possibility separately by mediation, as referred to by the noble of improving relevant civil procedures more generally. Lord, Lord Kennedy. Independent expert determination is also used in a very small number of cases. I noted In the course of this Parliament, we have made from the RICS document, which was part of the very considerable efforts to rein in the costs of civil litigation helpful Library Note put together for this debate, that in general so that they are more proportionate, including there is an RICS Neighbour Disputes Service which through a new civil procedure rule to ensure that costs provides access to a specialist panel of expert members which are disproportionate will not be recoverable, with experience of resolving neighbourly boundary even when they are reasonably or necessarily incurred. disputes. The service can involve expert determination We have also introduced new provisions for costs and mediation of a dispute, and therefore there is an management and costs budgeting. These and other alternative to formal litigation if any doubt or uncertainty steps should help to reduce the amount of costs so exists between parties on the correct boundary line. that they do not become disproportionate to the issue. The RICS advises those who might wish to seek a We believe that rather than restricting the flexibility slightly cheaper way to resolve their problems. of the current system and the range of methods that The core conclusions reached in the study are that can be used to resolve these disputes, it is preferable there is merit in the Government carrying out further for us to explore the feasibility of making further work to assess the feasibility of improvements as improvements. As I have indicated, there are a number regards a number of aspects of the current system, of approaches we wish to examine aimed at developing including the use of mediation and expert determination, and encouraging the use of mediation or other methods the spreading of best practice and the provision of of alternative dispute resolution, supporting robust better information, but that more radical reform such and timely case management and improving the quality as that argued for by the noble Earl, Lord Lytton, and availability of guidance and information to increase would not currently be justified. The particular approach awareness of the issues and the options available. I am the noble Earl advocates is the introduction of a grateful to the noble and learned Lord, Lord Hope, mandatory system for resolving disputes similar to for reminding us of what the Land Registry provides that used under the Party Wall etc. Act 1996. That by way of assistance to those who wish to have boundaries would involve the appointment by parties at as early a clarified. stage as possible of an independent expert, normally a On the question of general boundaries, which was surveyor, to determine the position of the boundary. referred to in the debate, I am advised that when land In the event that either party was dissatisfied, it would registration was first introduced there was an experiment be open to them to appeal against it to a court. with general boundaries from 1862 to 1875, when it It will be useful if I explain why the Government do was abandoned because it caused so many disputes. not consider that requiring everyone involved to follow On the question of what we can learn from Scotland, such an approach would be beneficial. First, the of course, it is always useful to learn from other determination of the legal position of a boundary in jurisdictions. I am advised that a local deeds registry GC 273 Property Boundaries[LORDS] Chancel Repairs GC 274

[LORD FAULKS] after a lay rector was sentenced to prison by the High existed in Yorkshire and Middlesex until the late Court for contempt of the ecclesiastical court for 20th century. We will consider, among other things, non-payment of CRL. It was seldom recovered during what we can learn from practice in Scotland, and, the succeeding half-century, and in 1981 the General indeed, from practice in Australia. Our core aim will Synod accepted the recommendation of its standing be to reduce the costs without in any way impeding the committee, headed by the late Archbishop of Canterbury proper opportunity for people to dispute boundaries Lord Runcie, to phase it out. In moving to receive the where they must do so. We intend to take forward committee’s report, Mr Clark of Southwark said: consideration of how action can best be focused in “So I hope we shall support the suggestion that we phase out these areas in the light of the findings of the scoping these liabilities, just as the Church of the 1830s agreed reluctantly study in order to reach more definite conclusions on to tithes being phased out”. next steps in the year ahead. I thank the noble Earl for The synod approved the recommendation, but declined his contribution to the debate and all those who have to use its legislative powers to implement it. Soon contributed to our enlightenment on this important after, and with Church of England involvement, the issue. As I have said, we are by no means complacent Law Commission recommended the abolition of CRL about this issue and the debate has been most helpful. by statute after a 10-year notice period, which would by now have long expired. That recommendation, 3.37 pm made in a well argued paper, was not implemented, but if the synod itself agreed to ending CRL, thinking Sitting suspended. it unlikely that compensation would be forthcoming from the Government in 1982, it would be even less realistic in this age of austerity to expect the taxpayer Chancel Repairs to reimburse parishes for the loss of a doubtful future income. Given the furore over even the registration of Question for Short Debate CRL of properties in the roughly one in 20 parishes thought eligible to do so, parochial church councils 4pm have wisely refrained from enforcing their legal rights Asked by Lord Avebury since 2003, so are they worth anything? The state already contributes hugely to the upkeep To ask Her Majesty’s Government what steps of churches through gift aid worth some £84 million; they are taking to abolish the liability of private the Listed Places of Worship Grant Scheme worth householders and others for chancel repairs. £42 million; the National Heritage Memorial Fund, currently funding repairs to Winchester Cathedral Lord Avebury (LD): My Lords, a consensus that costing £14 million and of York Minster at £18.3 million; reform of the law on chancel repairs is long overdue further grants to cathedrals recently announced worth has emerged from discussions with the church, the £8 million; Heritage Lottery Fund grants to churches Law Commission, the Law Society, the Country of £300 million in the 10 years to 2004, the lion’s share Landowners’ Association and the National Secular to the Church of England; and finally, £15 million Society. Since the Chancel Repairs Bill will not make recently announced by the Chancellor of the Exchequer further progress until after the general election, a for repairs to church roofs and rainwater pipes under preliminary debate on the issues is useful now. the Listed Places of Worship Roof Repair Fund. By the 12th century, the liability to pay for chancel In 2003, following a refusal by English Heritage to repairs, the CRL, was already linked to the tithes fund repairs to the church in Aston Cantlow in being received by the rectors of certain parishes. At Warwickshire, the local PCC refused an offer of £25,000 the Reformation, Henry VIII sold the right to the from the lay rectors, Mr and Mrs Wallbank, and the tithes to lay people who became liable for chancel parish took the case all the way to the House of Lords, repairs as “lay rectors”. Under the current law, the with the active support of the Archbishops’ Council. Tithe Act 1936, some lay rectors are still responsible There, the Wallbanks lost, and had to sell their farm to for those repairs, but the tithes which originally enabled pay the CRL and costs approaching £500,000. them to make a profit from the transaction were abolished. The unfortunate remnants were those who Parliament reacted with an order providing for owned land that was not relieved of the burden in registration of CRL at the Land Registry, to alert 1936, or their successors in title, who have been living buyers to land being subject to the liability, since it was under a sword of Damocles for the past 78 years. It is rarely shown on deeds, but lawyers doubt whether for discussion whether major institutions such as the buyers of unregistered land are protected as envisaged schools of Eton and Winchester or the colleges of when the order was enacted. The church warned PCCs Oxford and Cambridge should continue to be required that failure to register under the order might render to pay long-standing non land-based CRL, but it is trustees personally liable, so it is little wonder that an unreasonable for the owners of generally small plots estimated 17,000 titles in a few hundred parishes have of land in some 2,500 Anglican parishes in England— been registered. The vast majority are owned by ordinary around half of them—to be potentially liable for the householders, not major landowners. charge, which is without limit. Attempts were made to mitigate the harm to the The Chancel Repairs Act 1932 reasserted the little-used mission of the church that registration caused. Titles right to enforce CRL, but transferred enforcement were singled out where the return seemed most lucrative from the ecclesiastical courts to the county courts or there was likely to be opposition. PCCs often GC 275 Chancel Repairs[15 JANUARY 2015] Chancel Repairs GC 276 announced that there was no intention of enforcing all the opportunity to discuss a very important matter— the liability. However, assurances are not legally binding chancel repair liability. In my role as chairman of the and can be rescinded at the stroke of a pen. Even London Diocesan Advisory Committee and as an cancellation of the registration does not extinguish the active member of my parish church in Cornwall, I see right to enforcement. more of the varied picture that the Church of England PCCs were ill equipped for the laborious and exacting presents than do most people. The views I have heard work of registration, often involving missing, archaic from the members and officers of the Church of or inaccurate documents. Unsurprisingly, thousands England on the subject of chancel repair liability are of registrations have been made in error, compounding equally varied. I speak now as an individual member the distress caused to householders. This happened, of the church, not on behalf of any church body. for example, in Gorleston in Norfolk, where all of the As we have heard from my noble friend Lord Avebury, nearly 1,000 registrations had to be withdrawn. this matter is one that can come between churches and Given the hostility to registration reported by the their local communities, and it has long been understood media, churches would find it extraordinarily difficult that something must be done to remove the element of and counterproductive in terms of their relationships surprise from the situation. Those of us within the with their parishes to sue for recovery of CRL. It church had been resting on the assumption that something appears not to have been attempted since Aston Cantlow. has been done. In 2002, Her Majesty’s Government Registration is literally a medieval anomaly that brought the Land Registration Act on to the statute undermines the value and saleability of land, creating book, giving the church 10 years to get its house in lasting animosity towards the church, without achieving order and register legitimate chancel repair liability, the objective of improving the funding of chancel after which the door would shut in October 2013. That repairs. It aims at taxing citizens who may not even be was the date that we all had in mind: October 2013. Christian or belong to any religion, for the purposes of After that, it would be settled, with no more scope for one faith out of dozens in our multicultural society. nasty surprises—surprises for churches seeking grant Even more harmful for many landowners than the funding that are coerced into researching historic liabilities, exposure to unquantifiable and theoretically limitless and, of course, surprises for the owners of properties CRL is the blight of registration, significantly reducing affected by those liabilities. the sale price and even making the property unsaleable, particularly to buyers requiring mortgages. Since Aston There are two sides to every story, of course. In Cantlow, purchasers of land have routinely taken out fact, many registered chancel repair liabilities are against insurance against having to pay CRL, and this has wealthy institutions, the church authorities themselves proved very lucrative to the insurance industry, given or others who are well able to pay. Those landowners that payouts have been minimal. But for property would no doubt be pleased to see the value of their blighted by registration, premiums are astronomical asset rise as a result of the abolition of chancel repair or insurance is totally unavailable. liabilities. However, the worst-case scenario is more often quoted. An unsuspecting person of modest means The only fair solution is abolition, modelled on the buys an unassuming house only to discover, despite Law Commission’s recommendation, but until that having taken all possible precautions, that they are can be effected, a much greater availability is needed liable for a bill of a quarter of a million pounds to of compounding—the ability to buy out the liability mend the church roof. That nasty element of surprise to CRL, at low cost and minimal professional fees. At is undoubtedly one of the worst aspects of the current Edingale in the diocese of Lichfield, the diocese agreed state of affairs, but I wonder how often it actually after long and stressful negotiations to accept just occurs. I do not have the numbers, but I hope that my £45 from a householder to extinguish her liability to noble friend may have the list to hand when he replies pay CRL of thousands of times that amount if it had to the questions which I and others are asking. been recoverable. Without compounding, any would-be purchaser would have had to take into account the It was precisely that problem which Her Majesty’s probability that, ultimately, the church would be able Government sought to tackle in the Land Registration to enforce the claim, as it did in Aston Cantlow. Act 2002. At least, that was the popular understanding Some dioceses already recommend compounding, among my church friends. I think that it is fair to say but a uniform countrywide scheme would be the ideal, that in practice the law is not what we all hoped for, a possibly by way of amendments to the Ecclesiastical view supported by the Law Society in its parliamentary Dilapidations Measure 1923. The initiatives of the briefing. Its principal limitation is that it applies only Reverend Greg Yerbury, team rector of Penkridge, to properties sold since October 2013. All property Staffs, might provide a useful model. In any case, which has not been sold since October 2013 continues based on the principle that half a loaf is better than no to dwell under a cloud of uncertainty. Even worse, the bread, it might be sensible for the church to devise a point of sale being the completion of the sale means workable national scheme for compounding before we that, at least in theory, it is possible to discover and return to the Chancel Repairs Bill, abolishing CRL register a new chancel repair liability between exchange altogether after the general election. of contracts and completion. That means that even when a property search has been returned blank, there remains a risk. Unsurprisingly, the insurance industry 4.09 pm has risen to the challenge, and chancel repair liability Baroness Wilcox (Con): My Lords, I thank my insurance remains a lucrative business. In practice, the noble friend Lord Avebury for bringing this subject to 2002 Act has not met the needs of churches, landowners the attention of the Committee and thereby giving us or potential purchasers. GC 277 Chancel Repairs[LORDS] Chancel Repairs GC 278

