HL Deb 11 December 1986 vol 482 cc1302-9

7.25 p.m.

The Parliamentary Under-Secretary of State, Northern Ireland Office (Lord Lyell)

My Lords, I beg to move that the Health and Personal Social Services and Public Health (Northern Ireland) Order 1986, a draft of which was laid before your Lordships on 5th November of this year, be approved.

Your Lordships will appreciate that the order before us this evening contains a wide range of miscellaneous amendments to legislation which concern health, and the personal social services and public health. Article 3 to 14 of the order make amendments to the Health and Personal Social Services (Northern Ireland) Order 1972. I think your Lordships would bear with me if I did not propose to describe these amendments individually in any remarks that I might make at the outset because I think the scope of these articles, and the purpose, will be apparent from the draft order itself, and I hope from the explanatory note which accompanies the order. I shall certainly try to answer any queries or points which your Lordships wish to raise on the article. If I could concentrate my remarks on two remaining aspects of the draft order. The first aspect concerns the tighter controls which we propose to introduce over the sale of tobacco products to children and we find that in Article 15.

The second aspect of the order before us this evening concerns the provisions which we are introducing in Articles 16 17 and 18 to control the spread of infectious diseases in the province and also to bring our legislation for that purpose into line with that applicable in Great Britain.

Article 15 amends the Health and Personal Social Services (Northern Ireland) Order 1978 and it further restricts the sale of tobacco to young people. Many individuals and organisations have expressed concern at the amount of cigarette smoking by children in Northern Ireland. Your Lordships will be interested to note a survey sponsored by the Department of Health and Social Services in conjunction with the Ulster Cancer Foundation carried out in 1983. This survey showed that the children in the Province aged 11 and 15 years smoked approximately £2,340,000-worth of cigarettes each year. That is well over £2.25 million-worth every year. Twenty-four per cent.—that is, about a quarter—of the fifth-year pupils at secondary schools smoked regularly. I do not know whether that is once a week or once a day, but they were in the habit of regular smoking.

Further concern has been aroused by the manufacture as well as the sale of new tobacco products such as the things which are called Skoal Bandits. I must say to your Lordships that I am unfamiliar with them. Perhaps your Lordships have tried them or know them, but these Skoal Bandits are likely to be attractive to children and they constitute a considerable health hazard.

Article 15 strengthens controls on the sale of tobacco to young people in three important ways. First of all, it makes the sale of tobacco to children an offence of strict liability. At the moment, except for the sale of cigarettes, the vendor has a legal defence that he did not know the tobacco was for the young purchaser's use. As from today this defence will be removed. Secondly, Article 15 will deal with the definition of tobacco, and it will extend this definition to include products for oral or nasal use. This definition will cover products like Skoal Bandits which are sucked rather than chewed. The third control which Article 15 will place on the sale of tobacco to young people will increase the control of automatic vending machines because in future the court will be required to take action if it can be proved conclusively that a vending machine selling tobacco is being extensively used by children.

These amendments match the provisions in the Protection of Children (Tobacco) Act which was recently sponsored in another place by the honourable Member for East Lothian. I shall ensure that these amendments are brought to the attention of the police.

The remaining three articles in the order before us this evening amend the Public Health Act (Northern Ireland) 1967 and they are intended to strengthen controls available in Northern Ireland to reduce the spread of infectious disease.

Article 16 enables the department to determine the fee to be paid for a notifiable disease certificate, instead of prescribing the fee by regulations. The amendments in Articles 17 and 18 include provision for making regulations to deal with certain diseases, to prevent danger to public health from vessels or aircraft arriving at any place and to provide for removal to or detention in hospital of persons with notifiable diseases. The amendments match many of the provisions carried in the Public Health (Control of Disease) Act 1984 and will thus facilitate a common policy within the United Kingdom for the control of certain diseases, and, in particular, acquired immune deficiency syndrome (AIDS).

Suspected cases of notifiable diseases must be notified to the chief administrative medical officer of a health and social services board. These diseases are specified in the schedule to the Public Health Act (Northern Ireland) 1967 and are all infectious diseases, such as infective hepatitis, typhoid fever, dysentery, whooping cough and measles. Various provisions in the 1967 Act enable controls to be applied for the purpose of restricting the spread of notifiable diseases.

