Lords Sitting of 18 May 1988

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

NHS Estate Management
Lord Campbell of Croy Lord Campbell of Croy asked Her Majesty's Government:
When they will be ready to comment on the report by the National Audit Office on estate management in the National Health Service.
The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Skelmersdale): My Lords, the Public Accounts Committee examined the chairman of the National Health Service management board on the findings of the National Audit Office report on 9th May. The Government will follow the usual practice of responding to the Public Accounts Committee's report within weeks of its publication.
Lord Campbell of Croy: My Lords, I thank my noble friend for his reply. Since a sample has shown that as much as 40 per cent. of land owned by health authorities may be surplus to requirements is there anything the Government can do, bearing in mind the cost of maintenance of that land and the alternative use to which the value of the assets could be put to benefit the care and treatment of patients?
Lord Skelmersdale: My Lords, yes, absolutely. The figure of 40 per cent. mentioned in the report is an estimate derived from a small sample of eight health authorities. Over the National Health Service estate as a whole the Government estimate that almost 13 per cent. of property is available for disposal in the immediate future and a further 12 per cent. should be available over the next 10 years. All proceeds from the sale of surplus property are retained within the health service for reinvestment within that service.
Lord Ennals: My Lords, does not that reply conceal what I consider to be two scandalous facts in the report of the Comptroller and Auditor General? First, the DHSS has not even monitored the claim made five years ago that there is now a maintenance backlog of £2 billion in NHS properties. Secondly, health authorities have failed to achieve annual savings of between £300 million and £500 million. That money could have been saved by the effective disposal of surplus property. It could have gone into patient care or contributed towards the maintenance bill.
Lord Skelmersdale: My Lords, for someone who is leading a campaign not to close a hospital, that is an extraordinary question, if I may say so. I point out that the backlog of maintenance has been reduced by £500 million in the past five years. About 68 per cent. of the estate is in a condition described as category A or B; namely, as good as new, or adequate with only minor deterioration. If the trend continues, 70 per
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cent. of the estate should reach this condition during the year 1987–88.
Lord Ennals: My Lords, why then did the report not give those figures? Why was it stated that the DHSS had not even monitored the figures claimed five years ago? Was that information available?
Lord Skelmersdale: My Lords, as I said, much of the report was based on a very small sample. When the Government respond to the report in full in connection with their response to the Public Accounts Committee, the noble Lord and the House will receive a full answer.
Lord Kilmarnock: My Lords, the noble Lord said that the proceeds of such sales are retained inside the health service. Can he clarify that a little further? Are the proceeds retained purely on capital account or are they used for additional revenue expenditure? Perhaps the Minister can amplify.
Lord Skelmersdale: My Lords, the normal form is for capital receipts to go into the capital budget for capital improvements.
Lord John-Mackie: My Lords, can the Minister say where this land is available? Is it around hospitals?
Lord Skelmersdale: My Lords, one example might be a large mental illness hospital with a large amount of land surrounding it. It could be nurse accommodation in a very bad state which it was advantageous to sell and build elsewhere rather than put into a satisfactory condition. It could be an administrative headquarters or anything comprised in the word "estate".
Lord Harmar-Nicholls: My Lords, in view of the very clear innuendo behind the question put by the noble Lord on the Front Bench opposite, is there any evidence at all that the National Audit Office enquirers asked questions to which answers were refused?
Lord Skelmersdale: No, my Lords, absolutely not. As I said in my original Answer, the Public Accounts Committee which has the right and duty to call officials of my department examined the chairman of the National Health Service management board. I have had no suggestions that he did not fully answer its questions.
Lord Ennals: My Lords, bearing in mind the question put and the answer just given, perhaps the Minister would take note of page 4 of the report. At paragraph 11 there is a quite clear statement.
Lord Skelmersdale: My Lords, I believe that my answers have been equally clear this afternoon.
Earl Alexander of Tunis: My Lords, I declare an interest as a director of a hospital management company. Is my noble friend aware that negotiations are in progress to enable health authorities to make the best use of available land for medical purposes?
Lord Skelmersdale: Yes, my Lords. I am grateful to my noble friend for bringing out that point. Health

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authorities now have a full guidance package to enable them to proceed with a systematic rationalisation of their estates. And they are doing just that.
Lord Cledwyn of Penrhos: My Lords, is it not the case that paragraph 11 of the National Audit Office report makes it clear that the noble Lord's department has not monitored the level of expenditure required to clear backlog maintenance and does not know whether the position has improved or deteriorated since it was assessed at £2 billion in 1982? The noble Lord must reconcile what he has said with what is said in the report. What has he to say about that?
Lord Skehnersdale: My Lords, what I can say is that earlier this year a minimum data set on the estate was agreed and issued to the National Health Service as part of the KŐrner initiative on health service information. I do not accept that we are doing absolutely nothing in this area.

Airport Security: Kuwaiti Hijacking
2.44 p.m.
Lord Gridley Lord Gridley asked Her Majesty's Government:
Whether an investigation has been completed to ascertain how and where terrorists were able to board the Kuwaiti Airways jet hijacked on 6th April 1988, and whether they consider that adequate international co-operation is forthcoming.
The Minister of State, Foreign and Commonwealth Office (Lord Glenarthur): My Lords, the Airports' Authority of Thailand officially announced on 28th April that its investigation had shown that weapons used to hijack the aircraft were not taken aboard the plane at Bangkok Airport. We are pressing in ICAO, Summit Seven and the EC for a team of international experts to be set up under ICAO auspices to investigate future hijackings. We always seek to improve international co-operation against terrorism. The five-point plan which my right honourable and learned friend the Foreign Secretary put forward on 25th April contains concrete proposals to that end.
Lord Gridley: My Lords, I thank my noble friend for that Answer. With reference to the recent hijack, will he accept that there is considerable anxiety among business people who have many miles to travel by air on duty and among others who travel? They wonder whether they might land up in a difficult situation. I accept what my noble friend says and I am grateful for the information he has given to the House.
Lord Glenarthur: My Lords, I am grateful to my noble friend. I appreciate that there is anxiety but I hope that he will realise that we are doing what we can. With our EC colleagues and in ICAO we have put forward the five-point plan to which I referred of
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proposals to strengthen international obligations and procedures in relation to hijacks. I hope that it meets with success.
Baroness Burton of Coventry: My Lords, arising from the Minister's reply, do the Government feel able to push a little further with ICAO in suggesting that a report on security at all airports throughout the world could usefully be published for the benefit of travellers and airlines alike? Does he feel that the Government could put this forward at the next meeting of ICAO?
Lord Glenarthur: My Lords, the noble Baroness will be aware that two of the proposals in my right honourable and learned friend's five-point plan are aimed at strengthening airport security. The difficulty is that it is essential to secure international agreement if any of the provisions are to work. We are striving for that at the moment, but that is precisely why our efforts must lie in ICAO. I cannot say whether it will be possible to put this forward at the next meeting but certainly those two factors go a long way towards meeting the noble Baroness's point.
Lord Mellish: My Lords, the Minister will be aware that the terrorist incident in Kuwait shocked the whole civilised world. Is he aware that one of the most shocking parts of the story is that the terrorists involved seem to have got away scot-free? What has been done to find out who they were, and what will happen to them?
Lord Glenarthur: My Lords, we understand the motivation of those who wished to save the lives of the people on the aircraft, and we were relieved that the remaining hostages were freed unhurt. However, we regret that the terrorists seem to have been allowed to go free.
Lord Cledwyn of Penrhos: My Lords, is the noble Lord aware that we support the Government's stand on this matter generally and also the five-point plan to which he referred? Can he say what response the Government have received from our EC partners to the five-point plan? Can he further say where there is any chance or hope that Algeria will sign the 1975 Hague Convention and whether France will support Her Majesty's Government in the five-point plan and in persuading Algeria to do that?
Lord Glenarthur: My Lords, we shall have to hope that the last point of the noble Lord's supplementary question is achieved. On the outcome with our European Community colleagues, Foreign Ministers of the Twelve agreed on 25th April that counterterrorism experts should meet soon to examine the hijacking and its aftermath. Our proposals were discussed by an ICAO sub-committee on 29th April and 11th May. The United Kingdom representative was asked to provide a paper for further substantive discussion in early June, and we shall follow closely discussions in ICAO and are pressing EC and Summit Seven partners to support our proposals.
The Earl of Selkirk: My Lords, have the Thai Government offered any explanation of how weapons got on to the aeroplane before it reached

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Iran? Surely the staff on the aeroplane must have had some information about where they came from.
Lord Glenarthur: My Lords, the Airports' Authority of Thailand carried out an investigation which showed that the weapons used to hijack the aircraft were not taken on board the plane at Bangkok Airport. I am afraid that I can go no further than that.
Lord Wigoder: My Lords, if the weapons were not taken on board in Bangkok, will the Minister remind us of the other possibilities?
Lord Glenarthur: My Lords, I should imagine that they are legion. However, I can only report the result of the Thai authority's investigation.
Lord Mackie of Benshie: My Lords, I gather that the Minister is in some doubt as to the outcome of the investigation in Thailand. What kind of international authority can we have to ensure that international airports throughout the world, which are under the control of their own governments, are in fact secure?
Lord Glenarthur: My Lords, I think that my right honourable and learned friend's five-point plan goes a long way to addressing that particular matter. However there are already a number of relevant international conventions to deal with international co-operation on aircraft terrorism; such as, the 1963 Tokyo Convention, which required states to take all appropriate measures to restore unlawfully seized aircraft which land within their territory to lawful control. There was also the 1970 Hague Convention and the 1971 Montreal Convention which are also concerned with ensuring that offenders are brought to justice. The International Civil Aviation Organisation also produced guidance on responses to hijacking.
Lord Mackie of Benshie: My Lords, the Minister is reading from his brief but the fact of the matter is that, somewhere along the line between Bangkok and Kuwait, all those conventions did not work. Is that not the case?
Lord Glenarthur: My Lords, the noble Lord is quite right. It is all very well having such conventions but of course it is most important that they should function properly. That is precisely why my right honourable friend put forward a five-point action plan which covered many of the matters which concerned all of us and which we hope will lead to preventing the repetition of such a terrible incident.
Lord Campbell of Alloway: My Lords, does the Minister agree that although security measures on boarding an aircraft lie at the heart of the matter even if they are agreed internationally they are not really enough unless there is some further dimension, or further convention, to allow for some form of entirely new international verification that they will be carried out?
Lord Glenarthur: My Lords, that is what the procedures are designed to achieve. There are a number of different possibilities which we encourage
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all those with whom we have dealings—whether within Europe or elsewhere—to improve, build upon and to think further about. I can assure my noble friend that we do not cease to press where we can in that regard.
Lord Brougham and Vaux: My Lords, can the Minister say whether there is any truth in the rumour that the weapons might have been put into the plane with the food?
Lord Glenarthur: My Lords, I can go no further than to say that the investigation in Thailand showed that the weapons used to hijack the aircraft were not taken on board in Bangkok.

Salmon: Protection of Stocks
2.55 p.m.
Viscount Thurso Viscount Thurso asked Her Majesty's Government:
Whether in view of the high level of drift net catches being landed by the Donegal fishery they are concerned that Scottish salmon are being illegally intercepted on the high seas and whether it is intended to order the fishery protection squadron to take any action to protect Scottish salmon stocks.
The Minister of State, Scottish Office (Lord Sanderson of Bowden): My Lords, any illegal activity affecting Scottish salmon stocks, wherever it be carried out, is a matter of concern to the Government. As in previous years, fishery protection vessels will be deployed within the Scottish sector of the UK fishery limits with a view to maintaining the effort towards enforcing fisheries legislation at sea with particular problems targeted for special attention. Additionally, aerial surveillance will be undertaken by fixed-wing aircraft and helicopters in order to curb the activities of those who fish illegally.
Viscount Thurso: My Lords, I thank the Minister for his Answer. However, is he aware that illegal fishing is supposed to be taking place as far as 200 miles out on the high seas? Does he agree that the tonnages of salmon being landed in Donegal are probably twice those reported and could account for the whole of the missing Scottish salmon catch?
Lord Sanderson of Bowden: My Lords, that is a fairly wide question. I agree with the noble Viscount that it is each nation's responsibility to protect the fishery within the 200-mile economic zone of that nation—in this case, Ireland. Under international agreements an Irish vessel could be pursued from within our waters if it is caught within our 200-mile economic zone. However, we have no record of that "hot pursuit" process having occurred so far.
As regards catches, I understand that the nominal figure for 1986 was approximately 1,730 tonnes—that is, the Irish figure of landed and reported catch—as opposed to the Scottish figure of 1,270 tonnes.
Lord Campbell of Croy: My Lords, is my noble friend aware that at least two responsible bodies

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within the Republic of Ireland have drawn attention to damage being caused to stocks of salmon in rivers belonging to other countries? Will the Government raise the matter with the Irish Government?
Lord Sanderson of Bowden: My Lords, I understand the Irish Government commissioned a report, published in November 1987, which dealt with their own salmon fishery problems and the illegal fishing of salmon and its possible impact on stocks and angling opportunities. The report of the Irish Salmon Review Group, issued last year, referred to illegal fishing and made recommendations for additional central measures. However, none of those measures has yet been accepted by the Irish Government with the exception of the weekly close time which they intend to change.
Lady Saltoun of Abernethy: My Lords, do the Irish have a fishery protection squadron and, if so, where does it patrol? In any event, who is responsible for policing the high seas outside the in-shore fishing limits?
Lord Sanderson of Bowden: My Lords, I am sorry if I did not make myself clear. The responsibility lies with the fishery protection service of the nation state concerned up to the 200-mile economic zone. That, of course, includes its own 12 mile in-shore limit. As regards the size of the Irish fishery protection service, yes, it is smaller than our own. However, there are good relationships between our own fishery protection service and the Irish service.
Lord Morris: My Lords, can my noble friend tell me what criteria determine the nationality of a salmon?
Lord Sanderson of Bowden: My Lords, no; I cannot.
Lord Mason of Barnsley: My Lords, is the Minister not aware that the Atlantic Salmon Trust and the Salmon and Trout Association have constantly expressed concern about illegal drift-netting off Ireland and in the Atlantic? Surely much more must be done by Her Majesty's Government if they are going to treat salmon conservation seriously. Secondly, the noble Lord ought to consider banning the nylon monofilament gill net. Thirdly, in view of the large expansion of the grey seal population in Scottish waters—90,000 grey seals are devouring thousands of Atlantic salmon every year—there ought to be a grey seal cull as well. If the Minister took those three positive steps we would be more interested in his positive intent to conserve the salmon.
Lord Sanderson of Bowden: My Lords, I am aware of all three points raised by the noble Lord. However, a seal cull is well wide of this particular Question; no doubt the noble Lord can table a Question for me to answer on the subject. Coming from north of the Border, I agree, of course, over the monofilament net situation.
Lord Kimball: My Lords, without in any way wishing to downcry the damage that is done by the
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Donegal fishery, will my noble friend bear in mind that 1985 was a dry summer. The toll of salmon taken in nets around the coasts of Great Britain, and also Ireland, was very large indeed. It accounted for the fact that in the autumn of 1985 there were only one-third of the fish there should have been on the spawning grounds—to reproduce themselves. Surely that must be a factor causing the bad spring fishing now.
Lord Sanderson of Bowden: My Lords, I am grateful to my noble friend for that information. We are particularly concerned about the returning grilse to Scottish waters. In fact that is a matter which causes us some concern in the whole question of the amount of salmon being taken, as has been indicated by the noble Viscount, Lord Thurso, in his Question.
Lord Grimond: My Lords, I apologise if I misheard the Minister. While he told us that there have been various reports commissioned by the Irish Government, did he actually answer the question as to whether Her Majesty's Government have approached the Irish Government, or had conversations with them, on the problem which is clearly a joint one?
Lord Sanderson of Bowden: My Lords, I think I clearly indicated that there were ongoing discussions between the fishery protection services of both countries. That is the area where we have to look as regards safeguarding stocks. I can assure the noble Lord that as far as enforcement is concerned, dialogue is taking place between my department and the department concerned in Dublin. I can say no more than that.
Lord Moran: My Lords, is the Minister aware that the tagging of smolts has shown that salmon heading for Welsh rivers as well as Scottish—
Noble Lords: Reading!
Lord Moran: —are endangered by the fishery? Does he recall that the Irish report to which he referred pointed out that drift netting off Ireland is putting at risk other nations' stocks? Will he therefore take every opportunity to raise this matter with the Irish Government at ministerial level in Dublin, Brussels and elsewhere?
Lord Sanderson of Bowden: My Lords, I am very well aware of what the noble Lord says about the effect that the over-fishing of salmon stocks can have not only on Welsh rivers but on Scottish, and other rivers for that matter. This is a matter that must be addressed on an international basis.
Lord Carmichael of Kelvingrove: My Lords, will the Minister respond to the statement made by the noble Viscount, Lord Thurso, about the official figures of landings in Ireland and the suggestion that the unofficial figures were much higher? Will he say whether there have been any visible signs that that is having an effect on salmon going back to the rivers in Scotland?
Lord Sanderson of Bowden: My Lords, the noble Lord will realise the difficulty in establishing the correct figures. Therefore, I should not like to speculate on how much greater the actual catch is than the officially registered catch. We are concerned about the effect that it is having on Scottish rivers and we shall look carefully at what is happening not only in Irish territorial waters but within its 200-mile economic zone.

Coal Industry: Future
3.2 p.m.
Lord Dormand of Easington Lord Dormand of Easington asked Her Majesty's Government:
What plans they have for the privatisation of the coal industry.
Viscount Davidson: My Lords, the percentage of our energy consumption met by private sector industries has increased from 41 per cent. in1979 to 73 per cent. now, and will increase to 87 per cent. with the privatisation of electricity. This demonstrates Her Majesty's Government's commitment to return nationalised industry to the private sector. Coal is no exception. While Her Majesty's Government have no plans at present for coal, we clearly have ambitions.
Lord Dormand of Easington: My Lords, in view of the slight indication at the end of the Answer, why do not the Government come clean and say that they will privatise the coal industry at the earliest possible moment? We all know that an increasing amount of work within the industry is being given to private contract. Is the Minister aware that if the coal industry is privatised it will receive no support from the miners, not least because of the closure of unprofitable pits, with the loss of thousands of jobs—that is still going on—and because new and profitable pits will prove rich pickings for people whose only concern is to make money and who have no interest in the industry or the country?
Viscount Davidson: My Lords, your Lordships will appreciate that the measures required to transfer and allocate mining reserves and liabilities are complex and will take some time to prepare. Her Majesty's Government do not want to deflect the industry's management from its objective of the restructuring of the industry so that it can compete profitably in the market place.
Lord Strabolgi: My Lords, in the event of nationalisation, what is to happen—
Noble Lords: Privatisation!
Lord Strabolgi: My Lords, it means the same thing. What is to happen to the coal research station which is doing such important work with regard to coal liquefaction to replace petrol? Is the noble Viscount aware that in the days before the last war when the coal industry was owned by private colliery companies nothing was done in that direction?
Viscount Davidson: My Lords, I am grateful to the noble Lord for pointing out that matter. As I said, at present we have no plans to privatise coal.
Lord Harmar-Nicholls: My Lords, if it ever were decided to put the coal industry on offer, in view of the questions that we have just had, does he think that there will be any takers in this country or anywhere else?
Viscount Davidson: My Lords, by the time we come to privatise coal, I am sure that my noble friend will realise that there will be takers.
Lord Mason of Barnsley: My Lords, is the noble Viscount aware that privatising the coal industry could mean that there will be many dire days ahead for the coal communities in the North of England? With the privatisation of electricity, which is the forerunner to coal, it is estimated that up to 160,000 jobs will be lost, again mostly in the coal communities. With unrestrained cheap coal imports and, after privatisation, fewer mines, there will be a serious unemployment problem, again in the North, which will emphasise the North/South divide. The policy is unwise, dangerous and should be abandoned.
Viscount Davidson: My Lords, I do not want to get into a political debate at this stage because I have already said that we have no plans to privatise coal. For those who work in the coal industry I can say that the necessary investment in mines will be provided by private capital markets subscribing to a profitable enterprise.
Lord Orr-Ewing: My Lords, has my noble friend considered loosening the regulations which prevent people from doing open-cast mining for coal? Is it necessary to continue with those regulations which have been in effect unnecessarily for a long time?
Viscount Davidson: My Lords, I shall convey that point to my right honourable friend.
Lord Stoddart of Swindon: My Lords, the noble Viscount denies having plans to privatise the coal industry, but he spoke of ambitions. Is he aware that the coal industry was nationalised because of the enormous chaos that was caused by the private ownership of the coal industry pre-war'? In his ambitions, does he advocate a return to that chaos and the closing of mines before their economic reserves are used up? Is that not against the national interest?
Viscount Davidson: My Lords, I did say that I did not not think that this was the occasion for a political debate as we do not have any plans. It is a hypothetical question and I do not believe it requires a hypothetical answer.
Lord Dormand of Easington: My Lords—
Noble Lords: Order!
Lord Denham: Will the noble Lord give way?
Noble Lords: Order!
Lord Denham: My Lords, we have been 30 minutes on Question Time today. The House generally accepted that 20 minutes was the ideal. We sometimes go a little over. I believe that we should end. If the noble Lord, Lord Dormand, would like to put his question and my noble friend to answer it, we can then perhaps move on to the next business.
Lord Dormand of Easington: My Lords, I am grateful for that sympathetic view. I was merely going to point out—
Noble Lords: Question!
Lord Dormand of Easington: My Lords, from my short time in the House I understand that the convention is that we are allowed a second question.
Lord Denham: My Lords, may I put the noble Lord right, because this point has been misunderstood? No noble Lord who asks a Question has the right of reply at the end. The general consensus is that the noble Lord who puts the Question may ask one supplementary question. Out of politeness he then gives way to other noble Lords in different parts of the House. If he wishes to ask a further supplementary question later on, provided that it is not too much later on, he is entitled to do so.
Lord Dormand of Easington: My Lords, I am grateful for that advice. In view of the kindness which is always shown in the House, I now put a second question. Does the noble Viscount accept that privatisation will inevitably mean more open-cast mining, which has few friends anyway, and a considerable increase in coal imports?
Viscount Davidson: My Lords, no.

Business
3.8 p.m.
Lord Denham: My Lords, it may be for the convenience of the House if I say a word about the length of speeches in today's debate standing in the name of the noble Lord, Lord Basnett, to which your Lordships have agreed to apply a five-hour time limit. The number of speakers is such that it is not necessary to apply a formal time limit, but I am sure that noble Lords would agree that it would conform with the spirit of these debates if they would keep their speeches within the 15 minutes maximum time limit of speeches recommended by the Procedure Committee.

Petition: Education Reform Bill
Baroness Seear: My Lords, I beg to present a Petition from members of university communities, which prays that this House will amend those Clauses in the Education Reform Bill which seek to stifle and fossilise our universities and inhibit them from continuing to make their contribution to the life and prosperity of the
United Kingdom.
The Petition bears 20,600 signatures.
Petition presented.

The Mentally III and Handicapped
3.10 p.m.
Lord Basnett Lord Basnett rose to call attention to the needs and problems of people who are mentally ill and mentally handicapped and their families; and to move for Papers.
The noble Lord said: My Lords, it is with a sense of humility that I move the Motion standing in my name on the Order Paper. It is with humility because I know that some of your Lordships speaking after me, because of close associations with organisations concerned with mental health and handicaps, will speak with more authority than I. I speak with humility because my experience has made me more intimate with the questions than the answers.
However, I believe that there are three questions which clearly deserve an answer. First, are we sufficiently aware of the size of the community of people with mental illness and disability and the scale of their needs and their families' needs and problems? Without knowing that, we do not have a sufficient political priority to provide the resources. Secondly, are we aware of our failure sufficiently to meet their needs and the consequences for them of that failure? Lastly, as an inevitable consequence of the second question, if we are becoming aware of those matters, why has this failure occurred and what do we need to do about it?
The scale of the problem is fairly well documented. The 1975 White Paper stated that each year some 5 million people consult their general practitioner about a general health problem, with 600,000 of them being referred to a specialist service. More recently, MIND has said that over a lifetime one in four people will experience psychiatric symptoms. Of those, more than one in five will seek help from a general practitioner while over one in 10 will be treated with drugs. Out of every 1,000, 17 will be referred to outpatients. According to MENCAP the figure for mental disability shows that there are 1.2 million people with that handicap; over 2 per cent. of our population.
That large and, with the growth of dementia, growing population has led one author, taking an international view, to describe this as, a pandemic of mental disorder, the scale of which has not entered the public's awareness, not drawn the attention it deserves from the media and not gained the political priority and resources it deserves.
A doctor friend of mine has explained that last point by suggesting that there are no votes in mental health. That is no doubt unjustified and perhaps as unjustified as drawing your Lordships' attention to the fact that when the National Health Service was debated on 28th March, of the 30 speakers in that debate not one mentioned the issue of mental health. While MIND and MENCAP are doing sterling work in arousing public awareness, this is a task which needs government resources. A government funded educational campaign would increase public awareness and understanding.
As we become more aware of the failure properly to implement current policies, the consequences of that failure become more and more obvious. Care

