Commons Sitting of 15 January 2004

Preamble
The House met at half-past Eleven o'clock
PRAYERS
[MR. SPEAKER in the Chair]
Oral Answers to Questions
  EDUCATION AND SKILLS
  The Secretary of State was asked—
  EDUCATION AND SKILLS

    Higher Education
    Mr. Peter Pike: Which five local education authorities had the lowest percentage of students going on to higher education in 2003. [147866]
    The Secretary of State for Education and Skills (Mr. Charles Clarke): The latest available figures are for students entering in 2002, and they show that Thurrock, Manchester, Hackney, Kingston upon Hull and Knowsley had the lowest proportion of 18-year-olds entering full-time higher education courses.
    Mr. Pike: I thank my right hon. Friend for that answer, but I am sure that he will recognise that, within Lancashire, Burnley has a low take-up of people going on to higher education. We need to encourage our schools to encourage their students to want to go on to higher education. However, does he believe, as I do, that his move to abolish up-front fees and to provide grants and other assistance is likely to remove the barriers that exist for lower-income families in areas such as Burnley?
    Mr. Clarke: I very much agree with my hon. Friend; he is absolutely right. I know that he shares my view, and that of the Government, that improving the schools and basic education in Burnley is an important element in being able to achieve what we all want to do. I was in Lancashire on Tuesday this week and spoke to the leadership of the county. One of the issues discussed was investment in Burnley. We need to focus both on the schools and on the higher education package that is before the House.
    Mr. Tim Yeo: There is a substantial burden of new costs associated with the Government's Higher Education Bill—costs that have increased as a result of some of the concessions that the Secretary of State has been forced to make. Will the costs be met within the higher education budget or by additions to that budget?
    Mr. Clarke: The former.
    Mr. Yeo: If the costs are going to be met within the higher education budget, does that not imply that
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    universities will not receive the full benefit of the income generated by top-up fees? If that is the case—and possibly even if it is not the case—is it not clear that the cap of £3,000 to the fees will mean that university funding needs cannot possibly be met by fees charged within the Government's cap? Will they not therefore be announcing quite soon an increase in that cap? Is the Secretary of State aware that any verbal assurance that he tries to give on this matter is undermined by the fact that the whole policy represents a breach of the promise that the Government made to electors less than three years ago?
    Mr. Clarke: I explained very clearly to the House last Thursday the precise safeguards that we have in place to ensure that any increase in the cap would take place only after very full consideration and by a vote of every Member of the House. It is a bit rich for the hon. Gentleman to make these observations when his proposals would take hundreds of millions of pounds out of universities and would reduce by hundreds of thousands the number of places available in universities.
    Jonathan Shaw: Does my right hon. Friend agree that although we do well in terms of overall performance for A-levels and degrees, we have one of the worst performances in the OECD for young people staying on in education post-16? If more people are going to go on to higher education, is it not essential that when the educational maintenance allowance programme rolls out in September this year, the learning and skills councils and local education authorities have a real campaign so that we can get the issue on the radar of families who would otherwise ignore the prospect of staying on post-16?
    Mr. Clarke: My hon. Friend is absolutely right in everything he says. The fact is that the early evidence on the educational maintenance allowance is very positive from the point of view of staying on. I am confident that the rolling out nationally from September that he describes will be very effective. That is the fundamental reason why we have decided to extend and strengthen the higher education grant part of our package that we shall be considering in the Bill later this Session.
    Mr. David Rendel: The Secretary of State has just confirmed what we all know. Students from the poorest parts of the country tend to go least frequently to university. The Prime Minister said yesterday that the new scheme would be
    "a prime example of the modern path to social justice".
    However, the only way in which students from poor backgrounds will benefit financially under the new scheme, as opposed to using their grants to pay off their fees, will be if they go to some sort of second-class university where the fees are actually lower than the top-up fees. They can then use some of their grant for maintenance. Is that not a rather odd way of introducing more social justice? In effect, there will be a bribe for the children of poorer parents to go to second-class universities, thus leaving more places at the more prestigious universities for the children of the toffs.
    Mr. Clarke: The hon. Gentleman has it completely wrong. I do not know whether he would, for example,

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    describe Cambridge university as a second-class university. With his educational background, he may do so. The fact is that the bursaries announced by Cambridge university of £4,000 a year for such students—
    Mr. Rendel: Are they part of the scheme?
    Mr. Clarke: They are entirely part of the scheme. It is as a result of the Office for Fair Access that these bursaries are being announced, and the £4,000 from Cambridge, plus the £1,500 grant, plus the fee remission mean that a student from a working-class background going to Cambridge will, in effect, receive £6,500 to £7,000 a year to deal with their expenses. That is a significant element, and I would not describe that as putting such students at a disadvantage.
    Mr. Adrian Bailey: I represent a constituency that historically has a low take-up of higher education places. While I recognise that certain measures in the Higher Education Bill will remove some of the financial disincentives for potential students, will my right hon. Friend outline the steps being taken to break down some of the cultural and aspirational blocks to students in areas such as mine?
    Mr. Clarke: Higher quality schools is absolutely central to the specialist schools that I identified in particular, as is the education maintenance allowance programme—to which my hon. Friend the Member for Chatham and Aylesford (Jonathan Shaw) referred—to encourage students financially. The whole structure of apprenticeship skills training leading to foundation degrees and the higher education courses in further education colleges make university courses more attractive. There is a whole package, of which the Bill is just one part, to focus on the issue to which my hon. Friend referred of raising higher education take-up rates in the poorest communities.

    Synthetic Phonics
    Mr. Nick Gibb: If he will make a statement on the use of synthetic phonics in the teaching of reading in primary schools. [147867]
    The Parliamentary Under-Secretary of State for Education and Skills (Mr. Stephen Twigg): The National Literacy Strategy has put phonics—synthetic and analytic—right at the heart of literacy teaching in primary schools. That has contributed to the sustained improvement in literacy standards among primary school children.
    Mr. Gibb: The Minister may be aware that at the Kobi Nazrul school in a deprived part of Tower Hamlets, 92 per cent of 11-year-olds achieve level 4 in reading, while a school in a leafy middle-class suburb can achieve only 71 or 72 per cent. Is it the case that one of those schools places much greater emphasis than the other on synthetic phonics in the teaching of reading? Does the Minister accept that if he wants the delivery unit to
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    report progress on his stalled target for reading, he must insist that greater emphasis is placed on synthetic phonics in primary schools?
    Mr. Twigg: I also pay tribute to the school to which the hon. Gentleman referred and to others in Tower Hamlets, which have demonstrated the great importance of phonics teaching—including synthetic phonics—in primary schools. Prior to the national literacy strategy, many schools were using synthetic phonics barely or not at all. The take-up is much greater than it used to be. I am considering whether we should conduct additional research to evaluate the different programmes available, to ensure that best practice is shared among primary schools throughout the country.
    Paddy Tipping: Has not the literacy hour—which provides a framework within which teachers can use look-and-say, phonics and synthetic phonics—been an enormous success? Should not the Department identify good practice, examine professional judgment, and promote best practice?
    Mr. Twigg: My hon. Friend is absolutely right. Earlier this year, we published "Excellence and Enjoyment" to build on the success of the Government's literacy and numeracy strategies. Some 60,000 additional 11-year-olds are achieving at least level 4 as they leave primary school, which is important progress. As my hon. Friend said, the literacy hour and broader literacy strategy have been vital to the progress made by primary school pupils and teachers.

    Antisocial Behaviour
    Hugh Bayley: What support is available to help schools to deal with antisocial behaviour. [147868]
    The Parliamentary Under-Secretary of State for Education and Skills (Mr. Ivan Lewis): Ours is the first Government to put behaviour and attendance at the heart of the school standards agenda. Our programmes include training in consultancy support for all secondary schools, behavioural improvement, enhanced support to tackle bullying, a concerted drive to reduce truancy, the work of Connexions and of the youth services, and positive activities during school holidays for young people judged to be at greatest risk of being involved in crime and antisocial behaviour.
    Hugh Bayley: Does my hon. Friend agree that teachers are in the front line of antisocial behaviour by youngsters—not just as victims but as part of the solution—in working with youngsters who have behavioural problems? Will the Government consider earmarking resources for local education authorities' special educational needs budgets, so that resources can be made available centrally to schools, and provide learning support assistance? Further, does my hon. Friend agree—
    Mr. Speaker: Order. One supplementary question is fine.
    Mr. Lewis: In the Green Paper "Every Child Matters", we said that we sought to bring together all

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    the resources that are being used in schools and by external organisations that support schools to ensure that children fulfil their potential. We want to bring the money together more cohesively to ensure that professionals work together to have maximum impact on schools' ability to nurture children's potential. We are currently reviewing that to ensure that we make best use of the vast amount of resources that are being invested in schools and support to schools.
    Mr. Roy Beggs: Last week, I had the privilege of attending the north of England education conference in Belfast, at which several of the Under-Secretary's colleagues were present. I attended a seminar to promote and provide information on the success of the Prince's Trust XL club scheme. The principal who gave the address said that, in 16 years, he had not had to exclude a pupil. Will the Under-Secretary commend the use and involvement of the XL clubs project in schools as a means of increasing achievement and reducing antisocial behaviour?
    Mr. Lewis: I shall support the work of that programme. We have to be imaginative and innovative in using the voluntary sector and community-based organisations to support our desire to ensure that we motivate young people positively, connect them with their local community's activities and support their development as positive citizens. We need to harness all the resources that are available to us in the statutory and voluntary sectors.
    Helen Jones: The measures that the Government have taken so far are welcome, but further to the question that the hon. Member for East Antrim (Mr. Beggs) asked, will my hon. Friend consider seriously methods of aiding and encouraging schools to allow young people to undertake useful work in the community that improves their behaviour and breaks down the barriers between the generations? Will he consider making perhaps a small amount of pump-priming money available to enable schools to get such projects off the ground?
    Mr. Lewis: I agree that we need to ensure that we offer young people a personalised learning experience that is about educational attainment and their development as all-round citizens. That is why we are increasingly linking schools, colleges and employers and focusing on enterprise education. It is also why our long-term ambition for reforming education for 14 to 19-year-olds is to build a curriculum around the needs of each young person. It should consider not only educational content but their community activities.

    School Funding (North Yorkshire)
    Miss Anne McIntosh: What representations he has received on school funding in (a) North Yorkshire and (b) York for 2004–05. [147869]
    The Minister for School Standards (Mr. David Miliband): We have received few recent representations about school funding in North Yorkshire and York for 2004–05. On 29 October, my right hon. Friend the Secretary of State announced proposals to restore
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    stability and certainty to school funding. In 2004–05 all authorities will have an increase in their school formula spending share of at least 5 per cent. per pupil. North Yorkshire's increase is 6 per cent. and York's is 6.8 per cent.
    Miss McIntosh: My pile of papers shows the number of representations that I have received from schools in my area, which covers North Yorkshire and the city of York. The Minister's school report will read: "He must try harder." The procedures are complex, bureaucratic and inflexible. There will be more staff redundancies this year and it is as difficult as ever to get money for the schools building programme. What will the Minister do about it?
    Mr. Miliband: I look forward to receiving representations, but the hon. Lady should give credit where it is due. My hon. Friend the Member for City of York (Hugh Bayley) has passed on a representation to me from the director of education in York. He says:
    "This year, the FSS for schools in York was significantly higher than last year and…amongst the best in the country."
    He continues that
    "the DfES has made huge efforts to address the problems…and should be congratulated on what has been achieved."
    Mr. John Grogan: Does my hon. Friend also know that the widely respected director of education in North Yorkshire has written to all North Yorkshire Members of Parliament to say that, in many ways, the picture for school spending is better than for many years? Will he do everything possible to sustain the increase in spending that has led to 300 extra teachers in North Yorkshire in the past five years?
    Mr. Miliband: I am sure that the letter also pointed out that there has been an increase of 47.9 per cent. in funding for pupils in North Yorkshire under the Government, in contrast to the cuts that occurred when the Conservative party was in power.

    University Funding
    Mr. Tam Dalyell: What representations he has received on the funding requirements of universities in 2004–05. [147870]
    The Secretary of State for Education and Skills (Mr. Charles Clarke): I have received numerous representations from universities on a number of matters relating to the funding of higher education, both in formal correspondence and in meetings with vice-chancellors and others from the higher education sector.
    Mr. Dalyell: Even if the English universities receive more funding as a consequence of a new fee regime, will not most of that be used up in supporting teaching? What does the Secretary of State propose to do about the funding of research in the UK?
    Mr. Clarke: My hon. Friend is absolutely correct. The bulk of the extra income will be used, and is intended to be used, to support teaching and to increase the quality of undergraduate education in universities. However, as he will know, the increase in research funding through the comprehensive spending review has been the most

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    substantial in 25 years, and that will continue. I accept my hon. Friend's point that research funding is vital for the success of universities, and we certainly intend to continue to support that in every way possible.
    Rev. Martin Smyth: The Secretary of State will agree that universities have been underfunded for some time. What discussions has he had with his colleagues in Northern Ireland about the impact of his policies there, bearing in mind that although Cambridge and a few other universities might be able to offer some bursaries, other universities are not in such a position, and their students could be worse off?
    Mr. Clarke: The hon. Gentleman makes an important point, which I have discussed with my ministerial colleagues responsible for education in Northern Ireland. I also took the opportunity to discuss that issue, and a variety of others, with the vice-chancellor of Queen's university when I was in Belfast for the meeting of the Association of Commonwealth Universities last September. We are discussing that, and we acknowledge the cross-border issues implied in the hon. Gentleman's question. I make an open offer to him today: I am happy to discuss with him and his colleagues their concerns over how we can take our approach forward.
    Mr. David Chaytor: In my constituency, 18 per cent. of the population are university graduates. Does my right hon. Friend find it strange that some people find it quite acceptable that the other 82 per cent. have had to pay variable fees for every bit of education and training that they have had since they were 18, but consider that variable fees are unacceptable for the most privileged, that 18 per cent. who are graduates?
    Mr. Clarke: I agree—that is one of the more surprising aspects of this debate. The fact is that about 50 per cent. of students at our universities, including part-time, postgraduate and overseas students, already pay variable fees in precisely the way that my hon. Friend suggests. Moreover, with regard to skills training in the 16 to 19 age group, many people themselves, or their employers, pay for the education and training that they receive. I regard our proposals as creating a rational approach to that variety, and enabling universities precisely to focus on attracting students from the communities that he wants to encourage, as do I.

    Top-up Fees
    Mr. David Amess: What recent representations he has received on top-up fees. [147871]
    The Minister for Lifelong Learning, Further and Higher Education (Alan Johnson): My Department has continued to receive correspondence on issues relating to variable fees from a range of organisations and individuals. In addition, I have had meetings with a number of MPs, vice-chancellors and representatives of interested groups to discuss and clarify the proposals set out in the Higher Education Bill. We have listened to
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    concerns and taken account of them in the proposed student support package that my right hon. Friend the Secretary of State announced on 8 January.
    Mr. Amess: How will the Minister reply to those people who have written to him to remind him that the Labour party manifesto said that the Government would not introduce top-up fees and had legislated to prevent them? How has he replied to constituents who have reminded him that, according to Barclays bank, under this rotten Government students will face debts of more than £33,000 by 2010?
    Alan Johnson: On the first question, we will not introduce variable fees until after the next general election. Let me just remind the hon. Gentleman of the days, which are becoming increasingly distant, when his party was in government. Government is about looking at serious problems, which we should address, not duck. I make no apology whatever for realising that the university sector requires additional funding—and extremely soon—for the economic success of this country.
    On the second question, I would patiently remind anyone who wrote to me or to any Member of the House saying that the Government's proposals mean a £33,000 debt that the biggest threat to students going on to university is well-meaning people plucking figures out of the air for what student debt will be. I remind those people that the average debt recorded by the student income and expenditure survey, which the National Union of Students has more to do with than we have, is £8,666—not£30,000, not £3,000, not£25,000.
    David Taylor: Why cannot we be frank about what the debate before us involves? The current fees produce £450 million out of a £9 billion budget—about 5 per cent. The debate is not about the small amounts of extra finance, which would be rather slow to come, or the expansion of opportunities for working-class students; it is about marketisation. Why cannot we be frank about that?
    Alan Johnson: Because it is not about marketisation—it is about getting rid of up-front fees, reintroducing a maintenance grant of £1,500 and making it easier for graduates to repay not just any fee, but their loans. The amount that they will pay back goes down substantially under our proposals. [Interruption.] It goes down £18,000 a year—from £13.85 a week to £5.90. That is the reality of our proposals.
    In relation to marketisation, we are bringing in an extra £1 billion on top of £800 million from fees and a £3 billion investment from the taxpayer—a 34 per cent. increase since 1997. We are doing that because we read very closely the report of the Dearing national committee of inquiry, which said that if we do not go down this route we will never properly fund our university sector.
    Mr. Andrew Turner: I do not think that any of us, on this side of the House at least, is surprised that the Government are breaking their promise. What we would like explained is why they made the promise in the first place.
    Alan Johnson: That is a change of tack. The hon. Gentleman is a respected member of the Education and

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    Skills Committee, which to a large extent goes along with our proposals and certainly supports graduate contributions. There was an interesting article in The Sunday Times by my right hon. Friend the Home Secretary—
    Miss Anne McIntosh: Answer!
    Alan Johnson: This is the answer, if the hon. Lady cares to wait.
    My right hon. Friend wrote an article, as well as the manifesto commitment, and he pointed out the terms of the debate in 1997 and 1998, following the Dearing report. Top-up fees meant that the Government set a fee and universities were allowed to top them up to whatever level they liked. I was pleased that my right hon. Friend reminded us of the true terminology that we were debating, and we will not allow that to happen. We did not allow it in 1998 and we will not allow it now. If anything, the proposal that £3,000 or less can be charged is top down rather than top up.
    Mr. Andrew Miller: Does my right hon. Friend agree that the removal of the up-front element in the proposal before us will have a significant impact to the benefit of the students coming from poorer families?
    Alan Johnson: That is a crucial point. Even though 40 per cent. of students did not have to pay that fee, there was the impression in youngsters' minds that if they want to go to university it will cost them or their parents money up front. The other interesting point is that from the student income and expenditure survey we now know that 26 per cent. of students are themselves paying an average of £700 towards that up-front fee. In fact, abolition and a move to an income-contingent repayment system after they have graduated is not only more helpful for those applying to university, but will help students to manage the cost of being at university.
    Mr. George Osborne: The Minister referred in his opening answer to meetings with Members of the House. How many of those meetings were held at the suggestion of Lords Commissioners to the Treasury—in other words, Government Whips?
    Alan Johnson: Quite a few would be the answer to that. That in no way suggests, however, that those individual Members whom I met were not delighted and happy to meet me.

    School Sport
    Tony Cunningham: What steps he is taking to improve links between schools and sports clubs. [147872]
    The Minister for Children (Margaret Hodge): From parliamentary sports to schools sports, Mr. Speaker, we are implementing a range of measures to improve the links between schools and sports clubs. With an investment of more than £1 billion, we are enhancing sports facilities, creating 400 specialist sports colleges, funding partnerships between schools to increase
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    sporting opportunities for children, and making money available to encourage links between schools and sports clubs.
    Tony Cunningham: I thank my right hon. Friend for that reply. To put this subject in context, about 20 per cent. of school leavers in this country continue their sport with a sports club; in France, that figure is about 70 per cent. I am therefore delighted about the investment. Will she talk to colleagues in other Departments—the Department for Culture, Media and Sport, the Home Office and the Office of the Deputy Prime Minister—so that we can have a co-ordinated approach to this matter?
    Margaret Hodge: I congratulate my hon. Friend on the work that he is doing to encourage not just sports in schools but young people to carry on their sporting activity beyond school. I assure him that in this area of policy, as in many others, we work extremely closely not just with colleagues in DCMS but with colleagues in the Office of the Deputy Prime Minister and the Home Office.
    Mr. Michael Jack: In the light of the Minister's encouraging reply, will she consider the application made by St. Bede's high school in my constituency for a specialists sports facility? It is the only high school of its type without a sports facility and it wishes to link with local sporting clubs, thus achieving the Minister's objective. Will she assure me that she will consider carefully that application, which is supported by the county council and is much needed?
    Margaret Hodge: I am delighted to note the right hon. Gentleman's support for our specialist schools programme. I hope that he acknowledges, as we do, that they raise achievement among children—[Interruption.] In response to the comment made from a sedentary position, the Conservatives may have had the spark of an idea, but we provided the funds that they now intend to cut.
    Mr. Andy Reed: I am sure that my right hon. Friend has had the opportunity to read the Adjournment debate on grass roots sports that we had on Tuesday. She will realise that to increase mass participation right across the age range, especially as people get older, the school-club link is crucial as there is a drop-off rate, particularly among girls and women. Will she work closely with the DCMS and others to ensure that as well as having specialist sports colleges and sports co-ordinators, we get coaches into schools through those links, possibly even in after-school hours? We must make sure that we use the facilities in schools and make a real effort to drive up the participation rate.
    Margaret Hodge: I congratulate my hon. Friend on securing the Adjournment debate the other night, and I agree entirely that creating those school-club links, across the range of sports, is crucial. Not only do I hope that the school-club links project in which we are investing £4.5 million will support that, but that our extended schools programme, in which we hope to open up schools to provide extra-curricular activities, will

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    encourage more coaches from clubs to work with children and young people to develop their sports competences.
    Mr. Nigel Evans: In encouraging sports pros to come into schools, to try to alleviate the problem about which we are all worried—obesity in our youngsters—and to get those young people off their couches and on to sports fields and facilities, will the Minister examine carefully the problem of the long school summer holidays? In terms of opening up those sports facilities, the schools tell us that part of the problem is insurance: they are afraid that youngsters will get injured while using the facilities. Will she consider opening those facilities this summer for all our youngsters?
    Margaret Hodge: I am delighted that there is cross-party agreement on this matter. I have always believed—and I imagine from what the hon. Gentleman said that he agrees—that schools and their facilities are a most precious asset in our communities and are valued by everybody. For them to be closed for much of the day and much of the year is a terrible waste of a valuable asset. Any step that we can take to open them up so that they can he used not just by the school community but by the wider community must be of benefit to all.

    Education Maintenance Grants
    Mr. Harry Barnes: What assessment he has made of the impact of education maintenance grants on post-16 participation. [147873]
    The Parliamentary Under-Secretary of State for Education and Skills (Mr. Ivan Lewis): In the evaluated pilots, the number of 16-year-olds participating in full-time education increased by 5.9 percentage points. That represents a significant increase, and reinforces the importance of extending education maintenance allowances to 16-year-olds in all parts of England from this September.
    Mr. Barnes: I welcome that reply—and I do not normally say that.
    I recognise that the scheme must be phased in, with pilot schemes followed by participation by 16-year-olds. Some students in the second year of their national vocational qualifications courses are not eligible, but learner support funds provide one-off grants for the purchase of books and equipment. Could provision be extended so that people do not miss out entirely during their later years of study?
    Mr. Lewis: One of the proposals in the skills strategy that we launched in the summer is to allow young people in full-time education beyond the age of 19 access to maintenance grants. That will give them a new opportunity. However, we will also try to ensure that all learner support funds are used to support young people, raise their aspirations and enable them to stay in education—especially those from communities in which that is not currently the norm.
    Mr. Graham Brady: Given that those who stay in education after the age of 16 earn more in later life than those who do not, would it not be consistent with the Government's other policies for them to charge fees for their education rather than giving them money?
    Mr. Lewis: No, it most certainly would not. Let us consider the logical conclusion of the Conservatives' higher education policy. They would tell 16-year-olds "Take an education maintenance allowance, but you cannot have a university place." The Conservatives would reduce the number of places significantly, and which young people would lose out? Those who were eligible for the allowances.
    Nothing changes in terms of the dividing line between the Government and the Conservatives. We want everyone to have equality of opportunity.
    Dr. Phyllis Starkey: I welcome the rolling out of maintenance allowances across the country to regions such as mine, but will the Minister ensure that his AimHigher programme continues to be funded? I have seen it operating in schools in my constituency, encouraging young people in years 9 and 10 who would otherwise not even have thought of going to university to begin planning their school careers with that in mind.
    Mr. Lewis: I assure my hon. Friend that we will continue that programme, which has been very successful in persuading young people that higher education is a serious option when it has not been on their radar screens hitherto. The combination of our investment in Sure Start, our school standards agenda, the work of the Connexions service and our proposed reforms of education for 14 to 19-year-olds is helping young people to fulfil their potential in a way that has not been possible before.
    Mr. Mark Simmonds: With the maintenance allowance, the Government have established the principle of using taxpayers' money to encourage students to go on learning, thus gaining wider career opportunities and greater earning potential. Can the Minister explain how that policy is consistent with that of variable tuition fees, which is predicated on substantial student debt, with students having to repay money because of the possibility of those wider career opportunities and greater earning potential?
    Mr. Lewis: The hon. Gentleman has clearly taken advantage of the literacy programme, but not of the numeracy programme. As a consequence of the proposals presented by my right hon. Friend the Secretary of State last week, the reintroduction of a maintenance grant to support young people while they are undertaking higher education is entirely consistent with education maintenance allowances. If the Higher Education Bill were voted down, what the Conservatives would be voting for would be no maintenance grants and the continuation of up-front fees.
    Valerie Davey: I welcome the maintenance allowances that reached Bristol in the roll-out programme this September. Does the Minister agree that such direct funding on an income-related basis encourages more young people from low-income families to consider going to university?
    Mr. Lewis: I agree entirely. The important thing about increasing access to university is enabling far more young people to gain the necessary qualifications by the age of 18 and getting them to believe that university is a serious option. That is how we will widen participation and genuinely ensure that higher education is available to all who want and are able to pursue it in our country.

    School Budgets
    Mr. Henry Bellingham: When he next expects to meet representatives of local education authorities from Norfolk and Suffolk to discuss school budgets for the next financial year. [147874]
    The Minister for School Standards (Mr. David Miliband): My right hon. Friend the Secretary of State meets representatives from Norfolk on a regular basis. This year's package of funding includes a targeted transitional grant made available to local authorities, which would otherwise have the smallest increases in support for education over this year and next. Norfolk is eligible for £5.3 million and Suffolk for £3.1 million.
    Mr. Bellingham: Has the Minister had a chance to see the recent article by Steve Downes, the education correspondent of the Eastern Daily Press, who flagged up the possibility of £400 million being necessary to repair and upgrade Norfolk schools, given that one in nine classrooms in the county is below the accepted standard? He will also be aware that I am very concerned about the reorganisation in the Hunstanton area, which will require an upgrade. We are very grateful that Norfolk will benefit from a substantial private finance initiative project, but what is our share of "Building schools for the future" likely to be?
    Mr. Miliband: I appreciate the spirit in which the hon. Gentleman asked that question. I follow Steve Downes's articles in the Eastern Daily Press carefully—especially when the hon. Gentleman shows them to me just before Question Time. I am glad that he referred to the increased capital funding for Norfolk. The "Building schools for the future" programme is designed to enable every local education authority in the country to modernise the secondary school estate over the next 10 to 15 years. The funds will be distributed on the basis of need, the power of the educational vision to deliver on improved standards, and the capacity of the LEA to deliver the programme. We are waiting for the bids to come in, and the moneys will be allocated on that basis.
    Mr. Bob Blizzard: May I ask my hon. Friend not to listen to what the hon. Member for North-West Norfolk (Mr. Bellingham) said about
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    school buildings in his county? I taught in Norfolk for 10 years before entering the House in 1997. I can tell my hon. Friend that many of the schools then were rotten and had leaking roofs; that many of the children were taught in sheds called "mobile classrooms", except they never moved; that the Tory county council was proud of how little it spent on education under a Tory Government; and that there has been huge extra investment since 1997 in Norfolk and Suffolk. The hon. Gentleman's point was completely wrong, and the remaining defective buildings are remnants from the dark days of the Tory era.
    Mr. Miliband: I am glad that my non-aggression pact with the hon. Member for North-West Norfolk (Mr. Bellingham) can now be abandoned and that I can make it absolutely clear that capital funding, which was a mere £4.9 million for the whole of Norfolk in 1996–97, is now £39.7 million. That puts right the dark days that were left to us.
    Mr. Mark Hoban: Is the Minister confident that the transitional target money to which he referred in his answer will help all the schools that set either a deficit budget or used reserves or money for capital projects to balance the books this year, or will we hear more from schools in East Anglia about teachers being laid off and staff being cut?
    Mr. Miliband: What we will hear more of is the Conservative lead spokesman on education in Norfolk county council, who says that the money to which the hon. Gentleman referred will replace the funding that was missing last year. In fact, he went on:
    "We have been working hard to persuade the Government that Norfolk needs a better overall settlement, and that is what we appear to have achieved."

    Russell Group Universities
    Mr. Michael Connarty: What percentage of young people from England and Wales gained entrance to courses at the Russell Group of universities in 2003.[147875]
    Mr. Graham Allen: Come in No. 10.
    The Minister for Lifelong Learning, Further and Higher Education (Alan Johnson): Your time is up. [Laughter.]
    In 2003, 6 per cent. of the 18-year-old population gained entry to full-time undergraduate courses in Russell Group universities. We want the best young people, whatever their social background, to apply to the top universities and we are encouraging all universities to reach out and find talented young people from all backgrounds who have the potential to benefit from higher education.
    Mr. Connarty: I am grateful to my right hon. Friend for that reply. He knows that I told his Parliamentary Private Secretary that I have been speaking to vice-chancellors from Russell Group universities—though not Oxford or Cambridge, I might add. They told me

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    that they would charge£3,000 for every course at their universities and also told me that they would support a fixed universal graduate repayment scheme, if it were proposed, but that they had been told that they must support the Government's variable scheme or get nothing. Surely my right hon. Friend sees the merit in further exploring a fixed graduate repayment scheme, which would stop misleading students about what it would cost them to attend university courses and stop the Government bullying the universities. It might even save the seats of several Labour Members at the next election.
    Alan Johnson: I should tell my hon. Friend, who is a friend of long standing, that I simply do not understand that argument. According to it, were we to fix the fee at £2,500—the accepted figure in terms of bringing in the same amount of revenue—all our problems would dissolve overnight. The idea is that poorer youngsters would be put off by £3,000, but not by £2,500. The simple fact is that none of the Russell Group universities will be able to charge anything above £1,125, which is the current standard fee, unless they satisfy the access regulator that they are doing everything they possibly can to encourage youngsters from non-traditional backgrounds—to use the jargon—to come to their university. As my right hon. Friend the Secretary of State said, Cambridge has already responded with an incredible £4,000 per year grant for youngsters whose families have an income of up to £31,000 a year. That is on top of the £2,700 we are providing centrally.
    This is an opportunity at last to close the social class gap that actually widened when higher education was free, through generous maintenance grants. So I do not understand the philosophy behind the fixed versus variable argument.
    Dr. Vincent Cable: If we are to accept the Government's premise that graduates, particularly from prestigious universities, should pay back more to society for their university education, why should that principle apply only to new graduates? Why should it not also apply to former, high-earning graduates, particularly those earning more than £100,000 a year? Almost 90 per cent. of such high-earners are graduates, who acquired their degrees in the days when they were more exclusive and more financially remunerative.
    Alan Johnson: I refer the hon. Gentleman to the Dearing report—a national committee of inquiry that was comprehensive, greatly appreciated at the time, and supported by Members on both sides of the House. Dearing set out six arguments as to why a graduate contribution scheme, which is what we are suggesting, is superior to a graduate tax, not least because he foresaw the difficulty of applying legislation retrospectively. However, he did point out that we need a culture in which individuals who have benefited from higher education are more willing to put money back in, in endowments and other forms. So I invite any Member of this House who feels a sense of guilt at not having paid enough for their university education to send their former university money. That would be very much appreciated.