It is at times desirable that some of these controls should be applied to other infectious diseases, and under the new provisions in Article 17 regulations may be made to enable appropriate controls to be applied to any disease which may be specified. It is the intention to use these powers to make regulations which will apply to AIDS some of the controls in respect of notifiable diseases. I hasten to stress to your Lordships that these controls already apply in Great Britain. I want to make it clear that AIDS is not a notifiable disease and it is not the intention to make it one. There is a risk that some people suffering from AIDS might be reluctant to seek medical help if the disease were notifiable.

In Article 17, the opportunity has also been taken to introduce the necessary regulatory powers to Northern Ireland public health legislation in respect of public health risks from the arrival of ships or aircraft. Similar powers were originally contained in United Kingdom legislation, but certain provisions have now become transferred or reserved matters and new powers must be provided in Northern Ireland legislation. The provisions for public health control of arrivals of ships and aircraft correspond to similar provisions in the Public Health (Control of Disease) Act 1984, which replaced the provisions in Section 143(1) to (7) of the Public Health Act 1936.

Article 18 makes provision for the compulsory removal to or detention in hospital of people suffering from notifiable diseases. There are no existing powers, but there may be rare and very exceptional circumstances where the clinical condition of a patient who is suffering from a notifiable disease places him in a dangerously infectious state and yet he refuses medical care and admission to hospital, or refuses to remain in hospital. In those circumstances, the new provisions in Article 8 of the order empower health and social services boards to apply to a resident magistrate to make an order for the removal to or detention in hospital of a person with a notifiable disease. A resident magistrate will decide whether the person presents a serious risk of infection to other people and if satisfied he will then make the necessary order.

The new provisions are among those which will in due course be applied to AIDS. They will not be applied to other diseases. Although one would naturally not wish to use such powers, they are a necessary safeguard and are appropriate given the concern which exists about AIDS. I should add that under the Magistrates Courts (Northern Ireland) Order 1981 there is a general right of appeal against the decision of a magistrates court.

If I may wind up, the draft order represents an important contribution to public health in Northern Ireland, not only in terms of safeguarding against disease but also in terms of the risk to children from tobacco. I commend the order to your Lordships. I beg to move.

Moved, That the draft order laid before the House on 5th November be approved.—(Lord Lyell.)

Lord Prys-Davies

My Lords, as the Minister has explained, this order contains a wide range of miscellaneous amendments bringing the health legislation of Northern Ireland into line with the health legislation of Great Britain. We warmly welcome Article 15, which makes it an absolute offence to sell tobacco products, including new tobacco products such as Skoal Bandits, to young people under the age of 16 years. We are sure that this article will be endorsed by the organisations and parents in the Province who are concerned about the prevention of cigarette smoking by children. Similarly, we welcome Articles 17 and 18, which strengthen the controls available to reduce the spread of those diseases which can be a danger to public health.

However, having regard to the comments made elsewhere and in another place, perhaps the Minister will again confirm that the individual has the right of appeal when he considers that he is being unjustifiably admitted to or detained in hospital. Moreover, is the individual patient told that he has this right of appeal or is this something that he may or may not stumble across?

We note that Article 5 provides for the registration of common lodging-houses, and Article 9 provides for the short-term assessment of persons for admission to old people's homes. I should like to trespass for a minute or two and to put a few points to the Minister about the problem of homelessness among single people in the Province who are in need of help.

There is mounting evidence that the position of homeless single people is, or at least should be, a cause of great concern. This concern was voiced by a deputation which came to Parliament a few weeks ago and it has been voiced, in particular, by the Simon community for Northern Ireland. I understand that half of those who approached the homeless advice unit in Belfast are single people, yet there is only one statutory hostel for single people maintained by the Eastern Health and Social Services Board and it is unable to meet the demand. I am told also that single people are the largest group on the Housing Executive's waiting list of 24,000. So there are many homeless young people languishing on waiting lists.