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and support by the professionals has been too little available, with a consequent and sometimes unbearable pressure upon the family. In the absence of family support, in too many cases the mentally ill or mentally disabled face unsuitable temporary accommodation, institutional hostels, prison or the company of vagrants. There is no doubt that that has occurred.
The Audit Commission Report of 1986 stated:
"It must be a matter for grave concern that although there are 37,000 fewer mentally ill and mentally handicapped patients today than there were 10 years ago, no-one knows what has happened to many of those who have been discharged".
Despite the 1986 Audit Commission report, the DHSS has not funded a full-scale enquiry to discover what has happened.
However, there is some anecdotal evidence. The Esther Rantzen programme "That's Life" has on three Sundays dealt with community care and mental health; two were concerned with what happened to people discharged from mental hospitals and one with families which care for them. On our screens was a picture of distress, chaos and disorder. After the programme they received far more letters than usual, which divided into five categories: from parents about the distress of parents trying to cope with a mentally ill relative; from relatives and hospital staff about the fate of those discharged without parents who because they have no parents cannot cope; from relatives, patients and staff about the fear of relatives and patients at the prospect of hospital closures; and from relatives and prison staffs about the plight of the mentally ill who commit offences; and lastly, from the general public, outraged at the state of mental health care.
The Minister of State has asked for a selection of those letters. Perhaps I may quote a passage from one of them. It is from a family who has a mentally ill daughter and who has had to put the other children in boarding school in order to take care of her. It describes the circumstances at home, and says:
"I get a higher rate of attendance allowance and invalid care allowance. It comes to about £50 altogether and those few pounds absolve the State from any further responsibility".
There is no doubt of the misery, chaos and disorder of some of the mentally ill and their families in our society.
The causes arise from a combination of the failure to provide or ensure the provision of resources and a reduction of essential support from housing and social security, together with a failure to co-ordinate our services. On available financial resources, the hospital and community health service spending has increased by only 1 per cent. per year in real terms since 1980–81. The Government have agreed that 2 per cent. growth per year is necessary to meet demographic changes and advances in medical technology. On this basis hospital and community health services have been substantially underfunded since 1980. In addition to that, local authority expenditure has not risen to provide the services needed to take account of the fact that in the past 10 years hospital in-patients have decreased by 16,800. In order to meet the needs of those people the Audit
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Commission has said that local authorities needed to have spent £240 million more in the past decade. In fact they spent £20 million more.
More generally, because of Government policy the low level of local authority response to the needs of community care is depressing. Less than one local authority in five spends as much as £2 per head of population per year on mental health services; three out of five have not increased their expenditure to keep pace. A further nine have actually cut their expenditure in real terms. And all that undermines the community care programme.
Housing is of course an essential component of community care and yet the housing investment programme has been cut by 60 per cent. in real terms since 1979. Housing subsidy has been eroded and council house starts are at an all time low. All of that again undermines the community care programme as do the problems of personal financial support. Debt and budgeting problems play a significant part in reducing a person's ability to continue living independently in the community and can cause an otherwise unnecessary return to hospital.
The impact of the Social Security Act 1986 can only mean fewer basic rights, more means testing and reduced financial support for many. In particular the introduction of a cash limited and discretionary social fund will worsen the plight of rather than assist the people with mental health problems who are trying to re-establish themselves in the community.
The familiar pattern of personal poverty, growing financial debt, poor housing and deteriorating physical and mental health is being reinforced. And that occurs within a structure of a mental health service which is confused and where responsibility and accountability are fragmented between different tiers of the National Health Service and local government. That must affect the way in which public funds are used to support community care policy. That makes the absence of recommendations from the Griffiths Report concerned with the coordination of health, social services, housing and the voluntary and private sector puzzling.
No doubt others will comment more fully on the Griffiths Report. I shall content myself with observing that there are welcome and unwelcome recommendations. For instance the recommendation that a Minister of State should oversee community care is seen by most as a good idea as is the recommendation that social service authorities should be supported by general and specific targeted grants providing a significant proportion of the total cost of the programme.
But while the emphasis on individual needs is welcome there is no mention of the service user's right to challenge the decisions. The clear implication that families or informal carers should provide the necessary care—only if this is impossible should public funds be spent—must be unacceptable to many while the question of means-testing which runs right through the Griffiths Report would make many people a good deal poorer.
One statement however within the body of the report reflects what I believe is a consensus as to how community care should be introduced. It is that:
"no person should be discharged without a clear package of care devised and without being the responsibility of a named care worker.".
I wish to conclude by suggesting five essential developments to bring about that situation. The first must be to ensure the availability of more financial resources to make a reality of community care. MIND has estimated that £500 million in five years is needed to finance the transition from hospitals to community care and that in addition a national care fund is needed.
Secondly, I think that consideration of personal income problems must have priority. A comprehensive disability income would begin to relieve these problems but would have to be linked to the provision of other forms of help, support and treatment. Perhaps as important is improving the availability of employment. The Government really should try to be more helpful in this area than they were, for instance, in insisting on the removal of your Lordships' amendments to the Local Government Act.
The third important consideration is the help for carers. Those relatives or friends who care informally for people with mental illness need help in cash and in kind. A proper carer's benefit would assist those who wish to care for a disabled relative, and effective support from health and social services would ensure that carers were able to continue caring for longer than they can at present.
Fourthly, there is the key problem which was not addressed by the Griffiths Report—that is, the coordination of health, social services, housing, the voluntary sector and the private sector. A good quality community mental health service will provide psychiatry, psychology, community nursing, occupational therapy and support to general practice linked to the provision of social services through field social work and home helps, together with housing management and peripatetic support to clients. Effective means of co-ordination of these are essential.
A mental health service development group which would have delegated budgets and would draw representatives from each of the agencies mentioned above is one suggestion for achieving that. A joint consultative committee could perhaps do that work. The Government in their review of the National Health Service will, I hope, give a higher priority to the question of mental health than we have seen in resource terms recently. Fifthly there is the key component of community care which is good quality housing and appropriate support. Most patients need support, help and attention at least from time to time; but they also need decent housing, either as individuals or in small groups, where they can obtain the support they need and where they can rebuild valued lives and go out into the community to make friends and build relationships.
If the Government are inactive on those issues, care will not be there in the community for those who need it. What will be there will be a growing demand
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to slow down releases from hospitals and institutions. None of us wants that. However, it is a situation which is a consequence of a series of policies, from the availability of resources through social security support to housing, all of which converge to the further disadvantage of the most disadvantaged group on our society—the mentally ill and the mentally disabled. The Government need to act now to repair the damage which has been done and to establish community care on a more caring basis. I beg to move for Papers.
3.30 p.m.
Lord Skelmersdale: My Lords, it is not often in this House that a junior Minister is asked to explain the Government's policy on an issue for which he has some executive responsibility. Mental illness and mental handicap are two such issues, and so I am grateful to the noble Lord for raising this important subject.
As we all know, nothing very fast or very dramatic happens in this area. But down in the jungle of statutory and voluntary provision something has been stirring in recent years. In the mental illness field, modern treatments such as the major tranquillisers and the anti-depressive drugs have led to enormous changes in the need for hospital provision brought about by a marked fall in the number of patients resident in hospital by half, to just over 60,000 in the last 20 years. Over the same period the policy of providing services better suited to the individual needs of mentally handicapped people has meant that the number of people destined to spend their lives in large mental handicap institutions has also fallen by about half to around 31,000.
That has resulted in a two edged approach to provision of care both inside and outside hospital. Care in the community has become the buzz word. This means moving towards a modern, locally-based mental health service involving very much more than the redistribution among health authorities of the resources presently contained in the large multi-district hospitals. Delivering a comprehensive range of services involves or should involve health authorities, local authorities (especially social services, housing, education and leisure services), the voluntary sector, the private sector, the families and friends of people with mental disabilities and last but by no means least, those suffering from mental illness or a mental handicap themselves. As health districts develop their plans for new mental health services, it will be essential for them to consider not only the span of services that they need to provide but also the extensive resources available from this range of interested bodies and individuals who can contribute to the development of a successful service.
The words of the Motion are interesting because they call attention to the needs and problems of mentally ill and mentally handicapped people and their families. Although I shall deal with those separately, I know I am about to shock many of your Lordships by asking, are they so very different? Indeed, almost the first question I asked when I took up my present portfolio was, what is the difference between mentally ill and mentally handicapped

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people? I got a very quick reply: the ill are potentially curable. Of course there are fundamental differences in the forms of care or treatment required by each group. However, going round the country as I do I am struck by the many similarities in services needed for those who are severely mentally handicapped or who are chronically mentally ill. In my view it is right that this should be so because the definition of care in the community covers both groups.
What we need in this country is an acceptance of the basic philosophy that people should not need to live in large hospitals unless there is no alternative. Government policy is that people should be encouraged to live at home for as long as it is practical and desirable for them to do so. That sounds obvious, but let us examine it. We know that almost all mentally handicapped people and most long-term mentally ill people can now live better lives in the community. Their position must be made secure by providing alternative accommodation, properly planned, to take account of the alternative facilities available; the capabilities of the caring and treating authorities, whether statutory or voluntary, public or private; and most importantly the views of parents and, whenever possible, those of the people themselves. In other words, the ideal is a personalised care plan.
However, before we can get to that we need, as my noble friend Lord Jenkin said in Care in Action in 1981, to set three tasks for the mental illness services. We have stuck firmly to those priorities and they remain at the centre of our current policy aims.
The first of these tasks was to create as quickly as possible a local service in those districts which still had little local provision. That involved reducing the catchment areas of mental illness hospitals to their own local health districts. The second was to provide in every district enough suitable accommodation for the care of elderly mentally ill people, taking account of the likely increase in numbers. The third task was to make arrangements satisfactory to patients and staff locally for the closure over the next 10 years or so of those mental illness hospitals which were not well placed to provide a service reaching out into the community and which were already near the end of their useful life.
It is by no means a matter of chance that in listing these three policy objectives I spoke of development of local services before I mentioned hospital closures. There is a good reason for that. Closure of mental illness hospitals is not a primary objective of mental illness policy. Any closures occur as a consequence and a consequence only of the development of local services and of the continuing fall in numbers of resident patients. I am most concerned to emphasise that no hospital should close until there has been a re-provision of a full range of replacement services. It is not our intention that all the large mental illness hospitals should close and, indeed, the majority of existing hospitals are likely to be incorporated within the future district-based services.
Our aim is to have a full range of local services, including day centres, residential homes, hostels, sheltered accommodation, supported lodging
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schemes, ordinary housing, group homes, social clubs, drop-in centres, sheltered workshops and self-help groups, as well as education, training and employment services. Achieving this calls for a considerable degree of co-ordination and collaboration among the providing agencies as well as improvements in communication between the caring professionals and their patients and families.
As in other areas of health and personal social services, it does not matter who provides the facilities so long as they are provided. I know that much still remains to be done to improve collaboration. There are many reasons—geographical, administrative and financial—why some health authorities and local authorities are still finding it difficult to get together to plan and provide integrated services. I do not shy away from the question of resources. There are always calls for more spending but innovation and good practice can be achieved in spite of all the difficulties. Health and local authorities in areas ranging from inner London boroughs such as Hackney on the one hand to West Dorset on the other have shown how things can be done to the great benefit of the users of the service.
I was surprised to hear the noble Lord, Lord Basnett, describe that as depressing. I hope that no speaker in the debate will blame rate capping. Noble Lords will remember that Hackney is one of the rate-capped boroughs. If Hackney can show the way forward, so too should those London boroughs which have not benefited from that financial reprimand.
I have mentioned the need for more resources. But it is equally, if not more, important to consider the management of those resources and to look at whether improvements are possible to secure the right services at the right time for those in the most need. It was for this reason that we asked Sir Roy Griffiths to undertake his overview of community care policy. Sir Roy has produced a very interesting report which we are studying closely. The issues it raises are important, too important to be buried, as Sir Roy said the other day, and demand the most careful scrutiny from all concerned with the future of care services. There are no easy answers to many of the points raised—to quote Sir Roy again
"no Rubik Cube which will be easily solved"—
and it is therefore right that we take the time necessary to analyse his recommendations thoroughly before deciding on the way ahead. We need, for example, to set the recommendations in the wider context by looking at the conclusions of other relevant work such as Lady Wagner's report on residential care. We also need to ensure that the outcome of this exercise is complementary to the results of our review of the health service.
I note what the noble Lord has said about a Minister of State with responsibility for care in the community, for example. There are other points in the report with which the noble Lord agreed but equally some with which he did not agree. That emphasises how difficult it is to come to a conclusion.
I should like to emphasise one point. We have said that we will bring forward our own proposals in due course. I can firmly repeat that commitment this

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afternoon. Weare listening carefully to all the views put to us as we frame those proposals and will particularly note your Lordships' comments this afternoon and take account of them in deciding on action.
I should now like to turn to some areas of special concern. Although an increasing proportion of mentally ill people have been discharged from hospital, it is sadly true that many people do not make a full recovery and are left with disabilities, at times severe, which leave them with special needs. How well those patients are cared for and how well the needs are met must be one of the standards by which the new pattern of service is judged. In the past far too much of the care for that group was available only in the large distant hospitals. The development of locally based services does not imply any lower degree of commitment on the part of Government to provision of adequate care for this most vulnerable group of patients. The problem that each local service must solve is how to provide that care without adding the burden of institutionalism to the disabilities of illness and handicap.
The provision of effective continuing care for those discharged from in-patient treatment is of central importance. Ministers have repeatedly emphasised in this House, in another place and elsewhere the importance of professional teams agreeing individual care plans with each patient, and where appropriate with their families, at the time of discharge. Clearly such a plan is likely to be in the interests of the patient once he or she is back in the community. With proper monitoring and co-ordination, especially in the case of those who are chronically ill or regarded as most vulnerable, it will help clinical teams to identify any problems as they develop and to act accordingly.
I have been speaking of those coming from long-term care. But we need to look critically at the needs of those who have come through an acute stage of their mental illness. The House will be aware that consideration has been given to the feasibility of some form of compulsory treatment in the community to prevent relapse in the case of certain chronically mentally ill people who do not see the need to continue medication voluntarily. This is a complex matter and there are conflicting views on the principle and practicality of such an approach. Several groups are party to the continuing deliberations, including the relevant professional groups, the Mental Health Act Commission and the patients' rights lobby. No specific proposals have yet been put to Ministers.
I believe the time is nigh when the interested parties must come to a decision one way or the other, otherwise we shall continue to drift from pillar to post. It is the patients who have had short-term admissions for treatment who will suffer.
I am particularly concerned that staff in the range of facilities within the community pattern of care—for example, day hospitals, day centres, outpatient clinics—work closely together so that the patient or his relatives do not lose touch with services and do not face the problems of having to find out for themselves what help is available.
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A measure of our concern is that we are currently considering what might be done to provide a system of co-ordinated continuing care for people chronically disabled by mental illness. I attended a working conference in February of this year, organised jointly by the department and the National Unit for Psychiatric Research and Development, at which a number of people from the health and social services discussed the detailed requirements of such a system. I also intend to be present at the national unit's annual conference in September when that work will be carried forward. A report of the February conference will be published by the national unit and I shall be studying its contents very carefully.
The Government recognise of course the immense contribution made by informal carers, and I should like to pay tribute to their dedication and humanity in the face of the daunting but worthwhile tasks they face. It is clear that those carers need advice and information about how to cope both with emotional and with practical problems, as well as the back-up of effective services which will enable them to lead as normal a life as possible. The department has instigated a number of measures aimed at improving matters in this direction.
First, we are funding a programme of research being undertaken by the University of York to investigate the financial circumstances of a sample of adult carers of working age, to investigate the nature and impact of caring responsibilities of spouses and to evaluate support services for carers. This will supplement the information derived about carers from the Government's general household survey and the national survey of disabled people, and will enable planning for community care to take account of the needs of all carers.
We are supporting a number of national voluntary organisations directly or indirectly interested in carers through our general scheme of Section 64 grants. These organisations include MIND—with which the noble Lord, Lord Ennals, has a long but sometimes interrupted connection—the Association of Carers and their Elderly Dependants and the Alzheimer's Disease Society. We are also providing funding through our Helping the Community to Care initiative for a number of projects specifically aimed at the needs of carers.
In 1986 the entitlement to claim the invalid care allowance was extended to married women, and as the overwhelming majority of carers are understood to be married women, this should offer some compensation for many people who have to give up work to look after a disabled relative.
I am aware of the concerns of many families and others involved in the provision of services that the community at large may not provide a welcoming environment for mentally handicapped people. In this context we have continually stressed the importance of consultation with the local authorities and winning the good will and support of potential neighbours. Authorities have been advised that possible initial resistance from neighbours should be considered when selecting sites for accommodation and that special steps such as liaison with local councillors,

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community groups, schools and youth groups are likely to mitigate those difficulties.
In the care of mental handicap in the community much depends on individual determination and good will to get together to make the machinery work. When we talk about joint planning for mental handicap services we naturally, as I have already said, first look to health authorities and social service departments to take the lead. However, other agencies are much involved.
I cannot overemphasise the fact that, like everyone in the community, mentally-handicapped people have a wide variety of needs. Some they share with the rest of us but others are special requirements depending on their disabilities. Consequently the range of general and specialised services necessary to meet all their needs will be provided not just by statutory bodies, whether local authority or health departments, but also by the voluntary and private sectors which have made and will continue to make an essential contribution. The Government do not passively welcome that contribution: we actively encourage it.
I should like to conclude by returning to what I said in my introduction. One of the central themes of our years in office has been the development of community care services. The Government remain committed to that and are constantly reviewing how it can best be achieved. We have a good record in providing more resources for service development. At 1985–86 prices gross expenditure in hospital and community health service spending on mental illness grew by 16 per cent. in real terms between 1978–79 and 1985–86 to £1,077 million. This year hospital and community health services expenditure will increase by about 10 per cent. in cash terms and personal social services expenditure by about 8 per cent., compared with forecast general inflation of 4.5 per cent. in the last year. This has benefited community care developments enormously and helped to extend the range of services provided throughout the country.
However, I agree finally with the noble Lord, Lord Basnett, that there is no room for complacency. The task of managing the resources devoted to community care is a major challenge for management and professionals at all levels. We must ensure that the result is the right services for those who need them most.
3.50 p.m.
Lord Winstanley: My Lords, the noble Lord, Lord Basnett, is to be congratulated on bringing forward for debate a subject of such immense importance.
It is a field in which he had a very distinguished record in his public life before he came to this House. As we know, he has done a great deal for the people with whom this Motion is concerned. In your Lordships' House there are many other people who have been concerned with this matter for very many years. This House has a proud record in this field. In 1983 the Mental Health Bill was debated night after night and a whole number of amendments were made to it. It was improved enormously before it was finally enacted. The noble Earl, Lord Longford,
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initiated two or three debates on this subject in the House and set up a committee of inquiry serviced by the Richmond Fellowship—a splendid body, which does such good work in this field. It presented a most detailed report, after lengthy inquiries, to Her Majesty's Government—to which we have not yet received a response. The noble Lord, Lord Allen of Abbeydale, who is to speak to us later, has always taken a very close interest in this subject, as indeed have many other noble Lords.
The noble Lord who introduced this debate was absolutely right in putting the figures with regard to the size of this problem quite starkly before your Lordships' House. It cannot be disguised. I do not want to guess the ratio but there can hardly be a family in Britain now in which there is not some member who at some time will require psychiatric treatment. Indeed in many families there will be several members who will need residential treatment, sometimes compulsory treatment within a mental health institution of one kind or another. This is a large problem that cannot be hidden or forgotten. As the noble Lord said, it is a growing problem.
The Motion draws attention to the needs and problems of people who are mentally ill and mentally handicapped and their families. We must never forget that the needs of those two groups—the people who are mentally ill or mentally handicapped and their families—are not always identical. Indeed sometimes they are in fairly sharp conflict. That is a matter about which we have to think constantly when making effective provision for the care of the mentally ill. We also have to think about the families and the impact on local communities and on other members of the family who are not mentally handicapped or mentally ill.
We are fortunate, as the noble Lord, Lord Skelmersdale, has told us in responding to the debate, that the reply will be given by the Minister who has departmental responsibility for this subject. We also have a noble Lord who has a deep personal commitment to it and parts of his speech today sounded to me as if they were his own words, not just those of his private office. I believe that his heart is in the right place—whether he is free to do with it what he wishes we do not know. However, it is reassuring to know that we have a Minister with some departmental responsibility for the subject and who takes a great interest in it.
By curious coincidence—something of which I am quite sure the noble Lord, Lord Basnett, was unaware—shortly this afternoon the All-Party Mental Health Group of both Houses of Parliament (of which I have the honour to be vice-chairman) will be meeting to hear an address by Professor Robin Priest, Professor of Psychiatry at St. Mary's Hospital, Paddington, and Registrar of the Royal College of Psychiatrists, entitled, What is Parliament Doing to Psychiatric Patients? I should have liked to hear that address before speaking to your Lordships. However, I have managed to extract one or two notes from it and perhaps it would not be altogether inappropriate for me to mention them—though it would not be entirely proper for me to make Professor Priest's speech before he makes it himself in about an hour's time upstairs.

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To noble Lords and to Members of another place, he will say:
"Mental health care has improved beyond recognition since the founding of the National Health Service".
That is absolutely true. Further, he will say:
"Psychiatry has been taken into the main body of medicine".
That is something which has taken a very long time. For many years it was regarded as totally separate. It was hidden away in separate institutions and not regarded as part of the ordinary body of medicine. He will also say:
"The standards of mental hospitals have been raised towards the levels expected in general hospitals. Almost all health districts have some psychiatric beds for their population".
That is encouraging, but how has that improvement been effected?
It has not been done by this Government, the last government or any previous government, but in the main by a gradual change in public attitude and an increasing understanding of the nature of mental illness and mental handicap. Without that increased public understanding, almost nothing could have been done. The fear and misunderstanding of mental illness and the stigma attached to it did so much to delay and obstruct developments of many kinds.
In his response the noble Lord, Lord Skelmersdale, said many things of great interest—I wish I had the text of his speech before me. There is so much of it that I should like to look at later. He said that we want to see modern, locally based mental health services everywhere. I should like to see that too but I should also like to know by whom it will be controlled. I will come to that point in a moment. Later in his speech he went on to say that no hospital should close until there had been a re-positioning of the services previously provided by the hospital.
We have been saying that for years. We are all in favour of community care. We are aware that community care is not a cheap option. But in very many cases it is the better option for the patients and their families. This is not a party matter; members of all parties and of none have said that we should not start closing down the large mental institutions and hospitals until we are quite sure that we have in place in the community the organisations and the services to provide community care. If we do the one before the other, two things will result. We shall put the patients and their families in jeopardy and dislocate the local communities. This will cause a great deal of trouble and in the end do something to change the mental attitudes, which, as I have said, have improved so much in recent years. If one once causes that kind of trouble in local communities by not providing properly for the people who are mentally ill, it will be no time at all before the prejudices start to return and we find the old biases returning—and once you have those you have a battle indeed.
The noble Lord said that it does not matter who provides the various services as long as they are provided. I say that too. I am most interested in the Griffiths Report, which he will remember was released in almost total silence the day after the Budget. Fortunately it has since received a great deal
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of publicity. He will remember when we recently debated the report of Sir Donald Acheson on the public health function, and the noble Lord said, absolutely rightly, that those two reports would have to be looked at closely together. I agree with that. They will have to be looked at in conjuction. But they will have to be considered very soon.
It is not a subject that can be left. Something must be done urgently. We have seen so many committees of inquiry that have produced reports which moulder in pigeon-holes. The Griffiths Report must not do so. I am not saying that the Government must accept all the recommendations, but they must do something about the issue to which the report is addressed.
Who is to be responsible in the community for community care? Sir Roy Griffiths clearly says that it should be the local authority social services departments. In some ways that is putting the clock back. I do not think that that is too bad a thing. I said in the earlier debate concerning Sir Donald Acheson that if we did that, and if local authority services departments suddenly found themselves responsible for community care and other such services, there may be a case for reinstituting the old, very powerful and influential office of medical officer of health. One would then have a known, responsible official. Everyone knew who he was and where he was. The two reports must be considered in conjunction and very soon.
Looking again at the brief notes of the speech that Professor Priest intends to make at any moment, he refers to the local authorities' responsibilities. He may not state this in his speech but I can say it:
"Social workers are employed by local authorities—even those that work in hospitals. Some years ago the hospitals agreed to hand over the responsibility for providing Social Workers"—
we no longer have lady almoners in hospitals—
"to local authorities and the money for their salaries".
He goes on to say:
"Now the local authorities are unilaterally withdrawing the Social Workers from the hospitals and pocketing the change"
I am not at all sure that that is right, but if it is going to be suggested at an important meeting of Members of both Houses later today, I should like to know what the Minister has to say.
Social workers in hospitals do a very important job indeed. They take most of the pressure off the ward sister. They answer questions. They deal with immensely complicated forms concerning this, that or the other benefit and the information that has to be sent to the department if an individual's circumstances change. Those workers are immensely important. They are employees of the local authority social services department. Is it true that the local authorities are withdrawing them? If they are, what is being done about it? I should like to hear an answer to that question.
I should also like to hear the preliminary reactions of the Government to the suggestion of Sir Roy Griffiths about giving specific responsibility for community care to local authority social services departments. I am not taking sides on this for a moment, but I should like to know the answer. I hope that somebody will be put in charge and that we shall

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know who is in charge and who is responsible if things are going wrong.
I said in an earlier debate that I have had personal experience of this in many ways. I have had many years in general practice and working in hospitals. I did my medical training long before the National Health Service started in 1948. Such knowledge as I gleaned about mental health—and teaching was very rudimentary in psychiatry—was in the huge mental institutions which were the most dreadfully impersonal places. I am delighted to see the improvement that has been achieved in recent years, brought about very much by a change in public attitudes rather than by government. That change has been of immense value. But I should be terrified if I thought that we were going to return to the old days.
However, let us look at some of the problems of introducing the concept of community care. I again quote two examples. One can have disasters of both kinds. In many cases it is better for the patient and the patient's family if he or she can be cared for adequately in the community. Of course one must have the back-up services; one has to have the social workers. One has to have the occasional respite for holidays with residential centres and day care centres to give everyone a proper rest. However, if these matters are not dealt with properly on both sides there can be disasters.
I had experience of two such disasters. One concerned a young man in a hospital who was almost institutionalised, having been there for many years. He was about to be discharged. The local authority had found him a flat which he had been taken to see. There was a social worker attached to him who was going to look after him. He had been in hospital for so long that he had no idea how he would manage in the community. We made a television programme, which included an interview with this young man, explaining the concept of community care. Before that programme was transmitted, so frightened was this man of being discharged that he committed suicide in the hospital. That is one case on one side.
The other case concerns a consultant pathologist in the Manchester area whose daughter was a social worker in a hospital in the South-East. She had a patient in hospital who was mentally disturbed and who was discharged for community care and put into a hostel which he did not like very much. He rather blamed the social worker for the conditions in the hostel. One day he marched into the hospital and stabbed her to death. I do not wish to say anything about the lack of security arrangements in the hospital; the fact that the panic button did not work; or that a patient could walk into a private office in a hospital without being stopped. I say nothing about that. However, the dangers of pursuing community care without immense sensitivity and without providing all the necessary resources are very serious indeed and should be borne in mind.
I hope therefore that when the noble Lord speaks to us again, as I know he will with leave, he will tell us that the Government will not pursue this question of closing down the institutions without first making
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sure, as he said he feels we ought, that the services are already in place in the community. We should halt the one until the others are in place. Perhaps we should also look at other legislation that is going through the other place and your Lordships' House which also affects the mentally ill and the mentally handicapped. The social security legislation, as I pointed out in another debate initiated by the noble Lord, Lord Banks, recently, makes the position immensely complicated. I have explained to noble Lords that the form of application for one benefit is now 17 pages long. It took me all day to help a person to fill it in. I cannot conceive that a mentally ill or mentally handicapped patient will ever be able to fill it in. They will need help.
We shall shortly have the community charge. We have many carers who are doing a great deal of work looking after mentally ill or mentally handicapped people. They are extremely concerned about what will be their situation under the new law, if and when it is finally enacted.
I am quite sure that I have said enough. If I sit down soon I may be able to hear the speech of Professor Priest from which I have quoted so often. It will be made in a committee room upstairs. I say once again that it is a very important subject, as your Lordships' House has shown many times. We have in our House the first chairman of the Mental Health Act Commission. The commission has done very interesting work. We have a new mental health Act, which has done a great deal to increase the rights of detained patients. However, psychiatrists point out to me that as a result of that Act, and very properly, much of their time is taken up in adversarial situations, pleading one or other side of an argument about the release or further detention of a patient, rather than in looking after patients.
The situation in this field is not wholly satisfactory, although I acknowledge, as do others, that it has improved vastly in recent years. But there is room for much more improvement. I hope that we shall hear soon a firm and definitive statement about what Her Majesty's Government intend to do about the recommendations of Sir Roy Griffiths.
4.8 p.m.
The Lord Bishop of Southwark: My Lords, I too should like to thank the noble Lord, Lord Basnett, very much for enabling us to talk and think about this subject today. I realise that I shall cover some of the same ground that has already been covered in all three speeches. It is almost impossible to avoid this with such a wide topic, but perhaps I can discuss it from a slightly different angle. I found the speech of both the Minister and the noble Lord, Lord Winstanley, very interesting and helpful.
There is a fascinating comment in paragraph 7 of the introduction of the report by Sir Roy Griffiths where he says:
"To talk of policy in matters of care except in the context of available resources and timescales for action owes more to theology than to the purposeful delivery of a caring service".
The implication of that sentence, I fear, is that theology offers little help to those who have to get on with the job. Not so. Whatever the constraints—and we all recognise that they are considerable—those on