    School Insurance
    Colin Burgon: What support he gives to local education authorities which face a shortfall in insurance payments to cover the cost of the replacement of school buildings after fire damage. [147876]
    The Parliamentary Under-Secretary of State for Education and Skills (Mr. Stephen Twigg): Authorities and schools are expected to take out adequate insurance for their school buildings, in accordance with good practice. Significant capital resources are allocated by formula to all authorities, enabling them to respond to the needs of their schools according to their priorities, including the covering of emergencies. Therefore, we generally do not provide exceptional capital support to local authorities to meet the costs of fire damage.
    Colin Burgon: My question comes about as a result of the experiences of Brigshaw high school, which is in my constituency. At Christmas, the gymnasium block burned down—I am glad to say that it was an accident—but in April 2000 virtually the entire school burned down. The Government and Leeds city council came together efficiently to ensure that the building work, costing some £8 million, went ahead. Under the leadership of their head teacher, Peter Laurence, the staff responded brilliantly to the crisis. Will the Minister assure me that he will give the school the same help and support through this current difficult period?
    Mr. Twigg: I am aware of the tragic circumstances at Brigshaw high school that my hon. Friend describes. I am certainly happy to give him a commitment that we will work with Education Leeds to ensure that the school can be rebuilt as soon as possible; I know that considerable damage has been caused on this occasion. Our preference is very much that these matters be dealt with at local level. We have increased fivefold the availability of capital funds to local authorities in the past six years. We hope that, in the first place, Education Leeds will work closely with the school and with my hon. Friend to bring about its rebuilding.
    Mr. Richard Bacon: While we are on the subject of support to local education authorities, given that an LEA thinks that it is doing well if 87 per cent. of its budget is passed on to schools and only 13 per cent. kept back, which in the case of Norfolk still means that more than £50 million is kept back—
    Mr. Speaker: Order. The hon. Gentleman has wasted a supplementary; the question is about insurance.
    Dr. Brian Iddon: In view of the huge chaos caused by fires in schools and especially in the light of the fact that the cost of fitting sprinklers and other fire protection systems can be greatly offset against the reduction in insurance premiums, should we not make it mandatory, or give strong encouragement, for all schools, in new build and in retrospect, to fit sprinkler systems?
    Mr. Twigg: I am grateful to my hon. Friend for making that point. I give him an undertaking that I shall explore what the Department can do to support such common-sense solutions.

  The Solicitor-General was asked—
  SOLICITOR-GENERAL

    Professor Sir Roy Meadow
    Mr. George Osborne: If she will review family court cases that involved evidence from Professor Sir Roy Meadow. [147843]
    The Solicitor-General (Ms Harriet Harman): I have met my right hon. Friend the Minister for Children to discuss family law cases involving evidence from Sir Roy Meadow. We await the written judgment of the Court of Appeal in the Angela Cannings case, which we expect within a fortnight, and when we receive that judgment I shall tell the House what action we shall take on criminal cases, and my right hon. Friend will tell the House what action she will take on family cases, that involved evidence from Sir Roy Meadow.
    Mr. Osborne: Professor Meadow's flawed evidence was instrumental in two massive miscarriages of justice, in the case of my constituent, Sally Clark, and in the Angela Cannings case, and was also instrumental in the collapse of the conviction of Trupti Patel. All those cases aroused massive public interest. Will the Solicitor-General confirm that she has still not actually started to review criminal cases where Professor Meadow's evidence was instrumental, and will she also confirm, perhaps on behalf of the Minister for Children, that there has as yet been no attempt to review all the family court cases? In those cases, too, there may have been great miscarriages of justice—children may have been taken away from parents and families broken apart—because of the same kind of evidence from Professor Meadow.
    The Solicitor-General: The hon. Gentleman is right to identify different cases, different issues in different cases and different jurisdictions—criminal and family. I recognise both his interest in such cases and also that of other hon. Members, such as my hon. Friend the Member for Putney (Mr. Colman) and my hon. and learned Friend the Member for Redcar (Vera Baird) with whom I know he has discussed the matter.
    I shall try not to take too long to reply, Mr. Speaker, so stop me when I run over my time—[Interruption.] These are quite difficult and complex issues and the hon. Member for Tatton (Mr. Osborne) has raised a very important point. In the case of Sally Clark, she was convicted and freed on appeal, and when the Court of Appeal gave its written judgment on that case it said that its concern was about Dr. Williams. The Attorney-General then set up an interdepartmental review of all criminal cases where the mother is still in prison, where the offence was of killing the child and where Dr. Williams's evidence was material. We have started that review and hon. Members might think that it would be an easy process, but in fact it is quite difficult. In many cases where Dr. Williams gave evidence that would have been crucial to the conviction we are not even sure whether it related to a man or a woman, because there is no indication of the Christian name. In some cases, there might have been other evidence that was crucial, rather
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    than that of Dr. Williams. I can say only that I am liaising closely with my right hon. Friend the Minister for Children about the family jurisdiction and we are already at work on the issues in the criminal jurisdiction. We are not sitting around while miscarriages of justices are not dealt with.
    Mrs. Anne Campbell: Does my right hon. and learned Friend agree that the Sir Roy Meadow cases throw up disturbing indications that expert witnesses are not always as expert as they should be? Does she also agree that witnesses who give expert advice to the courts should be registered with the Council for the Registration of Forensic Practitioners?
    The Solicitor-General: The Home Office has responsibility for forensic pathology, which is often at issue in cases such as this. In the Angela Cannings case, the Court of Appeal gave a verbal decision to free her, and made it clear that it was concerned about expert witnesses. We expect the court's written judgment shortly, but at present we do not know whether it will open up the whole issue of expert evidence in cases that otherwise might have been regarded as involving sudden infant death syndrome, or whether it will keep its conclusions in respect of Sir Roy Meadow. How wide our action is will depend on the court's findings, but we are working with the Lord Chancellor's Department, the Home Office and my right hon. Friend the Minister for Children to ensure that no stone is left unturned in this matter. I shall be happy to meet the hon. Member for Tatton (Mr. Osborne) and any other colleagues to keep them abreast of progress in these very important cases.
    Mr. Dominic Grieve: I am pleased to hear what the Solicitor-General has to say about this matter, but I want to press her a little further. I appreciate that her Department's responsibility in respect of family court cases is very different from its responsibility in respect of criminal cases. Nevertheless, the view taken by the Attorney-General and the right hon. and learned Lady of what has happened in criminal cases is likely to have a marked impact on whether people who have had their children taken away can have their cases reviewed in the family court. It will also affect the amount of public aid that might be made available to those people in order to have their cases re-examined. Will the right hon. and learned Lady bear those points in mind and ensure that the advice of the Law Officers is given to the Minister for Children and to the Lord Chancellor's Department if it is concluded that there are serious flaws in the expert evidence that has been advanced?
    The Solicitor-General: It is already clear that serious flaws exist, and that is why we are taking the action that we are taking. I have met my right hon. Friend the Minister for Children already, and the Attorney-General is in correspondence with her. I do not want to trespass on my right hon. Friend's jurisdiction in this matter, but a particular difficulty exists: that is, that many cases will not have come to court, as the expert evidence and advice might have been that a person did not stand a cat in hell's chance because the evidence was overwhelming. The advice might also be that giving up

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    one child for adoption might mean that the person involved could keep her other children. The matter might seem straightforward, but it is very difficult to track back in these cases. However, I assure the House that all efforts will be made, across both the criminal and civil jurisdictions, and that I shall keep hon. Members informed.

    Fraud
    Mr. Henry Bellingham: What plans she has to improve ways in which firms can be protected from fraud. [147844]
    The Solicitor-General (Ms Harriet Harman): The Crown Prosecution Service and the Serious Fraud Office are engaged in the work across government of the criminal justice agencies to improve the protection of firms against fraud.
    Mr. Bellingham: The Solicitor-General and I have corresponded on this matter. I am grateful to her for taking seriously the issue of fraud suffered by small firms, but more needs to be done. Does she agree that it would make sense if the SFO's main advisory panel contained a small firms representative? I appreciate that she may not know the exact answer, but can she tell the House how many stop now orders have been issued by the Office of Fair Trading?
    The Solicitor-General: I shall have to write to the hon. Gentleman with a response to his question about the OFT. I shall consider including a small business representative on the SFO advisory panel, but I agree that more needs to be done to protect businesses, both large and small, against fraud. That is a matter of ensuring that Government Departments and agencies work together. We intend to make sure that that happens, but we must also work with business to ensure that everything possible is done to advise and inform firms about how to protect themselves against fraud. We are also working with the Law Society and the professional accountancy organisations, and we are working internationally as well. We aim to toughen up on the proceeds of crime so that fraudsters do not think that they can commit a crime and live off the proceeds.
    Mr. Mark Todd: I wish to draw the attention of my right hon. and learned Friend to a case in my constituency, in which a small firm was able to produce what I thought was very substantial evidence of fraud by a company in Hampshire. My conversations with the local police in Hampshire have revealed that the main difficulty about pursuing the matter was the lack of available resources, and also that dealing with small-business fraud is given a relatively low priority in local police forces. Is not that a critical part of this picture?
    The Solicitor-General: My hon. Friend is right to raise the issue of the amount of resources that the tackling of
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    fraud is able to command. Fraud is not just a technical, victimless crime—there are real casualties along the way in terms of people's jobs, finances and, often, homes. I ask my hon. Friend to bring the case to my attention and I shall look into it.

    Rasul et al v. Bush
    Mr. David Heath: What discussions the Attorney-General has had with the Attorney-General of the United States on the subject of the amicus brief prepared on behalf of parliamentarians in the matter of Rasul et al v. Bush. [147845]
    The Solicitor-General (Ms Harriet Harman): The Attorney-General has not discussed the proposed amicus brief in the case of Rasul et al v. Bush as part of his discussions with the US authorities about the UK detainees in Guanatamo Bay.
    Mr. Heath: That is very disappointing, particularly given that it has been supported by four former Law Lords, a former Master of the Rolls and 85 right hon. and hon. Members of this House, including three former Cabinet Ministers and, indeed, the right hon. and learned Lady's predecessor. One wonders why the Government have not involved themselves in some action on behalf of British citizens who are incorrectly imprisoned.
    Can the Solicitor-General update the House on the negotiations that the Attorney-General has entered into? We heard from Ambassador Pierre-Richard Prosper a week ago that some movement was imminent, but that now seems premature, and the prospects are rather disappointing. Will she enlighten us as to when these people will either face due process or be released?
    The Solicitor-General: The Attorney-General and I are being kept informed about the proposed amicus that is being prepared by the peers and hon. Members, including my hon. and learned Friend the Member for Dudley, North (Ross Cranston), to whom the hon. Gentleman referred.
    As far as we are concerned, I refer the hon. Gentleman to what the Prime Minister said to this House on 7 January:
    "I hope that we will shortly be able to tell the House how the issue will be handled".—[Official Report, 7 January 2004; Vol. 416, c. 253.]
    He went further on 11 January, saying:
    "I think it will be resolved one way or another in the next few weeks".
    The timeframe of the Supreme Court is far beyond that, so we have a nearer focus on the matter. I remind the hon. Gentleman that the Prime Minister said that the timeframe is within "the next few weeks".

Business of the House
12.32 pm
Mr. Oliver Heald: Will the Leader of the House please give us the business for next week?
The Leader of the House of Commons (Mr. Peter Hain): The business for next week will be as follows:
MONDAY 19 JANUARY—Second Reading of the Civil Contingencies Bill.
TUESDAY 20 JANUARY—Debate on attendance and behaviour in schools on a motion for the Adjournment of the House.
WEDNESDAY 21 JANUARY—Opposition Day [3rd Allotted Day]. There will be a debate entitled "Failure of the Government to introduce a Civil Service Bill" followed by a debate entitled "Failure of the Government to address the West Lothian question".
Both debates arise on an Opposition motion.
I welcome the move by the official Opposition to return to the traditional practice of announcing the subject of their debates. That advance notice will assist all Members in planning their work for the week ahead. I hope that this sets the pattern for the future.
THURSDAY 22 JANUARY—Second Reading of the Armed Forces (Pensions and Compensation) Bill.
The provisional business for the following week will be:
MONDAY 26 JANUARY—Second Reading of the Fire and Rescue Services Bill.
TUESDAY 27 JANUARY—Second Reading of the Higher Education Bill.
WEDNESDAY 28 JANUARY—Opposition Day [4th Allotted Day]. There will be a debate on a motion in the name of the Liberal Democrats. Subject to be announced.
THURSDAY 29 JANUARY—Motion on Members' estimate matters.
FRIDAY 30 JANUARY—Private Members' Bills.
I should also like to inform the House that the business in Westminster Hall for the remainder of January will be:
THURSDAY 22 JANUARY—A debate on the Report from the Northern Ireland Affairs Committee on the illegal drugs trade and drug culture in Northern Ireland.
THURSDAY 29 JANUARY—A debate on "Afghanistan: the development challenge".
During the business statement last Thursday, hon. Members inquired about the publication of the Hutton report. Although the publication of the report is for Lord Hutton, not for the Government, I did commit to draw Lord Hutton's attention to the point that was raised by the hon. Member for North Cornwall (Mr. Tyler). Lord Hutton has informed me that when he announces the date for the publication of his report, he will also announce the arrangements for publication. Lord Hutton has also informed me that he has taken note of the point raised by the hon. Member for North Cornwall in relation to the publication of his report. I
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have committed to keeping the House as informed as possible on this issue, and I hope that hon. Members are reassured by this statement.
Mr. Heald: May I thank the Leader of the House for his comments about prior notice on Opposition days? He should not, however, hold his breath because from time to time we will want to be topical.
May I ask the Leader of the House about the failure by the Secretary of State for Trade and Industry to respond to this week's Opposition debate on post offices? He will know that I raised a point of order at the time, but does he agree that whenever possible the Secretary of State should respond to a debate moved by the shadow Secretary of State? Will he reassure us that there has not been a change in the Government's practice? We understand that from time to time the Secretary of State may not be able to attend a debate, but an explanation should be given—it should be good, too.
The Leader of the House will remember that last week he was asked detailed questions about the Hutton report, including a question about the structure of the debate, and that he said that he would give the matter further thought. Can he tell us, first, whether the Prime Minister will open the debate and, secondly, whether the Defence Secretary will make the winding-up speech? Will there be a substantive motion on Lord Hutton's recommendations and an opportunity for the House to vote on the matter?
Does the Leader of the House understand the widespread frustration in the House that the Prime Minister feels able to go on the Frost show and answer questions about authorising the release of Dr. Kelly's name, whereas when he is asked questions in the House he hides behind the need to wait for the report's publication? [Interruption.] My hon. Friend the Member for Altrincham and Sale, West (Mr. Brady) says that that is "dodging". Whatever it is, it is not satisfactory.
Finally, the Leader of the House will know that during this week's Opposition day debate on shortages of equipment for the armed forces in Iraq, the shadow Secretary of State for Defence called on the Defence Secretary to resign. The shadow Secretary of State for Defence cited the case of Sergeant Roberts, who was shot in the chest and would have survived had he not been ordered to hand over his body armour to other troops because of shortages. Since that debate, Sergeant Roberts's taped diaries have been released. In them, he said to his wife:
"We are going to war without the correct equipment."
Can we expect a personal statement on the matter from the Secretary of State for Defence in the next week?
Mr. Hain: The hon. Gentleman's first point was that we should not hold our breath about Opposition days. I understand his desire to call topical debates, which is the Opposition's right, but he must understand Members' rights. When Members plan their diaries, they know the Government business and topics for debate on a particular day. He is denying Members the opportunity to prepare speeches and to decide whether they want to speak. The practice has been adopted in

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previous years by both parties when in opposition. I understand his desire to be topical, but I hope that he will respect Members' rights.
On the post offices debate, I understand that a member of the shadow Cabinet was not present, so it was not automatically the case that the Secretary of State for Trade and Industry should have been present.
On the Hutton report, the hon. Gentleman says that the Prime Minister appears on the Frost programme but does not come before the House. The Prime Minister comes before the House every week for Prime Minister's questions, and he has been asked questions about that matter. He has made himself more accountable to the House than any previous Prime Minister. The hon. Gentleman presumably did not hear what was said at yesterday's Prime Minister's questions, because it was not in his interests to listen. The Prime Minister said:
"I have absolutely no intention of doing anything other than leading the Government's case on this issue."—[0fficial Report, 14 January 2004; Vol. 416, c. 809.]
That has been the position since I announced that the Prime Minister would make a statement to the House on the day that the Hutton report is published—I told the hon. Gentleman that weeks ago.
Mr. Heald: What about the debate?
Mr. Hain: The arrangements for the debate will be announced in the usual way, nearer the time and when the report has been published—there is nothing unusual about that. Since the hon. Gentleman repeatedly raises the matter, let me tell him that there is something distasteful about him and the Leader of the Opposition trying to second-guess a judge and his independent report. Perhaps it would be more judicious for the Leader of the Opposition to show a little more self-restraint and stop trying to manipulate the judgment of an independent judge in advance of the publication of his report.
On the equipment situation in Iraq, we obviously all sympathise with the family of Sergeant Roberts, especially Mrs. Roberts. However, I do not think that anyone would disagree—I am sure that the hon. Gentleman would not—that all our British soldiers fought with extreme efficiency in the war to depose Saddam Hussein, and that they performed valiantly and deserve praise from all of us.
Mr. Andrew Stunell: I thank the Leader of the House for reporting back on the question posed last week by my hon. Friend the Member for North Cornwall (Mr. Tyler) on the Hutton inquiry. We appreciate that feedback and look forward to further feedback as the situation unfolds.
May I draw the attention of the Leader of the House to the fact that the Secretary of State for Environment, Food and Rural Affairs has not once come to the House in the past 12 months to make a statement on environmental matters? Perhaps that is because she is at a loss to report anything that her Department has done on such matters. May I draw his attention to the report on climate change that was published last week by Leeds university, in the name of Professor Chris Thomas? It
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reports that over the next 50 years, we can expect one quarter of the land animal and plant species on the planet to be destroyed and thus to become extinct as a result of climate change. Will he tell the Secretary of State that there are important reasons why she should come to the House to give an account of what her Department is—or, perhaps, is not—doing?
Will the Leader of the House consider the situation in respect of the report by Judge Peter Cory on the Pat Finucane and Rosemary Nelson deaths? The report was presented to the United Kingdom and Irish Governments in October 2003, and it was stated that it would be published as soon as possible. The families of the bereaved and, indeed, the House are still waiting. Can he say when the report will be published and tell us the reason for the delay? Will he ask the Secretary of State for Northern Ireland to come to the House to tell us about the process and that delay?
I draw the Leader of the House's attention to early-day motion 375, which stands in the name of my hon. Friend the Member for Gordon (Malcolm Bruce), on the exceptions service and the Post Office.
[That this House calls on the Government to clarify as a matter of urgency how housebound, disabled and older people who are not able to cope with the Government's three direct payment options will be able to claim their pensions and benefits after 2005; notes that the Government has consistently acknowledged the need for an Exceptions Service, yet has failed to give any firm indication of how this system will operate; notes that the Exceptions Service will only be in place 18 months after the move to direct payments began and that letters to claimants and the Government's publicity material largely Jail to mention the Exceptions Service or that people can continue to use their order books and girocheques until 2005; notes that uncertainty about how they will be able to collect their pension or benefits has led to anxiety and distress among the most vulnerable members of our society and that many of these people have either not responded at all or have chosen an unsuitable method of receiving essential income due to ignorance of the Exceptions Service; and calls on the Government to guarantee that the Exceptions Service allows for multiple third party collectors, does not require a pinpad and PIN, is fully accessible at post offices and reinforces the viability of the Post Office Network.]
My hon. Friend raised that matter in the House last Tuesday at column 762, but the Minister for Energy, E-Commerce and Postal Services, who responded to the debate, did not have a word to say about it. Some 2 million Post Office customers could benefit from the exceptions service. It has been announced as a potential lifesaver for them, but it looks as though there will be extravagant delays in bringing it in. Will the relevant Secretary of State come to the House soon to tell us about that service?
Mr. Hain: I am grateful to the hon. Gentleman for welcoming my feedback in response to the point raised by the hon. Member for North Cornwall (Mr. Tyler).
The Secretary of State for Environment, Food and Rural Affairs makes herself regularly available to answer questions from the hon. Gentleman or any other hon. Member, and I am sure that everyone agrees that she is always accountable to the House. I agree that the

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climate change report from Leeds university is important, and he will understand that it is for that reason that the Government have adopted probably the most stringent emissions controls of any major economy anywhere in the world. We were enthusiastic signatories to, and advocates of, the Kyoto protocol as an attempt to try to control emissions so that the enormous environmental threat of climate change that the report identifies can be addressed. We are working internationally with other countries to get the protocol implemented in the most effective fashion.
I shall draw the hon. Gentleman's points on the Cory report to the attention of the Secretary of State for Northern Ireland. However, my right hon. Friend answered questions in the House only yesterday, so the matter could have been raised with him then.
The exemptions service for local post offices is important and, for a long time, the future of local post offices has been debated almost weekly. The Government are providing more and more pensioners and others with opportunities to use their cards. Two million pensioners have taken up the opportunity to get cash from local post offices with the card, which replaces the benefit booklet, and that is a sensible way to proceed.
Dr. Nick Palmer: In my constituency of Broxtowe, Boots has declared that one third of its headquarters work force will be made redundant. Will my right hon. Friend ask the Secretary of State for Work and Pensions to tell the House at the earliest opportunity what steps his Department will take to work with Boots to minimise the impact on the individuals concerned?
Mr. Hain: I will indeed. I accept my hon. Friend's concern, as that is obviously extremely bad news for those affected at Boots. However, the Government have a good record in these matters. The employment service and other relevant agencies have a good record of helping people who unfortunately have lost their jobs to find new ones. Repeatedly—I am not saying that this is true in every case—people have found new jobs, both in my hon. Friend's constituency and elsewhere across the country. When there were job losses under the previous Government people just wasted away on the dole, but now they are being helped into work, with employment rising all the time, as we heard in the announcements only yesterday.
Sir Patrick Cormack: The historic office that you hold, Mr. Speaker, has been unique to this House for 600 years or more. Does the Leader of the House therefore share the concern of many Members, both in this House and in the other place, about the suggestion that there should be a Lords Speaker in the other place? Does he agree that that would cause confusion, not least because the role of such an officer would be very different from that of Mr. Speaker in this House? Will he reflect on those things, give some encouragement to those of us who believe that it would be a retrograde step by the House of Lords, and institute conversations with our colleagues in the other place?
Mr. Hain: I accept the points made by hon. Gentleman. Indeed, there are other concerns about the
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matter, which I have discussed with the Speaker and, as a result, have had the conversations that he requested. There is no question in my mind but that the Speaker of the House of Commons is the Speaker, who is known and widely recognised across the world.
Mr. David Drew: Mr. Speaker, I totally concur.
My right hon. Friend will be aware that this week a report was published on mobile phones and other telecommunications equipment, including masts. Does he agree that that is an important report, so it is right and proper that the House should have the opportunity to look at some of the issues arising from it? In particular, does he agree that some of the commitments made by services such as Airwave about monitoring equipment are not always kept? The issue has caused a great deal of alarm among members of the public, who would like us to take it up. Can he therefore find time for such a debate?
Mr. Hain: I shall certainly look at the matter, which the Government agree is important. We already support a £7.4 million mobile telecommunications and health research programme, which is jointly funded by the industry, but my hon. Friend has raised an issue about which there is widespread concern across the country and, indeed, in the House. He has the opportunity, as do other Members, to apply for a debate. Given the concern that exists in the House, it may be possible to hold an early debate.
Mr. John Wilkinson: The Leader of the House will remember that when the Greater London Authority Bill became law, Her Majesty's Government promised that the House would still hold regular debates on London matters. Is he conscious of the fact that that has not occurred? In view of the burgeoning deficit of Transport for London, which will add to the already hefty precept paid by Londoners, it is time that Parliament debated London matters in the House, not Westminster Hall, as a matter of urgency.
Mr. Hain: As the hon. Gentleman knows, the Minister for London regularly answers questions before the House, and the hon. Gentleman has the opportunity to raise all sorts of issues with him and to apply for a debate. Notwithstanding the House's pre-eminent interest in such matters, he will also understand that, because of devolution, another authority is responsible for running such services and implementing policies. Obviously, adjustments have to be made in the way that we prioritise matters, given devolution, but the Minister for London is accountable and responsible to the House, and that will continue.
Mrs. Jackie Lawrence: Before Second Reading of the Higher Education Bill, will my right hon. Friend find time for a debate on the position of the university vice-chancellors? It is particularly important in view of the scathing comments made at a recent all-party group meeting on the position of the Liberals and Conservatives as being risible and beneath contempt.
Mr. Hain: I would certainly welcome such a debate. Obviously, if it is possible to find time for it before the

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higher education debate that I announced for 27 January, we will consider that. I agree with my hon. Friend that it is important that everyone understands that the vice-chancellors—who, I understand, met an all-party group in the Palace of Westminster only this week—regarded, as she says, with total contempt and as risible the Opposition's policies on that matter. I very much welcome the comments of the hon. Member for Wantage (Mr. Jackson), who said:
"On this issue, the Government is right and there is simply no good reason why the Conservatives should oppose its proposals."
He said that the Opposition's policies
"would deprive almost half a million young people of the opportunity to enter higher education. It is not too late to change course."
I hope that the hon. Gentleman's leader will listen to him.
Mr. Nigel Dodds: In the light of the very serious rioting that took place last night inside one of Her Majesty's prisons at Maghaberry in Northern Ireland, the very serious threats to prison officers' security in their own homes and the threat of possible industrial action arising from that, will the Leader of the House arrange for the Secretary of State for Northern Ireland to come urgently before the House to make a statement on those important matters concerning prisons in Northern Ireland, which could affect stability on the streets of Northern Ireland?
Mr. Hain: I understand the importance of that matter, and I am grateful to the hon. Gentleman for raising it. Northern Ireland Ministers are talking to the Prison Officers Association about those matters. Obviously, they will want to keep the House informed in the appropriate way, and I am sure that they will want to keep him informed about the outcome.
Richard Burden: Will my right hon. Friend find an opportunity in the next week for the House to recognise the death of Tom Hurndall, the British photographer who died on Tuesday night, having been in a coma for several months after he had been shot by an Israeli soldier while trying to rescue Palestinian children in the Gaza strip? If there were an opportunity to have such a debate in the House, we could use it, first, to pay tribute to Tom's bravery; secondly, to pay tribute to the dignity and determination that his family have shown during their ordeal over the past few months; thirdly, to ensure that the charges against the soldier who has been arrested for the shooting fit the severity of the crime and to make representations to Israel about that; and, fourthly, to suggest that all the evidence about that case should be made available to Tom's family. Finally, if we are to honour Tom and his memory, may I draw my right hon. Friend's attention to early-day motion 407, regarding Israel's separation wall?
[That this House calls on Israel to cease immediately the building of its Separation Wall deep within Palestinian territory, which, according to the preliminary analysis by the United Nations Office for the Coordination of Humanitarian Affairs of maps published by the Israeli Government, will be 687 km long and will leave more than
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274,000 Palestinians living in 122 villages and towns either surrounded by the Wall or trapped between the Wall and Israel's internationally recognised borders, some even requiring permits from Israel to continue living in their own homes; notes that the analysis estimates that a further 400,000 Palestinians living east of the Wall will be separated from their farms, jobs, markets, hospitals and schools, and that the Wall will have "severe humanitarian consequences" for 30 per cent, of the entire Palestinian population of the West Bank; contrasts this with the fact that UN figures reveal that 54 Israeli settlements in the West Bank and 63 per cent, of settlers will be on the side of the wall next to Israel, giving Israel control over the richest agricultural land and the aquifer system which provides much of the West Bank's water resources; further notes that the Wall is made up of concrete, razor wire and electronic fences, trenches, motion sensors, guard towers and security roads, that it costs $4.7 million per kilometre and that it violates articles 53 and 147 of the Fourth Geneva Convention, to which Britain is a high-contracting party, which forbids the destruction of property and confinement of persons by an occupier; welcomes the decision of the International Court of Justice to open hearings into the legal consequences of the construction of the Wall; further notes that, whilst Israel needs security, the Wall does not follow internationally recognised borders; insists that it does not become a de facto border for a future Palestinian state; further notes that only a reinvigorated peace process with full international support will stop the violence on both sides, not an 8 metre high wall; and calls on the British Government to bring all available pressure to bear on Israel to cease building this Wall.]
It would probably have meant more to Tom than anything else if we were to play a role in building bridges between Israelis and Palestinians, rather than allowing them to construct walls.
Mr. Hain: This was an absolutely appalling incident and a stain on the record of the Israeli defence force, and I join my hon. Friend in paying tribute to Tom Hurndall and to the dignity of his family, who have suffered gravely over the past few months. On the question of providing evidence to the family, I am sure that my hon. Friend will welcome the fact that Baroness Symons is writing to the Israeli Foreign Minister with the family's request for information, and we will certainly do all that we can to help in this situation.
Sir George Young: When will we have the annual debate on the rate support grant settlement? Is the Leader of the House aware of the widespread disbelief in Hampshire and elsewhere that council tax increases can be held to the level expected by the Government? A very large number of hon. Members on both sides of the House will want to take part in that debate, so will he organise adequate time and separate it from the debate about police resources? Those issues are traditionally discussed in the same debate, but this year they deserve separate debates of their own.
Mr. Hain: Obviously, the issues that the right hon. Gentleman raises—particularly given that he raises them with his authority in the House—will be closely looked at by Ministers. I am sure that he will appreciate

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that his council, along with other councils throughout the country, have had above-inflation increases under this Government, after years of cuts under Conservative Governments. We all want to see a limit on council tax rises—they have been going up at too high a rate—and the Government are working with local authorities and providing the funding that, I hope, will ensure that that happens throughout the country.
Mrs. Ann Cryer: Will my right hon. Friend comment on the usefulness of a debate on the new educational maintenance grant? We could then promote its take-up specifically in the Asian community, which could, in turn, lead to a reduction in the appalling number—300—of girls who are removed, year on year, from Bradford district schools at the age of 12-plus.
Mr. Hain: First, I acknowledge my hon. Friend's strong involvement in this vital area? Further education, especially, has been widely neglected over the decades. It is now being given exactly the priority that it always should have had, and educational maintenance grants are an important part of that. I am sure the issue that she raises—the importance of the Asian community having access to, and knowledge of, those grants—is one to which the Secretary of State for Education and Skills will pay close attention.
Mr. Andrew Mackay: I make no apology for returning to the Prime Minister's role in the Hutton debate when it takes place in the House because, week after week, we fail to get satisfactory answers from either the Leader of the House or the Prime Minister. Is the Leader of the House aware that only two Ministers were interviewed and cross-examined by Lord Hutton—the Prime Minister and the Secretary of State for Defence? So there is an open-and-shut case that they should open and close the debate. The Leader of the House has already partially quoted from column 809 of yesterday's Hansard and Prime Minister's questions, when the Prime Minister said:
"I can assure him that I have absolutely no intention of doing anything other than leading the Government's case on this issue.
That is important".—[Official Report, 14 January 2004; Vol. 416, c. 809.]
I endorse that. In the light of those comments from the Prime Minister, why was the Leader of the House not prepared to tell my hon. Friend the Member for North-East Hertfordshire (Mr. Heald) a moment ago that the Prime Minister would lead in the debate, as well as make a statement? There is absolutely no excuse or reason why he should not lead in the debate as well.
Mr. Hain: May I just say that the repeated way in which the right hon. Gentleman, the shadow Leader of the House and the Leader of the Opposition have sought to question the Prime Minister's integrity is shabby and distasteful? At the appropriate time, there will be announcements about the handling of the debate, as there always are, and about who will open and who will close it and on the other procedures for handling it.
The right hon. Gentleman and the whole House should leave Lord Hutton to continue to complete his report and to publish it in his own way. When he does so, the Prime Minister will be the first up in the House
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to report to the House in the statement, and arrangements for a debate will be announced as soon as it is possible to do so. The right hon. Gentleman will have to hold his breath for that.
Joan Ruddock: My right hon. Friend will have seen reports this week that genetically modified maize could be sown for commercial planting this spring. Does he think that that is a reality? Does he agree that a debate is long overdue, given that the GM science report, the GM economics report, the GM public debate report and the GM report on farm-scale evaluations have all been published without an opportunity for hon. Members to debate those matters in the Chamber?
Mr. Hain: I agree with my hon. Friend that a debate is needed; I have indicated as much before. The latest report adds to the case for having as early a debate as it is possible for the business managers and the Secretary of State to plan. It is important that all these issues are properly evaluated, and I know that there is concern about them right across the House.
Mr. Andrew Rosindell: The Leader of the House will be aware that, today, the Royal Mail is launching the United Kingdom's first ever digital stamp. That means that the traditional stamp can be ditched in favour of a computerised version. Will he arrange for the Secretary of State to come to the House to clarify the concerns of my constituents, who fear that this will mean the ending of the Queen's head on British stamps, and to eliminate the possibility that that could happen?
Mr. Hain: That is fatuous nonsense. The Queen's head will remain on all stamps sold to the hon. Gentleman, to other Members of the House and the public. He will understand that franking goes on—and has gone on for decades—by commercial organisations that do not use the actual physical stamp with the Queen's head on it. He will also understand that even he could move into the modern era and consider digital forms of franking. That is what the issue is about. He should really focus on more important matters.
David Winnick: In view of the remarks of the hon. Member for South Staffordshire (Sir Patrick Cormack) and in the spirit of modernisation, should we not learn from the devolved institutions? Is there not a case for the Government to consider whether the occupant of the Chair in both Houses should simply be called President?
Mr. Hain: No, Mr. Speaker.
Mr. Anthony Steen: In view of the pro-European credentials of the Leader of the House and his belief in open government, is he aware that, on 3 December at the European Scrutiny Committee, we voted to have our deliberative sessions in public? That is a great step forward for the media and the public. They will be able to hear what we are doing. We examine hundreds of pages of directives and other stuff every month, and we want to share them with the public and the media. Is there a problem with that, or could we just have a notice on the door saying, "Open to the public"?
Mr. Hain: I very much welcome the European Scrutiny Committee's decision. [HON. MEMBERS: "Oh."]

