Lords Sitting of 5 February 1991

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.

The Budget: Institute of Directors Report
Lord Donoughue Lord Donoughue asked Her Majesty's Government:
What response they have made to the submission to the Chancellor of the Exchequer by the Institute of Directors entitled Budget 1991: Reform in Difficult Times.
The Parliamentary Under-Secretary of State, Scottish Office (Lord Strathclyde): My Lords, my right honourable friend has read the institute's submission with interest and will be meeting representatives shortly. Noble Lords will understand that I cannot anticipate my right honourable friend's Budget Statement.
Lord Donoughue: My Lords, I thank the Minister for that reply, which I am sure will give comfort all round. Is he aware that in paragraph 31 the report states that the claimed:
"tax reductions since 1979 have been illusory",
and that the director general said that,
"contrary to popular belief, the burden of taxation has risen from 33% to 37% of national income since 1979"?
Are the Government aware that the British public have been misled in that way? Can he inform the House who has been deliberately creating that illusion? Will the Minister promise that in the run-up to the election the public will not be deluded into believing that the tax burden has fallen but will be told the truth—that the tax burden has risen significantly?
Lord Strathclyde: My Lords, I do not know whether there has been an illusion, but I wonder whether it is an illusion that such a notable member of the Opposition should be talking about reductions in the tax burden. The noble Lord does not appreciate that what counts is take-home pay, and in real terms take-home pay has risen by 30 per cent. since 1979 for married men with two children on average earnings.
Lord Bruce of Donington: My Lords, is the noble Lord aware that one of the more considerable mistakes made by Her Majesty's Government since 1979 was to raise VAT from 8 per cent. to 15 per cent? Is he aware that one of the easiest ways available to Her Majesty's Government to bring down the rate of inflation is to restore the rate of VAT to what it was under a Labour Government, thereby reducing the rate of inflation by at least three points?
Lord Strathclyde: My Lords, we are not going to reduce the VAT tax burden. In the early 1980s we made it quite clear what we felt about VAT. Something else that we shall not do is to return to a public sector borrowing requirement which at its peak when Labour were in power was equivalent to 9¼ per cent. of GDP.
Lord Ezra: My Lords, is the noble Lord aware that in the document to which the noble Lord, Lord Donoughue, referred the Institute of Directors states that it has focused on the themes of commercial survival and the promotion of saving? Will he indicate whether the Government are also focusing on those themes and, if they are, what they are going to do about them?
Lord Strathclyde: My Lords, I am sure that my right honourable friend the Chancellor of the Exchequer will have those views very much in mind when he makes his decisions on the Budget.
Lord Stallard: My Lords, is the Minister aware that the document speaks of the danger of thousands of small firms being driven out of business unless the rate of interest is reduced? Have the Government any intention of listening to that opinion and taking the report seriously?
Lord Strathclyde: My Lords, as I have already indicated, my right honourable friend will be meeting the Institute of Directors to discuss the report.
Lord Stoddart of Swindon: My Lords, does it not worry the Minister and the Government that the Institute of Directors, which is very friendly to the Government and the Tory Party, should be embarking upon such wide and cogent criticism of their policy? Is it not a fact that this Government in their economic strategy are embarked upon a policy of economic sadism against the people of this country?
Lord Strathclyde: My Lords, that is quite clearly nonsense. Had it been true, we should never have won three election victories and we should not win a fourth one, which I am sure we shall.
Baroness Blackstone: My Lords, in responding to that part of the Institute of Directors' submission concerned with tax cuts, will the Minister say whether he thinks that the tax cuts of 1988 have brought about the economic prosperity that the Government predicted at the time?
Lord Strathclyde: My Lords, the tax cuts of the 1988 Budget have shown themselves to be a great success in restoring incentives.
Lord Peston: My Lords, I do not know which is more bizarre, the Minister's answers or the Institute of Directors' document. I certainly do not envy the Government in having to meet those peculiar people. Do the Government have any comment on one of the more bizarre suggestions, that following the precedent in New Zealand the salary of the Governor of the Bank of England should be inversely related to the inflation rate?
Lord Strathclyde: My Lords, that is a direct proposal which the Institute of Directors has made. No doubt my right honourable friend will consider it very carefully.
Lord Hailsham of Saint Marylebone: My Lords, if we are to speak of things bizarre, is it not more bizarre than anything else that the Opposition Benches, who

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perpetually ask us to spend more money on this, that and the other, should now talk about reducing the burden of taxation?
Lord Strathclyde: My Lords, I have to say to my noble and learned friend that I regard it as being very encouraging.
Lord Peston; My Lords, I hope that the noble Lord has not been misled. None of my noble friends nor I have said anything about reducing the burden of taxation. Is he aware that if he cares to attend the economics debate next week, he will hear some quite interesting remarks on what ought to be done with fiscal policy?

EC Tobacco Regime: Costs
2.43 p.m.
Lord Boyd-Carpenter Lord Boyd-Carpenter asked Her Majesty's Government:
What is the total cost to the European Community of subsidies for tobacco growing and what is the total expenditure by member states on public warnings of the dangers of smoking to health.
The Earl of Strathmore and Kinghorne: My Lords, total expenditure on the European Community tobacco regime in 1989 was 1,139 million ecu (£746 million). Some 85 per cent. of this was spent on direct support for production; the remainder on intervention and export refunds.
Information on total expenditure by European Community member states on public warnings of the dangers of smoking to health is not available. The United Kingdom Government spend some £3 million per year on the Health Education Authority's programmes on smoking. Health warnings are printed on cigarette packets and advertisements in the United Kingdom at no cost to the taxpayer.
Lord Boyd-Carpenter: My Lords, I thank my noble friend for that far from comprehensive reply, inasmuch as he omitted all the European countries' expenditure on warnings against smoking. However, does he not accept that it is an absurd situation that we should be simultaneously financing the production of tobacco and financing the warning to people not to use it?