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the ground need to know in which direction they are trying to move and why. Otherwise there are real dangers in any walk of life, but notably in this field, that administration can become an end in itself and bureaucracy will ride triumphant over the weightier matters of justice and mercy and hope. Theologians are well aware of the constraints imposed by human limitation and human sinfulness, but that does not render their insights valueless.
I shall illustrate that. I believe that it is very important to preface any consideration of the proper care of mentally ill or mentally handicapped people with a consideration of why we are doing it and what we hope to achieve. Like the Minister I was a bit surprised to find that we are discussing both mental illness and mental handicap at one time, because they are still so often confused in the public's mind, whereas it is true that mentally ill people usually recover or at least achieve significant improvement with the help of modern drugs. So their needs are usually rather different, if only in timescale or physical mobility.
The General Synod of the Church of England debated the role of the local church in relation to the needs of mentally handicapped people in 1984. In the course of that debate many speakers stressed the importance of changing public attitudes towards those who are mentally ill or handicapped. There is still so much to do in helping each other to recognise our common humanity and none of us is as sane or as stable as we sometimes like to think. That is something to which the L'Arche communities bear conspicuous and moving witness. I can commend them to your Lordships as places which are really very moving and very encouraging. They are one way of helping the mentally handicapped.
In our discussion we recognised how difficult it can be to change attitudes at first, because of the many fears and prejudices that exist. Belief in the goodness and care of God for all his people helps us to sustain and develop that conviction about our common humanity and that we are in a deep sense all of equal worth, no matter how damaged a person's brain may be.
I have recently been in touch with the chaplains of several large mental hospitals which lie in my diocese. As one of them put it, what mentally ill or mentally handicapped people need to know above all else is,
"that they are accepted, they are loved, they are listened to, they are cared for".
So the question is, as we have already heard, how best, with the help of all our modern medicine and economic wealth, can this be done?
That takes us to the debate about the relative merits and costs of care in the community or care in hospital. Within those two broad distinctions there are others. It is important to underline what has already been said: community care may mean—in fact it usually does mean—care at home by relatives, who are still the main providers. It may mean care in the small residential hostels, which may be purpose built and very good for that. It may mean living on one's own in a house or flat. Hospital can mean a huge Victorian mental hospital, albeit modernised in parts, and much has been achieved, as the noble
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Lord, Lord Winstanley, particularly emphasised. It may mean a psychiatric ward or wing in a ultra-modern district hospital, or—and this is important—it may mean a geriatric ward, not so marvellous, or a prison cell, and Brixton is a good example on my own doorstep.
Ever since the early 1960s there has been this strong pressure to empty the large mental hospitals and return people to the community, but what is now being recognised is that community care is a very broad term which can mean almost anything. It is far from proven yet that some forms of community care now on offer are an improvement on what patients had before in a more structured environment. Ethical questions arise about the quality of life which exists for the mentally ill or mentally handicapped and whether, for example, the supposed freedom which they now enjoy outside the institution is real freedom at all. What kind of freedom is it to sleep rough because there is nowhere else to go or, because someone is so confused and has fallen out of what little provision there was when he or she first came out, deliberately to break a window in order to get back into the relative warmth and security of a prison cell?
It is ironic that the number of mental hospitals we are closing at present is matched almost exactly by the number of prisons we are building. The savings may not be quite so great as we imagine. Security and a measure of control even in a large hospital can also mean—I do not say it always does and it certainly often did not in the past—a measure of affection, friendship and support which is not always available and certainly not automatically so in the wider community. We need to keep that in mind.
So the question of the quality of community care and the volume and use of resources to make it good is crucial to the whole debate, as the Minister pointed out very strongly. Cutting costs cannot be an end in itself. That is a profoundly ethical point. I should like to end by illustrating what I have been trying to say in a rather more general way and perhaps, as was also said in the earlier speeches in the same general way, by drawing on the experience of a relative of mine who died 18 months ago in her fifties. For many years Jean—I shall call her that—was a schizophrenic and she had spent many years in hospital. It was for the most part a rather poor, restricted life that she led there and she was not happy. Then, with the help of modern drugs, somewhere at the end of the 1960s or in the 1970s (I cannot remember exactly when) she went home once again to live with her elderly mother. The strain on both of them was very great. Her mother had to cope as best she could. Sometimes her daughter refused to take her drugs and became violent.
Apart from the little help that the general practitioner could offer—for the most part only on demand in a crisis—there was no trained support for either of them and some apprehension existed among the neighbours. Eventually that arrangement came to an end and it shows us clearly why drugs and discharge by themselves are not enough. Jean went to live in a part of the country where the health authority was one of the relatively few which were

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experimenting with a much wider range of support in the community. Jean had a place of her own in which to live. She had a patient and sympathetic GP who knew what to expect and did not mind the occasional bursts of rather irrational behaviour or demand. A community psychiatric nurse called regularly and a day centre was there, to which she went every week. There was also the availability of residential care for a week or two whenever she had a bad patch and needed some stabilisation.
For ten years she lived much more happily in that place, befriended by many neighbours and members of her local church. That is a picture of what good community care is all about. But it does require at least all those basic ingredients; without them it does not work. The Griffiths Report, if it is implemented in broad terms, will certainly help to target attention more effectively. I hope that that will happen, but unless the actual resources of trained nurses—and I do not think that has been much mentioned but it is extraordinarily important—and community psychiatric nurses, support for carers, the day centres and so on are also in place, and of course appropriate housing accommodation, we are doing mentally ill or mentally handicapped people no kindness by simply placing them in the community. In this, as in so many other things, there are no short cuts or cheap solutions. I am talking not just about money but even more about human care and, I would want to say, prayer.
4.21 p.m.
Lord Ennals: My Lords, it is a long time since we had a debate which concentrated purely on mental illness and mental handicap. I suspect there has not been one since the debates to which the noble Lord, Lord Winstanley, referred in connection with the 1983 Act. As a Member of the other place at the time, I was extremely grateful to your Lordships' House for making some improvements to that legislation. I wish the House equally well in dealing with other legislation still before us.
The debate takes place on the initiative of my noble friend Lord Basnett. I congratulate him on a very well-informed—in spite of his modest introduction—and sensitive speech which has produced most interesting contributions from the Minister, who introduced several additional issues, from the noble Lord, Lord Winstanley, and from the right reverend Prelate whose every sentence showed the tremendous human sympathy and understanding required in the debate.
We have now a very disturbing situation. On the one hand, there are public statements suggesting that mental illness and mental handicap are priority services and have been so for years and years. On the other, we have a situation of appalling human neglect, of which this House really must take urgent notice. The noble Lord the Minister gave some figures of expenditure including some increases. I suspect the increases—he was talking about community care—are mainly due to the increasing age of our population and the increasing incidence of senile dementia as well as the greater life expectancy
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of the mentally handicapped and the greater improvement rate of the mentally ill.
I became involved in this issue 20 years ago when, as a Minister, I had to deal with the report of the Ely Hospital in South Wales. That was the first of the "horror" reports on conditions in psychiatric hospitals for the mentally ill and the mentally handicapped. It was the first of many, awakening the government of the day—and the then Opposition too, because it was not a party matter—to a sense of urgency in dealing with the problem. All parties resolved that it had to be an issue of priority.
A start was made with new resources for improving old hospitals and building psychiatric wards in district general hospitals. My friend and boss at the time, Richard Crossman, played a very important role. Those involved then started to contemplate the planned reduction and eventual closure of old hospitals and the development of care in the community. I must say that I was a little disturbed to hear the Minister suggest today that it may be necessary to go slow on the plans for hospital closure. If he did not mean that, I will give way now to him. I do not want to misunderstand what he said.
Lord Skelmersdale: My Lords, may I intervene briefly to correct an obviously wrong impression. I did not in the least intend to suggest that we should go slow. I was suggesting that the policy should be strictly and rigidly adhered to. My own responsibilities include this matter. Where there is local argument over whether mental illness or mental handicap hospitals should close, this is something I look at most particularly.
Lord Ennals: My Lords, I am grateful to the Minister. I shall say what I was going to say in case he should come under pressure. It has taken a long time to initiate the movement towards hospital closure and the improvement of community services. It took a long time before the first hospital was closed in Banstead. If we turn our back on this, as I know some people are suggesting, it would be a terrible tragedy and we might not get the impetus again. I believe the emphasis must be on additional resources for community care.
Certainly, there is a severe problem of resources and of keeping a balance between the community services and hospital closures. Mental illness inpatient days have fallen by 20 per cent. since 1977 while expenditure on hospitals has increased by 7 per cent. in real terms since that time. This is partly because of increased unit costs as the number of patients has gone down. But as my noble friend said, the figures for local authority expenditure on community health services are moving nothing like so fast as the offsetting hospital rundown. To give one or two examples, day hospital and day centre places have risen by only 9 per cent. over five or six years and by only 9,000 in that period. In 1985, 24 local authorities still had no day care services at all for people with mental illness. The number of psychiatric nurses has risen, but only modestly. And that applies also to occupational therapists, of whom there is a gross inadequacy in the community. There is also the fact that housing provision has been greatly reduced

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as a result of the 60 per cent. cut in the housing investment programme.
A severe situation faces those who are discharged from hospital. An interesting question has been raised by the National Schizophrenia Fellowship. The director said:
"We badly need your help in asking Ministers what is actually happening and going to happen to people with a severe mental illness like schizophrenia. In 1986 25,000 people were admitted to hospital with schizophrenia, and of these 90 per cent. were re-admissions. Where were they between admissions—in the community of course—but where were they living and what care did they get?".
We know too of the very severe problem, touched upon by the right reverend Prelate, of the increasing number of people who are discharged from psychiatric hospitals and become homeless. In 1983 over 170,000 households applied to local councils because they had nowhere to live; only half were provided with accommodation. Many more of course did not trouble to apply because they did not believe they had a chance. Many mentally ill people living in large hospitals are there only because they have nowhere else to go. Often when they are discharged into the community there is not the careful planning there is supposed to be. Many of them end up sleeping rough on park benches, in grossly unsatisfactory temporary shelters, or in old institutions with emergency bed and breakfast services. Some—I am afraid an increasing number—simply take their own lives. That is a terrible tragedy which should not be allowed to occur.
Several years ago it became clear that the mental health services were heading for a crisis. People were daily discharged from hospital into a community which was not adequately prepared to look after them. The consequences have been very serious. I have been looking at the evidence given to the Social Services Select Committee of another place. I should like to pick out at random some of the quotes in the introduction to the report. MIND told the inquiry:
"A number of inappropriate discharges from hospitals are taking place when no real support exists in the community to care for that person.".
The Psychiatric Rehabilitation Association said:
"Many patients are being discharged to the community unable to cope with day to day living.".
The National Schizophrenia Association wrote that most chronic schizophrenics:
"are returned to their 'families', if any. The rest are on park benches, in prisons, doss houses or seedy and rapacious lodgings".
The Society of Clinical Psychiatrists wrote of:
"turning the mentally ill and unrecovered onto the streets, boarding houses, lodging houses, gutters and prisons.".
So it goes on. The report was published during 1984–85.
Shortly after that the right honourable Norman Fowler decided to ask Sir Roy Griffiths to recommend a course of action. In December 1986 the Audit Commission published a report which made a reality of community care and documented the grim situation. That was taken almost as a basis of evidence for Sir Roy Griffiths' report.
Clearly this is not the occasion for a detailed debate on the Griffiths Report. However, some of the
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comments that have been made today cause me a great deal of concern as regards the timing. The Minister implied that the Government would not reach conclusions until after they had decided on the outcome of the NHS review. That is a very long delay. It is not merely a matter of what the Government recommend but of what Parliament will accept. Surely the Minister will not say that, for example, by the end of this year the shape of the National Health Service will be absolutely clear. I plead with the Minister and the Secretary of State because if they are saying that they will not respond to Sir Roy Griffiths' report until the future of the National Health Service is decided I believe that to be a grave and serious error. We cannot wait that long.
Sir Roy Griffiths pointed to local authorities as having the main responsibility. How can they plan if they do not know whether the Government accept that basic recommendation or will reject it? A debate in the near future is urgent and decisions should be taken before the summer if local authorities are effectively to take the action that is required. I have chronicled the year after year delay—the Audit Commission, the Select Committee and now Sir Roy Griffiths' report—but meanwhile no decisions are being taken. That imposes terrible problems not only on patients and authorities but on families and voluntary organisations.
I should like rapidly to pay tribute to the voluntary organisations: MENCAP; MIND; the Richmond Fellowship; the Mental Aftercare Association; the Mental Health Foundation, which has a major role in research and grant making; the various local and housing associations set up for this purpose and working closely with social service departments. I believe that the voluntary organisations co-operate well together. For example, MIND and the Richmond Fellowship are members of a joint working party on the quality of care, a subject which has already been touched upon by the right reverend Prelate. It is very much the actions and the success of the voluntay organisations that have brought about a change in attitudes which all noble Lords warmly welcome.
We must deal rapidly with the main recommendations of the report from Sir Roy Griffiths. I shall not now enter into the details but only touch on important aspects. I believe that funding will be the central issue. I suspected that in his comments the Minister was a little complacent about the funding situation. I believe that if responsibility goes to the local authorities there must be a major injection of funds to enable them to develop community care facilities. I am talking not merely of institutional and residential care but of the support that must be given to families to enable them properly to look after the mentally ill or mentally handicapped person living within the family. Such people impose an almost intolerable strain upon the family unless support facilities are available.
It is important to note that the need is not only for additional revenue funds. I have argued MIND's proposal many times. There needs to be a bridging fund to provide additional resources allocated specifically for local authority use during the move-over period before the National Health Service can

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spare any of the savings for local authorities. The Minister has not commented on that proposal but I hope he will do so in his final speech.
Other proposals have been put forward by MIND and other organisations but I shall not now take time to enter into them. I plead with the Minister for an opportunity to debate the matter in this House in order to look at a whole series of proposals not only from Sir Roy Griffiths but from responsible organisations. I also plead with the Minister to deal with the issue that was rightly raised by the noble Lord, Lord Mottistone, on 4th May. It was the problem of families and relatives not being informed when patients were discharged and therefore creating extreme difficulties. The Minister accepted the difficulties but did not suggest any way in which the situation could be resolved. How can local authorities and families of patients being discharged from hospital make proper provisions unless they know that they will be discharged? We sought to achieve that in the Disabled Persons (Services, Consultation and Representation) Act 1986.
Today we are calling for a greater realisation of the effects on the happiness and mental health of so many people in society. They are suffering because they are in inadequate or inappropriate accommodation either in the health service or local authorities. I hope that action can be taken quickly by the DHSS and Ministers concerned and that there will not be delays. We need a properly funded major initiative in order to establish care in the community for those who do not need a regime of hospital-based treatment. That cannot wait for another year or so. It is required immediately if we are to fulfil the responsibilities which we have as a community for the growing number of people, including those with senile dementia, at present under the care of either the health service or local authorities.
4.38 p.m.
Lord Campbell of Croy: My Lords, I should like to join other noble Lords in congratulating the noble Lord, Lord Basnett, on raising this important subject today. He has drawn our attention to the needs and problems of the mentally ill and mentally handicapped. He has rightly separated them because they are in different categories.
I shall concentrate on mental illness, which can afflict anyone who has previously been normal and mentally well. Although the illness can last for long periods there is a prospect of improvement or cure. However, mental handicap is normally the result of a defect in or damage to the brain. While a great deal can be done for the person, complete transformation to normality cannot be expected.
Both serious mental illness and mental handicap cause disability. When we refer to disabled people we must include those who are physically entirely sound but are unable to function effectively or rationally with their minds. During 1981, the International Year for Disabled People, some of us made special efforts to promote public awareness of mental illness and handicap. As some noble Lords will know, I was chairman of that year for Scotland. Unless the population are informed and ready to encounter
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mental illness in public places, they may well react unkindly to what they see simply as eccentricity, blankness or aggressive attitude in a stranger whom they meet or observe.
Thirty years ago and more, people suffering from serious mental illness were put inside institutions, out of sight. Here I emphasise that a complete change in treatment has taken place. This requires more public knowledge and understanding. Advances in medicine and treatment in recent years have made it possible for many mentally ill persons to live nearly normal lives outside institutions. They usually continue to need supervision and may be on a regime of tablets, medicines or injections. Some also need access to a refuge, even to hospital, if there is a relapse. They cannot be thrown into the outside world and left to fend for themselves entirely. Of course, what I have been describing does not apply to those who are dangerous to others or to themselves. Those are a small proportion, I am glad to say, but they must still be kept under restraint.
The fact that more of these people can live and circulate in the community is to be welcomed. It is better for them, unless they are suffering acute distress; and it relieves the burden on the resources of mental nurses, who are specially trained and need a high degree of dedication. They, too, of course are also needed in community care. At the same time, arrangements must be made for care to be available in the community for those who have come out of institutions.
Reference is sometimes made to the Italian experience. This is not the occasion to go into it. I shall briefly record that, by national policy, the hospitals and institutions dealing with mental patients in Italy were closed over a short period, and in some areas of Italy virtually nothing was done to cater for the patients so dispersed. That has been an object lesson to other countries which observed what then happened.
Besides the necessary community care, there should be widespread awareness of what is entailed. That would be our aim. I believe that a valuable service was performed in a series of articles by Marjorie Wallace in The Times newspaper about a year ago. The subject of her articles was the illness which is responsible for about one-half of the serious mental disorders in this country, that is, schizophrenia. I understand that the cause of that illness is still not known for certain, or understood, and that there is as yet no cure for it. Progress has been made in successful treatment to reduce its unfortunate effects. In the public mind, it is unfortunately still regarded as a kind of Jekyll and Hyde phenomenon instead of what it in fact is; namely, a severe and distressing mental illness. I suggest, as I have on other occasions, that parliamentarians would make a contribution to better understanding by carefully refraining from using the terms "schizophrenia" and "schizophrenic" in other, usually derogatory, contexts. My only minor criticism of the series of articles is of its title. It was called "The Forgotten Illness". In my view the illness was never recognised or known by most people outside the medical profession so it had made no impression for the

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public to forget. For me, it is "the misunderstood illness."
Descriptions have already been given by earlier speakers of the mentally ill living in desperately inadequate conditions, in no state to look after themselves, so there is no need for me to add to those descriptions. The Motion of the noble Lord, Lord Basnett, includes reference to
"the needs and problems of … families".
That is highly relevant. There are far more problems for families with mentally disabled members than for those with physically disabled members. There are paradoxes, of which the public may not be aware. For example, schizophrenia does not normally strike and appear until the ages of about 14 to 16, and then it persists for life or for many years. The medical profession normally warns parents that the teenager concerned is likely to sever links with the parents as part of the illness and that that must be accepted by the parents. The advice given to them is that their presence, let alone any pressure, can make the condition worse. The result is that worried and willing parents are restricted in what they can do to help, and often cannot provide a home for the sufferer on doctor's orders. That is indeed a paradox that makes even more difficult the treatment of sufferers with that mental illness in the community.
I suggest that much more should be done to inform and brief officials and others whose work involves dealing with the public. This was illustrated by a case that the noble Lord, Lord Harris of Greenwich, raised in a debate on 4th March. It can be looked up in Hansard. Unfortunately, the case had a tragic ending—the suicide of a young man in custody. The behaviour of that young man while he was in custody exhibited the classic, easily recognisable symptoms of schizophrenia to anybody with any knowledge or experience of mental illness. It should be possible in future for such a case to be identified quickly as requiring medical, psychiatric attention.
I turn briefly to mental handicap. I wish to make one point. I believe that it is a mistake to generalise. Degrees of mental ability vary widely within the handicapped fraternity. I take as an example Down's syndrome. There are some who have great potential to enable them to live almost a normal life. It is wrong to assume, however, that they are all capable of reaching the same standards of attainment.
In making arrangements for Down's syndrome children, it must be recognised that some parents will have difficulties arising from complete inability to communicate by speech and from the problems of constant violence. In other cases the Down's syndrome child will be almost normal. One Down's syndrome family can have enormous problems requiring virtually 24-hour close supervision, while another can enable the child to live a near normal life. In both cases the parents will be devoted and caring, but the demands are of a quite different order.
A great deal remains to be done in spreading information and guidance about the mentally disabled. I urge the Government to play their part in full.
4.48 p.m.
Lord Thurlow: My Lords, we are privileged to have at the Dispatch Box the Minister whose special brief is specifically related to community care. We welcome this and wish him well.
Community care, as the noble Lord, Lord Ennals, told us, is very much under-rated in its requirements. I have had personal experience as a parent. I know the dangers, the risks and the embarrassments. I think that it is almost impossible to over-rate the problems that may ensue from any further escalation of the numbers of those who are coming out of the big institutions.
Looking back over 10 years we can acknowledge, as the noble Lord, Lord Winstanley, said, significant progress in public understanding. There has been a remarkable change. We are very grateful, as the noble Lord, Lord Ennals, said, to the voluntary organisations which are largely responsible for this. In particular, I should like to mention the National Schizophrenia Fellowship which does wonderful work in bringing us up to date. I am afraid the picture I still have is that, in spite of all the improvements and the increase in understanding, the amount of human suffering continues to grow. I believe that the numbers of patients are, if anything, increasing and likely to continue to increase. I am referring to the mentally ill and not to the mentally handicapped with whom I have had no particular personal association.
The Griffiths Report can be a milestone. We have had many excellent reports, as has been pointed out. But, in many ways, this report is different from its predecessors: it pinpoints a whole range of practical possibilities for action and does so in a very concise and forthright way. If many of the recommendations made in the report were implemented fairly quickly, this could create a revolution for many of the mentally ill. Sir Roy Griffiths has emphasised the fundamental need to have someone in a position to apply priorities and to see that those in need receive due care. There are so many overlapping authorities that it is necessary to have someone at the centre whose ministerial responsibility it is to keep track and to pull everything together, to encourage local authorities that are backward and to keep things moving generally.
In the other place on 31st March the Parliamentary Under-Secretary said that,
"we share the view that not enough resources have followed the patient out of hospital into the community".
She continued:
"The 31 planned closures of large hospitals will help to put that right".—[Official Report, Commons, 31/3/88; cols. 1313–1314.]
I do not follow that argument. Further "planned closures" imply a further great aggravation of the demand for community care which costs a great deal more per head if it is properly carried out with the right facilities and properly trained staff. It costs a great deal more per head than care in the big institutions. There still seem to be very great dangers ahead.
One of the main concerns is the number of separate services that all cater for different aspects of the problems of patients. For instance, the Griffiths Report proposes that the community care element of

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the social fund should be withdrawn from the social security system and the funds earmarked transferred to the social service authorities. We know that no department likes to lose part of its empire and one can see a ready-made scenario for the "Yes, Prime Minister" programmes. The Prime Minister calls in the Cabinet Secretary and says, "We have to stop this wrangle that goes on and on between the DHSS and the Department of the Environment", or whatever department is concerned; I do not point the finger at any particular one. Sir Humphrey Appleby draws himself up in his inimitable way and says, "Prime Minister, what a bizarre and what an amusing suggestion! As long as the departments disagree no clear-cut budget demands can be brought forward. The health vote is the main millstone around our necks. We do not want to do anything to make it easier to show that more money is needed. Oh no, Prime Minister, do nothing. That is the golden rule of bureaucracy. Let the departments argue forever".
That, of course, is an absurd caricature. I paint the picture simply to illustrate the strength of my view that there is—I am sure your Lordships will agree—a tremendous difficulty of continuing delay in a field in which the difficulties are so great. I can only express my earnest good wishes to the Minister in his work to try to knock heads together and get on with co-ordinated action.
There is an urgent need for more key workers to whom patients and relatives may turn. As we have been told, there are now 2,600 community psychiatric nurses. According to the estimate we need 10 times as many; that is, 26,000. That sounds a great deal and of course it is a very big increase. However, we have 60,000 staff working in the big institutions. One can consider the parallel of the military services and what must be done to remedy urgent requirements for specialised manpower. There are blitz programmes for training. If the need is accepted people will be forthcoming and training could be given.
I doubt whether public opinion, though it is much more alive to the problems than it used to be, has yet faced up to the unpalatable fact of the extent to which the costs of care in the community are greater than the costs incurred under the old system. For their part I hope that the Government acknowledge this change. In principle, are they prepared to make the extra resources available to local authorities to keep pace with discharges? If not, in spite of what the noble Lord, Lord Ennals, said, I hope that the programme of closures will be slowed down.
We now have an effective and quite-easy-to-understand blueprint. I hope that the Government will take hold of this and bring before us shortly a programme for new action.
5 p.m.
Lord Rea: My Lords, the fact that all is not well in community care for the mentally disabled has been made clear in the speeches we have heard. Even the Minister admitted this when he said that the Government were not complacent, which may be a way of saying that they are actually quite worried.
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This disquiet is reflected in a recent crop of reports on the subject. The most recent is the Griffiths Report. There is also the Wagner Report on residential care in the community. It is a long report. The book and the lyrics are very good, although they may not be to everyone's taste. Those are perhaps suitable Wagnerian characteristics. At the end of last year there was the widely praised Audit Commission report.
To me the document that best summed up the problem and made the most sensible recommendations was the report of the Select Committee on Social Services of another place on Community Care for the Mentally Ill. The evidence was taken in 1984 and the report was published in 1985. It should be remembered that the committee had a Conservative majority and that at the time of its inquiry into community care one of its members was Mrs. Edwina Currie.
Perhaps I may give a few quotations from the report. On costs, paragraph 21 said:
"A decent community based service … cannot be provided at the same overall cost as present services … We are at present providing a mental disability service which is underfinanced and understaffed, both in its health and social aspects".
The Minister of Health at the time—I cannot remember who it was as different ones have moved past our eyes very quickly; it could have been one of two but I am not sure which—was quoted as saying that, "If the functions of a hospital facility which has been greatly underfunded in the past are transferred to community care the cost will go up". In the light of those statements the request by MIND for £500 million of additional money over five years as part of its response to the Griffiths Report seems entirely reasonable.
As a practising general practitioner in inner London I find that the policy of community care has provided us with more experience of dealing with the continuing care of seriously mentally disabled people. We have found it more difficult to get acutely mentally ill patients admitted, but if they are admitted they bounce back again quicker. It is not so much long-stay patients being discharged into the community who provide the problems—in many cases, at least in Camden, they have so far been reasonably well cared for—but those who should have been in the long-stay category but never stayed in hospital long enough to qualify.
The population of mental hospitals has gone down from 131,000 to 60,000 in the past 20 years, but much of that reduction has been due to natural wastage. I do not mean that those tall chimneys emitting black smoke are used to dispose of the elderly inmates of those institutions. I refer to death from natural causes. At the same time there has been a limitation in "starting off" new patients as long-stay cases. It is the short-stay but possibly severely ill cases who give rise to most anxiety and for whom provision is least good.
Paragraph 24 of the Social Services Committee report states:
"The almost obsessive concentration in public policy on the mechanisms of 'getting people out of hospital' has sometimes obscured the basic fact that most mentally ill or handicapped people already live in the community … A common claim is that 90 per cent.