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Indeed I do. In fact, I would like to see greater scrutiny of European matters in and by the House. I shall be considering, along with colleagues on the Modernisation Committee, how we can take that forward.
Mr. Bill Tynan: Will the Leader of the House accept that we have a limited time available in which to discuss cannabis reclassification? Will he consider an urgent debate based on the evidence that there seems to be a growing incidence of mental health problems among users of cannabis? Will he do that as soon as possible?
Mr. Hain: Home Office Ministers are aware of the report and they have commented on it. I know that there is concern about this issue, and I am sure that Ministers will listen closely to the points that my hon. Friend makes. He will, of course, have an opportunity to secure a debate on the matter himself.
Mr. Andrew Mitchell: May I strongly support the comments of the hon. Member for Stroud (Mr. Drew) on the need for a debate in the House on the safety and health aspects of mobile telephony following the publication this week of the report by the Government's adviser, Professor Lawrie Challis, the findings of which can only really be described as inconclusive? Such a debate would enable hon. Members on both sides of the House to express widespread concern and also enable us to mount the case for more Government money to be spent on independent research. The research to which the hon. Gentleman referred is largely funded by the industry itself.
Mr. Hain: The hon. Gentleman makes an important point, and I know that he has applied for a private Member's debate on the matter. I hope that he, along with my hon. Friend the Member for Stroud (Mr. Drew), is successful in achieving it. We welcome the publication of the report of the Advisory Group on Non-ionising Radiation on the health effects from radio frequency electromagnetic fields. It is important that we keep this rapidly developing area under review. I know that the hon. Gentleman's constituency concerns are important in that respect.
Jane Griffiths: Will my right hon. Friend make time for an early debate on the atrocious situation in Zimbabwe? In discussions with his ministerial colleagues, will he bear in mind the hideous persecution being meted out to gay and lesbian people in Zimbabwe that has forced my constituent, Neil Noble, to become an asylum seeker?
Mr. Hain: The situation in Zimbabwe is tragic and atrocious. The deterioration of the country under Robert Mugabe's tyrannical leadership just makes everyone want to cry. The people in the country are suffering as they have never suffered before. In fact, they are suffering more than many of them, including Robert Mugabe himself, suffered under the old white minority
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regime. It is time that Zimbabwe changed direction and got back on the road to being the prosperous jewel in the crown of African countries that it once was.
Angus Robertson: Is now not the right time to debate extending the powers of the Scottish Parliament and the National Assembly for Wales? That might give the Leader of the House the opportunity to expand on his damning indictment of the Scottish Executive. Perhaps he could give the House an insight into whether he thinks that the problem is entirely the fault of the Scottish Labour party or whether he also blames its coalition partner colleagues, the Liberal Democrats.
Mr. Hain: This is another bit of nationalist spin joined by the Scottish press and the broadcasting authorities, who have completely misrepresented—as they all too often do—what goes on in the Scottish Executive and the leadership of the Labour party in Scotland. I have made it perfectly clear to those in Wales who want a Scottish parliamentary solution as an alternative to the present democratic settlement that, if they want that solution, they will have to have a referendum. There were tax-varying powers on which the people of Scotland voted in 1997, so there would have to be a referendum on that in Wales. As Scotland has had its own legal system for many years and Wales does not, there is also an issue there as to what is appropriate. Scotland, under the Scottish Parliament, has done very well. It is the case that Wales has done better economically; it has done better than any other economic region of Britain under the present powers of the Welsh Assembly.
I believe that the First Minister in Scotland, Jack McConnell, is doing an outstanding job and that the Scottish Executive are doing a good job for Scotland, with record public investment, record numbers of jobs being created and unemployment coming down. That has all happened under Labour and compares with what happened under the Conservatives when all that was in reverse. If the nationalists got their way, there would be an independent Scotland, and it would become bankrupt.
Geraint Davies: Members of the House are regularly e-mailed with unsolicited pornography. Most recently, there has been a massive increase in illegal child pornography, and that has occurred at a time when the NCH has released a publication producing research linking internet child pornography and child abuse. May we have an urgent debate to push forward action against those who produce child pornography and to link up with action in the United States and in the industry? That should focus in particular on the United States, which is the origin of the transmission of millions and millions of illegal images that are causing crime globally?
Mr. Hain: I agree with my hon. Friend. It is absolutely revolting and obscene that we, and citizens the length and breadth of the country, including children, should receive such outrageous pornography on our e-mail systems. That is why the House authorities are monitoring the situation daily to try to block it and to put firewalls in place that stop it. He can be reassured by

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that and by the fact that the Government are considering how we can stop the flow—electronically, as it were—of such awful material across the Atlantic.
Mr. Eric Forth: When the Leader of the House had his little whinge about Opposition days, did he not let the cat out of the bag? He implied that Government Members of Parliament really do not want to be here, want to have something utterly predictable in their diary and are incapable of preparing for a debate unless they are given lots of time to be briefed about it. When will we get the spontaneity back into our proceedings and when will the Government and the Leader of the House, in particular, allow greater spontaneity in questions and in debates? Will he please drop this pathetic attitude on behalf of his right hon. and hon. Friends that, unless they are briefed well in advance and know exactly what will happen, they cannot function as Members of Parliament?
Mr. Hain: I do miss the right hon. Gentleman as shadow Leader of the House. He was great fun. His successor is doing a great job but the right hon. Gentleman provided extra spice and interest for us all. Having said that, I find his specific question extraordinary. He quite rightly wants advance notice of Government business but wishes right hon. and hon. Members to be denied knowledge of forthcoming business—perhaps on a Tuesday or Wednesday.
Mr. Forth: Yes.
Mr. Hain: So the right hon. Gentleman thinks it is a good thing, even if Members cannot plan their diaries and perhaps have to cancel appointments because an important issue has arisen on which they want to speak? It is not about Ministers but about right hon. and hon. Members having notice—as they always have with both Conservative and Labour Oppositions in the past. I hope that the welcome practice announced today will continue.
Julie Morgan: Is my right hon. Friend aware that the Welsh Assembly voted yesterday to end the defence of reasonable chastisement in relation to parents hitting their children? Under the Assembly's present powers, it cannot do anything more, but will my right hon. Friend urge the Minister for Children to incorporate that policy into the forthcoming children Bill?
Hon. Members: No.
Mr. Speaker: Order.
Julie Morgan: Does my right hon. Friend agree that it cannot be right that adults have greater protection than children?
Mr. Hain: I was aware of the vote to my which hon. Friend referred. The Minister for Children is carefully considering that issue.

Points of Order
1.11 pm
Dr. Julian Lewis: On a point of order, Mr Speaker. I refer not to the presence of the current demonstration in Parliament square but to the volume of noise periodically projected into Parliament—such that right hon. and hon. Members cannot work peacefully in their own offices. When I spoke to the main protestor in Parliament square last night, he was frank enough to admit that the amplification is so loud because the small number of demonstrators want their protest to be heard above the traffic noise and penetrate these buildings. Does the Leader of the House know of any moves to ensure that Westminster city council which tells me it cannot do anything about it, or the police, who feel that they are not allowed to do anything respectively—can stop the pathetic failure to allow right hon. and hon. Members, staff of the House and residents to carry on their business undisturbed?
Mr. Speaker: I, too, am concerned about the noise to which the hon. Gentleman refers. I understand that matter has been taken up with the Leader of the House and the Procedure Committee. I hope that it can be resolved, because the demonstration goes beyond the normal peaceful protest in which I have been involved as a trade unionist and political activist—as have other right hon. and hon. Members.
Mr. Michael Jack: On a point of order, Mr. Speaker. I understand that, tomorrow, the performance and innovation unit at Downing street is to present the Prime Minister and senior Ministers with what is described as an audit of the Government's performance. As that document will have been produced using public funds, will it be possible to ensure that a copy is placed in the Library and is made available in the Vote Office?
Mr. Speaker: Why does the hon. Gentleman not raise that matter at Business Questions next week? Perhaps he will be at the front of the queue.
Mr. Hain: Further to the point of order raised by the hon. Member for New Forest, East (Dr. Lewis), Mr. Speaker. I agree with the sentiments that you expressed in respect of the situation outside the Palace. We shall proceed to deal with it as quickly as we can.

Privilege
1.14 pm
Mr. A. J. Beith: I beg to move,
That the First Special Report from the Constitutional Affairs Committee (House of Commons Paper No. 210) be referred to the Committee on Standards and Privileges.
I am grateful to you, Mr. Speaker, for confirming that the report raises an important matter and for giving it precedence over all other business today. I hope that we can deal with it expeditiously, so that right hon. and hon. Members can go on to deal with the Bill set down for debate this afternoon. However, the report is important because it concerns the freedom of witnesses to give evidence to the House and its Committees without fear of penalty or punishment. That freedom has been reasserted by the House on many occasions.
The Constitutional Affairs Committee conducted an inquiry last year into the Children and Family Court Advisory and Support Service—a non-departmental public body whose board was appointed by the Lord Chancellor. Ms. Judy Weleminsky, a CAFCASS board member, submitted written evidence on her own behalf, much of it critical of the management of CAFCASS. She received advice that she was protected by parliamentary privilege when giving evidence to the Committee.
Ms. Weleminsky's evidence, along with evidence from many other witnesses, greatly assisted the Committee in reaching its conclusions—which were severely critical of CAFCASS management, of the organisation's failure to meet its responsibilities to vulnerable children affected by court proceedings and of aspects of the Lord Chancellor's dealings with CAFCASS.
One of the Committee's recommendations was that a fundamental review of the board of CAFCASS should be undertaken. The Government accepted that and other recommendations and commissioned a review. The chairman of CAFCASS had already resigned. Following the review the Lord Chancellor asked all the remaining board members to resign. Ms Weleminsky declined to do so.
In December, Ms Weleminsky received a letter from the Lord Chancellor that suspended her from duty as a board member and indicated an intention to dismiss her, on grounds that included an allegation that she had
"failed to behave in a corporate manner".
Accompanying the letter was a document to which the letter referred—a review by a senior civil servant in the Department of Constitutional Affairs, Mr. David Crawley, of a dossier submitted by the former Chairman of the CAFCASS board, Mr. Hewson, before he resigned. The first of the six specific allegations set out in the document that accompanied the Lord Chancellor's letter was that
"Ms Weleminsky presented separate evidence to the Select Committee looking into CAFCASS, in a manner which undermined the organisation."
The document concluded that that evidence
"was (and was intended to be) in conflict with the evidence that CAFCASS itself had previously submitted to the Committee".
The document goes on to list other allegations, which Ms Weleminsky disputes but which are not part of the Committee's concern in relation to today's motion. Our
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concern is that the words to which I have referred, even if they are combined with other allegations, could amount to a serious case of interfering with a witness.
As soon as that matter came to my notice I wrote to the Lord Chancellor expressing grave concern and asking for an explanation. After taking advice, the Lord Chancellor replied that his decision to suspend Ms Weleminsky did not
"depend wholly, or in part, on the fact that she had given evidence to the Select Committee…I make it clear that no disciplinary action can be based on the fact of giving evidence to the Select Committee"
but further added that
"having regard to the reference in Mr. Crawley's dossier to this allegation, I should have made this clear".
He went on to give his view that
"even ignoring this allegation, suspension was clearly justified".
The Lord Chancellor's letter to Ms Weleminsky also reveals that he was considering her dismissal on the basis of allegations in the dossier before the review and before the decision to ask the entire board to resign. That correspondence is set out in appendices to the Committee's special report.
Mr. Douglas Hogg: Even if the Lord Chancellor is correct when he says that he did not take any account of the evidence given to the Select Committee, it is deeply worrying that a senior civil servant—no doubt reflecting the general understanding within the civil service—should have thought that giving evidence to a Select Committee was a proper subject for disciplinary action.
Mr. Beith: That is one of the reasons for the Committee's wish that the matter should be considered by the Committee on Standards and Privileges. Personally, I am not at all surprised that any witness receiving the Lord Chancellor's original letter together with the document containing the allegation should form the impression that they were being punished, at least in part, for giving evidence to a Committee of the House. Having considered the Lord Chancellor's reply, my Committee concluded that
"the process of disciplining Ms. Weleminsky, starting with the dossier prepared by Mr. Hewson, continuing with the review of the matter by Mr. Crawley and ending with the letter from the Lord Chancellor to Ms. Weleminsky and the supporting document might be regarded as a prima facie breach of privilege."
Committees of the House that seek to carry out effective scrutiny depend on being able to assure witnesses that they can give evidence freely, without fear of penalty. It needs to be clearly understood in Departments, public bodies and elsewhere that if that freedom is found to be threatened, it will be protected.
The Committee on Standards and Privileges has the power to establish whether a breach of privilege has taken place and, if so, to make whatever recommendations it believes appropriate. Accordingly, I ask the House to refer the matter to the Committee on Standards and Privileges.
1.20 pm
The Leader of the House of Commons (Mr. Peter Hain): I congratulate the right hon. Member for Berwick-upon-Tweed (Mr. Beith) on the typically even-handed manner in which he moved the motion.

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I want to make my position clear at the outset. With the leave of the House, I am happy to respond to any appropriate points that are made in the debate. The Government fully support the motion because it is right for the House to refer possible breaches to the Committee on Standards and Privileges and we welcome its scrutiny in this case.
The Government fully respect the privileges of the House and we will uphold them to the end. They are crucial to the independence of Parliament and the strength of our democracy. We are strongly committed to Select Committees. We have taken steps to increase their independence and effectiveness and we fully accept the need for witnesses to be able to speak out to Select Committees without fear or favour under the protection of parliamentary privilege.
The Government regard any possible breach of privilege with the greatest seriousness and look to the Committee on Standards and Privileges to establish whether such a breach has occurred in this case.
Mr. Hogg: I hope that the right hon. Gentleman will tell the House what directions will be given to the civil service to ensure that never again will a senior official regard giving evidence to a Select Committee as an appropriate ground for disciplinary action.
Mr. Hain: Although the right hon. and learned Gentleman has raised a point that is important to him, it would be wrong of me to anticipate the Select Committee's report.
It is not appropriate for me to deal here with the substance of the case. I simply draw attention to the statement that the Secretary of State for Constitutional Affairs made in his letter to the Committee. It appears as appendix 3 of the Committee's special report and states that
"it would be quite wrong to discipline someone in her position for having given evidence to the Committee, and I would not do so…I completely understand that individuals must feel free to give evidence to Select Committees …the fact of her giving evidence cannot form part of any action against her."
My right hon. Friend would welcome an investigation by the Committee on Standards and Privileges to clarify the matter and will, of course, provide whatever further information it requires to reach its conclusions.
1.22 pm
Mr. Oliver Heald: I thank the Leader of the House for the welcome assurance that the Government will support the motion. I join his tribute to the Chairman of the Select Committee, the right hon. Member for Berwick-upon-Tweed (Mr. Beith), for his presentation of the motion.
As the Leader of the House said, it would be wrong to prejudge the outcome. However, in supporting the motion, I emphasise that the allegation that Lord Falconer threatened a witness with dismissal for giving evidence to Parliament under the protection of a Select Committee is serious. It should therefore be referred for investigation. The ministerial code makes it clear that Ministers should require civil servants who give evidence before parliamentary Committees to be as helpful as possible in providing accurate, truthful and
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full information. It cannot be said that threatening someone's job for giving evidence to a Committee fulfils that standard.
The allegation would be serious if it were made against any employer, but it is doubly so when it involves a Minister who is also the most senior legal figure in the country. It is worth recalling that the Lord Chancellor has a parliamentary role in that he is the occupant of the Woolsack—the presiding officer of the House of Lords.
Mr. Speaker: Order. I like to give Front-Bench spokesmen leeway but we must be careful. We have a motion to put the matter before the Committee on Standards and Privileges. It is for the Committee to judge it and talk about the individuals involved. The matter will then revert to the House, when the hon. Member for North-East Hertfordshire (Mr. Heald) and every other hon. Member will have the freedom to argue the case about who was right and who was wrong. We must be careful at this stage.
Mr. Heald: I fully accept your ruling, Mr. Speaker. The reason for setting out the seriousness of the allegation is simply to emphasise that it should be referred—
Mr. Clive Soley: On a point of order, Mr. Speaker. I welcome the way in which the right hon. Member for Berwick-upon-Tweed (Mr. Beith), who chairs our Committee, put the case. It is important to get the case right. There are issues about the civil service and there may be matters about Ministers to consider. However, we should not judge them now. It is for the Committee on Standards and Privileges to determine the matter and we should debate it subsequently if necessary. Frankly, the less said the better at the moment. I ask you, Mr. Speaker, to rule that we simply refer the matter and get on with the business.
Mr. Speaker: I have already ruled on the matter. Again, I plead with the hon. Member for North-East Hertfordshire and others who are seeking to catch my eye to be very careful.
Mr. Heald: I fully accept that, and I pay tribute to the hon. Member for Ealing, Acton and Shepherd's Bush (Mr. Soley) for his conduct of the matter in Committee.
I want to make two other points. First, as the right hon. Member for Berwick-upon-Tweed said, the Committee and the Government accepted the points that were presented. Consequently, CAFCASS, which provides important services to vulnerable children, could be reformed in the manner for which the witness had campaigned for a considerable time.
The lady has been suspended on the ground that she was not corporate enough and that confidential information was breached. The Committee will have to explore that because the Nolan rules on the conduct of members of public bodies are clear and include nothing about having to be corporate or to respect information.

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They are about independence, openness, accountability and sticking up for one's views as a member of a public body. On that basis, we strongly support the motion.
Sir Patrick Cormack rose in his place and claimed to move, That the Question be now put, but MR. SPEAKER withheld his assent, and declined then to put the Question.
1.27 pm
Keith Vaz: I shall be brief, but I speak as a member of the Constitutional Affairs Committee. I fully endorse the words of the Chairman, who put the case very even-handedly. It is important that the issue does not distract from the excellent report on CAFCASS that the Select Committee produced. It showed the huge failings in that body's operation and resulted in a rare example of the Government doing what a Committee wanted it to do, in this case changing the way in which the board operated and making a fresh start.
To counter the point that the hon. Member for North-East Hertfordshire (Mr. Heald) made, the Lord Chancellor's letter of 8 January, which is published in the documents, makes it clear that the fact that the matter has come before the House has nothing to do with the way in which the witness gave evidence. He states that three times.
I hope that the Committee will consider confidentiality. When witnesses sign confidentiality clauses or appear in a confidential relationship and subsequently give evidence to a Committee, it should be clear that Parliament overrides that confidentiality. It has not been clear in the past, and the referral gives the Committee an opportunity to pronounce on that.
1.28 pm
Mr. Eric Forth: In deliberating on whether I should support the motion to refer the matter to the Committee on Standards and Privileges, I inevitably have to make some judgment about the contents of the report. It would be difficult for any hon. Member to make a decision about the relevance of referring the matter without making at least some judgment about elements of the report.
Several matters are involved, but two of the most salient are the political aspect, which is the Lord Chancellor's involvement, and the one that my right hon. and learned Friend the Member for Sleaford and North Hykeham (Mr. Hogg) raised concerning the conduct of a senior civil servant.
My plea, which I hope it is legitimate to make in this debate, is that when the Committee on Standards and Privileges comes to examine the matter―I hope that it will, as, on balance, I think I support the motion—it will feel free to examine the political aspects involving the Lord Chancellor, notwithstanding his own phrase in the document before us, that
"I completely understand that individuals must feel free to give evidence to Select Committees",
for which I suppose we must be grateful. I also hope that the Standards and Privileges Committee will spend as much time as it feels is necessary examining the role of
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the civil servants involved and, as has already been touched on, the perception that civil servants have of the role of this House and its Select Committees. Surely that is what is really at stake here, and we should therefore be grateful to the Committee chaired by the right hon. Member for Berwick-upon-Tweed (Mr. Beith) and to you, Mr. Speaker, for allowing us to pursue the matter.
If the examination shines a light on the attitude of senior civil servants to members of the public, or of public bodies, giving evidence to Select Committees, that will be a matter of the utmost gravity. It is very important for the Committee on Standards and Privileges to take all the time it needs, and to go as far as it needs, in examining the ramifications of the case. It might look like just one case, and it might or might not be isolated, but it sets the alarm bells ringing over the attitude of the Government, in political and administrative matters, to the Committees of this House and to the relationship between the Executive and the legislature. This case has the potential to be that important, so I urge the Committee to treat it with the utmost gravity and to go into it in whatever detail is necessary.
1.31 pm
Mr. Richard Shepherd: I want to express my gratitude to the right hon. Member for Berwick-upon-Tweed (Mr. Beith) for making such a succinct and powerful case in moving the motion. I agree with him, and with the Leader of the House and my hon. Friend the Member for North-East Hertfordshire (Mr. Heald), that this matter is important. It touches on something essential to the functioning of this House as a corporate body, if I may pick out language from the report. We have to be assured that any witness coming before a Select Committee is protected, and I recognise, as did the Government when they supported the Public Interest Disclosure Act 1998, that the concept of whistleblowing is important.
The circumstances clearly laid out in the report show that the right hon. Member for Berwick-upon-Tweed and the Constitutional Affairs Committee have grasped that, because they have brought the matter to the House to ask for it to be referred to the Standards and Privileges Committee. Like everyone who has spoken so far, I support the motion, which is in the interests of this House and important for those who do not understand the mysterious word "privilege". Privilege enables people to give their knowledge freely and honestly, without retribution, better to inform us in our judgments. Privilege in this instance is a protection not of our vanity but of the wider public interest. I know that the Government have always recognised that, in this and in the preceding Parliament, and that they work closely with Public Concern at Work. The issues surrounding that public interest that are raised are fundamental to privilege in this House.
1.34 pm
Peter Bottomley: Judy Weleminsky and the others who gave evidence to the Constitutional Affairs Committee when it was considering the Children and Family Court Advisory and Support Service will know that what they said was

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important not only to the Committee's report but to the way in which the Government are taking forward the important work that CAFCASS is doing. We should recognise, as have others, that the Government have paid attention to that report, which was important to the children whose interests are supposed to be represented by CAFCASS, and to their futures. That is the underlying point from the Constitutional Affairs Committee.
From the point of view of the House, the issues have been well spelled out. I should like to pick up on the question, posed by the hon. Member for Leicester, East (Keith Vaz), of when confidentiality agreements can be overridden in the public interest and in Parliament's pursuit of information. This time, that is an issue not for the Standards and Privileges Committee but for the Public Administration Committee or some similar Committee. I would ask that Committee to consider the very tight rules that the new Ofcom board is laying down for its members. I do not want to criticise that board, but that is an illustration of how tightly some such rules are now written. Being corporate and acting in solidarity can matter, but there are times when that needs to be overridden. It is worth having a serious investigation into that, which goes beyond this investigation into privilege.
There are some interesting questions on this issue. For example, from what board meetings has this board member been suspended, if that board has resigned? That takes us somewhat into Alice in Wonderland territory. We need to ask one simple question. If that lady had not refused to resign, would the House have known that evidence in the Department had come from the former chairman of CAFCASS—whom some of us believe should have resigned when our first Committee report came out—that showed that people were fingering her for the act of making information available in giving evidence to the Select Committee?
Keith Vaz: Before the hon. Gentleman strays into the details of the case, may I ask whether all the other members of the CAFCASS board have resigned?
Peter Bottomley: I cannot confirm that. I know that the board members have agreed to resign, but I am not competent to say whether the board no longer exists, and it is not relevant to the debate. I am in line with those who do not want to go into the detail, but I want to make the broader point that unless Ms Weleminsky had refused to resign, the House would not have known that the evidence was available, had been given by the outgoing chairman, was in the hands of officials and was listed as point No. 1 by the reviewing official from the Scotland Office. It is only because she declined to resign that we know that. She deserves praise for making it possible for us, as a House, to know what was going on. That is important because every week, officials, members of public bodies and others have to consider whether to make information available. Despite some embarrassment and difficulty, they have to overcome their fears. That is why the point about privilege is important.
Mr. Soley: The hon. Gentleman is not helping the situation, although he did a very good job with the rest of us on the Constitutional Affairs Committee
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yesterday. It is the job of the Standards and Privileges Committee to go into this sort of detail. It is for the House to debate that when the Committee has reported, if we think that that is appropriate. To go into such detail now is in effect to put on trial other people as well as the lady concerned. That is just not fair.
Peter Bottomley: At the risk of upsetting the hon. Gentleman, I think, bluntly and flatly, that he is completely wrong. I do not care whether I am the only person in the House who makes this point, but unless that lady had refused to resign, we should not have known what was disclosed in the documents. That is the point that I am trying to make, and on that point I shall end my speech. We actually depend—[Interruption.] This might be a laughing matter for some, but that does not serve this House.
We relied on that lady to give evidence in the original inquiry, and we would not have known what evidence against her was being accumulated if she had not refused to resign. My point is no greater than that, and it is not partisan. The hon. Member for Ealing, Acton and Shepherd's Bush (Mr. Soley) will recognise that I have not mentioned the Lord Chancellor or gone into details about him. I have made the sole point that we have this information because of her actions.
1.39 pm
Kevin Brennan: I want to make a few brief remarks as a member of the Public Administration Committee. On the remarks made by the hon. Member for Worthing, West (Peter Bottomley) and my hon. Friend the Member for Leicester, East (Keith Vaz) on confidentiality clauses, the Public Administration Committee is taking forward an inquiry into inquiries, and this matter may fall within its ambit.
One of my constituents approached me about the Chairman of the Committee's inquiry because she was giving evidence. She wanted to ask my advice as her Member of Parliament about how she should approach giving evidence to the Committee on the CAFCASS inquiry. I told her that she should give her evidence truthfully, without fear and in the knowledge that there would be no repercussions for her professional career. I am sure that every hon. Member would have given the same advice to any constituent who approached them on this matter. That is why I welcome the statement from the Leader of the House that the Government support the reference to the Standards and Privileges Committee. At this point, it would be inappropriate for us to explore in any further detail the minutiae of the case.
1.40 pm
Mr. Clive Soley: I had not intended to speak and it is perhaps a pity that people have spoken to the degree that they have, but I now feel the need to say that an important, central and narrow point was dealt with by the Committee on Tuesday and to tell the hon. Member for Worthing, West (Peter Bottomley), who was helpful in my view and absolutely right in that Committee to argue the cases that he did, that that narrow and specific point is that no citizen of the United Kingdom should face any fear or favour over giving evidence to a Select Committee. That is the core point.

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Around that central point in this case, there are many arguments about what was happening in the background. It is the job of the Standards and Privileges Committee to highlight what needs to be said there and to produce the report. It may be right to say many of the things that are being said now, but to say them about other people who are not in a position to answer for themselves at this stage, when we have not had the benefit of the report, is wrong.
That is why, very simply, we should refer the matter on this narrow issue knowing—I have full confidence in the Standards and Privileges Committee in this respect—that the Committee will do all the background work necessary to focus on the underlying factors, including the other members of the board, civil servants and the Minister. When the Committee has done that and produced its report, it may be important and necessary to have a debate in the House. If so, that will be the time to speak. This is not the time to finger other people or to start putting them on trial. That is wrong.
1.42 pm
Sir Patrick Cormack: All I want to say is that, clearly, this is a serious matter. I have every confidence in my right hon. Friend the Member for North-West Hampshire (Sir George Young) and his Committee, but I want to express the hope that they will be able to deal with the matter not only thoroughly, but expeditiously, so that the substance can be debated at the earliest reasonable date.
Question put and agreed to.
Ordered,
That the First Special Report from the Constitutional Affairs Committee (House of Commons Paper No. 210) be referred to the Committee on Standards and Privileges.