[BARONESS WILCOX] In Lytham St Annes, more than 6,000 titles were To my mind, the neatest, fairest and best solution to reportedly registered by the church, the largest number all this is to bring forward a law to fulfil what we in the country. I believe that the parish with the second hoped was the ambition behind the 2002 Act: to largest number of registrations, approaching 1,000, is remove uncertainty and any further possibility of nasty Gorleston on the Suffolk coast, a town I know well. It surprises. However, to abolish chancel repair liability is a town with a high proportion of elderly residents, altogether without compensation to the churches and not a wealthy one; 20% of people are on benefits, concerned would not send the right message to the compared with 13% for England as a whole. With so volunteers struggling to maintain our church heritage. many properties sharing the CRL burden, the individual sums recoverable would, one could argue, have hardly I do not dispute that the present Government have been worth collecting or registering, but much as in been generous in their funding for church buildings, Lytham, the church in Gorleston gave the impression but in the European context, where many countries’ that the registrations were made just to follow orders, churches are funded largely by the state to the tune of or as the vicar said, “in order to comply with the billions, we get extremely good value for money. The requirements of the Charity Commission placed on volunteers of the Church of England care for 12,500 the trustees of charitable organisations”. listed buildings—more than 10 times as many as the National Trust and English Heritage combined. While The tale goes on. The vicar offered property owners churches can apply to certain grant funding pots, there a way out: pay the parish £50 and receive what he is no guaranteed state funding at all for this substantial described as a “certificate of exemption”. He promoted part of our national heritage. this as being cheaper than insurance. The recognised way, of course, of buying out CRL is through the While grand country houses and ruined castles are, Ecclesiastical Dilapidations Measure 1923, under which at best, noble works of art and, at worst, symbols of the money goes to the diocese. These exemption proceeds local oppression, our historic churches represent the went to the parish, and an acknowledged expert on very best hopes and aspirations of the communities CRL has seriously challenged the exemption’s validity. that built them, celebrated their lives in them, and The vicar, too, seems to have had second thoughts, for were ultimately called to that final act of parish he has refunded the £50 contributions, which he had communion in their churchyards. In seeking to legislate said were better than insurance, seemingly whether or further to end the undoubted unfairness of the present not the property owners wanted to lose the exemption system of chancel repair liabilities, I urge the Minister they assumed that they had contractually secured. The to ensure that hard-pressed individual congregations parish has, it seems, thrown in the towel. I quote this tasked with caring for this very significant part of our as an example of damage done to the many. It has heritage are not put at a disadvantage as a result. thrown in the towel because every registration has been revoked, but only after about a year of heartache and uncertainty for those whose properties were registered. 4.15 pm Although I imagine that some owners may reasonably Lord Cashman (Lab): I, too, congratulate the noble assume that the Church’s right to sue for CRL is Lord on enabling this important debate on an issue thereby removed, the PCC remains free at any time in which should have been settled years ago but that I future to reregister or, more importantly, to sue for it. I hope will be settled soon. I know that I am not alone hope that I have put the case not only for reform but in having received supportive calls for the repeal, or at for repeal. I believe sincerely that CRL is a pernicious, least the reform, of this liability from, among others, medieval relic and the time is long past for the curtain the Law Society of England and Wales and the National to be dropped rather heavily upon it. Secular Society. The Law Society is calling for reform of chancel repair liability for a number of reasons, but primarily to reduce the financial burden on purchasers 4.20 pm of land and speed up the conveyancing process. It also Lord Taverne (LD): My Lords, until I found out puts the case that, more widely, reform could help to from my noble friend Lord Avebury what his debate improve the UK’s standing in the World Bank rankings was about, I must confess that I had never heard of of ease of doing business. Interestingly, in the section CRL. Then I discovered that this ancient, medieval, on registering property, we are currently ranked 68th, ecclesiastical relic still exists and can have potentially against an overall ranking of eighth. Much more, catastrophic effects on thousands of owners of mainly clearly, needs to be done. small plots of land in some 2,500 Anglican parishes. More widely, the number of property titles blighted Owners can be held responsible for the cost of repairs by CRL per parish ranges from as few as one to to churches amounting to tens of thousands of pounds hundreds or even thousands. Where it is a small number, and that potential liability can make their house unsaleable. the people singled out will feel doubly vulnerable The liability is perpetual and can be annulled only by because of the several nature of CRL—that, in many compounding—that is, by buying it out. This can cases, any one landowner can be sued for the entirety involve large legal, surveyors’ and insurance costs, if it of the repairs needed, as happened in the previously-cited can be insured against at all. case of Aston Cantlow. Where the number of CRL Churches have argued that owners knew or should registrations in a parish is large, untold distress is have known about this when they bought the land but caused to a significant proportion of the community, they generally did not know, or they would have including many without the knowledge or resources to avoided making the purchase. In time registration of cope with it. land was made an option for churches so that owners GC 279 Chancel Repairs[15 JANUARY 2015] Chancel Repairs GC 280 would know about their liability for CRL, recorded in recent decision. What is the resultant amount of the the Land Registry, but many bought their property liability and its calculation? Is it shared or individual—joint before registration. For example, 30 families in Broadway or several, to use the technical term? The timing of its found out about it only when they received a letter imposition and the inability to defer or amortise regardless from the Land Registry. It was a traumatic discovery of impact is significant. The reliability of safeguards causing an outcry of anguish, duly reported by their such as insurance and the implications for professionals, Member of Parliament, and in the end registration of which have been raised by the Law Society, are certainly their property was withdrawn because of its effect on uppermost in my mind as a professional myself. There the reputation of the church. is the difficulty of buying out the liability—or That unlikely adverse publicity for churches has compounding, to use the correct term—at a fair sum meant that since the Aston Cantlow case they have not and at a time of one’s choosing. There is the absence asserted their right to sue landowners, but its existence of a right of appeal against either the impost or the still blights owners’ property. One landowner was nearly quantum. There is the potential for expensive delay at driven to suicide because he lost his principal assets. critical moments, with consequential market-value effects, Sometimes registration by the local church has proved and it can be a severe impediment to transactions. ineffective because the archives holding the records Unfortunately, as the noble Baroness, Lady Wilcox, are difficult to trace. Some people have therefore tried mentioned, the Land Registration Act 2002 has not to get registration overturned, but the costs are huge resolved the issue; it has simply put a large part of it and the task is impossible for laypersons because of into the long grass. the legal complexities and because the owner might Liability falling on wealthy landowners may be one need to find the relevant archives which are kept in thing but when it falls on unsuspecting householders, different locations. It is no wonder that the Synod reluctantly deemed by the PCC to be the most amenable recommended in 1981 that CRL should be phased of various possible pockets, that is clearly something out. Unfortunately, it did not press the issue. else. The selectively capricious manner of its imposition The case for abolition of this oppressive anachronism hugely adds to the risk and to the disproportionate is overwhelming. It can ruin lives and I am told that resultant contagion. It can destabilise family finances, the legal position, even of those who have not had destroy livelihoods and wreck lives, as we have heard. their properties registered, is uncertain. It should go The ability to pay matters not one jot. I cannot prove the way of tithes, and I hope that the right reverend this but I suspect that CRL has the potential to Prelate will pass on to the most reverend Primate the destroy more third party property value than it confers Archbishop of Canterbury, who has shown deep concern in benefit in terms of chancel repair. about social justice, our pleas that this anachronous I am no great moralist, but if CRL were in the imposition of huge burdens on possibly thousands of hands of private landowners, such non-recourse powers landowners should be ended as soon as possible. would have long since been outlawed as contrary to the public interest. I was raised in the Roman Catholic faith. I know very well that desirable ends of maintaining 4.23 pm places of worship exist but they do not necessarily The Earl of Lytton (CB): My Lords, I, too, welcome justify capricious or inequitable means of financing this debate and thank the noble Lord, Lord Avebury, them. Part of the problem is that although there is a for the opportunity. In rising to support him, I declare perception of the great wealth of the established church, an interest as a chartered surveyor, as an occasional administered under the auspices of the Church provider of quinquennial surveys on ecclesiastical property Commissioners, this does not inure for the benefit of and as a valuer—not in the matter of professional parochial church councils, which are legally obliged to involvement with CRL but rather the implications for shoulder the funding of church repairs from their own valuation and the philosophy of this ancient impost resources and congregations. Although the real estate, more generally. if I can term it that, belongs to the diocese and is In every consideration of property valuation the administered centrally, it is the parochial church council question of risk looms large and often has a that has the unfortunate business at the sharp end of disproportionate effect on net present value. Typically, imposing CRL. This is a fairly invidious state of that is reflected in a discount rate or the rate of affairs. Clever financial minds—I do not single out the accumulation applied in a valuation. This is not just Church of England for this; far from it—have segregated theoretical science but reflects the real world of human asset from parish burden, and this is part of the issue. response to risk and reward over extended timescales Like the noble Lord, Lord Avebury, I ponder the and observed over centuries. CRL affects land value message that this sends out. It seems to me that there is because of how the liability is transmitted and how it a consensus that CRL should be abolished, and I hope attaches to owners. the Government will get on with it. There is one thing more potent in valuation than a 4.28 pm perceived liability and that is a liability that cannot be quantified. To counter it often requires the adoption Lord Rooker (Lab): My Lords, I am very happy to of a worst case scenario. CRL, to quote Donald support the noble Lord, Lord Avebury. I want to tell Rumsfeld, is full of “known unknowns” and here are your Lordships a story. It is the story of Helen Bailey some of them. First, whether it applies at all is far from Staffordshire, whom I spoke to yesterday evening. from obvious. The basis of liability—is it keeping a Helen Bailey said: “The parish church officials in chancel windproof and watertight, or is it something Edingale, Staffs, seemed entirely ignorant of the more elaborate?—has been the subject of a more consequences of registration on title holders, and they GC 281 Chancel Repairs[LORDS] Chancel Repairs GC 282

[LORD ROOKER] liability notices had been registered and we eventually appear to have given the affected individuals not one concluded that the only truly effective way to get rid of iota of thought and were utterly insensitive. They the blight was to buy out the liability via compounding appeared not to have had any guidance regarding the under the 1923 legislation”—which has already been human impact of CRL from the Lichfield diocese or referred to. from the church centrally, and seemed to be treating it “Again with Greg Yerbury’s support, I approached as some sort of purely legal and technical matter. No the church regarding compounding. Its initial response attempt was made by the church to consult with was unfortunately pretty unhelpful as it would involve owners, as had been the case in the adjacent parish of fees for solicitors, accountants and surveyors which Alrewas, as a result of which registration was not would have run into thousands and been quite proceeded with. Having decided in principle to register, unaffordable, even if shared. Eventually, and only it apparently did not occur to the Edingale Parochial after considerable effort, a more pragmatic solution Church Council to establish whether there were any was arrived at by Reverend Yerbury on the basis of a extenuating circumstances rendering registration an calculation proposed and agreed with all parties. Because act of callousness or even inhumanity. The church Edingale parish church is small, relatively modern and officials did not even observe the most basic courtesy the chancel is in good repair, the compounding cost of informing us”—that is, Helen Bailey and her ended up being calculated at around £50 per acre. In neighbours—“of what they were about to do, or even the end I succeeded in arranging compounding and it had just done. The first I learnt about registration was cost me £45”. when the letter arrived from the Land Registry. The Helen Bailey continued, “It has been suggested to next day I met one of my neighbours who had also me that this trivial settlement sum proves that I was received a letter; she looked as white as a sheet and making an unnecessary fuss about nothing, but the had clearly not slept. The owners of the adjacent absolute reverse is true. The settlement sum demonstrates farm, who own the bulk of the affected land, received the financial sabotage of CRL and the true idiocy of no notification. The land was not registered, so they enforcing this ancient and anachronistic legislation. got no notification from the Land Registry and it was The church has gained practically nothing. For the only much later, at the insistence of the affected sake of £45 they wrought disproportionate destruction homeowners, that the church took any steps to inform on the value of my home and brought misery to my them. neighbours and me. Had I not drawn attention to this “Some weeks after registration a church official in the media and tracked down Greg Yerbury, who has appeared on my doorstep, clearly very proud of his been most helpful”—he seems to deserve a medal, I prowess in having navigated the mechanics of registering might add—“I am sure that my neighbours and I CRL and apparently expecting me to congratulate would still be in this invidious position”. him. He seemed astonished when instead of being It is time for this legislation to go. I am in favour of impressed, I expressed my anger and concern and preserving our church buildings, although I am not a acquainted him with the consequences of his actions. churchgoer. I have two lumps of stone from St Laurence’s The church council appeared not to have done the in my back garden, bought at auction to support the basic internet research into CRL, which would have refurbishment of the church. I have no problem about revealed its potential to blight the lives of affected that, but this legislation has to go. individuals. “Fortunately, my background as an accountant and experienced CAB adviser and as an advocate equipped 4.34 pm me to do some research. Initially what I learnt served The Lord Bishop of Derby: My Lords, how do I only to create increased anxiety as the full implications follow that? I thank the noble Lord, Lord Avebury, for became clear. Recognising that CRL would in all introducing this debate. As a number of noble Lords probability make my property unmortgageable—and have said, the Church of England is on record as therefore potentially unsaleable—I had no choice but supporting the principle of abolishing what has helpfully to try to find a solution. Initial letters to the church been called CRL, to put it into shorthand. It is very yielded nothing beyond denials of responsibility and important to stress that. We are on record as saying hollow sympathy; there was an almost bewildering that we support abolition in principle. The question is refusal to engage in the distress it had caused. The how and on what terms. Clearly, it is in no one’s local vicar was more genuinely sympathetic but had interests to hear stories such as the one we just heard no idea how to resolve the damage inflicted on my from the noble Lord, Lord Rooker. How could CRL neighbours and me. In the end I was very fortunate to be abolished? The fact is that property—not only the find myself in contact with the Reverend Greg Yerbury, properties under CRL—is often subject to rights and whose integrity, expertise and kind assistance proved restrictions. This is not new, and it is not unusual. In invaluable. the Wallbank case in 2003 the House of Lords recognised “My researches revealed that the historical proofs that this was a right commensurate with other rights. relating to CRL in Edingale were less than unequivocal In the 2003 judgment, Lord Rodger of Earlsferry but sadly also revealed that my neighbours and I had stated that, to disprove liability rather than the other way around, “in principle I do not find it possible to distinguish”, something we could not possibly afford to do. Assurances CRL, by the PCC that they had no intention of ever enforcing “from the liability which would attach to the owner of land which CRL were of no value at all as they did not remove the is purchased subject to a mortgage, restrictive covenant or other blight. Insurance was no longer available now that the incumbrance created by a predecessor in title”. GC 283 Chancel Repairs[15 JANUARY 2015] Chancel Repairs GC 284

It may feel anachronistic, but the fact is that it is not 4.39 pm unusual for properties to be subject to these kinds of restrictions and challenges. In law, the most recent Lord Kennedy of Southwark (Lab): My Lords, like judgment we have from the House of Lords found that other noble Lords who have spoken, I thank the noble it was not easy to distinguish this from others. We can Lord, Lord Avebury, for tabling this Question for distinguish the pastoral effects of the cases, but in Short Debate today. It is a most timely discussion. terms of good practice in the management of property As we have heard, chancel repair liability derives and of rights it is a much more complicated issue. from the disposal of church lands following the Reformation. Previously, the rector had the obligation The noble Lord, Lord Avebury, made important for the repair and upkeep of the church and was able statements about the amount of funding the Church to raise sums of money—tithes—from parishioners. of England receives from the Government, and that is After the Reformation, much church land was passed very welcome. However, as the noble Baroness, Lady to lay landowners but the liability for upkeep remained, Wilcox, said, the churches have to put in an enormous and this is the problem in effect. The lay landowner effort to maintain the buildings. They are not just a with the liability to pay for chancel repairs has no vital part of our built environment, but a facility that means to cover the costs. is there for people when they want it, as they want it and on their terms. A very few of us keep these Some progress has been made to deal with this buildings fit for purpose as a spiritual resource and a anomaly, most recently in 2003 when the then Labour spiritual sign. Government changed the law, as other noble Lords have mentioned, so that after 13 October 2013, where It is interesting that the Tithe Act 1936 did not interest has not been noted at the Land Registry, any abolish CRL. Parishes are often willing to come to a purchaser of land to which the liability previously sensible arrangement, although in the story we have attached will not be subject to it, although the current just heard it was a very tortuous route. For instance, in owners in such cases would remain liable. That is some my own diocese in Derby, one of the former Dukes of progress but we need to go much further. Devonshire had quite a lot of liability in a number of We are fortunate in this country to have beautiful parishes of which he was a patron. Years ago he buildings of all ages and types. They tell the story of commuted this responsibility in return for a financial our history and they should be preserved. Our system payment, and he now has no liability at all. I make of listing buildings helps protect them. I note that the that point because, of course, if we suddenly abolish Church of England is responsible for maintaining all this, some people have paid compensation in good 45% of the grade 1 listed buildings in the country and faith and in recognition of that right and that the that the majority of all parish churches are grade 2 or Church needs to be recompensed in some way. We higher. The right reverend Prelate the Bishop of Derby have heard again that trustees have a liability to maximise made reference to this obligation. We have to find assets. Again, I do not endorse the way in which this another way to fund the upkeep of these buildings and was done in the story which the noble Lord, Lord phase out the chancel repair liability, particularly for Rooker, gave us. That showed the wrong enthusiasm, individuals. but you have to be enthusiastic for maximising the Looking at the Wallbank case, referred to by the assets that you oversee. noble Lord, Lord Avebury, which went all the way to How can we proceed to get rid of the CRL and all your Lordships’ House—which found against the the problems it causes? The advice we received is Wallbanks and left them with a repair bill that amounted that—under the European Convention on Human to £250,000 including VAT, and legal fees of £200,000— Rights and the Human Rights Act, and taking into you can have every sympathy with individuals who account the previous practice of the Government, the find chancel repair liability claims served on them, and Tithe Act, and the previous practice of individuals it illustrates how unsatisfactory the present position is. such as the Devonshires—in all those cases such a The case established that chancel repair liability, although right is commuted in return for some kind of ancient, is an enforceable part of the land law of compensation. That is the principle by which legislation England and Wales, whereby property owners can be would need to proceed. It is a well known constitutional compelled to pay for the repairs to the chancel of a principle that Parliament does not deprive a subject of church. a right in the nature of property without providing The noble Lord, Lord Avebury, introduced a Private compensation. Member’s Bill into the House of Lords on 14 July I propose that we have to proceed to change. All the 2014, the effect of which, on becoming law, would be speeches have made that clear. This has to be done on to abolish the liability on lay rectors for chancel repair. the basis of compensation. This would be fair to the With so few days left in this Parliament before it is current liabilities that property owners hold, because dissolved at the end of March, I do not think the Bill is they are legal liabilities. It would be fair to give parishes going to make much progress, as the noble Lord notice and some kind of recompense for having to himself suggested. What the Bill is proposing to do take on an even greater burden of the maintenance of goes in the right direction, but for it to make real buildings. This would be fair to current legislation and progress in the next Parliament there also have to be good practice in the administration of property and of provisions to identify replacement funding, and that is property law, as Lord Rodger reaffirmed in 2003. We where the Government come in. are fully behind this. It is just a question of how it is Responding to a debate in the other place on done. There is a very strong case that there needs to be 17 October 2012, Helen Grant did not offer much some element of compensation to be fair to all concerned. comfort and generally took the line that the provisions GC 285 Chancel Repairs[LORDS] Chancel Repairs GC 286

[LORD KENNEDY OF SOUTHWARK] England, is usually the PCC, to enforce the liability. in place as a result of the 2002 Act have achieved a This right can play an important part in the finances “better balance” and that the Government were not of the 5,000 or so churches with the benefit of the “persuaded” of the need for change. I contend that the liability. In earlier times, the main problem was that Government need to move on from that position and the liability was sometimes difficult, if not impossible, try to find a lasting solution. Not to do so would for a prospective buyer to discover. Now, following the continue to make certain properties unsaleable, bringing removal of its status as an overriding interest in October blight and distress to people, and that cannot be right. 2013, its existence is readily discoverable. This is a I hope that the noble Lord, Lord Ashton of Hyde, major improvement, as my noble friend Lady Wilcox when he responds to the debate, will be able to give a said. commitment that the Government recognise that there On the other hand, the unpredictability of the is a real issue here that needs to be addressed; that incidence of the liability, its open-ended size and abolishing the liability in its entirety or at least for particularly its joint and several nature, mentioned by private individuals is long overdue; and that they will the noble Lords, Lord Cashman and Lord Rooker, work with the noble Lord, Lord Avebury, and the still attract criticism. It is, however, unclear how far Church of England to enable him to bring forward these potential problems are causing widespread real another Bill early in the next Parliament that resolves difficulties in practice. The Ministry of Justice’s impression this question finally and provides a mechanism for is that enforcement, now and for some time past, replacement funding to be identified. That could just against ordinary homeowners is rare. This may be a be the Government ensuring that, when the liability is consequence of the relatively small number of chancels, removed, the Church of England will be able to apply probably about 500 to 600, where the liability falls on for other funding streams. If the Government committed individual property owners. It may also be because to working with the noble Lord, Lord Avebury, and PCCs are reluctant to enforce the liability. Their wider the Church of England in a similar way to that in mission may, perhaps, not be best served by imposing which they have worked with the noble Lord, Lord financial hardship on individual members of the local Naseby, on the Mutuals’ Deferred Shares Bill, they community. That is, however, a decision for individual could make much progress here, which would be to PCCs, who can get advice from the church and the their credit. Charity Commission, as well as their own legal advice. The noble Lord, Lord Ashton of Hyde, has heard Under Section 110 of the Charities Act 2011, trustees the right reverend Prelate the Bishop of Derby say can get reassurance from the Charity Commission that the Church of England wants to get rid of the that they are acting in accordance with their duties. It chancel repair liability. I therefore hope that he will may also be that the level of concern about the liability take up my suggestion and work to resolve this, and has been temporarily increased by the registration. not just tell the Grand Committee that the Government My noble friend Lady Wilcox asked how many ordinary are going to keep the matter under review, because we householders are affected by this liability. We do not all know what that means—that the Government are have the statistics indicating how many ordinary going to do nothing at all about it, which is not householders are affected, but the Land Registry has acceptable in this case. received about 9,000 applications for registration of notices and 160 applications for the registration of a 4.45 pm caution against first registration. What we can be sure about is that there are enough people who may be Lord Ashton of Hyde (Con): My Lords, I am grateful affected to take this subject seriously. to my noble friend Lord Avebury for raising the issue of chancel repair liability for debate today. I am also The Government appreciate that homeowners who grateful for the interesting contributions of other noble were unaware that their home was subject to the Lords who have spoken. I feel, in some ways, that the liability may well have been worried by the notice. The right reverend Prelate should be here, I will not say in speech by the noble Lord, Lord Rooker, reminded us the dock, but here with me to answer some of the of the effects to real people, not just in theory, but the speeches, which were all on the theme of changing the reality is that their legal position has not changed. The present situation. I listened carefully to the concerns fears that were expressed leading up to the deadline of expressed about chancel repair liability and I am sure October 2013 that the registration of a notice can that the Ministry of Justice will consider them in render a property unsaleable or unmortgageable do detail, but I must make clear—I trust that this will not not seem to have materialised, nor does the market in come as too much of a shock to noble Lords, except, chancel repair liability insurance seem to have disappeared. perhaps, to the noble Lord, Lord Kennedy—that the That is not to say that chancel repair liability cannot Government have no plans to change the law at present. or will not cause major problems for some homeowners, None the less, it is because we take the concerns but at present it is not clear that liability is doing so in seriously that we are keeping the situation under review. practice. I do not have time to go through the long history of Even if reform is necessary, it may not be chancel repair liability. In fact, my noble friend Lord straightforward, as the right reverend Prelate made Avebury has dealt with that admirably, as have other clear in a very measured speech. Abolition, as advocated noble Lords. The Law Commission has considered the by the noble Lords, Lord Avebury, Lord Cashman, liability a number of times since the 1960s. The present Lord Rooker and others, would almost certainly require legal position is that chancel repair liability is an compensation to be paid because chancel repair liability ancient but valid right that enables the owner, who, in is a property right protected by the Human Rights GC 287 Chancel Repairs[15 JANUARY 2015] London Health Commission: Smoking GC 288