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of care is provided by hospitals while 90 per cent. of the patients are in the community".
It may have changed a little since 1985 but I doubt whether it has changed by more than 1 per cent. or so.
It is worth looking at the term "community", which suggests that there is a caring body of people ready and able to take on the role of nurturing mentally disabled people when they are cast into their midst. In the case of patients being in their own families, this has always been so. As other noble Lords have mentioned, families still provide most of the care available in the community, but it is often a severe burden for them.
Providing care for people who are not related to you is a very different matter. Such people are not welcomed. In fact, resistance to small residential units is often manifest, as the Minister pointed out. Community care can be a euphemism. At worst it can mean dumping mentally ill patients on to an unconcerned or even hostile population, or requiring families to provide 24-hour care to their sometimes difficult and unpredictable relatives. A somewhat cynical view of a psychiatrist friend is that community care is a form of "newspeak." (It is perhaps interesting that the social services report which I mentioned was compiled in 1984.)
I do not want to be unduly pessimistic. The concept of community care is a good one. It is just that, to be effective, it needs adequate resources not only in terms of bricks and mortar but also in adequately trained staff. If skilfully handled, many community organisations can and do make a significant contribution. I am able to report a success story, in that my own practice has assumed responsibility for the care of eight residents in a hostel recently opened in Camden through combined funding. It is for patients discharged from Friern. It works well, though some of the residents still have to return all the way to Friern for daytime occupational therapy. It is also a pleasure to record how productive team work with community psychiatric nurses has proved to be, especially with some of our most disturbed patients.
Many of the "free living" mentally ill patients are in need of much more in the way of day care facilities. Some of these were mentioned by the Minister. It sounded an impressive list but they are by no means evenly distributed through the country. We need many more of them. The community psychiatric nursing service is crucial to the success of the community care policy. In this respect I echo the noble Lord, Lord Thurlow, and should like to ask the Minister for information about how this branch of the nursing profession will grow in the future.
I am aware that some nurses who are transferred from the psychiatric hospitals can be retrained to work in the community but in fact the community psychiatric nurse, working outside a hospital, is a new and rather special type of nurse; such people are invaluable in this whole move into the community. We are told that there is something in the region of 2,000 to 2,500 at present. A desirable ratio, as a minimum, would be one per 10,000 of the population, which would mean 5,000 or 6,000 throughout the country. Indeed, the noble Lord,
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Lord Thurlow, actually mentioned 26,000 as being an even more appropriate figure. I would be most interested to hear what the noble Lord has to say about the matter.
While on the subject of nursing staff, I should like to voice the disquiet felt by both the psychiatric and the mental-handicap nurses in the Royal College of Nursing. They feel that the Griffiths Report has not given sufficient weight to the part which psychiatric nurses should play in the planning and the operation of community care. I must say that I think they are right, especially as social workers since the—to coin a nasty word—"genericisation", or the reorganisation, which followed the Seebohm Report have lost some of their mental health expertise. Of course I hope that with the increased length of training for social workers, which has not been agreed, some of that expertise will be recovered.
There is also much anxiety among the nursing staff of the psychiatric hospitals about their future redeployment, especially with regard to their pension rights and security. I think the Government should fully meet those concerns.
I have not talked about the mentally handicapped because on the whole their health care needs are less than those of the mentally ill, if—and it is a big "if"—they are in a stable and caring environment. In fact, as a doctor, I find most mentally handicapped people easier to deal with than some patients who are supposed to be psychiatrically normal. Nevertheless, their physical care is of the utmost importance as they are a most vulnerable group.
As we all know the mental health service is often called a "Cinderella" service. We should not forget that Cinderella left a slipper behind at the ball, which eventually led her to riches and happiness. I do not think that we can ever expect a "happily ever after" solution to mental health problems. However, some robust footwear may be in the hands of the noble Lord and in my view that could at least alleviate much of the current distress.
5.14 p.m.
Lord Mottistone: My Lords, notwithstanding the encouraging remarks that we have just heard from the noble Lord, Lord Rea, I do not believe that I am exaggerating when I say that there is a crisis in our midst in some parts of the country, especially with regard to the mentally ill. Although more will always need to be done for those people, society at large seems to have become aware of the needs of the mentally handicapped. Thus I propose to concentrate my remarks on the mentally ill in general, especially those suffering from schizophrenia.
As Marjorie Wallace said in her illuminating articles which have appeared in The Times over the past two years,
"Schizophrenia is the forgotten illness",
although my noble friend Lord Campbell of Croy might prefer the phrase "the misunderstood illness".
Two and a half years ago I initiated a debate on just this subject and I am therefore deeply indebted to the noble Lord, Lord Basnett, for bringing the matter once again to your Lordships' attention. The debate

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will help to ensure that the illness is not forgotten or misunderstood. In the previous debate practically all the speakers, including myself, sought to bring home to the Government that the policy of closing mental health beds faster than care in the community was developing was placing an intolerable burden on the sufferers from schizophrenia and on their families. However, the situation is now worse in some parts of the country and it is a tragedy that the Government have not done more during the past two and a half years. I am sure that they have done some things, and I am sure that they have done their best to allocate some of the money, but it has not been enough. The problem stems from the fact that care in the community is provided to a large extent by local authorities and not by the health authorities.
The noble Lord, Lord Ennals, in a most powerful and impressive speech gave examples which emphasised the need to speed up care in the community. The information he gave us has assisted me in that I do not need to waste so much of your Lordships' time. However, while I entirely agree with what he said, I did not find it consistent with his almost equal emphasis on not slowing down the closing of beds. I agree that it would have been better if care in the community had progressed faster, but it has not done so. Therefore it is a terrible mistake to close the beds down at one rate and have the provision of care in the community progressing at a totally different rate. So the noble Lord's insistence on not slowing down on bed closures is inconsistent with his general approach, which I applaud.
Lord Ennals: My Lords, what I was really saying was that the priority should be to do what we have to do as regards community care and not to take the easy course, which is to slow down the whole procedure.
Lord Mottistone: My Lords, I shall not pursue the argument. I have made my point and I think the noble Lord has probably made his.
During the period between 1975 and 1985 the shortfall in replacement for closed beds by places in the community both in day care and residential came to a total of about 32,000. Indeed, I think my noble friend the Minister mentioned that fact; he implied that that was all that was necessary. However, I am advised that the number of cases of schizophrenia has not decreased by anything like that amount. Some of those people may now be more capable of living in the community than they were before 1975, but that does not mean to say that the total problem has gone away. The figure of 32,000 is a measure of the addition to the problem for families and sufferers, which was already intolerable for many of them before 1975. Therefore, it is not at all satisfactory at this stage to allow health authorities to grind away at shutting down beds in hospitals when they have not made absolutely certain that there was suitable provision in the community.
However, those country-wide figures cover a wide variation of family burdens. Some parts of the country are faring better than others. I am lucky that the Isle of Wight—although of course more could be
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done by both the health authority and the county council—seems to be meeting the need better than most. That is partly due to the fact that the two authorities deal with exactly the same area—to wit, the island. That is where we are lucky.
I hope that when the Government come forward with their expected overall new proposals for the NHS—I make this strong recommendation to my noble friend—they will include the rearrangement of health service geographical boundaries to coincide with those of the counties and districts. It would make a tremendous difference. I know from experience that it will make for much better coordination of effort. My noble friend mentioned that point and I say that this is the way to do it. It is possible that he and his colleagues have not thought much about the matter. I strongly urge him to do so. It will also help to achieve greater understanding with a third party whose unseen efforts to assist in coping with the mentally ill do not receive the recognition they deserve—namely, the police—whose own boundaries generally accord with those of counties.
When a schizophrenic is discharged from hospital, refuses to take his or her drugs and rejects family help, an all too common experience, he or she often breaks the law in desperation to obtain some sort of care. By chance, last weekend I read in the Isle of Wight County Press of a case which illustrated that point. A 39 year-old chronic schizophrenic threw a brick through the window of an elderly person's flat. The magistrates were told that he had been discharged from the local mental hospital a year or so previously to share a home in the community with five other former patients. He did not settle down in that environment, because the brick throwing was one of several similar cases during the previous year. The object, so the newspaper reported, was to get back to Whitecroft Hospital, our local hospital, or into prison where he could be cared for.
The newspaper article concluded happily by saying that he now felt comfortable in a new home with other former patients. Let us hope for his sake, and that of the police, that that position will continue.
That example shows that community care does not always provide asylum, even when the accommodation has been reduced to five former patients. Our director of social services was telling me the other day that they had one home built to take about 30 former patients. They found that the schizophrenic patients would not stay there because there were too many of them. They now have about 20 carefully selected landladies who take in not more than five schizophrenic former patients. They try to handle those patients in that way.
It is an experiment which shows that the earlier provision did not work. That is another reason why we must be flexible and why having the two community care sources, health and local government, together can achieve that solution much better than when they cross boundaries. That example also shows that the police often have to treat as criminal cases those for whom medical care has been withdrawn and to provide the care for a mental patient which should be met by health or social service workers.

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To conclude, I return to the families. The families founded the National Schizophrenia Fellowship some 16 years ago so as to share their problems. It has made great advances, especially in the past five years, establishing a network of branches all over the country. It is doing its best to raise funds with minimal resources. I have joined with others to found a parallel fund-raising campaign entitled SANE (Schizophrenia, A National Emergency). That organisation seeks to make people aware of the seriousness of the problem and to gain a basic sympathy for schizophrenics as a way of raising vast sums for research and for carers.
Thirty years ago people dared not speak of cancer and sought to ignore, for example, the mentally handicapped. The community now has a much healthier and more sympathetic view of both types of sufferers. Last year, for example, the Isle of Wight hosted the special Olympics, which provide international competition for the mentally handicapped. Her Royal Highness the Duchess of Gloucester most graciously came to those games and it was a joy to see how loving she and others were to the friendly advances of mentally handicapped people.
A similar ready acceptance of the mentally ill is not so forthcoming from the community as a whole. I can understand that because in some cases the mentally ill can be frightening. We need to achieve that acceptance; but in the meantime the pressure on patients and families, as I described earlier, remains and the NSF in particular desperately needs more of a share of funds from government sources to enable it to develop its resources now while charitable interest slowly develops. It responds to over 6,000 calls for help a year nationally, plus many more locally.
Out of the £1·2 million DHSS budget for voluntary mental illness organisations, the NSF receives only £83,000. Other new organisations, such as the Manic Depression Fellowship, which also deserves to be funded scarcely get a look in or receive very small grants. However, among the numerous small and very small grants given by the DHSS for mental illness the grant for MIND stands out. It is £415,000, which takes over a third of the entire budget. MIND receives three times as much as the next organisation—the Alzheimer's Disease Society—which receives £120,000, after being given special priority by my noble friend. That seems to be an inequitable sharing of resources. I hope that my noble friend will be able to rectify that position in future years.
As well as contributing more fairly to the burdens of those fledgling charities in their early years from whatever sum can be made available, I emphasise to my noble friend that a substantial increase in the overall budget to get those worthy charities for a hitherto unpopular problem in society off the ground could be a worthwhile investment for the future.
5.26 p.m.
Lord Allen of Abbeydale: My Lords, this is a debate on an important topic. We are much indebted to the noble Lord, Lord Basnett, for arranging it, even if it
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seems to have attracted an attendance a little less than we had about 24 hours ago. I propose to limit my remarks in the main to the mentally handicapped. Perhaps I may be permitted to start on a personal note. I recently succeeded the noble Lord, Lord Renton, as president of MENCAP, having followed him previously as chairman of MENCAP. I should like to take the opportunity to pay tribute to the work that he has done over the years on behalf of the mentally handicapped, not least in reminding your Lordships from time to time of their needs and problems.
I find it a little sad that not all the members of the noble Lord's party have listened to him. Like many of us, I looked at what was said in the Conservative Party Manifesto about poll tax. I read that it was to be a fixed charge for local services paid by those over 18, except the mentally ill and elderly people living in homes and hospitals. I am afraid that it stands out a mile that the author did not have the slightest idea that the phrase "mentally ill" did not cover the mentally handicapped.
It is interesting to recall that when we were discussing the Bill dealing with the Scottish poll tax the Government agreed to an amendment exempting the severely mentally handicapped. Incidentally, there was no hint of protest from anyone that the House was exceeding its proper functions. When subsequently the English Bill was introduced, it contained a comparable provision about the severely mentally handicapped; but, hardly surprisingly, not a word differentiating the mental illness of the manifesto from other forms of illness.
That lack of knowledge of what is a simple, basic issue is the more disappointing in that in 1981 the Conservative Policy Group on Mental Health produced a rather good report. It enunciated two underlying beliefs. The first was that life was not nearly as good for the mentally handicapped as it could and should be. The second was that there were ways in which the lot of that substantial section of the community could be improved. In the seven years since, has life for the mentally handicapped become as good as it could and should be?
There have been changes. As has been explained, there has been a greater public awareness, but I am afraid that it is still not possible to answer that question with a resounding affirmative. It is not that the Government have done nothing. No one who heard the noble Lord, Lord Skelmersdale, could possibly maintain that. He can properly point to a number of legislative and other changes for which the Government can rightly claim credit. One is still bound to ask whether enough has been done or is in prospect. The uncomfortable fact remains that there is a widespread belief among the mentally handicapped and their families that their problems are still not understood and that there is an inadequate appreciation of the need to foster their independence and their right to a life as nearly normal as possible with the freedom of choice which is open to more fortunate citizens.
In the next few minutes I shall try to explain some of the reasons that uneasiness and discontent are so widely felt despite the various steps which have been

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taken. Perhaps I may start with the subject of education. First, as the noble Lord, Lord Basnett, reminded us, in Britain there are something like 1.2 million people with some kind of mental handicap. Of these, perhaps 160,000 are severely mentally handicapped and some 60,000 of those are children. Of the severely mentally handicapped, about one in three has a sensory or motor disability in addition to permanently impaired mental ability. It is a small wonder that there was a very warm welcome for the Education Act 1981 following the Warnock Report and heralding, so it seemed, a new dawn for those with special educational needs. However, the working of that Act has so far proved to be very patchy. For example, one local education authority in the course of a year issued statements for 1,200 children, whereas another managed a miserable 25. Waiting periods for well over a year for the completion of statements are not uncommon. The Government are well aware of these imperfections but the noble Baroness, Lady Hooper, at col. 1125 on 11th May, could offer no more than a review of the Act later this year.
This happens to be one of the few days on which we are not talking about the Education Reform Bill and I do not propose to do so. However, against that background it is not surprising that the discussions on the Bill have caused a good deal of anxiety lest children with learning difficulties will be put at even greater risk than hitherto of finding themselves outside the main stream, and anxiety about the effects of opting out on those children. It has also been noted that although the Government have made a number of proposals affecting these children, some of the more important ones were not in the Bill as originally introduced.
I next turn briefly to the history of the Disabled Persons (Services, Consultation and Representation) Act 1986. That Act received Royal Assent in July 1986 and some of its most important provisions, including the assessment of those coming from long stay hospitals, have still not been implemented. I am in no doubt that the noble Lord, Lord Skelmersdale, will be ready to remind us yet again that the Government have always said that implementation must wait until resources are available. However, many people are increasingly asking why, when we are nearly two years on and the Government say that they are serious about care for the disabled, there is still a failure to provide the comparatively modest resources which will be needed.
I turn now to the Local Government Finance Bill. Again I have no intention of embarking on any detailed discussion of that Bill today—not even the definition of "severe mental handicap". However, I must make the point, echoing something said by the noble Lord, Lord Ennals, that the prospects are viewed with alarm by many parents in the community who have grown up children living at home who do not qualify as "severely mentally handicapped". There is also anxiety on the part of individuals who find the prospect of the tax something of a deterrent to any plans for independent living—a policy which they thought was looked on with approval by the Government.
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Looking at the noble Lord, Lord Carter, I must return for a moment to yesterday's Question about the Independent Living Fund. I believe it is conceptually wrong to take the payment of benefit outside the statutory system but, apart from that, there are still many unanswered questions about this fund: how long is it to last and so on? Apart from anything else, it was not ready when the statutory changes were made last month.
I do not want to add anything to what has been said about care in the community, particularly on the very day when a report on this topic has been published by the Public Accounts Committee in another place. It is a somewhat critical report and to me made rather uncomfortable lunch-time reading. However, as it seems to be the fashion in this debate to quote Sir Roy Griffiths perhaps I could have my pennyworth and refer to the passage in which he states that although community care has been talked of for 30 years, in few areas could the gap between political rhetoric and policy on the one hand, or between policy and reality in the field on the other hand, have been so great. I recognise that the recommendations of the Griffiths Report are not free from controversy and are likely to give rise to a good deal of argument. However, I go along with the hope that something will soon be decided, and I noted the commitment into which the Minister entered when he spoke earlier this afternoon. It has been observed that the report was not received by the Government with any great fanfare of publicity.
I could go on, but I shall content myself with one more addition to my cumulative list and that is the instruction to those operating the social fund to consider whether charities may meet an applicant's needs with the implication that charities may now be looked to in order to finance public policies. I know that this is not a new point but it is still causing anxiety among some of those who believe that they pay tax and national insurance contributions in order to ensure that statutory help will be available to those in need.
I have tried to highlight a few areas where there is disquiet and apprehension among a sizeable but inarticulate section of the community. I appreciate that others beside the Government have responsibilities, including local and health authorities. I also believe that the commitment and personal attention which the Minister has given to these matters has been widely appreciated.
I believe that the Government have compassion for the less fortunate members of society and wish them to share in the nation's rising prosperity. I believe that they have a social conscience. The trouble is that they do not always show very much imagination in seeing how their policies will work out for some, and they continue to look as though concessions are being forced out of them when they run across difficulties raised by other people which one would have thought they might have foreseen for themselves. There is certainly an impression that they are not over-generous with resources for the kind of problems that we have been discussing.
In the time at my disposal I shall not attempt a measured assessment of the Government's

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performance, diagnostic, formative or summative. But perhaps a more old-fashioned end-of-term report might have read something like this—"in the end has the right approach and tries hard but is not very imaginative and finds it difficult to keep up; could do better".
5.40 p.m.
Lord Prys-Davies: My Lords, we are very grateful to my noble friend Lord Basnett for giving us this opportunity of discussing this important subject. We thank him for his comprehensive review of the problems of the mentally handicapped and the mentally-ill patients and the problems of their families and for presenting that review in an outstanding speech.
I think that one of the crucial messages which emerges from the debate is as follows. The sensitive and difficult process of change from hospital care to community care, which we welcome, is running into problems in many parts of the country. That is because the development of community facilities is not keeping pace with the run down of large mental hospitals or their closure.
The noble Lord, Lord Mottistone, speaking from the opposite side of the House, produced very telling figures to show that as the result of the run down and closure of large hospitals there is by now a huge shortfall of places in day hospitals and local authority day centres. In the result, a substantial part of the burden of looking after patients who were formerly accommodated in hospitals, or who would have been formerly so accommodated, is now too often shouldered by parents and families without adequate facilities in support.
Again, we have been told this afternoon by many speakers that some patients are very lonely in the community at large when they find themselves in substandard hostels or bed-and-breakfast hotels without adequate support. We have been told that a small number end up on the streets or railway stations or even prisons.
When we write as we do from time to time to Ministers questioning the imbalance between hospital care and community care we are repeatedly told that the Government's policy:
"is not the running down and closure of hospitals, but better provision for individuals according to their assessed needs".
That is the stock answer which I have received over the past two years. But to many parents, families and to some voluntary organisations the reverse appears to be the case. It appears that there is a gap between the stated policy and the reality as it exists.
The National Schizophrenia Fellowship is not aware of any evidence to back up the Government's claim that there is no imbalance between hospital care and community care. According to the Royal College of Nursing it is evident:
"in many parts of the country that community care facilities are not operational when the long-stay institutions have been closed".
This conclusion is consistent with a number of authoritative reports published since 1985 including the report of the Public Accounts Committee published today.
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But while the Government now seem to accept that community care is not a cheap option, they have yet to accept the need for additional resources on the scale required during this difficult crossover period when both the hospital and the community services have to run in parallel.
When I wrote to the noble Lord, Lord Skelmersdale, last year about the problems of a particular hospital for the mentally handicapped, he gave me this answer in his letter of 13th July:
"The original plan would have taken a number of years to achieve the transition to community care, [it] would have presented difficulties for maintaining services and would have been financially wasteful in keeping parallel provision in both the hospital and the community."
That was a frank answer, as one would expect from the noble Lord, Lord Skelmersdale, whose contribution in this field is appreciated by all Members of the House. But one has to keep the hospital facilities and the community facilities for some time to come both available for mentally-ill patients and mentally-handicapped patients.
If the bridging costs, although they may appear to be financially wasteful, are not made available, one finds oneself in the position that on the one hand one cannot allow expenditure on essential improvements to a hospital for those patients who require high dependency because the hospital has no future and therefore its condition worsens. But on the other hand, one cannot spend as one would wish on building up the community facilities because one has to maintain the hospital facilities. So at the end of the day this particular problem is essentially a problem of shortage of money. This is a problem which only the Government can solve. But it can be solved given the will.
I strongly endorse the powerful plea made by my noble friend Lord Ennals that significant bridging funds should be made available during this difficult crossover period in order to build up the services which are required. I trust that the Minister will be able to comment on my noble friend's plea when he comes to reply to the debate.
In view of the great difficulty of hospitals running down their services before provisions are available in the community, I would urge the department to make it mandatory on health authorities to satisfy themselves that sufficient care facilities are available locally before they discharge more patients from their hospitals to the community.
Lord Winstanley: My Lords, I am interested in the noble Lord's argument all of which I support. I am also interested in the question that he has just put to the Minister. But I hope that in elaborating his argument the noble Lord will bear in mind that the difficulty is that the catchment area of some of the large institutions which are to be closed is so wide that one does not know to which community discharged patients will actually go. They do not all go to one community or to the immediate locality of the hospital. If they did, things would be much simpler. But what one does find is that as a hospital closes so some of the long-term patients go to far flung parts of the country in very different areas altogether.
Lord Prys-Davies: My Lords, that is a fair point. Whether the patient is to be returned to a local community or a distant community, the health authority ought to satisfy itself that the facilities are available.
I anticipate that the Minister may answer by telling us that the department has already made it known in either the 1985 circular or the 1986 document that patients should not be discharged before facilities are available in the community. He may plead either the circular or the document. To that answer, we reply that all too often the circular and the document are overlooked. We ask the department to consider taking the further step of making it mandatory for health authorities to satisfy themselves that the facilities are available. It is essential that the imbalance should be corrected. Otherwise, with 28 hospitals for the mentally handicapped scheduled to close between now and 1990 and about 35 large mental hospitals scheduled to close between now and 1995, the imbalance could undermine public confidence in the policy of community care, not only as a practical proposition but also as a philosophy.
Turning to an allied matter which has been touched on by a number of speakers, where the facilities which are required are not available either in hospital or in the community, a heavy and unfair burden is put on families who care at home for the mentally ill or mentally handicapped. There are distressed parents and families who undertake such tasks 24 hours a day for 365 days a year with inadequate support. In far too many districts there is a dearth of short-term respite facilities for families. Will the department press the regional authorities to consider how they can best ensure the provision of respite facilities for those hard-pressed families, and encourage the setting up of such facilities in districts within their regions? I hope that that item can be placed on the agenda.
Another worrying matter is that parents who are now in their 50s, 60s and 70s may be worried about what will happen to a son or daughter when the surviving parent dies if there are no care facilities available. Mr. Jackson, the chairman of Rescare, writes:
"The disturbing question that hangs over all caring parents is, 'What will happen when I die and am no longer here to care?' And the disturbing fear is that the son or daughter will ultimately be left to wander the streets unkept, unwanted, abused and exploited".
I am not sure how best to answer Mr. Jackson's difficult question in the short-term and in the absence of residential services for such a son or daugher. It has been suggested to me that the department and its lawyers, possibly with the help of the Charity Commission, should consider setting up a national trust or encouraging others to set up such a trust. Although it would be difficult, the trust should be charitable. Parents could bequeath to it their estate or the proceeds of sale from a home to be applied for the benefit of a son or daughter during his or her lifetime in addition to statutory support. Thereafter, proceeds could be applied for the benefit of the orphaned mentally ill or mentally handicapped.
Lord Mottistone: My Lords, perhaps the noble Lord might like to suggest that such proceeds should be sent to the new charity which I mentioned, SANE.
Lord Prys-Davies: My Lords, I am grateful for that suggestion. I shall consider the matter and possibly offer advice on the basis of that intervention.
We are all conscious that there are a number of important gaps in the services which do not make headline news. Services for some small goups of patients are sadly lacking in many parts of the country. One such group is the 80,000 autistic persons who have many unmet needs. I understand that in many parts of the country, early diagnosis of the condition is inept and treatment is lacking or inappropriate. The National Autistic Society, which has a well-proven track record in the field, and its local societies, such as the South Wales Autistic Society, which I support, have during the last 20 years provided 16 schools and 19 adult centres. Their education programmes are yielding rewarding results. Yet those schools and centres care for no more than about 1 per cent. of autistic people. More research to establish the cause of the illness is urgently needed. More residential schools and centres are also urgently needed. I urge the department, possibly in conjunction with the DES, to consider what assistance it can give in that direction.
In the course of our debate there have been many references to voluntary bodies which are working with other such bodies and with the statutory bodies and local authorities to improve services for the mentally ill and the mentally handicapped. They do a tremendous job. They bring support, understanding and hope to thousands of people. However, the voluntary organisations are handicapped—some more than others. They are handicapped by a shortage of funds. Will the department fund those organisations more generously in order to help them in their work for the mentally ill and mentally handicapped? That is my last plea to the department, at least for today.
5.58 p.m.
Lord Skelmersdale: My Lords, this has been an invaluable debate, as I envisaged in my previous remarks. I am very grateful to the noble Lord, Lord Basnett, for initiating the debate and to all noble Lords who have spoken in it. However, it oocurs to me, as I stand to wind up for the Government, that, as the noble Lord, Lord Winstanley, predicted might happen, we have had many equations today but remarkably few solutions. If I had hoped for guidance from the debate on how to conduct my responsibilities in the area, I would be to a great extent a rather disappointed man.
Indeed, anyone coming new to the subject would believe that the problems of long-term patients coming out of hospital are the same as those of patients who come from normal family homes and who go for short stays in hospitals for treatment before coming out again. The media constantly make that mistake. Reference has been made this afternoon, for example, to the recent Esther Rantzen programmes on this subject. One of the first television programmes in which I took part when I took up this particular responsibility was one of Roger Cook's. In both those sets of programmes these mistakes were made.

