Lords Sitting of 18 March 1985

Preamble
The House met at half-past two of the clock: The LORD CHANCELLOR on the Woolsack.
Prayers—Read by the Lord Bishop of Lincoln.

Building Industry: Statutory Requirements
Lord Dean of Beswick: My Lords, I beg leave to ask the Question standing in my name on the Order Paper.
The Question was as follows:
To ask Her Majesty's Government whether they have any plans to deal with people operating in the building industry who do not observe the statutory requirements.
Lord Skelmersdale: My Lords, the Government are always concerned to ensure that all those in the building industry fully comply with their statutory duties. However, assuming that the noble Lord's concern in asking this Question is fiscal, Her Majesty's Government are deploying more staff and simplifying the system to reduce tax evasion.
Lord Dean of Beswick: My Lords, I am grateful to the noble Lord for that reply, but is he aware that calculations are that last year in total householders in this country spent on building extensions and improvements to their homes approximately £5 billion and that £2 billion of that was on the black economy, resulting in a loss of £800 million in income tax to the Chancellor of the Exchequer? Can he give an undertaking that this type of thing will be looked at with the utmost thoroughness in order to recoup such money at a time when local authorities are having their own money withheld from them which could be used for building purposes?
Lord Skelmersdale: Yes, my Lords, I fully agree with the noble Lord. Tax evasion is a very serious problem. As I said in my original Answer, we are taking steps to deal with it. In the past two years an extra 400 staff have been redeployed by the Customs and Excise and in the period from 1979 to 1988 approximately 1,700 additional Revenue staff will have been redeployed in local tax offices, the PAYE audit force and the board's investigation office on anti-evasion work to combat the black economy, which, as I said, is a very serious problem.
Lord Broxbourne: My Lords, in the context of the Question of the noble Lord opposite, will Ministers continue their support for the work of the National Housebuilding Council and, where possible, reinforce it in prescribing suitable standards of house building and construction, particularly in view of their new status and responsibilities accorded under recent legislation?
Lord Skelmersdale: Yes, my Lords, I am most certainly ready to praise the work of the National Housebuilding Council, and the Government are fully
320
in accord with the work that it is seeking to do, especially its recently announced insurance work.
Viscount St. Davids: My Lords, when my noble friend uses the word "redeployed", does he mean that extra staff have been taken on or that these people have been taken from work elsewhere? Can he, if possible, in that case tell us where they have been taken from?
Lord Skelmersdale: My Lords, I understand that the Customs officers to whom I referred are extra staff, whereas the 1,700 additional Inland Revenue staff will have come from other posts. But the point is that their great knowledge and experience will be brought to bear on this problem in those areas, whereas before they were more widely deployed, if I may use the word.
Lord Graham of Edmonton: My Lords, is the Minister aware that action by his department in these matters will be applauded by all legitimate builders and building organisations such as the Institute of Maintenance and Building Management, the Building Employers' Confederation and the Federation of Master Builders? Will he bear in mind that what are required are incentives to comply with the taxation system and that what we do not want to see in the Budget this year is that which appeared last year—the imposition of VAT on building extensions, which certainly led to an increase in cowboys and the black economy syndrome?
Lord Skelmersdale: My Lords, I cannot pre-empt my right honourable friend's Budget Statement tomorrow, but last year's Budget brought an equalisation of tax effects between VAT and other taxes—for example, income tax and corporation tax—so I do not think that the noble Lord is right in saying that it was all bad.
Lord Graham of Edmonton: It increased the black economy, my Lords.
Lord Bruce of Donington: My Lords, will the noble Lord confirm that he understood the phrase, "statutory requirements", in the Question tabled by my noble friend to include the observance of safety standards and other such matters?
Lord Skelmersdale: Yes, my Lords, I am well aware of that, and it also includes training. So far as health and safety are concerned, the Factory Inspectorate deploys about 90 inspectors on construction works. They visit sites and head offices of all sizes of construction firms. They have substantial powers, including powers in magistrates' courts, against firms and individuals who seriously contravene legal requirements. Their effort will be continuous, especially in the small firm sector where there is a particular problem.
Lord Diamond: My Lords, when the noble Lord said in reply to the supplementary question of the noble Lord, Lord Dean, that he fully agreed with him, did he mean that he was endorsing the estimates of the extent of black market tax evasion? If not, what is his estimate?
Lord Skelmersdale: My Lords, I have no personal estimate, but Sir Lawrence Airey has estimated that it is between 6 and 8 per cent. of gross domestic product. If it was 7 per cent. of last year's GDP, the tax loss on that sum could have been as high as £6 billion. The £800 million to which the noble Lord, Lord Dean, referred is a particular amount for those people who have been—dare I use the phrase?—quasi-identified. In other words, it is what we actually know is going on. The other figures are gross estimates.
Lord Dean of Beswick: My Lords, may I ask the Minister whether it is not also a fact that there are other statutory financial obligations that this kind of builder is escaping, such as NHI contributions, training board levies, and so on? The £800 million about which I am talking is only part of a wider picture.
Lord Skelmersdale: Yes, my Lords, that is absolutely right. By definition the term "cowboy" means that the people in question are operating outside the law. The great worry is that by tightening the law in this respect you will increase the cowboy element.

Russia Committee: Records
2.44 p.m.
Lord Gladwyn: My Lords, I beg leave to ask the Question standing in my name on the Order Paper.
The Question was as follows:
To ask Her Majesty's Government why it is not possible to make available for public inspection the conclusions and recommendations of the Russia Committee of the Foreign Office for the period of Lord Gladwyn's chairmanship (1948–49).
The Minister of State, Foreign and Commonwealth Office (Baroness Young): My Lords, a number of the 1948 and 1949 papers of the Russia Committee fall within the terms of the general approval given by the Lord Chancellor in 1967 for the retention within Government departments of records relating to security and intelligence matters for longer than 30 years. The question of the release of records which interest the noble Lord was reviewed in 1982 and again in 1984 by two of my ministerial colleagues at the Foreign and Commonwealth Office. Both were unable to find grounds to vary the original decision to withhold these records.
Lord Gladwyn: My Lords, while thanking the noble Baroness for that not unexpected reply, may I ask her two very short supplementary questions? In the first place, is it not perhaps a little absurd not to allow the chairman of what was, after all, the first—and, I think, very successful—policy planning body of the Foreign Office, at any rate to refresh his memory of recommendations and conclusions of that body, more especially if he gave an assurance that he would never make any use of or refer in any way to these papers without the consent of the Foreign and Commonwealth Office? However that may be, since, as I think I recall, there were normally representatives
322
of MI5 and MI6 on this committee, including, from time to time, I rather suspect, the notorious Soviet agent Mr. A. R. Philby himself, would it not be desirable for the Government to recommend searchers after truth, and historians generally, to have recourse to the Ministry of Foreign Affairs in Moscow, where the documents would presumably be readily available?
Baroness Young: My Lords, of course I note what the noble Lord, Lord Gladwyn, has said. As he will appreciate, access to papers retained under the provisions of the Public Records Act 1958 is permitted only to those who need to see them for official purposes. Perhaps I may say that over the past 18 months my department has done its best to be as helpful as possible to the noble Lord, and my Ministerial colleagues in the Foreign Office have held a very extensive correspondence with him. With regard to his second supplementary question, I think that he has answered it himself.
Lord Cledwyn of Penrhos: My Lords, I should be grateful if the noble Baroness would make this clear. Is she saying that the noble Lord, Lord Gladwyn, cannot now have access to papers of a committee of which he himself was chairman, even if he makes plain and gives an undertaking, as obviously he would, and as he could on Privy Council terms, that if the Foreign Office so decides, he will not impart any of the information he obtains?
Baroness Young: My Lords, the answer to the question of the noble Lord, Lord Cledwyn, is as I have already given it to the noble Lord, Lord Gladwyn. It is a question of the law and what is allowed under the Public Records Act 1958.
Lord Thomas of Swynnerton: My Lords, bearing in mind that some papers in this series, including the terms of reference, are in the public domain, would it not be possible for the Government to consider a technique practised in the United States, where, when there are papers which would otherwise be available but which contain items or names which even now it would be considered undesirable to reveal, the Government can suppress those items and those names by means of blacking them out?
Baroness Young: My Lords, I note what my noble friend has to say on this matter. Of course what is right for the United States is not necessarily right for us. However, perhaps he would agree that it would be wrong to tamper with a historical record.
Lord Paget of Northampton: My Lords, did the noble Baroness say that there had already been an "eccentric" correspondence with the noble Lord, Lord Gladwyn, on this subject, or did I mishear her?
Noble Lords: Extensive.
Lord Paget of Northampton: Oh, "extensive". I thought she said "eccentric"; it sounded much more realistic. When the noble Baroness replied she said the Government could not vary their position. Apparently she was then talking, as the Question indicated, about

323
general publication. It now emerges that what has been asked is that the noble Lord, who is an ex-ambassador, and the man who drew up this report, should be allowed to have a look at his own report. How in heaven's name does that affect this country's security? This has reduced the whole thing to a farce.
Lord Gladwyn: Hear, hear!
Lord Paget of Northampton: My Lords, surely there should be a little revision here?
Baroness Young: My Lords, I do not think I have anything further to add to what I have already said to the House.
Lord Morris: My Lords, if the noble Lord in question had made his own notes at the time, this Question would not arise at all.
Lord Kennet: My Lords, one appreciates that the question is very complex, but can the noble Baroness say anything about the differences which appear to exist in the regulations affecting first, ex-Ministers; secondly, ex-ambassadors who wish to look at their own ambassadorial papers; and, thirdly, ex-ambassadors such as my right honourable and noble friend who want to look at their own old papers written before they became ambassadors? If the differences are as wide as I think they are, is it not verging on the absurd?
Baroness Young: My Lords, I cannot give the detailed information that the noble Lord, Lord Kennet, seeks without notice; but the position with regard to the release of papers is of course as I have described it in two supplementary answers that I have given.
Lord Mayhew: My Lords, is the noble Baroness aware that the proceedings of this Committee of which I, too, was a member would not have been reported to Moscow by Mr. Philby? This task would have been entrusted to Mr. Guy Burgess whose work was very closely associated.
Baroness Young: My Lords, I am very glad that the noble Lord. Lord Mayhew, can regard as a joke what may have happened with those two people in question.
Lord Diamond: My Lords, the House is obviously very concerned with what the noble Baroness is saying. I am a little concerned about her statement that she cannot refer to the answer in detail with regard to the difference between Ministers and senior diplomats. Will the noble Baroness accept from me, without bothering about the detail, that a Minister is fully entitled to look at his own papers at the time he was a Minister? Why then should there be this extraordinary difference between a Minister and a senior diplomat?
Baroness Young: My Lords, I did not say that I would not answer the question. I said that I could not answer a detailed question like that without notice. That is quite a different matter. I have described the position as it exists.
Lord Teviot: My Lords, as I have had the privilege of serving on the Lord Chancellor's advisory council on public records for nine years, would my noble friend confirm that the Act of 1958 relates to the 50-year rule while the 1967 Act relates to the 30-year rule? Is she aware that if the noble Lord, Lord Gladwyn, referred himself to the Master of the Rolls, the chairman of that committee, and asked for a review of the situation, he might fare slightly better? That is the rule of this country. It is the rule of the land. Equally, will my noble friend confirm what I think is the case—that no post-tzarist regime records are available in Moscow, which explains why, every January, Russians come here to see what we have opened up after 30 years?
Baroness Young: My Lords, it would be unwise of me I think to comment on what may or may not be Russian practice. I can confirm that if the Lord Chancellor wishes for a further opinion about the retention of records by the department, he may arrange for the Secretary of the Cabinet to look into the matter and advise him.

US Arms Supplies: Representations
2.52 p.m.
Lord Molloy: My Lords. I beg leave to ask the Question standing in my name on the Order Paper.
The Question was as follows:
To ask Her Majesty's Government whether they will consider making representations to the United States about arms supplies to Right-wing organisations and governments in South America and in the Middle East.
Baroness Young: My Lords, sales of arms, except to the Warsaw Pact countries and certain other destinations, which are subject to multilaterally agreed control, are a matter for national governments within their obligations under international law. In cases where arms sales by the United States might threaten United Kingdom interests, we naturally make our views known to the United States Government.
Lord Molloy: My Lords, while I thank the noble Baroness for that reply, is she not aware that some extreme Right-wing countries and extreme Right-wing guerrilla organisations have been guilty of the most appalling atrocities wrought upon ordinary people with arms supplied by the American Government? Is she aware that one classic example is Guatemala, where, after the butchering of tens of thousands of Indians with arms supplied by the United States, aid was stopped by President Carter but has now been restarted by the present administration? In so far as this constitutes a very serious threat to Belize which must involve the British Government, should we not continue protestations about this awful behaviour of the American CIA which is damaging their country and many other free nations as well?
Baroness Young: My Lords, the United States Government are well aware of our concern about the possible consequences of military aid to Guatemala,

325
not least for the British garrison in Belize. We continue to keep in close touch with the United States Government about this matter.
Lord Bottomley: My Lords, would not the Minister agree that Israel is the only truly democratic country in the Middle East? Is she aware that Israel is prepared to give technical skill and economic aid to all the countries in the Middle East to make the area really prosperous? Are these not additional reasons for meeting the request of my noble friend Lord Molloy?
Baroness Young: My Lords, on the specific question that the noble Lord, Lord Molloy, has asked, the sale of arms by the United States to any country is of course basically a question for the United States Government.
Lord Avebury: My Lords, will the noble Baroness confirm that our Government have expressed themselves in favour of the Contadora process on several occasions and that one element in that process is that none of the countries in the region of Central America should allow its territory to be used for acts of aggression against a neighbour? If that is so, will the Government not make strong representations to our friends in Washington that they should desist from arming terrorists who are using the countries of Honduras and Costa Rica for their terrorist actions against the people of Nicaragua?
Baroness Young: My Lords, I can confirm that we support the Contadora process, but we share with the United States administration the common objective of a peaceful settlement in Central America; indeed, on Contadora principles. There is a need for restraint on all sides in the present situation. In particular, we want Nicaragua to end the substantial build-up of arms, troops and foreign military advisers and to stop supporting attempts to destabilise neighbouring democratic governments.
Lord Kennet: My Lords, the Minister of State says that when we think that American arms exports will hurt our interests, we let the United States administration know. She has mentioned Guatemala. Can she tell the House of any other countries where we have made such representations?
Baroness Young: My Lords, we have made our position clear in regard to arms sales to Argentina.
Lord Molloy: My Lords, will the noble Baroness not agree that my original Question simply asked our Government to consider making representations on the evidence that is available to them? Only a few weeks ago, for example, the United States arms control and foreign policy caucus in Congress condemned United States policy and said that those responsible in that sphere were misleading the United States Congress as well as the United States people. Should we not give them our support by making representations? Or can the Government at least consider making representations to the United States on the basis of these reports?
Baroness Young: My Lords, as I have indicated, we have made representations. On the particular point about Guatemala, we most recently expressed our concern about military aid by voting in favour of a resolution adopted at the United Nations General Assembly in December 1984 which called on Governments to refrain from supplying arms or other military assistance to Guatemala so long as serious human rights violations continued.
Lord Molloy: My Lords, I agree with the noble Baroness on what she says about Guatemala. She is absolutely correct. What the American foreign affairs committee complained of was the behaviour of the American CIA under someone's command in El Salvador. Does she not think it is worth making representations about that?
Baroness Young: My Lords, I have indicated the Government's view on these matters. I do not think that there is anything further that I can add.

Chemical Weapons: Public Protection
2.58 p.m.
Lord Mottistone: My Lords, I beg leave to ask the Question standing in my name on the Order Paper.
The Question was as follows:
To ask Her Majesty's Government when they hope to issue civil defence guidelines on detection, warning and protective measures against chemical attack.
The Minister of State, Home Office (Lord Elton): My Lords, in the absence of a ban on chemical weapons, we are considering the questions of detection and warning of chemical attacks and protective measures against them. It is too early to say when this will be completed, but I shall of course keep your Lordships informed of progress.
Lord Mottistone: My Lords, in view of the fact that the Soviets have over a quarter of a million tonnes of chemical munitions, is it not a matter of importance that we should have the report to which my noble friend I think referred, accelerated? Therefore guidance can be given to local authorities combining protection for the public against chemical attack in the general consideration of their civil defence activities which they are now taking on.
Lord Elton: My Lords, it is important that we should have the report. However it is also important that the report should be right and that the guidance should be accurate and capable of being implemented. In view of the extent of the work needed and the variety of sources to be consulted, I am not able to give a date for the report.
Lord Jenkins of Putney: My Lords, does the noble Lord agree that in regard to chemical weapons—indeed, the same may apply to some other weapons as well—it is somewhat difficult to know whether the research and development that is being carried out is being carried out for defensive or offensive purposes?

327
In the event of the Government unhappily deciding to proceed any further in this matter, will they draw a sharp distinction between defensive preparations and any suggestion of offensive preparations?
Lord Elton: My Lords, there is no question of our using defensive research for offensive purposes.
Lord Mayhew: My Lords, does the noble Lord agree that the likelihood of chemical attack is somewhat greater than the likelihood of nuclear attack? Are the Government not giving too much priority to defence against nuclear attack as compared with defence against chemical attack?
Lord Elton: My Lords, without wishing to claim expertise in the matter, I think I am right in saying that the chemical weapon is generally more likely to be used in battlefield conditions. Of course, if there was a battlefield in the United Kingdom then the civilian population would in any case be exposed.
Lord Renton: My Lords, have not even the peacetime disasters shown that the most terrible damage can be done on a wide scale by chemical attacks, explosions and so on? Can my noble friend say whether the NATO defence committee, of which we are members, is taking any steps in this matter by way of research and advice and protection?
Lord Elton: My Lords, the Civil Defence Committee of NATO is developing guidelines on a wide range of civil defence matters, among them methods for the protection of the civil population against the effects of modern weapons.
Lord Mottistone: My Lords, is my noble friend able to tell us whether the recommendations from NATO will be part of what is put together as recommendations to local authorities by his department?
Lord Elton: My Lords, I am not certain what the process of assembly will be, but I can assure my noble friend that what is recommended will be congruent with that advice.
The Earl of Onslow: My Lords, I should like to ask whether any element of chemical warfare was built into the recent exercises which were carried out concerning defence against notional nuclear attacks. Surely it would not be wise to assume that chemical warfare would not be used and that only nuclear warfare would be used. Should we not amalgamate the amount of civil defence that is required to apply to both categories of warfare?
Lord Elton: My Lords, I am not familiar with the entire programme of the recent exercises, but I can assure my noble friend that we are not unaware of the extent of the threat of chemical weaponry, of which, as my noble friend Lord Mottistone has reminded us, the Soviet Union retains a considerable quantity, and also the capability of delivery.

Future Business
3.3 p.m.
Lord Denham: My Lords, at a convenient moment after 3.30 this afternoon my noble friend Lord Glenarthur will, with the leave of the House, repeat in the form of a Statement an Answer to a Private Notice Question in another place on cervical screening.
It may be for the convenience of your Lordships if I make a short statement about the re-arrangement of certain items of business this week. The Report stage of the Administration of Justice Bill, which in the event was not finished last Thursday, will now be concluded as first business tomorrow. In consequence, the Committee stage of the Trustee Savings Banks Bill, which was to have taken place tomorrow, will now be taken as first business next Thursday. Finally, I should mention that the Committee stage of the Land Registration and Law of Property Bill will not now be taken this afternoon, and no alternative date has yet been fixed.

Lerwick Harbour Order Confirmation Bill
Brought from the Commons; read a first time, and (pursuant to the Private Legislation Procedure (Scotland) Act 1936) deemed to have been read a second time, and reported from the Committee.
Reserve Forces (Safeguard of Employment) Bill [H.L.]
Report received.
Shipbuilding Bill
Read a third time, and passed.