The Earl of Strathmore and Kinghorne: My Lords, my noble friend makes an extremely good point. As I have said on previous occasions at this Dispatch Box, the entire tobacco situation poses a dilemma. However, the Government are concerned to ensure that the tobacco regime does not undermine efforts to reduce the incidence of disease and early death attributable to tobacco.
Lord Bruce of Donington: My Lords, is the noble Earl aware that the reports of the European Court of Auditors in respect of the Commission accounts for the years ending 31st December 1987 and 31st December 1988 have drawn attention to the widespread fraud in the administration of the tobacco
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regime? Will he give the House an undertaking that he will take up this matter with his right honourable friend the Chancellor of the Exchequer, who is primarily concerned, rather than with his right honourable friend the Minister of Agriculture, who is more concerned with defending the regime?
The Earl of Strathmore and Kinghorne: My Lords, as I have said on previous occasions, fraud is treated extremely seriously by this Government. I shall endeavour to pass on the noble Lord's comments to my right honourable friend. However, in relation to Treasury ministerial attendance at the Agriculture Council when tobacco is discussed, there is well established and satisfactory machinery by which Ministers attending councils of the European Community clear their lines on important matters with their colleagues, including Treasury colleagues.
Lord Renton; My Lords, cannot tobacco growers be persuaded to grow alternative crops of a more beneficial kind?
The Earl of Strathmore and Kinghorne: My Lords, because of terrain, soil and climate the problem is that few, if any, alternative crops are available. Almost all alternative crops, such as vines and olives, are already in surplus. Timber growing obviously has a long lead time and thereby produces no income for current tobacco growers.
Lord Hatch of Lusby: My Lords, can the noble Earl give the House the latest figures for the export of tobacco from Europe to third world countries, particularly high tar tobacco? Is it still the case that we subsidise tobacco growers to export to third world countries those tobacco products which are on the decline in Europe and push them there despite their high tar content?
The Earl of Strathmore and Kinghorne: My Lords, about one third of the European Community's tobacco production is exported outside the Community. Over two thirds of EC exports are sold to developed countries and only one third to developing countries of the third world. So only about 10 per cent. of EC production goes to the third world. Total exports in 1989 were 185,000 tonnes.
Lord Campbell of Alloway: My Lords, is my noble friend aware that in the context of this Question the decisions taken by the European Community are not governed by logic or reason, as the Question appears to suppose, but by purely political considerations?
The Earl of Strathmore and Kinghorne: My Lords, as I said earlier, the situation poses a complete dilemma.
Lord Gallacher: My Lords, can the noble Earl tell the House why his right honourable friend the Minister criticises with such vigour the Community regime for rice while adopting a somewhat passive attitude towards tobacco? Rice is a harmless if costly Community crop which is in surplus because consumers in the Community prefer to purchase rice produced in countries other than Europe. Can he say why the Minister is not more vigorous in his attitude towards the tobacco regime?—because that which is

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grown tobacco-wise is generally of poor quality and has little to commend it apart from the growers' acknowledged dependence on it.
The Earl of Strathmore and Kinghorne: My Lords, the noble Lord, Lord Gallacher, has made an interesting comparison with rice. However, as I said, because of the terrain, soil and climate few, if any, alternative crops are available to be grown on that ground.
Baroness Strange: My Lords, which countries in the European Community grow tobacco?
The Earl of Strathmore and Kinghorne: My Lords, mainly Greece and Italy.
Lord Boyd-Carpenter: My Lords, do not my noble friend's answers confirm that the Community's agricultural policy is a shambles? Can he assure the House that Her Majesty's Government are determined to remedy the situation, however unpopular they may make themselves in the process?
The Earl of Strathmore and Kinghorne: My Lords, I ask my noble friend to be patient. I understand noble Lords' anxieties about the EC tobacco regime. However, prospects for progress will not be clear for a while. First, we must see the outcome of the GATT round and how it will affect the way in which the CAP works at the Community's frontiers. Secondly, we must see what changes to the CAP will be made within the Community. We expect that the proposals from the Commission in this context will cover the tobacco regime. We know that it has been examining that critically. We hope that it will make robust proposals, as we have urged. Once those proposals are published tough negotiations will take place but they will take a good few months.

Homelessness: Local Authority Housing
2.51 p.m.
Lord Jay Lord Jay asked Her Majesty's Government:
Whether, in view of the increasing numbers of homeless persons and families, they will now remove the restrictions on local authorities using their capital receipts to build new low-cost homes to let.
The Parliamentary Under-Secretary of State, Department of the Environment (Baroness Blatch): My Lords, we do not propose to change the present rules on the use of capital receipts by local authorities. It is government policy that new subsidised housing for rent should principally be provided by housing associations with local authorities fulfilling an enabling role. If authorities were allowed to spend all of their capital receipts, areas of lower housing need would tend to have more to spend while areas of greater need would tend to have less. We introduced the new capital finance system in April last year to overcome this problem and to allow us to target higher levels of credit approvals where the need is greatest.
Lord Jay: My Lords, this Government's housing policy has produced a record number of homeless
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families—more than 130,000—and the attempt to build low-cost houses through the private sector has proved almost a total failure. Therefore, what conceivable reason is there for continuing this senseless restriction?
Baroness Blatch: My Lords, I profoundly disagree with the noble Lord's comments. The number of homeless people remained almost static during the 1980s. There are 2 million more houses than there were in 1979. Credit approvals for local authorities have increased; housing revenue subsidy has increased; housing corporation finances have increased; home ownership has increased from 50 per cent. to 69 per cent.—I could go on.
Lord Rippon of Hexham: My Lords, while recognising the truth of my noble friend's remarks, does she agree that at present the construction industry is not overheated and that there remains a real need for low-cost houses to buy and to rent? In regard to capital receipts, should not the Government apply their principle of accountability of local authorities to the local electorate?