Orders of the Day

  Human Tissue Bill
  [Relevant document: The First Report from the Culture, Media and Sport Committee, Session 2003–04, Cultural objects: developments since 2000, HC 59, is relevant.]
  Order for Second Reading read.
  1.43 pm
  The Minister of State, Department of Health (Ms Rosie Winterton): I beg to move, That the Bill be now read a Second time.
  The origins of the legislation lie in the distress, grief and anger felt by families in Bristol and Liverpool when they discovered that the organs of their deceased loved ones had been retained without consent. The Bristol, Alder Hey and Isaacs inquiries demonstrated that that had taken place on a large scale. It was a tragedy for the families affected and it was unacceptable. The aim of the legislation is to ensure that it will not happen again.
  The Bill has five key functions. First, it will ensure that no human bodies, body parts, organs or tissue will be taken for research or other specified purposes without the consent of relatives or patients. Secondly, it will prevent a recurrence of the distress caused by the retention of tissue and organs without proper consent by providing safeguards and penalties. Thirdly, it will improve public confidence so that people will be more willing to agree to valuable uses of tissue and organs for research and transplantation.
  The Bill will also improve professional confidence so that properly authorised supplies of tissue for research, education and transplantation can be maintained and improved. Finally, the Bill will allow national museums to repatriate human remains in response to claims from the descendants of indigenous people whose remains are held in museums.
  Dr. Brian Iddon: There is a lot of difficulty over the phrase "appropriate consent" in the Bill. As my hon. Friend has already referred to consent, without using that phrase, will she expand on and explain to the House exactly what the Government mean by "appropriate consent"?
  Ms Winterton: If my hon. Friend will bear with me, I will come to that point later.
  In 1999, at the public inquiry on children's heart surgery in Bristol, it emerged that it was commonplace for children's hearts and other organs to be retained post mortem without the parents' knowledge or consent. The subsequent Alder Hey inquiry, the Isaacs inquiry and the chief medical officer's 2001 census left us in absolutely no doubt as to the scale on which tissue and organs were being retained without consent.
  Those reports showed that that practice was not limited to particular hospitals or to children's post-mortems. More than 100,000 hearts, brains, lungs and other organs of children and adults were being kept. In Northern Ireland, the human organs inquiry confirmed that similar practices had occurred there. Part of the tragedy was that, ironically, in many cases the families

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  concerned would readily have accepted the use of their loved ones' tissues or organs for medical research if only they had been asked.
  Mr. Martyn Jones: My hon. Friend will be aware of the Valentines, a family in my constituency whose daughter Kayleigh was subject to the problems at Alder Hey. They had three lots of organs returned to them, which has made them distraught over 11 years. Through me, can she assure them that the Bill will insist on prior informed parental consent in such circumstances so that this never happens again?
  Ms Winterton: Yes, I can assure my hon. Friend that that will be the case, particularly because we are very aware of exactly the type of case that he has highlighted. It is difficult for us in the House to imagine the distress that families such as the one in his constituency have been through. That is why we are introducing the legislation. He is right in that post-mortem practice that is unacceptable in today's society had developed over many years. While practice was directed at supporting medical knowledge and research, it failed to respect the interests of families in the way that he described. It had become routine for tissue taken post mortem to be kept for archives, research and education, but without proper discussion with those close to the deceased.
  Rev. Martin Smyth: The Minister referred to Northern Ireland and she is right that people would have been prepared to give permission. In a particular case in my constituency, people gave permission on certain organs, but no more. However, that was not accepted and, later on, they were horrified to discover not only that things had been done against their wishes, but that the residue was sent back to them separately, leading to three separate interments.
  Ms Winterton: That is exactly the sort of situation that has led to continuing distress for many families, which is why we want the legislation to be specific. The guidance that will be issued will make it clear that relatives should be given the maximum information on exactly what tissues or organs are to be used.
  Mr. Andrew Lansley: As the Minister is helpfully explaining circumstances that gave rise to this Bill, it might help if she were to include circumstances in which consent has not simply not been sought or given, but in which organs were retained when it was the deceased's express wish that they be buried intact for religious reasons. That occurred in relation to Mr. Isaacs, the subject of the Isaacs report, and in relation to the husband of one of my constituents, who was also referred to in the anatomy inspector's report. We must deal with that problem.
  Ms Winterton: As I shall say later in my speech, Mrs. Elaine Isaacs, worked extremely hard to highlight that case. The Isaacs report showed that that was one of many occasions on which that had occurred, and that is another reason why it is important that we introduce this legislation, after having considered all the different circumstances that could apply.
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  Following the various reports that I have highlighted, we asked the chief medical officer, Sir Liam Donaldson, to make recommendations on the retention and use of human tissue and organs. Sir Liam reported in January 2001 and made 17 recommendations, all of which we accepted. Those recommendations were also formally accepted by the chief medical officer for Wales, and the National Assembly has worked closely with the Department of Health and other stakeholders in pursuing that agenda.
  Liz Blackman: I listened carefully to an interview that my hon. Friend gave on Radio 4 this morning with a member of the scientific fraternity. Can she assure me that during the passage of the Bill she will resist any attempt to soften the guidance and protocols in relation to the removal of tissue as well as organs, and that consent will also remain the watchword in that regard?
  Ms Winterton: I can give my hon. Friend that reassurance. As I shall say later, we have consulted extensively with the medical research community and the scientific community in putting together the proposals in the Bill. As I am sure she knows, the Bill encapsulates best practice that is already taking place. We do not expect to move away from the principle of consent that is enshrined. What most affects the medical and scientific community in research is the current situation, in which the law is not clear. The Bill clarifies the law and enables further research to go ahead. It gives the public and the research community confidence to be able to proceed as they wish to do.
  Dr. Andrew Murrison: Notwithstanding the Minister's remarks and those of the hon. Member for Erewash (Liz Blackman), does she accept that, in the minds of the general public, a clear distinction exists between blocks and slides and whole organs, and that that needs to be reflected in the Bill?
  Ms Winterton: Yes, a certain amount of discussion has taken place, as the hon. Gentleman knows, about the definition of tissue and organs. It was felt that defining that too closely could cause confusion. We believe that our approach, and the guidance that will be issued by the Human Tissue Authority, will make that clear.
  In implementing Sir Liam's recommendations and in making other changes, we have worked closely with professional and family support groups. I want to mention particularly the members of the national committee on organ retention, PITY 2—Parents who have Interred their Young twice; other support groups, including the Relatives Reference Group in Northern Ireland; and, as I said earlier, the tireless work of Mrs. Elaine Isaacs. I also thank the members and president of the Royal College of Pathologists, who recognised the need for change and have taken clear and positive steps forward. With their help and that of others, we have already achieved a lot.
  In April 2001, we established the Retained Organs Commission, which has provided advocacy, overseen the return of organs and tissue to families and given guidance to trusts. It has carried out admirably the most difficult of tasks in the most difficult of circumstances,

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  and I pay tribute to the chair and members of the commission for their dedication and commitment. We have published guidance and consent forms for post-mortems. We have given advice that clarifies the law as it currently stands. We have set in train a programme of work that includes providing information and support to bereaved families. We are supporting further training and development for health professionals so that the practices and principles that underlie the Bill can be taken up fully in future practice. Parallel work is being undertaken in Northern Ireland, and in Wales we have focused on the establishment of a network of trust co-ordinators to facilitate all aspects of change in anticipation of the Bill.
  The underlying principle of the changes is informed consent. Much has already been done, but the chief medical officer recommended that there should be a comprehensive review of the law relating to the whole area of the use of human tissue, from the living as well as the deceased, and its use for transplantation, research and other purposes, such as donation for teaching and education.
  Mr. Tam Dalyell: What is the time scale of this review? When are we likely to have any guidance on the question of presumed consent?
  Ms Winterton: The review to which I refer is the review that the chief medical officer asked us to conduct. That has now been completed, and its form is within the Human Tissue Bill that we are considering today. With regard to the issue of presumed consent, clearly, that has been given serious consideration. The principle of this Bill, however, is informed consent.
  We have looked closely at the experience of other countries with presumed consent, and while there may be a legal framework of presumed consent, the practice in all countries—Spain is highlighted as a country in which presumed consent is considered to have led to increased rates of organ donation—is that relatives are asked for their permission for organ donation to go ahead. If they object, that permission is not given. It is also necessary to approach relatives for health screening purposes, in case anything in the recent history of an individual could lead to infection if an organ were given to another person.
  The evidence that has emerged is that the structures that are set in place are what enable organ donation to happen: for example, having nurses or others who can approach relatives at critical points to secure organ donation. We have used the example of places such as Spain in our transplant framework, we have set in train those structures in this country, and we are already seeing improvements in organ donation rates. All the evidence is that that is the way to improve organ donation, and not through a system of presumed consent.
  Mr. Desmond Swayne: The Minister rightly stresses the importance of informed consent. What measures is she taking to ensure that more people give that consent? We could do much more to increase the number of people on the donor register. And what can be done to give effect to consent? Many
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  organs are wasted because action is not taken quickly enough following deaths. Current common law does not allow some forms of elective ventilation; perhaps, in certain circumstances, they could be granted legislative approval.
  Ms Winterton: We aim to have 16 million people on the register by 2010. Moreover, the Bill contains measures allowing organs to be preserved so that relatives can be approached within a specific period, and others providing that the wishes of those who have indicated that they want their organs to be donated must be respected. We must deal with the practicalities, however, and relatives will always be asked for information about a person's recent social history. We cannot claim that the Bill will solve everything, but it does contain provisions relating to the issues raised by the hon. Gentleman.
  Mr. Kenneth Clarke: Surely the Spanish experience shows that a system of presumed consent can be operated in an entirely sensitive way, and that families can be consulted and their wishes considered, but on a different basis from that which obtains here. The Spanish system assumes at the outset that there are no strong objections, which has resulted in a rate of cadaver donations more than twice as high as ours. The change was not drastic, but it has proved to be very significant. Meanwhile, we are left with one of the worst records in western Europe: we have a serious shortage of organ donors and donations.
  Ms Winterton: The right hon. and learned Gentleman assumes that the legal framework in Spain has brought about the current position there. The former director of the National Organ Commission in Spain has clearly stated that the increase in the number of donations has been achieved not by anything to do with presumed consent, but by the structures that we are replicating here.
  The right hon. and learned Gentleman should also bear in mind that following outrage among some families about practices that had taken place, France returned to a system of informed consent. Some people felt that consent might have been presumed but not verified, which caused enormous distress. We strongly favour the principles of informed consent underlying the Bill, combined with the other measures that I have described.
  Dr. Evan Harris: I hope the Minister will accept that there is some debate about her recitation of history in the context of France, and also that there is a genuine argument to be had about presumed consent and opting in versus opting out. Many professionals believe the evidence suggests that it is a significant factor.
  The system proposed by, among others, the British Medical Association, is used in Belgium, where there is strong evidence that it has made a difference. It does involve relatives being asked for the social history, so it is a straw dog otherwise, and strong objections are taken into account under that system of presumed consent.
  Ms Winterton: As I have said, relatives' objections are always taken into account and are rarely overridden.

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  We are talking about the rights of individuals, not just those of the state. The state does not own a human body; nor do doctors or scientists. It is up to individuals to choose whether to make this important gift, for it is a gift. We must respect their wishes. We must give them as much information as possible about the benefits of organ donation, but ultimately it is a matter of individual choice. We must empower people to make that choice, but we do not feel that it is for the state to dictate, or to presume that it has a right to someone's body if that person does not want to proceed.
  As I have said, there was considerable uncertainty about the law, and we conducted a great deal of consultation. In July 2002, jointly with the National Assembly for Wales, we published the consultation document "Human Bodies, Human Choices". We published the results of our consultation with a wide range of interested groups and individuals in April 2003, and presented broad legislative proposals in September. We then held a further round of stakeholder meetings with families, clinicians, researchers, heads of royal colleges and anatomic and other organisations including the BMA, the Retained Organs Commission, the Wellcome Trust, UK Transplant, the Human Genetics Commission and the National Assembly's organ retention advisory group.
  Mr. Lansley: The Minister will know that in April 2003 her predecessor, responding to a debate in the House, undertook that a draft Bill would be published before the summer recess. Notwithstanding the Minister's belief that the Bill clarifies the law, it has not been clarified as much as many people—including members of the organisations she just mentioned—hoped it would be. Pre-legislative scrutiny is designed expressly for that purpose. Why was a draft Bill not published for pre-legislative scrutiny, as was intended?
  Ms Winterton: I know it was hoped that time would be found for the publication of a draft Bill, but unfortunately that was not possible. That is why we published our broad legislative proposals in September, and held a further round of meetings. The organisations referred to by the hon. Gentleman, such as family support groups, want us to get on with establishing a legislative framework. The House will have an opportunity to debate the proposals, and they will be scrutinised in Committee. Given the broad consensus that emerged during extensive consultations, we decided that this was the best way of making our proposals law as quickly as possible. As a result of that work, we are proposing the Bill today.
  Part 1 deals with consent. We propose a comprehensive framework in which principles of consent will apply to all medical uses of human bodies, organs and tissue and to public display. We can therefore move forward in the knowledge that proper legal and ethical standards will apply to all circumstances in which tissue can be kept and used for the public benefit. The same principles will apply to the removal, keeping and use of tissue following post-mortem, and to the keeping and use of tissue from living patients. Except to the extent necessary to maintain the integrity of the coroner's investigation or the criminal justice system, the decision will lie first and foremost with the individual.
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  The role of the family or person closest to the deceased, where the individual's wishes were not given before his or her death, will be made clear and explicit, and there will be offences for keeping or using tissue or organs without consent.
  Clause 1 provides that consent will be needed for carrying out a hospital post-mortem, and that it will be needed for the subsequent keeping or use of tissue or organs for transplantation, research, education and training. For certain particularly sensitive purposes—the donation of the whole body to a medical school teaching anatomy for anatomical examination or for public display, as in Professor von Hagens' "Bodyworlds" exhibition—the prior personal consent of the individual will always be required. The Bill will not interfere with the coroner's authority to order a post-mortem for his purposes, related to establishing the cause of death, or with his power to ask for tissues or organs to be retained, should they be needed, for his purposes. That is made clear in clause 9.
  Harry Cohen: I saw the exhibition to which the Minister refers, as did many thousands of other people. It was informative, interesting and could be viewed in some respects as an exhibition of art—however gruesome some people might consider it. Do the Minister's comments mean that the exhibition would have been banned in this country?
  Ms Winterton: Such an exhibition would be allowed to go ahead if it had been properly licensed and if the prior consent of each deceased person had been properly obtained.
  Where tissue is taken from living patients, some purposes are so bound up with general diagnostic and clinical care that the consent that the patient gives to the procedure itself can be regarded as consent to those other purposes. These are set out in part 2 of schedule 1 and include clinical audit, quality control and on-the-job training in the laboratory. Separate consent will not be needed in those cases or for public health monitoring where tissue taken from living patients is used—unlinked and anonymised—for epidemiological studies. Those issues were discussed extensively with representatives of the medical and research communities as the proposals for the Bill developed.
  Although consent will not be needed for those particular uses, it will be good practice nevertheless to ensure that patients are aware that such uses might be made of their tissue or samples. That could include, for example, notices in waiting rooms or leaflets from outpatients, as set out in Department of Health guidance. However, consent from patients will be needed for further uses of tissue, by which we mean all material that contains cells—except hair and nail, which are regarded as disposable—such as for research, education and transplantation.
  My hon. Friend the Member for Leyton and Wanstead (Harry Cohen) asked about consent. Appropriate consent identifies whose consent is relevant in the circumstances, not what is needed by way of consent. It can come from an individual, nominated representative or next of kin, as I shall explain more fully later.

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  Failing to obtain consent—whether from patients themselves or, in the case of the deceased, from other appropriate people—may be a criminal offence and subject to penalty. I say "may" because there will be safeguards to ensure that people cannot commit an offence inadvertently. For example, it is not intended that individual researchers be subject to the licensing requirements and they will not, in fact, themselves retrieve the tissue from patients. They will probably receive it from others, perhaps a tissue bank. In those circumstances, the researcher could quite reasonably rely on the regulated system to deliver tissue that has the appropriate consent for the purpose.
  Mr. Lansley: I am grateful to the Minister for being so generous in giving way. I wish to be clear about the question posed by the hon. Member for Bolton, South-East (Dr. Iddon). The Bill defines appropriate consent and therefore qualifies what consent means, but the definition of consent is effectively left to the code set out by the Human Tissue Authority. If the House wants to qualify the consent process to make it acceptable, it will need to do more with the Bill to make that happen.
  Ms Winterton: As the hon. Gentleman says, the Human Tissue Authority will issue further guidance on that matter. It is true that the Bill does not set out precisely what form consent should take in any particular situation. The Bill gives statutory effect to the current requirement for consent. It would be unrealistic to imagine that we could set all that out in primary legislation. Consent to treatment, for example, is a current common law requirement, which is subject to quite extensive guidance from the Department of Health, the General Medical Council, the British Medical Association and the Medical Research Council, which also deal with the need for consent before taking tissue for research purposes. The regulatory body established by the Bill will issue a code of practice on obtaining consent. Clearly, that will have to be pragmatic.
  In some cases—for example, where tissue might be kept for some time—the fact that consent has been given needs to be recorded for future reference; and in many cases, as when blood samples are given, consent may be verbal or even a gesture such as holding out an arm. For surgical procedures, however, consent is likely to be recorded on a signed form. In all cases, consent will need to meet the general requirement that it is properly informed and freely given.
  The process of seeking and obtaining consent will reflect current good practice and need not be onerous, even where consent for research use is being considered. We know that people overwhelmingly support the use of surplus tissue for research. We are, in effect, setting out in the Bill what is already current good practice—for example, in the GMC guidelines. Moreover, as at present, research ethics committees will continue to have a role in considering whether legal and ethical standards have been met in the context of the specific projects that they consider.
  Dr. Evan Harris: On the question of authorised consent for transplantation, it is clear from clause 3 that
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  pre-morbid consent by the individual constitutes the consent and that—quite rightly, in my view—it is inappropriate for relatives to be allowed to veto it. Is it the Minister's understanding that the current donor card represents written and "appropriate consent", and that the current practice of relatives being allowed to veto that donor card request should therefore be discontinued as a matter of course, even in a minority of cases?
  Ms Winterton: I am not familiar with the wording on my donor card, but I shall certainly look into the issue to see whether any changes need to be made.
  Nick Harvey: Perhaps I can help the Minister. I have my donor card with me, which states,
  "Please let your relatives know your wishes, and keep this card with you at all times."
  Ms Winterton: That is the point. In such circumstances we can make absolutely clear what we expect to happen, but if relatives have to be consulted for screening purposes—in this day and age, that is increasingly important—and they choose to withhold that information, problems can arise. We must accept that there will always be some circumstances in which we cannot move forward as we would like.
  Dr. Iddon: My hon. Friend is being very patient in giving way. Researchers are extremely worried about future research that they may need to conduct. Will she assure them that they will have access to such tissue through the "appropriate consent" form, which was signed by the individual in question, or their relatives, way back in history? Researchers are concerned that they may be about to commit a criminal act by examining tissue for research, when consent was not gained for such a research application.
  Ms Winterton: It will be important to distinguish between removing a person's organs for transplantation purposes, where the screening issue is clearly vital, and consent in respect of a deceased person. In the latter circumstances, different considerations might have to be taken into account. As I have said, the Bill will simply adopt and make clear existing best practice. That should reassure the medical research community, and the proposals need give it no cause for anxiety.
  The Bill also introduces a new element to the question of consent. It provides that an individual may nominate another person to take decisions about tissue and organ retention, storage and use after his or her death. Where a person has not made their own wishes known and has not nominated another person, such responsibility will then revert to the next of kin, who would be empowered to take those decisions. Their consent would be needed, in contrast with the rather unclear formulation in the current human tissue legislation.
  There is one other aspect of consent and part 1 that I should deal with before I move on. Clause 7 deals with tissue that is already held—what the Bill refers to as "existing holdings". This is tissue and organs currently stored from a variety of sources and for various purposes. The Bill simply provides for this to be lawfully

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  kept and used. A pragmatic approach to the treatment of currently held tissue is vital. There is immense value in current archives, and it is important that we allow research options to remain open; but at the same time, respectful and appropriate disposal should take place where necessary. We have therefore provided for the new Human Tissue Authority to give guidance on the use and disposal of such tissue. Careful guidance from the Department is already in place. It was subject to lengthy consultation with researchers, families and other groups. That can assist in providing for a sensible approach to the future use of current archives.
  Members will doubtless realise that anything more than a cursory view of this issue will show how complex and sensitive it is. Part 2 therefore proposes a regulatory system to oversee the implementation of this overarching legislation.
  Mr. David Wilshire: I should point out that I hope to catch your eye, Madam Deputy Speaker, although not on this specific point. Before the Minister leaves the subject of consent, I draw her attention to clause 2, which deals with appropriate consent in respect of children. The Bill defines children as those under 18, and clause 2(4) states:
  "Where the child concerned has died and the activity involves storage for use, or use, for the purpose of anatomical examination…'appropriate consent' means his consent in writing."
  In other words, we are talking about not the parents' consent, but the child's "in writing". How will we handle the need for specimens from infants, who are not yet able to understand and cannot, therefore, give consent themselves?
  Ms Winterton: We are talking about anatomy—the dissection of whole bodies—which is why we have said that specific prior consent is needed. But the Anatomical Society has made it very clear to us that it is not the practice for examinations such as those to which the hon. Gentleman refers to take place on small children. The children referred to under that clause will be linked to the "Gillick test", to see whether they are able to give that consent
  The new Human Tissue Authority will be given the task of ensuring that the use of whole bodies, tissue and organs is regulated, in keeping with the legal and ethical standards that we have come to expect.
  Clause 13 sets out the licensing role of the authority. As I have said before, it will also be necessary to license the use of bodies for public displays such as the "Bodyworlds" exhibition. The authority will consist of members appointed by the Secretary of State and will issue codes of practice. It will have the power to vary, revoke or suspend licences where the necessary conditions have not been met. In establishing the new authority, we are streamlining the regulatory arrangements already in place. Regulation of tissue banks, which is likely to become mandatory under the proposed EU tissue directive, will be carried out by the new authority.
  Dr. Iddon: I am grateful to the Minister for her continuing patience in giving way. My understanding is that the Bill licenses an individual who is the custodian
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  of the tissue collection. How will an institution be able to continue if, for whatever reason, that person either dies or leaves the institution suddenly?
  Ms Winterton: The licence will continue through the person to whom it is then transferred. The Human Tissue Authority will issue guidance on exactly how that process will be continued.
  Clause 44 will contribute to expanding the scope for transplants by making it clear that steps may be taken to preserve organs while it is established whether there is consent to donation for transplantation. Clause 29 extends the current prohibition on commercial dealing in tissue under the Human Organ Transplants Act 1989. Clauses 46 and 47 make it an offence to have human material with intent to analyse its DNA without consent or for certain specified purposes. That provision responds to a recommendation of the Human Genetics Commission.
  Finally, under clause 49, the Bill will allow certain national museums to de-accession human remains—that is, to move them out of their collections; for example, in response to claims from the descendants of indigenous people. The statutory constitution of those museums currently prevents them from de-accessioning such remains, even where they may want to do so. Removing that barrier will fulfil a commitment that the Prime Minister made jointly with John Howard, at a meeting in July 2000, that they would increase efforts to repatriate human remains to Australian indigenous communities.
  The Bill provides a comprehensive response to a range of issues that have caused grief and distress to individuals, families and communities, but that have also created uncertainty among our medical and research communities. There is no doubt that many people suffered when they discovered that the organs of their loved ones had been kept without their knowledge. That must not happen again, and the aim of the Bill is to ensure that it does not. At the same time, we must create a framework to support research and development in science and medicine. With this Bill we can restore confidence and move from a difficult past to a stable and progressive future, and I commend it to the House.
  2.31 pm
  Mr. Andrew Lansley: I am grateful to the Minister of State for taking so many interventions and for beginning the process of considering the Bill with some care. I am sure that the House is grateful for the care with which she went through some aspects of the measure.
  It is more than four years since the then chairman of the Association of Community Health Councils first raised concerns about the unauthorised retention and use of human tissue. Of course, the CHCs are no longer with us to undertake that function. Shortly after that, as the Minister said, as evidence was being gathered for the inquiry into the tragic deaths of children at Bristol royal infirmary, it became clear that tissue and organ banks had been set up at many other places, in many cases without proper consent. Indeed, the Redfern report on Alder Hey set out the especially shocking extent, in that case, of the clandestine acquisition of human organs, especially children's organs.

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  As the Minister said, the chief medical officer's report, in 2000–01, illustrated the wide extent of organ and tissue retention. It is proper to say that the vast majority of cases had nothing of the clandestine character of the acquisition and retention of tissue demonstrated at Alder Hey, but were pursued according to what was regarded as normal practice. That is why we must be so careful to get the structure of the legislation right; we must ensure that normal practice has changed, continues to change and is properly buttressed by law.
  It was not due only to the events at Alder Hey and Bristol that the retention of organs gave rise to considerable distress. Many Members from all parts of the country will share my experience in my constituency and will have met families of those whose relatives' organs or tissues were retained without consent or, in some instances, directly contrary to their expressed wishes. One of my constituents told me of the loss of their son in a road accident in 1984. At the time, they did not wish any of his organs to be retained after the coroner's post-mortem and were assured by the undertaker that that was the case and that their son had been buried intact. Members will thus appreciate the family's distress when they made inquiries—at the time of the press reports on the Alder Hey findings—and found that Addenbrookes hospital, in my constituency, had in fact retained their son's appendix. After systematic collection and examination of the hospital records—as the chief medical officer required of hospitals—the family found that not only had their son's appendix been retained, but also his thymus. On successive occasions, many years later, they had to arrange further interment of their son's remains. Their concerns and suspicion about whether their son had been buried with his brain are unresolved, as there are no longer any records that would give them that information.
  Addenbrookes is a major teaching hospital so there was a substantial number of such retained tissue and organs, and a support network was set up by the affected families. I met them in late 2001 and since then have tried to work on their behalf to have legislation introduced. My colleagues and I are thus very much in favour of the principles behind the Bill and the desirability of proceeding with it. What has impressed me about my constituents has been their willingness to go beyond the pain and distress caused by the fact that tissues were retained and organs had to be buried. They want to ensure that such things never happen again and are working with the Retained Organs Commission and in the consultations to which the Minister referred so that the structure is right for patients and for families in the future. There will be much debate on the measure and I shall refer later to the many questions that arise about the detail of the Bill, and I hope that the House will recognise that we would be committing a disservice to those families if we did not maintain our determination that, in future, the retention of organs should be undertaken only with fully informed consent.
  As a constituency Member, I have represented not only the families of patients whose tissues and organs were retained but also the researchers, because much medical research is carried out in Cambridge. There was thus a difficult balance for me to strike when I discussed
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  the case that I mentioned earlier, which was covered in the Isaacs report, with both the constituent and the pathologist in question. It was perfectly clear that, in the majority of cases, pathologists had no malign intent; they were working according to what they believed was, in effect, normal practice in many parts of the national health service—retaining organs on the basis that they would be of value for future research, which, in the case covered by the Isaacs report, was a brain bank for research into mental illness. The pathologists believed that the practice was desirable and, as they explained, they did not want to put families through the pain and distress of having to consent to the retention of organs. However, they put those families through much pain and distress, and I hope that many people who had no malign intent at the time accept that what happened was wholly wrong and must not happen in the future.
  We must strike that balance of which I was only too aware. We need to ensure that there is a supply of tissues and organs for transplantation and research, but without prejudicing the principle of fully informed consent. We need a new legal structure. As the Minister said, it must incorporate the previous structure relating to anatomy, anatomical examination and anatomists.
  It is fair to say that we are not working on the basis of abuse by anatomists, but that we want to incorporate them in a consistent legislative structure, with an additional regulatory structure that provides the necessary assurances.
  I want to repeat a point about which I intervened on the Minister earlier. I have pressed for legislation on this matter since 2002, and have asked Ministers about the progress being made. The Minister said that it was agreed that a fundamental review of the law was needed before legislative proposals were introduced, but it was always clear that the matter was urgent. The chief medical officer's first recommendation was that the Human Tissue Act 1961 needed urgent amendment, to enforce the requirement for consent. That did not happen because a legal framework was required, but the urgency noted by the CMO was not negated.
  We have been asking for that legislation since 2002, and the Government accepted that the provisions should be introduced as soon as possible. Colleagues in all parties believe that these provisions would have been suitable for pre-legislative scrutiny, and I am disappointed that that has not happened. Pre-legislative scrutiny turns the principles and intended purposes of legislative proposals into draft form, so that all parties concerned with the practicalities of a piece of legislation, and its future interpretation, can determine whether a Bill will serve its purpose.
  The draft version of this Bill should have been published in July, but was in fact published in December. Now, in mid-January, the royal colleges, the Council of Heads of Medical Schools, the Wellcome Trust and other bodies are saying that the draft proposals are too complicated and do not give the necessary assurances and clarity. Proper pre-legislative scrutiny would have put that right.
  Perhaps we can solve those problems in Committee. This debate is not about the programme motion, but the Minister is asking the House to complete consideration of the Bill by three weeks from today. That means that we will have to get on with it, and there will not be much

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  time for evidence to be taken. I am sure that the Minister will not chide me for reminding her that I asked before Christmas for a Special Standing Committee to be set up. I wanted not to delay the Bill, but to ensure that we could take evidence from some of the organisations involved. There are not many of them, but their evidence could have helped with the way in which the Bill was drafted. However, the Minister wanted to expedite the Bill's passage through the House, and felt that a Special Standing Committee would not be appropriate. I am sorry about that, as I think that that approach would have been better.
  We must get the scrutiny of the Bill right, and we have only three weeks in which to do it. A number of organisations do not believe that the Bill is as clear as it should be. I have mentioned the Royal College of Pathologists, which was closely involved in the workshops and consultation that took place last year. It maintains that the Bill lacks clarity, and that it fails to establish a structure that ensures that appropriate consent is sought by health care professionals, on whom pathologists subsequently have to rely. That is an interesting point, and the consultation did not deal with it adequately. We must make sure that the necessary consents are taken, on behalf of pathologists, at the front line of the health care system. Pathologists will be at risk if the consents taken for the retention of tissues and organs do not serve the purposes of researchers. Front-line health care professionals must be given an appropriate structure for taking consents.
  The RCP also questions the extent of the record-keeping and information-flow requirements that will he needed as a result of the consent process. The estimate is that 3 million solid-tissue samples, and ten times as many blood samples, will be involved. It is clear that, even with the information management and technology programme in the NHS, it will be intensely difficult to manage information flows on that scale. In the immediate future, consent for the use of many tissues and organs may take the form of a written note but. for data protection reasons, those records will not necessarily be available to researchers. We must ensure that the consents will be passed on to researchers in a way that makes sense.
  The RCP makes constructive points in relation to about one third of the total number of clauses contained in the Bill. I hope that the Standing Committee can reflect the college's close interest in the matter, and its constructive approach.
  The Council of Heads of Medical Schools also questions the clarity of the Bill. It is concerned about the scope for the code of practice to be extended into statutory requirements that might give rise to penalties if the code is breached. That is, a breach of the code might amount to an offence that carries a criminal penalty. I know that the Minister has said that we must not worry, as the code of practice will be based on current best practice. However, we need to ensure that that best practice is adequately translated into the code of practice, and we must then consider the code alongside the Bill.
  Codes of practice are often published with the Bills to which they refer, but the relevant code for this Bill is not available yet. In particular, we need that part of the code that deals with the retention of human tissues and organs. That is very important, but there is a substantial
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  difference between what is current best practice and what actually happens. Under the Bill, people who fail to comply with the code of practice may expose themselves to prosecution for a criminal offence. I hope that, when he responds to the debate, the Under-Secretary of State for Health, the hon. Member for South Thanet (Dr. Ladyman), will assure the House that we will be able to see the draft code of practice as the Bill proceeds through the House. In that way, hon. Members can be reassured on this matter.
  The heads of the medical schools also say that they do not consider the Bill to be in line with the practicalities of clinical medicine and pathology. We will want to test that proposition in Committee, as we must achieve congruence in that respect.
  The Wellcome Trust has raised a number of concerns with hon. Members. One problem is the risk of criminalising currently legitimate research, especially in connection with the new offence of testing DNA. It is also concerned about the definition of DNA analysis in this context. I hope that, with the help of greater experts on this matter than me, we can make progress on that matter in Committee and determine how to deal with it.
  The Wellcome Trust also wants assurances about the provision for consultation by the Human Tissue Authority, a point that relates to what I said about codes of practice. It is also keen for the House to be able to put under proper scrutiny what the authority proposes. As I understand it, the authority will be able, through its code of practice, to extend the definition of what constitutes a criminal offence. We need to be sure that the House understands what is intended to be a criminal offence, and what is not.
  The Bioindustry Association has raised a concern for which I have some sympathy, although we must be careful in our response to it. The Bill retains the provision that makes trafficking in human material and body parts a criminal offence, but the association is worried that currently legitimate commercial activities could be criminalised. Those activities involve research using human tissues, or transferring those tissues between organisations. I want to be sure that the Bill recognises that there is a commercial element to research, and I think that the Under-Secretary of State was probably engaged in such commercial activity at one time. It must not be criminalised, as it makes a vital contribution to the development of new therapeutic methods and drugs. We must be sure that we are not trespassing on legitimate research.
  It will be apparent that many of the concerns that have been raised are about maintaining the extent and quality of medical research, clinical investigation or education. We have to achieve a balance between the necessity of securing fully informed consent and the desirability of supporting medical research. However, I want the Minister to be aware that such concerns do not derive only from medical research organisations and those working in pathology. Conservative Members, too, want to examine some issues more carefully.
  On the definition of consent, we need to be sure that we are clear about who gives consent and under what circumstances, and that consent is given for the specific purposes that are set out in schedule 1, which deals with purposes normally requiring consent. Sometimes specific purposes are consented to, while in some

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  circumstances it is reasonable that generic consent could be given to the whole range of scheduled purposes to prevent people from stepping into criminal activity at a later stage.
  We also need to be clear, as I suggested to the Minister in the Adjournment debate on 29 April, that, especially from the point of view of families of those who have died, the consent that is given relates to specific kinds of tissues or organs. In the past, people often gave their consent to the retention of tissues because it had been explained to them that that would be necessary for the purposes of the post-mortem analysis to establish the cause of death, and they understood that that might be necessary in relation to bodily fluids, for example, but they were not thinking of major organs.
  This morning, Dr. Mark Wolpert of the Wellcome Trust made a similar point from the standpoint of medical research, saying that there was often a distinction in the minds of families between the retention of small amounts of tissue such as skin, blood or fluid samples and major organs. Indeed, from the point of view of researchers there is an order of magnitude of difference between the retention of tissue samples and of whole organs. In that context, if we require detailed consent, the maintenance of records, and returning to families tissue blocks and slides for small amounts of tissue, compliance will be highly burdensome.
  Nobody, whether in the medical research world or in the families concerned, wants a system whereby to be sure that one has legal cover, front-line health care staff will have to ask for consent for the retention of relevant human material for all the purposes in schedule 1. The explanation that is given to families may not necessarily make it clear that whole, sometimes major, organs are going to be retained. We have to avoid reaching that position. We therefore need to think hard about whether we can build into the Bill or the code of practice a provision that distinguishes where major organs will be retained so that families understand that before any organs are taken from their loved ones. The "Human Bodies, Human Choices" consultation specifically addressed that. The Government have decided not to set off down that path, but I hope that they will reconsider, because the phrase "relevant human material" does not adequately convey the variety of organs and tissues that require specific consent.
  In due course, wherever possible, consent should be given in an explicit fashion in relation to major organs and the process should normally be related to specific purposes. However, in order to relieve the burden on medical research, we might be able to contemplate generic consent for other tissues and samples in relation to the whole set of scheduled purposes.
  The issue of nominated representatives needs to be dealt with, because it is not yet sufficiently clear. The spouse and partner question in the Bill is linked to other legislation that is forthcoming this year, and I hope that we can clarify the relationship between them. Grandparents are not currently reflected in the structure of qualifying relationships; that has been mentioned to me by at least one hospital.
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  Then there is the question of arbitration. As the Bill stands, if those in a qualifying relationship and more than one person at the same rank in the qualifying relationship differ, the consent of one could be accepted even if it was contrary to the wishes of the other. We need to be certain that that is what we intend. Complicated family arrangements might surround a person who has died. In a dispute about qualifying relationships, not many people in the health service will want to be responsible for arbitrating who is in what qualifying relationship to an individual and how they should be ranked in all the circumstances that can apply. We should consider whether we can give those NHS staff an easy way in which to pass the problem on to some form of independent arbitration, perhaps even to the Human Tissue Authority, thereby absolving the health service of the responsibility. Failing that, the situation could seriously interfere with the relationship between the clinical team and the family of someone being treated.
  This House should determine the possible extent of a criminal offence—it should not be left to the Human Tissue Authority—and I hope that we can do that in the course of our scrutiny of the Bill. I also hope, notwithstanding the desire to achieve a seriously enforced regulatory system, that we can minimise the burden imposed by the licensing requirement, which could otherwise be very substantial. We heard about some of the difficulties involved in the question of who a licensed designated individual is, how that is passed on to others, where the premises to which it applies are, and so on. The licensing process itself may be relatively straightforward, but the requirement to go back to the Human Tissue Authority to notify variations in the licensing may be so burdensome that it adds many thousands of pounds per year to the cost, because there will be somebody working more or less full time to tell the authority which individuals have entered or left a pathology department, which parts of a hospital are the appropriate premises for such purposes, which purposes are being acted on and what kinds of tissues are involved. The structure may become very complex if we do not try to ensure that it is minimised.
  On consent, the code of practice should allow families and patients sometimes not to receive information. That was part of the consultation, and I know that the Government have it in mind, but it is not reflected in the Bill. There must be a way in which families can be offered the full information that ought to accompany consent, but are not required to have it, in order subsequently to protect those who have received tissues and organs that were so consented.
  The Bill provides a necessary reform to which we can give our support. The system has to be clear and practical and has to be built on the principle of consent. I will not seek to direct my colleagues on how to think or vote about this issue when the time comes—they will be able to make those judgments for themselves.
  On presumed consent, I share the Minister's view that the evidence from Spain, on which I have corresponded, does not necessarily point so much to a structure of presumed consent as to an efficient and effective structure of organisation in hospitals to provide information and to form a basis on which consent is freely given. Let us leave that to one side. My personal