Local Government (Choice of Electoral Systems) Bill [H.L.]
3.5 p.m.
Lord Blake: My Lords, I understand that no amendments have been set down to this Bill and that no noble Lord has indicated a wish to move a manuscript amendment or to speak in Committee. Therefore, unless any noble Lord objects, I beg to move that the order of commitment be discharged.
Moved, That the order of commitment be discharged.—(Lord Blake.)
On Question, Motion agreed to.

Immobilisation of Vehicles illegally parked (London Boroughs of Westminster, and Kensington and Chelsea) (Continuation) Order 1985
3.6 p.m.
Lord Brabazon of Tara Lord Brabazon of Tara rose to move, That the draft order laid before the House on 25th February be approved. [14th Report from the Joint Committee.]
The noble Lord said: My Lords, this order will continue the police powers to clamp illegally parked vehicles in central London until May 1987. Your Lordships will recall that the wheelclamp powers were introduced at the request of the police to provide them with an additional tool to combat illegal parking. This, in central London in particular, was seriously impeding traffic flow and making it difficult for lorries to load and unload goods and for law-abiding motorists to find a legal parking space.
Your Lordships will also recall that when the wheelclamp powers in the Transport Act 1982 were under consideration in this House we made provision for an initial, two-year experiment in an area to he designated by order. My right honourable friend the Member for Guildford, the then Secretary of State for Transport, subsequently designated an experimental area consisting of parts of Westminster and Kensington and Chelsea. The area chosen was one where the problem of illegal parking was causing most concern. The experimental order expires on 15th May, and the approval of both Houses is needed if the police powers are to be continued.
As many of your Lordships will know, the Transport and Road Research Laboratory was asked to undertake a "before and after" survey of the effects of clamping. The laboratory's report examined the first six months' experience of clamping, and was published in October 1984. The TRRL report concluded that, following the introduction of clamping, compliance with parking regulations improved. The time taken up by illegal parking on yellow lines fell by 40 per cent. and that in residents' bays by 30 per cent. Traffic speeds increased, with implied annual savings in motorists' costs of £9 million to £15 million at 1979 prices, plus savings of £2 million to £3 million on fuel and wear and tear on vehicles. The laboratory thought that the reductions in illegal parking were probably due to the visual impact of the clamp and its consequent deterrent effect on other drivers.
My right honourable friend the Secretary of State for Transport consulted widely on these TRRL findings and the response was substantially in favour of continuing the use of wheelclamps in central London for at least a further period, so as to assess the effects over a longer period of time. Of 34 responses from individuals, firms and official organisations, 26 favoured continuation at least for a longer period, only five were against clamping, and the other comments were neutral. The responses to my right honourable friend's consultations very much welcomed the reductions in illegal parking with the consequent easing of problems for delivery drivers and for residents, and the improvements in road safety and traffic flow.
However, concern was expressed in some of the responses about the effects on trades such as service engineers; the possible deterrent effect on shoppers; the severity of the penalty; the fact that an illegally parked car might be present for longer as an obstruction if clamped than it would otherwise; and the possible damaging effect on the relations between the public and the police.
Your Lordships will recall that several of these factors were debated when this House was considering wheelclamps in 1982 during the passage of the clamping powers. Particular fears were expressed then, for example about the harm which might be caused to relations between the public and the police. I can reassure your Lordships that the fears have proved largely groundless. The police have carried out clamping with care and sensitivity, and it is doubtless largely due to this that clamping has on the whole been accepted by the motoring public without the dire effects that some people predicted three years ago.
Your Lordships may also recall that in our 1982 debates much concern was expressed that clamping should be used against persistent offenders and against diplomats. It would not he appropriate for the police to concentrate solely on persistent offenders, as they must deploy their resources where this will produce most benefit in terms of traffic conditions. However, many such motorists have in fact been clamped as outlined by my honourable friend the Minister of State for Transport in another place last Tuesday.
As regards diplomats, it was very disappointing when we had to suspend clamping diplomatic vehicles because of legal advice that this was in fact contrary to the Vienna Convention on diplomatic relations. The Government therefore urgently reviewed the problem of the number of diplomatic vehicles in London and my noble friend Lord Elton announced changes in the system of special "D" and "X" registration plates designed to reduce the number exempted from parking regulations. Immunity from clamping is now restricted to vehicles with "D" registration plates and these are limited to those diplomats with full immunity; the number of "D" plates issued has also been curtailed both for cars used officially and for diplomats' private vehicles. Those not entitled to full diplomatic immunity, but only to immunity when on official duty, now receive "X" registration plates and are liable for clamping. Forty such vehicles were clamped in the last quarter of 1984.
More generally, however, the Government remain concerned about the number of fixed penalty notices cancelled on grounds of diplomatic immunity. This is being taken into account in the current review of the Vienna Convention, its operation and enforceability, and as a result it is hoped to tighten up measures to deal with parking offences by diplomats.
The TRRL research on the effects of clamping could not of course predict the extent to which the welcome improvements in parking compliance and journey speeds would persist in the longer term. Various organisations who wrote to my right honourable friend took this point up and suggested that a further period of assessment was needed before any firm decison could be taken about the use of clamps on a permanent basis. The Government are mindful of the

331
strong arguments that have been advanced both for and against clamping. Any decision on such a drastic measure should only be taken with great care. But we believe from the results so far that a two-year extension of the present order is justified. This will enable the effects of clamping to be further assessed, with further monitoring from the Transport and Road Research Laboratory.
If your Lordships' House approves this continuation order—as the other place has already done—traffic authorities will be able to apply to my right honourable friend the Secretary of State for Transport for the use of clamps to be extended by order to other areas. If any such requests are received, my right honourable friend will consider them on their merits in the light of the traffic and parking situation in the areas concerned and taking into account the resources and back-up needed; that is, the police manpower, the vehicles, the pounds, etc.
Wheel clamping has so far been shown to be a useful means of complementing existing methods of enforcement—that is, the issue of fixed penalty notices and towing away. As with vehicle removal charges, the clamp fee is designed to cover police costs. As explained by my honourable friend the Minister of State for Transport in another place, the present declamping fee of £19·50 is based on an estimate of costs made before the start of the experiment. The fees for both clamping and vehicle removal have recently been reviewed and as announced by my honoruable friend, it is likely that the clamping fee will have to be increased from £19·50 to £25 and the removal charge by a broadly proportionate amount. My right honourable friend the Home Secretary will be consulting on the new charges proposed. The fee to be charged is not part of the present order and will be covered by a subsequent order to be laid before your Lordships' House.
I should like now to turn to the more positive side of the Government's approach. It is not enough just to punish those who flout the parking regulations. We need to see that the legitimate demand for parking spaces in central London is met and that ways are found to improve mobility in central London generally. We need to try to find better ways to help all road users go where they need to and better ways to ensure that motorists pay for the space they use when they park on the highway. My right honourable friend intends to tackle these urgent issues and encourage local authorities to adopt a positive approach to these problems.
I applaud Westminster City Council's initiative, as outlined by my honourable friend the Minister of State for Transport in the other place last week, in identifying nearly 1,400 extra on-street spaces which can be created by converting unnecessary yellow lines into parking spaces, and the further steps they are now taking.
The clamping powers were introduced by the Government only after the most careful consideration. It seems from the initial results that clamping has shown real benefits in reducing illegal parking and improving traffic conditions. The extension of the powers for a further two years will allow a further period of assessment before a final decision is taken. It
332
will also enable further work to be done on ways of improving mobility in central London and new parking arrangements, as well as assessing methods of enforcement.
Meanwhile the police must be given every support in their efforts to restore respect for parking regulations. Clamping has assisted them and I ask your Lordships to approve the order.
Moved, That the draft order laid before the House on 25th February be approved.—(Lord Brabazon of Tara.)
3.16 p.m.
Lord Carmichael of Kelvingrove: My Lords, I thank the Minister for his careful explanation of the order and for the valuable information which he gave us when introducing it. An order on a subject such as this is understandable to most Members because we nearly all drive and move around London. Indeed, we must perforce come to Westminster and in the course of doing so we see the traffic conditions. Such an order gives us the opportunity to review the problems and to ask the Minister some questions, many of which he has already answered.
The problems arise in any city, but especially in London and the very heart of the City of London. Throughout London there is the great problem of just how much on-street parking should be allowed and can be allowed. I was very glad to hear the Minister's concluding remarks which he told us how Westminster City Council has identified 1,400 new parking places. That is very important. However, a number of questions arise. The major question which always arises whenever parking—both on-street and particularly off-street—is discussed, is how may people actually need to bring cars into central London every day and how much control there can be over it. That is not a criticism merely from this side of the House, which used to have the reputation—but I hope that it has not now—of being anti-motorist. It is very important to recognise that we are just as involved as everyone else in trying to get a good deal for the motorist.
I was a Member of the Select Committee which dealt with this problem and it became very obvious that the commercial interests in London were very concerned about the problem of street parking. In the old days it was merely a case of making provision for the loading and unloading of goods in the central area and also making provision for the fire brigade and the ambulance service to be able to get in and out. However, a new dimension has arisen particularly with the construction of high rise office blocks, hotels and so on. That point was brought home very forcibly by the Chamber of Commerce and by various other business interests in the centre of London. They made the point that there must be a free flow of traffic to give access to maintenace engineers because there is the particular problem of lifts. Perhaps even more important nowadays, we must bear in mind that the automation of offices is reaching the stage where there could be a very big breakdown, and maintenance and repair staff must be able to get through very quickly or a whole section of the office community will be put out of business. That could lead to great difficulties.

333
When the original order was brought forward a point was made about untaxed vehicles. The noble Lord, Lord Elton, on 15th December 1983 at col. 344 said:
"As to widening the experiment to cover untaxed vehicles, again I can say that when a vehicle is clamped and found to be untaxed, it means big trouble for the owner".
Will the Minister either now or later let us know whether there has been any real advance in the tracing of untaxed vehicles since the introduction of clamping?
The Minister was slightly shy when he spoke about the difficulty of persistent offenders. When the original order was introduced we were promised that there would be a genuine attempt to look at persistent offenders. It must be very difficult and galling for the odd offender, who usually does his best always to be law abiding, to know damn well that there are certain owners of vehicles who somehow or other manage to get away with it week after week and, indeed, for long periods. Therefore, with modern communication between traffic wardens and with the police radio network, it should be possible to find persistent offenders.
All this is not to decry the clamp. It is merely to make people feel that at least fairness is being observed when the clamp is being used. I think that if people feel that the rules are being obeyed by everyone, they have little to grumble about. They know the rules before they start; we are all obeying the same rules.
One thing that is very annoying—I do not know whether the Ministry has thought of doing anything about it—is that in certain parts of London meter feeding is still very widespread. We know the streets in which it is done; people walk out and put extra money into meters. There should be some way to prevent this.
The whole problem of parking causes great frustration and great annoyance. Part of the Government's duty should be to try to convince people that while bringing a car into the centre of a city is always a hazardous business, at least there is a certain degree of fairness when they do so.
Having made those few remarks, I think that we are very much in favour of the extension of this order so that greater time may be given and the novelty will wear off. We must thank the TRRL and others in the motoring organisations for their co-operation. Both the RAC and the AA have been very helpful and reasonable in their objections. I do not always agree with them, but they have been very reasonable in their observations on this matter. We certainly give a welcome to the extension for the period which the Minister suggests, so that these bodies, and the Ministry, are able to find out more about the behaviour of motorists and the results of clamping.
3.22 p.m.
The Earl of Halsbury: My Lords, I should like to draw attention to a point made by the noble Lord, Lord Carmichael, about the sense of heavy-handed injustice which comes from the maladministration of the system that we have. I quite agree that there is a problem. I quite agree that clamping may be a partial solution to this problem, but at the risk of laying bare
334
my scars I want to tell your Lordships how the system can be made to work out at the moment.
For reasons your Lordships understand, I am a bachelor who lives by himself. I do my own housekeeping, catering and cooking, and I enjoy giving little lunch parties from time to time at which my guests can consume what I have cooked for them. This entails my housekeeping, shopping, catering and so on, and ends up with a visit to your Lordships' House, I hope in time for prayers.
One day I stopped my car in a little back street called Phillimore Walk, on a yellow line, to cross the road to cash a cheque at my bank in order to go on to my little shopping centre. I drew in behind a car already there. I came back five minutes later to find the car still there, my own car clamped, and the car behind me unclamped. So I was one out of three; and the car that was not clamped was there before I was. I disarranged nobody. I was not holding up the traffic. Phillimore Walk is a little back street which does not carry very much traffic.
The instructions as to how to go to pay my fine were so obscure that, having taken a taxi to Marble Arch, I wasted half an hour wandering around the innumerable tunnels under Marble Arch station, trying to locate the place where I could pay my fine. I then asked, "When can I get the car unclamped?" I was told "We can't tell you anything about that, you must go there and wait". I said, "I can't; I am host at a lunch party". They said, "That's your funeral, not ours." I said, "When you have unclamped me can you not put a phone call through so that I can go and collect my car?" They replied, "No, we never do that. All we can do is to tell them to get a move on and unclamp you". I then said, "If you can communicate with them, they can communicate with you. Both of you can communicate with headquarters and surely you can put a call through to me to tell me that I have been unclamped." "No, we never do that", they said. This is the bureaucracy. It is their convenience, not the subject's convenience, that is consulted. They said, "All you have to do is to go and wait". I said, "I can't. I have lunch to cook."
What do you do in these circumstances, my Lords? Your civic duty, your social duty and your public duties to this House are in conflict with one another and so you just have to throw in the sponge and go home and cook lunch. Then you go back after lunch and find that you have been unclamped, but nobody has left a notice to say, "Fine paid, give him an hour's grace"—no, nothing like that. The local warden slaps a £10 fine on you straight away.
It is an old principle of what people feel to be natural justice that the punishment should not exceed the crime. When you think that that cost me £29.50 plus taxi fares, it seems too much to pay for the price of harmlessly parking on a yellow line before cashing a cheque and then driving straight away. I was not there for five minutes.
There is another point. I do not know whether I am in order, but I feel that I have the leave of the House here. The noble Lord the Minister referred to making the motorist pay for parking on the public highway. I do not know quite in what sense he meant that, but I do pay for parking on the public highway. I pay £50 a

335
year, I think it is, to the Royal Borough of Kensington and Chelsea for the right to park in the street where I live. This gives me the right to park at all hours of the day when I do not need to because I am either out shopping or attending your Lordships' House. The time I need to park is when I come home late from your Lordships' House and find that every single parking bay with a licence attached to it is occupied by somebody without a resident's parking permit. All right, one can find a way round that, but the wardens are told to take people on yellow lines first; and then "ticket" people who are wrongfully in a parking bay second. This means that the innocent who have been pushed out of the place they paid a right to park in are fined, and those who are parking in their place do not get fined.
On the occasion when I caught an early morning train after a late night session here to attend the big "thump" last year when the Central Electricity Generating Board drove an express train into a nuclear flask to see whether it burst, leaked, or whatever, I counted six cars on one side of my street and seven on the other not bearing residents' parking permits but occupying residents' parking bays. I could not shift them. I parked my car on a yellow line the night before. I had to leave it there. Of course, when I got back—a £10 fine.
The noble Lord talked about persistent offenders. In a statistical sense of course I am an offender. What else can I do? I come back from a session at your Lordships' House to find every bay I have paid the right to park in occupied by somebody who has not paid for it. I therefore simply regard the £10 fines I get as a statistical expectation. It is just part of the cost of motoring. I do not believe that is the way to instil good feeling between the motorists and the authorities who are concerned with law. I hope that I have not taken up too much time on this matter. I have dealt as decently as I know how with the noble Lord and I hope that he will report it on.
Lord Boyd-Carpenter: My Lords, of course I lack the culinary and many other skills of the noble Earl who has just addressed us, and I want to put to my noble friend one very simple, but it seems to me basic, point. As he explained to us, the purpose of these clamping provisions is to prevent obstruction of our streets. All of us, of course, are with him there. Obstruction of traffic in the streets of London is not only a matter of intense irritation, but also of considerable economic damage. But this particular instrument for doing so seems to me to have in it almost entertaining aspects of paradox. If the clamping is to be applied, as I assume it is, only to cars which are obstructing the traffic it is a little difficult to see why a step should be taken which makes it impossible for the owner to move the car and cease to obstruct the traffic. The purpose seems to be defeated by the action taken by the authorities.
For years we have had a perfectly satisfactory method of dealing with vehicles obstructing the traffic; that is, to tow them away. If they are towed away, as a matter of definition they cease to obstruct the traffic. But, instead of that, to use the clamp seems to be self-defeating.
336
I yield to none of your Lordships in respect for the Transport and Road Research Laboratory. When I was Minister of Transport many years ago I had the highest regard for them. But it seemed that the figures which my noble friend quoted are not as convincing as they sounded when he gave them in his usual persuasive way. The clamping takes quite a lot of police effort and time. We see these cars driving about London marked "Clamp Units", generally with two policemen and often also a couple of pretty police women with them, and this involves considerable effort.
If the same effort were applied simply to towing away obstructing vehicles is it not at least possible that the same saving in traffic time, and therefore economic saving, might be achieved? I still retain the gravest doubts about this experiment. It is almost self-contradictory in the way it is applied, and I suspect that it is a misapplication of police effort which could be far better applied more directly by simply removing vehicles which do the obstruction.
Lord Morris: My Lords, is my noble friend aware that for many years the City of Paris clamped vehicles there but they have now completely given it up as a bad job, I believe for the reasons which have been mentioned by the noble Lord, Lord Boyd-Carpenter? Did the Ministry consider initially, for want of a better term, the Parisian experience in arriving at their determination to experiment? If not, have they considered it in the course of the experimentation before coming to their current view upon which we are about to decide?
Lord Peyton of Yeovil: My Lords, I should like first of all to express my sympathy with the noble Earl, Lord Halsbury, for the great inconvenience he has suffered, and to say how sorry I am that those directing this unit lacked the kind of second sight to realise quite the outrage they were perpetrating. I am extremely sorry to find myself at some difference with the noble Lord. Lord Boyd-Carpenter.
The noble Lord will be more familiar than I am with the problems of London's traffic. At the time that he was Minister of Transport, so far as I recollect, the job had not been totally filleted and made quite impossible. At a later stage London's traffic problems were, so far as I am aware, removed from the Ministry of Transport—the Minister being a rather vulnerable single figure—and passed over to a committee of the Greater London Council. Decency forbids me from going into the merits or otherwise of that particular body at this moment, but I am not greatly in favour of committees when it comes to enforcing laws of this kind. They are anonymous bodies, they are not particularly vulnerable to criticism, and they are not easily arraigned.
Therefore, I look with some favour upon the clamping experiment. I personally rather wish that more extensive use were made of it, not in the small by-streets to which the noble Earl referred but in large highways where quite unnecessary obstruction is caused—and they are main highways even if they are narrow. I believe that the use of this device is a considerable deterrent even though, as my noble friend Lord Boyd-Carpenter pointed out, there is some

337
temporary obstruction of the traffic as a result of the use of the device.
I hope that we shall proceed with it with some boldness, and that perhaps more extensive use can be made of it and not less. I think we have too much sympathy with those who persistently make it difficult, if not impossible, to move around the streets of our capital city.
3.35 p.m.
Lord Brabazon of Tara: My Lords, I knew that this was going to be a fairly controversial order when I rose to move it. May I try to answer as many questions as possible which have been raised by noble Lords. The noble Lord, Lord Carmichael, asked about the vehicle excise duty. If the police find a vehicle during the process of clamping which has not got an excise duty licence they report the case to the department's London enforcement office, which is responsible for enforcing these licences. I have not got any figures with me about how many apply in this particular instance. If I can find them out I shall let the noble Lord know.
The noble Lord also asked about persistent offenders and the payment of outstanding fixed penalties. The police are continuing their efforts to identify persistent offenders and are considering how improved technology might help them to identify the relevant vehicles more speedily. Meanwhile, many persistent offenders have already been caught both through police efforts and because continually flouting the parking regulations increases the statistical probability that they will be clamped. As my honourable friend mentioned in another place on one day when 127 vehicles were clamped, 45 had five or more unpaid fixed penalty notices outstanding including 18 with 20 or more.
The noble Lord also mentioned the subject of meter feeding. This is something which is illegal and the wardens must do what they can to prevent it. I do not know about the particular street the noble Lord is talking about. Perhaps he would like to have a word with me afterwards and we might see if we can do something.
I fully sympathise with the noble Earl, Lord Halsbury, in what happened to him. I am surprised it happened to him. As I understand it, vehicles left on yellow lines are supposed to get a ticket first, and a certain amount of time is meant to elapse before the clamp is attached. I can only sympathise with the noble Earl. As for illegal parking in residents' areas, the TRRL report showed that clamping appears to have cut that down by 30 per cent., so I hope it is a step in the right direction from that point of view.
My noble friend Lord Boyd-Carpenter mentioned obstruction. The point about the clamp is that it is not supposed to be used where a vehicle is causing an obstruction. It should not be used. Those vehicles will be towed away. It is only supposed to be used on yellow lines, or at parking meters, or in residents' areas, so it should not be used where the vehicle is causing an obstruction.
Lord Boyd-Carpenter: My Lords, is my noble friend saying that if I park my car in a position where it will definitely obstruct traffic, I shall be absolutely free from the risk of being clamped?
Lord Brabazon of Tara: My Lords, in that situation, the noble Lord should be towed away. Yes, he should be free from the danger of being clamped, but with 700 clampings a week I dare say that one or two go wrong.
My noble friend Lord Morris mentioned the experiment in Paris. I was not aware that they had given it up. As your Lordships are aware, this order is to renew clamping for a further period of two years so we shall see what the TRRL will come up with during that time.
I should like to thank my noble friend Lord Peyton of Yeovil for his support. He said he would like to see more extensive use. As I said in my original speech, as from May, when the renewal takes place, if other authorities want to introduce it and they can satisfy us that it is necessary we shall look at that matter.
On Question, Motion agreed to.