Baroness Blatch: My Lords, we have done a great deal in respect of the rented sector. We have introduced a process of deregulation which has helped the situation. It might help even more if members of the parties opposite would cease continually threatening to repeal deregulation. That has done a great deal to knock confidence in the rented sector. The situation in the construction industry has not inhibited our plans for housing associations to produce about 40,000 new houses in each of the next three years.
Lord Molloy: My Lords, is the Minister aware that families whose homes were repossessed because they could not pay their mortgage cannot be helped by housing associations because they assisted such families to acquire the house in the first place? Therefore, the local authorities are left to rehouse these families and sometimes the authorities are compelled to allow them to jump the housing queue. All that is at great expense; probably more expensive than if we had not meddled about with interest rates.
Baroness Blatch: My Lords, the noble Lord has mixed up many problems in that statement. I am addressing the subject of housing. The Government are taking many steps and I have named some of them. We have allocated £50 million to help rural areas; £270 million towards state action programmes; and £300 million in addition to main-stream funding to help the statutory homeless. I take this opportunity to congratulate the building societies which are going to enormous lengths to assist people and therefore avoid repossession.
Lord Hylton: My Lords, the Minister referred to housing associations. Is it not the case that even if their current output were doubled or trebled it would be inadequate to meet the need?
Baroness Blatch: My Lords, one cannot get away from demographic change. More young people are leaving home and requiring somewhere to live. People

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are living longer. That is good but it puts a demand on housing stock. I believe that we are doing what is practicable given the available resources and the fact that all the money we spend comes from taxpayers.
Lord Glenamara: My Lords, did the Minister notice that the number of homeless people became significant when the Government began to sell off council houses? As the number of council house sales increases so does the number of homeless people. Why do not the Government recognise the correlation between the two and stop the foolish policy of deliberately reducing the pool of low-cost houses for rent?
Baroness Blatch: My Lords, I disagree profoundly with the noble Lord's comments. The total number of homeless people remained almost static throughout the 1980s. Most people who purchased their council houses would still be living in those houses had they not done so. However, they are now more satisfied because they are home owners instead of merely tenants.
Lord Skelmersdale: My Lords, since we are always being told that local authorities are so impoverished will my noble friend tell the House how many local authorities spend up to the 25 per cent. capital receipt level, as they are allowed for this or any other purpose? Further, can my noble friend confirm that local authorities are allowed to spend 100 per cent. of their capital receipts for the purpose of immediate resale of houses to poorer people?
Baroness Blatch: My Lords, my noble friend is right in regard to his second question. We do not yet have statistics showing the number of local authorities which will spend up to 25 per cent. under the new scheme because this is its first year. The record was patchy for the old scheme and it was changed following reports on it.
Lord Jacques: My Lords, will the Government bear in mind that although housing is a complex subject it is a key problem? The less the Government succeed in solving the housing problem the more they multiply other social problems.
Baroness Blatch: My Lords, the noble Lord makes an important point. Housing is a key issue and the Government take it most seriously. Their record compares favourably with that of the previous government. At the end of the day one can do only what is practicable. The money that we spend on housing comes from the taxpayer.
Lord Moyne: My Lords, is there not a particular shortage of housing for young people who are not yet in a position to buy their houses? Is it not beyond the power of the well-supported housing associations to meet the whole of that demand?
Baroness Blatch: My Lords, my noble friend makes the important point that housing is a particular difficulty for young people. The reduction in inflation will go a long way towards helping them. Many
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building societies and housing associations are resorting to a number of mechanisms to help young people to become home owners.
Baroness Fisher of Rednal: My Lords, the Minister has paid great credit to the housing associations, but is she aware of the utter confusion that arose in the past year during the Government's change of financial policies? The result is that many associations which were building low-cost housing for the homeless had to stop doing so because of the cut-back in the grant from the Housing Corporation? That is a well-known fact. May I remind the Minister that, as a result of the sale of council houses, local authorities could have the money? All they need to do is work with building societies and housing associations in order to build houses for the homeless. That is what we are interested in, not statistics.
Baroness Blatch: My Lords, whatever problems the noble Baroness may attribute to the housing associations, the reason for those problems is not a cut in funding. The Housing Corporation received 35 per cent. extra in its funding this year and by 1993 it will have received an 88 per cent. increase over the current year. Therefore, the noble Baroness is not right in what she says.
Lord Dean of Beswick: My Lords, is the Minister not aware that her answers to my noble friends Lord Jay and Lord Glenamara were lacking in her usual candour? She said that in the 1980s the numbers of homeless remained static. However, the statistics issued by her own department demonstrate a dramatic increase. Is it not also the case that the house building programme in local authority areas has collapsed because since 1979 financial assistance from the Treasury to building programmes in the public sector has been reduced from over £5 billion to less than £1 billion? Bearing in mind that between £3 million and £4 million of public assets are doing nothing and that the building industry employment force will be cut by 100,000 people in the next year, will the Minister ask her department to see sense and unlock some of those resources so that the building industry can build houses for the benefit of all?
Baroness Blatch: My Lords, it is not that the money is not being used. Seventy-five per cent. of the money is reducing debt and 25 per cent. is applied to capital building. Secondly, the noble Lord and the Government must agree to disagree about the fact that he believes that only local authorities should be the direct providers. We believe that it is important that houses are built and that local authorities should be enablers.
The Lord Privy Seal (Lord Waddington): My Lords, your Lordships may feel that it is now appropriate to move on. We have spent 24 minutes on Questions and there is still another to be answered.

East Timor
3.2 p.m.
Lord Hatch of Lusby Lord Hatch of Lusby asked Her Majesty's Government:
What action they are taking in respect of Indonesian aggression in East Timor.
Lord Reay: My Lords, we support the efforts of the UN Secretary-General to promote contacts between the Indonesian and Portuguese governments aimed at achieving a settlement which reflects the interests of the East Timorese people.
Lord Hatch of Lusby: My Lords, is the noble Lord aware that in December 1975 the Security Council unanimously passed a resolution which,
"calls upon the Government of Indonesia to withdraw without delay all its forces from the territory".