Act, as confirmed by the House of Lords. The sums Lord Kennedy of Southwark: Is it not possible for involved in aggregate might run to hundreds of millions the Minister to say today that he would welcome of pounds. The right reverend Prelate suggested that discussions between his officials, the noble Lord, Lord compensation is the way to abolition but he did not Avebury, and the Church of England? If this could be mention by whom. The noble Lord, Lord Kennedy of resolved, everyone would be happier. I do not see why Southwark, said that that is where the Government he cannot even offer that to the Committee. come in. Schemes for release, redemption or compounding Lord Ashton of Hyde: I did indicate that when it might be created or present ones, as outlined in the comes to dealing with the church and the National Ecclesiastical Dilapidations Measure 1923, improved, Secular Society, we would take part in discussions if but their cost and attractiveness to prospective users required. I also made clear that if there was evidence would have to be considered carefully. The noble Earl, of hardship, the Ministry of Justice would consider it. Lord Lytton, mentioned some of the difficulties in I do not think that that is unreasonable in the absence estimating a compounded amount, taking into account of any actual evidence of hardship at the moment. If the net present value for an unlimited liability stretching there is evidence of hardship, we will discuss it, and of forever. What discount rate, for example, would one course we are always willing to talk to the noble Lord, use, taking into account the average interest rate across Lord Avebury, or any other noble Lords at any time. all years forever? I know that my noble friend Lord Avebury and 4.55 pm other noble Lords will be disappointed that the Government are not developing any proposals for Sitting suspended. reform at present but I assure noble Lords that the Ministry of Justice will consider evidence of actual hardship or general problems that the law may cause London Health Commission: Smoking and will keep the situation under review. Question for Short Debate

5pm Lord Kennedy of Southwark: Having heard the contributions of noble Lords, in particular from the Asked by Lord Darzi of Denham right reverend Prelate the Bishop of Derby, that is a most disappointing response from the Government To ask Her Majesty’s Government what plans and makes no attempt to deal with the issue. they have to support the recommendations of the London Health Commission with regard to combatting the impact of smoking on health. Lord Ashton of Hyde: The problem is that nobody has come up with a simple way of how to do it, except Lord Darzi of Denham (Lab): My Lords, in opening by providing compensation, because it is a property the debate, I declare my interests as in the register. right under the Human Rights Act. The issue is: who Over the past year, I had the privilege to chair the provides compensation to the people who own the London Health Commission at the request of the mayor, right? We have decided that there is no necessity to do Boris Johnson. I express my thanks to the mayor for that when there is no actual example of hardship giving me the opportunity to do so. As a politician, the taking place at the moment. The reason that I said mayor took a brave step by establishing an independent that we will keep it under review is that if there is commission, tasking it with examining the evidence evidence of actual hardship taking place, we will consider and giving my fellow commissioners and I the freedom this measure. to make the right recommendations for London. I also express my thanks to the thousands of health Lord Avebury: As we have a couple of minutes, I ask and care professionals and Londoners who contributed the Minister whether the Government will encourage to the commission. They were generous with their the church to consider the schemes of compensation time and their ideas. The work of the commission and that I mentioned at the end of my speech, which have the report, Better Health for London, are the expression been successful in certain parishes? As we heard, one of the passion and the ambition that Londoners have householder managed to compound his liability for for better health. London can be the healthiest major the sum of £45. If the church could be encouraged to global city. As our nation’s capital, London should be consider that sort of solution, it might solve the financial a leader and set an example for other cities in Britain. problem. London should not be an exception, and the proposals set out by the commission could, and indeed should, apply to other cities in our country. Lord Ashton of Hyde: I believe that the church is in We all want to lead healthy lives. Our health is discussions with the National Secular Society, for determined by all different parts of our lives—what example, in dealing with this. The Government have we eat and drink, whether we choose to smoke or said that they are prepared to join in those discussions drink and how much, how we travel to school or work, or to take account of them. Beyond that, I am not able and how we choose to spend our leisure time. Yet we to commit the Government but I know that we will be can lead healthy lives only by working together to interested to listen to what they have to say and we are improve health—schools, employers, charities and prepared to take part in those discussions. voluntary groups, local and regional government, GC 289 London Health Commission: Smoking[LORDS] London Health Commission: Smoking GC 290

[LORD DARZI OF DENHAM] “They leave all their cigarette ends on the floor”, and transport, the NHS and, above all, individuals and another young child said, “It’s really disgusting. I wish families. We each can choose to invest in our own they wouldn’t do it”. health and we can help each other to choose better That is what London schoolchildren think. Making health. parks smoke-free will not only help smokers to make At the heart of the commission’s vision of a healthy better choices by reducing the opportunities to smoke, city lies a very simple idea: making healthy choices it will help children to make the right choice to never should be easier. Making those choices easier requires start smoking. Yet this is more serious than childish action from us all. The healthiest choice is not always debate. The question of making parks smoke-free easy or obvious. Every day, we make hundreds of exists precisely at the boundaries of the proper role of choices that affect our health: how we get to and from the state. I understand and I acknowledge that different school or work, what we choose to eat and how we people will hold different beliefs. Our parks are public. spend our free time. The goal is to make each of those They are shared spaces that we should enjoy together. millions of individual choices that little bit easier, We already accept some limitations on our actions because in that difference is everything: making small within them. There are restrictions on letting dogs changes individually will make a huge difference foul, dropping litter or consuming alcohol. I believe collectively. that our parks should be spaces that promote healthy behaviour, such as exercise. Smoking is one of the worst choices for health. As a cancer surgeon, I see the pain and suffering of Every year, in London alone, about 8,000 people die people afflicted by smoking- related diseases, as well prematurely due to smoking and more than 80,000 as that of their friends and families. True compassion people die prematurely across the country as a whole. for their experience lacks authenticity if it is not joined The consequences of smoking cost society as a whole with resolute action. I have not come across a single at least £2.7 billion a year. Smoking does not simply patient who did not wish that they had never smoked. cause an earlier death; it causes poorer quality of life. I contest the notion that it is a question of liberty. Tobacco does enormous harm to health and limits Cigarettes are more powerfully addictive than narcotics, life’s possibilities. Tragically, about 45% of cigarettes as I said. There is no freedom in addiction. Indeed, that are smoked are consumed by people with mental addiction is the antithesis of freedom. I have always illness, contributing to life expectancy that is 10 to been struck by that great revolutionary rallying call, 15 years shorter than in the population as a whole. “Give me liberty or give me death”. The advocates of Hundreds of children take up smoking every week— smokers’ rights are generous enough to give them two classrooms’ full a day. With advertising outlawed, both. they do so inspired by the adults they see. Once they I have no doubt that parks will become smoke-free start, they continue, as cigarettes are more powerfully by the end of this decade. Thirty years ago, it would addictive than narcotics. It is little surprise that in have been unthinkable that pubs and restaurants would places where more adults smoke, more children begin be smoke-free. Today, it is unthinkable that we would to smoke as well. ever return to smoking indoors. The 2007 smoking ban was a major achievement of the previous Government Just as smokers’ lungs are polluted, the lungs of our and the present Government have continued the good city—our parks and green spaces—are polluted by work with new measures to control advertising at the smoking. London should lead the way for Britain, and point of sale and to stop smoking in cars with children. the mayor should lead the way for London by acting These measures are very welcome and I applaud the to make our public spaces smoke-free. Our parks and Government for having taken them. None the less, it is green spaces account for nearly 40% of the capital, the vital that the work continues. equivalent of 20,000 football pitches—imagine that space completely smoke-free. I also believe that Trafalgar As part of the work of the commission, we examined Square and Parliament Square should be rid of smoking. cities around the world that have made progress in the It would be a powerful message for the iconic centre of fight against smoking. New York City has famously our city and the political heart of our country to led the way. Noble Lords who have visited New York become smoke-free. Indeed, such a measure would recently will know that Central Park and all the city’s make our capital and our country an exemplar for the parks are smoke-free. Today, significantly fewer New world. Yorkers smoke than Londoners. The lesson of two decades of pioneering tobacco control in New York is Many noble Lords will have seen the launch of the that the fight must be sustained with new measures commission’s report last October, when the mayor and and initiatives. When it is not, smoking rates creep I played a game of football with a classroom of back up again. For that reason, I urge the Government schoolchildren. Of course, noble Lords may have seen to progress their plans for plain packaging of cigarettes it for all the wrong reasons, as it featured the rather in a timely manner so that the regulations are made entertaining sight of the mayor fouling a nine year-old within this Parliament. If they do, they will surely be boy. What was so striking was what the children had saving lives. With the election so uncertain a few to say, not about the foul, but about making parks months from now, Ministers, Members of the other smoke-free. They were universally stridently in favour place and noble Lords can proudly know that they will of the idea. They were far better advocates than I. One have saved lives. Other than the protection of corporate said, “It’s horrible when people come and smoke interests, I can see no earthly reason to protect the where we are playing football. I hate it”. Another said, brand value of tobacco. GC 291 London Health Commission: Smoking[15 JANUARY 2015] London Health Commission: Smoking GC 292

As I close, I encourage noble Lords to take a drink because they usually have a backpack with moment to read the findings of the commission. I am them, and have a smoke. If that smoking is not going an advocate for smoke-free parks, yet the report presents to undermine our smoking policy, tourists will not be a broader range of measures to make our capital the allowed to smoke in green parks and that will put healthiest major global city. Progress for better health them off. Or, if this policy does come in, it will result in can be made only through bold aspirations. I thank people smoking in doorways, which we know is a noble Lords for their contributions today and for terrible nuisance for those people who are working demonstrating their commitment to better health for and going in and out of these doorways. all the people of this land. There are some things that can positively be done. I used to be the leader of the London Borough of 5.09 pm Islington. There are things that local government can do. A number of local authorities are doing some very Lord Naseby (Con): The question before us this good work, putting money into the provision of publicity afternoon is contained in the report of the London targeted at encouraging people to cease smoking. If Health Commission, chaired by the noble Lord, Lord we could spend money on that, I am willing to bet that Darzi, which says under the headline “Smoke free would be far more effective than banning smoking in London”: parks. We can use the existing police community support “Each year, more and more Londoners are choosing to quit officers’ legislation to make sure that any smokers smoking, improving and lengthening their lives”. aged under 16 are marched out or told to stop. We can To my mind the question is: will the banning of improve the provision of public refuse facilities. We smoking in parks and green spaces actually result in a have moved on from that era where you could not reduction in smoking or not? hand in anything. There are facilities now, although It will not surprise colleagues that I had a quick they could be improved. And finally, we can amend look at what has happened in Australia on plain the law to enable the provision of indoor ventilated packaging. The policy has been in existence for two smoking rooms in pubs, as in other parts of Europe. years there. The targets were to reduce youth smoking, That will keep the smokers away from doorways and to reduce overall smoking rates and to increase the gardens. So I ask my noble friends to think again. This effectiveness of health warnings. Yet the evidence from will not work and it will deter the tourists. the Australian Government after two years is that youth smoking has not declined; it has grown to reach 5.15 pm a seven-year high. Plain packaging has had absolutely no effect on the sales of legal tobacco or on adult Lord Faulkner of Worcester (Lab): My Lords, I smoking and the imports of illegal tobacco have grown, think that the noble Lord, Lord Naseby, will find that which is perhaps a side issue. That shows that if we are he is a lone voice in this debate. I will not attempt to influenced by modern policy which is not based on counter all the points, but when he comes to reply, science, we are going to find that we are wasting our perhaps the Minister will have something to say about time. the so-called evidence adduced from Australia, which so far as I am aware has been produced only by the First, as regards the situation here, we are not tobacco industry itself. It funded the research. Perhaps talking about the direct effect on people’s lungs from the Minister will be able to confirm that. smoking; we are talking about second-hand smoke, otherwise known as environmental tobacco smoke or I shall start by congratulating my noble friend Lord ETS. This is in two parts: it is a mixture of exhaled Darzi on securing the debate and on contributing to a mainstream smoke and side-stream smoke released brilliant report which, if it is implemented, will help from a smouldering cigarette and diluted by the ambient London set the lead for all of us to lead healthier lives air. It is not the same as smoke inhaled by a smoker. in the future. I agree with absolutely everything he said So what are the risks? Some scientific work has been in his speech. done—one lot in Egypt, for which I am happy to As a direct result of the measures taken by Parliament, provide noble Lords with the source, and the other and particularly in this House, the UK is now a world one in Boston where Professor Michael Siegel of Boston leader in tobacco control legislation. Smoking by people University’s School of Public Health says: aged 16 years and over has reduced over the past “No evidence demonstrates that the duration of outdoor decade by more than a fifth, from 26% to under 20%. exposure in places where people can move freely about is long As a result, there are almost 2 million fewer smokers enough to cause substantial health damage. … In trying to than a decade ago. Your Lordships will recall that all convince people that even transient exposure to second-hand the tobacco control measures contained in the Children smoke is a potentially deadly hazard, smoking opponents risk and Families Act 2014 began their lives not in the losing scientific credibility”. House of Commons but in this Committee Room, We must be very careful here in Parliament that we do and were the subject of amendments proposed by not undermine the scientists. Members from all parties. Three of them are here Secondly, if this did happen, what effect would it today, and I am delighted to see that the noble Baroness, have on London’s tourism? On the front page of Lady Finlay of Llandaff, is to speak and that the today’s Evening Standard the figures are pretty stark. noble Baroness, Lady Tyler of Enfield, has joined the Tourism is vital to the success of London. A record debate. It was to the Minister’s great credit that he £3.56 billion is spent by tourists over the three-month accepted the principle for adopting standard packaging summer period and £8.9 billion over nine months, for tobacco products here, and he graciously responded with tourism up by 6.6%. I suggest that what tourists to the defeat in the House on smoking in cars when like to do is go to the park, have a break, maybe have a children are present by ensuring that the House of GC 293 London Health Commission: Smoking[LORDS] London Health Commission: Smoking GC 294