Cervical Screening
3.39 p.m.
The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Glenarthur): My Lords, with the leave of the House. I shall now repeat, in the form of a Statement, the Answer which is being given to a Private Notice Question in another place on cervical screening. The Answer is as follows:
"Last year we gave all health authorities updated, comprehensive guidelines on an effective screening programme based on the advice of an independent expert advisory group. This followed the circular which we issued in December 1981 telling authorities to establish local recall arrangements for cervical screening by April 1983. All authorities should therefore now be offering a full screening service to all women with a recall service to those at highest risk.
"Responsibility for operating the cervical screening programme rests with individual health authorities. It is obviously important for each authority to have effective arrangements for following up positive tests which should always be notified to the clinician who initiated the test, who should then ensure that follow-up action is taken.
"We are looking into the circumstances of the Oxfordshire cases to see whether there are any general lessons to be learnt. We were already preparing a questionnaire to all authorities to update our information on screening services and we shall be issuing that shortly".
My Lords, that concludes the Answer.
Lord Ennals: My Lords, may I thank the Minister for repeating the Answer given in another place which inevitably leads to a large number of questions. I am sure he will agree that a disturbing and sad situation has been revealed in Oxfordshire that looks like the tip of a frightening and large iceberg. Does the noble Lord the Minister accept that cervical cancer is the one form of cancer which not only is easy to detect with a simple smear but can be cured if treated in good time? Does

339
he accept that far too many women with cervical cancer are somehow falling through the net? He must agree with this as he referred to an up-dating.
Will he confirm that, although 3 million tests are carried out annually, about 2,000 women die from cervical cancer in England and Wales each year? Is he aware that Mr. Frank Dobson, the shadow Health Minister in another place, has carried out a thorough review which shows, among many other things, that while in general the provision of testing is "hopelessly inadequate", Oxfordshire is not exceptional but it was one of the 20 authorities which did not respond to his request for information? His report shows that pathology laboratories are overloaded with work and are often understaffed. In one case, in Worcestershire, there was a backlog of more than 1,000 tests.
Is the Minister further aware that, according to a recent article in the British Medical Journal, of 1,000 women in the Nottinghamshire area who had a first abnormal result fewer than two-thirds had been followed up? As in the Oxfordshire case, some 4 per cent. of positive tests were not acted upon by the general practitioners. Is it not true that all health authorities should now install a computer call and recall system? May I ask the noble Lord what reply was sent to the Women's National Commission proposal to his department in January this year that women should be called for cervical testing at five-yearly intervals, starting at the age of 21? Is it really true that, in the light of this deplorable situation in which every year many women's lives are placed at risk, the DHSS has said, as was reported in the press last night, that no new initiatives were proposed to introduce guidelines or in any way to alter the present system of availability of testing and following up positive tests?
Finally, does this not show a deeply disturbing situation? Will the noble Lord ensure not just that there is a careful examination of the three cases in Oxfordshire of which we know, but that there is a thorough survey followed by some immediate action affecting women throughout the country?
Lord Winstanley: My Lords, on behalf of my noble friends on these Benches I should like to join the noble Lord, Lord Ennals, in thanking the noble Lord, Lord Glenarthur, for repeating this important Answer in reply to a Private Notice Question in another place. We share the view expressed by the noble Lord, Lord Ennals, that in recent years the women least at risk of developing a carcinoma of the cervix are women who have been having cervical smears with almost clockwork-like regularity, whereas those most at risk have often not been having smears at all, and the recall or warning process for those women most at risk of developing a carcinoma of the cervix has been virtually non-existent. In so far as this Statement and it related action will remedy that situation, obviously on these Benches we warmly welcome that.
In relation to other aspects of the matter which were referred to by the noble Lord, Lord Ennals, perhaps I could ask the noble Lord, Lord Glenarthur, to look a little further. The cervical cytology campaign has now been going on for nearly 20 years. I was closely associated with it when it first started, as indeed was the noble Lord, Lord Ennals. It has undoubtedly
340
achieved many results, but I think the noble Lord, Lord Glenarthur, will agree with me that we have not yet had authoritative figures over those nearly 20 years which can demonstrate conclusively whether the mortality and morbidity rates of carcinoma of the cervix have declined as a result of the campaign. I do not for a moment say that they have not, but it is high time that cost-effective studies were carried out on routine procedures of this kind which are highly consumptive of scarce resources and manpower.
One of the problems of cervical smears is that an increasing number of the smears are proving in the end to have ambiguous results which leave the doctor and the patient in something of a dilemma. Should they ignore a suspicious smear and wait to see what happens or should they take action—which can sometimes have long-term consequences for women who have not had children, and so on—just in case the smear proves to be a bad one? These are the difficulties.
The noble Lord, Lord Ennals, is right in saying that cervical carcinoma is relatively easily diagnosed and that it can be treated. We should like to know whether all this effort that has gone into the cervical cytology campaign throughout the country has had the effect of reducing the mortality and morbidity rates from these diseases as a result. Perhaps when the noble Lord and his ministerial colleagues in the department are looking into this matter they would consider the general assessment of the whole campaign. It is important to all of us to know what the results have been.
3.47 p.m.
Lord Glenarthur: My Lords, I am grateful to both noble Lords for their reception of the Answer which I have just repeated. I agree with both noble Lords that it is a disturbing and sad situation when things such as this come to light. Whether or not it is the tip of an iceberg is a worry which I understand the noble Lord to have. But in this case, as he will be aware, three women in Oxfordshire have developed cervical cancer after doctors apparently did not tell them that their tests were positive. One of the women has died and the other two are seriously ill. There may be more to it than has been possible to ascertain over the last couple of days for obvious reasons. It would not be proper for me to go into any more detail than I have given because not all the answers are known. But I assure both noble Lords that my right honourable friends the Secretary of State and the Minister of State for Health are looking carefully at this matter.
I entirely agree with both noble Lords that this particular form of cancer as such is easy to detect and is easy to treat. It is possible that people could fall through the net, but the difficulty in many cases is one of attitudes. The national recall scheme was stopped because it simply was not working. Only 20 per cent. of those being recalled were going back to be tested. It was for that reason that my right honourable friend the Secretary of State and others decided that the best scheme to adopt was a local system which could be refined within the prevailing circumstances at district level. That is what we have been pursuing, and that is what the issue of the circular last July to health authorities was in aid of.

341
The noble Lord asked me a number of questions which I shall endeavour to cover, but I hope I shall be forgiven if I do not in the end cover them all. I shall write to the noble Lord if I do not. He asked me particularly about the Women's National Commission. I can say that a reply has not actually been sent yet. There is as yet no proof that a call system, as opposed to a recall system, would be effective. The noble Lord, Lord Ennals, asked me about the necessity for having computers for the recall system. We do not believe on face value that a recall system by computer is necessary to achieve that recall. There are other methods which have been in existence without computers, in many cases for a long time, and those that set up a really competent arrangement should be capable of setting up a recall system without them.
We have advocated already screening for all sexually active women at five-yearly intervals—particularly bearing in mind that, whereas it is aimed primarily at the people in the most-risk group, those aged about 35 and over and those with more than three pregnancies, there are others who are younger who may also be active and need to come forward. However, I think he will agree that the prime thrust ought to be at those who are in the greatest-risk group. He quoted figures for deaths, as did the noble Lord, Lord Winstanley. The figure in 1983 was 1,959; but if that total is broken down, 1,415 of those deaths were in the 35 to 74 age group which I think makes the point quite well.
To turn to new initiatives, we are looking carefully at the system. We are monitoring the way in which it is working and we shall be pursuing the individual health authorities to make sure that the systems that they have are adequate. The question of delays in laboratory processing is one on which the department has had some reports. We have had reports of difficulties in processing cervical smear tests up and down the country from time to time. In visits that I have made to laboratories, I have seen that there have been some backlogs—but I think not quite as serious as some people make out. However, it is very much a matter for individual health authorities to determine their own priorities for the deployment of their resources to meet this need and lots of other serious needs as well. The fact is that in this particular case it is going to take some time before we get to the very bottom of it. I can assure both noble Lords that it is being looked at with some vigour. We hope that in the meantime all those who can take these tests will come forward and follow the practice which the department has advocated.
Baroness Seear: My Lords, was the noble Lord really talking about an age group of between 35 and 74 years of age? That would not be a group, that would be a regiment.
Lord Glenarthur: My Lords, I did say that. Perhaps I can give the breakdown to the noble Baroness. The deaths in 1983 were three in the age group 22 to 24; 43 in the age group 25 to 29; 78 in the age group 30 to 34; and then 1,415 (the vast majority) between the ages of 35 and 74; and 420 in the over 75-group. That is
342
statistical information however the noble Baroness would like to categorise it.
Lord Dean of Beswick: My Lords, I too am grateful for the Statement which has been made by the noble Lord the Minister on this very serious and dangerous illness. Can he tell us whether the figure he has quoted for deaths is an increase or a decrease on previous years? When the Minister in his answer referred to "health authorities", was he referring to regional authorities or to district authorities? I listened to his reply to the noble Baroness who has just put a supplementary question. The noble Lord said that it is up to each particular authority to decide its own priorities regarding this and other services for which it is responsible related to its own allocation of resources. Is it not the case that if it is left to the district or area authorities, and not the regional authorities, we could not only have a national imbalance but a regional imbalance for the treatment of this very dangerous and serious disease? And if there is shown to be an imbalance of any kind, is it not the fact that it ought to be corrected urgently on a national basis?
Lord Glenarthur: My Lords, I am sorry, I forgot to give the figure. The figure of deaths has declined by 13 per cent. over 10 years. I can tell the noble Lord opposite that cervical screening is the responsibility of the district health authority. I do not see anything that is particularly unusual about that. That is the way most of the system works.
Lord Dean of Beswick: My Lords, perhaps I may put this to the Minister. If he said that the level of activity on this particular illness or disease would be at the prerogative of the district authority and dependent on the resources that they have allocated for this and for other uses and responsibilities that they have to carry out, would this not indicate that, depending upon geographical location, there could be a different level of service all over the country? Does he really think this is desirable?
Lord Glenarthur: My Lords, it happens in every case within the health service. It is up to the local health authorities to decide their priorities. It would be wrong for Ministers in the DHSS to lay down from the centre what should apply right across the board. It is the system that prevailed also when the noble Lord's party was in power so that I do not know quite what the noble Lord was so concerned about. It is a system which has prevailed for many years. It is the only way to run it. We could not run from here precisely a particular recall system in district health authority "X" somewhere in the North-West of England. It would be quite improper that we should. It is right that we should give them the resources and they should determine what their priorities are within the range of resources that are given to them.
The fact is that this system has been going on, as we have heard, for the past 15 or so years. The figure of deaths over the past 10 years has declined by 13 per cent. We agree that it ought to be greater; we agree that it is an easily treated problem and that is why we issued the circular in July which set out the re-affirmation of our existing policies and went into the detail of how monitoring of screening programmes should take

343
place. We shall certainly follow up all that has been learned from the instances in Oxford. I can assure all noble Lords that that is what we shall do.
Baroness Phillips: My Lords, I wonder whether I may underline what the noble Lord, Lord Winstanley, has said. I too was in at the beginning of the original campaign a long time ago. I should like to suggest to the Minister that perhaps the time is ripe to go back to the women's organisations who are admirable campaigners when their help and support is enlisted. This case will have highlighted the necessity for them to get the message through to every woman; and I would seriously suggest that the Minister, through his department, looks again at the marvellous campaign which was got off the ground originally through the women's organisations.
Lord Glenarthur: My Lords, I think that the noble Baroness is making a very valuable point because of the 2,000 or so deaths to which I have referred, about 60 per cent. were of people who had not had tests. The problem is one of getting the older women to go for recall. It is one of attitudes, really. As I have said, 94 per cent. of deaths are in the older age group so I think that what the noble Baroness says may well be right. We are funding the Women's National Cancer Control Campaign to publicise the need for screenings and I hope that that will have some effect.
The Earl of Halsbury: My Lords, may I observe that an age-group block is frequently referred to by medical statisticians as a cohort, and I think the reference to it by the noble Baroness as a regiment is not perhaps altogether inapposite.
Lord Ennals: My Lords, I wonder whether I may follow up on the point made by the noble Baroness about the breakdown of the total figures. Quite obviously the largest figures were in the age group between 35 and 74. Could there not be a tighter breakdown in this higher age group? I should be fascinated to know the figures for the 35 to 40 age group. As the Minister said, it is perhaps at the age of 35 where the greatest danger lies. I should have thought that the figure for the 35 to 40 group is a crucial one. Can he say whether the DHSS issued a statement, as I quoted, saying that there were going to be no new initiatives as a result of this sad situation?
Lord Glenarthur: My Lords, I shall certainly try to find out the breakdown of statistics of deaths between 35 and 40 or 35 and 45 or whatever the noble Lord would like. I hope that that might also meet the concern of the noble Baroness, Lady Seear. I am afraid that I do not have the figures before me. For reasons which I do not understand, they have not been worked out in that way. Why precisely that should be so, I do not know.
However, I have some information which may be useful to both the noble Lord and the noble Baroness and which gives the breakdown for the age group 35 to 39, which might help. I think I had better show the information to them afterwards, because it will take me more than a minute or two to work out what it means; but I will certainly do that.
344
So far as not following up advice is concerned, we are in fact about to put out a questionnaire, as I indicated just now. I am not quite sure what information the noble Lord has received which is contrary to that, but I can assure him that we do monitor the matter carefully, and the fact that we are about to put out a questionnaire indicates how seriously we take it.
Baroness Seear: My Lords, I do not wish to be frivolous about what is a very serious subject, but I should like to follow up what my noble friend Lord Winstanley said. The statistical information on this is, quite frankly, totally inadequate. We want far better figures so that we can find out what in fact is the result of this long campaign. When the noble Lord tells us that most deaths occur in the older age group, your Lordships' House is very good evidence that this happens in many groups, even those that are not subject to cervical smears.
Lord Glenarthur: My Lords, I did not mean to treat it in a frivolous way at all myself. I merely gave the figures, which happened to be broken down in the way that I indicated; that was the way they were presented to me. However, I have here a table which shows deaths from malignant neoplasm of cervix uteri between the years 1973 and 1983 in all ages. A breakdown of ages is given, and I can tell the noble Baroness that in the age group 35 to 39 the number of deaths in 1983 was 92; for the age group 40 to 44 it was 104; for the age group 45 to 49, 127; for the age group 50 to 54, 155; for the age group 55 to 59, 184: and for the age group 60 to 74 the figure was 717. I will certainly let the noble Baroness and the noble Lord, Lord Ennals, have a photocopy of that immediately after this Statement has been completed.
Lord Mulley: My Lords, since this is a matter of general and not specific interest to the two noble Lords, would it not be better for a written Question to be put down, and then the Answer would be available not only to us but to people outside?
Lord Glenarthur: My Lords, certainly that is one possibility, but I think that the best way to deal with it, in view of the arrangements that now exist, is for me to write to both the noble Lords, and a copy of my reply will be placed in the Library.
The Countess of Mar: My Lords, could the noble Lord say whether he has information on the breakdown of social classes from which the women who died came?—because I very strongly suspect that it is women from the lower social classes who are the ones who are dying from cervical cancer. I was recently in hospital in a bed next to a woman who died from cancer of the cervix, and it was extremely unpleasant. We were told by her relations that she just did not know what symptoms to expect, or indeed anything else, until it was too late. Would it not be a good idea if we tried to aim publicity at those people and not at the people who already have enough intelligence to go to their doctor when anything is wrong?
Lord Glenarthur: My Lords, I think the noble Countess may be right, and perhaps that is a role which could be played by the women's organisations,

345
as the noble Baroness, Lady Phillips, described. I have no information on the social classes at present, but if it is available I will certainly let the noble Countess know.
Lady Saltoun: My Lords, would it not be possible to enlist the help of women's magazines in telling women what symptoms to look out for?
Lord Glenarthur: My Lords, I am sure that is a good idea. Whether or not they actually undertake it I personally do not know, but I hope they would take note of what the noble Lady has said.