What have Her Majesty's Government done and what are they doing to implement that Security Council resolution, a part of which also called upon all members to support the resolution and its implementation? Is the noble Lord aware that in the meantime, according to Her Majesty's Government's figures, between 60,000 and 100,000 people in East Timor have lost their lives as a result of that invasion and occupation?
Lord Reay: My Lords, the United Nations has moved on since 1975. I remind the noble Lord that in 1982 the United Nations Secretary-General was asked by the General Assembly to promote talks between the two governments with a view to reaching a bilateral settlement. We support that process and believe that the Secretary-General's approach is the best way forward.
Lord Cledwyn of Penrhos: My Lords, taking account of what the noble Lord has just said, and given the way that Indonesia has treated the East Timorese, how can the sale of arms on a huge scale by this country to Indonesia be justified? Can the noble Lord say whether Her Majesty's Government support the United Nations' decision to send a fact-finding mission to East Timor in the spring?
Lord Reay: My Lords, with regard to the first question, our policy is to meet requests from the Indonesian government for their legitimate defence needs. I do not have any figures for the amount of arms which we have supplied in recent years. However, there is no evidence that British military items sold to Indonesia have been used in East Timor.
Lord Cledwyn of Penrhos: My Lords, is the noble Lord able to justify the sale of arms, including arms which could be and are used against the East Timorese, resulting in the death, as my noble friend said, of between 60,000 and 100,000 out of a population of 600,000 Timorese, on such a scale? Does he not agree that their sale by a civilised country like Britain is one of the causes and seeds of war in this world at present?
Lord Reay: My Lords, I understand that at present there is anxiety as regards the export of arms.
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However, I repeat that there is no evidence that British military items sold to Indonesia have been used in East Timor.
Lord Rea: My Lords, does the noble Lord not agree that if Security Council Resolution No. 384 of 1975, mentioned by my noble friend, had been acted upon—not necessarily involving armed force—then other potential aggressors, such as one with whom we are having a certain amount of bother at present, may have been deterred? Do the Government now regard the Indonesian aggression in East Timor as a fait accompli?
Lord Reay: My Lords, there are important differences between the two cases which the noble Lord seeks to raise. However, the important point is to look forward. In our view, the Secretary-General's efforts offer the best prospects.
Lord Cledwyn of Penrhos: My Lords, perhaps the noble Lord will answer the second part of my question about the United Nations fact-finding mission.
Lord Reay: My Lords, I have no information with me with regard to a United Nations fact-finding mission. However, I shall investigate the matter and write to the noble Lord.
Baroness Ewart-Biggs: My Lords, is the Minister aware that an East Timorese member of the Indonesian National Assembly was reputed to have been arrested recently? Is that true and, if so, has that member since been released?
Lord Reay: My Lords, I have no information on the issue which the noble Baroness raises. Again, I shall look into the matter and write to the noble Baroness.
Lord Hatch of Lusby: My Lords, is the noble Lord not aware that his original Answer to me was not completely correct by implication? In the original Security Council Resolution No. 384 of 1975, responsibility was passed to the Secretary-General who was asked to promote talks between the Portuguese and the Indonesians. That is now nearly 16 years ago. How is it that Her Majesty's Government and the Government of the United States—apparently friendly with and supportive of the Government of Indonesia for 16 years—have been in breach of a Security Council resolution passed unanimously which still stands and has not been overtaken by events?
Lord Reay: My Lords, it is also true that in 1982 the United Nations Secretary-General was asked to do what he could to promote talks between Portugal and Indonesia with a view to reaching a negotiated agreement. We believe that we should support the United Nations in those endeavours.

Civil Jurisdiction and Judgments Bill [H.L.]
3.8 p.m.
The Lord Chancellor (Lord Mackay of Clashfern): My Lords, I beg to move that this Bill be now read a third time.
Moved, That the Bill be now read a third time.—(The Lord Chancellor.)
Lord Mishcon: My Lords, on Second Reading the noble and learned Lord summarised the purpose of this Bill in the one sentence:
"The purpose of the Bill is to make it easier to enforce civil court judgments throughout most of Europe".—[Official Report, 20/12/90; col. 921.]
Nothing need be added on Third Reading to those discussions in the course of which the noble and learned Lord, Lord Wilberforce, made a most interesting and useful contribution. It remains only for me to congratulate the noble and learned Lord on his pilotage.
The Lord Chancellor: My Lords, I am grateful to the noble Lord, Lord Mishcon, for his remarks and also to the noble and learned Lord, Lord Wilberforce, for his participation at Second Reading.
On Question, Bill read a third time.
The Lord Chancellor: My Lords, I beg to move that the Bill do now pass.
Moved, That the Bill do now pass.—(The Lord Chancellor.)
On Question, Bill passed, and sent to the Commons.

Crime of Vagrancy (Abolition) Bill [H.L.]
3.10 p.m.
Read a third time, and passed, and sent to the Commons.

New Roads and Street Works Bill [H.L.]
3.11 p.m.
The Minister of State, Department of Transport (Lord Brabazon of Tara): My Lords, I beg to move that the Bill be now further considered on Report.
Moved, That the Bill be further considered on Report.—(Lord Brabazon of Tara.)
On Question, Motion agreed to.
Clause 67 [Fee for occupation of the highway]:
Lord Lucas of Chilworth Lord Lucas of Chilworth moved Amendment No. 115:
Page 37, line 41, leave out subsection (1) and insert:
("(1) The Secretary of State may make provision by regulations, where the provisions of this part are consistently not complied with, for an undertaker executing works in a street designated as traffic sensitive to pay the prescribed fee for occupation of the highway").
The noble Lord said: My Lords, in moving Amendment No. 115, standing in my name and that of
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the noble Lord, Lord Tordoff, I shall speak also to Amendments Nos. 116, 117 and 118, also standing in the name of the noble Lord, Lord Tordoff.