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  view is that in a Bill whose purpose is to make the giving of organs the subject of a positive decision based on fully informed consent, the concept of presumed consent does not count as consent at all. It is directly contrary to the underlying principle of the Bill. I would find it difficult to say to the public, "Under all normal circumstances, if you want to assist medical progress in the future, we have to explain in great detail to you what will happen and obtain your consent, but if you want to assist medical intervention now, we can just take the organs and presume that you have given consent." That is inconsistent.
  Mr. Dalyell: Is the hon. Gentleman likely to oppose the Bill that will be presented by my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh) on 3 February? Does he recollect that the Conservative party used to have very different views? I presented a ten-minute Bill on 18 May 1971. As usual, hon. Members filed out of the Chamber, but one colleague who remained to hear what I said was the then Prime Minister, Ted Heath. Two days later he told me that he was sympathetic to my cause but that I would never persuade Keith Joseph. What is the Conservative party's position, a third of a century later, on presumed consent?
  Mr. Lansley: I understand that the hon. Member for Mitcham and Morden (Siobhain McDonagh) will present a ten-minute Bill and I try, whenever possible, not to oppose leave to bring in a Bill. If it makes progress, we would then consider it substantively. The implication of my views is, however, that I would also oppose her Bill on principle at Second Reading, if we ever reached that stage. I would also oppose the introduction of presumed consent to the Bill before us. That is a personal view, although I think that it is shared by my hon. Friend the Member for Westbury (Dr. Murrison), who is in his place on the Front Bench. It is an ethical point of view: we believe that presumed consent is inconsistent with the principle that we should allow people to decide themselves whether and for what purpose their bodies and organs are used. The Minister made the same point.
  I do not pretend that my view is the uniform view of the Conservative party. We may discover later that my right hon. and hon. Friends have different views—
  Mr. Kenneth Clarke indicated assent.
  Mr. Lansley: I look forward to hearing that argument, because I know that it will be presented as effectively as an argument can be.
  I hope that in the next three weeks we can provide an assurance to those who have suffered in the past that it will not happen again—as the Minister said. I hope that we can allay the many concerns of those who believe that excessive burdens might be imposed on medical research, education and training as a result. I hope that we can legislate for a regulatory structure and that we can be reasonably certain that normal practice in health care will not develop over time so that the bureaucratic compliance requirements of the legislation are met, but the substance of what was intended is avoided. We would do better if some of the changes that I have mentioned were included in the Bill, so that we focus on
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  the substance of giving informed consent and understand the emotional implications of doing so, especially for the loved ones of those who have recently died. I hope that we can also ensure that if there are those who treat human tissue negligently or maliciously, the regulatory structure will ensure that they cannot continue to do so for years, as happened in the past. On that basis, I hope that the House will give the Bill a Second Reading, with the intention of being appropriately critical during subsequent consideration.
  Several hon. Members rose—
  Mr. Deputy Speaker (Sir Alan Haselhurst): The opening speeches have taken a little longer than anticipated. No time limit was imposed on Back Benchers' speeches, but we may now have a difficulty with time. It would be appreciated if hon. Members tried to be as concise as possible.
  3.5 pm
  Mr. Frank Dobson: I welcome the Bill, for which I must take some responsibility. I met the Bristol parents and listened to their arguments, and I decided to establish the inquiry into what had happened to their children. That set in train the process that revealed the extent and nature of the massive holdings of human tissue across the NHS. It struck me in those meetings that while the Bristol parents were concerned to find out what had happened to their children, they also wanted to ensure that arrangements were put in place to prevent it from ever happening again. That needs to be the theme of today's debate.
  The Bill seeks to update, codify and clarify the law on the retention of human tissue by health professionals for the purposes of research and training. It is based on the concept that those professionals should be required to obtain the informed consent of the individual whose body parts may be used, or their parent, parents or representatives, in place of the practice in the past, when health professionals sought simply to demonstrate the lack of objection. We must not pretend that the process of securing consent is simple or easy for anyone involved. A patient who faces a dangerous operation may be reluctant to hear questions about what should be done with their body if the operation fails. The professionals involved may also, for obvious reasons, be reluctant to put such questions. If someone has been seriously injured in an accident and then dies, the doctors and nurses may be exhausted, upset and disappointed that they failed to save a life. They will not be in a good state to approach distraught and heartbroken parents or other relatives. We can discuss the Bill in the cool, calm and collected atmosphere of the Chamber—at least, it is this afternoon—but that is not always the situation in hospital for patients, relatives or professionals.
  We owe it to all concerned to get the law right and, above all, to make it clear and easy to understand for those who will have to operate it. We should not forget that we propose to introduce criminal sanctions if they fail to comply with the law. We should do our level best to keep lawyers out of hospitals, except when they are there as patients. We need to make the law clear, so that

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  it can be understood by those who have to implement it in difficult circumstances, day after day. We also need to try to keep down the bureaucratic burden.
  At the same time, we do not want to inhibit the use of human tissue for training and research. Health professionals need to be trained to understand the workings of the human body, and some of that understanding can be obtained only by studying parts of the human body—an organ or piece of tissue—from the inside. That is less necessary these days, because of technological change, but observation of diseased specimens, for example, is still crucial to the proper training of health professionals.
  I have real concerns about several threats to medical research. The Bill could be a threat to medical research if we were to get it wrong, but I do not think that we will do that. The animal rights lobby is clearly a threat to some research on animals that is intended to benefit human beings. The combined impact of rather frightened ethical committees and the data protection law already seems to be inhibiting several epidemiological studies.
  We cannot over-emphasise the importance of medical research on human tissues for the rest of us. For a start, such research helps us to identify specific illnesses and conditions. After such conditions are identified, the research enables professionals to understand their causes, and it is only after the causes are understood that professionals may come forward with a basis for the prevention or treatment of conditions. Medical research saves lives and relieves pain and suffering, and we must remember that it has gone on since time immemorial—from the Greeks studying anatomy to William Harvey discovering the circulation of the blood.
  I have a more recent example of the benefits that can flow from research. We are faced with variant Creutzfeldt-Jakob disease, but the variant form of the disease was discovered only because of the post-mortem examination of the brains of people who had suffered from it. The later discovery that the disease was probably linked to bovine spongiform encephalopathy in cattle—although that is not certain even now—was possible only because of the post-mortem examination of brains. That evidence led to the enhanced slaughtering of cattle, which we hope has reduced the impact of CJD on the rest of the population.
  Such research is still going on, and requires the examination of not only the brains of those who have died from vCJD, but the brains of people who have died from classic CJD and other degenerative conditions of the brain, because comparing the two is one way of identifying specific characteristics that might eventually prove useful. If we are to deal with the condition, it is vital that we continue that research. Given those circumstances, it is necessary for relatives to be willing to allow the brains of their loved ones to be used for research in an effort to ensure that we prevent the condition affecting other people.
  We intend to make the law clearer on tissue taken from the dead and to make it clear that informed consent is required. However, as the hon. Member for South Cambridgeshire (Mr. Lansley) said, we must ensure that such consent is wide and long-lasting so that
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  after it has been given, further research that was not mentioned when it was given may be carried out. I do not imagine that many people would object to that.
  The Bill also deals with the subject of tissue taken from the living. I understand that consent has not been required for the study of such tissue up to now. The examination, study and analysis of cancerous growths taken from people during the treatment of their cancer have transformed our understanding of genetic and other aspects of the process and progress of cancer, which has meant that professionals have become more able to treat cancerous conditions. That progress would not have been made without the study of human tissue. The Bill will require consent to be given for such activities in future, so we must ensure that it is broad and long lasting.
  Few people know that samples of tonsils and appendices that were removed during routine operations have been held in slides throughout the country for decades. When I was Health Secretary, I was asked to authorise the study of the slides as an attempt to find out the prevalence of vCJD in the general population. If the material had not been held—it would otherwise have been discarded—such surveillance would not have been possible. We hope that the information that it provides will throw light on the progress of the disease because it has so far defied anyone's attempts to understand it. Will the Bill inhibit the retention of such material? I hope that it will not. I cannot possibly expect the Under-Secretary of State for Health, my hon. Friend the Member for South Thanet (Dr. Ladyman) to respond today to all the technical matters that I am raising, but we must consider them carefully.
  I was struck at the time that the examination of that material was subject to decisions by local ethical committees—there are more than 200 in the country. The process was time-consuming and unpredictable, so we should contemplate establishing a national ethical committee—perhaps, although not necessarily, through the Bill—that could decide on the ethical provenance, if that is the right word, of such national schemes so that progress could be made quickly if it seemed it were necessary.
  I have a further worry about the interpretation of rules on data protection by ethical committees. At present, programmes of the anonymous and totally unlinked sampling of blood and tissue exist as an attempt to establish the spread of HIV/AIDS. Some local ethical committees are concerned that such sampling could be contrary to data protection laws, so if that is the case we need the Bill to ensure that the data protection lot keep their noses out of it because the sampling is intended to benefit humanity generally. We must be clear about whether such a programme will be lawful if the sampling is anonymous. If the research is unlawful, society as a whole will be worse off.
  I raise a further detailed issue with the Under-Secretary. If I were to go into hospital and a blood sample were taken as part of my treatment, I understand that I would not need to give consent for any research that its pathology laboratory might carry out during my treatment. However, pathology laboratories, in the pursuit of quality standards, rightly organise sample testing to determine the standard of their analyses. If a test is run on a person's blood sugar level, the laboratory

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  will examine a sample of blood sugar tests to check whether they are accurate. As such an activity would be research rather than treatment for a person's benefit, the Bill would require people to give research consent before the sampling could take place—I do not know whether that is the case but it is my interpretation of the Bill. We clearly do not intend for that to happen, so the Bill should make it clear that it will not.
  Professionals in my area are studying aneurisms that have burst and caused sudden death. There is little use in trying to study the aneurism of a person who has been the subject of an attempted surgical effort to keep them alive because it would undoubtedly be destroyed in the process. The professionals want to examine aneurisms that have been cut out of people's bodies during coroners' post mortems. As I understand it, the law currently says that a coroner can keep parts associated with the cause of death. If an aneurism was the cause of death, by keeping the tissue in which it occurred the coroner is doing something that is a straightforward part of their role. However, is relatives' consent needed to conduct research on aneurisms? How is that research to be carried out and how can we facilitate it?
  There are a number of detailed points that we need to consider, and no doubt others will make them. However, my main theme is that the Government and the professions need to bang the drum about the merits of crucial research on human tissues if we are to continue make progress in treating people. We must not let the monstrous activities of Gunther von Hagens at Alder Hey ruin medical progress. We must not get too carried away. We need to get that message across because, like the Bristol parents, most decent people would he happy for parts of their own or loved ones' bodies to be used for research if they were asked for permission and were confident that it would be of benefit to everyone.
  Willing consent is therefore a big step forward, but we must be clear about the aim of the legislation. We are introducing criminal sanctions in a difficult area, and there is a danger that we will inhibit research by placing too many bureaucratic restraints on people so that, as a result, they do not seek consent for taking tissue because it is simply too much bother. We need to avoid that consequence. As the Minister of State said at the outset, if we can create public confidence in the consent procedure and convince people that the research is worth while everyone will benefit. There are no party political differences about the Bill, and I hope that all the time available can be devoted to getting it right. However, more consultation will be needed with the Royal College of Pathologists, the Royal College of Physicians and others to try to make sure that we get the details right and achieve what we all want to achieve—a clear law that can be implemented by the people who are doing their job day in, day out, in difficult circumstances.
  3.22 pm
  Mr. Paul Burstow: I echo the remarks of the right hon. Member for Holborn and St. Pancras (Mr. Dobson)—a clear law that restores clarity to the issue will restore public confidence, thus enabling us to ensure that medical research and education continue to thrive and prosper. We do not want them to be damaged by the way in which the Bill
  1006
  may, or may not, work—something about which hon. Members on both sides of the House have voiced concern. Providing that clarity in the Bill will be the task of the Standing Committee.
  We ought to acknowledge the fact that in some ways the Bill is born of failure: first, the failure of drafting and scrutiny by those who framed the Human Tissue Act 1961; secondly, the failure of pathologists and physicians who allowed the retention of organs after post-mortem without the family's knowledge to become commonplace; and, thirdly, the failure of institutions and managers either to provide adequate oversight of staff or to act on complaints. The Alder Hey and Bristol inquiries paint an extremely disturbing picture. Parents buried their children without knowing that many of them had not had their organs returned. In some cases, they did not even know that organs had been removed. It is impossible to step into the shoes of the parents who were affected and fully understand their anger, pain and sense of betrayal.
  The chief medical officer's report on the census of organs and tissues retained by pathology services revealed that, while the malpractice of one particular pathologist was not the norm, poor practice and paternalistic attitudes were widespread. Over almost 30 years, 54,300 organs, body parts, stillbirths or foetuses were retained by pathology services. The census found that the vast majority of NHS trusts complied with the letter of the law and had signed forms of agreement from relatives. However, the Alder Hey inquiry and, indeed, the census found poor cataloguing and recording of retained tissues and organs in hospitals and university research collections. The distress caused to some families by second, third and fourth funerals must never be repeated.
  As the summit held by the chief medical officer in January 2001 revealed, many parents had no idea what had happened. Some were given inaccurate and misleading information, some were lied to and told that they were burying children with all their organs returned. I cannot pass up the opportunity to cite part of the transcript of the summit, as it sums up the feelings of many parents who spoke that day:
  "It almost was—I mean, if I could just use an analogy, it was almost like scrap cars being taken to a scrapyard. The cars were dismantled, the alternators were taken out, the batteries were taken out, put on a shelf, then when somebody comes along and wants one of those parts they pay for it. In the case of our children, they were disassembled completely. The organs were stored, never used."
  That is how one of the parents expressed their feelings and anger. The words, "never used" certainly stay in my memory. Their children's organs were poorly stored and, in some cases, left on a shelf. Even when they were used, the lack of accurate records meant that there was no feedback to the families on any research that was undertaken. There was therefore no opportunity to provide a modicum of comfort that the research had led to some good.
  The inquiries, census and summit led to the publication of 17 recommendations in a report by the chief medical officer entitled, "The Removal, Retention and Use of Human Organs and Tissue from Postmortem Examination" in 2001. The first recommendation, which has already been referred to,

  1007
  was to act immediately to amend the Human Tissue Act to remove any confusion between lack of objection and informed consent. That Act provides for a person to express their preferences in respect of the use of their body after death. In the absence of such an express wish, the onus is on the clinician to make such reasonable inquiries as are practicable to ascertain whether the surviving spouse or any other surviving relative objects to the removal of organs or tissue.
  The test was therefore lack of objection. However, there was a defect in the Act, as it was vague about clinicians' tasks and how hard they should try to obtain the views of patients and relatives. Parliament's intention was not so vague. In introducing Second Reading in December 1960, the then Parliamentary Secretary to the Ministry of Health said:
  "It is proposed to recommend hospital authorities to adopt the same procedure of obtaining consent of relatives where they are available in relation to the removal of any part of the body as authorised by this Bill."
  In other words, a requirement for consent formed part of Parliament's intentions when the Human Tissue Bill was debated in 1960. However, that requirement seems to have been lost. Indeed, the Parliamentary Secretary went on to say:
  "The hospital authorities will also be recommended to ask the available relatives whether they know of others who might object. Any relative will be able to object to the removal, and this will override the consent of any other relative … This is felt to be a wise precaution to avoid the risk of causing offence to the feelings of any known relatives."—[Official Report, 20 December 1960; Vol. 632, c. 1232–33.]
  That issue may be contentious today, but it was not debated further on Second Reading of the Human Tissue Bill. The Parliamentary Secretary made the position clear at the outset of the debate, so perhaps the drafting of the Bill and the lack of debate on consent are a reflection of the prevailing paternalism at the time. Although a recommendation to seek consent was made, a provision was not included in the Bill. It is academic now whether or not the Department of Health did, in fact, implement the Minister's words. The evidence of the inquiries and the census all points to a departure from the intended spirit of the law and, at best, an adherence to its letter. The Bill will put right the mistake of over 40 years ago by making it clear that consent must be obtained.
  One issue that struck me in preparing for the debate was the importance of sensitive support for families at the time of bereavement. That picks up the point of the right hon. Member for Holborn and St. Pancras about the pressures on staff and on relatives and the emotions that emerge at that time. The report of the inquiry into children's heart surgery at Bristol royal infirmary identified the need to improve bereavement services in the NHS. That was covered in recommendation 12 of the CMO's report, which states:
  "All NHS Trusts should provide support and advice to families at the time of bereavement."
  It continues:
  "This support should include the services of a bereavement adviser, who can help families in the difficult period following death or where the situation allows to offer support through the dying process."
  1008
  However, the practice to date has been to ask relatives to authorise post-mortems shortly after death—in some cases, just after the news of death was broken.
  Treating family members with dignity and respect and discussing complex emotional issues, such as postmortems and the retention of tissues and organs, is difficult at the best of times, and I am told that it is poorly taught in medical training. Perhaps such training needs to be reviewed to ensure that it is the very best. Families need time to come to terms with their grief. When a post-mortem is suggested, unbiased information written in plain English and other languages should be supplied and support offered.
  NHS trusts have been required to designate a named individual to act as bereavement adviser since 2000, so what is the current position in respect of bereavement services? The answer is that it is patchy: some are good, some are average, some are bad and some are developing. That is my reading of the results of the bereavement services report produced by the Department of Health following its survey back in 2001. That report's conclusion says:
  "It is clear that every Trust does provide support to the bereaved in some form, but the extent of this support seems to vary. It is mentioned frequently that greater consistency could be achieved by training more (if not all) hospital staff in basic bereavement awareness and communication skills."
  The report's findings include the fact that fewer than half of NHS trusts had a dedicated member of staff to look after bereavement. Only 15 per cent. had a bereavement officer, and 20 per cent. said that they were doing well on issues relating to post-mortems and organ donation, while 7 per cent. said that they were not doing well. The report is silent about the other 73 per cent. of trusts. That should be a cause for concern.
  Almost a third of trusts said that their provision of follow-up support and visiting needs much improvement. It is no wonder therefore that the CMO in his progress report on his web pages says:
  "More work needs to be done to ensure that the provision of bereavement services is given the priority and attention that it needs."
  To be fair, the Bill's explanatory notes state that £2.7 million per annum has been included in the NHS baseline to develop bereavement services in 2003–04. Of course that is welcome, but it remains to be seen how it will work on the ground.
  The explanatory notes say that the funding is sufficient to develop services that will be compliant with the Bill. However, will that extend to developing the follow-up support and visiting services that are so important? Can the Minister say whether strategic health authorities will include the development of bereavement services in their performance management work? I understand that the Department is supposed to be undertaking a follow-up survey to find out how improvements are progressing. It would be useful to know the time scale for that work.
  One of the reasons why I raise bereavement support is that it goes to the heart of how we ensure that appropriate consent is achieved. Bereavement services that provide support in a helpful, informed and unbiased way can help people to reach decisions more easily. I raise that issue in particular because of a case that demonstrates that bereavement services have a long

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  way to go. It occurred over the Christmas period at the St. Helier hospital, which is part of the Epsom and St. Helier NHS trust.
  The case was drawn to my attention by my constituents, Mr. and Mrs. Cornwell, who were visiting a relative of theirs, Mrs. Howe. They were rung by the hospital at 4 pm on 3 January and told that her condition was deteriorating and that they should come soon to see her. They visited and stayed until 7 pm, and they said their goodbyes. When asked, the doctor said that what was meant by the word "deteriorating" was that their relative was dying. They went home, which was very nearby, but they had no call from the hospital after that.
  On Sunday 4 January, Mr. and Mrs. Cornwell decided to visit the hospital again, thinking that their relative was perhaps still alive—they wanted to see her again. They rang the hospital before setting out, and they were told by a junior staff nurse, after some discussions among the nursing and other teams at the hospital, that their relative had died at 9 pm the previous evening—two hours after they had left—and that they should contact the bereavement officer after 10 am on Monday. No information or counselling was provided and no suggestion was given as to what else they should do. They rang the bereavement office on Monday and told the person there that they had not been informed about the death, but had learned about it through their own positive action.
  The office took the details and phoned back that afternoon to say that there was concern about the cause of death and that there would need to be a post-mortem. It did not inform medical staff that the relatives had not been informed and it told the Cornwells that they should go to the ward to collect their relative's personal effects. I cite what happened, because it is an example of how things can go wrong. Even when the relatives were told about the need for a post-mortem, no reference was made to the fact that forms had to be signed or to the issues that the Bill is all about. That is why the system must be improved.
  To be fair to the trust, it has acknowledged that it made mistakes. In particular, it acknowledged three mistakes at a meeting that took place in my constituency this morning. The first was that, when the night duty nurse went to the ward on the Saturday, there was a misunderstanding from the duty nurse about whether the relatives had been informed of the death. A box was ticked, but there was no follow-up—not even when the relatives did not arrive and the body was moved to the mortuary. The bereavement office should have been informed by medical staff, but it was not. Therefore, it should not have told the Cornwells to pick up the personal effects. Finally, the trust did not provide all the information that it should have done to the Cornwells. It certainly failed to provide them with support.
  The trust has acknowledged the mistakes and is putting in place procedures, but they should have such procedures now. If the interim procedure is already in place, it should inform how such matters are dealt with today. The fact that it does not is a great cause of concern for me and for others.
  Transplantation is the second issue that I want to raise, and it has already been touched on in the debate. According to UK Transplant, the number of people
  1010
  waiting for organ transplants has increased by almost a third in the last 10 years. Today, 7,172 people need a lifesaving or life-changing transplant. Every year, nearly 400 people die waiting for a suitable organ to become available. They are the ones lucky enough to get on the transplant list in the first place.
  I understand from a press notice issued by UK Transplant that 10.9 million people have already pledged their organs for transplant by joining the NHS organ donation register. I can testify, having tried it out quite recently—perhaps having been stimulated by preparing for the debate—that it can take a matter of a few minutes, if that, to register one's intent to donate one's organs on death. I urge anyone to visit the website and to take the steps to doing just that.
  One question that must be asked about the Bill is whether it will help to tackle the serious shortfall between the number of people awaiting donor organs and the number of people taking the positive step of registering their willingness to be donors. Planning for one's own death is still something of a taboo subject in this country. We do not like to talk about that or our mortality. That deters people from taking the positive step of recording their wishes to donate.
  Polls have found that 70 per cent. of the population say that they are willing to donate their organs for transplantation after their death, yet just 15 per cent. formally register. One way—and I stress that it is one way—to bridge the gap between what people say they want to do and what they actually do would be to adopt a system of presumed consent. I stress that such a system of opting out would not mean that the views of relatives would be ignored, but it would change the nature of the discussion between the clinicians and members of the family that takes place at such a crucial point. The BMA briefing for the debate says:
  "most families do not discuss their wishes about donation and, when asked at the time of bereavement, many opt for the default position, which is not to donate. Studies show that many people later regret this decision."
  The worrying thing is that the refusal rate is increasing, so what is the current state of public opinion on the question of presumed consent? A survey commissioned by the Department of Health in 1999 found that 50 per cent. supported the current opt-in system and that 28 per cent. supported presumed consent, with 21 per cent. having no preference. Since then, two further surveys found that concern about the availability of organs for transplants has led to a shift in opinion. The National Kidney Research Fund discovered that 57 per cent of the persons sampled supported a system of presumed consent. The BMA system would allow organs to be removed for donation after a person's death unless the individual had registered an objection during his or her lifetime; or if it were clear from information provided by the spouse or partner—or where there is no spouse or partner, by a parent or child—that the individual had expressed an objection to donation that had not been officially registered; or if it were clear that the donation would cause major distress to the individual's partner or, where there is no partner, a parent or child. The BMA makes it plain that that arrangement would not apply to persons under the age of 16. I do not pretend that presumed consent alone would solve the shortage of donor organs but it should form part of a wider strategy to increase donation rates.

  1011
  I recognise that the issue is one of conscience for many right hon. and hon. Members. If during the passage of the Bill there is the opportunity to debate and vote on a suitable amendment, I hope that it will be the subject of a free vote. I certainly welcome the indication by the hon. Member for South Cambridgeshire (Mr. Lansley) that such an approach will be taken by the Conservatives. My hon. Friend the Member for Oxford, West and Abingdon (Dr. Harris) hopes to catch your eye, Mr. Speaker, and to develop the arguments for presumed consent.
  The hon. Member for South Cambridgeshire mentioned the problem of defining human tissue and organs—an issue that he raised in an Adjournment debate last April. The chief medical officer's report stated that "tissue" had not been explained in the past. In particular, it was not made clear that it could include whole organs, especially in small babies. Most parents thought that the term meant small amounts of tissue for microscopic examination. Informed consent would require clear communication and shared understanding. The Bill ducks that issue. Definitions of tissue and organs should not be left to guidance or codes of practice alone. I hope that the Committee will debate and arrive at a consensus to move that aspect forward.
  The Royal College of Pathologists makes the point that while the Human Tissue Act 1961 is vague and misleading, the Bill is so tortuously worded that it will be incomprehensible to those who, under its regulations, will risk being exposed to penalties. The college suggests that schedule 1 should distinguish more clearly between activities for which consent would be mandatory and those not always requiring consent, as determined by the proposed Human Tissue Authority. I hope that the Minister will give some reassurances on that point when he winds up.
  Those who remove tissue from living patients will be expected to seek consent for all subsequent uses of it. Persons working in medical education or research, for example, will need to ascertain the material's consent status. Does the NHS have the capacity to take on that additional work and cost? The Royal College of Pathologists states that to record the explicit wishes of all patients in a manner that allows laboratory staff rapidly to retrieve relevant information on large numbers of patients will require investment in information technology that cannot reasonably be funded from existing NHS laboratory or hospital budgets. It is estimated that 3 million solid tissue samples are taken from living patients each year. Is the Minister confident that existing resources are sufficient to put in place the necessary systems to implement the spirit and letter of the law?
  If a doctor publishes a research paper in support of a hypothesis that includes pathological diagnoses culled from pathology reports, is a criminal offence committed if it transpires that in one of the cases, the consent for research box on the surgical consent form was not ticked? If an offence is committed, who commits it—the pathologist, the physician or the doctor who writes the paper?
  The Bill deals with many public concerns about the way in which organs and tissues are removed, retained and used. It is a vast improvement on the 1961 Act and
  1012
  it should receive a Second Reading. It took almost 40 years before the weaknesses in the 1961 Act were exposed. The Bill is not the subject of party political dispute and I hope that that will liberate the Standing Committee that examines it and allow it to do a genuine job of revision and improvement.
  Members of Parliament can never hope to make up for the pain and suffering of the Alder Hey families but we can ensure that their legacy is a sound system that safeguards individuals' rights to give their consent and respects the rights of the family.
  3.45 pm
  Dr. Ian Gibson: The erudition shown by all hon. Members makes it easy not to be repetitive and ask the same questions, which will be tackled in many places.
  I have seen many human tissues from cancer patients and worked with them at all levels. I have especially examined DNA and cancer genes, which have recently been shown to be important in defining whether someone may get cancer and whether it runs in the family. It was important that we did not have to go back for permission once it had been secured. I hope that we will preserve that because this country has been at the forefront of such work and won Nobel prizes for it. It has also been important to share the information internationally.
  During the Alder Hey business, several constituents who had, sadly, lost their children approached me. They were worried about the location of tissues and I took them to various hospitals throughout the country. I especially remember Great Ormond Street hospital because the parents wanted the microscope slides and tissues—not organs but tissues. After negotiations, and because of the furore, they were able to bury the microscope slides. Whatever our personal feelings, we must understand how those parents felt. For them, something had been taken away and they wanted it restored.
  We need to restore public confidence in science and medicine. The march of knowledge depends on that; we cannot move forward without the public behind us. The Bill recognises that—it is one of its major features. I believe that the measure will be a landmark Bill, of which we shall all be proud.
  Any regulations that we make require the serious thought and involvement of many different parties. We get it wrong at our peril. If we do not get it right, there will be media controversy, communication breakdown and a lingering cynicism about organisations whose intent is honourable. We must get the conditions right. Public trust is hard to win but exceptionally easy to lose. We all have experience of that. Trust is often the key to the political success or failure of regulation.
  Scientific and medical authority will no longer legitimise new regulation. I said "authority" but some people would use the word "arrogance" for the assumption that one can act without asking permission. When we took tissues, we had long discussions with people about the purposes for which they might be used. After a while, they would come back and ask, "What did you find out?" It is in the nature of things that one does not always have much to say, but such questions emphasise that people have given tissues and expect something to happen.