Can the Minister tell us how the department views the position? Does it consider that the eastern board and the Housing Executive are coping adequately with the position? Is the department satisfied that those two bodies have identified the genuine cases of need, and can more be done for the genuine cases of need? Looking to the future, is the department satisfied that both bodies have adequate plans for the provision of additional accommodation for single people in need of help in the period 1987–92? One is bound to ask whether in these circumstances there is any agency in Northern Ireland which is monitoring what becomes of homeless single people who cannot find accommodation.

The year 1987 has been designated as the International Year of the Homeless and I understand that the Government will be introducing next year a homeless persons order for Northern Ireland. It would be helpful if the Minister could tell us something about the timetable for the proposed legislation. Also, will the department be publishing a list of bodies with whom it will consult before finalising the term of the draft order? Will those bodies have ample opportunity to feed their proposals into the department? I have been specifically asked to raise that particular question with the Minister.

Article 10 gives authority to the department to recover the cost of provisional residential accommodation in the circumstances described therein. I should be grateful if the Minister would confirm to the House whether or not this article will have retrospective effect. It is not clear to me from reading this article whether or not it will have such effect.

Finally, perhaps I may say something about the dissolution of the Northern Ireland Social Services Council. Some of us have some reservations about the wisdom of dissolving the council. The National Health Service is a large enterprise serving a huge public. It could be argued that what is required at the Northern Ireland level is not only specialist advisory committees—and certainly one requires such committees—but also an organisation outside the department with its own research and intelligence unit on which members of the general public will serve. This kind of organisation should be able to range freely over the whole range of health policies at work in the province and question the assumptions. But in any event, I am not convinced that the case has been made out for abolishing this council, at least until an elected assembly has been reconstituted and is functioning effectively.

With those few comments, we on these Benches are pleased to support the draft order which is now before the House.

Lord Donaldson of Kingsbridge

My Lords, perhaps I may begin by saying that it is a remarkable fact that the number of people sitting on the Government Benches has actually doubled in the past five minutes.

As I thought, the noble Lord, Lord Prys-Davies, has dealt with this matter fairly fully, and I shall therefore not deal with it very fully because I wish to say a few things on the next order. I should like to say that we support the order throughout. In particular, we are interested in the tobacco problem as regards children and in the new risks which the modern trend of sucking and sniffing have brought. We shall do everything we can to support the Government in their efforts to fight these trends. The same applies to the disease regulations and particularly to the new and frightening rise of AIDS in this country. I do not know to what extent that disease has yet occurred in Northern Ireland; I hope it has not occurred.

As regards homelessness, this is a point which is not really covered by the order but it is a very interesting point. I am glad that the noble Lord mentioned the Simon Community. This community was founded by a man called Wally Clifford, who had been a probation officer and whom I first met in 1952 or 1953. He founded the Simon Community, which was interested only in people who were below the bottom line. It has done a wonderful job and I am glad that it was mentioned.

I shall say no more, other than that we support this order fully. As time goes on, if matters arise under it we shall do what we can to support the Government.

7.45 p.m.

Lord Lyell

My Lords, I am sure your Lordships will agree with me in being grateful for the close attention that has been paid to this order, particularly by the noble Lord, Lord Donaldson, and the noble Lord, Lord Prys-Davies, both of whom have spoken this evening. I was not necessarily aware of the ebb and flow of my noble friends behind me, since I was paying close attention to the reasoned arguments of noble Lords who were speaking. However, I am particularly grateful that the noble Lord, Lord Donaldson, pointed out that the number of my noble friends had doubled. This must be some indication of increasing interest in the order before us this evening.

The noble Lord, Lord Prys-Davies, raised a number of points, some of which I hope I shall be able to answer fairly easily. I think I may have to write to him on one of those points, but I shall have a stab at answering it this evening. The noble Lord raised the question of the dissolution of the Health and Social Services Council. We regret one side aspect of this particular question, which is that the existence of the Health and Social Services Committee of the Assembly (which your Lordships will be aware is not functioning) was only one of a number of factors contributing to the department's decision to dissolve the council.

I have to tell your Lordships that the primary reason was that the council had not made the contribution which possibly they had hoped and certainly we had hoped they would make towards the development of policy. We believe that advice and contributions to policy development come adequately from other channels and we are definitely satisfied that we receive the advice that we ought to be receiving. I stress to the noble Lord, Lord Prys-Davies, that the order before us this evening in no way affects the five central advisory committees. The noble Lord will be aware that there is one committee for each major professional discipline. Those committees will continue to advise the department. They, with a number of other bodies, will give us all the advice we seek and we are very grateful for it.