Road Races (Northern Ireland) Order 1977 (Amendment) Bill [H.L.]
4.4 p.m.
Lord Dunleath: My Lords, I beg to move that this Bill be now read a second time.
While not wishing to detain your Lordships, I feel it would be only courteous for me to try and give a few words of explanation of what lies behind this apparently brief and bland Bill. I am grateful, I may say, to Her Majesty's Government for having afforded the opportunity to propose that this Bill be read a second time at such an early date.
The background to it is that over the last 16 years we in Northern Ireland have been living through what might be described as a dark age; and those of us who live in the Province and have a stake in it have been doing our best to try to make good things happen. Unfortunately, so many bad things have happened and unfortunately, also, bad news inevitably gets more publicity than good news. Therefore, I hope I may be forgiven for spending a couple of moments in outlining some of the more constructive, desirable and civilised things that have been happening in Northern Ireland and of which we who live there have perhaps some reason to be proud.
Having said that, I must say that during this period of "dark age" we have been deeply grateful for the moral, material and indeed sacrificial support that we have received from those of your Lordships and the rest of the community living in Great Britain—and when I say "sacrificial support" I would add that we mourn every bit as much the death of any soldier who comes from England, Scotland or Wales as we do the death of any member of the Northern Ireland security forces, whether they be members of the police or of the Ulster Defence Regiment, because the British Army is our army and we mourn the casualties there as much as we do those among our own kinsmen. We are grateful for the support that we have received—and the financial support has been very considerable. But we do not want to be beggers. We want to be able to stand on our own feet, and those of us who live in Northern Ireland have endeavoured to try to encourage constructive activity, to encourage civilisation and to encourage movement towards better things.
As I say, good news does not always receive as much publicity as bad news, and that is inevitable. I would
346
quote one or two good things that have happened. Well before the troubles started, a distant relation of mine, who is my guest here today, started an organisation called the Ulster Enterprise Voluntary Committee. She roped in, apart from myself, a couple of other prominent people in Northern Ireland, and we tried to promote good ideas and good initiatives from people in Northern Ireland. We had limited success, but the important thing is that the germ of that idea was developed and, I think, has now blossomed in the Local Enterprise Development Unit. That is notable for its success in promoting small industries and good ideas with initiative as their background in Northern Ireland. To someone like my relation, to whom I have already referred, I think a great deal is owed for the initiative that was undertaken some 20 or 25 years ago.
In addition to that, other civilised things have taken place in Northern Ireland. On the cultural level, we have seen the magnificent early Victorian palmhouse in the botanic gardens being restored. We have seen the opera house being restored. Also, St. Anne's Cathedral in Belfast, through a great act of faith on the part of the dean, the very reverend Samuel Crooks, has been completed, and this in a most unpropitious period. And dear to my heart is the fact that William Hill's grand organ in the Ulster Hall, dating from 1861, has been fully restored and is now once again firing on all cylinders. Coupled to that, I might mention that only yesterday afternoon, instead of going to Down Cathedral at Downpatrick to shout insults at Cardinal O'Fiaich, I went to the depot of the Railway Preservation Society of Ireland and placed my hand on the regulator of locomotive No. 85, which was one of our first high-speed express passenger locomotives dating from 1932, and having been out of service since 1962 she is now in steam once again and going. This, to me, was a particularly gratifying moment.
But having run over one or two of the gratifying things that have happened in recent years, I would look back to the 1920s and recall that our predecessors, like Lord Craigavon, also realised that it was important to try to present a favourable image of the Province, because after all in the early 1920s the future of Northern Ireland was far from secure. They took a number of steps and invested a considerable amount of time, effort and money in trying to set up the Province as a viable unit.
One of the things they did was to attract the Tourist Trophy race to Northern Ireland. It had previously been held in the Isle of Man, but the circuit had proved to be such that the race was unable to continue thereon. Lord Craigavon with his colleagues, Lord Londonderry, the inventive and famous Harry Ferguson and others, identified a racing circuit in the Ards area which eventually was considered to be the best racing circuit in Europe until the Mirburgring was established. Of the two European races, it was equal with Le Mans in public esteem and prestige, but of the two Ards was the more testing and demanding circuit on both motor-cars and drivers. It was supremely successful, attracting up to half-a-million spectators for each event. The ships from Liverpool, Glasgow and Heysham shuttled backwards and forwards bringing spectators, drivers, crews and

347
journalists to Northern Ireland and this was the biggest sporting event ever to have been held at any time in the British Isles.
There is a great deal of nostalgia for the Ards TT Race. There are still many people who remember it and the younger generation, who have heard about it, ask their elders eagerly what it was like. Such is the nostalgia that in 1978 we—and when I say "we" I mean members of the Ulster Vintage Car Club—decided to commemorate the golden jubilee of the first Ards TT race by having a commemorative run. We tried to get a road closure order in the interests of public safety, but unfortunately the 1977 Road Races (Northern Ireland) Order precluded any additional road closures. None the less, I must say that the Minister, the department and indeed the police were sympathetic and we had a most successful event.
Unfortunately, however, despite repeated appeals, the general public did not accede to our request to keep off the circuit and, while three demonstration runs were conducted by authentic TT cars of the period, the public wanted to join in with their modern cars. Such was the atmosphere of the occasion and the enthusiasm that was generated. But, quite honestly, what with children, dogs and people on bicycles, I was scared that an accident might have occurred. But the police were superb on that occasion, with the result that it was a great success and, by the grace of the Lord, there was no untoward incident.
Since then, there have been many calls from the general public, from enthusiasts both in Northern Ireland and overseas, to repeat such an occasion. Indeed, one came from a recently retired divisional commander of the RUC who asked, "Could you do this again?" But, as president of the Ulster Vintage Car Club, I must say that I myself would not be prepared to lend support to a repeat performance unless the roads could be closed in the interests of public safety. Therefore, what I am suggesting now is that if this amendment Bill should go through it would be entirely at the Minister's discretion whether or not to grant a further road closure order, which would enable us to have a 50th anniversary golden jubilee race of three or four laps on the Ards circuit next year as a commemoration.
In saying that, I would point out to your Lordships who may not be familiar with the motor racing situation—though I know that many are—that vintage racing is not only much safer but also more spectacular than modern racing, because speeds are that much lower and using authentic vintage tyres you can drive sideways very much more safely with complete impunity, and indeed with pleasure, whereas modern cars hang on for very much longer and then, when they do break away, it is very much more difficult to "catch" them. So what we are envisaging is that we should have a race next year of three or four laps, which will be confined to authentic touring cars of between the dates of 1928 and 1936. There will be no racers and no specials but, as it was at the time, cars which any member of the public could buy out of a showroom and which were on general sale.
The safety factor of vintage racing is such that I can envisage no risk of any repeat of the most regrettable accident that occurred after the war on the Dundrod
348
circuit when speeds had risen to a considerable extent and when TT cars were no longer ordinary touring cars on sale to the public but had developed into sports racing cars. On that occasion, unfortunately, a vehicle spun and stalled halfway across the road and the other competitors were unable to pull up without running into it.
I can envisage no problem of that sort, nor indeed can I envisage any risk of the sort of accident which occurred in 1936, when a Riley broke a shock absorber, developed front wheel tramp, got out of control and drove into the crowd who were standing on the pavement at the side of the road in Newtonards. That would never occur now. Our attitude towards spectator safety has completely changed since the 1930s, and in no circumstances would spectators be allowed to stand on the pavement with cars racing past them and with nothing between the spectators and the competitors but a road. That would not occur and that would not be a problem because the topography of the Ards circuit is such that in many sections the land rises gradually from around the circuit, thus providing a natural amphitheatre. So there would be no difficulty of that kind.
Finally, I would say that this proposal has received the unanimous approval of the Northern Ireland Assembly and of both the councils involved, Ards Borough Council and Castlereagh Borough Council. This is purely an enabling Bill to give the Minister the discretion to allow an additional road racing order should he think fit. Of course, the Minister would take into account the views of the Royal Ulster Constabulary, of the Royal Automobile Club, of the Ulster Association of Car Clubs, and of all interested parties, before deciding whether or not to grant such a road closure. But what I am asking your Lordships to do this afternoon is to give a Second Reading to this purely enabling measure so that if, in his wisdom, the Minister decides to agree to an additional road closure, it would give us in Northern Ireland what we want—a chance to help ourselves.
We do not want to be beggars. We want to be able to establish our own status and reputation as a place where people are welcome to come and, as so many have said, where they are glad to come. We are convinced that this will attract a tremendous number of tourists—not thousands but hundreds of thousands—and world-wide the press coverage would, I am convinced, be entirely favourable. Having said that, I beg to move that this Bill be now read a second time.
Moved, That the Bill be now read a second time.—(Lord Dunleath.)
4.22 p.m.
Lord Prys-Davies: My Lords, we have been told that this is a Bill to amend one of the 10 articles of the Road Races (Northern Ireland) Order 1977. It is a modest Bill. It is not a supercharged Bill but it may be better for not belonging to that category. It often seems to me that in the midst of the draconian and alien emergency legislation and the lawlessness of the past 15 years or so, the Road Races (Northern Ireland) Order 1977 is an attractive piece of legislation.
The order deals with road races on public highways by four-wheeled motor-cars, by motorcycles and by

349
pedal cycles and with hill-climbing competitions within a defined area. Notwithstanding the militancy and the tension, I have a feeling which is reinforced by the words of the noble Lord, Lord Dunleath, that in its own modest way the Road Races Order, together with other achievements, has helped to make Northern Ireland a more civilized Province to live in. Indeed, in the words of the noble Lord, "It has helped to make good things happen".
It has been the practice since at least 1977 for the department to make up to 10 orders in a calendar year declaring that any roads specified in the order may be used for motor races during the days specified in the order. The year 1977 is not a long time ago; and this evening the noble Lord, Lord Dunleath, invites the House to agree that the number of such orders should be increased from 10 to 11. That is not a radical change. We have listened to a constructive speech in support of the proposed amendment.
The noble Lord, Lord Dunleath, has painted a picture of the benefits which will ensue if the Bill is passed. But the greatest benefit of all is that it would, albeit in a small way, contribute to or promote normality in the Province; and on that count, even if there was no other supporting factor, I believe that the Bill would deserve the support of the House. The noble Lord has referred to other benefits. It will help in particular with the development of tourism.
So far as I know, this Bill has not generated controversy. Indeed, this is reinforced by what the noble Lord has told the House this evening. The English football team Tottenham Hotspur, and athletic teams have had to pull out of Northern Ireland engagements, which is sad and disappointing, but so far as I know there is no evidence that motor racing is a cause of division. Indeed, we may find that a new Ulster TT will attract the crowds and the tourists by their thousands.
I therefore welcome the Bill introduced by the noble Lord. It has a good deal going for it. I do not know whether the exercise of the power given by the Bill would cause difficulties for the police or for the communities that would be affected, but I am sure that the Minister would consult widely before deciding whether or not to exercise the road closure power which the Bill gives him. I am sure that all objections would be assessed and taken into account. I am sure that we on these Benches agree that the Minister ought to be given this power.
Lord Hampton: My Lords, perhaps I may come in just briefly. I speak for myself and not for my party. I was not able to get hold of the order which we are amending but I have listened with interest to the first two speakers and, as an amending Bill, I would support the Bill wholeheartedly.
4.27 p.m.
The Parliamentary Under-Secretary of State, Northern Ireland Office (Lord Lyell): My Lords, first of all, I am sure that all of your Lordships would wish to join me in congratulating the noble Lord, Lord Dunleath, upon his admirable presentation of the little Bill that is before us this afternoon. I hesitate to say "little Bill" but it is commendably short compared
350
with much of the legislation to which the noble Lord, Lord Prys-Davies, referred, and which the noble Lord, Lord Dunleath, knows occupies so much of your Lordships' time at odd hours of the day and night, matters such as the appropriation orders with which we dealt last week.
I think that your Lordships are also very grateful for the way in which the noble Lord, Lord Dunleath, set out his proposals in the context of Northern Ireland. I have to say on a personal note that the Lord, Lord Dunleath, does much to enrich the life of Northern Ireland both at his home and with his tremendous collection of motor-cars. Indeed, it was only last autumn that I must have passed upwards of 200 cars proceeding through the southern suburbs of Belfast to, I think, a gathering at the home of the noble Lord.
We are full of admiration for the noble Lord because of the manner in which he has developed this proposal for the commemoration of the fiftieth anniversary of the running of the last motor race in the series of the Ards Tourist Trophy events in Northern Ireland. The noble Lord also mentioned the last race on the Dundrod circuit. I recall that race in 1955 and, as the noble Lord pointed out, the motor-cars racing just thirty years ago were far different from what one could actually buy in the showrooms, and were far removed from the normal type of vehicle that most of us would drive about the countryside.
Some months ago the noble Lord mentioned to me the possibility of just such a commemorative event, taking the form of a racing competition or event of that type, by motor-cars of the period to which he has referred over the roads of the old Ards TT circuit. Your Lordships may not know that it is just to the east of Belfast.
I did, indeed, attend the debate—I think that is the right word to describe it—in the Northern Ireland Assembly at which the noble Lord proposed this event. It gave rise to much comment, all of it favourable to the noble Lord. The event he has outlined to your Lordships this afternoon would require the roads in question comprising the old Ards TT circuit to be closed to all normal traffic.
I am sure that your Lordships were impressed by the intent of the noble Lord's proposal and by his very graphic presentation of his proposal. Indeed, I have much sympathy with what he seeks to achieve. The prospect of the classic marques of sporting motorcars, of, I believe it was, 1931 to 1936 and onwards, competing in their full racing trim is a most attractive one. It would doubtless appeal to people of all ages in Northern Ireland. It is a fact that the legend of the Ards TT races and of the feats of the racing heroes of those days are still a part of Ulster folklore. The event proposed by the noble Lord, Lord Dunleath, would no doubt strike an evocative chord in the hearts of many senior and more youthful citizens in the Province.
I am equally persuaded that, as the noble Lord has himself suggested, such an event would attract many visitors to Northern Ireland, but I ask your Lordships to consider just some of the factors which have to be considered by the Government and by those of us responsible for the running of sporting motor events of the kind we are allowed to run, and indeed do run, in Northern Ireland.

351
All all times the Government have to consider the convenience, welfare and safety of all kinds of road users. Above all, they have to consider those people who live along the roads which would have to be closed, not forgetting the many people who live in residential districts who would be effectively isolated were the roads comprising the Ards TT circuit to be closed. These are very difficult and intricate considerations. Indeed, they are taken fully into account in all cases of applications for the closure of roads for motor racing under the existing governing legislation.
In mentioning motor racing I hope that I can clear up one misapprehension which arose in the mind of the noble Lord, Lord Prys-Davies. The 10 occasions on which the roads may be closed for racing in Northern Ireland relate to races for motor cycles and motor cars as we know them. I believe that the noble Lord mentioned cycle racing. That comes under separate legislation. In the case of all 10 events covered under the 1977 order, they are for road racing motor cycles of up to 750cc—motor cycles and superbikes. I am sure that the events covered by motor cars are in the line of rallies. As far as I am aware, there is only one motor racing circuit in Northern Ireland, and that is at Kirkestown. There may still be a circuit for hill climbing; I am not quite sure. In any case, the 10 events I have mentioned are covered by motor vehicles, be they motor cycles or motor cars.
It is basic to an understanding of the noble Lord's proposal to appreciate that the area served by the roads which would have to be closed to normal traffic have changed enormously since the 1930s. From my own point of view, I remember going to Newtonards in the 1960s and the changes even since then have been colossal. Indeed, the changes are all the more marked when one considers that the roads were last used for the purposes of motor racing nearly 50 years ago.
In those days the area was largely rural in nature and was relatively lightly populated. But now the old Ards TT circuit is encompassed to a large extent by the Greater Belfast region. As the noble Lord, Lord Dunleath, will be aware, much of the circuit is heavily populated. It is urbanised and has large industrial and commercial enterprises abutting the circuit. The circuit also contains—if I may put it that way—two major hospitals, both serving wide areas and having great importance in the whole area of Northern Ireland.
I shall give your Lordships a brief illustration of what would be involved and the number of persons who might be affected by closure of the roads. The circuit would commence at a point approximately one quarter of a mile from my office in Belfast, in the village of Dundonald. We first come to the Ulster Hospital, which is the first turning on the left on the old circuit. The front entrance would have to be closed and access for ambulances and any people who might require treatment would have to be by the rather twisty and narrow roads, of which I have experience myself, to the rear of the Ulster Hospital.
In the village of Dundonald one then comes to the Wellworths shopping centre, which is of no mean size. This would be effectively isolated during the period of
352
the road closures. In fact, Dundonald is considerably larger than a village. To help matters—or perhaps not—the Royal Ulster Constabulary station abuts directly on to the route, which would effectively restrict the RUC in any operations they may wish to carry out.
Leaving Dundonald, one comes to some 1,500 houses in the Ballybeen Estate which would be entirely enclosed by the roads which would have to be closed. Leaving Dundonald behind, the route turns left, as one leaves Belfast and Dundonald, and then reaches Quarry Corner, and runs down Bradshaws Brae, which I am advised is relatively trouble-free, provided one's brakes hold and one does not suffer the kind of mechanical misfortune with which the noble Lord regaled the Northern Ireland Assembly; I shall not do so this afternoon.
One then arrives at Newtonards. The first obstacle there is the Woolco shopping centre. This was inside the old cirucuit and would fall inside the new circuit. Any noble Lord who has been in Newtonards at a weekend will appreciate just how busy is this main shopping centre, which draws shoppers from the whole of the Ards peninsula and area, and from most of the east of Belfast. Similarly, the Ards Hospital would fall inside the circuit.
The noble Lord, Lord Dunleath, will know also that there is a Saturday market in the town square. That would have to be cancelled, though that might perhaps be one of the easiest things to do—or it might not be. Once again, the RUC station there would be effectively restricted and closed down. It would fall inside the circuit, and I understand that most of the access roads to it would be affected by road closures.
Leaving Newtonards, we find two large housing estates of approximately 1,600 houses. These are the Scrabo and the Westwinds housing estates, which would be effectively cut off. The road then proceeds, leaving Strangford Lough on one's left, into the town of Comber. Here there are two estates, the Copeland and Enler estates, of some 800 houses which would also be severely restricted in terms of access during the period of the road closures.
The route from Comber back to Dundonald is, I am advised, relatively trouble free; that is, until one approaches Dundonald itself, which becomes increasingly densely populated. At the Dundonald end we come right back with the Ballybeen Estate on the right this time, before reaching what I would imagine to be a particularly sharp corner at Dundonald. That is just a brief view of the obstacles, if one can call them that, around the circuit.
I think that the noble Lord would accept that it would interfere with things over what might be a considerable period of time. I say a considerable period of time, because I think he suggested that the roads might have to be closed for a shorter or longer period over each of the two days. It would be interfering with the daily activities of a very large number of people. It would affect the livelihood of many of them and the functioning of the vital services that we take for granted. All those problems would have very serious implications. The nature of any such disruption would place very serious burdens on the