In Clause 67 we return to the vexing question of fees for the occupation of the highway. This matter was debated at Second Reading and during Committee stage. The primary reason for the tabling of these amendments arises from the contribution made by the noble Lord, Lord Tordoff, in the clause stand part debate during Committee stage.
I recognise that the Minister reiterated the Government's intention to include this scheme in the Bill. Equally, I recognise the assurances that have been given, particularly those contained in government Amendment No. 141 at Committee stage which allows for repayment of fees already paid where the work is completed earlier than expected. Nevertheless, the utilities have a right to place apparatus in the highway. That is conferred upon them by a number of statutes all of which have been reconfirmed by Parliament within the past few years.
When the noble Lord, Lord Clinton-Davis, spoke to an earlier amendment on 6th December he said that the placing of apparatus in or under the highway was a privilege and not a right. But clearly the reverse is true. In 1984 under the Telecommunications Act, in 1986 under the Gas Act and in 1989 under both the Electricity and the Water Acts, specific powers were conferred upon the utilities to lay plant in the public highway.
This series of amendments is designed to overcome practical difficulties; to add sensibility to the Bill, and to underline the intentions of the Government. I suggest that if a scheme involving fees is introduced, it should relate only to traffic-sensitive routes. At the same time, any such scheme should provide for free periods when no charges would be payable. That would represent the core time for a job. Where emergency works are concerned, almost by definition the utility needs no incentive to complete the job as quickly as possible and such works could reasonably be exempt from fees.
I suggest that it is unreasonable to prescribe a fee where emergency works are undertaken. Why should an undertaker be charged for fulfilling his obligations to protect the public from likely danger? That is essentially how emergency works have been described during the debates on this matter. In practical terms it is impossible to determine how long emergency repairs will take until the full extent of the emergency is recognised. Indeed, that recognition cannot be made until remedial works have at least started. To fix some arbitrary period seems to be not only unreasonable, but also not sensible.
At the outset I said that I recognised that the intentions of the Government were to impose a financial incentive for works to be completed quickly. I do not believe that Amendment No. 115 would in anyway diminish that responsibility. I beg to move.
Lord Tordoff: My Lords, in supporting the amendment I briefly return to what was said when, as the noble Lord, Lord Lucas, was kind enough to say,

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I raised the matter during the debate on clause stand part at Committee stage. We have teased out the problem quite a long way. It is clear that the Government believe that in many circumstances to charge a fee would instil a discipline on the person digging the hole in the road. However, the Government have accepted that this is a provision that will be used only in exceptional circumstances.
The noble Lord, Lord Lucas, set out the position extremely well this afternoon. However, I should like to make one point. The danger of putting an arbitrary period on emergency works may create a tendency to short-cut the situation and lead to some safety or health hazards. The people who will be carrying out these works feel that it is right for the Government to spell out that the provision will be used only in limited circumstances. They believe that it is something which should appear on the face of the Bill.
The local authorities understand the situation. They are prepared to go along with it in principle, although they may not be especially happy with the wording of the amendment. I had hoped that by this time the local authorities and the utilities might have got together and come up with a joint amendment. Perhaps it is not too late for that to happen before the later stages of the Bill. It not only has to come back here for Third reading, but it also has to go through another place.
This afternoon, even if we achieve nothing more, it would be useful if we obtained agreement from the Minister that he too would like to see the provision on the face of the Bill, provided that agreed wording could be found. It is an important issue. As we have said many times, there has been a considerable amount of agreement about the Bill between the local authorities and the utilities. This House, both at Second Reading and Committee, has been unwilling to upset the balance between the contending forces.
The amendment concerns an area which is still unresolved. I hope that the Minister can assist. Even if the series of amendments is not totally to his liking, I hope that he will be prepared to introduce a government amendment at a later stage.
Lord Nugent of Guildford: My Lords, I wonder whether it would be wise to reduce the effects of the provisions in Clause 67 as much as my noble friend Lord Lucas proposes with these amendments, especially in limiting their application to traffic-sensitive routes only. Of course we want to maintain the co-operation and harmony which have been achieved in these very complicated matters between the highway and the statutory authorities. My noble friend started off by emphasising the statutory right of undertakers to place works in the road. That is true. But what Parliament has not really defined before this Bill is at traffic has the right to use the road. What we are considering here, I think for the first time, is the balance between the needs of the statutory undertakers to place their works in the road and the needs of the vehicles to pass along it.
When every year now there are literally millions of openings on the roads, especially in towns, and when
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traffic congestion is such a very important aspect of town and city life throughout the country, this is a timely moment for my noble friend the Minister to put this clause into the Bill. It will introduce into the Bill and onto the statute book some balance between the needs of moving traffic and the needs of the statutory undertaker. By the introduction of a scheme which has been called lane rental on motorways, for the first time the statutory undertaker has a direct incentive to be as quick as he can in his own interests and in those of the people for whom he is working. That must surely be a sensible and practical measure.
I am quite certain that my noble friend has no thought of laying down an arbitrary time limit within which a statutory undertaker has to work. However, if he knows that he is paying for each extra day that he works there and has his equipment on the road, naturally he will have a strong incentive to be as quick as possible. The application of this principle to motorways has shown a substantial saving both in time and money. Therefore, its general application to all roads seems to be no more than sensible and practical. I am sure that my noble friend will balance carefully the amount of the charge and the conditions of its application when he comes to make the regulations which will introduce the measure.
My noble friend Lord Lucas said that the statutory undertaker needs no incentive to be as quick as he can. In the real world we see a statutory undertaker who is about to undertake work on a road—
Lord Tordoff: My Lords, I am grateful to the noble Lord for giving way. I think that the noble Lord, Lord Lucas, referred specifically to emergency work when he used those words; namely, that there is no incentive for delay when doing emergency works because there is necessarily a danger to health and safety. I do not think he extended the measure beyond emergency work.
Lord Nugent of Guildford: My Lords, we can both look at Hansard tomorrow. I wrote down what my noble friend said as he said it.