[LORD FAULKNER OF WORCESTER] If I had a little more time, I would widen the debate Commons was given the opportunity to vote on it too. and talk about the tobacco control plan for England, I understand that the regulations to give effect to that which expires at the end of the year, and ask the will be with us shortly. Minister to give an assurance that it is his intention However, like my noble friend Lord Darzi, I am that it will be taken forward after it expires. I also hope concerned that there seems to be some doubt about that he will be able to say positive things about the the Government’s resolve on standard packs. My measures contained in the London Health Commission’s understanding is that to ensure that Parliament is report, including the licensing of retailers for tobacco. allowed its say before the general election, the Government I will finish with the comment of the Chief Medical must ensure that regulations are laid this month so Officer, Professor Sally Davies, who supports the smoke- that they can go through parliamentary scrutiny by free park plan, saying that it will stop, the Joint Committee on Statutory Instruments and “role modelling in front of children”. the Secondary Legislation Scrutiny Committee in time. I really hope that the Minister will be able to confirm It is children and young people that this policy must today that this is their intention. To delay a vote on be directed towards. standard packaging until after the election would be seen by the tobacco industry as a significant victory and would seriously damage the Government’s credibility 5.21 pm on health issues. Lord Rennard (LD): My Lords, I, too, congratulate The case for standard packs is simple. Cigarettes the noble Lord, Lord Darzi, on initiating this opportunity are the only legal products sold in the UK that kill to debate the important issue of the harm done by their consumers when used exactly as the manufacturer smoking, and the best ways for it to be eradicated. intends. No company should be allowed to promote In recent weeks, the world has been shocked by the such a product through advertising and marketing. loss of life in events such as the terrible murders in Thanks to our efforts here and those of the public France, and in Nigeria, and by accident in the recent health community, packaging is the tobacco industry’s AirAsia plane crash. Approximately 2,200 human beings last remaining avenue to lure vulnerable children into lost their lives in those events. People have rightly been starting to smoke. It must therefore be made as unattractive outraged by the murders, and anxious to prevent such as possible. Contrary to what the noble Lord, Lord loss of life, whether caused by evil people or air Naseby, says, it is a policy that works. Recent evidence accidents, in future. from Australia, which was the first country to introduce standardised packaging, shows that soon after standard Today we are discussing how we can prevent many packs began to appear in shops, smokers reported avoidable deaths and much suffering resulting from a finding cigarettes in these packs less appealing or legal product, but one which we now know to be satisfying. Research has also shown that smokers anything but safe. I have drawn attention to the consuming cigarettes from standard packs were 81% approximate number of people who lost their lives in more likely to have thought about quitting at least those terrible events because it is a comparable figure once a day during the previous week. to the number of people who in the UK alone lose their lives each week as a result of smoking-related Standardised packaging is intended to protect children diseases. Despite many years of progress, smoking-related and young people from starting to smoke. Young disease still claims 272 lives prematurely every day in people are a vital market for the tobacco industry, the UK, causing approximately 100,000 deaths annually. particularly young women. The marketing message is This is something about which we can take action—to this: smoking is cool, glamorous, and constitutes adult reduce the loss of life; to create substantial health behaviour. Some two-thirds of smokers start before benefits that will raise the quality of life for many they are 18 and the vast majority while still teenagers. people; and to reduce poverty and increase opportunity Every day, hundreds of children in the UK start for many of the least well-off people in our country. smoking. Standardised packaging would remove the existing attractive promotional aspects and require the The tobacco industry works furiously hard to avoid appearance of all tobacco packs to be uniform, including erosion of its profits because its products result in the the colour of the pack. They are not going to be plain early death of one in two of its customers. It needs to packs, as the noble Lord, Lord Naseby, says; they will continually recruit new smokers to maintain its profits. allow for the promotion of strong anti-smoking and However, its new customers are nearly always children health messages. Studies from around the world show or young people. Two-thirds of regular smokers start that plain, standardised packs are less appealing, make before the age of 18 and two-fifths of them start health warnings more effectively, and reduce the before 16. I wholeheartedly welcome the recommendations ability of the packaging to mislead customers about made in the London Health Commission’s report. It is the harm caused by smoking. In April this year, Sir Cyril clear from the findings of the noble Lord, Lord Darzi, Chantler’s government-commissioned independent and that London needs to do more to tackle smoking, comprehensive review of evidence reported that there which is the major cause of preventable premature is a strong public health case for the policy, concluding death in the capital. Measures such as smoke-free that, parks and a strengthening of work on illicit tobacco are very welcome, but many other important measures “the body of evidence shows that standardised packaging … is very likely to lead to a modest but important reduction over time must be implemented if we are to continue to drive on the uptake and prevalence of smoking and thus have a positive down smoking prevalence in the future, as we have impact on public health”. done so successfully in the recent past. GC 295 London Health Commission: Smoking[15 JANUARY 2015] London Health Commission: Smoking GC 296

This House took important steps, tabling amendments parliamentarians sympathetic to it stopped the clearly to the Children and Families Bill, subsequently taken expressed will of Parliament on this issue from being up by the Government, to prohibit smoking in cars implemented. with children and to require all cigarettes to be put in plain, standardised packaging. However, while the 5.28 pm regulations on smoking in cars have been laid and, once voted on, will be implemented this year, there Baroness Finlay of Llandaff (CB): My Lords, like remains a silence from the Government about standardised other noble Lords, I welcome this debate and congratulate packaging. I hope that the Minister will break that the noble Lord, Lord Darzi, both on securing the silence this afternoon. debate and of course on his work on the important report from the London Health Commission. I, also, The Tobacco Advertising and Promotion Act has have had many conversations with patients dying from been effective in reducing children’s exposure to tobacco-related diseases. I have never had a patient promotional activity and has brought about a consequent who is glad that they smoked and that their life has reduction in awareness of tobacco marketing among been shortened by it, but I have had enormous numbers young people. Between 2003 and 2013—very much of patients who regret that they are leaving children contrary to the arguments put by the noble Lord, orphaned early, because their lives are coming to an Lord Naseby, when he opposed restrictions on tobacco end prematurely and there is no way that that can be advertising—regular smoking among young people stopped. declined from 10% to 3% in the UK. However, we I strongly support the findings of the London must do much more. Health Commission report and, as have already been Tobacco packaging is now the most prevalent form said, the Royal Parks becoming smoke-free sets a very of tobacco advertising. Smokers display the branding clear example and message that these are open spaces—we every time they take out their packs. In doing so they are fortunate enough to have fresh air in London. I are making a statement about how they want to be question the assertion from the noble Lord, Lord seen by others as they display, and endorse, the brand Naseby, as regards New York, because I have not seen that they have chosen. The arguments put forward by any evidence that the tourist industry there has suffered the tobacco industry to oppose plain paper packaging at all. In fact, anecdotally, I have heard people say it is are completely undermined by the vehemence of their welcome that in Central Park there is smoke-free and a opposition to it. The industry’s credibility was undermined sporting open area. long ago by its denials about the link between smoking The advantage of Parliament setting an example to and lung cancer, the addictiveness of nicotine and the the rest of us by having Parliament Square Garden effects of passive smoking. The tobacco industry now smoke-free is of course clear. The city-wide working claims that standardised packs will lead to an increase against illicit tobacco certainly needs to be strengthened, in tobacco smuggling. but that is a secondary part of tackling the issue of tobacco overall. As the report states, there are still The hypocrisy of the industry on this issue was well 1.2 million smokers in London and smoking-related exposed by the disclosures about its own role in organising disease causes 8,400 premature deaths in the city and tobacco smuggling. I noted that the noble Lord, Lord more than 51,000 hospital admissions. We have heard Naseby, was reading from the brief of the Tobacco in recent weeks how the whole NHS is creaking under Manufacturers’ Association, which can hardly be the strain—in London as much as anywhere, though it considered to be objective in this matter. The association is widespread. Boroughs with a high prevalence of claims that there has been an increase in tobacco sales smoking are also among the poorest, and smoking in Australia since the introduction of standardised remains a cause of health inequalities. packaging, but it ignores the increase in population in Australia in that time. Adjusted for population, tobacco The NHS needs a radical upgrade in prevention sales per person in Australia have in fact fallen since and public health, as was stated in the NHS Five Year the introduction of standard packs. Forward View. The cause of preventable deaths through tobacco is the same as the next six causes put together, The strong cross-party support for the tobacco including alcohol, obesity and illegal drugs. I hope control measures contained in the Children and Families that the Government will undertake to renew their Act amply demonstrates the strength of feeling of very successful coalition Government’s Tobacco Control parliamentarians on this issue. I know that my Plan when it expires. party wants to see that time is allocated for the required We do, indeed, have the necessary measures to debate and a vote on the introduction of standardised tackle this in the Children and Families Act 2014. packaging before Parliament rises for the general There is evidence that two-thirds of smokers start election. before the age of 18. In 2011, it was estimated that There is a choice ahead of us between promoting more than 200,000 children aged 11 to 15 started public health or rewarding the tobacco lobbyists. It smoking. I warmly welcome the regulations to prohibit will be greatly to the discredit of this Government if smoking in cars that were laid before Parliament in they do not ensure that the necessary regulations for December last year and are due to come into effect plain paper packaging are laid before Parliament, in this October. I urge the Government to set a date for time for the regulations to be voted on as soon as the the regulations to be voted on at the earliest opportunity. notification to Europe process comes to an end on I shall take a moment to address e-cigarettes because 2 March. It would be a public health disaster if the I am concerned that they contain nicotine, which is a views of the tobacco industry and a small minority of highly addictive element in cigarettes. That risk certainly GC 297 London Health Commission: Smoking[LORDS] London Health Commission: Smoking GC 298

[BARONESS FINLAY OF LLANDAFF] I also pay tribute to the Government for all their needs to be assessed and tackled. There is evidence work on tobacco control and, indeed, to the Minister that e-cigarettes are helping people who are smokers personally for everything that he has done. I remember to quit smoking, but I was worried by the Trading very clearly the strength of feeling in this House when Standards Institute’s finding that 40% of retailers are we debated the Children and Families Act 2014 around willing to sell these products to young people under the standardised packaging of tobacco and about 18, despite the fact that the vast majority—about banning smoking in cars carrying children. The way 80%—of the products carry warnings that they should the Government responded to that strength of feeling, not be sold to people under 18. The consultation on looked at the evidence and then came back and accepted the regulations to bring forward the primary legislation those things was an example of Parliament at its very in the Children and Families Act enabling regulations best. The fact that the work was done very much on a to prohibit the sale of e-cigarettes to under-18s was cross-party basis really showed what can be done in launched before Christmas. I hope that that will proceed this House when people come together and work without delay. together very sensibly. Perhaps I may turn to the issue of standardised I had the great privilege during that period of packs. More than half a million children have taken briefly meeting with the Minister in Australia, who up smoking since the Government first announced in was personally involved in steering this measure through 2011 that they would consult on this measure. A vote in her country. It was wonderful to hear from her how on the necessary regulations has to happen before the they had got that through and the impact that it was general election. If the Government table them starting to have. I want to add my voice to others in immediately this can happen. I am concerned that we this afternoon’s debate to say how important it is that have been told that we cannot have them laid before the standardised packaging regulations are laid in the end of the period of notification to Europe on sufficient time for them to be considered, and for a 2 March this year. That is, in fact, a red herring. I do vote to take place before the election. I also hope that not understand why they cannot be laid now, so that the Minister will be able to give us some comfort on as soon as 2 March is past a vote can be held. In the that because so much has been achieved in this Parliament extremely unlikely event of an amendment being required, that it would be a real travesty if we fell at the final a short timeframe could be used to review whatever hurdle. recommendation comes out from the relevant committees. I was interested to hear on the “Today” programme this morning that Labour now plans to incorporate this in its manifesto, if I have understood correctly. 5.37 pm Perhaps other noble Lords will clarify that. Lord Hunt of Kings Heath (Lab): My Lords, I start The security markings on the proposed packs would by reminding the Committee of my presidency of the be no easier to counterfeit than the current security Royal Society of Public Health. Of course I very much markings. The evidence from Australia has been welcome my noble friend’s debate and, indeed, the overwhelmingly positive. Over the last few weeks, more excellent report. I like the aspirations and ambitions than 4,000 doctors and allied medical professionals contained in it. Coming from Birmingham, I rather have called on the Government to stop dragging their wish that we could have a similar report, and I will try feet on regulations. Section 94 of the Children and to persuade my noble friend to come and write one. It Families Act allows the Secretary of State to introduce strikes me that the traditional joint strategic needs regulations for these packs and was overwhelmingly assessments produced by directors of public health passed in both the House of Lords—nem con—and are often dry documents that do not really capture, in the House of Commons, where only 24 MPs voted their very succinct message, the challenges and what against the move. A poll on support for standard needs to be done about them. I would love to see other packs conducted for ASH found that 64% of adults in parts of the country follow this model. Britain were in favour; but what I found interesting is In Birmingham, 22% of young people are obese, that in Australia the number of smokers supporting and we know that that is going to store up huge the measure has risen from 28.2% before its introduction problems for the future. Yet, looking at my noble to 49% after implementation. Therefore, I hope that, friend’s paper, the figures are even worse for London. in answering today’s debate, the Minister will have He mentions that: some good news for us about the progress on standardised packs. “London has the highest rate of childhood obesity of any peer global city, and the highest proportion of obese children in all the regions of England. In London almost 1 in 4 children in Reception 5.34 pm and more than1 in 3 children in Year 6 are overweight or obese”. Baroness Tyler of Enfield (LD): My Lords, I rise to If you think about the scale of that problem, it is speak briefly in the gap. The UK is a world leader in imperative that we start to do something about it. On tobacco control, of which I feel very proud. I have smoking, my noble friend points out that: worked and lived in London for virtually all my life, and I would love to see London set a real lead and a “London boroughs with high smoking prevalence are also real example by becoming a smoke-free city in the way some of the poorest boroughs. Although there is a downward trend across most of London, there is a difference of 10% described by the noble Lord, Lord Darzi. I congratulate between the best and worst performing boroughs, and stark the noble Lord on securing this debate, on all his work health inequalities are caused by smoking rates being and on the recommendations of the London Health much higher amongst people who work in manual or routine Commission, which were very far-reaching. occupations”. GC 299 London Health Commission: Smoking[15 JANUARY 2015] London Health Commission: Smoking GC 300

That is matched by the inequality experienced by and rather too much under their influence. He could, children born today in different parts of London, who at a stroke, put that right by telling noble Lords that can have very wide differences indeed in their life these regulations are going to be laid within the next expectancy. few days. I hope that he will do so. The aspirations and ambitions seem to me to be excellent. I like many of the proposals. The idea of 5.43 pm boosting the number of active Londoners to 80% is quite a goal. Gaining 1.5 million working days a year The Parliamentary Under-Secretary of State, Department by improving employees’ health and well-being offers of Health (Earl Howe) (Con): My Lords, I thank the a very apt illustration of the link between health, noble Lord, Lord Darzi, for securing this important well-being and the general economy. It is something debate. As we have heard, the Mayor of London set up that we need to really work on. I like the ambition to the London Health Commission in September 2013, have the lowest death rates in the world for the top with the noble Lord, Lord Darzi, as chairman, to three killers. I agree that GP practices in London review the health of the capital, from the provision of should be open from 8 am to 8 pm and that services services to what Londoners themselves can do to help should be delivered in modern, purpose-built and make London the healthiest major global city. In designed facilities. My noble friend told us how to do October, the London Health Commission published that quite a few years ago and it is to my eternal regret its report, Better Health for London, with a range of that we did not make enough progress on it. Anyone recommendations for the Mayor of London to consider. looking at the problems we are now facing in primary I congratulate the noble Lord, Lord Darzi, and the care and wanting to see the solution need not look members of the London Health Commission on their much further than my noble friend’s report. well considered and thought-provoking report. It is coincidental, though I would like to think that Local government has responsibility for improving we planned it together, that the Labour party today health and well-being in their communities, including announced the public health programme that we wish in reducing rates of tobacco use. Noble Lords will to take forward post-election. It is very much dual-pronged understand that it is not for me as Health Minister to in the sense that we see a really positive role in, rather respond to the London Health Commission’s report. than finger-wagging at adults, actually helping them That is for the Mayor of London, for whom the to be empowered with information to make healthier London Health Commission prepared its report. I choices and supported to get active, along with all the will, however, be very interested to see how the mayor other things needed to improve their health. However, progresses the recommendations that have been made. in the case of children, we wish to see statutory action and we particularly emphasise maximum limits to be Nevertheless, given the Government’s commitment set on levels of fat, salt and sugar in food marketed to tobacco control, I particularly welcome this opportunity substantially to children. That would have a very big to tell your Lordships more about the work we are impact on obesity issues, alongside many more doing to tackle tobacco use. Tobacco remains one of programmes around lifestyle in schools, particularly our most significant public health challenges. Smoking in physical activity. is a leading cause of cancer, cardiovascular and respiratory disease; smoking is the primary preventable cause of On smoking, we wish to reduce smoking prevalence morbidity and premature death; smoking is a significant to 10% by 2025. We will have a goal that children born driver of health inequalities and remains the biggest in 2015 will become the first smoke-free generation in cause of inequalities in death rates between the richest hundreds of years. I was very proud to move the and poorest in our communities; and smoking places amendment to ban smoking in cars with children and an enormous strain on the NHS, while the overall I received support from almost every noble Lord economic burden of tobacco use to society is estimated present in the debate today. It was very good to see. I at more than £13 billion a year. We must also remember was struck by the overwhelming public support for that tobacco use is harmful not only to individual that measure: it shows that the public will support smokers, but to others around them. these kinds of measures. We are also keen to introduce a levy on tobacco companies to be used to ensure that Reducing smoking rates is a public health priority they make a greater contribution to the cost of tackling for this Government. In early 2011, we published the tobacco-related harm. Tobacco Control Plan for England, which set out a comprehensive package of evidence-based action to There is nothing further I could say about standardised be implemented at national level to support local areas packaging that has not been said already. I simply in driving down rates of tobacco use. We also set out remind noble Lords that this was done on the basis of in the plan the importance of our efforts to reshape the report undertaken by Sir Cyril Chantler, who social norms around tobacco use to promote health concluded that the body of evidence shows that and well-being. The noble Lord, Lord Faulkner, and standardised packaging is very likely to lead to a the noble Baroness, Lady Finlay, asked what our plans modest but important reduction over time. I stand were for refreshing the tobacco control plan. As they behind Sir Cyril Chantler’s report. said, the plan sets out action until the end of this year. I hope that the noble Earl is going to give us good Like both noble Lords, I, too, hope that whoever are news today. He will understand that there is a mite of in government after the election continue to take scepticism about the Government’s approach to these comprehensive and effective action on smoking. However, matters. There is a suspicion that the Government are it will be, essentially, for the next Government to take rather too close to some of the tobacco companies that decision. GC 301 London Health Commission: Smoking[LORDS] London Health Commission: Smoking GC 302