353
RUC. There could be problems also for the fire service and any emergency hospital cases. There would be problems going to and from hospital. That would tax resources a good bit further.
I draw the attention of the noble Lord and of all your Lordships to one aspect of the Bill before your Lordships. As the noble Lord has set it out it would increase permanently from 10 to 11 the number of road-closing orders that may be granted—I do not say will be granted—in any one year. The present limit of 10 has stood unchallenged for very many years and we believe that it has proved satisfactory. We believe that the limit reflects the wishes of both your Lordships' House and another place to balance the needs of motor sport with the disruption to the public and the services which people demand, even given the tourist potential which the noble Lord pointed out and, above all, the great popular appeal in Northern Ireland which even I have found. Any road closures would affect the public and the services. I am not aware of any demand for the number to be increased. The present 10 road-closing orders permitted under the legislation are granted for long-established motor car and motor cycle events. The circumstances in which they are applied at present do not involve disruption or the problems which I have sought to outline to your Lordships on a scale at all comparable to that which would be encountered under the proposal so ably put forward by the noble Lord.
In the course of my remarks I have drawn attention to the reluctance of the Government to accept a continuing increase in the number of road-closing orders that may be made in Northern Ireland. I have given an indication of what I am sure the noble Lord will accept are the practical problems that would result from a single closure order in favour of the event which he described to us. For that reason, with considerable regret, I have difficulty in supporting the Bill.
The Government have every sympathy with what the noble Lord is seeking to achieve and what we believe in many respects would be a pleasurable, certainly a colourful and for many thousands of people a nostalgic and memorable event. I thank the noble Lord for explaining the Bill to us this evening and, above all, for his continuing efforts in this direction. But I ask him whether he can seek to develop the proposals which he has so ably outlined to us in a manner which would avoid the difficulties which I have tried to spell out to your Lordships. I hope that I have not been too pessimistic, but I am sure that the noble Lord will appreciate these various choke points—as I think they are called—which would present great problems mainly to the RUC. I have had a very close briefing from the RUC. I asked all kinds of questions, and I am afraid that the RUC was not able to be any more sympathetic than I was able to be. For the reasons which I have sought to explain, I am afraid that I cannot say that the Government can actively support, or indeed accept, the noble Lord's Bill, let alone as it is drafted at the moment, as it would permanently increase the number of road-closure orders allowed every year under the 1977 order from 10 to 11.
4.45 p.m.
Lord Dunleath: My Lords, I am grateful to noble Lords who have been kind enough to respond to my proposal for a Second Reading of this Bill. The noble Lord, Lord Prys-Davies, clearly appreciated the motivation behind the Bill. One point on which he touched is tremendously important. It is that motor sport is a unifying element in Irish society, north and south. There is no differentiation between Association football and Gaelic football. For as long as motor sport has been going its enthusiasts have joined together in a spirit of co-operation, friendship and comradeship. We look at this as an extension of that. I am grateful to the noble Lord for taking up the point.
I am also grateful to the noble Lord, Lord Hampton, for his general expression of support. I know that he also understands what we are on about. I am grateful to the noble Lord. Lord Lyell, for having replied in such detail and with such care. The main burden of what he said—and I know that he was sympathetic—was realistically to draw attention to the difficulties which could be involved. He mentioned the people residing in and around the circuit and the businesses conducted there. I can only say that to date I have been conscious of a tremendous groundswell of support from the people living there and the businesses there. This has been reported to me and I have myself heard it firsthand. But I shall certainly pursue the matter and take a further census of public opinion. The general reaction that I have had is entirely favourable. I have called on shopkeepers, publicans and others who live around the circuit and they say not to worry; whatever inconvenience there might be would be negligible compared with the extra business which would be generated. That tends to be the attitude that I have experienced so far.
I entirely agree that hospitals are another matter. As the noble Lord suggested, there is access to the Ulster Hospital via the Stoney Road. It is a fairly narrow road, but the access is there. But having said that, and also acknowledging that the Ards Hospital at Newtonards would be cut off, let me say that there is nothing unusual about having ambulances on a circuit during the course of a race, if only to cart away our fallen comrades. That has been traditional for many years. Indeed, the Monaco Grand Prix conducts itself through the streets of Monte Carlo without any apparent difficulty; so I do not think that this would be an insuperable problem.
Again, the soundings that I have taken indicate that the authorities would be prepared to consider and discuss it, without of course in any way committing themselves as to whether they consider it would be feasible, as indeed is the case with the RUC, who, as I say, were superb on the last occasion in 1978 and who have been entirely sympathetic and understanding. I should not like to commit them to anything at all. It would he quite wrong of me to do so. However, while being non-committal, they were, at the same time, prepared to explore the possibilities, and this is a process that I should like to pursue.
The noble Lord was quite right in saying that the existing 10 road closure orders under the 1977 Road Races (Northern Ireland) Order are, on the whole, non-disruptive because they involve roads which

355
traverse parts of the Province which for the most part are not particularly built up. I fully appreciate the difference between the Ards circuit as it was in 1936 and the way it is in 1985 and will be in 1986. This is a factor which we have in no way overlooked.
However, having listened with great interest and, indeed, gratitude to what has been said, perhaps I may venture to propose that if your Lordships were good enough to give this Bill a Second Reading, I should be very happy to look further into the questions that have been raised and do my best to answer them at Committee stage. I think that it would be a pity just to leave the matter as this juncture. During my speech I did not go into the questions which I had been expecting because I was aware of the time, as indeed, I am now. Therefore, if I may crave the indulgence of your Lordships to give the Bill a second reading, I should be very happy to deal in much more detail during Committee stage with any questions that might be raised. My Lords, I beg to move.
On Question, Bill read a second time and committed to a Committee of the Whole House.

Licensing (Amendment) Bill [H.L.]
4.52 p.m.
Lord Harmar-Nicholls: My Lords, I understand that no amendments have been set down to this Bill and that no noble Lord has indicated a wish to move a manuscript amendment or to speak in Committee upon it. Therefore, unless any noble Lord objects, I beg to move that the order of commitment be discharged.
Moved, That the order of commitment be discharged.—(Lord Harmar-Nicholls.)
On Question, Motion agreed to.

Pneumoconiosis, Byssinosis and Miscellaneous Diseases Benefit (Amendment) Scheme 1985
4.53 p.m.
Lord Glenarthur: My Lords, I beg to move that the Pneumoconiosis, Byssinosis and Miscellaneous Diseases Benefit (Amendment) Scheme 1985 be agreed to.
The purpose of this amendment is to make changes to the principal scheme, the Pneumoconiosis, Byssinosis and Miscellaneous Diseases Benefit Scheme 1983, by the addition of a further disease for which benefit may be paid. This disease is lung cancer, when accompanied by asbestosis or bilateral diffuse pleural thickening.
The principal scheme provides for benefit to be paid out of the National Insurance Fund for disablement or death caused by certain diseases, if they result from employment before 5th July 1948 and neither workmen's compensation nor benefit under the industrial injuries scheme is payable.
On 1st April 1985 lung cancer, when accompanied by asbestosis or bilateral diffuse pleural thickening, will be added to the list of prescribed industrial diseases for which benefit can be paid under the
356
industrial injuries scheme. Section 5 of the Industrial Injuries and Diseases (Old Cases) Act 1975 provides for any disease which is a malignant or potentially malignant neoplasm, and which is prescribed under the industrial injuries scheme, to be included in the principal scheme. Lung cancer, when accompanied by asbestosis or by bilateral diffuse pleural thickening, is such a disease and is therefore being included in the principal scheme.
We are also taking the opportunity in Article 5 of the amendment scheme to revoke Article 6(1)(a) of the principal scheme. This article provided for the payment of a child dependency allowance where the beneficiary was in receipt of an allowance for total disablement under the scheme, but not unemployability supplement. The child dependancy allowance of 15p weekly payable was the same as that payable to someone in receipt of sickness benefit under the social security scheme. This allowance was abolished in November 1984 and, as a result, Article 6(1)(a) of the principal scheme became redundant and is now being revoked. My Lords, I commend this order and I beg to move.
Moved, That the draft scheme laid before the House on 25th February be approved. [14th Report from the Joint Committee.]—(Lord Glenarthur.)
Baroness Jeger: My Lords, I am sure that we all welcome any extension of assistance to people suffering from industrial disease. However, I should like to ask the Minister one or two questions. The amendment scheme before us today has to be cross-referenced with the principal scheme. I noticed that Schedule 4 to the principal scheme is to be amended so as to provide that benefit will apply where death is after 1st April 1985. It seems to me that where people have not only lung cancer but also suffer from other distressing diseases, surely they should warrant the kind of assistance which will be given to people who manage to live until after 1st April 1985. I am sure that that would be the wish of all noble Lords. I am very sorry if I have misread anything, but I have looked very carefully at Schedule 4 to the principal scheme and at the amendment of Schedule 4 which is before us today.
I should have thought that where there has been a definite diagnosis there could be some generosity to people who might well be nearing the end of their lives. I should have thought that it would be more realistic to accept that definite diagnosis of lung cancer plus the other illnesses should be sufficient to ensure sympathetic consideration.
I wonder how we are proposing to help widows and dependants of people whose cases will now be brought within the scheme. I notice that in the principal scheme the allowance for widows and children was fixed in 1983 at £300. That is in Paragraph 9 on page 10 of Statutory Instrument 136. I wonder whether the Government are considering uprating that amount, even if only to keep pace with inflation, as has happened in some other aspects of the social security system. I also wonder what steps the Minister is taking to make this change known perhaps to the employers and through trade unions, so that any people who may be unaware of the changes will get to know their rights.

357
While I welcome any extension of the scheme, my main problem is my regret about the rather brutal date that has been written into this proposal. It seems to me that there is nothing sacrosanct about 1st April 1985. I should have preferred, as I think would have my noble friends, that it should be from the date of diagnosis and from the date of the onset of the disease that people in their last months should receive assistance. I very much regret that that is apparently not to be so. I only hope that I am wrong, but I shall wait with attention to hear what the Minister has to say.
Lord Davies of Leek: My Lords, perhaps the noble Lord the Minister would like to answer the noble Baroness first.
Baroness Jeger: My Lords, perhaps my noble friend would care to speak at this stage.
Lord Davies of Leek: My Lords, when I was Under-Secretary in another place, I moved a Bill dealing with pneumoconiosis. In the case of asbestosis, we found that not only a docker working in asbestos suffered lung trouble, but so did his wife. That was because when his wife laundered his trousers after he had been working on ships there was asbestos dust in the turnups. She herself suffered and ultimately died. We had cases like that. I cannot find anywhere in our legislation any cover for wives of people working in asbestos who may themselves suffer from asbestosis through laundering the clothes of their husbands. I shall leave it at that in order not to delay the House, but I have I think made the point.
5 p.m.
Lord Glenarthur: My Lords, I am grateful to the noble Baroness, Lady Jeger, and to the noble Lord, Lord Davies of Leek, for their comments. To answer the noble Baroness's prime point and what she described as the rather brutal date, it is not intended to be brutal in any way. The fact is that we are not making this legislation retrospective. There are huge difficulties in making legislation retrospective. The noble Baroness will be aware of the comments that are generally received in this House when we make legislation retrospective. It is not something that people like.
We are dealing with a disease that does, I know, take many years to develop. The other diseases covered by the prime scheme to which reference has been made are very slowly developing malignant diseases. When new things come to light, as in this case, it is not always possible to make them retrospective.
As to widows and dependants, so far as I am aware—I hope that I have it right; if not, I apologise in advance and I shall get it right when I can find out the details—the increases are linked to the various Social Security Acts. Any increases in social security benefits will be reflected in the prime scheme. That is what normally happens. I have no reason to believe that it is not the case in this instance. I imagine that there will be no great difficulty in making the scheme known. Those associated with this problem are only too aware of the need to make claims where claims can be made.
358
I shall note the noble Baroness's remarks. If there is anything particular that should be done here that is not normally done, I shall take steps to put that in hand. I believe that the amendment to the scheme will be promulgated in the usual way.
The noble Lord, Lord Davies of Leek, asked particularly about dependants and their connection with asbestosis should they be involved in handling the clothing and such like of the prime beneficiary. I should like to study the noble Lord's remarks. My understanding is that no payment is made at the moment for wives or dependants. There can he a one-off payment on the death of a contractor of the disease itself. I do not think that the payments can be made to someone who handles the laundry or anything like that. However, I take the point that the noble Lord made.
Baroness Jeger: My Lords, before the noble Lord sits down, is he telling the House that a man has to die after 1st April 1985 before he can benefit from this scheme? And how does he benefit from it if he is dead? Is the only benefit to be that of the £300 plus whatever increment there might be to his widow and family? It would be a good thing if this matter could be looked at again. I cannot withdraw my regret about this aspect of the scheme.
Lord Glenarthur: My Lords, the allowance, as I understand it, will he paid to the person who suffers from the disease, not when he dies. The fact is that the legislation cannot be made retrospective earlier than 1st April. This is the normal practice in these cases. I see no reason for making it different in this case.
Baroness Jeger: My Lords, I am sorry to come back, but this is a question of Schedule 4 of the principal scheme which states dates after which death from diseases must have occurred. The amendment before us today provides that 1st April 1985 shall apply for the matter we are discussing. As for retrospection, surely in the case of war injuries and certain industrial injuries, we do look back a bit?
Lord Glenarthur: My Lords, I do not think that we look hack quite as far as the noble Baroness would want because of the difficulties involved. The noble Baroness is right in saying that if someone dies before 1st April they will not have been able to claim because the allowance will not have come into effect until 1st April.
On Question, Motion agreed to.

AIDS: Prevention and Control
5.5 p.m.
Baroness Cox Baroness Cox rose to ask Her Majesty's Government what steps they are taking to prevent and control the spread of the disease AIDS.
The noble Baroness said: My Lords, I am grateful to have the opportunity to raise these issues as discussion of them is timely for a number of reasons. First, there has been a great deal of understandable public anxiety about the nature and spread of the acquired immune deficiency syndrome, generally known by its acronym,

359
AIDS. Secondly, this anxiety has been exacerbated by misinformed press publicity which has fostered the belief that AIDS is highly infectious. Thirdly, this belief has in turn led to uncertainty about the appropriate ways of responding to people who are, or who are suspected to be, suffering from AIDS. Finally, new information is becoming available which should help to clarify the situation and, by putting it in context, to offer some reassurance.
Therefore, I thought that it might be helpful to begin the debate with a brief outline of the nature and extent of AIDS. This will be very general. I am grateful to see that other noble Lords will be speaking later, including noble Lords who are medical practitioners, who will be able to provide any further details that they think are appropriate.
In essence, AIDS is a very rare condition which prevents the body's own internal defences against infection from working effectively. This loss of resistance renders a person more likely to succumb to illnesses which he would normally fight off quite easily. Two of the illnesses which most commonly afflict AIDS patients are relatively rare diseases. Kaposi's sarcoma is a type of cancer mainly of the skin, but it can also affect other parts of the body. The other is pneumocystis carinii pneumonia, which I shall refer to as PCP, a serious infection of the lungs. Many AIDS patients have one or both of these diseases.
The origins of AIDS can be traced back to 1981 in the United States of America, when a number of previously healthy homosexual men were reported as suffering from one or both of these conditions. Five cases of PCP were reported in Los Angeles, and, at about the same time, 26 cases of Kaposi's sarcoma were reported in New York and California, four of those affected also having PCP.
Within a few months, the Center for Disease Control at Atlanta had detected 159 similar cases, and a new disease was formally identified in terms of the following characteristics: first, a reliably diagnosed disease that is at least moderately indicative of an underlying cellular immune deficiency, for example, Kaposi's sarcoma in a patient aged less than 60 years, or an opportunistic infection; and, secondly, no known underlying cause of the cellular immune deficiency nor any other cause of reduced resistance reported to be associated with the disease. This definition has been accepted by most other countries and by the World Health Organisation Collaborating Centre for AIDS.
By January 1985, about 7,000 cases of AIDS had been reported in the United States of America, about 700 in Europe and 118 in the United Kingdom. Classification into groups with the highest risk of catching the disease shows that about 75 per cent. are practising homosexual or bisexual men. Other groups at risk include drug abusers who inject drugs into their veins, sexual partners of persons with AIDS, some people who have lived in Haiti or Central Africa, especially Zaire, the Congo, and Rwanda, and haemophiliacs who have received infected blood products. The risks to haemophiliacs have been a cause of considerable anxiety, and it is therefore worth noting that in Britain no one in this category has developed symptoms fulfilling the criteria of the
360
disease as given above, although several patients have developed antibodies after receiving blood transfusions. However, it is hoped that very soon this risk will be effectively minimised by adequate screening.
It is too early to predict with any accuracy the rate of spread of the disease; but it is reasonable to hope that Britain will not see the same escalation as occurred in the United States of America because now more information is available and more precautions can be taken. However, it must be recognised that the disease has a long incubation period of several years, and some increase must be expected. Epidemiologists indicate a figure perhaps of the order of 1,000 to 2,000 cases by 1988 unless there is a scientific breakthrough in the meantime.
Although these figures are obviously disturbing, they need to be seen in context. For example, deaths from measles in the past four years numbered 70, compared with 51 from AIDS. Moreover, any predictions about the future spread of the disease need to be treated with great caution. Epidemiologists have stressed the need for great care in the interpretation of predictions—a point which has been well made in the article entitled, AIDS for All by the year 2000?, in the British Medical Journal on 9th February 1985. It is most important to emphasise that AIDS is not highly infectious in the same way as, say, smallpox used to be. It is not transmitted by aerosol infection; in other words, one does not become infected by sitting in the same room as an AIDS sufferer, by sharing a meal, by shaking hands or talking together. So there is no need to treat a person who is suffering from AIDS as if he or she were a leper or some kind of pariah figure. The main way in which AIDS has been transmitted has been through sexual intercourse between male homosexuals, especially those who have many different partners. It has also been transmitted to people suffering from drug addiction, who have shared needles, and by contaminated blood products.
Although the virus known as HTLV 3, which is considered to be a primary causative agent of AIDS, has been isolated from blood, semen and saliva of patients with AIDS, there is no evidence that the disease is transmitted through the saliva. This is a very important point when discussing the implications of AIDS for people involved in first aid and other emergency procedures such as mouth-to-mouth resuscitation. This brings me to the question of the anxieties felt by many people with responsibility for caring for patients who have, or who are suspected of having, AIDS. Anxiety is a natural concomitant to uncertainty. Thus, while little was known about the ways in which AIDS might be transmitted, it was understandable that many people working in health care and in the voluntary services should feel apprehensive about becoming infected through direct contact, especially such close contact as is involved in cardio-pulmonary resuscitation. Thus, certain unions, wishing to protect their members, instructed them not to take such risks. But now more information is available and various guidelines have been issued which should allay such anxieties. If followed, they should ensure that patients receive the specialist care they need and that staff are protected from risk of infection.
Two such documents issued recently are the interim guidelines issued by the Advisory Committee on Dangerous Pathogens (ACDP) and the nursing guidelines on the management of patients in hospital and the community, issued by the Royal College of Nursing. These two documents give comparable and complementary advice. The ACDP guidelines are naturally aimed at all staff who come into contact with people who have AIDS, or with specimens of their excreta. The Royal College of Nursing guidelines are naturally more concerned with nursing care and with trying to meet patients' physical, psychological, social and spiritual needs; and they also draw attention to the particular needs of patients' families and friends. Both documents discuss specific points concerned with health and safety of staff and other patients, with advice on important practical matters such as disposal of plastic aprons, gloves, soiled linen and dressings. Particular attention is paid to procedures for venepuncture, with useful advice on the care of needles.
An important point, which is made by both sets of guidelines, is that the responsible clinician should ensure that all staff who are likely to be involved with the care of a patient suffering from AIDS should be notified of the nature of his condition and made aware of the potential hazards. There have been a number of cases reported where nurses who have been caring for AIDS patients have not been informed of the diagnosis. Such a situation clearly puts them at unnecessary risk, and it also means that they cannot take the precautions needed to protect other patients appropriately. It is to be hoped that these situations will not recur, especially now that the guidelines are available for reference. These guidelines are to be warmly welcomed.
Also welcome are the initiatives taken by the voluntary services such as St. John Ambulance and the British Red Cross Society, which reassure first-aiders that nowhere has there been a recorded case of AIDS transmitted through first-aid treatment, including mouth-to-mouth resuscitation. They also seek to allay anxieties felt by some of their members about the use of models for instruction purposes by reminding them of standard procedures which have already proved to be effective in maintaining hygiene and safe practice.
It is to be hoped that these authoritative documents and statements will reassure front-line workers and will act as a corrective to the sometimes sensational and inappropriate responses which have occurred in some quarters. However, it must be recognised that they are still interim guidelines. They cannot stand as definitive statements while the condition of AIDS and its transmission are so problematic. I wish therefore to ask my noble friend the Minister whether any research is being done in this area of identification or clarification of the requirements of safe practice for health care workers, members of the emergency services and first-ciders.
Finally, I should like to turn very briefly from consideration of the protection of health care workers to the sensitive issue of patients' needs. People who have been infected with the AIDS virus may find themselves anywhere on a continuum from feeling physically fit and free of symptoms to episodes of
362
illness of various kinds, to terminal illness and death. One of the most frightening aspects of AIDS is the fact that it can have a very long incubation period, and so people in the high risk groups may live in constant fear of having the disease with nothing to show for it but are perhaps just waiting for it to erupt. It has indeed been said that there are two diseases: AIDS, and the fear of AIDS. Given this deeply worrying situation, initiatives such as that taken by the Health Education Council are very welcome. Its booklet entitled, Some Facts about Aids, gives a very clear account of the nature of the disease, indicates those people who are most at risk, and gives advice on what to do if anyone is worried about the possibility of having the disease. It also gives practical advice on other matters, such as sexual behaviour and giving blood.
Another source of helpful advice, particularly for homosexuals, is provided by the Terence Higgins Trust, which runs an AIDS information telephone line and support groups for people with AIDS, and their friends and families.
One of the most regrettable aspects of the development of AIDS has been the tendency in some quarters for those who suffer from the disease to be treated as pariah figures. This may in part be due to ignorance and to fear of infection; it may also be related to the social stigma which may still attach to homosexuality. It is profoundly to be hoped that such attitudes towards the victims of this disease will change and that they will be accorded all the care which they need—care which needs to embrace not only them but their loved ones, in a particularly sensitive way, given the difficulties and problems inherent in their predicament.
It was largely because of this unhappy predicament of AIDS sufferers and the fear and uncertainty experienced by those who care for them that it seemed appropriate to raise these questions in your Lordships' House. I greatly look forward to learning more about these and related matters from the noble Lords and Baronesses who will be taking part in this debate, and I am most grateful to them for doing so. I also look forward to hearing from my noble friend the Minister the latest information concerning the control and prevention of this tragic disease, which is causing such widespread suffering, fear and anxiety. In this situation ignorance is the opposite of bliss—it is worry, uncertainty and even agony. It is my earnest hope, therefore, that the provision of more information may help to alleviate some of these problems and to reduce some of the suffering emanating from misinformation and the fear of the unknown.
5.22 p.m.
Lord Rea: My Lords, the noble Baroness, Lady Cox, has performed a very useful and timely service by putting down this Unstarred Question, and we should all be grateful to her for giving such a crystal clear account of the problem. We are used to hearing speeches of such quality from the noble Baroness, and her speech today has been no exception.
The noble Baroness has mentioned some points which should reassure us. In particular, she said that AIDS is not a highly infectious condition and that it spreads only through very intimate contact or through blood or blood products, or contaminated syringes or