  1013
  Open government requires public engagement, which is difficult to achieve. Attempts to get the public to come forward and get involved are plagued with many difficulties. We are finding that with genetically modified crops and measles, mumps and rubella. We must take on the problem and try to ensure that the process is inclusive and that nobody is denied the right to say something. In that context, the fastest growing profession is that of people called ethicists. They are crawling out of the woodwork and making millions. The subject used to be called moral philosophy. Is there a difference? I can never understand it, but people will go on for hours about the difference between an ethicist and a moral philosopher.
  Earlier, it was said that one can never tell what one will find from tissues that are kept and maintained. One never knows what will be found as knowledge moves forward. Let me give two examples of that, because it is important to get this message across to the public during the debate on these issues. The causal agent of peptic ulcers was discovered by a pathologist—an histologist, indeed—who looked at tissue and saw some wiggly things that turned out to be bacteria in the ulcer material. He asked permission to examine certain archive material and, blow me, he found the bacterium helicobacter in every piece of ulcer material. That caused a revolution in the way in which we treat peptic ulcers. Instead of using all the treatments that had been available previously, we suddenly had the drug that had been developed against that bacterium. That discovery revolutionised the treatment.
  The other example involves rectal tumours. People suddenly discovered, by examining tissue, that they had to cut out more than just the rectal cancer. They discovered that they had to extend the surgery a little further because the cancer returned in those patients who did not receive such treatment. When examining the cases of patients who had survived for long periods of time, it was found that extra tissue had been taken from around the rectal cancer. That discovery was made while examining archive material. There are many similar examples, and I am sure that the professional organisations could get involved in telling us all about those developments.
  The examples of those two practices could be used to build public confidence as the Bill proceeds. We shall all be very proud that, following the tragedies that have occurred, we have found a way of restoring public confidence, not only in the practice of taking tissues but in science and medicine generally. That confidence is badly in need of repair, and we are now part of a huge process of revolutionising medicine and science in this country.
  3.51 pm
  Mr. Kenneth Clarke: I welcome the Bill, so far as it goes, and I certainly agree that this area of the law is in need of modernisation and clarification. The law as it will be after the Bill has been enacted will be a considerable improvement on what we have now. I hope that we get it right, and that the Government continue to pay attention to the concerns of those in the medical research and other establishments, and to ensure that we do not over-react to the understandable public horror at the excesses that were revealed a few years ago in such a way as to damage worthwhile
  1014
  medical research. I share the views of those who are not sure that the wording of the Bill is quite right, and who think that there is a need to consult, particularly as it was not possible to produce a draft Bill. We shall not have an opportunity to return to this issue often.
  I hesitate to upstage the Father of the House, but I recall that, when I was a student, I went into the Strangers Gallery after a dinner in the House and found myself listening to the Second Reading of the Human Tissue Bill. At the time, I did not think that I had picked the best possible evening to witness the heights of political rhetoric, but subsequent experience in the Department of Health and of the reactions to recent events has shown what a sensitive subject this is. I think that the hon. Member for Sutton and Cheam (Mr. Burstow) was a little harsh to criticise the authors of the 1961 Act; it has lasted for more than 40 years. We do, however, need to re-establish such principles as informed consent and to re-establish the reputation of those who need human tissue if they are to make valuable progress in medical research.
  The subject on which I propose to concentrate today is the impact of the Bill on the problem of the shortage of donor organs for transplant in the national health service. I have always believed that that is a serious clinical problem, and it is getting steadily worse, year on year. In 2001, when I drew a place in the ballot for private Members' Bills, I produced a Bill called the Transplant of Human Organs Bill to enable us to have a debate on the problem of that shortage and to seek to tackle some of the essentially legal problems that are causing the difficulties involved. I was drawn seventh in the ballot, so the contents of my Bill were extremely modest—it had to be non-controversial in order to get through. It did, however, give us the opportunity to canvass opinion on other things.
  My Bill did not receive the support of the Government or the then Minister, whose response was that the Government were waiting for the comprehensive survey of all the legislation on which they would then embark. I was somewhat irked by that response, but I congratulate the Government and the present Minister on having addressed at least one of the fears that I expressed at that time. I feared that it would take years to get parliamentary time for a comprehensive Bill on the subject, so I congratulate her on having got a measure into this year's programme and giving us a chance to address the problem.
  Whatever the Bill's impact in the other important and sensitive areas involving human tissue, including its retention, control and use, I fear that it may be regarded as a missed opportunity to do something positive about the continuing shortage of donor organs. I understand why the Government are cautious in this area—the issue is terribly sensitive, so they are right to be cautious—but opportunities rarely arise to rectify the legal problems that give rise to the needless death of many patients awaiting donor organs.
  In 2001, there was a fear that the strong and understandable public reaction to the tragedies and scandals that had been unveiled at Alder Hey and at Bristol would damage the organ donor programme.

  1015
  Fortunately, that did not happen directly because everybody struggled to ensure that it did not happen, but the Government's approach to the Bill has been coloured by the recollections of the ferocious public reaction to the subject as a whole. That has made them more cautious than they need otherwise have been on organ transplantation and the availability of donor organs.
  The bulk of the public recognise the value of having donor organs for those who suffer failure of one kind or another, of their kidneys or hearts in particular, and there are different public attitudes on that subject, which are easier to address than some problems that arise in the examples of anatomy, training, research and so on.
  The organ donor problem is important. Although successive Governments, for as long as I can remember, have tried to tackle it, we ought to face up to the fact that our efforts have not been very effective. It is one of the biggest problems in the NHS that large numbers of people are dying needlessly because of the shortage of organs for transplant. It has already been stated that several hundred die each year who are on the waiting list, waiting for an organ to become available.
  The problem goes beyond that in my opinion, because, quite apart from the death of those who are still waiting, the difficulties in the lives of people who spend some years waiting for an organ transplant while contending with dialysis or with exhaustion, which can affect a patient who needs a heart transplant, are considerable and do enormous damage to the quality of life of many of our constituents.
  The difficulty is that the problem is increasing. The situation is getting slightly worse year by year, not getting better. I am obliged to the Library for enabling me to tell the House that the lengthening waiting lists had reached 5,793 at the end of November 2003. Those are all people who could benefit if more donor organs became available.
  In practice, although the number of patients who are getting on to waiting lists because medical science will enable them to benefit is increasing, the number of donors—in particular, cadaver donors—is slightly decreasing each year. The problem is therefore getting worse. I believe, and I think we all accept in principle, that that situation could be improved by changes in procedures, but also by changes in the law. Legislation would not in itself solve the problem, but where it could contribute we must ensure that we take this opportunity to get it right.
  I welcome some changes that are being made to the procedures designed to speed up the process of identifying available donor organs and making them available to those who are going to treat patients, as well as the Government's attempts to streamline the functions of UK Transplant. The Bill also tidies up some important details of the law, which I addressed in my private Member's Bill, but it does not go to the heart of the matter. The biggest and most important question about the availability of donor organs from people who are deceased is that of consent. I am afraid that the Government have taken too cautious a view.
  Let me make it clear: I realise that assent is at the core of every aspect of this Bill. The principle of
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  informed consent is absolutely essential, and I trust that no civilised person would seek to deny that as long as we do not take it too far in the case of blood samples and minor slide samples, as others have mentioned. Of course, it is essential that no organ is used for donation to a sick patient if we have any reason to believe that the deceased person would have objected to that, or, if the deceased person had expressed no view, if some close family member would be deeply distressed if it took place or believed that the deceased person would have objected. All that must be coped with. The present position, however, puts many obstacles in the way of making use of available cadaver organs, which goes far beyond that.
  The biggest single issue that troubles me, however, is not presumed consent, about which I will speak briefly in a moment. The first issue that I hope we can address is the present confused situation in which people carry donor cards or have their names on the NHS organ donor register. We all accept that not enough people carry cards, and not enough people put their names on the register. We should ask ourselves, however, what assumption are people making if, as I hope everybody in the Chamber does, they carry a card or their name is on the register? I think that we all assume that if that desperate misfortune happens, and we are run over crossing the street and die, when someone finds the card in our wallet, or looks up our name on the register, the whole process will instantly move into gear, with the transplant co-ordinator trying to find out whether anyone can make use of such organs that remain in a usable condition. As I understand it, however, that is not what occurs.
  In many cases, the card that we carry is used by the staff of the hospital to assist them in getting the consent of the relatives for the use of the organs. It is used as a basis to try to persuade no doubt desperately bereaved relatives that the person who has just died would have wished that to happen. That is no doubt helpful, but it does not cut out the process of deciding which relatives to consult, getting hold of them and handling people at a time when they are most vulnerable, and sometimes least rational, and trying to get them, in the middle of their grief, to address the problem of whether the kidneys or heart can be removed for the benefit of another patient.
  It is astonishing that the Minister—in no way am I criticising her—was not able to answer when the hon. Member for Oxford, West and Abingdon (Dr. Harris) asked her what I think is the most important question: what is the effect of the Bill on the status of donor cards, and, I would add, on those on the register? I realise the difficulties of holding all the details of such a complex Bill, but if the Minister cannot answer it, what will happen to the practitioners in the field who want to know their legal position? That may require some alteration to the wording of the donor cards, but my belief is that it should normally be assumed that if the deceased person was found to be carrying a donor card, that is the deceased person's consent to going straight into the process of using the organs. My belief about that is even stronger in the case of the NHS register.
  In the course of consideration of the Bill, I hope that that issue can be addressed. The Transplant Partnership and the British Medical Association have long

  1017
  advocated that the law should refer specifically to the NHS register—I would add donor cards to their recommendation—to put the question beyond doubt. When we try to persuade our fellow citizens to indicate a willingness to make their organs available if they should tragically or suddenly die, in conditions in which they have available organs for use, that should be taken as full consent authorising fully what happens.
  Staff will in any case try to contact relatives and discuss the tragedy with them—there will be no question of their not knowing what is going on—but I see no reason why the long list of relatives specified in the Bill should have the final say. It is, after all, conceivable that some half-brother who had had no contact with the deceased person for some time might turn out to hold religious beliefs that the deceased person did not have, and refuse consent; or the divorced parents of a deceased child might have arguments that staff could not resolve. The point of the cards and the register is to avoid such problems.
  It will be suggested that staff find it convenient to have the cards in order to obtain the consent of relatives. I am sure that that is true, as most relatives do consent when they know that the person carried a card. The problem, however, is not that when people get around to it they cannot use the cards to obtain the consent of relatives, but that the process involved puts people off. In a hard-pressed intensive care unit people simply may not bother to work through all the relatives and find a suitable one, while ensuring that no relative in a priority category has been missed out. No bother will be necessary if the discovery of a card means it is possible to proceed, and then inform relatives as quickly and as sensitively as possible.
  The Minister was not able to answer off the cuff when asked this question earlier, but can we be told whether the carrying of a donor card or the registering of a name will in itself constitute sufficient consent for organs to be donated? If the answer is not clear, will the Minister undertake to ensure that it is made clear during the Bill's progress, so that in due course an Act will make it crystal clear that carrying a card gives the go-ahead for the use of organs?
  I shall not say a great deal about presumed consent, because the issues are clear and no doubt the subject will be discussed when an amendment is tabled. Obviously there will be a free vote for all parties, given that the issue is devoid of party politics. I support what the Transplant Partnership and the BMA have called the soft presumed-consent procedure, whereby the seeking of relatives' consent starts from a presumption that if there is no evidence that the deceased person took any steps to object, that constitutes his consent—but if relatives who are found express strong views priority must immediately be given to their feelings.
  That would not constitute a dramatic change in itself. No one is suggesting that relatives should not be consulted or informed of what is going on. I believe, however, that presumed consent would give rise to a more positive view of transplantation generally in the NHS, and indeed would help relatives. If the presumption is that organs will be used unless relatives have strong moral or religious objections, or believe that the deceased person would have objected, relatives will in fact be relieved of some of the burden of having to
  1018
  give positive agreement to the cutting up of a body to remove organs that are not diseased. In their desperate state, they may not feel able to make such a decision.
  That is what the Spanish do. I accept that it is not the only thing that is done right in Spain, and not the only thing that produces a better record than ours throughout western Europe when it comes to the availability of donor organs. I believe, however, that it must contribute to that. As I said earlier, the cadaver donor rate per million of population in Spain is more than double our own rate. I believe that we have the worst record in western Europe. We must do something about that weakness in the law.
  Mr. Dalyell rose—
  Mr. Clarke: I give way to the hon. Gentleman, whose ten-minute Bill I hope I voted for in 1971.
  Mr. Dalyell: The right hon. and learned Gentleman did vote for it. When I did a long survey over 42 days, it was almost pathetic to note that many people who had not given permission for some part of their loved ones to be used later regretted it. It was a matter of considerable sadness to them that they had not been able to help other people.
  Mr. Clarke: I quite agree, which is why it is so much better for people to indicate their wishes during their lifetime or to make a presumption that they would have consented unless a relative is quite sure that they would not have. In fact, we waste many available organs: after making inquiries into many deaths, in only a small proportion of cases is it found that people persisted in objecting to the removal of a kidney or heart for a transplantation operation. I hope that the issue will he re-assessed during the Bill's passage through both Houses.
  We all agree that it is not a partisan issue and we have all joined in congratulating the Government on presenting a Bill that provides us with an opportunity to deal with all transplantation and other human tissue issues in one piece of legislation, tidying up and clarifying the law. However, if we make no advance on our present law and practice in respect of the shortage of donor organs, we will regret having missed that opportunity. I hope that the House will encourage the Government to be more ambitious in their intentions and to press more ambitious amendments as the Bill proceeds. Otherwise, we will have a growing scandal of a steadily deteriorating position in which people are dying needlessly or having their lives destroyed by waiting for organs that never become available.
  4.11 pm
  Mr. Robert N. Wareing: I, too, welcome the Bill, as it signifies the Government's clear intention to clarify the law. I have some reservations about it on the grounds that it does not completely clarify the law and is less comprehensive than I would have liked.
  Practice over the use of a patient's organs has varied from place to place, and the Bill attempts to put into statute what is already best practice. I certainly welcome that. However, because it is not comprehensive enough,

  1019
  it needs to be examined carefully in Committee. I only hope that the Committee has enough time. The hon. Member for South Cambridgeshire (Mr. Lansley) is right that we must have enough time to examine the Bill carefully.
  The Bill has been introduced without following through what the chief medical officer said should happen in January 2001, which relates to my reservations. At the chief medical officer's summit on 11 January 2001, Professor Donaldson said that, after the publication of Royal Liverpool's children inquiry, the move forward on any necessary changes, including legislative changes, should be "all in one go". He also said that the Department had large research programmes and that there was "no way" that it would wish
  "to divert or suppress any research".
  Professor Donaldson was, I believe, looking for a more comprehensive measure than the Bill before us this evening. I hope that we will reflect carefully on what he had to say.
  The chief medical officer's report of January 2001 was entitled, "The Removal, Retention and Use of Human Organs and Tissue from Post-Mortem Examination". What Professor Donaldson recommended was accepted:
  "As soon as possible, there should be a more fundamental and broader revision of the law, encompassing the taking, storage and use of human tissue from the living and the dead and introducing an independent system of regulatory control. To be comprehensive this should encompass aspects of Coroners' practice. It should shift the emphasis from 'retention' to 'donation' to signal a new relationship with the public and bereaved families."
  For me, the issue is why these matters have not been followed through. We need to take a proper look at the question of consent for coroners, which, of course, is automatic at the time of the inquest. Permission is required after the inquest has been conducted; however, many people are misled by the existing legislation.
  I want to express my admiration for the excellent work of the staff of the Royal children's hospital, Liverpool—or Alder Hey, as it is better known—which is just across my constituency border. It has treated patients from all over the United Kingdom, and even from abroad, and its reputation will undoubtedly outlive its recent problems and shortcomings. It has for a long time had a unit devoted to assisting bereaved parents with the utmost compassion. In my view, it remains a world leader in the treatment of children.
  Following inquiries into the events at Alder Hey, however, it became apparent, as my right hon. Friend the Member for Holborn and St. Pancras (Mr. Dobson) said, that the storage of human organs and tissue without consent was widespread. Both the hospital and university authorities—they have not been mentioned specifically in the debate so far—were culpable. There was no criminal sanction, but the existing law proved ambiguous. Parents were told at the time of their bereavement that all the organs had been returned to the bodies. That was untrue. The situation was horrendous, and, as has been said, in some cases the bereaved parents had to endure multiple
  1020
  funerals. Even where consent was given, the parents had no idea that it meant the extraction of all organs, and that what they were burying were the mere shells of their loved ones. I hope that the proposed Human Tissue Authority will address that issue properly when drawing up a code of practice.
  I am a little worried about codes of practice. Will the code, which should certainly be very clear, be enforced in the manner of the highway code, for example? If it is not to be regarded by the health service in the way the highway code is regarded so far as transport matters are concerned, there should be clear legislative enactment of it. People ought to know that a criminal sanction will apply, should the code be offended against.
  Some say that there should be a presumption of consent, but I am a little unhappy about that. In my view, the needs of research and medical training should never take precedence over the rights of bereaved relatives.
  Dr. Evan Harris: I can reassure the hon. Gentleman that those Members who support the option of presumed consent—including a "soft" version, whereby relatives are consulted—propose that it apply not to organ use for teaching and research, or to children's organs, but only to life-saving transplantations.
  Mr. Wareing: I welcome the hon. Gentleman's comments, which are in accord with my views on what should happen.
  The right balance should be struck between the needs of society and the interests of parents. The right hon. and learned Member for Rushcliffe (Mr. Clarke) was present when we discussed this issue, but he was unable to interject and offer his wise comments. The Human Tissue Act 1961 certainly fails in respect of creating the right balance. Currently, medical education comes first, and the retention of organs is based on lack of objection, rather than on consent. That issue needs to be looked at very carefully when the Bill is gone through in detail in Committee.
  Clause 24 deals with qualifying relationships in respect of who may give or refuse consent—I think the right hon. and learned Member for Rushcliffe wrongly referred to clause 35 in that regard. However, it is unclear what would happen if there was disagreement between two persons of equal ranking under the provisions. There could be religious objections of the type referred to by the right hon. and learned Gentleman, or the person might not have seen the deceased for many years, or even decades, and their views might stand in the way of what the deceased person might have wanted. It is possible that a majority of people will continue not to carry donor cards, and although I hope that situation will change it seems unlikely to do so significantly.
  The Bill provides that a living child may give its consent if competent, but what exactly is meant by "competent"? How is one to discover whether a child is competent?
  The Bill does not include provision for a decision to be made on behalf of mentally incapacitated living donors. Will that matter be addressed in Committee, or will the Government's mental health Bill include a suitable clause to cover such contingencies?

  1021
  When news of the retention of organs broke, Alder Hey made an attempt to provide families with counselling, which was a good thing. However, the counsellors either were, or were assumed to be, connected with Alder Hey and thus not independent, so families were sometimes reluctant to take up the service. Should not counselling support be independent of the organisation at fault? Will the Minister consider tabling a new clause on that issue? Many bereaved parents—certainly in the Liverpool area—did not go to the hospital for counselling because they thought that the counsellors were in league with the people at fault over their loved ones.
  We tend to ignore the international dimension of these matters. There are many differences of practice between states. Is not there a need for harmonisation, at least between the countries of the European Union? United Kingdom citizens should be covered when abroad. Spain has been mentioned, but I believe that in Austria all organs are stripped from a dead person. That has happened to British tourists, no doubt against the wishes of their bereaved relatives.
  What is our current policy on the European convention on human rights and biomedicine? About two years ago, in their reply to my question on that subject, the Government seemed to be of the view that they were considering the convention, but I do not think that anything has happened since then. What is the current situation?
  I hope that the Minister can answer my questions. The Bill deserves a Second Reading and I am sure that the whole House will support it, but it needs detailed consideration, and although I shall support the programme motion it is very restrictive.
  4.24 pm
  Mr. David Wilshire: Although the Bill is about more than organ donation, it is on that subject that I rise to speak. I do not speak as a party politician; this has to be free-vote territory. I speak simply as an individual whose awful experience may help others to clarify their approach to at least one of the difficult issues raised by the Bill.
  At the outset, I want to make it clear that I have no objections at all, in principle, to the removal of parts of a dead body. In fact, I have carried a donor card for many years. However, I do have some concerns about consent, and they arise from the death of my daughter.
  Twenty-two years ago, my 12-year-old daughter choked to death at school. Very shortly after that catastrophic event, I met some of her teachers and some of the staff at the hospital to which she had been taken. I was too distraught to turn my mind to organ donation, and I suspect that they were too kind to risk causing me further distress by raising the subject. As a result, no part of the body that was no longer of any use to Sarah could be used to help others. As the Father of the House predicted a few minutes ago, that is something that I deeply regret to this day.
  When they hear me recount that story, people might believe that it is an argument in favour of presumed consent. However—and perhaps curiously to some people's minds—that experience has led me to become an opponent of presumed consent, and I want to try to explain to the House why that is so.
  1022
  All hon. Members have probably received representations recently urging us to use the Bill to introduce some form of presumed consent for the removal of organs from a dead body unless someone has registered opposition to that course of action. I readily accept that there are powerful arguments in favour of that approach. Principal among them are the shortage of donor organs noted by my right hon. and learned Friend the Member for Rushcliffe (Mr. Clarke), and the many and growing opportunities to help people in need of organ transplants.
  I accept that helping those people is an entirely worthy objective, and I hope that the entire House supports it. I certainly do, but I believe that we can achieve that objective by means other than through presumed consent. There are serious anxieties about presumed consent, and I have my doubts about whether it would solve all the problems that its supporters claim that it would solve. The potential abuse of presumed consent is a very real fear. Appropriate amendments to the Bill might resolve that problem, but we must also consider the impact of presumed consent on bereaved relatives.
  If presumed consent had been in operation on that June evening so many years ago—and I take the point about its not applying to children made by the hon. Member for Oxford, West and Abingdon (Dr. Harris)—a doctor would have got on with what he judged needed to be done, or he would have had to check that I had no objections. If I had discovered later that, although I was in the hospital, no one had taken the trouble to consult me, I would have been outraged. Had I been invited to object rather than to agree, it is probable that I would have been made to feel guilty for the rest of my life if I had found the need to refuse.
  Please believe me: the last thing that a person who is struggling to cope with the death of a daughter wants is additional and avoidable grief. That is why I oppose presumed consent. To my mind, something that has the capacity to add outrage and guilt to the hell that one goes through in those circumstances simply has to be wrong.
  That said, I can readily understand why I might sound selfish to other people. I know that doctors are busy people, so why put obstacles in their way? It is not easy to ask permission from a bereaved family, so why make clinicians do something difficult and unpleasant?
  Let me give my answers to those two questions. If there were ever a situation where the needs and wishes of patients and their families must come first, this is it. On such occasions, clinical convenience must always be a secondary issue. Presumed consent would not spare doctors the difficult task of raising the subject of organ donation with bereaved families—all it would do, as the hon. Member for Sutton and Cheam (Mr. Burstow) said, is alter the nature of that discussion. In my opinion, asking, "Do you wish to object?" is no easier than asking, "Please may we?", but to my mind, "Please may we?" is much kinder and much gentler.
  Those who speak on any subject have a duty, if they oppose a certain way of achieving something desirable, to say what the alternative ways of achieving it are. In this case, I suggest "required request". Let me give the House a few examples of what I have in mind. We could

  1023
  train, then require, GPs to raise the issue with their patients, especially when registering new patients, and they could record all those agreements on a central database. We could help, then require, hospital managers to add a question to their admission forms: I am sure that that would help. We could train, then require, hospital doctors, especially those who specialise in accident and emergency, to raise the subject gently with the bereaved. I would have been eternally grateful had they done that with me those 22 years ago.
  Before I conclude, I add a footnote about the events at Alder Hey hospital that triggered the drafting of the Bill. I, too, had constituents who were affected and a local hospital that was involved, and I therefore witnessed for myself the distress, grief and anger to which the Minister referred. Because of the death of my daughter and the post-mortem that followed, I, too, could have been personally involved. Had I been, the last thing I would have wanted—whatever the facts that may have been discovered—would be someone knocking on my door 20 years later and reopening a still very sore wound. I may sound like a coward, but some things that people demand that they know, I would rather not know. My hon. Friend the Member for South Cambridgeshire (Mr. Lansley) put it well when he said that there is a right not to know, as well as a right to know.
  The Bill raises many more issues than those that I have mentioned. I readily accept that they are all important, that they are all difficult, and that none of them is party political. Using human tissue and organs can save the lives of others and is essential for medical research—that is why I support it—but we must not allow our enthusiasm to help others run away with us in the decisions that we take. Potential donors and their families must have equal consideration.
  I realise that it is probably inevitable that I am on the side of the bereaved, and I feel no need to apologise for that. Even if others disagree with me, I hope that sharing Sarah's experience and my conclusions with the House may, in some small way, help this House to reach compassionate conclusions on all the intensely personal issues that are raised by the Bill.
  4.35 pm
  Mr. Tom Watson: This is a good Bill. As many hon. Members said, it is the result of a desire on both sides of the House to provide justice for the families of Alder Hey and Bristol. What better tribute could there be to the daughter of the hon. Member for Spelthorne (Mr. Wilshire) than that we can have an open debate about how we can advance compassion in medical science?
  The hon. Member for Spelthorne made a powerful case for an opt-in system and advanced some creative ideas as to how we can improve the organ donor register. I should like to put it on record that I believe that the initiatives that the Government have taken in the past two years are excellent—not least, sending out licence reminders to 6 million people and encouraging electoral returning officers to add an opt-in system to people's voter registration forms. That obviously means that we can advance towards the target that the Minister discussed earlier, and 11 million people on the organ donor register must be welcome.
  1024
  I would like to take this opportunity to advance the cause of presumed consent. Many Members have said that they believe in a system of weak consent. When I first approached the matter, I believed that if a deceased person's body could be used to save a life, then a hard form of presumed consent should be included in legislation. I must say that I have changed my view because of conversations with my constituents, which is true of my approach to many debates in the House.
  One such constituent is David Nix, who is a great man. He runs the organ Donor Family Network and, having received a small grant from the Department of Health, he operates the organ donor bus. Week in, week out, he tours the country and has signed up tens of thousands of people to the organ donor register. David convinced me that families must be involved in the decision to donate organs. When I attended a ceremony in my constituency to honour the memory of Sarah Lewis, I met Sarah's parents, David and Katherine. At the time of their maximum grief, only a few months after her death, they took solace from knowing that Sarah's organs had saved many lives. That helped them in their grief and convinced me that, if we are to introduce a form of presumed consent, parents must be consulted and have the right to veto, and that all the issues must be dealt with sensitively.
  Transplants are the wonder of modern medicine. I hope that the Bill results in robust legislation that stands the test of time like the Human Tissue Act 1961—I agree with the right hon. and learned Member for Rushcliffe (Mr. Clarke) that that was a good Act. When the legislation was debated in 1961, medical science had not developed ways to transplant spleens, kidneys, hearts and lungs and to conduct multiple transplant operations. The 1961 Act has stood the test of time, but it is right for us to take the time to consider the advances of the next 40 years. I hope that the Bill will allow for future advances such as xenotransplantation and stem cell research, and that will be an issue in Committee.
  As the Minister in the debate in 1961 said, the test of the Bill will be whether we can build public confidence and convince people that organ donation is morally right. The 1961 Act succeeded. As has been said, most market research shows that at least three quarters of the British public believe in organ donation, and some surveys show that 90 per cent. of the population believe in organ donation. If nine out of 10 people in Britain support organ donation, it is obviously a problem that only 15 per cent. of people are on the organ donor register. As the Father of the House said, one way of addressing that gap is presumed consent.
  I have read the Father of the House's contribution to the 1971 debate, and I have read the five further contributions that he made throughout the 1970s. Although it was not unexpected, I was sad to hear the announcement of his retirement at the end of this Parliament. As a new entrant in 2001, I had the benefit of his support and advice when I moved a ten-minute Bill on organ donation last year. He is renowned for yielding to no one in pursuing what he thinks is right, be it organ donation, the sinking of the General Belgrano

  1025
  or, dare I say it, the decision of this House to enter Iraq. He will be sadly missed and I hope that he can still make a contribution after he leaves the House.
  The House does not have a great reputation for introducing legislation that meets the advances of medical science. The Corneal Grafting Bill was introduced by the then hon. Member for Tonbridge in 1952, but we had the technology to do corneal grafts in 1900. It took the House 52 years to pass an Act with a framework with which clinicians could engage. I would like to think that we will ensure that we do not make that mistake again.
  During the course of my research for the debate, I came across a Select Committee report from 1828 and a debate on the Bill that became the Anatomy Act 1832, which dealt with body snatchers. The debates arose because colleges could not teach medicine without cadavers, so a black market for them existed. If the Government do not reduce the gap between the number of people who require organs and the number of organs available for transplant, we will create a black market again. I do not want us to lack the courage to act today and thus create an eBay body-snatcher culture of the kind that we have read about in the press in the past two weeks. I hope that we can be bold, and that those on both Front Benches may be convinced not to close the door entirely on presumed consent, while trying to be as sensitive as possible to the views of parents and loved ones.
  4.41 pm
  Dr. Richard Taylor: It is with some diffidence that I start by declaring an interest, because it is relatively unimportant compared with the major aspects of the Bill: I must own up to still possessing the skeleton that I bought as a student along with Gray's "Anatomy" and dissecting instruments—it cost the princely sum of £16. The language of the Bill is fairly incomprehensible, as I shall go on to illustrate in relation to more important matters, so I am not sure whether I have possession of the specimen only for the purpose for which I was so authorised to have possession of it. I am not sure whether I am legally allowed to lend it to my children for display in their schools during lessons in human biology. I am not sure whether I am allowed to sell it at what would be its value today of something like 240 quid. That is just one example of how difficult it is to understand provisions in the Bill.
  At yesterday's briefing by Cancer Research UK, we heard that it thinks that the Bill's drafting is incomprehensible. It said:
  "Complexity is not an excuse for opacity."
  I cannot resist reading to you, Mr. Deputy Speaker, a sentence from the Bill that Stephen McGinness of the Library staff drew to my attention. Clause 30(4) is a classic of incomprehensibility that says:
  "Regulations under subsection (3) shall include provision for decisions of the Authority in relation to matters which fall to be decided by it under the regulations to be subject, in such circumstances as the regulations may provide, to reconsideration in accordance with such procedure as the regulations may provide".
  That is rather abstruse. I do not share the Minister's belief that schedule 1 is clear because several items in part 2 of the schedule—purposes not normally requiring consent—require the use of human tissue, so the situation needs clarifying.
  1026
  As many hon. Members have said, by far the most important aspect of the Bill is consent. Consent is crucial to patients, families, clinicians and, especially, pathologists. The word "appropriate" has already been discussed. Why are we in a position in which we require legislation on the use of human tissue, which is a basic necessity? It is because requests for operations and post-mortems in many hospitals have been delegated to the most junior member of the team for generations. The houseman who has only just arrived on the scene has no knowledge of what the pathologist is going to do. I myself have been guilty of obscuring the difference between the removal of tissue and the removal of a whole organ. I am probably one of the few hon. Members with experience of asking for post-mortems and transplantation. A basic and practical point is when is the best time to make such a request? Should doctors do it at the same time that they tell the family about the death, or should they bring them back the next day, ostensibly to collect their relative's belongings, so that they can ask them at an easier time? Is it an easier time for the doctors, or is it easier for the family? There are therefore practical issues that need to be addressed.
  From the doctor's point of view, a post-mortem to confirm diagnosis and the effects of treatment is vital. Attendance at the post-mortem provides an educational opportunity for the clinical team, which is often split by shift working, to come together. An article in the British Medical Journal in October by the vice-president of the New Zealand Medical Association examined the effect of the declining number of autopsies on medical student training. It said of post-mortems:
  "Attendance also heightens awareness of the large number of patients with multiple conditions and the level of uncertainty in medicine."
  That experience is not easily gained elsewhere, so post-mortems are still of great importance. Consent is crucial, and equally crucial is the method of obtaining it. I have a copy of the agreement form for post-mortems that is used in my own trust and which, I am sure, is representative of forms used throughout the country. It is daunting for a hard pressed doctor to find the time to supervise the answering of 14 questions with ticks and filling in two boxes. The Minister of State kindly said that she was determined that it would not be onerous to request consent. However, it will be onerous if we do not get it right, and I hope that the Standing Committee will address that in detail. My trust's consent form ends with a killer request:
  "Please read the booklet 'Information for Relatives' before you sign this form."
  Much work therefore needs to be done on the way in which consent is requested. For example, should the pathologist be involved in obtaining consent?
  I shall deal briefly with the Human Tissue Authority, because I am sure that it will be addressed at greater length in Committee. Codes of practice and licensing requirements are an essential part of its role. Provisions on its membership are loose in the Bill, but the Royal College of Pathologists would like representation, as