[EARL HOWE] that closed in August and the results are informing From the outset, we ought to reflect the enormous decision-making. It is important that the Government amount of progress that we have made over the past have time to carefully consider all issues relevant to decade. Smoking rates in England are at their lowest the policy. I assure noble Lords that a decision will be since records began. Today, around 18 per cent of made in due course. However, in saying that, I reassure adults are smokers, down from around half of adults your Lordships that we in the Department of Health smoking in the 1970s. Almost 2 million fewer people are, as I speak, very actively working towards a decision. in England are smokers compared to a decade ago, The draft regulations for standardised packaging were and London has some of the lowest smoking rates in notified to the European Commission under the technical the country. We know that the majority of smokers standards directive on 29 August. We have received take up smoking when they are teenagers. Most smokers detailed opinions from 11 member states, which extends were regularly smoking before turning 18 years of the “standstill” period to six months. This will expire age—before they were able to make informed, adult on 2 March 2015 and until then we are unable to make decisions about tobacco use. regulations, although I hear what the noble Baroness, The good news is that rates of regular smoking by Lady Finlay, says about laying regulations. children in England between the ages of 11 and 15 years As regards evidence from Australia— have declined by some 70 per cent since 2000. However, I want to be clear that continuing to reduce the uptake Lord Faulkner of Worcester: Before the noble Earl of smoking by children is essential. Research published moves on, will he confirm that Sir Cyril Chantler’s in 2013 shows that every day around 600 children aged report, which he commissioned, is helpful to him in between 11 and 15 years start smoking in the United coming to a view as to whether or not standardised Kingdom. packaging should be introduced? Does he accept the The Government have taken action to protect young report and its conclusions? people from tobacco and nicotine addiction and a range of new powers relating to smoking were introduced Earl Howe: Undoubtedly it is extremely helpful through the Children and Families Act 2014. We have although I am sure that the noble Lord would be the laid regulations to end smoking in private vehicles first to acknowledge that there are considerations that carrying children in England, which shortly will be Sir Cyril did not address, which we obviously have to considered your Lordships’ House and in the other do across government before taking a final decision. place. New legislation will stop adults buying tobacco on behalf of children. Lord Naseby: Can my noble friend assure those of The Department of Health is currently consulting us who take a detailed interest in this that the decision on proposed regulations to bring the same age-of-sale will be based on the independent evidence from Australia requirements into place for electronic cigarettes that after two years of implementation against the yardsticks exist for tobacco. I would just say, on electronic that that Government set? cigarettes—mentioned by the noble Baroness, Lady Finlay—that while there is emerging evidence that Earl Howe: I am grateful to my noble friend. I was e-cigarettes may be helpful to some people wishing to about to answer the question posed by the noble Lord, quit smoking, the quality of products on the market Lord Faulkner, on exactly that point. Evidence and remains highly variable. We continue to work towards experience continue to emerge from Australia, as my a regulatory framework that ensures for those smokers noble friend rightly said. I can reassure noble Lords who want to use e-cigarettes to cut down or quit that that my department is looking very carefully at the they meet quality standards and are accompanied by evidence as it emerges. We will introduce standardised sufficient information to enable informed choices. tobacco packaging if, having considered the evidence However, e-cigarettes are not risk free. We do not both here and around the world and other relevant know enough about the long-term health effects of information, we are satisfied—I emphasise “satisfied”— adults, let alone children, using e-cigarettes. Furthermore, that there are sufficient grounds to do so. as there have been no long-term studies to examine The UK leads the world in supporting smokers to whether e-cigarettes serve as a gateway to tobacco use, quit, and local authorities are now responsible for we cannot be certain at this stage about whether there providing “stop smoking” services in their communities. is a gateway effect from the use of e-cigarettes into The Government have continued to invest in tobacco tobacco smoking, so further research is needed to marketing campaigns to encourage smokers to quit. answer that question definitively. YourLordships may have seen Public Health England’s The display of tobacco products in shops can promote latest campaign that is currently running. Our “Stoptober” smoking by young people and undermine the resolve campaign has become hugely successful, encouraging of adult smokers trying to quit. Legislation to end smokers to quit for a whole month, giving them a tobacco displays has already been implemented for significantly better chance of remaining smoke-free large shops such as supermarkets. All other shops for good. Today, we offer smokers information and selling tobacco, including corner shops, will need to support through a range of media, including through end their displays of tobacco on 6 April. the internet and mobile telephone applications. The issue of standardised packaging for tobacco A new European tobacco products directive has has been raised by almost every Peer who has spoken. been agreed and will come into force in 2016. The new I want to be clear that the Government have not made measures cover labelling, ingredients, tracking and a final decision on whether to introduce legislation for tracing, e-cigarettes, cross-border distance sales and standardised packaging. We held a final, short consultation herbal products for smoking. GC 303 London Health Commission: Smoking[15 JANUARY 2015] London Health Commission: Smoking GC 304

Making tobacco less affordable is proven to be an That is a recommendation in the London Health effective way of reducing smoking prevalence. The Commission’s report. However, I do not believe that Government continue to follow a policy of using tax changes to smoke-free legislation would be needed to to maintain the high price of tobacco at levels that achieve this. I commend local authorities across England have an impact on smoking prevalence. In the Autumn for the commitment they have shown to reducing Statement, my right honourable friend the Chancellor tobacco use; for example, more than 80 councils have of the Exchequer announced that the Government signed the Smokefree Action Coalition’s Local Government will consult on whether to introduce a levy on tobacco Declaration on Tobacco Control. manufacturers and importers. That consultation is My time is up. I will finish by saying that the now under way. Department of Health has worked actively to support The Government have taken sustained action to the implementation of the World Health Organization’s reduce levels of illicit tobacco, and over the past Framework Convention on Tobacco Control, including decade, the illicit market has declined significantly. In protecting tobacco control from vested interests, and the past two years, nearly 3.6 billion illicit cigarettes is today regarded as a global leader in the implementation and 1,050 tonnes of rolling tobacco have been seized. of effective tobacco control policies. The UK deserves Local authorities continue to take their own action that reputation and I am proud to be able to share against illicit tobacco, which is to be welcomed. with your Lordships the news that the Department of Smoke-free legislation, implemented in 2007, has Health has just been named as the winner of the had beneficial impacts on health. I would say to my American Cancer Society’s prestigious Luther L Terry noble friend Lord Naseby, who mentioned this, that Award for exemplary leadership by a government the legislation has been highly successful in terms of ministry in the field of tobacco control. public health and it continues to be popular and well complied-with, on the whole. The Government have Noble Lords: Hear, hear! no intention of amending this important legislation along the lines suggested by my noble friend. As I said, levels of compliance and public support for the law Earl Howe: With that, my Lords, I end by thanking are high. While smoke-free legislation covers enclosed the noble Lord, Lord Darzi, once again for this debate. work and public places, local authorities may wish to take action to limit smoking in open-area environments. Committee adjourned at 5.57 pm.

WS 83 Written Statements[15 JANUARY 2015] Written Statements WS 84

Since the code was last published in 2008, there Written Statements have been substantial changes and updates in legislation, policy, case law, and professional practice. The revised Thursday 15 January 2015 code now reflects and embeds developments since 2008 in areas including the use of restrictive interventions; Advisory Committee on Clinical Excellence use of police powers to detain people in places of safety; and the use of community treatment orders. Awards When we published Transforming care: A national Statement response to Winterbourne View Hospital and Closing the Gap: Priorities for Essential Change in Mental The Parliamentary Under-Secretary of State, Department Health we committed to improving mental health of Health(EarlHowe)(Con):MyhonfriendtheParliamentary services. Closing the Gap set out 25 priority actions to Under Secretary of State, Department of Health (Dr Daniel improve the provision of mental health care, promote Poulter) has made the following written ministerial recovery and the experience of patients, their families statement. and carers. Transforming Care also committed the I am today announcing the start of the Triennial Department to review and consult on a revised code to Review of The Advisory Committee on Clinical Excellence address the need to improve the quality of care received Awards (ACCEA). by patients detained under the Act. All Government Departments are required to review We remain committed to ensuring that high quality their Non-Departmental Public Bodies (NDPBs) at care is always provided for all patients treated under least once every three years. Due to the wide ranging the Act. Care should always be a means to promote reforms made by the Health and Social Care Act 2012, recovery, be of the shortest duration, be as least restrictive the Department was exempt from the first round of as possible and keep the patient and other people safe. reviews in 2011-14. In order to ensure that the Department The revised code is attached and is available in the is an effective system steward and can be assured of all library. It can also be found on the Gov.Uk website at the bodies it is responsible for, we have extended the https://www.gov.uk/government/publications/code-of- programme of reviews over the next three years to all practice-mental-health-act-1983. its Arm’s Length Bodies and Executive Agencies. This Statement included the following attachment: The review of the ACCEA has been selected to 1. Code of Practice: Mental Health Act 1983 (Mental_ commence during the first year of the programme Health_Act_Code_of_Practice.pdf) (2014-15). The review will consider the Committee’s functions and corporate form, as well as performance and capability, governance and opportunities for greater Corporate Transparency efficiencies. The Department will be working with a Statement wide range of stakeholders throughout the review. The Parliamentary Under-Secretary of State, Department for Business, Innovation and Skills (Baroness Neville-Rolfe) Code of Practice: Mental Health Act 1983 (Con): My hon Friend the Parliamentary Under Secretary Statement of State for Employment Relations and Consumer Affairs (Jo Swinson) has today made the following The Parliamentary Under-Secretary of State, Department statement. of Health (Earl Howe) (Con): My Rt Hon friend the I have today published our current plans for the Minister of State, Department of Health (Norman implementation of Parts 7 (‘Companies: Transparency’) Lamb) has made the following written ministerial statement. and 8 (‘Company filing requirements’) of the Small Following a public consultation, the Government Business, Enterprise and Employment Bill. has today laid a revised Code of Practice: Mental These timings are obviously subject to the will of Health Act 1983 before Parliament. We intend that the Parliament. However, we want to make sure those revised code becomes effective from 1 April 2015. affected by reform have as much notice as possible. In The code, which applies in England, is important summary, we intend to implement proposals in three because it underpins the Mental Health Act 1983 main stages - two months after Royal Assent, October which affects the lives and liberty of many people with 2015 and April 2016. Companies will be required to a mental disorder, impacting upon them and their keep a register of people with significant control from families, friends and carers. In 2013-14, there were January 2016. They will need to file this information at more than 53,000 detentions in hospital in England Companies House from April 2016. under the Act. The revised code does not include any These are significant changes and we are thinking changes to primary legislation. carefully about the secondary legislation, systems changes, The code routinely informs the practice of health guidance and communication requirements we will and social care professionals; it helps to safeguard need to give effect to them. patients’ rights and ensures compliance with the law. In October 2014 I published a discussion paper on The code can help make sure that anyone experiencing core elements of the PSC register policy, seeking views mental disorder and being treated under the Act gets on the statutory and non-statutory guidance needed the right care, treatment and support, knows what to support understanding of the new requirements; their rights are, what they can expect in certain situations the way that a person’s control over a company is and what to do if things are not done correctly. recorded on the PSC register; and the process by WS 85 Written Statements[LORDS] Written Statements WS 86 which people at serious risk of harm can apply to have Foreign Affairs Council their information protected from public disclosure on Statement the PSC register. The paper closed on 9 December and I am grateful to all those who responded. I look forward to continued The Minister of State, Foreign and Commonwealth dialogue and engagement as we develop the draft Office (Baroness Anelay of St Johns) (Con): My Right regulations. Honourable Friend the Minister for Europe (Mr David The responses confirmed the need for clear guidance Lidington) has made the following written Ministerial to support implementation of the PSC register. I statement: therefore intend to create a working group with a My Right Honourable Friend the Secretary of State broad membership, including business representative for Foreign and Commonwealth Affairs will attend bodies and civil society groups, to oversee the development the Foreign Affairs Council on 19 January. The Foreign of the general guidance required by companies and Affairs Council will be chaired by the High Representative others. I have asked Peter Swabey of the Institute of of the European Union for Foreign Affairs and Security Chartered Secretaries and Administrators (ICSA) to Policy, Federica Mogherini. The meeting will be held chair this working group, given ICSA’s experience in in Brussels. developing company law guidance. I have today published Foreign Affairs Council the draft terms of reference for that group. Russia: I also intend to ask a select group of experts, This discussion will focus on the EU’s relationship composed of company law specialists, to form an with Russia, which has deteriorated rapidly following ‘expert working panel’ to draft the statutory guidance Russia’s illegal actions in Ukraine. The UK will argue required to set out what is meant by “significant that the EU must continue to lead the way in holding influence or control” in the context of the PSC register. Russia to account for its actions. There must be full On the question of recording control on the PSC implementation of the Minsk agreements before any register, there was strong support for further Government reduction of sanctions measures against Russia. Any regulation. I intend to adopt a business-friendly approach, new relationship with Russia must recognise that Russia requiring people to state which one or more of the can no longer be considered a strategic partner to the “specified conditions”for being a person with significant EU and that business must be conducted with full control they meet. This will ensure consistency in implementation of national and EU law. terms of the information on the register and provide Climate Change: clarity for companies and others. The High Representative will update Ministers on The process by which individuals may apply to have the UN climate negotiations. Ministers will discuss the their information suppressed from public disclosure in aims for coordinated EU climate diplomacy activity in exceptional circumstances is a key factor of the secondary 2015 ahead of negotiations to agree a global deal on legislation implementing the PSC register. The discussion climate change at the Conference of the Parties to the paper sought views on a number of elements of the UN Framework Convention on Climate Change in regime and we received a wide range of views. We will December. The UK will stress that climate change, continue to develop this complex and important area with the risks it presents to international prosperity over the coming months. and security, must remain a foreign policy priority for I am minded to limit those able to apply for protection the EU and that the EU needs to demonstrate leadership to individuals at serious risk of violence or intimidation in the pursuit of an ambitious global climate deal in as a result of a company’s activities. We are continuing 2015. to consider this point. However, we do not anticipate Libya: extending the regime to cover purely economic risks. Discussions on Libya will focus on the deteriorating I agree with the majority of respondents who felt security situation. The Secretary General of the Arab that applications should be able to be made by third League, Nabil Elaraby, may join Ministers for part of parties on behalf of people with significant control - this discussion. The UK remains deeply concerned by such as the person’s legal representative. We also agree increasing violence and political polarisation in Libya there is merit in allowing people to apply in advance of and its impact on the wider region. The UK’s priority becoming a PSC, so that they can ensure the protection will be to ensure the continued support of Member will apply from day one. States for the efforts of the Special Representative of the UN Secretary General for Libya, Bernardino Leon, to resolve the political crisis and pave the way for peaceful political dialogue. Disclosure and Barring Service Statement Insolvency Proceedings Statement The Parliamentary Under-Secretary of State, Home Office (Lord Bates) (Con): The 2013-14 Annual Report and Accounts for the Disclosure and Barring Service The Parliamentary Under-Secretary of State, Department is being laid before the House today and published on for Business, Innovation and Skills (Baroness Neville-Rolfe) www.gov.uk. Copies will be available in the Vote Office. (Con): My hon Friend the Parliamentary Under Secretary WS 87 Written Statements[15 JANUARY 2015] Written Statements WS 88 of State for Employment Relations and Consumer to collect debts are set appropriately. These policy Affairs (Jo Swinson) has today made the following changes will ensure that this is the case and this will statement. continue to be monitored and a review will be carried In August 2014 I announced a Call for Evidence in out after 2 years of operation. order to review the way in which Debt Relief Orders have performed since they were introduced in 2009, including looking at the eligibility limits for applying Parliamentary Assembly of the Council of for a Debt Relief Order. This Call for Evidence also Europe: UK Delegation asked for views on the creditor petition limit for Statement bankruptcy, which was set at £750 in 1986. We asked whether this figure should be increased and, if so, to what level. We also undertook a survey of debtors The Lord Privy Seal (Baroness Stowell of Beeston) who had applied for Debt Relief Orders. (Con): My Rt Hon. Friend the Prime Minister has The responses to both the Call for Evidence and the made the following statement to the House of Commons: survey of users showed that Debt Relief Orders are The Rt Hon. Member for Ross, Skye and Lochaber thought to be working well and have provided an (Charles Kennedy) has been appointed as a full member important additional route for debt relief for vulnerable of the United Kingdom Delegation to the Parliamentary people, with benefits for mental health and family Assembly of the Council of Europe in place of the relationships as well as allowing a fresh financial start. Hon. Member for Portsmouth South (Mike Hancock). Following the Call for Evidence, it was apparent The Hon. Member for Taunton Deane (Jeremy Browne) that it was widely believed that some of the limits on has been appointed as a substitute member. Debt Relief Orders needed to be increased. Bankruptcy is considerably more expensive than applying for a Debt Relief Order and I was made aware that there Property Boundary Disputes may be people who are unable to apply for bankruptcy Statement but have very low assets and income and creditors would therefore not be likely to receive any payment. The Government has therefore decided to increase The Minister of State, Ministry of Justice (Lord the Debt Relief Order eligibility criteria, the maximum Faulks) (Con): The Government is today publishing an debt level increasing from £15,000 to £20,000 and initial scoping study on property boundary disputes. asset limit from £300 to £1,000. This will allow more This fulfils a commitment given by the Ministry of people to access debt relief. No change will be made to Justice in response to a Written Parliamentary Question the maximum level of surplus income allowed. from Charlie Elphicke MP on 14 February 2013 With regards to the creditor petition limit for (Commons Hansard 14 February 2013, Column 874W). bankruptcy, there was also a strong body of views that The scoping study was undertaken because of concern this should be considerably increased. Bankruptcy is that such disputes are all too often disproportionately the strongest of insolvency tools and I believe that bitter, protracted and expensive. The study took the someone should only be put into bankruptcy by a form of interviews with a small number of key creditor for a significant level of debt, especially taking stakeholders and the distribution of a questionnaire into account that various other debt collection methods, to 30 organisations with an interest in land law issues such as county court judgements, are available. Having including boundary disputes. Input was also received taken account of all the responses, the Government during the period of the study from a number of has decided that the creditor petition level should be individuals involved in boundary disputes. raised from £750 to £5,000. The study reflects the views expressed in the responses I am today laying statutory instruments to give received on the nature, frequency and causes of boundary effect to these changes from 1 October 2015. disputes, the effectiveness of current resolution methods, We also received a number of helpful suggestions and the problems that currently arise and what could relating to the how the Debt Relief Order process be done to address them. It discusses a number of works. We will ensure that those at risk of violence are options for legal or procedural change, and concludes sufficiently protected when applying for a Debt Relief that the Ministry of Justice should carry out further Order. We will also undertake some monitoring to work to assess the feasibility of improvements in a ensure consistency on process between Competent number of areas, including in particular the use of Authorities who assist debtors in their applications. mediation and expert determination, the spreading of We will provide more options of how payments can be best practice and the provision of better information made when applying for a Debt Relief Order. We are with a view to reaching more definite conclusions in also contributing to work to ensure common guidance 2015, but that more radical reform is not currently across all financial organisations with regards to how justified. surplus income is calculated for different debt relief Copies of the scoping study are being placed in the purposes, ensuring fairness and transparency. Libraries of both Houses. It is important to me to ensure that those who This Statement included the following attachment: require debt relief have access to it, while taking 1. 1. Boundary Disputes - A Scoping Study (Boundary Disputes account of creditors’ interests, and that creditors’ powers - A Scoping Study.pdf)