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In my travels around the country—on average one day a week during the time when Parliament is sitting and, I am glad to say, three days a week when it is not—I have discovered that the problems are quite different. In the past, I admit, there have been difficulties with the discharge policy proceeding too fast. I do not believe that that has been the case over the past two years.
Restricted community care—which is not supposed to be a new catch phrase but I hope explains what I mean—is in good shape in most health authority areas. However, the problems occur where there are ex-short stay patients or those whose stability in the restricted sector (as I have called it) has become such that they have decided to move into other accommodation. If it is properly conducted that is the ultimate in community care; people move from the ultra care situation into more and more limited requirements for personal care. It is there that the problems really arise.
As I implied earlier, the speed and detail of the development of services in any one area will depend primarily upon the relevant health and local authorities making the best use of resources available to them. I was interested in and I take the point of my noble friend behind me concerning what is termed in the jargon "coterminosity"—in other words the same geographical areas of local authorities and health authorities. I admit that there is a lot to recommend it. However, it is not necessarily a logical decision but a highly political decision as to whether coterminosity should apply in those parts of the country where it does not occur. Although applied for the best of reasons, it upsets a great many people. Indeed I seem to remember that a previous Conservative Government is believed to have lost a General Election because they were so brave as to muck around with county boundaries. I should not like that to happen.
However, there are ways in which central government can make a direct contribution to the development of community care projects. For instance, under our mentally handicapped children initiative we have made available to health authorities and the voluntary sector a total of £11½ million to help finance projects aimed at moving mentally handicapped children out of hospital into more suitable forms of care. Some 340 children have been helped directly through that initiative. Equally important, our initiative has played an important role in helping to demonstrate to authorities what can be done. The number of children in large mental handicap hospitals has fallen from 2,400 in 1980 to below 400 at the end of 1986. Most authorities have plans to make alternative provision in the near future for those remaining.
What else can central government do to help? There is, as we all know, no magic wand that we can wave. But we can and we do encourage health authorities. The regional review system enables the National Health Service Management Board and Ministers to discuss with regional health authorities points of concern on planning or the provision of services and to set objectives for action. Good collaboration is one of the points we look out for, or
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rather the absence of it. In the review process we tackle regions if there seem to be problems.
The noble Lord, Lord Basnett, asked the crunch question at the beginning of the debate: how many mentally ill and mentally handicapped people are we talking about? I regret to have to tell him that that is not known in any definitive sense. Hospital admissions and discharges are known but I assume that the noble Lord was referring mainly to those in the community. It is estimated that there are 50,000 to 100,000 people in the community who are chronically disabled by mental illness, and that schizophrenia affects about 1 per cent. of the population. We shall have a guide certainly to the numbers of mentally handicapped and I hope to an extent to the mentally ill when we receive the reports of the Office of Population Censuses and Surveys, the first of which is expected later this year.
Not surprisingly most speakers in the debate have referred to the Griffiths Report. I should like to say particularly to the noble Lord, Lord Ennals, that I understand his impatience. But I think that it is much more important to get it right than to get it fast. Anyone would have thought, listening to the noble Lord's speech, that absolutely nothing is happening in this field and that there is a great hesitation while we await consideration of the Griffiths Report, Lady Wagner's report and the interaction of the two, and the possible results of my right honourable friend the Prime Minister's review of the health service.
I suspect that the noble Lord moves around the country to an even greater extent than I do. He will know that all kinds of units are being built in the community. There are very impressive schemes in some parts of the country which we should all like to see duplicated elsewhere. It strikes me that many of those schemes are new. We will not put a stop to the innovation that is taking place around the country if we wait a little longer for the Griffiths Report and, as I said, get it right.
I should like to make two points about the Griffiths Report. For many years local authorities have been resistant to central government moneys being targeted at and spent totally on the services for which they are provided. It is my personal belief that local authorities are changing their ideas. However, before the Government come down on one side or the other in this matter, we must obtain the views of the local authority associations. I am very conscious that the people who run local authorities are elected locally. It is only right that they should have a major say in this decision.
As far as concerns which Minister, if any, should do the job and in which department he or she should be situated, the noble Lord, Lord Thurlow, gave us an amusing caricature of what may or may not go on in No. 10 Downing Street. He is right in one sense because it is indeed in the gift of my right honourable friend the Prime Minister to decide who and which department does what.
To come back to the central points of the debate, the noble Lord, Lord Winstanley, pressed for an indication of the Government's response to the Griffiths Report. All I would add to what I have just

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said is that I shall not ask my right honourable friend to rush his response, for the reasons I have given.
Local authority funding of mental health services was mentioned. I believe that we cannot look at that issue solely in terms of increased rate support grant support. Questions of the priority which local authorities attach to mental health services in comparison with, say, child health or the care of the elderly are—because they are elected—a matter for them. That funding is supplemented to a great extent from the rate fund and so it is up to them to prioritise.
The noble Lord, Lord Ennals, quoted a number of sources complaining about the discharge of mentally ill patients into the community. The Government continue to stress that patients should not he discharged without an adequate plan of care. I said that at the beginning of the debate, but I regard it as very important indeed. Many are short term patients who return to their existing home background. The future of long stay patients who are discharged must be most carefully assessed because it is the long stay patients for whom the state has been responsible for so long.
So far as concerns bridging finance, most regional health authorities have made their own arrangements in the district allocations. If this was the major problem that the noble Lord, Lord Ennals, suggested, regional chairmen in meetings with my right honourable friend would have continually pressed the Government for action on bridging finance. But that has not happened.
The noble Lord, Lord Thurlow, spoke of providing care for mentally disordered offenders on release from prison. That brought a new factor into this debate. It was one of the issues looked at by the inter-departmental working group on mentally disturbed offenders in the prison system. As a result, discussions are taking place and we are seeking further to encourage regional health authorities to develop a comprehensive network of provision to meet the mental health needs of mentally disordered offenders and to develop a network of services within the community for the chronically mentally ill who may lose touch with services and then commit petty crimes, whether or not they intend to do so (and that refers to another point that was raised), and find themselves in prison. Further, we are discussing ways of ensuring that those mentally disordered offenders on leaving prison can be put into touch with psychiatric services. Noble Lords remarked on the idea in the Griffiths Report of a named carer. I believe that this should come in here as well.
Many points have been raised. In all conscience I do not think, having spoken once, that I should refer to all of them; but I shall reply in writing. However, I should like to call particular attention to the very important role played by the voluntary sector in the provision of respite facilities and care attendance schemes. I should like to pay tribute to the enormous contribution made by a whole host of different people and organisations in this field. Together they form part of the long tradition of voluntary services in this country, which is one that Ministers are keen to see preserved. We shall continue to support the
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voluntary sector to best of our ability—by that, I mean giving organisations both moral and financial support.
In the mental illness field, for example, we shall spend nearly £1.5 million on grants this year to over 20 voluntary organisations. These and other organisations make a vital contribution to the total provision of community care services. We greatly admire the imagination and resourcefulness that enables the voluntary sector to provide a level and quality of service that belies the limited resources available to them.
I can tell my noble friend Lord Mottistone that I am well aware of the imbalances in the Government's mental health budget for voluntary bodies. This is largely for historical reasons. I had a naughty thought when listening to my noble friend that some of this imbalance may be reflected in the fact that the noble Lord, Lord Ennals, was particularly interested in this area and could—I put it no higher than that—have influenced it. However, I am seeking over a number of years to rationalise this situation. But my support, respect and gratitude for charities in the mental illness field come second only to my feelings for those who appear for and support the needs of sufferers of mental handicap and their families. In the last financial year I was able to authorise grants totalling more than £800,000.
It has been quite constructive in this debate to find that the only person to zero in, as it were, on the problems of the mentally handicapped in the community was the noble Lord, Lord Allen of Abbeydale. I know of his interest in this area and of his new appointment at MENCAP (in which we are all extremely interested). I do not know whether the noble Lord was in the House yesterday when I answered a Question on the Independent Living Fund; but I think he will find that some of his questions today have already been answered. There is one question of great interest which I did not answer, and that concerns the £5 million which is the Government's start-up money. The Government believe that it will be more than adequate for the first year; but, if it is not, clearly we shall top it up. So far as the time is concerned, I gave three to five years for it.
Finally, in response to one point made by the noble Lord, Lord Prys-Davies (of which he gave me previous notice for which I am grateful) I sympathise with the concern of parents about future provision for their mentally handicapped sons and daughters when the parents are no longer there to provide a home. The MENCAP Homes Foundation, with help from the department I have the honour to represent, has led the way in helping parents make provision for their children along the lines that the noble Lord has suggested. But I shall certainly consider whether there is anything further that we can do to help, either within the direct or the indirect public sector.
Your Lordships may feel that I have spoken quite long enough for one afternoon. Perhaps I may conclude by thanking all noble Lords and again the noble Lord, Lord Basnett, for introducing this fascinating debate.
6.14 p.m.
Lord Basnett: My Lords, there remain for me only two tasks to perform. First, I join the Minister in thanking all those who have taken part in what, as he says, has been a fascinating debate, but which equally has been a well-informed and caring one. Secondly, I should like to withdraw my Motion for Papers.
Motion for Papers, by leave, withdrawn.

Access to Medical Reports Bill
6.16 p.m.
Lord Tordoff: My Lords, I beg to move that the Bill be now read a second time.
Some of your Lordships may remember—and it may have been noticed at the time—that my honourable friend in another place, Mr. Archy Kirkwood, last year presented a Bill on access to personal records, which I had the pleasure of moving and getting through all its stages in one day just prior to the general election. This dealt with a number of matters—access to records for housing, and so on. At that stage, we should have liked to have put in something about access to medical records. It was fortuitous that again Mr. Kirkwood, who seems to have a remarkable streak of luck in these matters, came high in the ballot in another place this year and introduced the Bill which I am now introducing to your Lordships.
It is a very limited Bill. It seeks to deal only with access to medical reports and not access to medical records. I would that it went further than it does, but one has to take these things slowly. In brief, the objective of the Bill is to give people a chance to see medical reports that their own doctors send to an employer or to an insurer so that they can correct any inaccuracies, and discuss and up-date the doctor on anything that is recorded on the medical record that is not up to date. It gives them the opportunity to know what they are consenting to when they sign a form authorising a medical report for employment or insurance purposes. They can make representations on any proposed disclosure which they would regard as an unnecessary breach of their privacy. Ultimately, if they are wholly dissatisfied with the proposed report, they can withdraw consent for it to be supplied.
If they do not make use of the opportunity to see the report before it is sent, and for some inexplicable reason they are later turned down for a job or for an insurance policy, after the event they can check whether the mistake in the doctor's report might have been responsible. Even at that stage they might be able to reverse the decision or prevent that mistake recurring in a future application.
A number of case histories have been reported in another place. I propose to quote only two, one of which is new and one of which has been mentioned before. The first case which illustrates the need for access to information of this kind is from a woman who said that certain clinical data regarding herself had come to light and recently, on opening a referral
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letter from her GP, she found that the GP had written:
"I know nothing about her, except that she has had emotional problems since the death of her husband".
This lady goes on to say:
"I married my husband in 1961. I was a spinster, he a bachelor. My husband is alive and living here with me in our home…At no time in my life have I ever had to consult a Doctor because of emotional problems".
She adds that the GP has no direct personal knowledge of her. Although on the list of Dr. A for some years she has never sought a consultation with him. The truth is that she has never met or set eyes on Dr. A. She was very upset and angry about this because she regarded the suggestion that she suffered from emotional problems as extremely damaging to her. She had held high positions in management in charge of staff, and with the label of emotional disturbance she would expect the level of her standing to be greatly reduced. It was obviously damaging her possibilities of obtaining employment in the future. That is one case.
Another case was quoted in Hansard in another place at col. 678 on 29th April in which the speaker said:
"Not long ago I went to the family practitioner committee in my neighbourhood. It has very good people and has recently computerised its records. It proudly punched up my cervical smear test record and said, 'You have not had one for ages. You are due for one now'. I said, 'But you haven't got any of my cervical cancer smear test records on your computer, I had one as recently as—"
and the date was given.
"It punched more buttons and the computer record was a total blank.
"The reason for that was that it had the wrong NHS number. It had one digit wrong. I knew that and I was probably the only person in the entire country who did. It had punched 'LNUN' instead of 'LNVN'. That was clearly a mistake in somebody's handwriting".
That was a quotation from Edwina Currie speaking on this Bill in another place. Mrs. Currie has been extremely helpful in the process of this Bill. I realise that the Government will wish to maintain a neutral postion on this Bill. Nevertheless, I should like to go on record as saying that Mrs. Currie has been extremely helpful to my honourable friend and I think that the Bill is all the better for the co-operation that we have had.
Access to reports for employers may be particularly important where there is anything in the medical record to suggest a history of mental illness. A 1978 report by MIND described repeated cases of employment discrimination against people with a past history of mental illness who were presumably currently healthy and otherwise qualified for work. We must ask ourselves whether patients who consent to the revealing of their medical history understand what that entails. Do they hope and expect that the doctor will be somewhat choosy in presenting the information? I doubt whether the consent of patients may be described as informed consent. Do they realise that their written consent amounts to much more than most of us would believe? People would suppose that there would be some brief, factual report of their general health. But it can be much more, and not all of it always objective. It is somewhat inaccurate, as we have seen in those two case histories.

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With people worrying about AIDS—and no one is more worried about AIDS than the insurance companies, and one can understand why and I do not criticise them for that—the result is that they are becoming much more intrusive in the questions they ask. There is no doubt that jobs can be missed and insurance refused by the reporting of misleading. Inappropriate or even thoroughly wrong information.
Let me deal with the scope of the Bill. The Bill applies only to reports produced by a doctor who has been responsible for the clinical care of the individual—that is to say the patient's GP or a psychiatrist or a consultant who has treated the person. It does not cover reports produced by a doctor who has not treated the patient—for instance, a company medical officer who has carried out a pre-employment medical examination—or a doctor who has carried out an independent medical examination on behalf of an insurance company. Although the Association of British Insurers has questioned whether a strict reading of the Bill as drafted supports this interpretation, we believe that it does, and we have the support of the DHSS in that belief. Nevertheless, the DHSS has been good enough to say that it will have this confirmed by parliamentary counsel, and if there is any doubt we can provide an amendment at a later stage of the Bill; and I undertake to do that.
The reason for concentrating on reports produced by a doctor who has treated the person is that the doctor will have acquired information from the patient on the understanding that it is only to be used for medical purposes and protected from disclosure by mutual confidentiality. Disclosure of this information to an insurer or an employer for commercial rather than medical purposes involves virtually an enforced breach of this confidentiality. This is not the case when the individual submits to a medical examination for an insurer or employer. The person knows from the outset that the examination is carried out for the benefit of the company rather than for his or her own health.
As the Bill stands, the definition of employment— the "employment purposes" covered by the Bill—relates strictly to employees. Again the Government have said that they will be content to see the definition widen to bring in reports relating to self-employed persons acting under contract. Again I am hoping that we shall have some advice on that before we reach the next stage of the Bill when it might be necessary to propose a further definition in Clause 2.
Clause 3(1)(a) is the part of the Bill that requires an insurer or employer to have the written consent of the applicant before approaching the applicant's doctor for a medical report. Originally the Bill limited the validity of that consent to 90 days. But that caused problems for the insurers in that it would have prohibited their approaching the doctor on the death of the insured, perhaps in cases of suggested fraud. We found it impossible to secure a form of words that would be acceptable both to the Association of British Insurers and the BMA. The Bill, therefore, is now silent on this matter and preserves the present
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situation whereby doctors will limit consent to the particular transaction. There is no change from the current practice.
Perhaps I may say a few words on how to apply for access to a report before it is sent. The Bill allows an applicant to have access to a report before the doctor supplies it, and for six months after it has been supplied. The procedure for applying for access to a report which the doctor intends to supply is as follows. First, the insurance/employment application form which asks for consent to take up a medical reference will invite the applicant to indicate whether he or she wants to see the report before the doctor sends it. Secondly, if the applicant says, no, or does not indicate, yes, the company can approach the doctor and the doctor can reply immediately. Thirdly, if the applicant says, yes, he or she has 21 days in which to contact the doctor and make arrangements for access. The company has to notify the applicant that it is seeking a medical report—reports are not sought in every case—and the 21-day period starts from the date on which that notification is given. Finally the company also has to notify the doctor that the applicant wishes to have access and to tell the doctor to wait for up to 21 days before sending the report to give the applicant time to arrange for access.
A parallel procedure exists under Clause 4(3) which deals with those cases where the company gets the applicant to pass the request for a report on to the doctor. It will also be possible, as I indicated before, to apply for access after a report has been sent. The doctor is required to keep a copy of the report for at least six months. Originally there was some suggestion that there should be a much longer period. However, I recognise that in practice six months will be long enough because this will probably come into effect only when people who have been turned down for a job or for an insurance policy wish to look back to see whether there is any reason in their medical report.
The exemptions are contained in Clause 6 and they are based on those in the Data Protection Act—about which the noble Lord, Lord Mottistone, knows far more than I do—and in the order which regulates access to health records under the Act. Thus the words in Clause 6(1) about disclosure, which:
"would indicate the intentions of the practitioner in respect of the individual".
are included at the suggestion of the Government to bring it into line with the Data Protection Act. Similarly the words in Clause 6(3) about exemptions have also been included at the Committee stage in another place at the fairly firm suggestion of the Government.
Clause 8 deals with disputes over the contents of reports and when the applicant sees a report which the doctor intends to supply and disagrees with something, there are three options open. First, if the information is demonstrably wrong the doctor should correct it under Clause 5(2)(a). If the doctor unreasonable refuses, when it is obvious that the information is inaccurate, the applicant can as an ultimate step go to court for an order under Clause 8(1) requiring the doctor to comply.

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If there is a difference of opinion which is not provable one way or the other, the doctor is not required to amend the report in any way. He would merely invite the applicant to provide a written account of his concerns, and the doctor would send that to the employer or insurer with his medical report. Finally, if the applicant is wholly dissatisfied with the report he or she can withdraw consent of it to be sent at all, bearing in mind that that would probably jeopardise the application for employment or for insurance but it is an option that the applicant should have open to him.
The most important aspect is that the Bill does not give the applicant the right to force the doctor to suppress any relevant information or to change a professional opinion.
The Bill does not apply to Northern Ireland, but I understand that the Government have undertaken to give effect to that by an Order in Council if the Bill receives Royal Assent. I shall be glad if, when the Minister replies, he will confirm that.
As I have said, I understand that the Government wish at some stage to suggest an amendment relating to the definition of "employment records". That exposition takes us through the Bill. It is a limited Bill and Mr. Kirkwood and I are beginning to learn that we have to move slowly on these matters. We certainly wish to include other medical reports such as those for social security and housing, but we decided that we did not want to take on too many Government departments at one time. Discussions are taking place between doctors and the department on the wider issue of access to medical records. Indeed I wish that that were in the Bill before us today, but there has to be time for the doctors to try to come to some agreement with the Ministry on how access to medical records can be achieved. However, I feel that they cannot go on dragging their feet for ever. Meanwhile the more modest but important proposals on medical reports are before the House.
We believe that openness will in the end lead to greater accuracy, perhaps even to greater honesty, but it is important that the Bill leads to greater accuracy. People will not find themselves failing to get jobs or insurance policies because of inaccurate or misleading information in reports about which they know nothing. I beg to move.
Moved, That the Bill be now read a second time.—(Lord Tordoff.)
6.34 p.m.
Lord Mottistone: My Lords, I am in general in favour of the Bill as drafted and welcome it. However, there is one worry, and that is that it does not fully protect all persons who might in certain circumstances be attacked by a mentally ill person who has access under the provisions of Clause 6 to a medical report, even if restricted under the terms of the clause. I should add that I am advised in this respect by the National Schizophrenia Fellowship.
What we should like to see in Clause 6 is the addition of "or others" after the word "individual" in line 34 on page 3. A researcher reporting in The Lancet on 6th December 1986 about giving psychiatric patients access to their medical files, also
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drew attention to the small but not negligible number of patients—I emphasise "not negligible" because he reckoned the number is eight out of 100—who already had a history of violence and might react aggressively. The researcher mentioned factors which might trigger off a reaction. For example, a report for an employer forming part of a medical report might say, "This man would be a poor employment risk and I do not advise taking him on". That would put at risk the person who wrote the part of the report concerned, such as a previous employer who might have been consulted.
It may be argued that that person could be protected by Clause 6(2). However, even that subsection is not wholly protective in all cases. The NSF had a recent case of a member whose sister (once in Broadmoor) was allowed to see her notes by a GP. There were statements made by members of the family which caused the sister to write threatening vengeance. Suitably edited in accordance with Clause 6(2) the family members might be protected, but their children could be at risk. It might be further argued that perfectly applied Clause 6(1) and (2) provide the necessary protection.
As I have attempted to show, however, there are potential loopholes which could arise from inadequate editing. These could simply be dealt with by including an amendment on the lines that I have suggested. I believe that the Government might support such a safeguard because a recent DHSS consultation paper sent out in March 1988 about regulations under the Access to Files Act, says at paragraph 10:
"The regulations will enable access to be refused if it would be likely to result in serious harm to the physical or mental health or emotional condition of the individual requesting access or to any other person".
I emphasise the addition at the end of the quote, "or to any other person"; and it is just such a phrase that I am seeking to add to the Bill.
Thus, knowing all the difficulties of amendments to Private Members' Bills from another place, I most sincerely hope that it will be possible for the Government to back a simple amendment on the lines that I have described when we come to the next stage of the Bill and will help the Bill if it has to return to another place through that process which I believe the Government can readily do if, as I suspect they might, they agree to what I am suggesting.
6.38 p.m.
Lord Rea: My Lords, I wish to speak extremely briefly as a member of the profession most concerned in the Bill. The Bill will be very helpful and I fully support it. Here I am speaking not only for myself but for the British Medical Association, which I understand has been working on the Bill with the original sponsor in another place.
Many patients who give consent to the release of confidential information about themselves are not aware of the extent and the probing nature of the questionnaire submitted to their doctors. Access to such reports would improve their awareness and validate their consent.
There are just one or two points upon which I should like the noble Lord's comments. I am not sure

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why the access is restricted to reports for employment or insurance purposes only: why not all reports which are prepared for patients by their doctors for a third party? Although most medical reports which are used for legal purposes are shown to clients, not all of them are.
Some reports to housing or social service departments are not made available; perhaps they should be. Can we be sure that the provisions in Clause 4, which require a delay of up to 21 days in the submisson of reports when access has been requested, do not unduly delay the sending off of those reports? Usually I am under pressure from the patient himself to produce the report absolutely as soon as possible, because a mortgage or a job may depend upon it. Is it not possible that by requesting access, a delay, possibly unwittingly, might be incurred? Could the noble Lord say whether pressure by the requesting firm or person might in fact dissuade a patient from requesting access to a copy of his report?
One small and useful aspect of the Bill is that it will require medical practitioners to keep a copy of the report they make for at least six months. This is useful not only for purposes of the Bill but also for the clinical records, because the report often provides a useful summary of the patient's medical history to date.
I should like to make one last point on Clause 6. I think it is essential to allow the withholding of information in certain cases. It has to be inserted for the very small number of patients who might be damaged by hearing or reading some bad news about themselves which has so far not been given to them. This would concern only a very small proportion of patients, certainly in my own case; but I think it has to go in.
I may have missed the point made by the noble Lord earlier in his introduction of the Bill but at the end of Clause 6(1) it refers to a medical report whose disclosure:
"would indicate the intentions of the practitioner in respect of the individual".
One can think of all sorts of things that that might mean. Could the noble Lord perhaps spell out what is actually meant by these words in the Bill? I think that this is a very useful Bill and I intend to support it fully.
6.43 p.m.
Lord Ennals: My Lords, I do not need to add much to what has already been said. I very much welcome this Bill and congratulate Archie Kirkwood on introducing it in another place and the noble Lord, Lord Tordoff, on introducing it here in a somewhat amended form following its passage through the other place.
Until I read the report of the debate, I had not fully realised the importance of this small piece of legislation. I had not clearly thought, as I should have done, that when any of us applies for a life insurance policy we are in a sense giving permission for information to be made known to other people that we may not precisely know ourselves; nor would we realise how many people may be involved.
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It is essential that we should at least have the protection of being able to see the information which is being passed from one person to another, particularly as, as the noble Lord, Lord Tordoff, said, there may be a mistake. It could be that the information given not only includes something about another person but may contain something which is quite incorrect about ourselves. We simply would not know that such information had been passed on and we do not know what has been passed on. It is absolutely essential that such problems are dealt with. The doctor may have mixed us up with another patient or he could have made some reference about sexual behaviour or drug addiction which could be extremely damaging whether or not it is true.
The purpose of the Bill is absolutely right and it may be that as a result of the representations that I am sure several of us will have received from the British Insurance Association some amendments may need to be introduced.
I heard the point that was made by the noble Lord, Lord Mottistone, who is not in his place at the moment. I would not wish to comment on the point made by the National Schizophrenia Fellowship without studying it more carefully. I would be concerned if anything were done in this House that would prevent the Bill achieving Royal Assent. We would have to look very carefully at an amendment proposed at this stage, bearing in mind that any amendment approved by this House would have to go back to the other place. It is perhaps a pity that any such changes could not have been introduced in another place. However, I am encouraged to know that the Bill at this stage has the approval of the BMA, and if there have to be amendments we will look very carefully at them from these Benches. I hope we can pass this Bill, which is already a compromise Bill, pretty rapidly through your Lordships' House.
6.46 p.m.
The Earl of Arran: My Lords, perhaps I may begin by paying tribute to the noble Lord, Lord Tordoff, who has given us such a clear and lucid explanation of the Bill, and to the honourable Member for Roxborough who introduced this Bill in another place.
Although the Government would not have chosen to legislate in this area, they believe that as a matter of principle people should have the right to know what is recorded about them. Where somebody finds that information is incorrect or misleading, it is only right and proper that they should have the opportunity to amend or modify that information.
The Bill provides for individuals to have the right of access to medical reports relating to themselves provided by medical practitioners before they are passed to a prospective insurer or employer. Where considered necessary, the individual has the right to amend the report or even prevent it being sent. This Bill is confined only to reports prepared by the medical practitioner who is or has been responsible for the clinical care of the patient.
The medical history provided in those reports prepared for employment or insurance purposes will

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be reflected in an individual's medical record. The Government gave an undertaking last year that they would enter into talks with the medical profession with a view to opening up medical records to patients on a non-statutory basis. This Bill comes at a time when such talks are taking place, and indeed had they been completed it may not have been necessary. It is nevertheless compatible with our general philosophy and we do not therefore seek to oppose it. The complications of trying to legislate on even this limited front are illustrated by the Bill before us. In many ways the practical difficulties of implementing a Bill of this kind confirm our belief that the non-statutory approach is to be preferred if at all possible.
The Government have an interest in seeing that legislation that reaches the statute book is satisfactory. We wish this Bill well in its passage through your Lordships' House and we shall be taking advice to see whether any technical deficiencies exist in its drafting which can be put right at Committee stage.
In the meantime I can confirm to the noble Lord, Lord Tordoff, that it is the intention to apply the Bill to Northern Ireland by Order in Council once it receives Royal Assent. Furthermore, in response to my noble friend Lord Mottistone, we shall be looking at the points made by him before it is considered in Committee.
6.49 p.m.
Lord Tordoff: My Lords, I am most grateful to everybody who has joined in the debate today on this short but important Bill. The noble Lord, Lord Mottistone, has clearly raised an important point and one which I should like to take away and look at to see what might be done. My initial feeling is that perhaps it is covered by Clause 6(1) and (2), but if I am wrong about that let us by all means find some way of covering it. I believe also that his comment is probably more applicable to medical records than to a report of this kind where the whole record would be exposed and quotations from other people may be seen and need to be expunged. It is less likely that such quotations will be contained in a medical report, but we shall look at the matter and see what can be done.
I am grateful to the noble Lord, Lord Rea, who raised the question of housing and social services and other matters about which I spoke. It is a fact that we must go step-by-step and it is foolish to try to educate too many government departments at once. Once one moves away from the step-by-step approach, one often finds oneself in the crossfire of a number of interested parties. To a certain extent that occured between the BMA and the insurers, but I believe that we have come through that all right.
The 21 days' delay is as much in the hands of the applicant as anyone else. It is a maximum period of 21 days. If the applicant is in a tremendous hurry to obtain the results, he can see them as soon as he is in a position to see the report. In other words, once the doctor has produced the report, it should be possible for the person to see and agree it. It can then be sent off straightaway and there is no question of having to delay for a period of 21 days. That is the maximum
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period during which the doctor may have to hold it back in order that access might be given.
Clause 6(1) indicates the intentions of the practitioner. Apparently it contains some kind of magic wording from the Data Protection Bill. It was not included by us but at the suggestion of the Government. I cannot pretend to be an expert on the subject in the way in which the noble Lord, Lord Mottistone, is; but I gather that it is a formulation which needs to be included.
I am grateful to the noble Lord, Lord Ennals. I am glad that now he has read the debate which took place in another place he realises that the issue is perhaps more important than it appears at first sight.
The Minister said that the Government prefer a non-statutory approach. I should like to think that that is true, but I fear that there must be carrots and sticks in such matters and this is a fairly gentle stick. If by the passage of this modest measure we encourage the medical profession to move more quickly into a non-statutory situation regarding other matters connected with medical records, the Bill will have achieved a bonus. However, the Minister rightly says that that is not incompatible with the kind of approach that the Government are making. I am grateful for his comment on Northern Ireland and the Order in Council.
I am grateful to all noble Lords for their participation in the debate.
On Question, Bill read a second time, and committed to a Committee of the Whole House.