363
needles. In other words, normal social, rather than sexual, intercourse with affected or high-risk groups is perfectly safe. As the noble Baroness has pointed out, there is no need to make pariahs of the whole "gay" community.
Unfortunately, the discovery of the acquired immune deficiency syndrome has been used by many intolerant people as an excuse for what has been described as "gay bashing". I join with the noble Baroness in condemning such action in the strongest possible terms. Its extent was revealed recently in an unusually frank article in Time Out on 28th February, which also gave some extremely useful advice to high-risk groups.
I am sure that at the conclusion of this mini-debate the Minister will put us in the picture about current research into the condition and about possible avenues that may lead to the development of an antiviral agent that may be useful, or a vaccine. That is some distance ahead, but there is a great deal of work going on at present. The condition has caused great interest throughout the scientific community, and in the end it may lead to greater understanding, not only of AIDS but also of other virus diseases, and may assist the development of the relatively young science of immunology. It is also likely to prove a further boost towards research into the endemic diseases of Africa, to the great benefit of the African people as well as ourselves.
One of the causes of anxiety is that like some other so-called "new" diseases that have recently been described—such as lassa fever or legionnaire's disease—it is possible to depict it as a visitation by an enraged and vengeful god creating a new weapon to punish us for our sins. In fact, all these diseases have turned out to have been present for many years, usually in a tropical environment, but they have been unrecognised in those places amidst a whole host of other diseases. It looks as though AIDS is another of those diseases—"an old disease from Africa", as one BMJ article has suggested. It is highly likely that, in an area of high mortality with much serious illness, including malnutrition—an area such as Chad or Zaire—immune deficiencies would be overlooked.
The first death from an AIDS-like illness in a European was of a surgeon working in Equatorial Africa in 1977. The almost simultaneous occurrence of the condition in Haiti and the United States seems to have occurred after some American citizens visiting Zaire came home and passed the virus to the "gay" community in the United States. As Haiti was often used in the 1970s as a holiday haven by the American "gay" community, it was thus perhaps passed via the United States to Haiti and was not originally endemic in that country. That is only a hypothesis, but it is quite a likely one.
As the noble Baroness, Lady Cox, has pointed out, one of the major difficulties is that the incubation period is unusually long—from one to five years—and carriers are usually unaware that they have been infected. Small wonder that genitourinary clinics throughout the country are besieged by people wanting to know whether they are incubating the disease! A further problem is that the test for evidence of infection by HTLV III (the virus now thought to be
364
responsible) is not yet a definite indicator of infection. Even if the antibody is present, it is not certain whether the subject will contract the disease or can pass it on. Those are some of the reasons why a reliable test has not yet been made available for general use either in genitourinary clinics or in the blood transfusion service. Work is going on as rapidly as possible in several laboratories evaluating suitable tests. I am told that later this year we may well have one that will be available for use. However, it cannot be 100 per cent. reliable, and those who are servo-negative—that is, who do not have the antibodies—but who are in the high-risk groups will still need to take sensible precautions and should certainly not donote blood.
While on the topic of blood products, a reassuring fact is that although one-third of the haemophiliacs who have been tested have been found to be positive for HTLV III, nearly all haemophiliacs in this country have received factor VIII made from pooled blood products imported from the United States. Despite the fact that one-third of haemophiliacs have the antibody, only three seem so far to have developed the full syndrome of AIDS. Another comforting fact is that although more than 100 minor "accidents" involving health staff looking after AIDS sufferers have occurred—such as pricking themselves with needles that have been used for collecting blood samples from patients—not a single case of AIDS has so far been reported as a result.
I do not want to criticise the way in which the DHSS has handled the problem. It is always convenient to point accusing fingers. Prompt and appropriate action has been taken in blood transfusion centres by the publication of the guidelines for health staff, to which the noble Baroness referred (and some people even say that those guidelines are too stringent), and by the encouragement of excellent research which is now going on at the Communicable Disease Surveillance Centre at Colindale, and other laboratories.
What I think the Government could do is to encourage the production of more guidance material for risk groups giving quite explicit advice; provide support for more counselling staff at the GU clinics; and take strong action against victimisation, so that the disease "Fear of AIDS" rapidly diminishes, while at the same time appropriate and effective action is taken to control the real disease of AIDS.
5.30 p.m.
Lord Winstanley: My Lords, I am very conscious of the fact that this is not a short debate but an Unstarred Question—an Unstarred Question admirably, and if I may say so, very professionally put to your Lordships' House by the noble Baroness, Lady Cox. If I wished to take issue in any way with the noble Baroness, Lady Cox, in what she said, and indeed to an extent with what was said by the noble Lord, Lord Rea, in his speech, I think that in some cases they gave answers to questions with perhaps a greater degree of certainty than I think our present state of knowledge entitles them actually to possess. The noble Baroness said quite clearly that there is no question, that this disease cannot be transmitted by droplet infection. She may very well be right. I think she probably is right. I certainly hope she is right, but I should like a little more certainty before we tell people with absolute

365
certainty that this is the way it is spread, or that is the way it is spread, and so on.
This being an Unstarred Question I shall content myself as far as I can with merely underlining some of the questions which have already been put and perhaps putting one or two more myself to the Minister who, at the end, will reply. There is a great deal which I think we need to know about this fairly new, and undoubtedly very alarming, disease.
The first thing I should like to know—and I do not think that the noble Lord the Minister is going to be in a position to tell me at the end of this debate, and probably not at the end of the debate in 12 months' time; but at least he could make a start—is what steps are being taken to find out the following information. I, and many others, should like to know the precise nature and identity of the responsible virus. There are those who I think believe they do know. Is it a new virus? Is it an old virus that has undergone some kind of mutation? Or is it something that has become much more virulent than it used to be? The noble Baroness in her mention of measles pointed to the fact that diseases change. Not only do diseases change, but the response of human beings who contract various diseases changes very frequently also.
The noble Baroness mentioned measles. I think it is my recollection that when measles was first introduced into Fiji three-quarters of the population died. They died because they had never previously been subjected to that comparatively minor disease and therefore it had a very serious effect on that particular population.
I make those points merely to illustrate the fact that once one has identified a particular virus, one has not necessarily defined clearly what its effects are likely to be. But I should like to know what is the present state of our knowledge of the nature and identity of this particular virus.
Secondly, I should like to know what is the present state of our precise knowledge about the mode of transmission of this disease. I realise that the noble Baroness has suggested that we already know a lot. So, too, has the noble Lord, Lord Rea; and he knows a lot about a great many things. I have been in medicine perhaps longer than the noble Lord, Lord Rea, and longer perhaps even than the noble Baroness, Lady Cox; has been in nursing, but I am bound to say that the more I have found professional colleagues to be absolutely certain about things, the more I personally have been inclined to doubt them, and the more often I have sometimes found that they have subsequently proved to be wrong.
I should therefore like to ask the Minister what is the present state of our precise knowledge about the mode of transmission of this particular disease? In particular, one really wants to know whether or not this is a disease which is exclusively sexually transmitted. If it is not, it is high time we said so—and said so loud and clear. But if we are going to say that, then of course we have to say by what other means it can be transmitted. I am not saying that we must carry out some kind of alarmist propaganda to frighten people and to suggest that it can be picked up in all kinds of strange ways. But I believe that in your Lordships' House we have a duty to try to find out the real facts before we can decide what is the best way in which to communicate
366
those facts to the public as a whole and, indeed, what are the best steps to take.
Thirdly, I should like to be told a little more as to what we know about the length of the incubation period. The noble Baroness, Lady Cox, told us with absolute conviction that it was seven years. I thought that that was what she suggested. I should like to know at least—
Baroness Cox: My Lords, perhaps I may say that I said that it is presently thought to be any time between six months and six years, according to present state of knowledge.
Lord Winstanley: My Lords, the noble Baroness confirms my view that the state of our knowledge on the length or shortness of the incubation period is extremely limited; and that is something about which I should like to know more.
Lord Rea: My Lords, our state of knowledge as to the length of the incubation period is not lacking. It is fairly definitely known that it is very variable and can be between six months and six years, and that is knowledge which is scientifically backed up. It may be anything between those times; there is a variable length of time.
Lord Winstanley: My Lords, it would appear that the noble Lord, Lord Rea, is a rather more willing absorber of knowledge than I am. I have heard things, too, but I do not necessarily regard them as entirely finite and proved for all time.
Let us move on. I think we want to know a little more about high risk groups. Certainly enough has been said to realise that we know of one high risk group. We also, of course, know of another—the unfortunate people who suffer from haemophilia. Because of their need for blood products, Factor VIII and so on, and the method by which this is supplied to them, they are of course at risk. With regard to that particular group which is at risk—persons suffering from haemophilia—the well-known expert, Dr. Peter Jones, has already done admirable work with his book Aids and the Blood, A Practical Guide. It is a very comprehensive work which gives all the answers which those suffering from haemophilia, or those associated with persons who suffer from haemophilia, might wish to know.
It is time that similar guidance was compiled for any other groups who may happen to be at risk. Of course, there are many other people who require blood transfusions and blood products of one kind or another. They, too, will want to know the news, whether it he good or bad news. They are entitled to know it; and so are we.
To get the answers to all these questions we really need a great deal of research and effort and I think I am right in saying that these are not things that can be done very hurriedly. It takes a great deal of time and, if we look back at the experience we have had with other diseases, we see that it has not always been quick. Sometimes when we thought we had the answers we in fact did not have them.
I am moving from virus diseases to bacterial diseases. Let us take whooping cough, for example.

367
When we finally found the responsible organism and discovered the vaccine, we found that we had created new difficulties which also had to be looked at. Let us go back to viruses and consider infantile paralysis—acute anterior poliomyelitis (to give it its proper name) or polio, as it is more commonly called. We identified that virus a very long time ago and then it took a very long time indeed to devise and to develop an acceptable, and efficient and wholly safe vaccine. A great deal of research was done by ourselves, by the Americans, and indeed by the Russians in the Soviet Union, before we finally had the present oral vaccine with the outstanding, successful results.
I quote that particular example merely to show that this is not a very easy matter in which one can find all the answers very rapidly and then provide the solutions rapidly. It takes time. Not only does it take time; it takes investment and it takes money.
The noble Baroness, at the end of her speech, expressed the earnest hope that the ministry would be able to provide the answers. I think that in order to provide the answers the Minister and his colleagues will have to provide some of the cash. At Question Time a day or two ago questions were raised about extra funds in this regard for the Medical Research Council. The noble Earl, Lord Caithness, in reply to a question which I put, said, entirely in good faith and most sensibly, that additional funds had been provided for this purpose. That is precisely the answer that any sensible, well-intentioned Minister would give. It is the obvious assumption that when the nation is faced not with a crisis, but with a peril of this kind, funds will be provided with which to combat it. The noble Earl has since told me that that was his honest and sincere opinion, as I am absolutely sure it was, but in fact they were not extra funds; it was merely that the Medical Research Council had spent extra money out of its existing funds.
That I wholly accept, and I wholly accept that the noble Earl in his answer was giving a sincere answer and what he thought was a sensible answer. Surely, my Lords, it was, but extra funds have not yet been given either to the Medical Research Council or to the National Blood Transfusion Service, who may indeed need them for further research, or perhaps to the Blood Products Laboratory, who are going to have to do a lot of thinking in relation to this disease.
What kind of a society do we live in if we can readily provide extra funds for policing picket lines, for Trident, or for maintaining a substantial military presence in the Falkland Islands—I am not going into these matters—and not provide extra funds to combat a menace which may perhaps ultimately spread far beyond the Falkland Islands in its significance? We do not yet know anything like enough with certainty about this particular disease. We are not going to know enough until we have made the necessary investment in research. Having carried out the research and got the answers from that research, we shall have to have further investment in order to provide further answers.
I shall say no more save to welcome the noble Baroness's timely Question and to welcome in advance the answers we are going to get from the noble Lord when he comes to reply. I hope that he will be
368
able to tell us that his ministerial colleagues in the department are sufficiently seized of the importance of this particular problem, that proper efforts are being made and that the necessary finance is being provided to deal with what is in fact an emergency.
5.42 p.m.
Lord Richardson: My Lords, I am sure you were all much impressed by the lucidity and the manner in which the noble Baroness, Lady Cox, introduced this Question. It was in fact no surprise to me. She is the daughter of an illustrious surgeon who wrote a textbook of medicine whose brevity and lucidity were such that it enabled me to compete with my Cambridge examiners 51 years ago. My only anxiety this evening is that many of the points that I wished to make were made by her, and that you, my Lords, will have the same sensation that doubtless my examiners had that I had read the book but had not understood it nearly so well as the author had.
There are many lessons and there are some questions which arise from this discussion this evening. One is the creation of anxiety. A great deal of appalling anxiety has been created in connection with this disease. Of course there is appalling anxiety. It is a very dangerous condition indeed. Not least is the question of the incubation period, which was taken up by the noble Lord, Lord Winstanley. To have to wait for three weeks to know whether your child is going to get measles is an anxious business, but to have to wait at least six months and perhaps even six years to know whether you or your child—your son in most instances—will have to face this terrible disease must be appalling. Therefore, much support, as has already been emphasised, is needed for those who are potential sufferers—and that potential is known—and for their families.
Dr. William Hams was quoted in The Times of the 6th as saying—and this is a question—
"Has the media any idea of the terrible problems it gives us through irresponsible reporting?"
Those terrible problems are not only problems which lead to questions being asked, and pressures being exerted, which are at that time virtually unanswerable and could therefore be misleading or productive of anxiety, but if they are sufficient they could lead to wrong decisions.
It is a matter of great gratitude that we should feel that the medical advisers and the Ministers at the Department have not made this into a notifiable disease despite the pressures. If they had, disaster—and that is not an exaggerated term—would follow, because the confidentiality which must surround this sort of situation would have been broken, or at any rate threatened, and the essential process which applies in all venereal disease situations of contact tracing would become even more difficult, and the risks of spread and of failure to recognise those at risk would have been enormously and, as I have already said, disastrously extended.
Again the pressures which can arise from reporting which is alarmist and ill-informed can lead to all sorts of unnecessary precautions, diverting attention and resources from the areas where they are most needed. The noble Lord, Lord Winstanley, raised the point about the numbers, the degree of infectivity, and how

369
the disease is transmitted. At the present time, it is clear that it is transmitted sexually by homosexuals, or by blood in presumably large doses as in transfusions. The answer to the question whether there can be a great many more groups which are at risk is at any rate partially given by the fact that if it was transmitted by the sputum—the virus is there in the sputum—then there would be a vast quantity of patients with this disease, at any rate in the United States where the incidence is so much higher than it is here. Therefore, the ordinary, non-statistical, common-sense answer that it just has not spread as it would if it were to do so by droplet infection, or through the sputum, can in that sense be reassuring.
Again it has been said—and I think it was the noble Lord, Lord Rea, who said so—that of the tens of thousands of health workers in America who have been in contact with patients, and a few thousand in this country, none has acquired AIDS. It is apparently—and at this point it is wise to say "apparently"—considerably less infective than is hepatitis B, a condition which has plagued us for many years but about which we now know a great deal.
Before this debate I talked to the professor of virology at my old hospital, Saint Thomas's, and he said, "The disease is not very spreadable". That is a heartening little sentence. He went on to say that the precautions which should be taken in the wards and in the laboratories could well be described as good housekeeping. This is in step with the much larger experience that the United States has had. Doctors there and the professor of virology, Professor Banatvala, stress that it is the established precautions about which we—doctors, nurses and hospital workers—should all know must be applied thoroughly, with understanding and with tight discipline, but that more than that does not seem to be necessary. Where such precautions were applied more stringently in the States they have now largely been given up. I said "the precautions that we ought to know". There should be much more education about the simple precautions and their rationale for all those who work in hospitals. I do not exempt doctors or even nurses from that need.
Mention has been made—and here the noble Lord, Lord Winstanley was strong—about the importance of research. It is very remarkable that difficult though viruses are to work with in the laboratory, this virus was isolated as recently as May last year and now already its entire genetic structure is known. That was a considerable feat and the rate at which it was achieved was encouraging. But that does not mean to say that we are anywhere near the point where we have a vaccine as a preventive or a drug as a curative. A great deal of research is needed. Perhaps the Minister will be able to help, as the noble Lord, Lord Winstanley, asked, and tell us what research is being done. We know that it is going on into tests: the significance of false positives and negatives; the latter easily understood and the former more difficult. Indeed epidemiology can and should help us by working out some of the utterly unploughed ground of the natural history of the disease: that is how it can affect the individual in varying degrees.
370
It was very recent that we felt that every case was invariably fatal. This was easily understood because the diagnosis was made by the fatality of the disease. But now things are slightly different. I should like to quote from Dr. Don Jeffries, a virologist at St. Mary's Hospital, a hospital that is taking a great lead in the AIDS problem. He wrote in The Times:
"There has been a significant number of people with AIDS antibodies plus immune disturbances"—
those one will feel very gloomy about—
"who, followed up over a year or two, have gone back to normal. We don't know what these changes mean"
—more research—
"but it is very encouraging that people with at one time quite profound laboratory defects and with swollen lymph glands can return to normal."
As I have said, a vaccine and a drug may be a long way off. They certainly were in the hepatitis-B researches leading to a vaccine. The difficulty is that the virus is in the body cell and to kill the parasite one must be careful not to kill the cell at the same time.
Intensive research—even if it is not leading very rapidly to a cure—through more understanding of epidemiology and on the immune responses of the body and how they are disturbed, greater knowledge of the possibilities of the patients with the extraordinary disease called Kaposi's sarcoma in Africa which is related to this condition to possibly mild cases with little but blood changes to show that the patient has ever been infected may—and I think will—come out with epidemiological study.
I should-like to end by emphasising the point made so clearly by the noble Baroness, Lady Cox, that support, advice and counselling for the relatives, sufferers and potential sufferers is absolutely essential. This is going on. Great initiative has been shown; and it is of major inportance, as I am sure the noble Lord the Minister understands, that it should receive all possible encouragement.
5.56 p.m.
Baroness Dudley: My Lords, I am most concerned about the risk to our young men and boys in catching AIDS. I believe that in America the number of cases has doubled every six months since 1980, and that 97 children under the age of 13 have caught it. Could something be done about it in this country before our young people are affected in similar proportions? Is it possible for the Government to issue an information leaflet on AIDS, its nature and causes, to parents of schoolchildren? Perhaps a film giving details of the virus could be shown in schools and colleges of education where boys and young men may be exposed to approaches from homosexuals. Already in Britain I believe there have been 132 cases with 58 deaths, and the public is anxious and confused about the disease and how it is transmitted. As male homosexuals are the main people at risk, they must be made fully aware of the dangers so that the progress of the disease can be checked. All "gay" communities should take a responsible attitude to safeguard those who are likely to be affected by any irresponsible actions. If possible, stricter checks could be made on giving blood.
Recently a baby was born in Birmingham with the AIDS virus in its blood after its mother had received contaminated blood from an AIDS victim. More