  1027
  would the General Medical Council. I shall not spend more than a moment talking about consent for the transplantation of organs, because it has been fully covered by the hon. Member for Spelthorne (Mr. Wilshire), who spoke from very personal experience. The right hon. and learned Member for Rushcliffe (Mr. Clarke) mentioned a serious drawback for practising clinicians. In the intensive care unit of the hospital where I used to work, we almost groaned when someone was able to donate organs for transplantation because of the time that that took to organise. People do not realise that not only kidneys, hearts and livers, but skin may be used, which is incredibly disfiguring and one of the things to which relatives can really object.
  Research has been fully covered by the right hon. Member for Holborn and St. Pancras (Mr. Dobson) and the hon. Member for Norwich, North (Dr. Gibson). The crucial importance of human tissue to research has already been mentioned.
  I will conclude with some warnings from practical pathologists that illustrate some of the points made by the hon. Member for South Cambridgeshire (Mr. Lansley). First, a practising pathologist in Manchester said:
  "While the intention of the bill regarding tissues from the deceased is entirely laudable, it also legislates for tissues from the living. As a consequence, any use of human tissues for teaching not 'incidental to medical diagnosis or treatment' and all use for research will require explicit consent from the patient"
  or the relatives. That is a huge burden. Another pathologist also emphasises the tortuousness, the lack of clarity and how hard the language is to follow. He even goes to say that he believes that there is a risk of defensive practices by pathologists, who may withdraw from activities that might put them at risk of criminal prosecution.
  It is crucial to separate the retention and use of tissues from the deceased, which is emotive, from the use of surplus tissue excised for the good of the patients, which is obviously far easier to understand. So I welcome the intentions of the Bill, but I feel that there is a tremendous lot of work to do in Committee, and I am rather doubtful whether enough time will be allowed for that.
  Several hon. Members rose—
  Mr. Deputy Speaker: Order. May I try to help the House? Four hon. Members are seeking to catch my eye. We must wind up the debate at 5.30 pm, or thereabouts. If the time can be shared, everyone should be satisfied, I hope.
  4.51 pm
  Harry Cohen: The hon. Member for Wyre Forest (Dr. Taylor) made a valid point about improving the clarity of the language used in the Bill, and I hope that the Government will take that on board and that that will come about in the later stages, as the Bill passes through Parliament. However, I welcome the Bill as a whole.
  The Bristol royal infirmary and the Royal Liverpool Children's NHS trust, Alder Hey, cases were scandals, and it is right that the Government have come up with
  1028
  the Bill to address such issues. Body parts were kept without the consent or knowledge of parents and relatives, and the doctors failed to communicate with the families. Those families were denied their right to bury their loved ones wholly, and suffered subsequent anxieties. We have heard about some of those anxieties today, such as having to carry out multiple burials and dealing with the fact that some of the parts could have been experimented on without the family's consent.
  The Bill rightly makes consent the principle for the retention and use of human tissues and organs. The post-mortem laws will remain unchanged. The removal and storage of human material at the direction of the coroner to determine the cause of death remains. Also, the police can still use human tissue for DNA testing to investigate suspected crimes—again, without consent. I want to return to those issues a little later in my remarks.
  I welcome the principle of consent and the setting up of the Human Tissue Authority. It will have regulatory powers and responsibilities, including licensing for the specific purposes where it will be legitimate to store and use body parts. It will also have a general role in informing the public about the issues involved. When considering the creation of such quangos, what went through my mind was the Food Standards Agency, which is a good organisation—I am not critical of it—but it has a bit of a balance to address, and I sometimes think that it leans more towards the industry than consumers. I would not want that to be the case with the Human Tissue Authority. It is important that it recognises the public interest as opposed to those of the industry or, in this case, the pressure groups concerned with anatomy issues.
  The authority will have the power to determine legally binding standards without oversight from Parliament. Again, I am not very happy about that. That means that the authority will not be as properly accountable as I would like it to be. The authority should report to Parliament annually to make it more accountable. Overall, however, I welcome the fact that it is to be set up.
  The Bill rightly creates a new offence of trafficking in human bodies or body parts. That problem is very much linked to poverty and desperation, so it is absolutely right that such trafficking should be made illegal and subject to penalties. Harsher penalties should be imposed on those trading in organs than on the desperate people who sell them. However, the provisions on that should not stop proper organ transplants that would save lives.
  We shall have to consider the modern ethical issues relating to reproductive and genetic tissue. Cell lines from stem cells can be used in the production of commercial products. There can be variations in the way in which the human material is used irrespective of how the original consent was obtained. That and the issues of whether the body part can be tracked back to the donor or whether the donor's or his family's privacy has been affected also create ethical questions.
  Perhaps banks of tissues could be set up in the private sector—it is likely that they would be in the private sector—for subsequent profitable production. Therefore, the Human Tissue Authority should have the power to intervene if the use and storage of parts and

  1029
  tissues is deemed to be contrary to the public interest. The profits of a corporation do not provide sufficient reason for there to be a loophole that could lead to the retention and use of many body parts. I re-emphasise my point that the authority should not be in the pocket of industry when it considers such important ethical issues.
  The Minister referred to the "Bodyworlds" exhibition. I think that it was an excellent exhibition. It was extremely educative. It had an art element as well as changing and informing perspectives on the human body and how it works, and on death itself. It would have been wrong to ban the exhibition, although it was banned in Germany, for example. It was seen by more than 100,000 people and they probably learned a lot. The Human Tissue Authority should have to consider all the issues involved with such an event and it should do so openly.
  My main reason for wanting to take part in the debate is that I asked a parliamentary question about the rules for the removals of brains, and was told in reply that organs and tissues may be removed if a person
  "who has died has authorised that prior to their death".
  The removal can also be authorised by their relatives or by a coroner who can remove or retain organs on his own authority. However, if they are used for a subsequent purpose, he must obtain a separate authorisation. The organs may also be removed
  "for anatomical examination when a person has bequeathed his or her body for this purpose."—[Official Report, 4 June 2003; Vol. 406, c. 485W.]
  That was updated by the 1984 coroners rules, which state that the brain can be removed if that material, in the coroner's opinion, bears upon the cause of death and that it can be kept for such period as the coroner thinks fit. The coroner's opinion may not be openly stated and be in the public domain and the period might not be specified, so the organ could be kept for much longer—and those are only coroners rules, not reality.
  I suspect that there may be loopholes, particularly in respect of major criminals—who sometimes hold a fascination that is out of proportion. I was amazed to read a report that Ronnie Kray was buried without his brain. Clearly, prior consent from Ronnie Kray or his relatives was neither sought nor obtained—which I found offensive. Although I asked a number of parliamentary questions, I could not get to the bottom of how that procedure was allowed and how widespread it is in relation to criminals. I have tabled another question asking whether Harold Shipman's body will be disposed of intact, and look forward to receiving the answer. Treating criminals in that way is a form of mediaeval punishment, showing contempt and disrespect post-death. It seems uncalled for and verges on barbarity.
  Such practices also give rise to the possibility of Frankenstein-type experimentation. Together with the possible future reproduction of stem cells, the retention of the brains of criminals such as Ronnie Kray could make possible the recreation of criminals by a mad Dr. Frankenstein-type scientist or even by an officer of a state institution, perhaps accidentally. I am still not confident that such risks are ruled out by the Bill. There could be a loophole via the police, a coroner or the Human Tissue Authority that allowed such procedures, even if they were not explicitly or directly authorised.
  1030
  Such a loophole would be an abuse of the role of the state. Are criminals treated differently from other members of society? They are not mentioned specifically in the Bill, yet in the past they have been treated differently. Does Crown immunity come into this? I do not think that it should apply.
  My hon. Friend the Member for Liverpool, West Derby (Mr. Wareing) made the point that mentally ill persons may be alone and unable to make reasoned, proper judgments. The Bill should be reviewed in Committee to give such persons greater protection and to clarify their position.
  I very much welcome the Bill. The Government have been brave to tackle this issue and have done a good job in bringing the measure before us—but I hope that the aspects that I have mentioned will be reviewed before the Bill completes its passage through the House.
  5.4 pm
  Dr. Evan Harris: I congratulate the Government on introducing the Bill, which has many good aspects. I also congratulate the Minister on her stamina in sitting in the Chamber throughout our debate. That is most welcome.
  I declare a personal interest in the organ retention aspects of the measure because my father was professor of child health at Alder Hey hospital before Professor van Velzen carried out his unacceptable practices. My father was mentioned in the Redfern report—because he was involved in van Velzen's appointment—but he was completely exonerated by the General Medical Council.
  Mr. Dobson: I thank the hon. Gentleman for correcting me. I said the wrong name in my speech. Van Velzen was indeed the villain of the piece.
  Dr. Harris: I am glad that the right hon. Gentleman could make that point.
  Events at Alder Hey are an example of what happened throughout the country, and of an old-fashioned paternalistic attitude. Something that was unacceptable on deeper reflection became routine practice. There is no doubt that, at Alder Hey and perhaps elsewhere, there was deviousness if not malice in the continuation of such practices, not simply with thoughtlessness or recklessness about consent, but with disregard to whether consent had been given.
  As far as the Bill's provisions on retaining organs for research go, they are an appropriate response, as was the Government's action when the Alder Hey affair came to light. However, it should be stressed that pathology is an honourable profession. Pathologists are an essential part of a modern and effective health service. It can only be regretted that some of the side effects of the controversy mean that they have felt personally oppressed by some press coverage. That also applies to some extent to paediatricians. We can only be pleased that the reputation of Alder Hey hospital's clinical work, which, as others have said, is second to none, has been maintained after the controversy.
  I want to consider presumed consent. I acknowledge with due humility the long-standing contributions of the hon. Member for Linlithgow (Mr. Dalyell) and the right hon. and learned Member for Rushcliffe (Mr. Clarke).

  1031
  The hon. Members for Broxtowe (Dr. Palmer) and for West Bromwich, East (Mr. Watson) introduced ten-minute Bills on the subject, and I understand that the hon. Member for Mitcham and Morden (Siobhain McDonagh) intends to introduce one. A broad cross-section of hon. Members have therefore made contributions on the issue. In 1998, I introduced a ten-minute Bill on it.
  My interest arose from the time that I spent working on a renal ward as a senior house officer. I saw the other side of the equation—the people who were literally dying while waiting for transplants. However, in my three years in acute hospital practice, I also saw the donor side and how often that was handled badly, if at all. I am a member of the British Medical Association medical ethics committee and of the Transplant Partnership. I spent four years on a research ethics committee that considered research protocols, some of which used tissues. I currently chair the all-party kidney group.
  Opinion is clearly split and we must acknowledge that both sides have strongly held views that have been powerfully expressed. However, the issue is so important that it places an extra onus on us beyond the usual practice of the House, which sometimes does not extend further than party political point scoring—I am as guilty as anyone else of that. There is an onus on the Government to allow a proper debate in the House and a public debate. As far as it is within their power, they should provide for a free vote, which should also apply to the payroll vote, given that the matter is an issue of conscience. Those of us who support presumed consent have a duty to try to deal with the concerns of the other side.
  Those on each side of the debate have a duty not to fiddle the figures and to ensure that, when statements are verifiable and quantifiable, the evidence is presented at the same time. Simply making assertions and claiming that they are facts does not do justice to the issue.
  We on our side of the argument must recognise the opposition of conscience of people who feel strongly about bereaved relatives' rights to consultation and veto. They may feel that those rights should be above the presumed wishes of the patients, above the interests of those dying while waiting and above the interests of the other set of relatives, who will soon be bereaved unless something is done. I hope that we make that recognition clear in our debates. However, we must start by recognising, as many have done, the need to increase the number of organs for donation, although I shall not repeat the figures that have been given. That is why we have a duty to be careful. I, for one, would drop my support for presumed consent if any of the following three things were demonstrated: that it was not effective; that there was public opposition; or that there was an ethical consensus against it. I hope, by the same token, that the Government and others, apart from those who have a fundamental objection of conscience, would drop their opposition to my proposal if they were shown evidence that it was effective, that there was public support and that there was not an ethical consensus against it. I hope that we will see that development in the coming debates.
  1032
  It is important to deal with some of the arguments against presumed consent. First, we should say what presumed consent is. It would give adults—it is important to note that it would not apply to children—the right and opportunity to opt out in multiple ways, such as using post offices, driver's licences or electoral registration forms. Such a scheme would promote discussion among relatives who would be asked at the appropriate time, the opt-out register having been checked, whether they knew of any objection that had not been registered. Of course, relatives would also be asked the usual questions about social history required for screening purposes. There is no difference between the two schemes in that regard, so it is not appropriate for the Government to argue that that need means that presumed consent could not work.
  The difference between the two schemes is that under presumed consent, relatives would have to volunteer their opposition. Organs would not be taken despite there being no opt-out or evidence of one if that opposition were significant and taking organs would cause the relatives major distress. But the presumption would be that donation would take place. That has been shown to reduce the stress on relatives who would otherwise have to second-guess, and to increase the number of organs made available.
  Presumed consent is also more likely to give autonomy to the person whose organs are involved. We know that between 70 and 85 per cent. of people want their organs to be used, but that when relatives are asked, 50 per cent. say no. That cannot be right. We are talking not about going against a person's wishes, but ensuring that we are more likely to satisfy those wishes.
  The hon. Member for Spelthorne (Mr. Wilshire), in his moving and eloquent contribution, was very helpful in pointing out the stresses on relatives during the current process, even if that process is not practised, as in his tragic case, when he was not approached. I have to say, however, that the point of presumed consent is that patients would come first because their wishes would not be vetoed by the family. The interests of the relatives would also be taken into account because they would be less likely to be feeling guilty for saying no at the height of their grief, despite the patient having had no known opposition, and some good would then have come from the death of their loved one. Relatives would not be asked, as the hon. Gentleman suggested, "Do you wish to object?" They would be asked, "Do you know whether your loved one had an opposition to organ donation that we have not found on the register?" If the relatives answered no to that, they would then be given an opportunity to volunteer their own fundamental objections, but that would not be fished for as at present. That system has been acceptable to the public and to relatives where it has been used.
  That is the soft system of presumed consent. No one is suggesting that organs would be taken against the fiercely held views of relatives. Indeed, the Government recognise in the Bill that there is a clash. From my reading of clause 4, it suggests that if there is a donor card that satisfactorily fulfils the requirements for appropriate consent—as the right hon. and learned Member for Rushcliffe said—relatives will not be able to veto that consent, in that opt-in approach. The question

  1033
  of relatives' views being against the presumed or actual views of the patient is not new in respect of presumed consent.
  I want to deal with the question of evidence. In a press release yesterday, the Government said:
  "There is no evidence that a policy of presumed consent increases the number of organs for transplantation."
  I find that surprising, especially when that statement is not accompanied by any dossier that I can find in the Library to verify it. In fact, the published evidence is that that policy has a positive effect. A review was published that stated:
  "In three western countries there is evidence that changing to a contracting out system resulted in an increase in organs".
  That review is very clear, and first among its authors is Professor Sir Ian Kennedy, who is also the author of the Bristol review. The source for that information is The Lancet of 30 May 1998, volume 351, so there is some evidence there.
  In October 1999, Transplant Newsletter reported the findings of an expert committee of the Council of Europe. At section 4.6.1, that report said:
  "Presumed consent laws, when fully accepted, seem to benefit donation".
  That is another clear example of evidence from a review group. I can also cite, although I will not go into it, the paper by Paul Michielsen entitled "Presumed Consent to Organ Donation: 10 Years' Experience in Belgium", which appeared in the December 1996 edition of the Journal of the Royal Society of Medicine, volume 89, and a paper by Roels and Vanrenterghem in Annals of Transplantation, volume 1, No. 4, entitled "Legislative Aspects of Organ and Tissue Donation in Belgium".
  If the Government are going to keep saying that there is no evidence that such a policy would be effective, they have to provide the data to hon. Members, because the data that I can find suggest that the expert view is that it does produce an effect.
  Presumed consent is not the only game in town and those of us who support it are not of the view that introducing it is the only thing that needs to be done. We recognise the other steps that the Government are taking.
  In respect of public support, according to this morning's edition of The Guardian, the Government have claimed that doctors do not support presumed consent, but the British Medical Association overwhelmingly supported a move to presumed consent. At the moment, there is not sufficient opinion poll evidence to tell either way what the situation is. I certainly would not back as good opinion poll evidence a listeners' poll on the "Today" programme, but it was interesting and I pay respect to the powerful advocacy of Richard Spurgin, who made a case for a change in the law.
  Although I acknowledge the Government's attempts to increase the supply of organs, the paper recently produced by UK Transplant shows that there is a significant problem: when relatives are asked about transplantation, 50 per cent. say no. Only a small number are never asked and there is only a small number of cases in which organ donation is not considered. That deals with the question of the "required request" that was raised by the hon. Member for Spelthorne. My proposal could have a powerful effect and I ask the Government to give it a fair wind. They should allow and join in a public debate on this important issue.
  5.18 pm
  Dr. Doug Naysmith: Although time is precious, I must refer to the very personal speech made by the hon. Member for Spelthorne (Mr. Wilshire). At one stage, he said, I think, that some might consider him a coward. I can assure him that nothing he said sounded in any way like cowardly behaviour to me.
  I welcome the opportunity to take part in this debate on Second Reading for two main reasons. As a Member representing a Bristol constituency, I am well aware of the suffering experienced by parents during the events associated with paediatric surgery at Bristol royal infirmary and during the subsequent Kennedy report on those events. The Minister talked of distress, grief and anger. I certainly agree with her about that. Taken with the somewhat similar occurrences at Alder Hey, those events created the impetus to produce the Bill that we are considering today, which ought to ensure that the stress and pain associated with relatives discovering that organs had been retained from their dead loved ones' bodies—without their consent—does not happen again. I very much welcome that, as does almost everyone in Bristol.
  My second particular interest is almost professional, in that before being elected to the House I worked as a research immunologist for more than 30 years. My work was mostly in pathology departments and frequently made use of human lymphocytes, lymph node tissue and occasionally other small pieces of human tissue. I know that the uses to which those pieces of tissue were put were at least sometimes of benefit either to the individuals concerned or to other people in the wider sense, and occasionally for both purposes. It is unlikely that specific consent was given for such procedures in every case—hon. Members should remember that I am going back more than 30 years—although I suspect that in almost all cases it would have been freely given if it had been properly sought, albeit that it would not always have been possible.
  My right hon. Friend the Member for Holborn and St. Pancras (Mr. Dobson) outlined clearly in his excellent speech the importance of being able to use small quantities of living tissue for experimental and investigative purposes. That conclusion was reinforced by the examples outlined succinctly and clearly by my hon. Friend the Member for Norwich, North (Dr. Gibson).
  Although it is clear that the public need to be confident that strict guidelines and procedures are in place to control the use of organs and tissues both from cadaveric and living donors—whether to be used for transplantation, teaching or research purposes—it is crucial that regulations and guidelines are not drawn so restrictively that they inhibit necessary and worthwhile clinical medicine and research.
  I have received two letters that illustrate that dilemma. One is from a distinguished emeritus professor of pathology at Cambridge, who believes that the Bill is too long, too complex and badly drafted. He believes that
  "we have lost sight of the proper balance of the rights of the individual and the rights of society".

  1035
  Others will have seen copies of the second letter from a consultant histopathologist in Manchester, to which the hon. Member for Wyre Forest (Dr. Taylor) has already referred. He is concerned that while agreeing that the provisions of the Bill regarding tissues from the deceased are entirely laudable, there will be problems in dealing with some aspects of the use of tissues taken from living donors. He says:
  "The distinctions between diagnosis, teaching, quality assurance, audit and research are simply not as clear-cut as one might at first think and there are dangers of both defensive practice by pathologists withdrawing from activities which might put them at risk, and also of criminal prosecution for entirely harmless and socially beneficial activities. I would like to see a clear separation between the retention and uses of tissues from the deceased, which is highly emotive for some, and the use of surplus material by NHS laboratories for the common good, which should be allowed to continue without the threat of criminal sanctions."
  Although I do not necessarily agree with everything in that and some other quotations that we have heard this afternoon, it seems to me that some improvements can be made to this Bill, and I hope that my hon. Friend the Minister intends to be flexible in Committee.
  I know that the Minister has made it clear that she does not see this Bill as a suitable vehicle for the introduction of presumption of consent permission, particularly for organ donation purposes. That is a pity—I have supported such a change for a very long time. I understand why she says that, however. Perhaps it would complicate the Bill too much, and even make it too controversial. It is really good to have all-party support for such an important measure, and I understand why she does not want to prejudice it. I hope, however, that she does not intend to include any provisions in the Bill or subsequent regulations and guidelines that will make its eventual introduction more difficult or even impossible.
  5.24 pm
  Nick Harvey: I, too, welcome the introduction of the Bill. I have taken an interest in these matters since I was involved in the mid-1990s in helping to uncover the events at the Bristol royal infirmary. It is worth remembering that the parents involved at Bristol went through three subsequent sessions of anguish: first, losing a baby, which is a tragedy in itself; then, some years later, discovering that it was not simply an accident, as they had thought, but part of a wider picture; and, some years after that, coming to terms with the extraordinary news that they had buried babies who were not complete and, without their knowledge, had had parts removed. I want to pay tribute particularly to my constituent, Mrs. Michaela Willis, who, having gone through all that, still found the energy to campaign for an inquiry into the events at Bristol.
  I congratulate the right hon. Member for Holborn and St. Pancras (Mr. Dobson) on setting up that inquiry, thus honouring a commitment made by his Conservative predecessor, who had pledged that such an inquiry would be held after the GMC proceedings. I also pay tribute to Professor Kennedy, who diverted slightly from his remit to consider this important matter and report on it separately.
  1036
  When what had been happening arrived in the public domain, people were astonished. When it became clear that it had been relatively common practice for years and had been going on more or less anywhere, they became more and more astonished and indignant. Immediately after that, the chief medical officer conducted a survey to establish just how widespread the practice had been and how far it had gone. We had meetings here with groups from all over the country who were worried about what had been going on in their local hospitals.
  As a result of all those events, the relationship between the medical professions and patients has changed significantly. I do not think that things will ever be quite the same after the events of Bristol. Of course this is not the only factor in the change in the relationship between patients and doctors; the growth of medical information on the internet, for example, has made patients much better informed. The idea that the doctor is always right is part of a paternalistic tradition that, I am glad to say, seems now to be fading.
  Many Members have spoken of the importance of striking a balance. They are right: no one wants to thwart medical progress. Recent developments in medical science have already necessitated the use of tissue that has been retained for many years. Who can say what may happen in the next few years? Who can say what new diseases or threats we may uncover, and what scientific breakthroughs may be made? In such circumstances, going back and looking at tissue could be valuable. We must not establish a regime that would prevent that, would traumatise professionals, or would simply make the process of obtaining consent for their important work too cumbersome.
  What is most important is the position of patients and relatives, and the principle of informed consent that the Bill rightly attempts to introduce. There is copious evidence that many grieving relatives are only too willing to give consent—that, indeed, they derive comfort from the thought that some good will come from the use of organs or tissue from their loved ones for the benefit of others who may not have to suffer in the same way. It is, however, essential for us to ensure that the arrangements for consent are comprehensive, that consent is informed, that it is obtained sensitively and—as the hon. Member for Wyre Forest (Dr. Taylor) said—that the arrangements are not so heavy-handed that they are impossible to administer.
  Presumed consent has been raised several times today. Let me say to those in favour of it that there is a real danger of our undoing the basic good that the Bill tries to do. We are trying to bring about a new climate, a new atmosphere of informed consent and a new relationship between patients and doctors. There is a real risk that presumed consent could undermine that. The hon. Member for Norwich, North (Dr. Gibson) said how easy it was to throw away trust, and how difficult it was to gain it. I merely sound a warning bell to my hon. Friend the Member for Oxford, West and Abingdon (Dr. Harris) and others about the risk of undoing some of the good that the Bill aims to achieve.
  Let me also say that the public are nowhere near ready for a system under which they would be expected to opt out. There is not nearly enough public understanding. There would have to be a huge campaign of information and education for people to make sense of the system

  1037
  and participate in it. Such a campaign would always bring us full circle. As the Minister suggested, that, rather than the legal aspects, might bring about a transformation in organ availability. She pointed out that what was happening in Spain might be more to do with the boost in availability there than with the law itself.
  I have an old school friend, also a constituent, who has been waiting a long time for a kidney transplant. As far as I can see, he is going to have to wait much longer. He shared one of his concerns with me. He was told—I am not sure that it is still the case—that if people are killed in a road traffic accident in the more remote parts of the west country, even though they have a donor card, have signed up and are on the register, the practical arrangements are simply not in place—in such a sparsely populated area with so many miles of road—to get the organs into the medical system to benefit someone who can make use of them. Much work remains to be done—I entirely accept that the Government have already embarked on some of the necessary good work—on improving the practical arrangements of organ donation.
  There is a danger of thinking that the presumed consent issue will be some sort of magical solution; in truth, I am not convinced that it will. I shall keep an open mind when it comes to any votes, but I believe that a warning needs to be sounded that it will not be a magical panacea.
  Having said that, the Bill stands every opportunity of providing a valuable legacy for those whose organs were improperly retained and for grieving relatives who went through so much pain, but fought on to see this Bill introduced. It is incumbent on the House to get the detail right. Some hon. Members will deliberate on the Bill in Committee, and I wish them well in that task.
  5.31 pm
  Dr. Andrew Murrison: The Opposition welcome the Bill. It is a good Bill, and we have had a good debate. Twelve Back Benchers have spoken and, more importantly, we have heard speeches of real quality. That is just as well, because the pre-legislative input that we called for did not happen. As a consequence, the Bill has been robbed of the expert and informed contribution of people in the know in a complex and sensitive field. However, we are where we are, and we have to move on; and today's debate has been characterised by good humour and general consent. Indeed, the Bill is all about consent, drawing as it does on the Kennedy and Redfern inquiries into the unsatisfactory state of affairs at the Bristol royal infirmary and at Alder Hey in Liverpool.
  In our general enthusiasm for the Bill, however, we should also be aware of the possible hurdles that it could put in the way of medical research, education and all the things that we hope will deliver us a better tomorrow. The hon. Member for Norwich, North (Dr. Gibson), with his long experience in these matters, reminded us firmly of that.
  Between 1979 and 1985, I was in the foothills of my medical career at Bristol. Looking back, I can well recognise the patrician mind-set that led to the distressing circumstances revealed by Kennedy. To be fair to health professionals, they have gone a long way
  1038
  to put their own house in order, and I am pleased that they have largely welcomed this attempt to put good practice on a statutory footing.
  I should like to deal with presumed consent. Although it is not expressly in the Bill, it has been raised by several right hon. and hon. Members. My right hon. and learned Friend the Member for Rushcliffe (Mr. Clarke)—I see that he is not in his place—supported it so well, and the hon. Members for Sutton and Cheam (Mr. Burstow), for Oxford, West and Abingdon (Dr. Harris) and for Bristol, North-West (Dr. Naysmith) also supported it. In two notable Back-Bench contributions, the hon. Member for North Devon (Nick Harvey) and my hon. Friend the Member for Spelthorne (Mr. Wilshire) took a contrary line. All hon. Members who were present would acknowledge that my hon. Friend's speech will remain with them for some time. All hon. Members bring valuable experiences to the House, and my hon. Friend demonstrated the value of them in his contribution. The Bill, as I understand it, is about making consent explicit and fully informed—or it is nothing. Presumed consent, I submit, is no consent at all.
  We certainly need more organs to be donated, as the hon. Member for West Bromwich, East (Mr. Watson) said in his contribution. Although the majority of people are in favour of organ donation, many of us would be uncomfortable with the appropriation of body parts by the state in the manner that appears to be favoured by the British Medical Association. I hope that the Bill will help to restore confidence in the gifting of body parts, not make the public more suspicious of what for many, particularly in the light of recent events, is a shady, even slightly sinister, domain. For those people, the doctrine of presumed consent would not help.
  For our part, we suggest a stronger role for the Human Tissue Authority in the popularisation of voluntary organ donation, and we are disappointed that that is poorly reflected in the Bill's wording. My right hon. and learned Friend the Member for Rushcliffe mentioned the organ donor card and its status in, his contribution—an issue that, I must confess, had not occurred to me. I am sure that we will examine that issue very closely in Committee, and table amendments that will improve the card's status, thereby increasing, we hope, the number of organs available for donation.
  In response to the Adjournment debate led by my hon. Friend the Member for South Cambridgeshire (Mr. Lansley) on 29 April last year, the hon. Member for Salford (Ms Blears) said that the Human Tissue Act 1961 was "unclear" and "ambiguous". I was given a copy of it earlier today. It extends to two and a half sides of A4—how different from the measure before us today! Nevertheless, it was apparently unclear and ambiguous. In contrast, the hon. Lady promised us that, before the summer break, draft proposals would be available for parliamentary scrutiny that were "unambiguous and transparent". I regret that in both timing and intention, the Government have fallen well short of their laudable intentions.
  The Bill is remarkably difficult to navigate, given that it is meant to lend clarity to the obscurities relating to the removal, storage and use of body parts. A number of organisations have voiced concerns, several of which we

  1039
  have heard today. There is a real risk that the vagueness of the Bill's wording and its lack of clarity in places will act as a disincentive to engaging in legitimate research and teaching based on human material. We will urge improvements on Ministers, to ensure that those working for our benefit—researchers and clinical teachers—do not feel that the heavy hand of the law will for ever be resting on their shoulder. The right hon. Member for Holborn and St. Pancras (Mr. Dobson) said in his excellent contribution that lawyers should be kept out of hospitals unless they are patients. He might have added that we should do what we can to keep doctors out of the law courts.
  Cancer Research UK is worried that those making career choices in research are already inclining towards basic science, in preference to the clinical research that would embroil them in regulation and bureaucracy and the possibility of legal dispute. It has noted the implications for cancer registries of the Data Protection Act 1998 and the forthcoming implementation of the EU clinical trials directive, and fears that this latest initiative will add to the wheelbarrow of material that is preventing it from doing what it wants to do—improve the lot of people with cancer. That is the very last thing that those involved with Alder Hey would want.
  It is important to point out that much of the distress caused by Alder Hey had less to do with the removal of organs than with the fact that they were stored and not turned to any great purpose. The hon. Member for Liverpool, West Derby (Mr. Wareing) will relate to that point, given his obvious constituency interest. Indeed, we are told that many parents would have been far less troubled had organs been used, and at least some good had come from their removal.
  In examining the Bill, we must constantly remind ourselves that the general public apply different significance and weight to various types of human material, and to the various ways in which it may be handled and used. For most people, blocks and slides of tumour removed during surgery are a world apart from a cadaver in an anatomy suite, or a child's heart in a pot in a medical school. For most people, surgically removed tissue is uncontested waste. Few owners will agonise, for example, over the fate of a necrotising section of malignant colon, but the removal of an organ—diseased or otherwise—from a loved one after death has a completely different psychological and emotional context. It is important that the Bill in its final form reflects that reality.
  The Bill does not take the opportunity to deal in any depth with the human anatomical displays that can pass as art in UK galleries. The hon. Member for Leyton and Wanstead (Harry Cohen)—he is not in his place—enthused about the activities of Professor Gunther von Hagens and his "Bodyworlds". But it is probably true to say that what one might describe as the Damien Hirst school of anatomy sails fairly close to the wind legally, and it is certainly regarded by many as not being in particularly good taste. With that in mind, I am not sure that so-called "qualifying" museums should be accorded the special status and freedom from licensing given by the Bill, as to do so would deny easy access by the Human Tissue Authority and its inspectors. We must bear it in mind that Professor Gunther von Hagens
  1040
  may hold exhibitions in the future and that an obvious place for them to be held would be in a qualifying museum.
  We should remember that post-mortem suites, medical school dissecting rooms, research laboratories and their staff are already multiply regulated, scrutinised and licensed for all manner of things. Why then, when constructing the Bill, was so little attention paid to areas that are, arguably, far more opaque?
  I am concerned about the lack of scrutiny of imported material and am worried that that could lead to exploitation. I recall with affection the skeleton that accompanied me throughout my medical school career. The hon. Member for Wyre Forest (Dr. Taylor) has a similar recollection, but unlike him I have no idea where my skeleton is now. At the time, however, I was informed that, like hundreds of others, it came from the Indian subcontinent to circumvent the difficulties that arise in this country from the process of skelatinisation. The Minister will probably say that that loophole—if loophole it is—is a matter for a code of practice, but I fear that the Bill leaves so many aspects to be covered by codes of practice in future that the House can have but little idea of what the actual landscape that will eventually result will look like.
  The failure to make words crystal clear in the Bill risks repeating the mistakes of the Human Tissue Act 1961. I shall set out a few examples, starting with the notion of appropriate consent. Organisations that we have consulted are concerned that future research needs, of a sort that we may not be able to anticipate at present, may be precluded because of the difficulties inherent in the notion of appropriate consent. There is, for example, confusion in the Bill about the use of existing specimens for DNA work. It is necessary to be more explicit about the nature of consent so that researchers, institutions and charities have the confidence to proceed with their work, which will, in any case, be subject to the rigours of local ethics committees.
  The Bill does not really get to grips with licensing. We can all understand both the need for proper premises and that they should be licensed and inspected, but does the Minister have in mind an institution, a building or just a suite of rooms? Under extant legislation, there are licensed teachers, who are hands-on—I remember them well from my time at medical school; they were doctors who carried out dissections and taught students and were very much in control of the situation. The Bill does not indicate who our future licensees will be: will they be chief executives of hospital trusts or pathologists on the shop floor? We do not know. What responsibility will the licensees have for end users—for research workers from Cancer Research UK, for example? Representatives from that organisation and from the Wellcome Trust kindly met several of us last night.
  The Bill refers to "relevant material", but we are left with no great understanding of its authors' intentions. Human cells seem to be a common thread, but does that include acellular serum and plasma, which, for their owners, are just as much blood as whole blood is? Why should cell lines be excluded? They may be created outside the human body but they are still very much related to the donor of the index tissue. Too much in the Bill defaults to codes of practice, and too much latitude is given to Secretaries of State to amend it by order at some future date.