Companies (Audit Committees) Bill
6.53 p.m.
Lord Bruce of Donington: My Lords, I beg to move that the Bill be now read a second time. If noble Lords do not already know, they will be sorry to learn that unfortunately the promoter of this Private Member's Bill, Sir Brandon Rhys Williams, died in the small hours of this morning. I am sure that the whole House will wish to send a message of sympathy to Lady Rhys Williams and their three children.
Noble Lord: Hear, hear.
Lord Bruce of Donington: My Lords, he fought his last illness with great bravery and it is a shame that at the early age of 60 he should be taken from the House in another place and from us in this House.
For some time Sir Brandon Rhys Williams fought a battle for what he conceived to be the rights of ordinary shareholders in large companies. He wrote several works on the subject, among which I commend to your Lordships his book entitled More Power to the Shareholders.
I should like to explain how I, who belong to the opposite political party to Sir Brandon Rhys Williams, find myself in the position of moving the Motion today. On 28th April of this year I received a telephone call from Sir Brandon Rhys Williams. He was in hospital and he asked me to see that his Bill is passed through the House of Lords because it is a

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non-party measure which has the support of nine prominent Members of the Conservative Party in another place, a Member of the Labour Party and a Member of Plaid Cymru. It went through the House of Commons on the nod. I looked in the House of Commons record on the subject and found that it had given him leave to introduce the Bill on 22nd March of this year. It passed through all its stages on 15th April. I looked at Hansard and there it was. The entry contained 12 lines indicating Second Reading, Committee, Report and Third Reading. In due course the Bill came to your Lordships' House.
The moment I learnt of that and checked it I went to my Whips and said: "The Bill will go through as a formality. Do you mind if I propose it?" They raised no objection and so I went to the Government Whips' Office and asked if I could have a date. They said that it would be 18th May and asked how much time I required. I said that on the basis of its performance in another place I thought that two minutes would suffice. I thought that I would merely say, beg to move", and that the Bill would go through all its stages.
From that moment onwards all hell broke loose and the the CBI erupted. The noble Lord, Lord Mottistone, who will presently move an amendment, indicated that he wanted the whole issue postponed for six months. The Motion that he will move to that effect will virtually have the effect of ensuring that the Bill goes nowhere. Moreover, noble Lords must believe me when I say that I thought I would speak for two minutes and that the Bill would go through on the nod. However, today, instead of a comparatively small debate we have no fewer than 17 Members of your Lordships' House who wish to speak on this subject. They include some of the leading captains of industry who are easily recognisable.
In order to avoid any misunderstanding as to the contents of the Bill, it would be right to acquaint your Lordships with the provisions. It has only three provisions. In the case of public companies it provides that its directors shall state,
"which, if any, of the directors at the end of the relevant financial year were independent directors.".
That is all they must do—just state that—and it is all that is required for the information to the ordinary shareholders. I cannot see that that smacks of dictatorship. I believe that it is a normal concomitant of the new capitalism, as described by the Prime Minister, where shareholders should receive information of that kind.
The second provision, together with the third, relates to what is described in the Bill as a "major public company". Within the terms of the Bill, a major public company is one that has an annual trading figure of £300 million and at least £100 million in its balance sheet total and employs over 2,000 people. I believe that there are some 250 to 300 in the country. They are very big and very powerful.
Sir Brandon's Bill requires, first, that in the case of major public companies the directors shall state whether it is their policy to make appointments of independent directors. That is all. The Bill does not
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require the directors to appoint them. I should have thought that that was fairly innocuous.
The second provision of the Bill relating to major public companies is that all the shareholders should be afforded the opportunity at an annual general meeting to say whether they wish an audit committee to be appointed comprising independent directors. Nothing in the Bill says that the company must appoint them willy nilly by virtue of the Bill. It provides that shareholders may be given the opportunity to decide whether such an audit committee should be appointed. If a majority of the shareholders decide not, that is the end of the matter. The Bill does not order that they shall do so. All that these powers mean is that the shareholders, if they wish, can decide upon these principles.
I know that in the course of the Bill—it would follow—there are definitions of the duties of such an audit committee when appointed. There is laid out a schedule of the proceedings that take place in the audit committee. The conditions under which the audit committee shall report to the directors are described. There is also a definition clause that seeks to define what an independent director is.
I willingly concede, as Sir Brandon conceded, that there must be ways of defining "independent director" more precisely. These, I submit, are Committee points. Similarly, some changes may be desired in the way that the audit committee itself is comprised and in the manner in which it conducts its affairs. There may be such variations. Indeed, I discussed them with Sir Brandon when he was still alive.
I submit that nothing in the Bill should have sent such a tremor of terrified horror into the august ranks of the CBI. Indeed, I am given to understand that the CBI is not without representation in another place any more than it is without representation here. How come that the CBI did not know what was happening in another place? I do not want to make too much of it, but it does not smack of too much efficiency to me. I should have thought that the most minute attention would have been paid by the CBI and its members to the proceedings in another place.
I submit that the Bill in principle should be given a Second Reading by the House on the basis of establishing the complete validity of the principles with which I have endeavoured to acquaint your Lordships. Either people's capitalism means something or it does not. The general public, or those who have the money, were told in the privatisation campaign that they were now going to become capitalists, which means of course that they would have some power. If their shares entitled them to no more than the same kind of privileges but without the security that a building society deposit would give them, there would seem little point, while of course asking them to subscribe to shares, in calling it a popular capitalism because, on the face of it, the CBI and its august members would seem to be unduly sensitive about the matter.
One is well aware that the larger companies—though not all of them—are director controlled. The directors may have only a minority of the shareholding themselves. Their shareholdings may be

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widely diffuse. It is so in some cases; it is not so in others. I am reluctant to think that the CBI will throw its weight behind directors purely because directors do not want shareholders nosing into the business that they control, as that would surely be an unworthy posture of the CBI.
I come now to the position of the Government in this matter. They had an opportunity of considering a Bill in May 1987. They considered it in Committee, and were most helpful to Sir Brandon Rhys Williams. It went through with the approval of the Committee, which had all parties sitting upon it. Then it could not be taken because of the pressure on parliamentary time in the 1987 session. My friend—and I call him that—Sir Brandon Rhys Williams, benefiting from the counsel that he had received in the meantime to improve it slightly, then brought it back.
What is the attitude of Her Majesty's Government? I am given to understand that it is one of neutrality. What a posture for a government supposed to be full of dynamic and to have the positive or negative answer to everything! If that be the attitude of the Government, I suggest that it reflects a weakness that has so far remained concealed but apparently can be concealed no longer. One can almost say to the noble Lord: why—what stretch of the intellectual perception is necessary to say "Yes, we approve it" or "No, we do not"? What ambiguity of policy, what nod from the Prime Minister, is necessry before an imprimatur of either yes or no can be given to a Bill of this kind? Why the paralysing, shivering indecision? Is it because Her Majesty's Government are afraid of the CBI? The noble Lord of course will have much to answer for.
I hope that the House will give the Bill a Second Reading. That will enable the House and the country to arrive at a decision on whether the principles that I have outlined, which I have not sought to stretch in anyway and which are in the Bill, are broadly acceptable with the oft expressed desire to protect the interests of the small shareholder. I concede that, there may be parts of the Bill, more particularly the detail, that may give rise to legitimate arguments. I shall seek to answer or to accommodate on behalf of Sir Brandon Rhys Williams, as many of those as possible. Tonight I cannot speak for my party but, as your Lordships' will be well aware its position will be in the very capable hands of my noble friend Lord Williams of Elvel.
I hope that the House may find that in the present circumstances the decent and honourable thing to do is to allow Sir Brandon's Bill to have its Second Reading. I beg to
move.
Moved, That the Bill be now read a second time.—(Lord Bruce of Donington.)
Lord Mottistone Lord Mottistone rose to move as an amendment to the Motion that the Bill be now read a second time, to leave out ("now") and at end to insert ("this day six months").
The noble Lord said: My Lords, I am indeed sorry that Sir Brandon Rhys Williams has died. For perfectly genuine reasons I did not have the privilege of knowing him, but he was obviously an important Back-Bencher in another place who had the courage
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of his convictions. That stands out from this Bill. It is extremely sad, that he should have died this very day. I have spoken with people about whether or not to postpone consideration; but, on the whole, I think perhaps not. We have consulted the Clerks on this matter. The Bill may have been initiated by Sir Brandon and could be described as his Bill, but once it appeared before Parliament it became Parliament's Bill. It is as Parliament's Bill that we should consider it today.
If, as I hope, your Lordships will back me, my amendment will dispose of the Bill for the rest of this Session. I am fully aware that by convention we do not normally treat Private Members' Bills from another place so drastically. However, this is no normal Bill and it has arrived before us somewhat unusually. The convention to which I have referred is normally exercised for balloted Bills that reach us. This Bill was a Ten Minute Rule Bill which slipped through all its stages in under an hour and when few people knew that it was being taken. The CBI, which is advising me on this matter, knew that there was such a Bill but did not receive the usual warning that it receives when company Bills are being taken. Indeed, it had no warning at all.
It is not reasonable of the noble Lord, Lord Bruce, to imply that the CBI was somehow deficient in this area. There are arrangements that take place but in this case they did not. One may question why that was so, but it is old history and is not the point. It is relevant in this case because it means that this is an unusual Bill. Therefore, I believe strongly that this Bill—the previous versions of which have failed in another place over 15 years—is a had Bill and it is proper for us to reject it.
The Bill is bad because it stems from the draft European Community Fifth Directive and the draft Vredeling Report which proposes a form of two-tier boards on the lines of company direction in Germany, both of which directives were rejected by your Lordships' European Community Select Committee about 10 years ago. Although the Bill does not produce the same two-tier boards as Vredeling, it effectively undermines the unitary board structure as practised in this country to our own very great advantage. For example, Germany is in sharp decline at present, industrially. There was an excellent article explaining this on page D9 of The Sunday Times last week emphasising the fact that the fall in competitiveness was due in no small measure to the Germans catching what used to be called "the British disease"; namely, wages too high for work done, inflexible working practices, etc. Although the article does not say so, a strong contributor to the German decline will have been the two-tier boards because they divide and weaken the authority of top management.
Britain's top management was weakened in other ways in the 1960s and 1970s and we do not want that situation to return ever again in any form. The Bill seeks to establish by law, as the noble Lord, Lord Bruce, has told us, that all companies employing more than 2,000 people should have at least three non-executive directors—I call them non-executive directors although they have a different title in the Bill—who shall form an audit committee half of

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which shall be non-executive with a non-executive chairman. Ironically, the CBI is currently encouraging voluntary adoption of just about the same system in all companies. Furthermore, most medium and large companies already have non-executive directors and many also have audit committees.
Your Lordships might therefore wonder why it is so terribly wrong to confirm this practice by statute. The trouble is the small print in the Bill. Voluntary audit committees are now formed by companies from wise and knowledgeable, mainly non-executive, directors because the companies want the kind of advice that such committees can provide. There is no question but that the audit committee is other than subordinate to the main board and its reports are made accordingly. The schedule to the Bill gives much independent power to the audit committee and in paragraph 16 it makes the audit committee report directly to the shareholders. This feature alone, I suggest, introduces two-tier boardism with all the disasters of divided control that can stem from it.
Although the schedule is nominally voluntary guidance—it says so in the Bill—it is not hard to see that its very existence will gradually create a demand for its enforcement; insidiously, company by company. Thus the Bill does not harmlessly enact a good practice which the CBI encourages; it creates a monster which could destroy a good company from within. In any case, if we have a good practice used sensibly by successful companies and encouraged by the CBI, why enforce it legally with all the dangers that could come from that?
I trust therefore that your Lordships will support my Motion. I note that there are many noble Lords who are to speak. I thank them very much because I believe that some of them may agree with me on this point. I hope that for the benefit of all they think it suitable to say a few words in support but to restrict their contribution to under a minute or two. I beg to move.
Moved, as an amendment to the Motion that the Bill be now read a second time, to leave out ("now") and at the end to insert ("this day six months")—(Lord Mottistone.)
7.19 p.m.
The Earl of Halsbury: My Lords, I am greatly obliged to my noble friend Lord Milne for allowing me to intervene in the debate at this point. Sir Brandon Rhys Williams was my cousin and my friend. He was 20 years my junior and I had known him from the day he was born until this morning when he died in the small hours. Nothing is sadder for a person in my age group, as he totters into his ninth decade, than to watch the departure from active affairs of younger people who had so much promise and so much to give.
Heroically, he arose from his deathbed to move the Third Reading of the Bill in the House of Commons. Last week, knowing that his life was ebbing to its close, he sent me a message. He asked me to support my noble friend Lord Bruce of Donington on the Bill. I sent him a message saying that I would. Having
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given my word, I must keep it. My noble friend must therefore accept that if he needs a Teller at the end of the debate there will be at least two of us.
I do not want to oppose the temperate speech of the noble Lord, Lord Mottistone, with whom I have been friends for many years, as I was with his noble father for many years, but he has produced what I might call a battery of industrial heavyweights in support of his thesis. I have to ask myself: does he represent the voice of British industry or the voice of British industrial complacency? I regard myself as a British industrialist who in permanent opposition to British industrial complacency has forged a career. Before I was 30 I had conceived an industrial process, built the plant to operate it, taken the product on to the road and sold it at a profit, and then passed on to my text task. I ask all those who think they stand for British industry as opposed to British industrial complacency whether they did what I did before they were 30; and I have been doing it ever since. Many of them seem to be administrators, share manipulators and merger administrators, but have they ever held in the hand the product they designed? I ask them to ask their consciences whether that is so before they oppose the views expressed by my noble friend Lord Bruce of Donington.
I think I have said enough to comply with the pledge I gave to my counsin that I would support the noble Lord, Lord Bruce, in his promotion of the Bill.
7.23 p.m.
Lord Milne: My Lords, I rise to support the amendment in the name of the noble Lord, Lord Mottistone. I believe that the Bill is unnecessary. Most of the large groups already have an audit or a similar committee, while the principle of the non-executive or independent director for quoted companies is well accepted. It is untimely because directors are still reeling from the weight of unassimilated legislation of the past three years. It is impractical. When it is already difficult enough to recruit non-executive directors it will place upon them duties which I would not relish and which some, if not professionally qualified, will not be capable of carrying out. In an acquisition or takeover, when time is all important, separate reports are almost impossible. Any director who has been involved in a takeover will know the truth of that statement.
This brings me to what I think is the most unfortunate attitude of the whole Bill. It is thoroughly divisive. It introduces a "we" and "they" concept into company management. At paragraph 15 of the schedule the chairman of the audit committee is required at the annual general meeting to read out a report on the board of which he is a member. I dread to think what the noble Lords, Lord Hanson, Lord Weinstock or Lord Forte, who I see in his place, will say. It might even be negative. The Bill virtually sets up a mini-board alongside the main board.
While I share the grief of noble Lords at the sad death of the author of the Bill, I would not wish to consider it in Committee and I therefore support the amendment proposed this evening.
7.26 p.m.
Lord Lucas of Chilworth: My Lords, I rise to support my noble friend Lord Mottistone in his amendment but at the outset I should like to endorse what the noble Earl, Lord Halsbury, had to say about the late Member for Kensington, a man of untold energy. It is sad that the efforts he spent over the years on Bills of this nature should be thwarted.
The Bill is intolerable in a number of respects. It is intolerable that a Bill of this kind should require that certain companies must state a particular classification of director, the first point in the division between members of a board, as the noble Lord, Lord Milne, pointed out. It is intolerable that shareholders should, subliminally, be advised as to what they should ask of their board at the annual general meeting.
I have never been a director of a public company but I have been a shareholder of a number of companies. Shareholders are well able to ask of their board at an annual general meeting almost anything they want, or find ways and means of having those questions raised. I do not believe that this subliminal interest, as set out in Clause 3 of the Bill, is in the best interests of the company. All directors, whatever one calls them—non-executive or independent—have an equal responsibility in the conduct of the company's affairs. That, in the light of recent examples of perceived failures to observe proper practices and procedures, may give rise to concern, but this Bill does nothing to deal with that problem.
It may equally be that changing conditions and new pressures on companies make reliance on custom and practice and personal relationships established over many years perhaps less sensible and appropriate. One especially significant feature of recent incidents seems to be that, at best, methods were lacking to ensure that board members and senior executives were informed about events, or at worst, the apparent ease with which a minority of directors and senior executives were able to conceal from their colleagues what was happening. It is not that the hitherto informal, and typically British, mainly unwritten framework within which most major boards tend to work has been wrong or is unworkable. However, there may be a need to bring some degree of certainty to the relationships between the board, the individual directors and the secretary and to the internal workings of the board.
I understand from the Institute of Chartered Secretaries and Administrators that it is not opposed to the introduction of audit committees by companies. However, it has reservations about a statutory requirement. That view is worth upholding in the course of this debate. Some parameters, within which improved self-regulation by companies must fall, are emerging. Any requirements must involve the minimum of direct legislation, the minimum interference with commercial activities and the minimum of bureaucracy within the company. I mentioned the Institute of Chartered Secretaries and Administrators because the company secretary is the only officer whose role is expressly defined. It may be that his or her responsibilities to and relationships with the board should be examined. Whatever may
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be deemed necessary, any change should be within the context of a review of company legislation; perhaps a total updating. Therefore, I ask my noble friend Lord Beaverbrook whether his department the Department of Industry—now I think called the Department of Enterprise, although perhaps it should be called the "Department for Enterprise"—has any such review and further action in hand?
7.30 p.m.
Lord Benson: My Lords, audit committees are a well-established principle of company administration. The accounting profession, of which I am a member, has advocated them for many years. I have publicly and privately supported them. I have sat on numerous audit committees, sometimes on one side of the table and sometimes on the other. The difficulty with this Bill is that its defects are so obvious and so deep-seated that I do not think it will be possible to tinker with it by amendment. For that reason I think that there is only one possibility and that is to take the Bill away and, if necessary, rewrite it altogether. I shall return to that point later in my speech.
Before I comment on the Bill's defects, I should like to make two general comments. The first is that audit committees are primarily designed so that the auditors can bring to the attention of the directors, especially the non-executive directors, points and matters arising out of the audit—that is, not just the audit of the parent company but the audit of all the subsidiaries, not only in the United Kingdom but also overseas. Occasionally the chairman of the board, or the board itself, will give the audit committee specific tasks. However, the way in which they now operate, and have done so with great success for many years, does not give the non-executive directors a supervisory role over the executive directors.
My second general point concerns the functions of the non-executive director. In practice a non-executive director's function is to provide general advice to the hoard. Sometimes—as in the case of audit committees—the chairman of the board, or the board as a whole, will ask the non-executive directors for such advice. However, the advice they give is related to policy and principle. They are confined to doing that because it is quite impossible for them to do anything else. Any attempt to invest the non-executive directors with greater powers and responsibilities is, I suggest, doomed to failure.
There are five defects in the Bill which make it impossible for it to continue in its present form. The first is that the apparent object of the Bill—certainly its effect—is to impose a policing or supervisory function on the non-executive directors over the executive directors. That is highly divisive and will be deeply resented by the executive directors. It is also a function which the non-executive directors—as I have just explained—are quite incapable of exercising. Apart from anything else the provisions of the Bill add a top hamper of administration, meetings and reports, which will only clog the administration

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of commercial and industrial companies. Companies are already over regulated and such an additional provision will merely add fuel to those flames.
The second defect is that Clause 3(a), which goes to the heart of the Bill, is totally unworkable. It provides that the non-executive directors should review the financial statements. However, there is no definition as to what "financial statements" are or as to the meaning of "review". I wonder whether it is realised just what financial statements really involve. They are prepared by the executive directors with the aid of subordinate staff. They have to comply with an enormous raft of particular provisions from the Companies Act and they must also comply with accounting standards. The possibility of non-executive directors making a review of such statements, which sometimes have taken weeks or months to prepare, is really ludicrous. Apart from anything else, many of the non-executive directors have no financial skill whatever; they are appointed for different purposes—for example, because of their skills in research, in personnel or in international affairs. Therefore to load them with the responsibility of making a review on something which has been prepared by the executive directors is out of the question. If financial statements have to be reviewed at all, the proper body or organisation to do it is the auditors. Such people are skilled in the task and they spend their life on the job.
The third defect is that if the Bill becomes enacted, every public company in the country will be required to state whether or not its directors are independent. Again, this leads to a misunderstanding of the role of the hoard of directors. The members of a board of directors have a collective responsibility for directing and administering the company. The idea that any directors can be identified as being independent is quite unrealistic and, if it is allowed to go through, it will mislead the public.
The fourth defect is this. There are many audit committees already in existence and others will be appointed. They work very well in practice. However, if the Bill goes through it means that some audit committees, appointed under the provisions of what will then be an Act, will have certain statutory obligations. As a result there will be a hotchpotch of audit committees up and down the country with differing responsibilities. The public will not know what an audit committee actually intends to do and what safeguards it provides. Again, the public will be misled.
The fifth defect of the Bill is that the definition of what is called an "independent director"—wrongly I think—is so narrow that it will be most unlikey that enough independent directors will be found to staff the boards of the companies to which the Bill is directed.
In any event, I think the Bill will be self-defeating. No responsible board I have ever dealt with would dream of appointing an audit committee which complied with the provisions of the Bill. They would know that it would be divisive; they would resent the task put upon the non-executive directors and they would know perfectly well that the non-executive
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directors could not possibly comply with the directives put upon them by the Bill. For that reason the Bill will fail, in any case, should it become an Act.
The other objection to the Bill is that it will imply in the public's mind the fact that the non-executive directors can give a much greater supervisory role than is possible—again the public will be misdirected, and misled. Therefore, for all those reasons, there is no alternative but to reject the Bill in its present form. In any event, I doubt whether legislation is necessary. However, if it is thought to be necessary, I should like to point out that the duties of non-executive directors have been well set out in authoritative publications for many years past. Oceans of professional ink have been used in defining the duties of audit committees and as a result of all that such committees have worked well.
If the introduction of a Bill is necessary, I suggest that it should be drawn from what is already in operation and already well documented in authoritative publications. However, there is one other alternative. If the Government are convinced that such legislation is necessary—although I think it unlikely—the proper place to implement it is in a revision of the Companies Act 1985. That will happen in any case probably next year or the year after in order to comply with the provisions of the European Community and its directives.
Under all those circumstances I suggest that the Bill should not receive a Second Reading.
7.40 p.m.
Lord Hanson: My Lords, I should like to associate myself with the tributes paid to Sir Brandon Rhys Williams. I should also like to say that the noble Lord, Lord Benson, has more than covered all the points that we consider to be undesirable about the Bill. However, my reasons for opposing the Bill and supporting the amendment moved by my noble friend Lord Mottistone are that it is unnecessary; it would be detrimental to industry and shareholders; and it is unworkable.
As your Lordships have heard from other noble Lords, the Bill would change company law as we have known it for generations, and known it to work successfully. The present system has been built up over many years, refined by voluntary means as needed, and has stood the test of scrutiny by companies' auditors, the Stock Exchange, the media, and, most important, the shareholders.
It is a system based on equal responsibility and mutual trust between executive and non-executive directors, meeting on a monthly, quarterly or annual basis to protect the interests of their shareholders, employees and customers. Surely there is a great deal to be said for that old saw, "if it isn't bust, don't fix it".
We in industry are not against the appointment of non-executive directors; we welcome them. We are not opposed to sub-committees, wages committees, charity committees, investment committees or even audit committees. What we do oppose most vigorously is the imposition by statute of a requirement that seeks to place non-executive directors in a position of having legal authority over that of the rest of the board.

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I was recently a member of an audit committee of a major joint stock bank. As the noble Lord, Lord Benson, has said, its function was to examine the facts and figures, question management and the auditors, and then report back to the chairman and the main board for them to take such combined action, if any, as they felt necessary. That works very well.
The Bill would undermine the powers of the main board—the whole board—a board properly appointed by the shareholders. My 40 years as a director of many companies, private and public, at home and overseas, warns against a step that would be to the detriment of all major companies and would in no way help British industry.
From personal experience in business I say, away with restrictions. Regulations of this kind, in the midst of a most welcome upturn in the fortunes of British industry, will do nothing at all to increase our country's new-found prosperity. I urge the House to support my noble friend Lord Mottistone in his amendment.
7.43 p.m.
Lord Marshall of Leeds: My Lords, I also join noble Lords in their regret at the death of Sir Brandon Rhys Williams. Nothing I say, shortly I hope, in opposition to the Bill is to be taken as indicating that I am against non-executive directors. I have been one for over 35 years and I still am. Neither am I opposed to audit committees. I have served on audit committees. I currently serve on a voluntary audit committee.
Audit committees will be seen as the thin end of the wedge. I agree with my noble friend Lord Mottistone that in due course they will lead to a suggestion for two-tier boards. It is for those reasons that I say the Bill is ill-conceived. Many plcs currently do not have independent directors. That is either because they do not believe in them or because they just do not want them, or, if they do believe in them, they cannot get them. They cannot recruit them because they will not pay enough fees for them. A whole army of non-executive directors will be required if the Bill goes much further.
The undesirable consequences inherent in the Bill would be that the audit committee would be placed in a preferred position in regard to the consideration of financial material. Secondly, it would distance the auditors from all members of the board who are not members of the audit committee and vice versa. It would appear to authorise the audit committee to dictate to the board as a whole the matters to which it thinks the board should give its attention. That, I believe, is the consequence—whether intended or not—of Clause 3. In so doing, it would create first and second-class board members. In plain words, it would be a denigration of those directors who are not selected to sit on the audit committee. It would delay the provision of financial information for the entire board. It would run completely counter to the concept that all directors are, in the eyes of the law, responsible and liable to the shareholders for the proper conduct of the company. They are liable both individually and collectively; both jointly and severally.
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I would not care to serve on any boad of which I was not a member of the audit committee. I have never been an executive director so I would have much more chance of being on the audit committee, if my age were not against me.
There is one final point, which I think is a serious one. Your Lordships will recall that the recent insolvency legislation has significantly enhanced the liability of directors when a company goes into liquidation and where the liquidator becomes a litigator and inquires into the company's affairs. There is now this new concept that without having been actively dishonest, a director can, by his passive indifference, or his failure to pay attention, place his personal assets at risk and put himself in the position of having himself declared by the court to be disqualified from acting as a company director for a period of years.
I remember that the noble Lord, Lord Bruce of Donington, was much involved in that Bill in the House. It would be an ironic mitigation for any company director who falls foul of the company insolvency laws to be able to plead that as he was not on the audit committee he received only a garbled ex post facto statement from the audit committee as to the financial state of the company, and that it was rather too late for him to do anything about it. He could have his personal wealth put at risk.
It is because I feel that the concept of the single-tier board should not be eroded that I believe it would be wrong to dictate that the concept of audit committees should be put on the statute book. It is also wrong for the appointment and remuneration of auditors to be removed from the decision of the board as a whole and to be vested instead in the audit committee. The Bill will not commend itself to many people in business and commerce. For those reasons I support the amendment.
7.48 p.m.
Lord Wilberforce: My Lords, I hope that I may be permitted to add my voice to those who have paid tribute to the sponsor of the Bill in another place. Like the noble Earl, Lord Halsbury, I can claim that Sir Brandon was related to me by marriage. I live in Kensington, which he represented with such distinction for a long time. Apart from those connections with him, I long admired him in politics as an independent and socially-minded advocate of useful reforms. If there is one thing for which he was renowned it was for the care with which he consulted interests which might have been involved in any legislation. One has seen that in many other measures he brought forward.
I refer to Sir Brandon Rhys Williams's speech in another place on the First Reading of this Bill. He consulted the following bodies: the Bank of England, The Stock Exchange, the Takeover Panel, the CBI, the Institute of Directors, the Institute of Chartered Accountants, the Chartered Association of Certified Accountants and colleagues on both sides of the House, with useful hints from the Department of Trade and Industry. It cannot be said that wide interests have not been consulted, but perhaps one

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can weigh the benefits of those consultations against the powerful voices which have been heard this evening from one interest.
With some diffidence I raise only a small voice against a powerful artillery which has been assembled against the Bill. However, I suggest that this is not a monster of a Bill in any sense. It is a modest but useful piece of legislation. Let us consider why we need it at this point. I believe that there is a greater need now than there has ever been for understanding and openness about the financial affairs of our great companies. They no longer simply make articles and sell them. They engage in an enormous number of very complicated activities involving huge sums of money. They are managing other people's money in the institutions and pension funds for private shareholders. Necessarily, and often beneficially, they engage in huge financial operations, mergers, takeovers and so on. In principle it is surely good that greater openness as regards the shareholders should be available and should be taken into account by those who ultimately own the companies.
There is nothing very terrible about audit committees. Many speakers have pointed out that they exist anyway and have been found to be very useful, and that in effect this Bill comes very near to what is already a fairly good and well established practice. One has to bear in mind that auditors of the great companies are not always independent and certainly not independent of the board. In some cases to have another committee looking at the financial statements can only be for the benefit of the shareholders.
As to outside directors—and I use the word "outside" at the moment without prejudice—many speakers have said that they recoginse their value. They exist in a number of our greatest companies. They are liable to have not much to do until calamity strikes, and then their role becomes very important. This Bill gives them a little more power and a few more duties but not—and I shall return to this—in any way a divisive power. I believe that it is a misconception that their power is divisive. That misconception lies at the root of much of the opposition of the Bill and is not well founded.
This is a permissive Bill and is in no sense authoritarian. It does not impose anything on anybody. It leaves everything in the hands of the shareholders. There is no obligation on anybody to set up an audit committee. It says that an audit committee may be established by ordinary resolution. Everybody who has been to a general meeting of a company knows perfectly well that an ordinary resolution with a large number of shareholders is a fairly difficult measure to pass if the board opposes it. The chairman will be there with a whole sheath of proxies in his hands, and large institutions will have made up their minds. However, unless the shareholders, supported by the board or at least by the major institutions, wish an audit committee to be established it will not be established.
In essence this Bill enables an audit committee to be set up without the necessity of altering the articles of association. Any meeting of a company altering
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the articles with a three-quarters majority can set up an audit committee. The Bill simply gives power to the shareholders without the necessity of altering the articles if they wish and if they can muster the majority of an ordinary resolution to set up an audit committee. The directors can oppose it and if they do it is not very likely that it will be carried.
I shall not deal in detail with some of the points urged, particularly by the noble Earl, because I feel sure that the noble Lord who sponsored the Bill will reply more effectively than I can. However, perhaps I may make a few points which are contrary to the suggestions from previous speakers. First, there is no imposition on any company to appoint independent directors. It does not, as I have seen the CBI suggest in correspondence, fix a set number of independent directors. It does not create any obligation to appoint any independent directors. It merely states that if there are no independent directors, that that should be reported to the shareholders and one then has to see what happens. There is no mandatory obligation to appoint independent directors.
The second point—and I have already made this to some degree—is that there is no compulsion for an audit committee. One cannot be set up without an ordinary resolution and that depends either on the wishes of the directors or the institutions.
Thirdly, and I believe this to be very important, the Bill does not promote or encourage a split in the board of directors. It does not create a division on the board between one set of directors and another. One has only to look at the schedule to see that the audit committee is a committee of directors and not a particular section of directors. Paragraph 1 states:
"The audit committee shall be composed of such directors of the company as the directors shall determine".
It is simply a body of directors.
The schedule goes on to say that there have to be at least three independent directors, and there must be as many independent directors as there are ordinary directors, and it gives a casting vote to the chairman. If anybody is afraid of that let them amend the schedule by taking out the casting vote of the chairman. If they wish, let them give the majority vote to the ordinary directors.
However, the concept of the schedule is perfectly sound, is it not? It does not create a separate body over and above the board of directors. It creates a committee of the directors to do the job which the audit committee should do. What is it to do? It merely reports to the directors. It does not override anybody. It does not take over the powers of the directors. It reports to the directors and the directors have to decide what to do.
A reference was made by one noble Lord to paragraph 16 of the schedule, which says that it has to be attached to the balance sheet and read before the company in general meeting. If anybody thinks that that is too strong meat, let them take it out. There is liberty to amend the schedule. A company does not have to adopt the schedule if it does not want to. It can produce its own regulations. If noble Lords feel that its presence in the optional schedule is too strong, let them move to have that paragraph taken out.