371
research could perhaps be done on the screening of blood and the treatment of AIDS sufferers. Perhaps the Government should now consider a review of the current law relating to homosexuals and children to ensure that the risk of AIDS is taken into account. Is there any danger from acupuncture and pierced ears and those sort of things?
5.58 p.m.
Baroness Masham of Ilton: My Lords, this Question on AIDS which has been put down by the noble Baroness, Lady Cox, follows from a Question which I asked on 13th February. That followed from one asked last year by the noble Baroness, Lady Dudley. We have had three Questions asked on the acquired immune deficiency syndrome by three female peers. Females are a small percentage in your Lordships' House and it is interesting that 100 per cent. of the questions on this important subject have been asked by women.
Looking into a new disease is fascinating, but in this case it is extremely worrying. In AIDS the immune or defence system becomes defective leaving the way open for potentially serious invaders which the body normally rejects. One arm of our two-armed defence system is affected. These are the T-cells which normally are primed to repel invasion by viruses and other organisms. The other arm, in which the B-cells work, is left relatively intact so that most bacterial invasions are still repulsed. Therefore, it is the T-cells which cannot combat a viral attack. AIDS, for the people who do not know, stands for "acquired immune deficiency syndrome". "Acquired" signifies that it is caught as an infection rather than inherited; "immune deficiency" means that the body cannot defend itself properly; and "syndrome" means the illnesses that result. One of the greatest concerns is that at the present time there is no diagnostic test for AIDS yet available. We hope that scientists and doctors throughout the world will work closely together to find preventive measures and a cure.
I wonder whether this vital matter was discussed between our Prime Minister and the President of the United States of America when they last met. War against disease should be considered as important as any other sort of war. It would be wrong if any countries working on a vaccine did not work together because of the monetary gain on finding a vaccine. With the amount of fear and suffering that this virus is causing, the sooner a remedy is found, the better the world will be.
There is a great deal which can be done by many people to relieve some of the human suffering until a cure is found. The Government, through its machinery, can help. We should look at the positive things that can be done. I quote a few lines from a very useful book AIDS and the Blood, written by Dr. Peter Jones and published at the Newcastle Haemophilia Reference Centre in association with the Haemophilia Society and the Terence Higgins Trust:
"AIDS hurts. It intrudes on the security and privacy of families. It attracts ill-informed and sometimes cruel comment. Faced with the possibility of AIDS, people experience bitterness and anger. Sometimes anxiety or depression threatens to overwhelm them".
People with fears about AIDS should be able to talk about it in confidence to well-informed people. I do
372
not think that a worried woman who may suspect her husband of having dual relationships with herself and homosexuals should have to go to a special clinic, a VD clinic. She might not go. Could there not be a confidential centre in each health region where these people could be referred by their general practitioners?
I hope that this debate will be useful and will help people to understand a little more the needs and the problems created by AIDS. The symptoms and signs of AIDS listed by the Centers for Disease Control and the American Association of Physicians for Human Rights are: (1) profound fatigue, persisting for weeks with no obvious cause; (2) unexplained weight loss (more than 101b in two months); (3) drenching night sweats that may occur on and off for several weeks; (4) fever lasting for more than 10 days; (5) cough lasting for more than two weeks and not due to smoking—this may be associated with shortness of breath, persistent sore throat and difficulty in swallowing and the white spots of "thrush" may be visible in the mouth; (6) persistent diarrhoea; (7) swollen lymph nodes (glands) lasting more than a month; (8) purplish or pink blodges in the skin.
These symptoms and signs could mean many things and, in themselves, they do not mean that AIDS is present or that the person concerned is going to develop AIDS. They may not be of consequence, but anyone experiencing prolonged ill-health and worried about AIDS should seek consultation with a doctor quickly. There is a vital need for considerate and correct counselling up and down the country. Many people are worried. They need to have their questions answered. Fear grinds away. Innocent people may have had blood transfusions; hundreds of haemophiliacs and people suffering from Christmas disease will have had Factor VIII and IX. I have been asked by someone who has worked in Africa as a missionary if gamma globulins could carry the virus.
My Lords, the fear of the unknown is very great. I think it would be wise and helpful if the Government would set up a series of conferences in different parts of the country for medical, nursing, social and technical staff so that they can be kept up to date with information and can gain counselling skills. Junior staff will always need continual back-up from senior staff. Many people who are going to have operations are asking if they can have their own blood collected a few weeks beforehand and use that blood should the need arise. This seems a reasonable request and perhaps the Minister would look into it to see whether it is practicable.
It is known that the bowel wall is very thin and delicate and can easily have lesions and I think I am correct in saying that the purple blotches in Kaposi's sarcoma are only present when homosexuals develop AIDS. As much as possible should be done to prohibit at-risk groups from giving blood. Perhaps if people are bisexual and married and have been giving blood for years, they do not want their wives to suspect them if they have been living double sex lives. It seems to me that counselling ought to take place at blood-donating sessions to make at-risk donors realise what danger they might inflict on innocent people. This is most important now as no diagnostic test for AIDS is yet available.

373
I should like to ask the Minister whether the AIDS virus has changed and whether the AIDS antibodies which are found are themselves immune. They are passive. What is making them unable to fight? This mystery illustrates the need to encourage doctors and scientists who work in the field of virology: their work is most vital and should be considered a top priority. Blood is the lifeline of the National Health Service. When I sustained my injury I also had a mammoth internal haemorrhage. It was blood transfusions which saved my life.
The impact of AIDS on the blood transfusion service will not be limited to the cost of testing AIDS alone. It is hoped that a test will be available during 1985–86 and it is thought that the cost will be about £2 extra on every unit of blood. In order to prevent any possibility of infection from blood products, heat treating will be necessary. This process of heat treating reduces the potency of the substance by approximately 20 per cent. and therefore 20 per cent. more blood will be required to produce the same level of product, and I do not think that red blood corpuscles can be treated in this way as it would damage them.
My Lords, I think that for years we have been taking our blood transfusion service for granted. A great deal of amazing work goes on and I should like to pay tribute to the dedicated people who do such an excellent job. Perhaps in the past they have been neglected and perhaps that is why we are not yet self-sufficient in blood products and are still importing them from America and, sadly, we have also imported the AIDS virus. This extra need for plasma and the extra work that AIDS is imposing on the regional blood transfusion services means that they need more money. Is the extra money going to have to come from the normal regional budget; or is the money going to be forthcoming from the Treasury? Is there going to be something special in the Budget tomorrow for "blood money"?
I cannot see any reason why people should be fearful of donating blood. I read in The Times today that Britain's blood transfusion service is facing a serious shortage. I am sure that if an appeal is widely made, many "clean" people will come forward to give their blood. We cannot do without an adequate supply of blood. This is a good opportunity to say that new needles are used each time for blood donation. They come in sterilised packs and after being used once only they are thrown away. This knowledge should be widely advertised to help recruit donors.
I am sure the Minister will agree with me that screening for AIDS should not be done at blood transfusion centres. If the problem spreads, so should the services required. The stress on the staff dealing with many cases must put an enormous extra workload on a hospital. Tribute ought to be paid to Dr. Pinching and his staff at St. Mary's Hospital, Paddington, who have been dealing with 45 AIDS patients. The large cities like London seem to attract the high risk groups. More resources will be needed for the acute services, and I hope the Government will learn now from the experience gained at St. Mary's Hospital.
374
There does also seem to be a problem over disinfecting some instruments such as flexible endoscopes, which are used to examine the bowel for cancer. The endoscopes are used many times in each session and the disinfectant which is efficient in regard to AIDS is causing some problems to nurses who have allergies to it. With the constraints on the National Health Service budget, these are all added problems. Please, will the Government look into all these matters?
With AIDS, prevention must be of paramount importance. It must be remembered that many nurses over the years will have become accustomed to a routine of dealing with used needles after taking blood. It is while putting them back into the sheath that the nurses can prick themselves. The needles should be placed in a rigid container for disposal. The instructions should be simple and straightforward so that nurses do not forget. With the problem of hepatitis B and drug addicts, most general practitioners have become more careful over the disposal of needles because drug addicts scavenge dustbins for used needles for drug use. It is advisable to take used needles to a hospital for disposal. This precaution should help to lessen the risk of spreading AIDS.
Dr. Peter Jones from Newcastle, when talking to me last week, said that he enjoyed talking to patients and felt that close communication was vital especially for mothers with young children. I felt that maybe AIDS brings the worst out in some people but with a doctor like Dr. Jones it is showing the good and positive side of human understanding.
The Haemophilia Society has among its members many high-risk people. I just want to say that AIDS has put extreme pressure on that small society, which is producing information and advice for its members. They are most grateful to the Government for their helpful grant, which was most timely.
When the part-time prison chaplain died from AIDS, it was understandable that prison personnel were concerned because very little positive information about the virus had then been circulated. Inmates and staff live in very large human factory-style institutions, with people coming and going like a conveyor belt. Information has now been circulated. Far more cases from the AIDS virus have been confirmed in America, but no one working in the American penal system has contracted it as a result of their work. With our large prison population and a great variety of inmates, it is really very remarkable how few outbreaks of infections there have been in our prisons.
Having said that, and knowing of some overcrowding, I would humbly ask whether perhaps it would be wise to increase the washing facilities for prisoners. Hot soap and water could be a precaution well worth taking. As it is, in some prisons the inmates only get one shower a week. I hope the Government will endeavour to do everything possible to prevent and control the spread of AIDS and the neurosis which goes with it.
6.15 p.m.
Lord Kilmarnock: My Lords, we are all grateful to the noble Baroness, Lady Cox, for introducing this

375
short debate on this very important subject. I should like to start by agreeing with her that great damage is done by the misinformation and the hysteria which has been fostered by the popular press. I think that point was also made by the noble Lord, Lord Richardson. Some extrapolations have been quite extraordinary as a result of this disease. I think one of them produced a certain figure for the year 1990, and had it been extrapolated to the year 2,000 it would have produced 100 million AIDS sufferers—that is to say, almost more than twice the population of these islands. So the press has obviously not been doing us a good service in spreading these sorts of rumours. And of course, as has already been pointed out, exaggeration tends to lead to victimisation of the groups at risk. The noble Baroness, Lady Cox, also referred to this. The noble Baroness also said, as have other speakers, that more information is becoming available fairly rapidly from other parts of the world and in particular from America, from the National Cancer Institute of Bethesda, Maryland. That is welcome news, but of course it does not mean that we should relax our own efforts.
The noble Baroness and, I think, the noble Lord, Lord Rea, and also the noble Baroness, Lady Masham, mentioned haemophiliacs, who are particularly at risk from imported blood products, not only from AIDS but also from hepatitis, as they have been for many years. I wonder whether the noble Lord, Lord Glenarthur, can tell us about the current situation in respect of heat treatment of imported blood products. The long-term answer is obviously the development of self-sufficiency in Factor VIII; but of course we are not there yet. Is the noble Lord satisfied with the arrangements for the treatment of imports, in particular from the United States?
Still on the subject of haemophilia, I understand that in the long term, in the next 10 years perhaps, we can expect synthetic Factor VIII to become available. Can the noble Lord assure us that when this is the case there will be no financial obstacle to the widest possible use of what will, after trials, be a clinically safe material carrying no risk whatsoever?
I want to address the rest of my brief remarks to the question of research funding, which was referred to by my noble friend Lord Winstanley and also by the noble Lord, Lord Richardson. My noble friend mentioned the reply that he had received from the noble Earl, Lord Caithness, in regard to a Question put by the noble Baroness, Lady Masham, on the 13th February, when the noble Earl, Lord Caithness, said at col. 182 of Hansard:
"We do not intend to starve the Medical Research Council of funds: in fact we are giving it more funds on this particular matter."
Later during the exchanges on the same Question, in response to a supplementary question of mine, he said this (and again I quote, from col. 183):
"I believe I am right in saying that they are extra funds, and we shall continue to give extra funds wherever there is a special project on this which is worth it".
After that exchange, the noble Earl, Lord Caithness, came to me, very commendably, and said he thought he might have misinformed the House and that he might have been wrong in relation to the additionality of the funds that he was talking about. He suggested
376
that I should put down a Question for Written Answer which would enable him to put the record straight.
Accordingly, on 5th March I put down a Question, which I shall now quote, and then I shall give the noble Earl's Answer, to which I think he will have no objection, which I received today. The Question which I put down was as follows:
"To ask Her Majesty's Government, whether, in view of the references made by the Earl of Caithness on 13th February 1985 (Official Report, Cols. 182 and 183), to the provision of additional funds to the Medical Research Council for research into AIDS, they will now state the level of funding for this purpose for the years 1984–85 and 1985–86".
The first part of the noble Earl's Answer is as follows:
"The Medical Research Council have authorised grants for AIDS research at a total estimate of £369,000 of which £59,000 will be provided by my right honourable friend the Secretary of State for Social Services".
So we have there a figure of £369,000. I checked this with the Medical Research Council, and they came up with a figure of £387,000. The difference is not great, and I am sure there is an explanation for it, so I do not want to pursue that.
But what I should like to draw the attention of the House to is the figure of £59,000 which has been provided by the noble Lord's department, the DHSS, because I think we should try to consider whether we think that is sufficient. I think I am right in saying that it means that there is an element of additionality to the tune of £59,000, though the rest of the funding is all coming from within the Medical Research Council's main budget.
As I understand it—and perhaps the noble Lord will correct me if I am wrong—that £59,000 from his department is distributed as follows: £45,000 going towards the project headed by Professor Ardler at Middlesex on research into all aspects of the disease, and £13,500 going to the project headed by Dr. Craske at the Public Health Laboratory in Manchester on haemophilia. I understand that those are the two areas in which the noble Lord's department is making a contribution. That is useful information which we are glad to have, but I should like to ask the noble Lord whether, in view of some of the remarks that have been made in this debate, he considers that that sort of contribution from the Department of Health and Social Security is really sufficient in the circumstances.
In the second part of his reply to me the noble Earl, Lord Caithness, said as follows:
"The grants authorised are for periods of 2 and 3 years; it is not possible to estimate expenditure for 1984/85 and 1985/86 as two of the grants have not yet incurred expenditure and their starting dates are unknown".
That is perfectly clear. We all know that these projects are carried on over a period of time and that the money is used up only gradually. But I should like to seek the noble Lord's assurance that additional funds will be available for good, new projects if and when they come forward, and indeed for any trials which may be required resulting from epidemiological research.
I go back to the point that I made earlier. We are learning a lot from the United States of America, but I suggest to the noble Lord—and I hope he will agree—that we really must have our own research capability fully open and available for trying to find a cure for AIDS. I particularly noticed that the noble

377
Lord, Lord Richardson, said that the virus had been isolated only in May last year, which is not very long ago, so there is a great deal to be said on the plus side. But as the noble Lord also said, we are still nowhere near to a vaccine or to a drug, so it seems that we should not relax our efforts and, particularly, that there should not be any drying up of funds if promising research is coming forward.
Finally, I should like to ask the noble Lord this question. I understand that there is a working party of the Medical Research Council which is monitoring all these areas of research, and I believe that five research projects are in progress at the moment. I also understand that there is a new group within the DHSS which, presumably, is monitoring the progress of the disease and of the research into it. I should like to ask the noble Lord to say a little more about this command post which is said to exist inside the department. Is it in constant touch with the Medical Research Council, and will he guarantee that there will be no shortage of additional funds, if and when they are genuinely required and there are real research projects which need them?
6.25 p.m.
Lord Ennals: My Lords, like other noble Lords and Baronesses, I think we all owe a very great deal of thanks to the noble Baroness, Lady Cox, for opening this debate and for doing it, as the noble Lord, Lord Richardson, said, with such skill, knowledge and sensitivity. It has been interesting that four of the speakers have been professional people, with two general practitioners, a consultant and a very senior nursing Baroness. The noble Baroness, Lady Masham, referred to the minority of women in your Lordships' House. If we look at today's debate we see that they have distinguished themselves, as they usually do. That means that male laymen like myself are in a very small minority in today's debate, so we must just do our best.
The main reason for congratulating the noble Baroness is that we in this House and Members of the other House, and all those who are concerned, have the major task of educating ourselves—which I think we have been doing—and of educating the public. After all, we are dealing with a virus which is relatively new; for which, as the noble Lord, Lord Rea, said, no preventive vaccine has yet been found; and for which there is as yet no known cure. Its importance is added to by the fact that, though the disease is still comparatively rare—I think the noble Baroness gave the figures of 7,980 cases in the United States and 118 in Britain in January—all the signs are that the numbers will, certainly for a period, continue to rise quite sharply. It is for this reason that we have to be very careful about some of the horrendous reports to which reference has been made.
The noble Lord, Lord Winstanley, posed some questions to which I would certainly not dare to give an answer, but from what one knows the epidemiological features so far indicate that the disease is virtually unknown outside the group that a number of noble Lords have defined—homosexuals, intravenous drug abusers, people from the Caribbean and from central Africa, and haemophiliacs.
378
Nevertheless, as the noble Baroness, Lady Cox, said, the existence of this disease, even though AIDS seems not to be contagious, has created a tremendous degree of concern, and indeed fear, among those who think that they may be severely at risk. We must know some, and we must also know that there are tens of thousands of others who today are living in desperate fear, partly because they have been misled, their misleading having been stimulated by some of the horrendous, over-dramatised press reporting. Part of the duty of your Lordships in a debate like this is to seek to set the record straight, in so far as people are prepared to listen to what we have to say.
The dangers are put into perspective in the authoritative article in the British Medical Journal, which was referred to by the noble Baroness, Lady Cox, on 23rd February 1985, and I want to re-quote just two sentences:
"The fact that tens of thousands of hospital workers in America and several thousands in Britain have been exposed to the virus and yet none has developed AIDS is reassuring, for it suggests that it is appreciably less infectious than Hepatitis B".
I have no hesitation in repeating that because this should be clearly understood by those full of fear.
The article ends by saying:
"Doctors have a responsibility to put the record straight, to help people view the disease in perspective. Patients with AIDS not only need our professional help, but also our sympathy and understanding".
I was glad that the noble Lord, Lord Rea, referred to "gay bashing". I heard only a few days ago of a public house in East Anglia that has a sign over its bar which says, "No homosexuals allowed". It is this kind of danger which we must seek to allay.
As early as 21st April 1984 an editorial in the British Medical Journal said:
"Even though our experience of patients is limited, we have our own examples of hysteria taking over from reasoned judgment of the facts".
The editorial then referred to the fact that some 94 per cent. of American patients so far fall within the group which we have already mentioned. From American experience we can narrow down the group very substantially.
Personally I am most grateful to the Royal College of Nursing for their excellent guidance, which has been referred to by the noble Baroness, Lady Cox, which has value for people far beyond the nursing profession. I hope that these guidelines will be widely read not just by people who need to know, but by people who seek to know. Perhaps I may briefly paraphrase one or two of the points made in the guidelines. Referring to health education, they say that those who comprise the main at-risk groups should be advised to observe certain precautions within their particular life style:
"No one in the at-risk group should at the present time donate blood unless for research purposes or allow their organs to be used for transplantation. Such education and advice must make the subjects aware that they have an important role to play in preventing further the spread of that condition".
So far as homosexuals are concerned—and again I shall paraphrase—there should be no contact with body fluids—saliva, semen, faeces and urine. These subjects should be strongly advised,
"to avoid sexual contact with men from North America. These restrictions also apply to heterosexuals within the at-risk group".