WA 257 Written Answers[15 JANUARY 2015] Written Answers WA 258 Written Answers Cyprus Question Thursday 15 January 2015 Asked by Lord Maginnis of Drumglass To ask Her Majesty’s Government what assessment Al-Sweady Inquiry they have made of the 29 December 2014 statement Question by the Greek Cypriot Archbishop Chrysostomos II in respect of civil and human rights for Turkish Asked by Lord Blencathra Cypriots; what recognition they accord to the role of the Archbishop in Greek Cypriot decision-making; To ask Her Majesty’s Government, further to and what impact this statement will have on their the statement made by the Secretary of State for current policy towards the Cyprus. [HL3959] Defence, Michael Fallon MP, on 17 December 2014 (HC Deb, cols 1407–9), whether they will take action against Public Interest Lawyers for pursuing The Minister of State, Foreign and Commonwealth “completely baseless allegations”against the Ministry Office (Baroness Anelay of St Johns) (Con): The of Defence. [HL3955] Government is aware of the statement made on 26 December by Archbishop Chrysostomos II. While we have not made an assessment of that statement, we The Parliamentary Under-Secretary of State, Ministry recognise that the unresolved political situation in of Defence (Lord Astor of Hever) (Con): The Government Cyprus has also given rise to human rights challenges is considering all available options. for both communities and for religious minorities on the island. The recent UN “Report of the Office of the United Nations High Commissioner for Human Rights Armed Forces: Credit Unions on the question of human rights in Cyprus” notes that Question the persisting division of the island remains an obstacle Asked by Lord Kennedy of Southwark to the full enjoyment of human rights by all Cypriots. The report concludes that the human rights situation To ask Her Majesty’s Government what progress in Cyprus would be greatly improved by the achievement they are making in enabling credit unions to offer of a comprehensive settlement. The Government shares services to members of Her Majesty’s Forces and this assessment. their families. [HL4030] We recognise the importance of the Church of Cyprus in Greek Cypriot society. Civil society, including religious leaders, can play a vital role in supporting The Parliamentary Under-Secretary of State, Ministry efforts towards reunification by building bridges between of Defence (Lord Astor of Hever) (Con): I refer the communities. Archbishop Chrysostomos II has himself hon. Member to the answer given in the House of played a role in nurturing inter-faith dialogue, notably Commons by my hon. Friend the Minister of State for through his role in the 2014 Good Friday service in Defence Personnel, Welfare and Veterans (Anna Soubry) Famagusta. on 8 December 2014 to Question number 216988 to the hon. Member for Harrow West (Gareth Thomas). The Government continues strongly to support UN-led efforts to end the division of the island through a http://www.parliament.uk/business/publications/ lasting and just settlement. written-questions-answers-statements/written- question/Commons/2014-12-03/216988/ This Answer included the following attachment Hansard Extract 8 December 2014 (HOC 216988.doc) Developing Countries: Family Planning Question Bahrain Asked by Baroness Tonge Question To ask Her Majesty’s Government whether they Asked by Lord Patten will advocate proposals for a 10 per cent of Official Development Assistance to be allocated to Population To ask Her Majesty’s Government, further to Assistance at the forthcoming International Conference the Written Answer by Baroness Anelay of St Johns on Financing for Development to be held on 13–16 July on 16 December 2014 (HL3617), what are the names 2015, in Addis Ababa, Ethiopia. [HL3984] and sentences of those imprisoned in Bahrain. [HL4020] The Parliamentary Under-Secretary of State, Department for International Development (Baroness Northover) The Minister of State, Foreign and Commonwealth (LD): The UK Government is proud to have fulfilled Office (Baroness Anelay of St Johns) (Con): Due to our commitment to spend 0.7% of GNI on ODA, and consular confidentiality, any information about British intends to continue to do so. Within this, it is important nationals detained abroad cannot be released without to maintain the flexibility to target our programme to the express written permission of the individuals the areas where support is most needed, and where UK concerned. development assistance can have greatest impact. For WA 259 Written Answers[LORDS] Written Answers WA 260 this reason we do not support sub targets on Official change in our domestic law is thought necessary in the Development Assistance (ODA) to specific sectoral light of that judgment. No such change is expected to areas. arise from the relevant European Court judgment (Fag og Arbejde v Kommunernes Landsforening – aka the “Kaltoft” case. Driving: Licensing Question Asked by Lord Willoughby de Broke Asked by Lord Laird To ask Her Majesty’s Government what assessment they have made of the impact on small and medium- To ask Her Majesty’s Government whether under sized enterprises of the recent decision of the European the new arrangements for the design of the United Court of Justice in Fag og Arbejde (FOA) v Kingdom’s driving licence the Union flag will appear Kommunernes Landsforening (KL). [HL3911] on all driving licences. [HL3977] The Parliamentary Under-Secretary of State, Department The Minister of State, Department for Transport for Business, Innovation and Skills (Baroness Neville-Rolfe) (Baroness Kramer) (LD): All driving licences issued to (Con): A formal assessment of the impact of a court drivers in England, Scotland and Wales will display judgment on business is only carried out where a the Union flag from summer 2015. change in our domestic law is thought necessary in the light of that judgment. No such change is expected to Egypt arise from Fag og Arbejde v Kommunernes Landsforening Question (aka the “Kaltoft” case). Asked by The Lord Bishop of St Albans To ask Her Majesty’s Government what Entry Clearances: Nepal representations they have made to the government Question of Egypt on behalf of Mohammed Hegazy. Asked by Lord Ashcroft [HL3910] To ask Her Majesty’s Government, further to The Minister of State, Foreign and Commonwealth the Written Answers by Lord Bates on 8 December Office (Baroness Anelay of St Johns) (Con): We are 2014 (HL3326) and 18 December 2014 (HL3645), concerned about the case of Mr Mohammed Hegazy, how many applications from Nepal were received in who converted to Christianity in 1998. We raised 2014 in Delhi and how many of these were approved. Mr Hegazy’s case at official level with the Egyptian [HL3896] Embassy in London on 7 January. We deplore all discrimination against religious The Parliamentary Under-Secretary of State, Home minorities and constraints on their freedom to practise Office (Lord Bates) (Con): There were 7,022 Visa their faith. The Government of Egypt has clearly applications made in Nepal and processed in New stated its commitment to protecting the rights of minorities Delhi between Jan - Sep 2014. Of these, 5,251 were and of the need for religious tolerance, and the Egyptian approved. constitution contains protection for freedom of religious belief. It is important that these rights are respected. In September our Ambassador to Egypt called on Eritrea the Patriarch of Alexandria, and officials from our Question embassy in Cairo recently met members of the Coptic Christian community to discuss the challenges they Asked by Baroness Kinnock of Holyhead face. To ask Her Majesty’s Government what assessment The British Government will continue to raise concerns they have made of the outcomes of the visit to about such cases with the Egyptian authorities. Eritrea by Foreign and Commonwealth Office and Home Office representatives in December 2014. Employment: Obesity [HL3979] Questions Asked by Lord McColl of Dulwich The Parliamentary Under-Secretary of State, Home Office (Lord Bates) (Con): As part of an ongoing To ask Her Majesty’s Government what assessment dialogue on migration related issues between the UK they have made of the financial implications for and Eritrean governments, a joint delegation of senior employers of the ruling by the European Court of Home Office and Foreign Office officials visited Eritrea Justice that under certain circumstances obesity on 9-11 December. The delegation held a number of should be considered a disability. [HL3903] discussions with government ministers, officials and non-government actors on topics including the current The Parliamentary Under-Secretary of State, Department drivers of irregular migration, ways to mitigate it, and for Business, Innovation and Skills (Baroness Neville-Rolfe) voluntary and enforced returns. The meetings were (Con): A formal assessment of the impact of a court constructive and identified a number of potential areas judgment on business is only carried out where a for joint co-operation, including on returns. We are WA 261 Written Answers[15 JANUARY 2015] Written Answers WA 262 now considering how best to use the information The Minister of State, Foreign and Commonwealth gathered during the visit to develop our approach to Office (Baroness Anelay of St Johns): I refer the Noble managing migration from Eritrea. Lord to my answers of 20 November 2014, 4 December 2014 and 16 December 2014. The Government’s position has not changed: the European Union must reform to EU Immigration: Horn of Africa become more competitive, democratically accountable Question and fair for those inside and outside the Eurozone. I also refer the Noble Lord to the speech by the Prime Asked by Baroness Kinnock of Holyhead Minister, my right hon. Friend the Member for Witney (Mr Cameron), on the 28 November 2014; and the To ask Her Majesty’s Government what programme speech by the Deputy Prime Minister, my right hon. of research they are undertaking on the drivers of Friend the Member for Sheffield, Hallam (Mr Clegg), migration to support the European Union–Horn of on the 5 August 2014. Transcripts of the speeches are Africa Migration Route Initiative. [HL3978] attached for ease of reference. This Answer included the following attachments: The Parliamentary Under-Secretary of State, Home 1. PM speech 280Nov 2014 (PM speech 28 Nov 2014.docx) Office (Lord Bates) (Con): Following its launch at a 2. DPM speech 5 Aug 2014 (DPM speech 5 August 2014.docx) Ministerial Conference in Rome on 28 November, the Government is working with other EU Member States and African partners to develop the new Horn of Africa Migration Route Initiative (the Khartoum Process), Financial Services which is intended to tackle people smuggling and Question human trafficking in the Horn of Africa. Asked by Lord Kennedy of Southwark Our work under the Khartoum Process to date has drawn upon on a number of sources of information To ask Her Majesty’s Government what steps on migration routes in the Horn of Africa and the they are taking to protect consumers from continuous countries of the region, including information on the payment authority abuses. [HL3938] drivers of migration. This includes research specifically commissioned or undertaken by HM Government and information provided by its posts in the region. The Commercial Secretary to the Treasury (Lord We are also drawing on the broader expertise and Deighton) (Con): There are two sets of regulations that information held by other EU partners, and on protect consumers from abuses of continuous payment information provided by international organisations authorities (CPAs) – the Payment Services Regulations and partner countries in the Horn of Africa. 2009, and the Consumer Protection from Unfair Trading Regulations 2008. In June 2013, the Financial Conduct Authority European Central Bank issued a warning to banks, reminding them of their Question obligation to cancel CPAs immediately at the customer’s request. Banks are also required to refund consumers Asked by Lord Stoddart of Swindon if companies continue to take money without the account-holder’s permission. To ask Her Majesty’s Government whether they In addition, the FCA has introduced tough new support a policy of quantitative easing by the European rules limiting payday lenders’ use of CPAs to two Central Bank; and if so, what would be the implications unsuccessful attempts. These rules also prevent payday for the United Kingdom if such a policy were lenders from using CPAs to take partial payment – a implemented. [HL3928] lender can only take payment if the entire amount owed by the customer is available in their account. The Commercial Secretary to the Treasury (Lord Deighton) (Con): It is for the ECB Governing Council to decide the appropriate monetary policy stance for Financial Services: Regulation the euro area. Question Asked by Lord Stewartby European Union Question To ask Her Majesty’s Government what plans they have to reconsider the attitudes, capabilities Asked by Lord Stoddart of Swindon and experience required for senior posts in regulation in the light of the outcome of the Davis Review of To ask Her Majesty’s Government, further to the Financial Conduct Authority. [HL3937] the Written Answer by Baroness Anelay of St Johns on 16 December 2014 (HL3536), whether recent statements by the Prime Minister stating that during The Commercial Secretary to the Treasury (Lord negotiations on European Union reform nothing Deighton) (Con): The Davis Review contained no can be ruled out mean that the United Kingdom recommendations for the government. The response could withdraw from the European Union if the to the Davis review conclusions is a matter for the Government’s objectives can not be met. [HL3927] Financial Conduct Authority. WA 263 Written Answers[LORDS] Written Answers WA 264