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Fourthly—and this is a development of the same point—it does not set up a supervisory board German style. There is no foundation whatever for saying that. Why frighten us with a supervisory board German style? Why frighten us with European directives? This matter has nothing to do with that at all. It creates an audit committee of the directors. There is no separation of one board above another and no interference with the directors' powers.
One can argue about many of the directors. If this Bill continues I shall want to say something about the definition of an independent director, which is taken from the Insolvency Act 1986 and is an enormously complicated definition, involving nephews, persons associated in all sorts of ways and so on and so forth. I should want to have some restriction and clarification placed on that section of the Bill, but that is a matter which can be discussed in Committee.
I suggest that the principle of the Bill is quite harmless. If one wished to criticise one could say that it was not strong enough and that it has not got enough teeth in it; it is too permissive and too gentle. But to describe it as a monster imposing all kinds of unacceptable restrictions on boards of directors and creating a division within them represents a misunderstanding of the Bill. I am afraid that I have spoken for too long. But with such vigour as I can command from these Benches, I venture to suggest that the Bill should be given a Second Reading and if necessary be approved in Committee.
8 p.m.
Lord Rippon of Hexham: My Lords, I wish to be associated with the tribute paid by the noble Lord, Lord Bruce of Donington, to Sir Brandon Rhys Williams and with his expressions of sympathy to Sir Brandon's family on this sad day. He was a friend and colleague of mine for many years both in another place and in the European Parliament. In both places he played a notable part particularly in promoting social and economic ideas.
Undoubtedly the provisions of this Bill were a matter close to his heart. He presented a similar Bill over many years in the House of Commons. I am not sure that he had wholly recognised the extent to which the practice of appointing non-executive directors and audit committees had advanced but certainly he could have had no more worthy supporter and promoter of this Bill in the House than the noble Lord, Lord Bruce of Donington. I am sure that he would have appreciated what the noble Lord had to say.
As someone who has been a non-executive director and chairman of a number of companies, both industrial and financial, over a period of more than 30 years, I have no doubt myself of the importance of the non-executive director. I think that he plays an important part on the boards of many companies. Sometimes that is a different part and sometimes there are companies in which there is no need for a non-executive director. I thought that the definition of the role of the non-executive director advanced by the noble Lord, Lord Benson, was perhaps necessarily simplistic. It has, as he said, been the subject of much ink over many years. I gave a speech
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not so long ago which lasted 40 minutes to an American business graduates' association. Fortunately I have not brought it with me but I am sure of one thing and that is that I never suggested and I never would suggest that the appointment of a non-executive director should be mandatory.
Equally I can see that in many companies there is a value in an audit committee. It may depend on the size of the main board. Also, if there is to be an audit committee, I do not believe that that should be mandatory in any way and certainly the shareholders would not be in the best position to judge whether or not that was necessary. I do not think it should report to anyone but the chairman of the board as a whole.
I do not like the concept, however defined, of a so-called independent director. On all the boards on which I have ever served I have always seen the board as a team. It has been put together as a team and the members of the board fulfil different functions whether they are executive or non-executive. This matter must be left to the discretion of the board itself. But the board is appointed by shareholders and if at a shareholders' meeting dissatisfaction is expressed then no doubt note can be taken of that.
It has been said that this Bill is just guidance. I do not believe that legislation is the proper place for guidance nor do I think in this particular case that the guidance is necessarily right or appropriate. The public would obviously regard an Act of Parliament as not simply guidance. They would consider that it was intended to be implemented. To that extent it would be misleading.
I also take the view which has been expressed by various noble Lords that if there is to be legislation it should be legislation promoted by the Government as part of a general review of company law. I take up the point of the noble Lord, Lord Bruce of Donington. I cannot see any reason why we should not now, faced with a Bill which many of us believe to be fatally flawed and incapable of reasonable amendment, say quite clearly yes or no. For my part I shall support the amendment of the noble Lord, Lord Mottistone.
8.4 p.m.
Lord Bruce-Gardyne: My Lords, I too wish to join other noble Lords who have already spoken in tribute to Sir Brandon Rhys Williams. We served together in the House of Commons on and off for 15 years and he was a good friend. It is indeed tragic that he was unable to live to witness this evening's events as I am sure he would have wished to do, because, as a number of noble Lords have pointed out, he had promoted a Bill analagous to this one on numerous occasions over a great many years. I am sure that he would have wished to see the first occasion when this particular proposition got as far as it has.
I must admit that in the 1960s, when I believe Sir Brandon introduced his first Bill on this subject, he asked me to be a sponsor of the Bill. I had to tell him that I would not do that. I must honestly say that my reason for not doing so then was more or less precisely the same as the reason for which I shall be supporting my noble friend Lord Mottistone and his amendment tonight.

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Let me hasten to say to the noble Earl, Lord Halsbury, that I would not remotely claim to belong to the battery of heavy industry. I do not think that I am even a bombardier in that respect. But I have served for the past 15 months as a non-executive director member of the audit committee of the TSB. So I have, not surprisingly, everything in favour of the propositions behind this Bill. But unlike Sir Brandon Rhys Williams and others who have spoken in favour of this Bill tonight I am bound to say that I do not believe that we advance this cause by the route of legislation. I am bound to confess that in general I have never subscribed to the view that legislation is conducive to the sum total of human happiness. I certainly do not think that that is the case today.
Above all I share the anxieties which have been expressed by a number of noble Lords about the inevitable division which this Bill would create inside the boardroom between what one might call the sheep and the goats. I am not quite clear whether it would be more invidious to be designated as a sheep or as a goat.
I listened with care to what the noble and learned Lord, Lord Wilberforce, had to say when he explained that there was nothing which imposed such divisions within this Bill but I have to confess with the greatest respect to the noble and learned Lord that his reading of the Bill is somewhat different from mine. For all those reasons I personally hope that your Lordships will decide that this Bill is not the right vehicle to achieve the purpose which many of us believe in—the desirability of major companies having on a voluntary basis an audit committee in which non-executive directors should be involved. I hope that your Lordships will agree to support my noble friend Lord Mottistone and his amendment tonight.
8.8 p.m.
Lord King of Wartnaby: My Lords, it is of course a sad time to be discussing this Bill. Therefore one feels perhaps a little inhibited about what one might say about it. But my noble friend Lord Mottistone has reminded us that this is now a Parliament Bill. I think it a clumsy, ill-considered piece of legislation. I am surprised that it received such scant attention in another place. No one is quarrelling with the view that audit committees and non-executive directors can and do make valuable contributions to our corporate affairs. Some of my best friends are non-executive directors. What the Bill seeks to do is to discriminate in an insidious way between the two categories of directors. The effect of the Bill would be to derogate from the collective unity and responsibility of the board. It would be interpreted as a move in the direction of a two-tier structure which this country plainly does not need and, on the evidence, does not want.
I am strongly opposed to dictating by statute the number of non-executive directors which a company shall appoint and to which committees they shall be appointed. Anyone who wants to gain a bit of experience in how a board is put together should become the chairman of a nationalised industry. That
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is something which anyone speaking on the matter should experience. I am strongly opposed to the prescription by statute to an audit committee of the functions stated in Clause 3. I am strongly opposed to making the appointment of an audit committee a direct and exceptional responsibility of the annual general meeting of a company in the way that is envisaged in Clause 2 of the Bill.
I do not doubt the good intentions of the author of the Bill. However, the protection of commercial integrity and the promotion of virtue are not achieved by a mechanistic approach. Some things can be achieved by legislation; some must be achieved by persuasion. If, by legislation, we require a corporation to appoint against its will and judgment a minimum number of outside directors, what calibre of directors do we think that company will appoint? How competently can we expect them to discharge the duties imposed on them? We may stipulate that the category of non-executive directors will be imposed on a company as guardian of its morals. Pray, who will guard the guards?
We should be well advised to scrap the Bill. If we feel that there is a need for a better understanding among companies of the importance and value of audit committees and the place of non-executive directors on the committees, we should listen not only to the advice of businessmen but also to the views of the professional institutes and representative organisations such as the Institute of Directors, the Confederation of British Industry—I am not in touch with them—and the Stock Exchange. All those bodies are in favour of greater use of non-executive directors. They have their own codes of practice and advice for members. They are opposed to the measures being enforced by legislation. It would be ill advised for us to disregard their views. I urge noble Lords to vote for the amendment.
8.15 p.m.
Lord Polwarth: My Lords, I speak for no particular interest and without the vast experience of some noble Lords who have spoken this evening. I speak with experience as at various stages an auditor, a non-executive director of various public companies, a non-executive chairman of two companies and a member of the audit committee of a major American corporation. Indeed, I have been the chairman of that committee for two years.
From my experience I believe in audit committees. They have a valuable function to perform. I hope that more British companies will adopt them. However, I hope that they will be adopted by companies in their own way and in their own time. Their great virtue is maximum flexibility in what they consider and how they consider it.
We found in the company in which I served that it was a marvellous opportunity for the chairman to confide in the non-executive director and to let his hair down. It was also an opportunity for non-executive directors to satisfy themselves to the maximum that they had done all they should to see that the company was being run properly. I do not think that that will be achieved by a measure as legalistic as this one, which will result in a straitjacket.

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I hope that we shall see more audit committees. I believe that we shall, and for that reason I do not support the Second Reading of the Bill.
8.17 p.m.
Lord Weinstock: My Lords, I am sorry to have missed the opening speeches of the noble Lords, Lord Bruce of Donington and Lord Mottistone. I was unable to arrive more promptly. I am also sorry to have learnt of the death of the mover of the Bill in another place.
I agree with the noble Lords, Lord Benson and Lord Hanson, that the Bill in its present form is neither necessary nor effective. In that sense I also agree with the noble and learned Lord, Lord Wilberforce, as to the modesty of the Bill. It is unnecessary because a voluntary code of recommended practice on non-executive directors was published in April 1987 with the imprimatur of the Bank of England, the Stock Exchange and the Confederation of British Industry. In September 1987 the Stock Exchange introduced an amendment to its regulations (21(T), Chapter 2 of Section 5) making it mandatory for listed companies to identify independent non-executive directors in their annual reports, complete with photographs.
The term "independent director", which appears to trouble the noble Lord, Lord Rippon, is not in that context so novel as was suggested in a letter published in today's issue of the Financial Times. The Bill is ineffective because, as the noble and learned Lord, Lord Wilberforce, has told us, it does not impose any obligation as to either of the matters with which it is concerned; the appointment of non-executive directors and the appointment of audit committees. It only requires that they be considered. Many public companies already have non-executive directors and audit committees. The GEC, for which I work, has six non-executive directors, all of them independent both financially and personally. We also have an accounts committee, which is approximately the same as an audit committee. On that committee non-executive directors form a majority. Similarly there is a directors' remuneration committee.
I doubt whether such arrangements would be thought objectionable by any serious manager. I do not share the view of the noble Lord, Lord Benson, that the first job of non-executive directors is to supply advice. Certainly that is a valuable function. However, I should have thought that the first duty is to see that the management of a company is competent and honest and that the interests of shareholders are not traduced.
If management does not believe that the appointment of independent directors is in the best interests of the company, its view is unlikely to be overridden by a shareholders' meeting. The restrictive definition of "independent" which is contained in the Bill makes knowing absolutely nothing about the company the only necessary qualification.
As to audit committees, the formal rules specified in the Bill are likely to make management less likely to accept it than it is now with the existing voluntary
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code. The Bill raises but does not answer questions about the responsibilities of non-executive directors. Would they bear heavier responsibilities than other directors? What special responsibilities, if any, do directors of audit committees have to shareholders? To what liabilities will they be exposed?
Perhaps more important is the fact that the Bill bypasses the serious consideration which will sooner or later have to be given to the Fifth Directive of the European Commission. At that time we shall have to confront such issues as two-tier boards, to which I understand there is strong objection in the CBI and elsewhere. We have heard some reverberations of those matters in your Lordships' House this evening.
There are certainly disadvantages to two-tier boards. There are also disadvantages to the present system. As things are today, accession to the main board of a big company is seen by executive managers as an important overt mark of success conferring business and social status, which are perhaps even more coveted than higher remuneration or other benefits. Who can blame them in our society? However, it can be rather a nuisance when there is not enough room round the board table! Too frequently such managers do not have sufficiently wide experience outside their own speciality. In contrast in the United States the position of company vice-president without a main board seat is readily acceptable to very senior executives.
These are serious matters and they need serious contemplation. If there is to be legislation it should be introduced by the Government and its impact on the Companies Acts taken fully into account. I suggest with respect that the best thing for your Lordships' House to do tonight is to accept the amendment of the noble Lord, Lord Mottistone, and take up the matter at the appropriate time and in the proper circumstances.
8.20 p.m.
Lord Williams of Elvel: My Lords, the House will be grateful to my noble friend Lord Bruce of Donington for taking up this Bill, which was passed under what Madam Deputy Speaker in another place described as extraordinary procedures. No government spokesman was apparently present to comment upon the Bill, and I must admit that no opposition spokesman was there to comment upon the Bill either. It went through in a rather curious manner.
The Bill was promoted by Sir Brandon Rhys Williams. I should like to say officially from these Benches how sorry we are that Sir Brandon is no longer with us. Although he was not of our political persuasion, over the years we have admired the effort and determination he put into the causes that he adopted. The fact that he was Welsh may have had nothing to do with that but it must certainly have contributed to the determination with which he pursued those causes.
The Bill which my noble friend has put before the House following Sir Brandon's efforts in another place arouses intense passions, as we have heard during the debate this evening. Like the noble and learned Lord, Lord Wilberforce, I am rather surprised that it arouses such passions. As he said, it

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is a permissive Bill. It allows a certain number of people to do certain things and it does not compel anybody to do anything.
I have listened this evening to very distinguished industralists—heads of important companies speaking on the subject. Not so very long ago in your Lordships' House we had a debate on business education. That is a very important subject. I believe that it is also very important to the noble Lord, Lord Young, and the Government. Not one of those distinguished industrialists who has spoken today addressed us on the subject of business education. I am sorry if special interests, if I can put it that way, come to the fore on an occasion like this, but the noble Lords do not attend for a general subject such as business education. I said that on a slightly sour note, for which I apologise, but I wanted to make that point.
I should like to spend a little time—but not too much time because I do not want to detain the noble Lord, Lord Beaverbrook, too long before he responds to the debate—on the substance of the Bill. I find the argument that it is in some way encouraging a two-tier board system to be quite extraordinary. I think that the noble Lord, Lord Mottistone, implied that the two-tier board system was leading Germany into some form of financial or economic crisis. I find that argument even more extraordinary. I do not believe that the Bill has anything to do with a two-tier board system. Anyone who has looked seriously at the two-tier board system—the Aufsichtsrat Vorstand and the Conseil de Surveillance Directoire system—and how it works (for, as the noble Lord, Lord Weinstock, said, we shall have to deal with all that in the course of time) and at the way audit committees operate in the United States will understand that there is a very clear difference between the establishment of an audit committee and a two-tier board system. I cannot take that argument very seriously.
I think that all noble Lords who have participated in the debate agreed that audit committees are desirable. I cannot think of any speaker who has said that we should not have them or that they are in some way wrong. The question is whether there should be a requirement in statute for shareholders to be able to ask for an audit committee. There will be those who will say, quite properly, that it should be part of Stock Exchange regulations or should be part of something else but should not be in statute.
Perhaps I may say to the noble Lord, Lord Lucas, that I found his views on this topic quite extraordinary. I remind him that only two years ago he was promoting the Financial Services Bill in your Lordships' House from the Government Dispatch Box. That Bill contained statutory definitions of practically everything one can think of. Here he is today saying that it is utterly intolerable that this kind of thing should be put into statute. I must say to the noble Lord in the greatest friendliness—for I am a friend of his although not in the same political party—that we cannot in this House have one attitude, even from the Government Front Bench, on one subject and another attitude on another subject.
Lord Lucas of Chilworth: My Lords, I am most grateful to the noble Lord, Lord Williams, but if he quotes me I should be grateful if he would quote me in entirety. I said, "By virtue of this Bill". I found it intolerable that the Bill should be used for this purpose. I concluded by saying that if change was necessary, it should come about within the context of the review of the Companies Act, and I asked my noble friend what was happening in that respect. That is rather different.
Lord Williams of Elvel: My Lords, I am most grateful to the noble Lord, but I notice that he did not tell me that my quotation of his use of the word "intolerable" in this connection was wrong. We have to take a balanced view as to what is proper in statute and what is not.
I found the arguments of the noble Lord, Lord Benson, to be well expressed and well balanced. He is in favour of audit committees. I hope that the noble Lord will intervene if I have misinterpreted him. He believed that the Bill espoused a good cause but was too flawed to be put into statute. I would agree with him that it espouses an appropriate cause but would argue that in Committee it could be amended to the point where it could be put into practice.
I believe that there are many points in this Bill which need amendment. If your Lordships give it a Second Reading we from these Benches will be moving amendments designed to clear up a number of points which have been raised by noble Lords this evening. We shall be looking at the question of independent directors. I believe with a number of noble Lords that that presents a problem as drafted. The definition is not right. We should like to see it, as one noble Lord put it, in a form in which someone who is interested in becoming a director can become a director rather than being excluded. We also believe and would like to incorporate into the Bill that representatives of employees should have a place and be entitled to a place on audit committees. And I hope that we will come to employee stock option programmes, if I may use the American expression.
We would wish to clean up the definition of financial statements. That is a point which the noble Lord, Lord Benson, raised. We would also like to clarify the relationship between what is included in a financial statement approved by an audit committee and what is approved by the board of directors as a totality under the terms of the Companies Act. My own view is quite plain. I think that the board of directors takes complete responsibility for all documents and all statements issued by companies. In Clause 4 we wish to redefine a number of expressions. We shall have many comments to make if your Lordships decide to give this Bill a Second Reading.
However, I come back to the principle. All noble Lords whom I have heard speak today have said that they are in favour of audit committees. I believe—although I have no evidence—that the Government are in favour of audit committees. If the Bill is not to be given a Second Reading, the Government have to make a commitment to bring forward legislation which will do what the noble Lord, Lord Rippon, said it should do, which is to

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consider, consult and bring forward legislation which will incorporate the measures contained in this Bill. Failing that from the Government, I ask your Lordships to oppose the amendment of the noble Lord, Lord Mottistone, and give the Bill a Second Reading.
8.31 p.m.
Lord Beaverbrook: My Lords, on behalf of the Government I fully support the compliments that have been paid this evening to Sir Brandon and to his persistence and tenacity over the years on matters including the one before us tonight, in which he passionately believed. He was a powerful advocate who earned widespread respect for the skilful and professional way in which he approached whatever task to which he set his mind. He will be a sad loss to Parliament and our sympathies go out to his wife and family.
Turning to he Bill itself, as has been pointed out, the Government have adopted a neutral attitude towards it. This is not because we believe that the matters that it covers are not worthy of attention. On the contrary, they are of major significance touching as they do on the way in which public limited companies conduct their business.
The Bill relates to two particular areas affecting the running of PLCs—independent directors and audit committees. The Government are among those who believe that independent or non-executive directors have an important contribution to make to the affairs of many companies. I do not think that anyone here tonight has said anything against the contribution that non-executive directors can make. We also believe—and I would say this particularly to the noble Lord, Lord Williams—that audit committees can play a valuable part in many companies and I know that business and accounting circles are becoming increasingly interested in extending their use.
But the Government believe very firmly that it should be left to a company's directors and shareholders to decide whether or not it should make use of either independent directors or audit committees. That is why we resisted for so many years the proposals which were regularly put forward by Sir Brandon. Although Sir Brandon's proposals changed in detail over the years, their common feature was a requirement that both non-executive directors and audit committees be made compulsory for some categories of companies. In the present proposals there is a major change from those earlier ideas. The purpose and scope of this latest set of proposals have already been explained in detail and I need do no more than emphasise that they now contain no element of compulsion. They do not attempt to take from shareholders and directors the duty and responsibility of deciding whether a company should have independent directors or audit committees. This aspect is fundamental to the Government's decision to take a neutral line on this Bill.
My noble friend Lord Lucas asked whether the Government have any general review in hand to update the totality of company law. There is no such
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review in hand but I have noted my noble friend's suggestion that when there is the subject should be included in it.
The Government would not themselves have brought forward such a measure. But with a Private Member's Bill, such as this, the issue for the Government is rather different and, all things considered, we do not see the actual proposals in the Bill as sufficiently objectionable to cause the Government themselves to oppose it. However, if the Bill proceeds to a Committee stage the Government will bring forward a series of technical amendments which will be designed to improve a number of drafting deficiencies in the Bill.
8.35 p.m.
Lord Bruce of Donington: My Lords, I am most grateful to those noble Lords who have taken part in the debate this evening. I am particularly grateful on behalf of Sir Brandon for the support from the noble Earl, Lord Halsbury, and the noble and learned Lord, Lord Wilberforce, as well as from my noble friend Lord Williams of Elvel. I must confess to some disappointment this evening with the contributions from some of those reputed to be among the leading industrialists and financiers in our country. It is quite clear from the debate that has taken place that some of them at least had not even bothered to acquaint themselves with the precise contents of the Bill. They must have been extremely grateful to the noble and learned Lord, Lord Wilberforce, for having given them adequate instructions where my initial speech must obviously have failed. It seems that the captains of industry are in favour of audit committees. Or are they? Some were, some were not. If they are set up voluntarily, completely ignoring the fact that this is precisely what the Bill does, it gives the company or its shareholders—for they are the owners—the option of appointing an audit committee by a majority.
There has been a mixed reception to the whole concept of an independent or non-executive director. Some noble Lords appear to think that such directors are of little consequence and that some of them would probably not be capable of doing their work. Other noble Lords expressed considerable support for the whole concept provided that the directors were there voluntarily. It seems that some noble Lords, particularly those who are leaders of powerful enterprises, can be said to be guilty of talking with forked tongues. When there are developments in industry involving the ordinary people of this country or their trade unions there has to be legislation— there is no question of it being voluntary. If, however, the interests of boards of directors are affected, it seems that legislation is unnecessary and the voluntary way is much better.
I have nothing more to offer your Lordships, especially after the excellent support that I was privileged to have from the noble and learned Lord, Lord Wilberforce. I hope that noble Lords, after expressing their views this evening, if necessary in the Lobbies, will re-read what they have said in the debate that has taken place and consider its relevance to the contents of the Bill as distinct from the fears

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that have been put about at the behest of the CBI and those who are prominent in its counsels.
I intend to honour my own promise to Sir Brandon Rhys Williams. I shall do my very best to continue to press the virtues of the Bill so far as I am capable, bearing in mind the very necessary amendment which I have already admitted may have to be made.
I therefore urge your Lordships to give the Bill a Second Reading and enable it to have further consideration, rejecting the amendment of the noble Lord, Lord Mottistone, which I think is entirely inappropriate on this occasion.
8.40 p.m.
Lord Mottistone: My Lords, I always enjoy the fierceness with which the noble Lord, Lord Bruce, seeks to convince his opponents. Somehow I feel that fierceness is not the best way to impress people.
I should like to thank all noble Lords who have taken part in the debate, including those who have been opposed to my amendment. I have two points to make. The noble Earl, Lord Halsbury, asked me whether I represented the heavyweights or industry. I have to tell him that I am a non-executive director of two very small companies which are far below the effects of this Bill. To that extent I represent industry. However, as we all do when we speak in this House, I am representing myself. I should like to think that my noble friends and the noble Lords opposite have also spoken for themselves.
I was intrigued by the arguments of the noble and learned Lord, Lord Wilberforce, because it struck me—and I hope that he will not take this amiss—that unlike most of the other people involved, he had not had practical experience of trying to run a big company. That came through because when one has that experience—and I have been an administrative director in a big company; I have never been a board director—it gives one a different perception.
I was also interested in the arguments of the noble Lord, Lord Williams of Elvel, who rubbished my warning about two-tier boardism and then proceeded to talk about employee-directors, which comes to the same thing. I rather thought that his rubbishing was not to be taken too seriously.
That is quite enough speech. I ask the House to agree to my amendment. I commend it to the House.
8.42 p.m.
On Question, Whether the said amendment shall be agreed to?
Their Lordships divided: Contents, 43; Not-Contents, 22.

DIVISION NO. 1

CONTENTS

Ampthill, L.

Craigavon, V.

Bathurst, E.

Craigmyle, L.

Bellwin, L.

Cross, V.

Benson, L.