379
The guidelines go on to say that health education is much more effective when the adviser stresses the things which can be done to maintain or promote a meaningful relationship and at the same time to encourage safe sexual practice. There are of course substitutes for those who feel deep affection for their male partner and we should not underestimate at all the grave problems that are faced by some of those who are living in perfectly stable homosexual relationships.
There is also some advice to intravenous drug abusers. The best advice that the health care adviser can offer is that the subject should seek help with the problem, and the adviser can give information on drug abuse centres. Of course, even more important advice is to give it up, but having said, "Give it up", one recognises that everyone is not going to give it up and that to do so is difficult. Where such advice from drug abuse centres is not welcome or relevant, hygiene education is essential and drug users should be advised to use only sterile equipment, as was pointed out by the noble Baroness, Lady Masham, including needles, when preparing drugs. There is more helpful and sensible advice and I think that it is our task to ensure that it is widely communicated throughout the community, especially to those who are at risk.
I want to say a word about a subject that has been mentioned by a number of your Lordships. I want to endorse the appreciation of the work of voluntary organisations and of volunteers in this field. Reference has been made to the Terence Higgins Trust, the role of which has been very important. It is the only organisation which has been able to concentrate virtually entirely on this problem. Reference has been made to the Blood Transfusion Service which, although run departmentally, is a voluntary service. Reference has been made to the Haemophilia Society. They are faced with people with grave worries at the present time. I admire the way in which they are helping to put the facts before those unfortunate people.
I want to deal now with the Government's responsibilities. I say straight away that I welcome the guidance to nurses and other action, particularly that concerning the Blood Transfusion Service which I think was rapid and exactly what was needed. I wish to make a number of other points. First, funds must be found to provide special units for handling what we know will be an increasing number of cases. Reference has been made by both the noble Lord, Lord Richardson, and the noble Baroness, Lady Masham, to the very heavy burden that is now falling on St. Mary's. This emphasises the need for other recognised equipped units which can deal with this increase.
Secondly, I endorse all that has been said by the noble Lord, Lord Winstanley, the noble Baroness, Lady Masham, and the noble Lord, Lord Kilmarnock, about research. I shall not repeat what they said.
Thirdly, I wish to make an urgent plea to the Government to take no action on the proposals of a DHSS cost-cutting working party in relation to the Public Health Laboratory Service. The recommendation that has been made in the working party's report, which I think has not yet been published, is that the PHLS should hand over its 52 laboratories in
380
England and Wales to local health authorities. I do not think that the local health authorities, in view of their own financial difficulties, will appreciate this new burden being placed upon them.
Members of the governing board of the service are warning that such a move might seriously jeopardise the agency's ability to monitor the spread of infectious diseases, particularly AIDS. Scientists and technicians in the local laboratories test some six million specimens a year for viruses and for bacteria. Their skills in microbiology and their equipment make them uniquely qualified to track down the AIDS virus. I say to the noble Lord the Minister that I hope nothing will be done for cost-cutting reasons to undermine the status of the Public Health Laboratory Service, which I know from my own experience renders an extremely important service. This would be quite the wrong time to time any change.
Fourthly—and this is my penultimate point to the Government—I believe that AIDS should be a notifiable disease. Of course I noted the point made by the noble Lord, Lord Richardson, in which he took the opposite view. I have known the noble Lord, Lord Richardson, long enough to realise that in these matters he is wiser than I. I suppose that I must think again; nevertheless I say that there would be great merit in making it notifiable. I believe that it would not so much scare off from coming forward people who have or who fear they have the disease, but would do a great deal to reassure other people who are at present scared. I know that the Government are considering this matter and I hope that the Minister will say a word about it when he replies.
Finally, advice, information and guidelines must be made available not only to nurses, as has been referred to, but also to the prison service, to the police and to the fire service, because fear born of ignorance leads to decisions which add to the hysteria and panic which can only do harm to those who are patiently struggling to cope with this new and deadly disease. Therefore, anything more that the Government can do to make the facts as they are now known available to all who might have reason to fear would be action which I believe would be welcome by all Members of your Lordships' House.
6.40 p.m.
Lord Glenarthur: My Lords, the disease AIDS has certainly attracted considerable media attention and has generated much public concern and even unnecessary hysteria, as the noble Lord, Lord Richardson, suggested when he spoke. I therefore welcome this opportunity to explain some of the facts and to dispel some of the myths. I am most grateful to my noble friend Lady Cox for providing an opportunity to do this. She is certainly an expert, as is the case with so many other noble Lords who have spoken. Indeed, much of what I shall say tonight will be simply reinforcing many of my noble friend's remarks and those of others of your Lordships who have taken part.
It may be helpful if I first confirm some basic facts about the disease AIDS. AIDS is still a rare disease in this country. At the end of last month, as we have heard, 132 cases had been confirmed, of whom 58 have died. Contrary to some of the stories which have appeared in the media, AIDS is not a highly infectious

381
disease and poses very little threat to members of the public who are outside the at-risk groups; it was these particular groups about which the noble Lord, Lord Winstanley, asked. The main way in which AIDS is passed is person-to-person through sexual intercourse between male homosexuals, particularly those with many different partners. Cases have also been recorded as a result of the infection being transmitted between drug misusers sharing needles and through contaminated blood products. A few cases have also occurred in the heterosexual partners of bisexual men.
Despite the attention it has attracted, much remains unknown about AIDS. What we do know is that in 1981 an apparently new disease appeared in the United States of America after separate reports of pneumocystic carinii pneumonia and Kaposi's sarcoma occurring in homosexual men. One hypothesis is that AIDS originated in sub-Saharan Africa and then spread to Europe in two ways; first, via the homosexual population in the United States and secondly, by Africans coming directly to Europe, particularly from Central Africa. The search for a causative agent resulted in the isolation of a virus from patients with AIDS and in AIDS risk groups in France and the United States. Both the French virus, known as LAV, and the United States virus, known as HTLV III, are now considered to be very similar and to be the primary causative agent, or at least one of the agents, of AIDS.
As to the incubation period about which the noble Lord, Lord Winstanley, asked, he and others who spoke were broadly right. Incubation is variously given to be between six months and five or so years. Through research under way in this country and abroad, we are confident that knowledge about the disease will improve. Research in the United Kingdom is being co-ordinated by a working party of the Government-funded Medical Research Council and is proceeding through five MRC projects. The DHSS is also funding the evaluation of AIDS antibody screening tests, and other work is going on in laboratories in various parts of the country.
As far as concerns detailed projects being conducted through the agency of the MRC, I can say that the two major projects into which the DHSS has a financial input are those being carried out by Professor Adler and Professor Tedder at the Middlesex Hospital with an investigation into the immunology and etiology of AIDS. The other is being undertaken by Dr. Krask at the PHLS in Manchester: he is making an epidemiological study of the relationship of AIDS in patients with disorders of blood coagulation to its possible acquisition through treatment with blood products.
So far as cost and the input of cash into the MRC are concerned, I am aware of the answer which my noble friend Lord Caithness gave to the question to which the noble Lord, Lord Kilmarnock, referred. I should like to look again at that particular answer because there appears to be some conflict in the figures which I cannot resolve immediately. I simply do not know why there should be this problem but I will look into this matter again and let the noble Lord know the answer.
382
So far as plans for further spending on research are concerned, it is of course a matter for the MRC to decide its specific priorities within the resources available to it from its grant in aid from the Department of Education and Science. I understand that the MRC is always willing to consider soundly-based research proposals but they do of course compete with other applications. In saying that, I do not want to leave the impression with either the noble Lord, Lord Kilmarnock, or the noble Lord, Lord Ennals, that the problem of AIDS is not one that is being taken extremely seriously.
Our officials are in regular contact with the World Health Organisation AIDS Reference Centre in Paris, which collates AIDS data from European countries. They are also in contact with officials of the United States Government, and staff of the Public Health Service and Communicable Disease Centres. There is also United Kingdom membership of the Comité de la Récherche Medicale Working Group on AIDS, which is responsible for European Community medical and public health research on the disease. As well as maintaining contact with the CRM working group, members of the United Kingdom Medical Research Council Working Party on AIDS are collaborating with research workers overseas who have isolated the AIDS-related virus to which I referred.
In the light of information available, the Government are taking a number of important practical steps to prevent and control the spread of the disease. We have set up an expert advisory group, the membership of which includes experts on all aspects of the disease from all over the United Kingdom. The group and its working parties have already met several times and further regular meetings will take place. The first priority of the group is to advise on measures necessary to control the spread of the disease.
The noble Lord, Lord Kilmarnock, asked about the connection between the MRC and the expert advisory group. The members of that group include Dr. Tyrrell, who chairs the MRC's working party, I can assure the noble Lord that liaison between those two bodies is extremely good. As some of your Lordships will be aware, and as the noble Lord, Lord Richardson, said, we have considered the desirability of making AIDS a notifiable disease. The noble Lord, Lord Ennals, also referred to this point. Having consulted the expert advisory group and sought the views of doctors specialising in the field, we are satisfied that the present reporting system to the Communicable Disease Surveillance Centre is operating effectively and that we do not need any new powers at the moment to monitor the spread of the disease.
Furthermore, experience with other sexually transmitted diseases suggests that notification would not assist in control of the disease; this was the main point which the noble Lord, Lord Richardson, was making. This is because the problems of sexually-transmitted diseases, including AIDS, are different from other types of infectious disease and require expertise in tracing, treatment and counselling not normally found in local authority environmental health departments which receive reports of cases of notifiable diseases.
There is also the possibility that this reporting system would cause problems of confidentiality which

383
would make those at risk reluctant to come forward for treatment. It is for these reasons that no sexually transmitted diseases in this country are subject to a statutory reporting system to local authorities. Having said that, however, we will keep the situation under constant review.
We have looked at the benefits to be gained from making the disease subject to other statutory public health provisions. The limited infectivity of AIDS, and the minimal risk it poses to the general public, limit the need for such measures. However, very rare and exceptional cases might arise. We believe therefore that some reserve provisions should be available to safeguard public health if they do. We have therefore announced our intention to lay regulations to allow a patient to be admitted or detained in hospital in such exceptional circumstances.
The Government have taken other steps to prevent the spread of AIDS. At the centre of our strategy lie a number of public health measures aimed at health professionals and "at risk" groups. At the request of the health departments and the Health and Safety Commission, the expert Advisory Committee on Dangerous Pathogens has drawn up interim guidelines to safeguard the health of medical staff, nursing staff, those to whom my noble friend Lady Cox referred, and others who may come into contact with AIDS patients and specimens taken from them. These guidelines were distributed on 16th January to all health authorities.
It is recognised that rapid advances are taking place in the understanding of the disease and the virus related to it. It is for this reason that the guidelines are interim. In answer to my noble friened's question about further research on this issue, I can tell her that the advisory committee will be reviewing the practical operation of the measures recommended in the guidelines within the next 12 months. It will take into account any new scientific information, together with evidence or comments submitted by health care workers, researchers in the field, and other interested parties.
Secondly, leaflets have been produced by the Health Education Council to promote greater awareness of the risks of the disease. These are now being made available in substantial numbers to individuals in "at risk" groups such as male homosexuals and intravenous drug misusers. They are also available to the public generally, and that of course would include young people who have worries about the disease and for whom my noble friend Lady Dudley expressed concern.
There is also a valuable role for the voluntary sector to play in this field. We have already made a grant of £15,000 to the Haemophilia Society to help its AIDS-related information and advice activities. The Terrence Higgins Trust, to which my noble friend Lady Cox and others referred and which is a voluntary organisation named after the first person to die of AIDS in this country, has also been doing important work in providing information, counselling and support to AIDS sufferers and others who have worries about the disease. Today I am pleased to announce that we shall be giving it a £25,000 grant to allow it to expand its activities connected with AIDS. I hope that
384
that will be some encouragement to the noble Lord, Lord Rea, as well, who particularly mentioned how worthy he thought that its work was.
Thirdly, measures are being taken to safeguard recipients of blood and blood products. We have strengthened our efforts to dissuade persons in the AIDS high-risk groups from donating blood. The latest edition of our leaflet, AIDS—Important New Advice for Blood Donors, has been sent to all regional transfusion centres and is being distributed individually to all donors.
Fourthly, tests to screen blood donations for antibody to the AIDS virus HTLV III are being developed both in the United Kingdom and abroad. We are concerned that no test should be introduced routinely into the National Blood Transfusion Service until it has been proved to be reliable and satisfactory. We cannot accept significant rates of either false positives or false negatives. We are therefore co-ordinating evaluation work to assess these tests as they become available in this country. We have written to regional health authorities asking them to set aside funds in 1985–86 to introduce screening tests, when proved satisfactory, into their blood transfusion centres.
Finally—and this was a point that was raised by the noble Lord, Lord Kilmarnock, particularly—we have granted a number of product licences for imported heat-treated Factor VIII for haemophiliacs. It is hoped that by April this year all the Factor VIII made by the blood products laboratory at Elstree will be heat-treated. Limited supplies are available at present for clinical trials. I hope that I shall be able to reassure the noble Baroness, Lady Masham, by saying that we are taking steps to ensure that the United Kingdom is self-sufficient in all blood products as soon as possible. In particular, as I think she will be aware, we are investing £35 million in new developments at Elstree to come into production in 1986.
So far as artificial Factor VIII is concerned—which was another point raised by the noble Lord, Lord Kilmarnock—I understand that it has been synthesised in recent laboratory work, but the commercial sale of manufactured products such as artificial Factor VIII is several years away. I think that the Factor VIII that we shall be able to get from the Developed Blood Products Laboratory at Elstree is the most immediate answer to the problem.
The noble Baroness, Lady Masham, asked several other questions about blood. I am aware of the concern of those who either receive blood, or blood products, or who give it. I am grateful to her for making the point that needles are used only once. The country is already self-sufficient in whole blood. Those who are at high risk from AIDS have been told not to donate blood, as I said. Our voluntary donor system means that there is no financial incentive for them to give blood, and there is therefore only a remote chance of contracting AIDS from ordinary blood transfusions given in hospitals. As we have stressed in the past, donors cannot get AIDS by giving blood—again on the point that the noble Baroness made about needles being used only once.
So far as the screening test itself is concerned, the diagnostic test kits to detect antibody in blood to the

385
AIDS-related virus are likely to be offered for sale in this country shortly. They are intended strictly for laboratory use. It is the department's intention to evaluate those test kits as soon as possible and to use an independent test centre for doing so. It will then publish a list of those which are found to be satisfactory and reliable for routine use in the National Health Service. The tests will detect the presence of AIDS antibody in a person's blood; but of course that does not necessarily mean that he or she has or will have AIDS. That is an important point to make. The tests merely show that they have been infected with the virus at some time. Those tests are likely to find the greatest application in screening blood donations when they are validated. However, they may be appropriate for use in VD clinics and in the diagnosis of illness which is suspected of being caused by the AIDS virus.
Lord Winstanley: My Lords, are the kits to which the noble Lord refers of British manufacture or imported?
Lord Glenarthur: My Lords, I think that they are imported. I am not 100 per cent. sure. I can certainly look into it and let the noble Lord know. In any case, they have to go through the same evaluation procedure, which is the important point to make.
The noble Lord, Lord Ennals, asked me particularly about St. Mary's. The vast majority of cases have been dealt with by that unit in the past. I am aware of the concern which has been expressed by the noble Lord and others. As a result of that concern and the workload which falls upon the unit, we are now discussing with the regional health authority how best the difficulty can be met.
The noble Lord also asked about the future of the Public Health Laboratory Service. A review of the Public Health Laboratory Service Board has been carried out under the normal accountability arrangements for non-departmental public bodies. We shall issue a report of the review for consultation in the near future. I can certainly arrange for a copy to be placed in the Library when it is available. We shall consider the report's recommendations in the light of that consultation. But I should not like the noble Lord to think that in any sense will that review stand those who suffer from AIDS, or may do, at any risk in the future. I too have a responsibility—a special responsibility—for the PHLS. It is a separate issue, but I can certainly make the report available when it arrives.
As to the future spread of AIDS in this country, we have very few cases and it is too early to make accurate predictions. However, this is because there is evidence to show that people in the "at risk" groups have taken notice of the health education material and have been changing their behaviour in response to the threat of the disease.
Lord Harmar-Nicholls: My Lords, may I ask a question? My noble friend may already have given the answer. Is every batch of blood in the bank tested? The point that puzzled me a bit is this. I accept what my
386
noble friend has said—that people in what we call the high risk groups have the pamphlets and are generally advised, but that they are not isolated because that could stop people reporting to transfusion centres for fear of being recognised as being in a high risk group. However, if someone in a high risk group has been a regular donor and is rather proud of the badges that he has received for having given blood over the years, is that not a reason why such a person, perhaps for social reasons, would not take heed of the pamphlet? That is the same basis as the argument for not isolating people. However, that would not matter if each batch went through some kind of test before it was put into the bank. Is that done? My noble friend may have said that it is, but I was not clear.
Lord Glenarthur: My Lords, I think the first point made is that the people who donate blood in this country are on the whole responsible people and they are not going to want to put at risk those who might need blood at any time in the future. There is not a test. This is the point that I was trying to make. I described the kits that may be available, but until we have a reliable test to check whether or not the AIDS virus or the AIDS antibody is present in the blood, we cannot really take it any further.
Baroness Masham of Ilton: My Lords, may I just follow on from that because that was the major point that I made in the debate? I was concerned about the need for counselling. A homosexual might well go to give blood and not want his wife to know that he has a dual relationship. This is the big problem.
Lord Glenarthur: Yes, my Lords, I agree that it is a very big problem. But in advising people at blood transfusion centres we have to be very careful not to run the risk of some kind of panic-induced collapse in the supply of blood. At the same time we have to balance that against the very real worries of those who might contract the disease through blood or blood products. As I have said, there is really no incentive on the part of anybody to part with his blood if he is from an at-risk group. The leaflets have been made available; they are going direct to donors and they are available at transfusion centres, and I think that that is the best way of dealing with this particular problem. I certainly agree with the noble Baroness when she says that counselling is important. At the same time, one cannot be too inquisitive about people's habits.
Lord Rea: My Lords, I am sorry to come in again. There is some information on this very point. I believe that many blood transfusion centres allow donors to state in private whether or not they want their blood to be used (I quote) "for experimental purposes only". This is done confidentially so that their partner does not know about it.
Lord Glenarthur: My Lords, I was interested to hear the remarks of the noble Lord. I can say that in Scotland they have decided to require a signed declaration that the person concerned is not in the at-risk groups. But this is not directed solely or specifically at their sexual habits. It is a very difficult area; I think both the noble Baroness and the noble Lord, Lord Rea, understand that. Nevertheless, we are

387
satisfied at the moment that the response we are getting from the steps that we have taken is satisfactory. I should certainly like to leave it like that at the moment, while bearing in mind the concern which has been expressed this evening.
I end rather as I started, by saying that AIDS is a serious and often fatal condition. But I must stress, as others have done, that it is extremely rare; and it is not infectious in the way measles, chickenpox, hepatitis or 'flu are. It is not passed on by infection from lavatory seats or dirty glasses, or by shaking hands with an infected person. Although the virus has been found present in saliva, there is no record, here or abroad, of the disease being transmitted through it. Nevereless, the Government believe that the steps we have taken, coupled with widespread international research, are sensible and practical means to control the spread of the disease and deserve the confidence of the public at large.

Gosport Borough Council Bill
  Lloyds Bank (Merger) Bill
    National Bank of NewZealand Limited Bill
    The Examiner's Certificates that no further Standing Order is applicable were ordered to lie on the Table.

    Cinemas Bill [H.L.]
    Returned from the Commons agreed to.
    House adjourned at four minutes past seven o'clock.