The point I am making is that it is common experience that when undertakers are about to begin roadworks they bring the equipment along one week and start work the following week. That denies people the use of a lane on the road. We see that happening all over the country. We need to offer an incentive to stop such practices and also to clear up afterwards. Every day equipment is left on roads that interferes with the flow of traffic, and that is costing all traffic users and the town road system extra money in terms of delivery costs.
We are talking about the real world and not an imaginary one. It is sensible to build this incentive into the Bill. I do not think that the extra discipline will seriously interfere with the work of the statutory undertaker; it will probably improve it. I have said once before, and it is worth saying again, that there are modern techniques of trenchless digging which can greatly reduce the degree of tearing up the road surface and thereby reduce the charges made in order to carry out the work on the highway. As we know,

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British Gas has introduced trenchless digging over thousands of miles of work, and it is greatly to its advantage because it is much cheaper. It is even more to the advantage of moving traffic.
It is a desirable incentive to use these modern methods of dealing with cables and pipes on the highway: their more general use should be encouraged. I hope that my noble friend the Minister will not reduce the effectiveness of the Bill by accepting the amendment to reduce the application of the provision to sensitive routes only. It should be applied to all routes. That would be the proper thing to do. My noble friend can cater for that with the statutory orders that he makes.
Lord Tordoff: My Lords, is the noble Lord aware that the Minister said at an earlier stage that the provision was not going to be used across the board? He said that it would be restricted to certain situations.
Lord Nugent of Guildford: My Lords, with the leave of the House, I shall also make a brief second speech. Of course I know what my noble friend said. But I expect that in his regulations he will take care of all practical considerations.
Lord Peyton of Yeovil: My Lords, I wish briefly to support what my noble friend Lord Nugent has said. Any visitor to this city could well come to the conclusion that the highway is meant for almost any purpose other than moving about. It would be wise to seek the advice of those who regularly use it. I am one of those who believe that some of the more intelligent people who use our highways are the taxi drivers. We must face the harsh fact that if we are not prepared to build new roads we have to restrict fairly severely the use of those we have.
Although the utilities are capable of painting quite attractive and alluring pictures of themselves and their activities, the general experience is very much on the lines indicated by my noble friend Lord Nugent just now. Contractors come along a week or so before they are prepared to do the work, make their preparations, leave what they believe is convenient to them on site and then go away until they are ready to complete the next stage. I very much hope that my noble friend will not be tempted, in the form of this amendment, into taking out of the Bill such teeth as it has.
Lord Underhill: My Lords, I wish to make it absolutely clear, as I believe I said at Second Reading and also in Committee, that the highway authorities do not in any way oppose the general principle of the clause. However, they have emphasised time and time again that they wish it to be a reserve power only to be used when everything else provided for is not working.
The two noble Lords who introduced the amendments went through the history so I shall not go into it. When the existing subsection (6) was introduced at Committee stage the Minister made the matter absolutely clear then and during the debate on clause stand part, when he said:
"This is a provision worth having in reserve".
He went on to say:
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"the first of any regulations made under this section would need to be brought in by an affirmative resolution instrument".
He continued:
"We shall of course continue consultations with those involved on that issue".—[Official Report, 6/12/90; col. 345.]
That followed what the noble Lord, Lord Tordoff, said about continuing discussions.
What rather surprises me in this is that we are all agreed that the provision should be an emergency power to be used only when everything else has failed. Yet for some reason the Government are very timid about writing that into the Bill; and with all due respect to the noble Lord, Lord Lucas, he is also timid about writing it into the Bill. I should like to echo what the noble Lord, Lord Tordoff, said. Although he was speaking in support of the amendment to which his name is attached, he said that he would like to have seen written into the Bill itself a provision stating that this was a reserve power only to be used when everything else had failed. If it has to be used it means that some of the basic principles in the Bill are not working. The local authorities would definitely welcome an amendment to the clause to provide that it is a reserve power. I should like to see this amendment carried today; equally, at the next stage, I should like to see the clause made stronger by a further amendment making clear that it is only to be used as a reserve power.
I know the Minister has stated that it is a reserve power. But as has been said time and again, while it is useful to have statements from the Minister, what is more important is that the face of a Bill should actually carry the provision. I hope the Minister will again make it absolutely clear that the Government regard this as a reserve power only to be used when this type of provision has failed and that he will be able to continue the discussions with a view to producing an amendment to make that clear on the face of the Bill.
3.30 p.m.
Lord Peyton of Yeovil: My Lords, before the noble Lord sits down, I have to say that I absolutely fail to understand his point. How can he claim that the making of a reserve power—only to be used therefore exceptionally—strengthens the Bill? It seems to me to weaken it.
Lord Underhill: My Lords, with the leave of the House, there have been discussions between utilities and the highway associations. I understand that the local authority associations are continuing the discussions. Anything that is written into the Bill is far stronger than a statement made by the Minister. That is really what we want to see done. I should like the Minister to say how, since 6th December, these discussions have progressed and whether there has been any disagreement on this issue. To my mind there has been no disagreement. Therefore the timidity on this matter both of the Government and of the noble Lords, Lord Lucas and Lord Tordoff, in introducing the amendment is something I cannot fully understand.
Lord Brabazon of Tara: My Lords, we discussed this clause both at Committee stage and Second Reading and I have discussed it with representatives of the utilities as well. It is well known that the Government want to use every means at their disposal to reduce traffic congestion and to get the most from existing roads. As my noble friends Lord Nugent and Lord Peyton said utility street works are a major cause of delays. In fact there is no disagreement in the House as to that matter. I am confident that at least some of these delays can be avoided, which would be to the benefit of all road users. Charging would act as a powerful incentive on utilities and others to plan their works so as to reduce the disruption they cause. By limiting their scope, these amendments would significantly weaken the provisions on charging for the occupation of road space during street works. For this reason the Government find them unacceptable.