This question has therefore been passed on to the systems for the majority of the recorded transactions, FCA and the FCA will reply directly to the Noble as this reduces the impact on both police and firearms Lord by letter. A copy of the letter will be placed in the dealers. However, we will continue to recommend that Library of the House. dealers keep computerised records as a matter of best practice. Firearms: Registration Questions Gatwick Airport: Immigration Controls Question Asked by The Earl of Shrewsbury Asked by Baroness Valentine To ask Her Majesty’s Government whether, following the requirement under European Union To ask Her Majesty’s Government what was Directive 2008/51/EC that all member states have a the maximum immigration control queue waiting computerised system to record all firearms by time at each of London Gatwick’s terminals on 31 December 2014, they have implemented such a Sunday 4 January; and why the immigration system; and if not, for what reason. [HL3975] control desks were not fully staffed at times of high demand. The Parliamentary Under-Secretary of State, Home [HL3980] Office (Lord Bates) (Con): In order to comply with European Union Directive 2008/51/EC, the Government The Parliamentary Under-Secretary of State, Home must have established a computerised filing system to Office (Lord Bates) (Con): There were no breaches of record and maintain details about the supply and the published service standard at Gatwick on Sunday ownership of legal firearms by the end of 2014. 4th January 2015; the maximum immigration queue We already have robust processes in place as firearms waiting times on that day were as follows: dealers are required to maintain their own register of North Terminal: 35 minutes for non-EEA passengers firearms under the Firearms Act 1968, details of which and 20 minutes for EEA passengers. are passed to the National Firearms Licensing South Terminal: 32 minutes for non-EEA passengers Management System in England and Wales and Shogun and 12 minutes for EEA passengers. in Scotland. Records and registers will now need to be The published service standard for queue times at kept for a minimum of twenty years and this will the border specifies that 95% of British, EEA and require an amendment to secondary legislation. Swiss passengers should wait no longer than 25 minutes Although our original approach was for dealers to at passport control and 95% of non-EEA passengers computerise their records, we recently announced that should wait no longer than 45 minutes. we would be continuing to use the existing centralised The operational managers continually monitor the systems for the majority of the recorded transactions, situation with regard to queuing times to ensure staff as this reduces the impact on both police and firearms are flexibly deployed in the right numbers at the right dealers. However, we will continue to recommend that times. The security of the border and the safety of the dealers keep computerised records as a matter of best public are our priorities. At Gatwick, eligible travellers practice. also have the option of using the e-Passport gates, of Asked by The Earl of Shrewsbury which there are 20 (15 in the South Terminal and 5 in the North Terminal), all of which were in operation To ask Her Majesty’s Government what is the on the day in question. status of Firearms Dealers Computerised Registers as originally required by the Home Office and agreed with the Gun Trade Association in July Gibraltar: Spain 2013; whether the requirement been rescinded; and Question if so, for what reason. [HL3976] Asked by Lord Patten Lord Bates: In order to comply with European To ask Her Majesty’s Government what is their Union Directive 2008/51/EC, the Government must assessment of the position taken by the government have established a computerised filing system to record of Spain that Gibraltar should be excluded from and maintain details about the supply and ownership the proposed European Union legislation Single of legal firearms by the end of 2014. European Sky Two+. [HL4019] We already have robust processes in place as firearms dealers are required to maintain their own register of The Minister of State, Department for Transport firearms under the Firearms Act 1968, details of which (Baroness Kramer) (LD): Gibraltar continues to be are passed to the National Firearms Licensing included in the scope of existing Single European Management System in England and Wales and Shogun Sky II (SESII) legislation, as it should be under the in Scotland. Records and registers will now need to be Treaties of the European Union. kept for a minimum of twenty years and this will At the Transport Council on 5 December, the require an amendment to secondary legislation. Government took a very firm position making it clear Although our original approach was for dealers to to the European Commission and Italian Presidency computerise their records, we recently announced that that Spain’s attempts to exclude Gibraltar airport we would be continuing to use the existing centralised from the proposed Single European Sky Two+ proposals WA 265 Written Answers[15 JANUARY 2015] Written Answers WA 266 were unacceptable to the UK and the Parliamentary The Parliamentary Under-Secretary of State, Home Under Secretary of State for Transport, Robert Goodwill Office (Lord Bates) (Con): Individuals may be detained walked out of Council to protest this approach. to effect their removal from the UK, to establish their The Government will continue to oppose Spain’s identity or basis of claim, or where there is reason to attempts to exclude Gibraltar airport from future believe that they will fail to comply with any conditions aviation legislation. attached to the grant of temporary admission or temporary release. In addition, asylum applicants whose claims are considered to be straightforward and capable Government Departments: Staff of speedy resolution may be detained under the asylum Question fast track process. Asked by Lord Marlesford Immigration detention is not subject to a fixed time limit but it must comply with the principles established To ask Her Majesty’s Government whether non- in leading case law. These broadly provide that: the British passport holders are eligible for employment power to detain can only be exercised for a permitted by the Home Office on duties connected with purpose; detention is limited to a period that is reasonably immigration control and the security of United necessary for the purpose for which it was authorised; Kingdom borders. [HL4040] what is a reasonable period will depend on all the circumstances of the case; and, if it becomes apparent The Parliamentary Under-Secretary of State, Home that the purpose of detention cannot be achieved Office (Lord Bates) (Con): The Home Office Policy on within that reasonable period, detention should be non UK national appointments is governed by the brought to an end. Nationality Rules. These are a matter of public record Asked by Lord Roberts of Llandudno at: https://www.gov.uk/government/uploads/system/ To ask Her Majesty’s Government whether they uploads/attachment_data/file/307925/nationality- intend to place time limits on detention for immigration rules_amendedjh101213.pdf purposes. [HL3992] All posts involving border control or decisions about immigration are deemed reserved posts for UK nationals. Lord Bates: The Government has no intention of introducing a fixed time limit on immigration detention Honours in the UK. Question Asked by Lord Jopling Immigration To ask Her Majesty’s Government, further to the Written Answers by Lord Wallace of Saltaire Question on 18 January 2012 (HL14630), 30 January 2012 Asked by Lord Avebury (HL14978), 10 July 2014 (HL828) and 28 July 2014 (HL1115), what were the relevant figures for the To ask Her Majesty’s Government why they have awards of Knighthoods and Damehoods in the yet to respond to the application submitted on 2015 New Year honours lists. [HL4090] 25 October 2013 by the person whose Home Office reference is A1342128 for indefinite leave to remain under the settlement protection route. [HL4007] Lord Wallace of Saltaire (LD): The information requested concerning the number of honours recipients described as holding the title of Professor in the New The Parliamentary Under-Secretary of State, Home Year2015 honours list at Knighthood/Damehood levels Office (Lord Bates) (Con): The Home Office does not is in the public domain at www.london-gazette.co.uk. routinely comment on individual cases and has obligations Percentages are as follows: in law to protect this information. Applications for indefinite leave to remain need to meet the requirements Number of Percentage of Knight/Dame Knight/Dame set out in the Immigration Rules. recipients who recipients who Number of described described recipients at themselves as themselves as Knight/Dame Professor Professor Japanese Knotweed Questions NY 38 12 32% 2015 Asked by Lord Greaves To ask Her Majesty’s Government what advice Immigrants: Detainees they are giving to each local authority in relation to Questions (1) the desirability of carrying out a survey of the incidence of Japanese Knotweed (Fallopia japonica) Asked by Lord Roberts of Llandudno in their area, (2) the desirability of establishing a To ask Her Majesty’s Government on what ground programme for its suppression and removal, and an individual can be detained for immigration purpose (3) the best means of doing this both on land they for periods in excess of 30 days. [HL3991] own, and on other land in their area. [HL4036] WA 267 Written Answers[LORDS] Written Answers WA 268

The Parliamentary Under-Secretary of State, Department responded positively to further Frontex requests for for Environment, Food and Rural Affairs (Lord De contributions to this operation for the coming year. Mauley) (Con): Advice relating to the identification We have also agreed with our European partners to and treatment of Japanese knotweed is openly available enhance co-operation within the EU given the continuing to local authorities through a variety of mechanisms. pressures in the Mediterranean, and to work with Defra and its delivery partners, including the Environment countries of origin and transit seeking sustainable Agency and Natural England, provide guidance on solutions by tackling the causes of illegal immigration their websites, as does the Non-Native Species Secretariat. along with the organised gangs that facilitate it, and The advice includes identification sheets and best practice enhancing support in North and East Africa for those guidance for management and removal. However, it is who need it. for the local authority itself to decide what priority and resource it places on tackling Japanese knotweed. Middle East Asked by Lord Greaves Questions To ask Her Majesty’s Government what progress Asked by Baroness Tonge is being made with the pilot schemes for control of To ask Her Majesty’s Government what Japanese Knotweed (Fallopia japonica) using the representations they have made to the government psyllid Aphalara itadora; and what assessment they of Israel concerning the boy killed and 24 children have made of schemes and proposals for the control injured in the West Bank last week as reported by of Japanese Knotweed (Fallopia japonica) in other the United Nations Office for the Co-ordination of parts of Europe, and North America. [HL4037] Humanitarian Affairs. [HL3930]

Lord De Mauley: Following rigorous laboratory The Minister of State, Foreign and Commonwealth testing which identified the psyllid Aphalara itadori as Office (Baroness Anelay of St Johns) (Con): While we a suitable biocontrol agent for Japanese knotweed, it have not raised these particular cases with the Government was released under licence to two sites in spring 2010, of Israel, we have raised the issue of excessive use of subject to a programme of close monitoring. After force, in particular the use of live fire, regularly with reviewing the data collected, the Food and Environment the Israeli authorities. We have urged restraint in the Research Agency, as the licensing authority, approved use of force to deal with security incidences and crowd releases in spring 2011 to seven sites in England and control. one site in Wales. The UN Office for the Coordination of Humanitarian The psyllid has successfully overwintered since then, Affairs report that the Israeli authorities have opened but numbers have remained low so additional releases a military investigation into this incident. were made at the sites in spring of 2012, 2013 and Asked by Lord Hylton 2014 to boost numbers with the aim of achieving establishment. This rate of progress is not unexpected. To ask Her Majesty’s Government what The sites continue to be closely monitored. representations they are making to the government This was the first intentional release of a non-native of Israel concerning (1) the removal of two military organism to control an invasive plant in Europe. Other bases in the West Bank in order to allow for the classical biocontrol programmes from around the world expansion of existing settlements, (2) the Israeli air have taken five to ten years from release to achieve attack on a cement factory near Khan Yunis in the successful biological control. Gaza Strip on 20 or 21 December, (3) the elimination of delays and full normal opening of the Tulkarm Crossing-point for Palestinians with permission to work in Israel, (4) approval for the construction of Mediterranean Sea 243 houses on West Bank land illegally annexed to Question Jerusalem, and (5) Israeli naval vessels firing live Asked by Lord Roberts of Llandudno ammunition at Palestinian fishermen off Gaza, damaging several boats. [HL3934] To ask Her Majesty’s Government whether they have changed their position on supporting search Baroness Anelay of St Johns: While we have not and rescue operations in the Mediterranean. raised these specific issues, we have repeatedly condemned [HL3990] Israel’s announcements to expand settlements in the Occupied Palestinian Territories, including East Jerusalem. Officials from our Embassy in Tel Aviv The Parliamentary Under-Secretary of State, Home regularly bring up the issue of settlements with the Office (Lord Bates) (Con): HM Government has not Israeli National Security Adviser, Ministry of Foreign changed its policy. Search and rescue operations remain Affairs and Ministry of Defence contacts. We are the responsibility of national Governments, although aware of an attack by the Israeli Defence Forces any vessels in the area of a boat in distress, including against “Hamas terror infrastructure” in the Khan UK ships, should assist in their rescue according to Yunis area of southern Gaza after a rocket was fired the usual laws of the sea. into Israel from Gaza on 19 December. Our Ambassador The UK continues to provide support for Frontex’s discussed this matter with the Israeli Ministry of Defence. Operation Triton, which commenced at the EU’s Officials from our Embassy in Tel Aviv regularly meet Mediterranean sea border in November. We have recently with the Israeli authorities – including the Israeli WA 269 Written Answers[15 JANUARY 2015] Written Answers WA 270

Office for the Coordination of Government Activities The Minister of State, Foreign and Commonwealth in the Territories/Ministry of Defence and the National Office (Baroness Anelay of St Johns) (Con): The UK Security Adviser - to urge them to ease restrictions on delegation to the North Atlantic Treaty Organisation Gaza, including the movement of commercial goods, (NATO) summit in Wales in September comprised a and persons from and to the Gaza Strip. Our Embassy total of 40 people, of which 10 were women. The first in Tel Aviv is looking into the situation faced by ever meeting at a NATO summit on Women, Peace Gazan fishermen and will consider Government action and Security (WPS) was held. The meeting launched on this issue. NATO’s new Policy and Action Plan on WPS, and made permanent of the role of the Special Representative on Women, Peace and Security. National Security Council Asked by Baroness Hodgson of Abinger Questions To ask Her Majesty’s Government how many Asked by Baroness Kinnock of Holyhead people comprised the Afghanistan delegation attending the NATO Summit in Wales in September; and of To ask Her Majesty’s Government how many those how many were women. [HL3905] countries of concern have been identified by the National Security Council, and how many countries have been prioritised for activity under the Conflict, Baroness Anelay of St Johns: According to the Stability and Security Fund. [HL3882] North Atlantic Treaty Organisation (NATO), the Afghanistan delegation to the Summit in Wales in September comprised a total of 12 people, of which The Minister of State, Foreign and Commonwealth 2 were women. Office (Baroness Anelay of St Johns) (Con): The governance arrangements for the Conflict Stability Asked by Baroness Hodgson of Abinger and Security Fund (CSSF) are currently being To ask Her Majesty’s Government how many considered. The CSSF will support delivery of the delegates in total attended the NATO Summit in Building Stability Overseas Strategy, National Security Wales in September; and of those how many were Strategy and the Strategic Defence and Security women. [HL3906] Review using the full range of government capabilities and expertise in tackling conflict, instability and insecurity. Cross Whitehall Regional Boards for Africa, Americas, Baroness Anelay of St Johns: According to the Asia/Pacific, Middle East & North Africa, South Asia North Atlantic Treaty Organisation (NATO), a total and Wider Europe and have been established, and will of 2226 delegates attended the NATO Summit in be responsible for disbursing the funding allocated to Wales in September of which 394 were women. However the countries in their region. Updates on the development the number of women may have been higher as 295 of of the CSSF can be provided once Ministerial agreement the 2226 delegates did not confirm their gender at the of these governance arrangements has been secured. point of registration. Asked by Baroness Kinnock of Holyhead Asked by Baroness Hodgson of Abinger To ask Her Majesty’s Government how many To ask Her Majesty’s Government whether the delegates from fragile and conflict-affected states National Security Council will have a strategy for attended the NATO Summit in Wales in September; each of its priority countries, and, if so, what those and of those how many were women. [HL3907] strategies will include. [HL3883]

Baroness Anelay of St Johns: The North Atlantic Baroness Anelay of St Johns: The Conflict, Stability Treaty Organisation (NATO) is primarily focused on and Security Fund (CSSF) is one part of a broader issues of Transatlantic security. However, the UK was approach to UK prioritisation in fragile states, governed keen to encourage broader participation at the Summit. by the National Security Council (NSC). With the NSC at the core, the Government has been making Allied Heads of State and Government met with strategic decisions for the most effective use of limited 27 partner countries including International Security departmental resources. This process is still ongoing Assistance Force (ISAF) contributors (Armenia, Australia, and updates on the development of the CSSF can be Austria, Azerbaijan, Bahrain, Bosnia and Herzegovina, provided once Ministerial agreement of these El Salvador, Finland, Georgia, Ireland, Jordan, Malaysia, arrangements has been secured. Mongolia, Montenegro, New Zealand, Republic of Korea, Sweden, the former Yugoslav Republic of Macedonia, Tonga, Ukraine, United Arab Emirates), countries from the region (Kazakhstan, Kyrgyz Republic, NATO: Newport Tajikistan, Uzbekistan and Pakistan) as well as Japan. Questions High level representatives of the United Nations and Asked by Baroness Hodgson of Abinger the European Union also attended. NATO agreed that its partner countries which To ask Her Majesty’s Government how many cooperate with NATO on interoperability should also people comprised the United Kingdom delegation be invited. As well as countries included above, the at the NATO summit in Wales in September; and of Republic of Moldova, Morocco, Serbia, and Switzerland those how many were women. [HL3904] also attended the Summit. WA 271 Written Answers[LORDS] Written Answers WA 272

Natural Gas: Ukraine the Rafah crossing when he met the Egyptian Foreign Question Minister on 27 October and again on 18 November. We continue to raise this issue in our contacts with the Asked by Lord Trefgarne Egyptian government. To ask Her Majesty’s Government what percentage of the United Kingdom’s gas supply comes through Parades: Belfast Ukraine; and whether they are satisfied about the Question security of this supply. [HL4012] Asked by Lord Laird The Parliamentary Under-Secretary of State, Department To ask Her Majesty’s Government why they of Energy and Climate Change (Baroness Verma) (Con): decided not to establish a panel to examine issues Due to the interconnected nature of the European gas around parading in North Belfast. [HL3951] system, it is possible that some gas feeds through to the UK via Ukraine. Nevertheless, we estimate that The Parliamentary Under-Secretary of State, Wales these are small volumes, likely less than 1 per cent of Office (Baroness Randerson) (LD): One of the key total imports. principles in the Terms of Reference for a panel on Since the gas agreement between Russia and Ukraine parading in North Belfast was that in order for it to be signed on the 31 October we assess the risk to the UK successful, the process needed to be able to engage and Europe’s energy supply is low and we have no effectively across the community. It became apparent grounds at present to expect a disruption to gas transiting that there was insufficient support for the panel, including the Ukraine. Ukraine has proved through the gas from amongst some of those most directly involved in dispute to date to be a reliable transit state. The UK the dispute. It was therefore decided, on balance, not and other EU Member states have reiterated that to go ahead with establishing the panel. existing contracts for gas supply from Russia to the European Union need to be respected. Police: Car Allowances Question Northern Ireland Government Asked by Lord Marlesford Question To ask Her Majesty’s Government why the police Asked by Lord Laird are paid 65 pence per mile for the use of private cars on official business; and whether they are required To ask Her Majesty’s Government whether the to pay tax on the surplus they receive above the talks leading to the Stormont House Agreement 45 pence HM Revenue and Customs Mileage included any discussion of the undertakings given Allowance payment which is non-taxable. [HL4038] by the government of the Republic of Ireland as part of the Belfast Agreement of 1998 to improve human rights in their country; and, if not, why The Parliamentary Under-Secretary of State, Home not. [HL3950] Office (Lord Bates) (Con): Motor vehicle allowance rates are set out in determinations made under the Police Regulations 2003. The current rates were reviewed The Parliamentary Under-Secretary of State, Wales and agreed in 2012 by the Police Negotiating Board Office (Baroness Randerson) (LD): A wide range of following a recommendation by Sir Thomas Winsor in issues were discussed in the talks which led to the his Independent Review of Police Officer and Staff Stormont House Agreement. The issue mentioned Remuneration and Conditions (Part 1, 2011) that the does not feature in the Agreement. existing Motor Vehicle Allowance for police officers should be retained, as “it provides officers with fair Palestinians reimbursement of their motoring costs incurred in the Question performance of their duties”. Any surplus mileage allowance paid above the 45 pence Asked by Lord Hylton HM Revenue and Customs Mileage Allowance must be declared for tax purposes as a benefit in kind unless To ask Her Majesty’s Government what alternative arrangements have been agreed by a police representations they are making to the government force with HMRC. of Egypt about full reopening of the Rafah Crossing, in particular for urgent medical cases, students, and other priority categories. [HL3935] Prisoners: Suicide Question The Minister of State, Foreign and Commonwealth Asked by Lord Patel of Bradford Office (Baroness Anelay of St Johns) (Con): We are concerned about the closure of the Rafah Crossing To ask Her Majesty’s Government how many and the impact that has on urgent medical and other people committed suicide in prison in England in priority cases in Gaza. The Secretary of State for 2014; and of those (1) how many received mental Foreign and Commonwealth Affairs, my right hon. health assessments prior to their deaths, and (2) Friend the Member for Runnymede and Weybridge how many were diagnosed with a mental health (Mr Hammond), raised the importance of reopening illness. [HL3902] WA 273 Written Answers[15 JANUARY 2015] Written Answers WA 274