Cullen of Ashbourne, L.

Brougham and Vaux, L.

Dilhorne, V.

Bruce-Gardyne, L.

Forte, L.

Cayzer, L.

Gowrie, E.

Colville of Culross, V.

Grantchester, L.

Colwyn, L.

Hanson, L.

Cowley, E.

Harris of High Cross, L.

406

Havers, L.

Mottistone, L. [Teller.]

Hylton-Foster, B.

Remnant, L.

King of Wartnaby, L.

Rippon of Hexham, L.

Kinnoull, E.

St. John of Bletso, L.

Lauderdale, E.

Seebohm, L.

Liverpool, E.

Selkirk, E.

Lucas of Chilworth, L. [Teller.]

Sharples, B.

Stevens of Ludgate, L.

McAlpine of West Green, L.

Stockton, E.

Marshall of Leeds, L.

Taylor of Hadfield, L.

Merrivale, L.

Weinstock, L.

Milne, L.

Wyatt of Weeford, L.

NOT-CONTENTS

Blease, L.

Nicol, B.

Bruce of Donington, L.

Parry, L. [Teller.]

Dean of Beswick, L.

Prys-Davies, L.

Elwyn-Jones, L.

Rea, L.

Ennals, L.

Sefton of Garston, L.

Falkland, V.

Tordoff. L.

Graham of Edmonton, L.

Underhill, L.

Halsbury, E. [Teller.]

Wilberforce, L.

Hylton, L.

Williams of Elvel, L.

McNair, L.

Wilson of Langside, L.

Morton of Shuna, L.

Winstanley, L.

Resolved in the affirmative, and amendment agreed to accordingly.

Bishops in the House of Lords
8.49 p.m.
Lord Tanlaw Lord Tanlaw rose to ask the Leader of the House whether it is now appropriate for the bishops to continue to have to wear robes and sit and speak from the spiritual Benches when taking part in the proceedings of the House of Lords.
The noble Lord said: My Lords, I beg leave to ask the Unstarred Question standing in my name on the Order Paper.
I am extremely grateful to the Leader of the House for allowing time for me to raise this Question during what has obviously been a very busy period in your Lordships' House.
It was with some trepidation that I sent the wording of this Unstarred Question to the most reverend Primate to inquire whether or not there would be any objection to the phrasing of the words that are before your Lordships this evening. I am most grateful to the most reverend Primate that he did not object, and noble Lords therefore have an opportunity to proceed with this short debate. I am hopeful that the Leader of the House in his reply will be able to throw some much needed light on this ancient convention of the House, the background to which is obscure and which is considered by some to have become an historical anachronism.
I realise that as a simple layman and a Lord Temporal I must proceed with extreme caution in those areas where even angels fear to tread and which are the sole province of the Lords Spiritual. However, it is my contention that there may be some confusion in the minds of other laymen besides myself both inside and outside the Chamber as to what is the role of the Lords Spiritual and what precisely is the significance, if any, of the robes they wear when taking part in the proceedings in this Chamber. I believe that the confusion extends beyond the procedural conventions of this House when in a number of situations outside this country bishops,

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both Protestant and Roman Catholic, have felt it incumbent upon themselves to take part, often at great personal risk, in political action or debate against the established policies of their respective governments. The governments concerned, which are notably of an authoritarian or non-Christian institution, have become unsure as to whether to treat the bishops as political activists of societas humana or as inspired ministers of societas mystica. This confusion will continue to arise in my view, with all its attendant dangers, so long as bishops continue to make strong political statements while wearing clerical apparel associated in the minds of laymen and government officers alike with institutional religion.
My fear is that in some countries the net result could be the subsequent persecution of all Christians through classification as political agitators. Therefore I should like to ask the noble Lord the Leader of the House why it is apparently necessary for the noble Lords Spiritual to take part in the proceedings in this House relating to secular issues associated with societas humana while wearing clerical robes representing the ritual and dogma of societas mystica.
The existence or non-existence of societas mystica is a matter of private and personal interpretation. However, it can be described as an invisible communion of sentients, not necessarily tied to institutionalised religion, who possess the knowledge of personal enlightenment. Access is voluntary, the route arbitrary and the journey continuous, therefore ritual, dogma and religious instruction are only accessories, to be retained or discarded at will by the traveller.
Clerical robes are also an accessory, and it would be interesting to know from the noble Lord the Leader of the House when and why they became obligatory apparel for the Lords Spiritual taking part in the proceedings of this House. Could it be that the original instructions for this convention are to be found in the Royal Declaration of the 39 Articles of Religion of 1562, or do they appear in the subsequent Act of Ratification of the Book of Articles of 1571? Can the Leader of the House say whether these Acts are still on the statute book and, if so, have they any relevance to the Question before us this evening? I must confess that after a cursory investigation the only reference I can find to apparel appears in the Book of Articles of Religion, Article XXXV, Second Book of Homilies, Homily VI which holds forth "against excess of apparel".
Whether or not this ruling is to be found in the Acts of Parliament I have mentioned or in the Act of Uniformity of Common Prayer passed in 1562 or, as is more likely, in the Act for the Placing of the Lords in 1539, has the time not come to look again at this convention and to ask if it is really necessary or relevant to the secular work carried out in this House, or for the Lords Spiritual who participate in it to be encumbered by an "excess of apparel"? If the Leader of the House in his reply deems it necessary for the Lords Spiritual to continue with this practice, can he then explain why the noble and learned Lords, except for the noble and learned Lord who sits on the
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Woolsack, are excused the wearing of their robes of office? Similarly can he explain why the noble and gallant Lords do not have to wear full dress uniform while taking part in the proceedings?
The second part of my Unstarred Question relates to the seating of the Lords Spiritual. In his reply, the Leader of the House will almost certainly quote to me from the Act of the Placing of the Lords 1539. If he does, can he explain why the Lords Temporal seem to have been able to ignore the contents of the said Act without incurring the displeasure of Their Majesties' Governments, regardless of their political tendency, for the past 50 years or so? If it turns out to be the fact that all the Acts I have quoted are in need of revision or repeal because they are outdated, will the noble Lord the Leader of the House not agree that now would be a good opportunity to bring this convention up to date by abandoning it?
However, I suspect that the noble Lord may not be able to consider this very reasonable suggestion until he has first established in what capacity the Lords Spiritual make their very constructive contributions to the proceedings of the House. Can he say in his reply if Lords Spiritual are contributing solely as representatives of the Church of England to the exclusion of all other churches, including Scotland and Wales, and the other denominations? Or do the Lords Spiritual sit as moral and spiritual guardians of Protestant Christian doctrine? The clerical robes which they wear indicate that either or both these postures are correct. However it is my contention that neither may be correct because the Lords Spiritual appear to me to act in this Chamber to all intents and purposes as though they were Lords Temporal who could sit as free agents on these Cross-Benches.
The right reverend Prelate the Bishop of London and his spiritual colleagues have demonstrated considerable political impact in the past few weeks by moving secular amendments to a secular Bill with notable assistance from the Cross-Benches but usually against the wishes of Her Majesty's Government.
However, when, during the course of these manoeuvres, the right reverend Prelate was confronted with a simple doctrinal—as opposed to political—question, he avoided a direct reply. That is recorded in Hansard at cols. 427–28 on 3rd May. Nor did any other of the Lords Spiritual give an authoritative answer to what in my view was a very fair question, considering that the amendment was about the religious education of children. I have since received a letter from the right reverend Prelate the Bishop of London, and from the noble Lord, Lord Sefton, which has explained to me that his intervention was a technicality and the reason he was asked that he be no longer heard in this Chamber was for this reason and not because he had asked a doctrinal question.
If noble Lords will bear with me, I believe it would be helpful if the noble Lord the Leader of the House could now give a ruling whether, in spite of the fact that the Lords Spiritual wear clerical robes—which presumably represent their high qualifications relating to the doctrine of the established Church—any questions on this subject by Lords Temporal

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are to be ruled out of order. Similary, are any other doctrinal questions raised in the future to be considered disrespectful to the proceedings in the House if they are raised by Lords Temporal?
Anyone who read the Official Report of the proceedings on 3rd May may be left as I was, perhaps wrongly, with the impression that such a ruling may already he in existence. What would happen in future if the Lords Spiritual or their equivalent were to take their seats on the Cross-Benches without the robes of office? Would the noble Lord the Leader of the House not approve of this move, which would publicly demonstrate that the functions of the Lords Spiritual within your Lordships' Chamber were entirely confined to secular matters relating to societas humana? Would he also not agree that philosophical and doctrinal questions could then be addressed to the Lords Spiritual or their equivalent only in their capacity as members of Synod, of the House of Bishops or of any other establishment associated with societas mystica, where the wearing of robes would correctly reflect their authority and ability to answer questions of this nature?
If this simple convention were to be implemented, might it not pave the way for more ecumenical representation to become acceptable in your Lordships' Chamber—perhaps similar to the suggestions made in a recent issue of the Church Times? Can the noble Lord the Leader of the House foresee the day when the Lords Spiritual could be replaced by a similar number of ecclesiastical Life Peers, who could sit on the Cross-Benches without robes and who would represent the episcopalian churches, with the Church of England in the majority and the balance filled with other denominations?
Finally, if a convention were to be accepted globally by bishops of every denomination that they would decline to wear ecclesiastical apparel while indulging in political activities, would that not reduce the risk of persecution, especially in non-Christian and totalitarian countries, of Christians who might wish to worship in public out of spiritual rather than political motivation?
It is clear that since Christianity became institutionalised in the third and fourth centuries AD, bishops have always been involved in secular activities connected with the establishment of the Church as part and parcel of societas humana. The recent encyclical, The Social Concerns of the Church, which was written personally by His Holiness Pope John-Paul II, confirms it and so do the contents of the address given last month by the most reverend Primate at the global forum of spiritual and parliamentary leaders.
All I am asking through this Unstarred Question is that bishops or any other officials of institutionalised religion who wish to take part in political activities may be able to do so on equal terms with their secular counterparts, without the props of excessive apparel. If the noble Lord the Leader of the House would kindly agree to look into this matter, I am sure there would be benefits to all concerned through clarification of the respective roles which we, whether
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Lords Temporal or Lords Spiritual, are intended to play within this secular Chamber of Parliament.
9.3 p.m.
The Lord Bishop of Southwark: My Lords, when some of the bishops first heard about this Question we asked ourselves what lay behind it. Was the noble Lord perhaps a friend of the honourable Member for Chesterfield in another place who is today proposing to disestablish the Church of England? Our researchers produced no obvious connection and it seemed unlikely, so we settled on the possibility that it was an oblique way of expressing disapproval either of one of us or possibly all of us but that I would have to wait for this evening in order to be sure.
I am somewhat relieved to hear the noble Lord's very interesting comments and to realise that we were a bit wide of the mark. But before coming to the more precise points which he raised about taking off our robes and changing our places, I should first like to say a word about certain things which need to be stressed rather clearly in relation to the Bench of Bishops in your Lordships' House. We do not regard ourselves, any of us, in any sense as party politicians. I realise that the noble Lord did not make that point, but it ought to be said because of the confusion that often arises here. We may occasionally make a speech or cast a vote this way or that which will support or criticise a policy, be it of government or of opposition. But few of us are card-carrying members of any party and still fewer of us, if any, would ever wish to be bound by some kind of party Whip—looking in the right direction while making that comment!
We sit in this House, as has been pointed out, as spiritual Peers, and of course the robes are a very visible reminder of this. We would be happy to answer doctrinal questions—I want to assure the noble Lord about that—but the case that he cited, as he explained, was one in which the right reverend Prelate the Bishop of London found himself in some difficulty because he believed that it was not the right moment to be dealing with that question, and indeed it was out of order, as the House subsequently decided.
However, I think I am right in recalling some debates not so very long ago about divorce and remarriage; for instance, where Members of this Bench made what might certainly be regarded as philosophical or doctrinal comments on the points at issue. That does not mean that we can never pronounce an opinion on any of the subjects which your Lordships discuss or debate here, since all are in the strict sense political. To say that we are dressed as members of what has been called the societas mystica makes a distinction which is very difficult to sustain unless you are going to attach enormous significance to this particular dress at this particular moment.
There is for us no sharp distinction between the spiritual and the temporal of such a kind that we can live our lives, as it were, in two distinct compartments. We shall come back to the question of whether the dress in some way marks an emphasis which is particularly confusing. I believe that the noble Lord used that word, and that may be the point

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around which this Question revolves. But I want to stress that politics, as distinct from party politics, is about the science and art of government, and it is difficult to see why Her Majesty should summon us here at all if she then requests us to be silent after Prayers.
So the issue is and always has been how and where to draw the line between the principles of justice, moral considerations and the assessment of human consequences—all of which must be our primary concern as spiritual Peers—and those details of legislation and administration about which we are certainly as fallible as anyone else.
Let me give your Lordships an historical illustration of the way in which this has often worked in the past. We are not talking about a relatively new issue. Herbert Hensley Henson was Bishop of Durham in the 1930s—a firm supporter of Tory principles and government, and known as such, and certainly not a prelate who could ever be accused of courting popularity. Yet in 1938 he came to this House one day to debate on foreign policy—an area normally regarded as somewhat outside a bishop's concerns and perhaps outside societas mystica—and began with these words:
"My Lords, there could have been no Englishman, whatever his denomination or political description, who did not read with a sense of dismay and humiliation the report of the recent proceedings at Geneva. … The representative of Great Britain was the noble Viscount, the Foreign Secretary, a man whose character stands so high" —
and there is more along those lines—
"and from his lips one heard the language—he must forgive me—the cold sophistry of cynical opportunism."—[Official Report, col 138; 18th May, 1938.]
Reading that again it struck me that the language used is a good deal stronger than any we have heard from these Benches in recent years. Here was moral outrage, as I suppose one could call it, not party politics, although sometimes it is easy to confuse the two. At one point I wondered whether the noble Lord, Lord Tanlaw, was actually raising the question of disestablishment, though for quite other reasons to some. The noble Lord is shaking his head, and that is fine because the issue is obviously far too large and complex to be dragged in by the tails of robes and benches, so to speak.
I should like to turn briefly to the specific proposals that he has made and the confusion about which he is concerned. I believe it is true that, if one asks most bishops, they will say that it is a bit of a nuisance to have to keep taking off one's robes and putting them on again every time one wants a cup of tea or something a little more fortifying, or to go into the Library. I do not believe that we have a sense of changing our personality, character or concern by putting our robes on and taking them off.
It is true that robes belong more naturally to the sphere of church and worship and one feels a little out of place wandering about in them here. I take the point that there may be a connection between the wider point that the noble Lord is making and how we sometimes feel. However, I should not wish to exaggerate that. They are perfectly appropriate for the prayers. They identify us and, with television in
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your Lordships' House, that may be more important than it was. If we dropped the custom of wearing them all the time your Lordships might wish another custom to grow quickly by which the sartorial habits of some of the more radical clergy did not spread to the Bishops' Benches.
If the robes went, I believe that there would then be an even stronger case for continuing to sit here. In any event, I believe that there is a strong case for sitting here because we are near the Throne. It reminds us and noble Lords that we are here by courtesy of a royal choice and summons of long standing and have a particular loyalty to the Crown. We are near the Government Benches because the Christian faith requires us to pray for and support good rulers. But we are not part of government, so as a lighthearted ending perhaps I may suggest that when the House is due for redecoration and upholstering we may have little mitres at the end of the two benches rather like those on the top of church wardens' wands. That would indicate that there is something a little different about these two benches.
Finally, I should like to say a word about members of other Churches. I cannot speak for all but I believe that many of us would undoubtedly welcome a further infusion of Church leaders of other Christian Churches or other faiths, as happened recently. There are still very few, though I must recognise, as I am sure do many noble Lords, that we keep tipping over into a question of reform in this House and it is a more difficult question than is sometimes realised. However, were that to happen, even on a modest scale, I am sure that many of us would be happy to share our benches with them. After all, the noble and Methodist Lord, Lord Soper, always wears a cassock so he should feel quite relaxed among us.
9.13 p.m.
Lord Williams of Elvel: My Lords, from time to time we have some interesting Questions in this House and the Question that has been tabled by the noble Lord, Lord Tanlaw, has been one of the most interesting. I have enjoyed the intervention of the right reverend Prelate the Bishop of Southwark.
There are a number of oddities relating to the bishops, if I may say so without disrespect. The Church in Wales was disestablished in 1921 and Buggin's turn does not appear to apply to Welsh bishops. As a result of disestablishment they lost their right to hold seats and be summoned by the Crown to Parliament. Similarly the Church of Scotland is established yet still has no representation in this House in the same way as Church of England. The noble Lord has done a service in drawing attention to those oddities.
I believe that there are three parts to the noble Lord's Question: first, should the bishops wear robes; secondly, should they speak from the Spiritual Benches; and thirdly, should they be involved in party-political or contentious political issues?
First, as to whether they should wear robes, I believe that they should because that identifies them, if I may so put it, as temporary Members of the House holding membership as long as they are bishops, unless of course through retirement and

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other appointments they become Members of the House. However, that is a separate procedure. While they hold episcopal or archepiscopal office, they have a certain role in the House and should be distinguished because they have that role. Therefore, they should wear robes.
However, there remains the question of what "robes" really means and what is the definition of episcopal dress. I believe that in the early 19th century a bishop was refused access to the Division Lobby in your Lordships' House because he was not wearing lace cuffs. The division was lost by one, therefore, because the bishop in question was improperly dressed. I notice that one right reverend Prelate sitting on the Spiritual Benches is wearing lace cuffs; the right reverend Prelate the Bishop of Southwark, I am afraid, is not. How do we distinguish?
I ask the noble Lord the Leader of the House to give us an instruction on how to distinguish between a bishop who is properly dressed and one who is improperly dressed. Is a pectoral cross a vital appurtenance of a bishop if he wishes to speak? Is the episcopal ring an important quality of the robes of which the noble Lord, Lord Tanlaw, speaks? I very much hope that the noble Lord the Leader of the House will be able to give some clear instruction on how we recognise a bishop when we see one and how we recognise a properly dressed bishop as opposed to an improperly dressed bishop when we see one.
Noble Lords who have visited Russia will be well aware that at Christmas time one sees, particularly in the streets of Leningrad, where it is an important festival—they call it the new year, but it is still part of the Christian tradition—a figure that to all intents and purposes looks like Father Christmas. It is in fact Father Frost, because the Soviet Union does not officially recognise the Christian religion. In Leningrad that figure is popularly known as Lenin in drag. I very much hope that we shall not reach the point where we have bishops in mufti simply because they have to take off their robes, whatever those robes may be, in order to speak on points that are not particularly pertinent to the Church of England.
Perhaps I may go back in time like the right reverend Prelate the Bishop of Southwark. In 1188 a certain Archbishop Baldwin of Canterbury went through Wales—mid-Wales, I should tell my noble and learned friend Lord Elwyn-Jones—and through the princedoms of Elvel and Maelienydd. He wore chain mail. At that time the Archbishop of Canterbury, as he was, wanted to recruit people for the crusade and was undoubtedly entitled to wear chain mail. I am sure that the right reverend Prelate the Bishop of London, had he had a suit of chain mail, might have felt yesterday that it was appropriate to wear it. Is a bishop who enters the Chamber in chain mail, following the example of the Archbishop of Canterbury of 1188, out of order?
I turn to the question of whether bishops should speak from the Spiritual Benches. In terms of the First World War song, which your Lordships will no doubt remember, it seems to me that we are here because we are here because we are here. I suspect that the answer to the question is that they are there because they are there because they are there. I do not
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believe that the noble Lord the Leader of the House will be able to give us any clear, logical definition of why the bishops happen to sit where they do rather than anywhere else. I make just one comment. Since the other side of the House is known as the Spiritual Benches because of the presence of the bishops, to enter a slighty political note, I find it very curious that the Government are sitting on the spiritual side of the House rather than on the temporal side of the House. Surely the Opposition should be on the spiritual side of the House and the Government should be on the temporal side. No doubt the noble Lord the Leader of the House will be able to clear up the point.
The noble Lord, Lord Tanlaw, raised another point of a quite serious nature. It came down to whether the bishops were entitled in some curious way to speak on secular matters at all. The right reverend Prelate addressed himself to this point. I wholly agree with him that there is no serious distinction between societas mystica and societas humana. I do not think that the practice of religion can be separated from the practice of governance of society. I believe that that is the fundamental point that the right reverend Prelate made. We on these Benches would certainly agree with that. I think that it was said that some churchmen were political agitators.
I am greatly looking forward to hearing what the noble Lord the Leader of the House has to say, particularly concerning the distinction between a properly dressed Bishop and an improperly dressed one. In the meantime, I believe that the noble Lord has raised one or two serious points but, having occupied the attention of the House for a little too long, I conclude.
9.20 p.m.
The Lord Privy Seal (Lord Belstead): My Lords, I am grateful to the noble Lord, Lord Tanlaw, for asking the Question this evening which has led to interesting speeches from the noble Lord himself, from the right reverend Prelate and from the noble Lord, Lord Williams. The noble Lord asked whether it is now appropriate that bishops should need to continue to wear robes and to sit and to speak from the Spiritual Benches when taking part in the proceedings of your Lordships' House.
First, perhaps, I may deal with the question of whether right reverend Prelates should continue to wear robes when taking part in the proceedings of the House. That is really a matter for your Lordships, Spiritual as well as Temporal, having regard to the custom of the House. The Companion to the Standing Orders provides that a bishop, on introduction, should wear episcopal robes, but the practice of wearing such robes at ordinary sittings of the House appears to rest on custom alone. In answer to the first of the questions put to me by the noble Lord, that does not arise from any of the ancient Acts which he itemised.
Episcopal robes comprise a white rochet with black bands, a black chimer and scarf. I understand that rochet and chimer were the ordinary outdoor habit of bishops in the 16th century; and 16th century bishops attended in their everyday dress. While the everyday dress of bishops in the world outside has

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changed somewhat, old customs die hard in your Lordships' House. However, I have to confess that there are colleagues of mine on the Front Bench who deprecate the passing of both the gaiters and the apron. I am sure that your Lordships respect the customs of the House and as regards this particular custom I am not aware that your Lordships would wish to see it changed.
The second question asked by the noble Lord, Lord Tanlaw, was, if that is the case, why not a particular dress for certain other noble Lords; for instance, the Law Lords. My only answer to that is that there is simply no historical custom of dress for other Members of your Lordships' House other than for right reverend Prelates. At that point the noble Lord, Lord Williams, asked about some other items of dress. As I say, I am advised that episcopal dress consists of a white rochet with back bands and a black chimer and scarf. As ruffs are not to be found in the Companion to the Standing Orders, presumably ruffs are not part of the episcopal dress for parliamentary purposes. I am advised that neither is chain mail. Of course, if a right reverend Prelate were to wear chain mail under his rochet, probably that would be acceptable.
I now turn to the seating arrangements and here again I believe that we have to look at custom which pre-dates even the 16th century. Your Lordships' seating arrangements seem to have evolved from medieval times. Until the 16th century I am advised that the normal seating arrangement of the House had the most reverend Primate the Archbishop of York to the left of the King and the most reverend Primate the Archbishop of Canterbury to the right. The bishops and abbots sat on Benches below the Archbishop of Canterbury; that is to say, on the right hand side of the House. The earls and barons sat below the Archbishop of York; that is to say, on the left-hand side of the House.
Lord Tordoff: Will the noble Lord forgive an intervention? I am grateful to him. He refers to left and the right, but looking in which direction?
Lord Beistead: My Lords, looking down the House from the Throne. I understand that was the way that the right reverend Prelates and the noble Lords disposed themselves. The reason for separate "sides" was doubtless due to the fact that before the Reformation there were rather more Spiritual Lords than there were Temporal Lords. This arrangement was broadly confirmed by the Act for Placing of the Lords of 1539, which is still in force to this very day. Under the Act, the Archbishops were moved to join the other Bishops on the right-hand side while the Lords Temporal continued to sit on the left in their degrees and according to the "ancienty" of their peerage.
It is unlikely, however, that the legal requirements of the Act were rigidly adhered to for long. Following the dissolution of the monasteries, the Lords Spiritual numbered only the two archbishops and the 24 diocesan bishops of the Church of England, while the Lords Temporal continued to grow in number and spilled over on to the spiritual side of the House, which is why one finds noble Lords who are
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temporal sitting on the side of the House on which I am my colleagues are sitting this evening.
The present convention is that, consistent with the statute of 1539, the bishops sit on the two Benches nearest to the Throne. Lords Spiritual must, by convention, speak from those two Benches. So we find that the seating arrangements, partly laid down by statute and partly by custom, go back a very long way. Here again, I detect no reason for change. Nor, I suspect, does your Lordships' House. Incidentally, it may be of interest that it is thought that the Government moved on to the spiritual side of the House after the union with Ireland in 1800.
One of the reasons the noble Lord, Lord Tanlaw, brought the Unstarred Question to the House this evening was to ask whether it is right that the bishops, sitting in the way that they do and dressed in the way that they are, should take part in the proceedings of your Lordships' House in the way that they do. I am most grateful to the right reverend Prelate the Bishop of Southwark for making the simple point that right reverend Prelates are summoned in the same way as all other noble Lords, personally, by Her Majesty, to come and give advice. It would be very strange if the advice was not wanted.
I have been interested to find that bishops could not originally be tried by their peers, nor could they take part in such trials. This was because canon law forbade spiritual persons from participating in judgments of blood. Therefore they are not Peers. Bishops are, however, Lords of Parliament and there are no restrictions on their right to vote. Not holding peerages, however, bishops leave the House on retirement. As we all know, in some cases peerages are conferred upon retiring archbishops in order that they may continue as Members of your Lordships' House.
It is to misunderstand the presence of right reverend Prelates to think that in some way on coming to the House there is something amiss by being on the Bishops' Benches but not taking full part in that capacity. The Writs of Summons are individually sent by Her Majesty. They are commanded to give counsel upon the "arduous and urgent affairs" which have occasioned the summoning of the Parliament. I therefore repeat that I very much agree with what the right reverend Prelate said: it is most important that the advice of the Bishops' Bench should be given on matters. Those are bound to include matters of political moment. I was most glad that the noble Lord, Lord Tanlaw, made the point that, when the advice is given, it is important advice given always in a constructive way. The fact that the Welsh, the Irish and the Scots are not represented by the Bishops' Bench has been covered by the noble Lord, Lord Williams, and I will not improve on that.
I should like to say a brief word to put a gloss on what the right reverend Prelate said about the question of doctrinal matters. The noble Lord, Lord Tanlaw, asked whether the bishops were answerable on doctrinal matters. Technically, I am advised, that is not so. The bishops sit in response to their writs; where necessary they act on behalf of the Church in promoting measures, for example. But they are not answerable to the House. Technically, they do not

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represent the Church of England. Indeed, the Companion to the Standing Orders of the House states that it is undesirable to ask questions in your Lordships' House on Church of England matters.
I think that leaves me with one last question to answer from a noble Lord who asked: should not bishops be replaced by leaders of other Churches and right reverend Prelates possibly sit in a new capacity with the other leaders? Of course there is no reason why life peerages cannot be conferred in such a way upon leaders of other Churches. Although their peerages are personal to them, it could be said that some noble Lords, who are colleagues of ours now, are looked upon as being representative of their religions. However, I repeat that their peerages, in all those cases, are personal to those particular noble Lords and I am not aware of any present plans to alter the composition of the House in that respect.
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I hope that I have gone some way, together with the noble Lord, Lord Williams, and the right reverend Prelate in covering the ground that the noble Lord, Lord Tanlaw, wanted covered.
I am most grateful to the noble Lord for raising what I think has been an extremely interesting debate. That is all I have to say except once again to thank the noble Lord for tabling the Question.

Matrimonial Proceedings (Transfers) Bill [H.L.]
Returned from the Commons agreed to.
House adjourned at twenty-nine minutes before ten o'clock.