The first amendment would permit the introduction of any such scheme only where the Secretary of State was satisfied that undertakers were consistently failing to comply with their obligations under this part. It would further limit the scope of any scheme, first, by restricting it to traffic-sensitive streets, and secondly—together with the final two amendments to this clause—by seeking to exclude all emergency works. However, any failure by undertakers to comply with their requirements under the Bill is a matter for the courts, and it would be neither possible nor proper for the Secretary of State to draw a line between acceptable and unacceptable levels of breaches of the law. As. I have said before, there will of course be full consultation with those likely to be affected by it before any charging scheme is introduced. The first regulations prescribing fees under Clause 67 will also have to be approved by Parliament.
We shall consider any proposals put forward by the highway authorities and utilities as to the scope of the charges that may be prescribed. However, we would wish to avoid unnecessarily limiting this new power which has been deliberately drawn wide enough to allow any charging scheme to be targeted at the avoidance of unnecessary delays. Which works should be subject to charges will become apparent after experience with the new arrangements. My noble friend Lord Lucas mentioned exemption of emergency works from charging. Exclusion of emergency works from the charging provisions would provide renewed scope for abuse of the category of emergency works. That abuse is well known at the present time. The street works associated with emergencies must be carried out efficiently and charging would provide an incentive to do so.
The wording of Clause 67 does not mean that a fee will be payable by undertakers in every case. The Secretary of State may not prescribe a scheme or may prescribe different rates of fee which could include free periods for different works. The power to charge would be used where it was considered most likely to achieve reductions in the amount of delay and inconvenience. The scheme could be structured so that the great majority of works not causing any more obstruction than was reasonably necessary would escape charges altogether. As my noble friend Lord
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Nugent pointed out, utilities could avoid passing charges on to their customers by entering into lane rental type contracts with their contractors. I confirm what my noble friend said about the success of lane rental contracts as concerns government roads.
Lastly, on the point of reserve powers, I say to the noble Lord, Lord Underhill, that it is undesirable to express this power in reserve terms. The amendment illustrates the difficulty of describing the circumstances in which a power would or would not be used. The requirement to have the approval of Parliament to the introduction of a charging scheme will effectively allow a review of the circumstances which have made it necessary to make those charges.
I hope that the House will not agree to these amendments. On strong grounds we believe that this is a useful power to have in the Bill. At the same time I hope that I have been able to give my noble friend some reassurance on the effect of it.
Lord Lucas of Chilworth: My Lords, I am most grateful to noble Lords who have taken part in the debate. I am sure that my noble friends Lord Nugent of Guildford and Lord Peyton of Yeovil would not accuse me of moving away from the lobbies which we have shared on questions of traffic movement. I seek with no lack of timidity to draw a balance between work that has to be undertaken properly and expeditiously and the free movement of traffic. On the question of an emergency, the noble Lord, Lord Tordoff, drew attention to what I said. My noble friend the Minister then suggested that it would be very difficult for the scope of an emergency to be defined. In my heart, I find that a little difficult to accept.
A balance has to be struck. Unless the regulations are most carefully drawn and have the full acceptance of the local authorities and the utilities, the provisions of the Bill will provide not an incentive to get on with work quickly but perhaps more of a disincentive to do certain works because of the definition of "emergency". Nevertheless, I am not prepared this afternoon to invite your Lordships to determine the case that I and the noble Lord, Lord Tordoff, have advanced. I thank my noble friend the Minster for his forbearance in dealing with the matter for a third time. I believe that he has taken account of the feelings which have been expressed and that he has given certain assurances which may later find their way on to the statute book.
In conclusion, I should tell my noble friend the Minister that I accept the fact that no provision should be put into a Bill which obliges the Secretary of State at any time to determine the law; indeed, that is for the courts. No one should seek to take that duty away from them. In the circumstances, I shall leave the matter as it stands. I have taken full account of what has been said both previously and this afternoon and of the points made by my noble friend. Accordingly, I beg leave to withdraw the amendment.
Amendment, by leave, withdrawn.
[Amendments Nos. 116 to 118 not moved.]
Clause 69 [Liability for cost of temporary traffic regulation]:
Lord Tordoff Lord Tordoff moved Amendment No. 119:
Page 39, line 17, leave out ("or in consequence of").
The noble Lord said: My Lords, noble Lords who were present on Second Reading may remember that I asked the Minister whether it was intended to charge for loss of revenue from parking meters. He replied that it was not the intention to do so. On that occasion I also asked what was the Government's view on attempts by local authorities to charge utilities for the loss of revenue from such meters. I said that in my view it appeared that a draconian measure was being taken in many areas. The Minister replied that,
"As regards the lost revenue from parking meters, I assure the noble Lord, Lord Tordoff, that there is no proposal to provide for compensation in such cases".—[Official Report, 20/11/90; col. 671.]
The simple purpose of the amendment is to make clear on the face of the Bill that consequential losses, such as meter revenues and road tolls, are not recoverable under the clause. I beg to move.
Lord Brabazon of Tara: My Lords, the amendment would limit the costs recoverable from undertakers in respect of temporary traffic regulation measures which are necessitated by street works. It would exclude costs incurred by a traffic authority or concessionaire "in consequence" of any orders made or notices issued. That could have the effect of excluding, for example, the costs of signing diversions. Clause 69 is based on a recommendation of the Horne Committee and would be weakened unduly by excluding from its scope an important element of the costs which undertakers' works impose on highway authorities.
The amendment is unnecessary as it will be open to an undertaker to challenge any costs which it considers to be unreasonable. Clause 89, as amended, would enable an undertaker to go to arbitration should the parties fail to agree on the level of costs incurred by the authority. In the light of those assurances, I hope that the noble Lord will feel able to withdraw his amendment.
Lord Tordoff: My Lords, I am grateful to the Minister for those reassurances. Nevertheless, I should have thought that if people seek arbitration then the rules should be clearly spelt out for them in legislation. I was somewhat worried that the rules do not appear to be altogether clear in the Bill. It was in that spirit that I moved the amendment. However, I shall read carefully what the Minister said and perhaps we may be able to leave the matter as it stands. In the meantime, I beg leave to withdraw the amendment.