The noble Lord wondered whether there would be any retrospective effect of Article 10. I am able to tell him that Article 10 is certainly not retrospective. However, as soon as provisions come into effect by the appointed day order we will take action immediately where people have disposed of assets within the past six months. The provisions will not be brought into effect in Northern Ireland until similar action is taken in Great Britain, and no decision has yet been taken as to when the provisions will be implemented in Great Britain.

Perhaps I may also point out at this stage that under the present arrangements for determining the level of charges we may take account of any assets which are deliberately disposed of and the resident may be charged accordingly. I stress the word "may" and I hope we shall not take a draconian view. I suggest to your Lordships that in practice assets disposed of more than 12 months previously will not be taken into account. Finally, I stress that people in Northern Ireland will have had lengthy notice of the intention to recover assets.

The noble Lord also had a query about appeals by an individual against a decision of a magistrate sending him to or detaining him in hospital. I do have a note, but this is a little complicated and perhaps the noble Lord will bear with me if I write to him. A brief search of company legislation indicates that there is relevant material in Section 67 of the Public Health (Control of Disease) Act 1984. The noble Lord will see that that covers part of the point. However, I think it better not to get into Section 67 of the 1984 Act this evening.

I hope that I have covered most of the problems which the noble Lord raised. If there is anything not covered in Section 67, I shall clear it up in writing. However, I would stress to your Lordships that there is a general right of appeal against the decision of a magistrates court. This is contained in Article 143 of the Magistrates Courts (Northern Ireland) Order 1981. I understand that this means that Northern Ireland does not require a specific right of appeal. That specific right in Great Britain is contained within the Public Health (Control of Disease) Act 1984. That probably cuts down my own dabblings in the law and I shall not go further tonight. However, I shall write to the noble Lord on that aspect of the matter.

The noble Lord asked me about homelessness. I understand that the Shelter Organisation monitors the number of homeless persons of all ages, the young and senior citizens as well. It makes available the results of its monitoring survey to the department. He will be aware that it is a voluntary organisation.

Perhaps I may deal with the noble Lord's main concerns. In regard to permanent accommodation, the Northern Ireland Housing Executive allocates available dwellings in accordance with its housing selection scheme. The scheme has been approved by the Department of the Environment. Under it dwellings are allocated to those applicants in greatest need. Normally we will find that families with children are regarded as having a need greater than single persons, but where there are special health or social needs a single person may be awarded greater priority. The health and social services boards already co-operate closely with the Northern Ireland Housing Executive in providing professional assessment of the medical and social needs of applicants. I stress at this stage that social security benefits would be payable to any homeless person who made a claim and who also satisfied the relevant prescribed conditions. The amount payable would vary according to the circumstances of the individual claimant.

The noble Lord asked me specifically about the Eastern Health and Social Services Board. I assure him that the board co-operates closely with the housing executive and with voluntary organisations in seeking to ensure that all those in genuine need receive the assistance, and above all the support, that they require. But with regard to the provision of permanent accommodation in the eastern board area, the Northern Ireland Housing Executive has modified its new-build programme to reflect the changing composition of its waiting list. I am able to tell the noble Lord, Lord Prys-Davies, that a greater proportion of dwellings suitable for single people is now being provided.

Finally, in winding up this topic of homelessness, perhaps I may say that we hope to publish next year a proposal for a draft order dealing mainly with homelessness. I hope that I may be able to fine that down next year in writing. I do not know whether it will be sooner or later. Perhaps I may have a first shot this evening and say "next year", and complete, so far as we are able to, the more precise timing for 1987 to the noble Lord in writing. I am able to conclude on this point by saying that interested voluntary organisations have already put their ideas to the Department of the Environment and they will be invited to comment following the publication of the proposal for the draft order.

I think I have dealt with the queries that were raised. If I have missed any, I shall study the Official Report closely and I shall certainly be in touch by letter with both noble Lords who have spoken. I beg to move.

On Question, Motion agreed to.