  1041
  In conclusion, I commend the Minister of State for introducing the Bill, with which my party is in general agreement. There are certainly some rough edges that might have been smoothed out during the pre-legislative scrutiny that we did not get, but we look forward to contributing in Committee so that the next time the measure comes before the House it will hold the confidence of the public, the research community and health professionals.
  5.44 pm
  The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman): If the House will forgive me, I shall begin by quoting something that the hon. Member for Westbury (Dr. Murrison) has just said:
  "The Opposition welcome the Bill. It is a good Bill".
  I repeated that because I never expected to hear those words in the Chamber and I never expect to hear them again.
  The hon. Gentleman's words sum up the tone of the debate. Members on both sides of the House have contributed their knowledge, experience and wisdom. The mood of the debate was constructive and it is clear that it will be followed by an interesting Committee stage, to which I greatly look forward.
  Before I get into my speech proper, I want to pick up on one thing that the hon. Member for Westbury said. He said that Cancer Research UK claimed that there was evidence already that people who were deciding about their careers were choosing to steer away from clinical science in favour of basic science. The reason for that was that they feared getting involved in the difficulties that this Bill might impose.
  I am a scientist. I know scientists—I have worked with them all my life, until I became a Member of Parliament in 1997—and I do not buy that for a second. I do not believe that such considerations feature on people's radar screens when they are making their choice of career.
  If we are to have a constructive debate, in Committee and with scientists outside the House, we must all avoid hyperbole. It is important that we try to ensure that everyone understands what the Bill is about, and what its impact will be.
  Dr. Murrison: The Minister needs to speak to Cancer Research UK, as I am sure he has in the past. I spoke to the organisation as recently as this morning. I understand that its survey of the vast number of students whom it is sponsoring for PhDs and other higher degrees has shown that about 70 per cent. are seriously considering doing basic science rather than clinical science, for the reasons that I outlined. I can do no better than quote Cancer Research UK.
  Dr. Ladyman: I have no doubt that the organisation reported those figures. I simply do not believe them, or the survey. My extensive experience of talking to people making career choices in science makes it hard for me to believe that such considerations make it on to their radar screens. However, we must not get bogged down in that.
  The background to this Bill is scandal. The organs of children and adults were routinely kept after postmortem examinations, without the knowledge of
  1042
  families. That was unacceptable, and the distress that it caused was immense. A practice that resulted in such tragedy for so many families may once have had its place, but it certainly has no place in today's health service.
  The hon. Member for Westbury referred to the patrician mindset that dictated how many people involved in clinical practice at the time made their judgments. That mindset is not acceptable now.
  The expectations of individuals and families are, quite rightly, that they should know what is happening. They should be consulted, and they should consent. Practice had to change, and it has changed, but the damage has been done. Families have discovered—sometimes many years later—that they did not bury their loved ones in the way that they had believed and expected.
  Many hon. Members have spoken about their constituency experiences, and the hon. Member for North Devon (Nick Harvey) recounted the distressing experiences of some of his constituents. The Bristol and Alder Hey inquiries, and the Isaacs report, exposed not a bungle or a mix-up, but a scandal. We would be failing in our duty if we did not take steps to address it.
  Of course, as the hon. Member for Oxford, West and Abingdon (Dr. Harris) said, pathology is an honourable profession. I would go further, and say that it is a vital profession. However, we do it no justice by ignoring the mistakes that have been made. I am delighted that the mood of the House is that we should not ignore those mistakes and that we should move forward with this Bill.
  In January 2001, the chief medical officer published his recommendations, and the Government accepted them in their entirety. That has led to a range of linked initiatives, including the establishment, in April 2001, of the Retained Organs Commission to oversee the return of organs, to give guidance to trusts, and to give support and advocacy to families.
  The Government published new post-mortem consent forms, and a code of practice on communication with families. We have allocated £2.7 million per year in the current spending round for trusts to use in the development of bereavement services. We are also supporting an ongoing programme of professional education and training and public education.
  There have been changes and improvements in practice, and more are taking place right now, but the Bill is needed to secure them firmly for the future. That is why we looked at the whole picture and prepared a Bill that is comprehensive and forward looking. But we have not done it alone. Through extensive consultation, we have found much consensus among family groups, professionals and other bodies, and we are pleased to have had a strong contribution from family support groups throughout the country. We also received good support from many groups, including those from Liverpool, Birmingham, Cambridge, Plymouth and Oxford, all of which helped in putting together a well prepared and welcome Bill.
  I was happy to hear the hon. Member for South Cambridgeshire (Mr. Lansley) commit the Opposition to working co-operatively to get the Bill right. Certainly,

  1043
  the Government intend to do that. My hon. Friend the Member for Bristol, North-West (Dr. Naysmith) asked whether we were open minded. As he knows, my hon. Friend the Minister of State and I have well deserved reputations for always being prepared to compromise, to see the other guy's point of view, and to go the extra mile to achieve consensus; and I doubt that our approach to the remaining stages of this Bill will be any different.
  The hon. Member for South Cambridgeshire said that people often act in a way that they believe to be benign. He is absolutely right—the road to hell can be paved with good intentions. That is why we have to balance the rights of individuals against the needs of researchers.
  The hon. Gentleman also asked, rightly, why we did not have pre-legislative scrutiny. We had hoped to do so, and to publish a Bill earlier, but it was simply impossible because drafting resources were unavailable. We therefore had to make a judgment call—do we balance the need for scrutiny against the needs of the families who are demanding that we make progress? We decided that making progress was more important than publishing the Bill in draft. However, given that we undertook two rounds of thorough consultation to reach this stage, we are not lacking the necessary level of scrutiny; and the Committee will provide a further opportunity to consider the Bill and to get it absolutely right.
  Several hon. Members, including the hon. Members for South Cambridgeshire and for Wyre Forest (Dr. Taylor) and my hon. Friend the Member for Bristol, North-West, accused us of making the Bill too complicated or convoluted. It replaces several pieces of legislation, including the Anatomy Act 1984, the Human Tissue Act 1961 and the Human Organ Transplants Act 1989, and provides a single legislative framework in an area where there is confusion and uncertainty. If that was not the case—if the current legislation had the degree of clarity that we are trying to achieve—would we face this problem or have had these scandals? Of course not.
  Although the Bill has its complexities, as does all legislation, it is important that we make the effort to try to get it right. I believe that it is simple and understandable, and that we will be able to explain it to the scientific community and to give them the reassurances that they seek. We have tried to make it as flexible as possible in order that it should, I hope, last as long as the Acts that it replaces, and several right hon. and hon. Members alluded to that. Instead of trying to include all the possibilities and to predict everything that science may throw at us in the coming decades, we have created codes of practice that can be changed as good practice changes. That is the right way forward.
  The hon. Member for South Cambridgeshire pointed out that the status of grandparents in the consent hierarchy is missing. I give him a commitment that we will consider that in Committee.
  My right hon. Friend the Member for Holborn and St. Pancras (Mr. Dobson) discussed whether consent would be wide and long lasting. He talked about the future uses of material and pointed out, as did the hon.
  1044
  Member for Sutton and Cheam (Mr. Burstow), that some discoveries relied on the fact that people were able to go back to old material. My hon. Friend the Member for Norwich, North (Dr. Gibson) gave some specific examples of that. The question was put whether medical staff must constantly return to relatives to obtain consent if new uses for material arise. The Bill sets out the fact that consent is needed for the use of tissue in research, but it does not limit the duration and breadth of the consent, so we would not expect patients to have to be revisited for further consents. I hope that that reassures them.
  The hon. Member for Sutton and Cheam correctly raised the issue of bereavement services. The Government demand that NHS staff be sensitive to the needs of bereaved people when they gather consents, whether for organ donations or any other reason. He asked me a specific question about a follow-up survey, and we are supporting a survey, which I am pleased to tell him will begin in the spring.
  My hon. Friend the Member for West Bromwich, East (Mr. Watson), the right hon. and learned Member for Rushcliffe (Mr. Clarke) and the hon. Member for Oxford, West and Abingdon all raised the issue of presumed consent. I suspect that we will return to that many times over the coming weeks, so I will not go into it in great detail. My hon. Friend raised the need to close the gap between demand for and availability of organs. I assure him that we are taking positive steps to increase the availability of organs. We have already made significant progress in reducing the gap between supply and demand without the need for presumed consent.
  The hon. Member for Spelthorne (Mr. Wilshire) made a moving and very brave contribution to the presumed consent debate—I doubt whether I could have made that speech if I were in his position. I congratulate him on giving us the other side of the presumed consent issue. I say to those who support presumed consent that, if we own nothing else in this world, we own our bodies. There is no question but that we have the right to determine how our bodies are used in life and how they end up in death. If we move to a system that challenges that ethical principle, we will make a significant mistake.
  The hon. Member for Oxford, West and Abingdon challenged the Government on whether in certain circumstances we might drop our objections to presumed consent. In return, I have a challenge for him: will he drop his campaign for presumed consent if we can show him in Committee that progress can be made without presumed consent, because it would not add significantly to the availability of organs, as he believes and hopes?
  Dr. Evan Harris: Yes, I will.
  Dr. Ladyman: We have another area of agreement.
  Mr. Kenneth Clarke: Has the Minister had time to take further advice on the Bill's effect on donor cards? Will carrying a donor card be sufficient evidence of consent so that other objections can be overruled if relatives disagree or cannot be found?
  Dr. Ladyman: Carrying a donor card would take precedence, but since we would need to survey relatives

  1045
  for screening purposes and would never perform a transplant against the strong wishes of a relative whether or not we had presumed consent, in practice the situation would not change. As far as the Bill is concerned, the donor card is a clear statement of the individual's preference.
  I shall correct one other point mentioned by the right hon. and learned Member for Rushcliffe. He said that the Transplant Partnership supports presumed consent, but I can tell him that it does not—it is the British Medical Association that supports presumed consent.
  My hon. Friend the Member for Liverpool, West Derby (Mr. Wareing) asked whether the code will be enforceable in law. Not following the codes of practice will not trigger proceedings, but the authority may take not doing so into account when it comes to issuing, reviewing or withdrawing licences. I hope that I have dealt with most of the points that have been raised; we will deal with the other points in Committee. I strongly commend the Bill to the House.
  Question put and agreed to.
  Bill accordingly read a Second time.

  HUMAN TISSUE BILL (PROGRAMME)
  Motion made, and Question put forthwith, pursuant to Orders [28 June 2001 and 6 November 2003],
  That the following provisions shall apply to the Human Tissue Bill:

  HUMAN TISSUE BILL (PROGRAMME)
    Committal
    1. The Bill shall be committed to a Standing Committee.

    Proceedings in Standing Committee
    2. Proceedings in the Standing Committee shall (so far as not previously concluded) be brought to a conclusion on Thursday 5th February 2004.
    3. The Standing Committee shall have leave to sit twice on the first day on which it meets.

    Consideration and Third Reading
    4. Proceedings on consideration shall (so far as not previously concluded) be brought to a conclusion one hour before the moment of interruption on the day on which those proceedings are commenced.
    5. Proceedings on Third Reading shall (so far as not previously concluded) be brought to a conclusion at the moment of interruption on that day.
    6. Sessional Order B (programming committees) made on 28th June 2001 shall not apply to proceedings on consideration and Third Reading.

    Other proceedings
    7. Any other proceedings on the Bill (including any proceedings on consideration of Lords Amendments or on any further messages from the Lords) may be programmed.—[Mr. Kemp.]
    Question agreed to.

  HUMAN TISSUE BILL [MONEY]
  Queen's recommendation having been signified—
  Motion made, and Question put forthwith, pursuant to Standing Order No. 52(1)(a) (Money resolutions and ways and means resolutions in connection with Bills),
  That for the purposes of any Act resulting from the Human Tissue Bill, it is expedient to authorise the payment out of money provided by Parliament of—
  (a) any expenditure incurred by the Secretary of State in consequence of the Act, and
  (b) any increase attributable to the Act in the sums payable out of money so provided under any other enactment.—[Mr. Kemp.]
  Question agreed to.

  HUMAN TISSUE BILL [WAYS AND MEANS]
  Motion made, and Question put forthwith, pursuant to Standing Order No. 52(1)(a) (Money resolutions and ways and means resolutions in connection with Bills),
  That for the purposes of any Act resulting from the Human Tissue Bill, it is expedient to authorise charges in connection with licences under the Act.—[Mr. Kemp.]
  Question agreed to.

  DELEGATED LEGISLATION
  Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6) (Standing Committees on Delegated Legislation),
  DELEGATED LEGISLATION

    EUROPEAN COMMUNITIES
    That the draft European Communities (Definition of Treaties) (Common Electoral Principles) Order 2004, which was laid before this House on 11th December, be approved.—[Mr. Kemp.]
    Question agreed to.

    WATER FRAMEWORK DIRECTIVE
    Ordered,
    That the Draft Water Environment (Water Framework Directive) (England and Wales) Regulations 2003 (S.I., 2003, No. 3242) be referred to a Standing Committee on Delegated Legislation.—[Mr. Kemp.]

  DRAFT DISABILITY BILL (JOINT COMMITTEE)
  Ordered,
  That the Lords Message of 17th December relating to a Joint Committee of both Houses to consider and report on the draft Disability Discrimination Bill presented to both Houses on 3rd December (Cm. 6058) be now considered.
  That this House concurs with the Lords that it is expedient that a Joint Committee of Lords and Commons be appointed to consider and report on the draft Disability Discrimination Bill presented to both Houses on 3rd December (Cm. 6058), and that the Committee should report on the draft Bill by the end of April 2004.
  That a Select Committee of six honourable Members be appointed to join with the Committee appointed by the Lords to consider the draft Disability Discrimination Bill.
  That the Committee shall have power—

  (i) to send for persons, papers and records;

  (ii) to sit notwithstanding any adjournment of the House;

  (iii) to report from time to time;

  (iv) to appoint specialist advisers; and

  (v) to adjourn from place to place within the United Kingdom.

  That the quorum of the Committee shall be two; and
  That Miss Anne Begg, Mr Roger Berry, Mr Tom Clarke, Mr Paul Goodman, Tom Levitt and Mr Roger Williams be members of the Committee.—[Mr. Kemp.]

Dr. Raj Mattu
Motion made, and Question proposed, That this House do now adjourn.—[Mr. Kemp.]
6 pm
Mr. Geoffrey Robinson: First, may I say how grateful my hon. Friend the Member for Coventry, South (Mr. Cunningham) and I are to Mr. Speaker for granting the debate? My hon. Friend wishes to contribute to the debate, although we are both conscious that we must allow time for the Minister to respond.
This is the third debate that we have had on the Walsgrave trust and the suspension of Dr. Mattu. On 20 March 2002, shortly after Dr. Mattu was suspended, we held a debate in which we welcomed the new management at the hospital and said that we hoped that the suspension would not be a repeat of the previous two—one ended in the vindication of Mr. Alban Barros D'Sa after nearly two years. Unfortunately, our hopes have been shattered and we are in the same position as we were during the second debate, which was held on 28 October 2003, when we could see that little, if any, progress was being made. During that debate, we asked the trust management, the NHS and the National Clinical Assessment Authority to make every effort to resolve the problem by finding a compromise agreement because the soundings that we were receiving were not good.
We are now three months further on—two years into the suspension—and, far from making progress, we have gone backwards. My hon. Friend the Member for Coventry, South will agree that I say that in the light of a meeting that we had on Tuesday of this week with the highest representatives of the NCAA and, indeed, Mr. Ian Stone, who has been appointed by the chief executive of the national health service himself to—as he put it—speed up the job of getting doctors back to work. I am sure that both gentlemen are fine civil servants, but they live in a different world from us. Indeed, I think that they live in a celestial world, so I am reminded of the hymn that goes:
"Oh Lord
A thousand ages in thy sight are like a night gone by".
It seems as though the investigation and those that preceded it have gone on for ages, yet despite the bureaucracy surrounding the case, the NCAA, the NHS, and the trust seem unable to grasp the fact that it costs money and causes pain and aggravation for the people of Coventry. Everyone would agree that the situation has gone on for too long and at too great a cost, and that it has caused too much personal suffering to the doctor involved.
It is all very well to say that suspension is a neutral act, but it is not a neutral act in the real world. It is a harsh act that is imposed on a doctor who thus suffers—perhaps rightly, perhaps wrongly. The fact of that suffering must carry with it a deep moral obligation to expedite the process as quickly as possible. On Tuesday, we quite reasonably asked how much longer the
1048
suspension would last. We were told, as if it did not matter at all, "Oh, at least another six months." Costs will probably therefore greatly exceed £500,000. It will probably be another nine months, or two or even three years before a solution is reached. The parties could have sat round a table at the beginning of this process to reach such a solution, had there been the will to do so. I shall return to that in a moment.
Essentially, the charges amount to bullying of a subordinate doctor by his superior. Bullying is a serious charge, and I do not wish to minimise its significance. My hon. Friend the Member for Coventry, North-East (Mr. Ainsworth), who is in the Chamber, is Deputy Chief Whip, but when he was just a Whip he was accused of bullying somebody in the Lobby. We did not take three years to sort that out—it was done via the usual channels in a week or two. So why is it taking so long to sort out Dr. Mattu's case? The National Audit Office has pointed out that £14 million has been wasted on suspensions. The Government and the NHS have finally been prodded into action by issuing many new guidelines to speed up the processing of suspensions.
However, those guidelines cannot help us in this case. We were told on Tuesday that we could not invoke them as the matter had gone too far. I want to alert the NHS and the NCAA to a new development. Dr. Mattu's principal accuser, Dr. Gieowarsingh, has now been reported to the General Medical Council—I cannot comment on the rights and wrongs of the allegation, just as I cannot do so in the other case—for serious misrepresentation on his CV. We will not prejudge the outcome or comment on the case, but we understand that the GMC is likely to respond and commission its own inquiry. There is therefore an inquiry into Dr. Mattu's chief accuser, and Dr. Mattu himself has been suspended for two years.
I believe that my hon. Friend the Minister is aware of the nature of the allegations against Dr. Gieowarsingh, which have been forwarded to my hon. Friends the Members for Coventry, North-East and for Coventry, South, as well as me. I shall not trouble the Minister with them now, but I shall send them on to him in case they have not reached his office. To use layman's terms, it appears that Dr. Gieowarsingh may have exaggerated the number of his quasi-surgical interventions by a factor of between three and five. There is therefore the prospect of new allegations, counter-allegations and an investigation of the person who called for the initial investigation. Neither the House, nor the Minister, nor anyone concerned could view such a prospect with equanimity.
I therefore urge the trust, via the Minister's good offices, to proceed carefully. It appears that it has looked at the allegations against Dr. Gieowarsingh which have been in existence for some time, and agreed on the nature of the figures that I shall send to the Minister. When it talked to staff—those conversations are not documented or recorded, and I am not aware of any signed affidavits—it concluded that he had performed far more procedures than were recorded. We have to wait to see what the GMC will make of that—I do not want to prejudge the outcome, as I have already said. It

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will also have to take into account representations by the clinical director at Walsgrave and David Edwards of the University Hospital of Wales, the hospital to which Dr. Gieowarsingh moved. Walsgrave has said that none of the allegations against Dr. Gieowarsingh calls into question the integrity of his CV.
We shall have to wait for the outcome of that case, but the prospect is a big mess—more costs, more delay and more personal suffering, which is to be shared by those who inflicted it on Dr. Mattu. However, there is an alternative, as a compromise agreement could be reached. If a compromise is to be successful, as I said in the Adjournment debate on 28 October last year, it must involve two things. First, allegations must be dropped by both sides—there can be no fault and no admission of fault. Secondly, it must reflect sincerity and good will on both sides. It is no good the trust asking where all the information came from, as one of our purposes as elected representatives in the House is to make representations on behalf of people who feel that their voices are not being heard. So it is no good the trust objecting to our using that information.
If the trust wants to know where the information comes from, I will tell it. It comes from Dr. Buckley, who is Dr. Mattu's GP. Dr. Buckley has circulated all that information to everyone involved, including the Prime Minister. I think that the only person to be exempted from his intentions is Her Majesty the Queen herself. Everyone else knows everything. He writes, quite clearly, that the trust recommended, as part of the so-called compromise agreement, that Dr. Mattu should see Professor Flahey. I called up his record on the internet, and he is an expert in pathological tendencies. So perhaps the trust got the two doctors mixed up: perhaps it thought that Dr. Shipman should be counselled, not Dr. Mattu—I do not know, but clearly neither of those points in any way shows good will on the part of the trust. So we are doubtful, and I think that I speak for my hon. Friend the Member for Coventry, South, who will speak in a few minutes' time. Everyone agrees that those two aspects of the so-called compromise that we can now bring into the public domain have to eliminated if the agreement is to be seen as genuine.
There is an alternative: perhaps those involved cannot bring themselves to settle on reasonable terms for whatever reason—perhaps loss of face or other irrelevant personal considerations. I do not understand why that should be so because, after all, the chief executive was not even there when Dr. Mattu was suspended, although the chairman was. Indeed, the case dates back to the previous chief executive, who left the trust precisely on the grounds of intimidating, bullying and suspended doctors, as about six of our colleagues know, and some of them have joined us this evening.
If the trust cannot enter into the spirit of compromise, the alternative is that we should have an independent investigation—but a genuinely independent one, not one commissioned by the trust, or under the auspices of the NHS or the NCAA, all of which seem to be on the side of the trust. This has become a confrontational arrangement, as nothing about suspension is neutral. How can it be neutral? The doctor was accused of something one day and was suspended one and a half days later. That does not even allow for the barest examination of the merits of the case.
1050
I am sure that a compromise would be every hon. Member's preferred solution, as it is in the House. Otherwise, let us have an independent investigation and face all the resulting consequences, which would be grave for the trust, grave for Dr. Mattu and, indeed, grave for the public interest.
6.12 pm
Mr. Jim Cunningham: First, I join my hon. Friend the Member for Coventry, North-West (Mr. Robinson) in thanking Mr. Speaker for granting us this Adjournment debate tonight. Secondly, I congratulate my hon. Friend on securing the debate. I shall not repeat what he said because he has covered the issue adequately, and I am conscious of the fact that we want to try to give the Minister adequate time to respond because it is no good our having a debate without a proper response. That is what the debate is all about.
We recognise that a lot of good things have happened, certainly since the change in chairman of Walsgrave hospital. I would not want to detract from the fact that a lot of positive things have happened at that hospital. I want to make it perfectly clear—I am sure that my hon. Friend would agree with this—that this is not an attack on staff or anything like that and it is not necessarily an attack on the management, but some of us come into politics because we have a sense of justice and we want to see justice done. It is not for us to judge who is right or wrong in this case, but I am alarmed that this is probably the third case that we have been involved in that has taken nearly two years to resolve.
Of course hon. Members will know that, fairly recently, the National Audit Office drew attention to the costs in these cases and to the length of the procedures. In fact, it made about 10 or perhaps 12 recommendations, if I remember correctly off the top of my head. In fairness to the Government, I have to say that they have made suggestions on implementing some of those recommendations. However, I would disagree with the Government about the six-month time frame. Most cases could be resolved in about three months. Many years ago, I used to be involved in industrial relations—I am not an expert in them, but I have a shrewd idea of how those things can be conducted.
Given that there had been a change at the top at Walsgrave, we took the view that the slate should have been wiped clean. The charges against Dr. Mattu were made before the new arrangements came in at Walsgrave, and we must be clear about that. I hope that the panel that has been set up will be totally independent, and I want reassurance from the Minister on that. We know that a list is used, but we have not had too much detail on that.
My second concern is that, if the panel recommends reinstatement, we do not have the situation in which the trust says no. That has happened before in one or two cases, but I hope that, in this case, the trust will feel bound to accept a person back into a job that he is well qualified to do. In fact, anyone who has considered Dr. Mattu's qualifications knows that he is extremely well qualified.

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That leads me to the next point that I hope the Minister will consider. Given that the doctor was not suspended for medical incompetence—on the contrary, he is an able cardiac specialist—I would have thought that the investigation should have been carried out before the suspension was proceeded with. However, in this and other cases, someone is suspended straight away and the matter may not be resolved for two years. The individual and his family suffer much hardship and, whatever we might think about the individuals involved, we must recognise the effect on their families. The Minister should seriously consider that point. However, when it can be proved that a doctor is guilty of medical incompetence and medical malpractice, it is right and proper that they should be suspended right away. I make that distinction.
My hon. Friend touched on another point that I wish to make. Rough estimates suggest that, over the past two, three or probably four years, the three cases together have probably cost the national health service £1.4 million or £1.5 million. The costs have not stopped yet, because the doctor is still suspended. That is a lot of money that could have been used in a far better way for health service delivery or care.
As I have said in previous debates, it is also strange that someone should be suspended within two or three days of an attempt at whistleblowing. Someone may put their neck on their line to expose something that they think is wrong, and Dr. Mattu exposed the practice in the hospital of what I term "five in a four-bed ward" that has been investigated and may be the subject of further investigations. He certainly thought that patients were at risk, and I am alarmed that suspension should result from that.
One would not have to be a very good shop steward to know that one can put a case together if one is determined to put a case together. That is the easiest thing in the world. The hardest thing in the world is to make a case that stands the test. My hon. Friend has already demonstrated that there are question marks against the case against Dr. Mattu to say the least.
I am conscious of the fact that we want the Minister to have adequate time to reply, but we cannot reinforce often enough the point about these lengthy suspensions. If they relate to a non-medical issue, the doctor should remain in post until such time as the case is properly heard—not the other way around. I have already drawn a distinction on that.
I agree with my hon. Friend that, to re-establish credibility in the personnel system and the disputes procedure, an independent body should have a good look at not necessarily the merits of the three cases, but the way in which they have been handled by the trust. There is a tremendous sense of anger among the public in Coventry not necessarily about who is guilty of what, but about the length of time and the costs that it has taken to try to resolve the matter.
Having made those points that reinforce my hon. Friend's argument, I shall leave the Minister adequate time to reply. However, once again, my hon. Friend and I wish to thank Mr. Speaker.
6.19 pm
The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman): I congratulate my hon. Friends the Members for Coventry, North-West (Mr. Robinson) and for Coventry, South (Mr. Cunningham) on their tenacious campaign to right what they see as an important wrong. Both have substantial experience of trade unions from different aspects, so I challenge them to put themselves in the place of a shop steward representing the individual who originally made complaints against Dr. Mattu and the others who made complaints against him. If they were in the position of that shop steward, would they be happy to listen to the comments that have just been made? Would they be happy to reinstate somebody against whom serious complaints have been made, knowing that the complainants still have to work in that environment?
Would my hon. Friends be happy to hear my hon. Friend the Member for Coventry, North-West make unsubstantiated allegations against an individual involved in this case, knowing that the trust cannot respond like for like because this matter may go to court one day and the trust must make sure that the proceedings are not prejudiced; and knowing that I, as the Minister, cannot respond like for like, because that might prejudice future proceedings? I challenge my hon. Friends to put themselves in the position of people representing the accusers or alleged victims of Dr. Mattu.
Mr. Geoffrey Robinson: I would be unhappy to hear my own remarks but it is entirely right to make them. There was only one accuser and one allegation. Two days after that allegation was made, Dr. Mattu was suspended for alleged victimisation without any investigation, That is the worst practice and procedure to adopt.
Dr. Ladyman: Surely my hon. Friend accepts that whether or not it was appropriate to leave Dr. Mattu in place depends on the nature and seriousness of the allegation. Although there was only one complainant initially, subsequently more than one person was shown to have a grievance against Dr. Mattu. We could debate the case ad nauseam.
My hon. Friend is right to say that it is the job of the House to bring facts into the open but it is also the job of the House to be even-handed. The position in which my hon. Friend places me does not allow me or the trust to be even-handed in the public domain. These matters must be handled in the proper way by due process, allowing both sides to have their say, to allow a judgment to be made.
Mr. Robinson: I take my hon. Friend's argument that it is difficult for him to reply to some points but when it comes to even-handedness, that is precisely the subject of our principal charge against the trust. It has not been even-handed. Dr. Mattu made a number of serious allegations against other people working in the hospital but they have not been investigated. Nobody else has been suspended. Equally, the charges against Dr. Gieowarsingh remain on the table. They have not been properly investigated and the trust refuses to do anything about them.
Dr. Ladyman: Even-handedness is important but I challenge some of my hon. Friend's interpretation of events.

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As this is not the first debate on the subject, I shall reiterate some of the points made by the Under-Secretary my hon. Member for Welwyn Hatfield (Miss Johnson), when she responded on the last occasion. I will not deal in detail with national health service disciplinary procedures, other than to acknowledge that the Government have already said that they are not fit for the purpose and we are in the process of dramatically transforming them.
I, too, am worried about the length of time that it is taking to resolve the case. Some of Dr. Mattu's supporters alleged that he had been suspended not because of bullying but because he was a whistleblower. It was said in the previous debate that the Government expect a climate of openness and dialogue in the NHS and that we will not tolerate the victimisation of whistleblowers. As part of that, I would expect all NHS employers to operate in the spirit of the guidance that we issued in 1999 and updated in July last year.
I stress at the outset that, after the previous Adjournment debate on the subject, I took note of the points that were made because the hospital falls within my regional responsibilities. I had a meeting with my hon. Friends the Members for Coventry, North-West and for Coventry, South, at which they reinforced many of those points. I looked into the matter and I did not find evidence of improper behaviour by those who decided on the action against Dr. Mattu. After examining the nature of the complaints, and with due regard both to the rights of Dr. Mattu and those of the complainants, whom, I reiterate, appear to be ignored in the debate, I reject the idea that the action resulted from any whistleblowing for which he may have been responsible.
Let me outline the background. Dr. Mattu has been employed at University Hospitals Coventry and Warwickshire national health service trust since May 1997 as a consultant cardiologist. He was suspended from duty on full pay on 21 February by the then joint medical director at the trust, following allegations of serious bullying. A further allegation was made after Dr. Mattu had been suspended, corroborating the original complaint. As my hon. Friend the Under-Secretary confirmed, the suspension was and remains neutral, pending investigation of the allegations. I accept the point of my hon. Friend the Member for Coventry, North-West that suspension is distressing and not neutral from a personal point of view. However, the circumstances are not ideal.
On the one hand, we have a person against whom serious allegations have been made and, on the other, an individual who believes that they have been victimised and bullied. We have to take into account the best way in which to manage the needs and feelings of both people.
I stress that the complaints against Dr. Mattu are serious and originate from more than one source. They cannot be ignored. If they were swept under the carpet, it would be unfair to those who made the allegations. A formal investigation was therefore conducted in accordance with the trust employment procedures for
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clinical staff. They have been agreed by the trust's local negotiating committee and are recognised as fair and appropriate.
During the investigation, statements were taken from people who were identified in the complaints about Dr. Mattu and several interviews were held. Dr. Mattu remains suspended. The joint medical director of the trust has reviewed his suspension fortnightly. After the investigation, an independent panel meeting was held on 30 January 2003, in accordance with trust procedure and agreed with relevant parties, to review the evidence and consider what, if any, further action was necessary on the continuing suspension. The panel undertook a preliminary assessment and found that a prima facie case of personal misconduct needed to be answered.
Dr. Mattu engaged the services of the Hospital Consultants and Specialists Association and a solicitor. The trust has been required to seek legal advice to reduce the risk of any legal breaches that may compromise the progress of the case. Not compromising any future procedures limits the trust's ability to respond publicly to some of the things that Dr. Mattu's supporters allege.
It is fair to say that progress has been slow. That is due to lengthy and complex disputes between the trust, Dr. Mattu and his representatives about the application of trust procedures. Dr. Mattu's unavailability due to sickness has also been a factor in the delays and it is therefore important not to attribute all the delay to the system.
Representatives of West Midlands South strategic health authority met the trust on 30 July 2003 to review the trust's processes and to ensure that the fundamental principles of due process and natural justice had been followed. The meeting was followed by a further meeting with the trust and Ian Stone.
I shall briefly summarise the remaining details of the proceedings because I want to comment on the current position before I have to resume my seat. Ian Stone, who is the chief medical officer's adviser on disciplinary procedures, has also examined the case. He acknowledged that it was complex but he has advised that the only appropriate way in which to resolve it is through the disciplinary process.
My hon. Friend the Member for Coventry, North-West knows that we suggested that a further attempt should he made to obtain a compromise solution. Such an attempt was made early in December. Consequently, meetings were held on 10 and 12 December between the trust and Dr. Mattu. Both sides agreed that the most appropriate way forward was the disciplinary process. I am sorry that Dr. Mattu's support group has tried to portray that differently, but it was a joint decision about the right way in which to proceed. In my view, it is the only possible forward. We must take into account the needs of Dr. Mattu and the accuser. There is no prospect of doing anything other than allowing the disciplinary process to run its course. I know that that will be a great disappointment to my hon. Friends, who have been tenacious about the matter. However, given the complexity of the case, I see no alternative but to allow the disciplinary process to continue.
Question put and agreed to.
Adjourned accordingly at half-past Six o'clock.