The Minister of State, Ministry of Justice (Lord The Parliamentary Under-Secretary of State, Home Faulks) (Con): The number of self-inflicted deaths in Office (Lord Bates) (Con): The government currently prison custody in 2014 is due to be released on the has no such plans, and I refer to my answer of 29th January 2015 at https://www.gov.uk/government/ 17 December 2014 to question HL3283 on this matter. collections/safety-in-custody-statistics The most recent Safety in Custody statistics bulletin Public Finance covers deaths in prison custody up to the end of Question September 2014. In the first 9 months of 2014 there Asked by Lord Greaves had been 58 self-inflicted deaths in prison custody in England. As it can be difficult to determine a person’s To ask Her Majesty’s Government how, for the intent to take their own life, the National Offender purposes of official statistics, they define (1) the Management Service (NOMS) classifies any death annual budget deficit, (2) the structural deficit, and where a person has apparently taken their own life, (3) the cyclical deficit. [HL4034] irrespective of intent, as a self-inflicted death. Information on mental health assessments and The Commercial Secretary to the Treasury (Lord diagnoses are not collected centrally. Deighton) (Con): The annual budget deficit is also referred to as Public Sector Net Borrowing (PSNB). Prisoners receive a detailed medical examination on The Office for National Statistics (ONS) defines PSNB reception and those identified as having mental health as the difference between public sector receipts and needs are referred for a further mental health assessment. expenditure as measured by National Accounts. It The reception healthcare screen also includes an also equals the net balance of the public sector’s net assessment of the risk of self harm or suicide. Prisoners acquisition of financial liabilities less its acquisition of identified as being at risk of self harm or suicide (on financial assets. In December 2009, the ONS defined reception, or at any point during their time in custody) an alternative measure of PSNB excluding the temporary are subject to Assessment, Care in Custody and Teamwork effects of the financial sector interventions (PSNBex). (ACCT), a flexible, prisoner-centred care planning process. The ACCT process includes a detailed Typically PSNB excluding banks (PSNBex) is the psychosocial assessment by a trained assessor within measure that is used to describe the public finances. 24 hours, and this is followed immediately by the first Further information on ONS definitions of the Public Finances can be found in the latest Public Sector multi-disciplinary case review, at which a decision is [1] reached about whether or not a further mental health Finance (PSF) release from December 2014 . assessment is necessary. The cyclically adjusted deficit and cyclical deficit We are applying strenuous efforts to learn from are not official statistics. These measures are estimates each death and are providing further resources and by the Office for Budget Responsibility (OBR) based support to prisons to help support their safer custody on assessments of the output gap. Information on work. Reducing the number of self-inflicted deaths in how these are derived can be found in the OBR’s Working Paper No. 3: Cyclically Adjusting the Public prisons is a top priority, and our dedicated resources [2] are providing support to many vulnerable prisoners Finances which can be found on the OBR’s website . every single day. [1] http://www.ons.gov.uk/ons/rel/psa/public-sector-finances/ november-2014/stb-nov-2014.html [2] http://budgetresponsibility.org.uk/wordpress/docs/Working- Privy Council paper-No3.pdf Question Asked by Lord Lexden Railway Stations Question To ask Her Majesty’s Government what was the Asked by Lord Kennedy of Southwark total size of the Privy Council on (1) 1 May 1997, (2) 1 May 2010, and (3) 1 January 2015. [HL4074] To ask Her Majesty’s Government what assessment they have made of the way Network Rail manages Lord Wallace of Saltaire (LD): The information is station rebuilding projects. [HL4028] set out in the table below. The Minister of State, Department for Transport Date Number of Privy Counsellors (Baroness Kramer) (LD): Network Rail is responsible for managing a large number of station rebuilding 1st May 1997 423 projects. The scope and scale of these works vary from 1st May 2010 554 relatively minor works to very large scale projects such 1st January 2015 639 as London King’s Cross or Birmingham New Street. The amount of assessment will similarly vary depending Prostitution upon the scale of the project concerned. For the larger Question schemes it is usual for the Department for Transport to appoint a scheme sponsor. These sponsors are in Asked by The Lord Bishop of St Albans regular contact with Network Rail to undertake assurance To ask Her Majesty’s Government, further to activity around delivery. the Written Answer by Lord Bates on 17 December In addition the Office of Rail Regulation undertakes 2014 (HL3283), what plans they have to introduce regular reviews of Network Rail’s delivery against its legislation to criminalise the purchase of sex. Business Plan commitments, and this will include station [HL3908] rebuilding projects. WA 275 Written Answers[LORDS] Written Answers WA 276

Right to Buy Scheme These data are available from the Department’s Question statistical tables at the following link: https://www.gov.uk/government/statistical-data- Asked by Lord Stoddart of Swindon sets/live-tables-on-dwelling-stock-including-vacants To ask Her Majesty’s Government whether they Private Registered Provider (housing association) will review their policy of right to buy in the light of stock can be found in live table 115, local authority-owned the continued shortages of social housing to rent. stock can be found in live table 116. These can be [HL4050] summed to provide an estimate of social and affordable housing stock. Total housing stock can be found in live table 100 from 2009. The Parliamentary Under-Secretary of State, Department for Communities and Local Government (Lord Ahmad Asked by Lord Greaves of Wimbledon) (Con): The Government is committed To ask Her Majesty’s Government for each local to enabling social tenants to achieve their aspiration housing authority in England, and for England as a for home ownership where this is the right option for whole, how many units of housing were sold under them. Right to Buy and Right to Acquire provisions in We are also committed to ensuring that affordable each year since 1980; and how many new units of rented housing is available to those who need it most. (1) council housing, and (2) other social housing, Over £600 million has been generated from additional were provided (by new build, conversion or purchase) Right to Buy sales since the policy was reinvigorated, in each of those years. [HL4033] and this is being recycled directly into providing new affordable homes for rent. Lord Ahmad of Wimbledon: Statistics on total Right Since April 2010, this Government has delivered to Buy sales in England for each year since 1980/81 217,000 affordable homes, and council housebuilding and Right to Acquire sales in England for each year is at its highest rate for 23 years. since 1998/99 are published in the Department’s tables 671 and 677 respectively. Annual Right to Buy sales for each local authority district for each year since 1998/99 Scottish Parliament are published in table 685. These tables are available at the following link: Question https://www.gov.uk/government/statistical-data- Asked by Lord Empey sets/live-tables-on-social-housing-sales Right to Acquire sales are not available by local To ask Her Majesty’s Government what plans authority district. they have to change the status of the Scottish Parliament. [HL4013] Annual statistics on delivery since 1991/92 of housing for social rent (table 1006) and since 2011/12 of housing for affordable rent (table 1006a) for each local authority The Advocate-General for Scotland (Lord Wallace district are published at the following link: of Tankerness) (LD): The Commission chaired by https://www.gov.uk/government/statistical-data- Lord Smith of Kelvin delivered a cross party agreement sets/live-tables-on-affordable-housing-supply on further devolution to Scotland on 27 November 2014. The Government has committed to producing These figures include newly built and acquired housing draft clauses by 25 January 2015. Individual parties delivered by both local authorities and Private Registered have made commitments to introduce legislation to Providers. Parliament following the General Election in May 2015. Statistics for Right to Buy starts on site by local authority district are only available from 2012-13 when one for one replacement on additional local authority Social Rented Housing sales - that is, sales above the level forecast before the Questions changes were made - was introduced. They are published in the Department’s table 693 at the following link: Asked by Lord Greaves https://www.gov.uk/government/statistical-data- sets/live-tables-on-social-housing-sales To ask Her Majesty’s Government what was (1) the total council-owned housing stock, and (2) the Councils have three years to start building the stock of other social housing, in each local housing homes after the sale, which gives them time to ensure authority in England for each year since 1980. new builds maximise value for money. [HL4032] Somerset Rivers Authority The Parliamentary Under-Secretary of State, Department Question for Communities and Local Government (Lord Ahmad Asked by The Lord Bishop of St Albans of Wimbledon) (Con): The Department does not hold figures at local authority district level to fully answer To ask Her Majesty’s Government what legal this question. The information published by the Department basis the newly created Somerset Rivers Authority can provide the numbers of local authority-owned will have; how it will interact with the county council stock from 1994 and numbers of social housing stock and other local authorities; and how it will be from 1997. funded in the long term. [HL3998] WA 277 Written Answers[15 JANUARY 2015] Written Answers WA 278

The Parliamentary Under-Secretary of State, Department publishes the majority of Finance Bill clauses in draft for Environment, Food and Rural Affairs (Lord De 3 months in advance of the bill’s introduction into Mauley) (Con): The Somerset Rivers Authority will be Parliament. For example, on 10 December this year, a new joint body in the form of a partnership between the government published 315 pages of draft legislation[3] existing local organisations. The County Council and for consultation with the aim of ensuring that legislation five district councils in Somerset will be member in Finance Bill 2015 is clear and works as intended. organisations and each have a representative on the [1] http://webarchive.nationalarchives.gov.uk/20130129110402/ Authority’s board. The other member organisations http:/www.hm-treasury.gov.uk/d/ will be the Environment Agency, the local Internal tax_policy_making_response.pdf.pdf Drainage Boards and Natural England. The Wessex [2] https://www.gov.uk/government/uploads/system/uploads/ Regional Flood and Coastal Committee will also be attachment_data/file/89261/tax-consultation-framework.pdf represented by a member on the Authority’s Board. A [3] https://www.gov.uk/government/uploads/system/uploads/ review will be carried out to identify a long-term, local attachment_data/file/385160/ funding solution from 2016/17. On 8 December the Draft_clauses_and_explanatory_notes_for_Finance_Bill_2015.pdf SoS announced that the SRA would receive funding of £2.7m for 2015/16; £1.9m from Defra and £800,000 from local partners. Transport: Capital Investment Question Tax Avoidance Asked by Lord Bradshaw Question To ask Her Majesty’s Government, further to Asked by Lord Stoddart of Swindon the Written Answer by Lord Deighton on 17 December (HL3391), what proportion of the appraisal of a To ask Her Majesty’s Government, further to typical road and a rail investment proposal is based the Written Answer by Lord Deighton on 9 December on (1) the aggregation of small time savings forecast 2014 (HL3168), what steps they are taking to ensure to be of benefit to users, and (2) other effects such that legislation is properly drafted such that as the wider economic impacts and the various Parliament’s intentions are clear with regard to regeneration effects. [HL3973] taxation. [HL3925] The Minister of State, Department for Transport The Commercial Secretary to the Treasury (Lord (Baroness Kramer) (LD): Transport investment decisions Deighton) (Con): In 2010 the government introduced are supported with a 5-part business case. Appraisal ‘The new approach to tax policy making’[1] with the information largely informs the economic case, which aim of improving the predictability and transparency aims to provide a comprehensive overview of a proposal’s of tax policy making. This commits to early and impacts. This includes a wide range of social and continuing engagement through all stages of tax policy environmental factors, as well as time savings and development. As set out in the Tax Consultation economic impacts. The proportion of benefits falling Framework[2], the government will commonly consult in these different categories varies on a proposal-by- on tax issues, why change is needed, what it is intended proposal basis and information on the proportion of to achieve and on the legislation itself to ensure it benefits from (1) small time savings, and (2) other achieves that intention. As part of this, the government effects such as wider impacts, is not centrally held.

Thursday 15 January 2015

ALPHABETICAL INDEX TO WRITTEN STATEMENTS

Col. No. Col. No. Advisory Committee on Clinical Excellence Awards...... 83 Foreign Affairs Council ...... 86

Code of Practice: Mental Health Act 1983 ...... 83 Insolvency Proceedings...... 86 Parliamentary Assembly of the Council of Europe: UK Corporate Transparency ...... 84 Delegation ...... 88 Disclosure and Barring Service...... 85 Property Boundary Disputes ...... 88

Thursday 15 January 2015

ALPHABETICAL INDEX TO WRITTEN ANSWERS

Col. No. Col. No. Al-Sweady Inquiry ...... 257 Immigration...... 266 Armed Forces: Credit Unions...... 257 Japanese Knotweed...... 266 Bahrain...... 257 Mediterranean Sea...... 267

Cyprus ...... 258 Middle East ...... 268

Developing Countries: Family Planning ...... 258 National Security Council...... 269

Driving: Licensing ...... 259 NATO: Newport...... 269

Egypt ...... 259 Natural Gas: Ukraine ...... 271 Northern Ireland Government...... 271 Employment: Obesity ...... 259 Palestinians...... 271 Entry Clearances: Nepal ...... 260 Parades: Belfast ...... 272 Eritrea...... 260 Police: Car Allowances...... 272 EU Immigration: Horn of Africa ...... 261 Prisoners: Suicide...... 272 European Central Bank ...... 261 Privy Council...... 273 European Union ...... 261 Prostitution...... 273 Financial Services ...... 262 Public Finance ...... 274 Financial Services: Regulation ...... 262 Railway Stations ...... 274 Firearms: Registration ...... 263 Right to Buy Scheme ...... 275 Gatwick Airport: Immigration Controls...... 264 Scottish Parliament...... 275 Gibraltar: Spain...... 264 Social Rented Housing...... 275 Government Departments: Staff...... 265 Somerset Rivers Authority...... 276 Honours ...... 265 Tax Avoidance ...... 277 Immigrants: Detainees...... 265 Transport: Capital Investment ...... 278 NUMERICAL INDEX TO WRITTEN ANSWERS

Col. No. Col. No. [HL3882] ...... 269 [HL3896] ...... 260 [HL3883] ...... 269 [HL3902] ...... 272 Col. No. Col. No. [HL3903] ...... 259 [HL3978] ...... 261

[HL3904] ...... 269 [HL3979] ...... 260

[HL3905] ...... 270 [HL3980] ...... 264

[HL3906] ...... 270 [HL3984] ...... 258

[HL3907] ...... 270 [HL3990] ...... 267

[HL3908] ...... 273 [HL3991] ...... 265

[HL3910] ...... 259 [HL3992] ...... 266

[HL3911] ...... 260 [HL3998] ...... 276

[HL3925] ...... 277 [HL4007] ...... 266

[HL3927] ...... 261 [HL4012] ...... 271

[HL3928] ...... 261 [HL4013] ...... 275 [HL4019] ...... 264 [HL3930] ...... 268 [HL4020] ...... 257 [HL3934] ...... 268 [HL4028] ...... 274 [HL3935] ...... 271 [HL4030] ...... 257 [HL3937] ...... 262 [HL4032] ...... 275 [HL3938] ...... 262 [HL4033] ...... 276 [HL3950] ...... 271 [HL4034] ...... 274 [HL3951] ...... 272 [HL4036] ...... 266 [HL3955] ...... 257 [HL4037] ...... 267 [HL3959] ...... 258 [HL4038] ...... 272 [HL3973] ...... 278 [HL4040] ...... 265 [HL3975] ...... 263 [HL4050] ...... 275 [HL3976] ...... 263 [HL4074] ...... 273 [HL3977] ...... 259 [HL4090] ...... 265 Volume 758 Thursday No. 85 15 January 2015

CONTENTS

Thursday 15 January 2015 Questions HIV ...... 891 Personal Independence Payments ...... 893 United States: Haggis Ban...... 896 Milk Production ...... 897 Business of the House Timing of Debates ...... 900 Natural Environment Motion to Take Note ...... 901 NHS: Accident and Emergency Services Question for Short Debate ...... 934 Mental Health Motion to Take Note ...... 948 Insurance Bill [HL] Third Reading ...... 980 Developing World: Maternal and Neonatal Mortality Question for Short Debate ...... 980 Grand Committee Cadet Units in Schools Question for Short Debate ...... GC 235 Criminal Bar: Funding Question for Short Debate ...... GC 249 Property Boundaries Question for Short Debate ...... GC 262 Chancel Repairs Question for Short Debate ...... GC 273 London Health Commission: Smoking Question for Short Debate ...... GC 288 Written Statements...... WS 83 Written Answers...... WA 257