Amendment, by leave, withdrawn.
3.45 p.m.
Lord Underhill Lord Underhill moved Amendment No. 120:
Page 39, line 25, after ("prohibition") leave out ("or").
The noble Lord said: My Lords, this amendment is tabled in the name of my noble friend Lord Clinton-Davis and that of the noble Lord, Lord Tordoff. In moving it I shall speak also to Amendment No. 121 because Amendment No. 120 is merely a small paving amendment to it. Clause 69(2) (b) makes absolutely clear the fact that a street authority can in
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certain circumstances recover from an undertaker the costs of traffic signing. The existing paragraph states that such a provision applies,
"in connection with the prohibition or restriction of traffic"
in order to facilitate street works. The amendment seeks to widen the provision so that it is not just the prohibition or restriction of traffic which is provided for but also the costs of signing a diversionary route. It is such an obvious and sensible amendment that I feel sure the Minister will be able to accept it. I beg to move.
Lord Brabazon of Tara: My Lords, Clause 69 allows a traffic authority or concessionaire, who because of street works makes an order or issues a notice temporarily prohibiting or restricting traffic, to recover from the undertaker,
"the whole of the costs incurred by them in conjunction with or in consequence of the order or notice".
That form of words is wide enough to allow the recovery of any costs incurred by the authority or concessionaire in signing traffic diversions that are in consequence of the prohibition or restriction. Since the ability to recover costs is only activated by the making of an order or the issue of a notice for the temporary prohibition or restriction of traffic, it is unnecessary to include specific reference in subsection(2) to the costs of signing diversions of traffic. In the light of that explanation, I hope that the noble Lord will be assured on the matter and that he will feel able to withdraw the amendment.
Lord Underhill: My Lords, I have taken very careful note of the Minister's reply. I understood him to say that the words,
"prohibition or restriction of traffic"
include a diversionary route. I believe that the Minister quite definitely said that. I understand that the utilities are quite happy with the provision which I have put forward. However, in view of the Minister's assurance that the wording covers the signing of diversionary routes, I have no hesitation in withdrawing the amendment.
Amendment, by leave, withdrawn.
[Amendment No. 121 not moved.]
Clause 70 [Liability for cost of use of alternative route]:
Lord Lucas of Chilworth Lord Lucas of Chilworth moved Amendment No. 122:
Page 39, line 26, after ("is") insert ("under any enactment").
The noble Lord said: My Lords, this amendment is also tabled in the name of the noble Lord, Lord Tordoff. In moving it, I shall speak also to Amendment No. 123. The amendment proposed may be perceived as being slightly mischievous. However, its purpose is to follow more closely the terms of the Highways Act 1980 which make clear that, in the case of a restriction, there must be a formal statutory order before an undertaker is fixed with the liability to indemnify the highway authority.
It is difficult to appreciate why there should be a departure from the position as set out in that Act. The proposal to give the street authority and the undertaker an opportunity to discuss and agree what

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is required before works are carried out—that is, works for which the undertaker will be paying—seems to me to be eminently reasonable.
I said in opening that the amendment may seem to be "slightly mischievous". I did so because one could envisage a situation where no discussion has taken place and where the highway authority has erected signs or caused diversions to be made along roads which it may desire to put into a better state. Consequently, it would be able, unfairly, to charge the undertaker for any further damage which may occur.
One has to appreciate the fact that when one is actually in the field, on the road so to speak, it is an individual working in a supervisory capacity—such as a foreman—who may determine such matters rather than an august body undertaking such discussions. Therefore, the amendments seek to bring some reasonableness into the matter by introducing the provision for discussions which will ensure that potential liability is dealt with before the works are carried out. I beg to move.
Lord Tordoff: My Lords, this is a simple amendment. As noble Lords will be aware, the clause as a whole is about the requirement on a utility to meet the cost of strengthening or repairing a road damaged as a result of a diversion. The cost is to be borne by the utilities. It is not unreasonable that the utilities should know what the cost will be before they embark on the work. It is in that spirit that the amendment is moved.
Lord Clinton-Davis: My Lords, in addressing the first amendment, I do not understand why it is necessary to incorporate the phrase "under any enactment". I have heard nothing from the noble Lord, Lord Lucas, which provides any further and better particulars about that point.
On the second amendment, I agree with both noble Lords. The requirement is not unreasonable. We should underline the fact that the decision concerning the works to be undertaken should rest with the highway authority. It already has two limitations imposed upon how it can act. In subsection (1) there is already the reference to costs being reasonably incurred by highway authorities. That is buttressed by the arbitration provisions which have been inserted into the Bill. I am most grateful, as I have said before, to the Minister, for agreeing to that proposition which I made earlier in the proceedings.
I do not understand why it is necessary to incorporate the words "under any enactment", and perhaps the noble Lord will cast some light on that point when he replies.
Lord Brabazon of Tara: My Lords, these two amendments seek in different ways to place limits on the powers of highway authorities under Clause 70. The first would restrict the highway authority's ability to recover costs it has incurred in association with the use of an alternative route as a result of street works. It attempts to do so by limiting the undertaker's liability to cases where use of a highway is restricted "under any enactment", a form of words used in Section 60 of the Highways Act 1980, which Clause 70 will replace, as my noble friend said.
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The inclusion of the words "under any enactment" is unnecessary since the use of a highway can be lawfully restricted or prohibited only by means of a temporary traffic order or similar instrument provided for in legislation. That answers the first amendment.
The second amendment would insert a new subsection. That would provide that, where a highway authority proposes to carry out strengthening or repair works to a highway used as an alternative route during street works, it must first consult the undertaker whose street works, it must first consult the undertaker whose street works led to the diversion.
However, the advance notice requirements under Clause 48 will in practice provide an opportunity for early discussion of planned street works, and a responsible highway authority would inform the undertaker concerned before carrying out consequential maintainance works on an alternative route. It would not be appropriate also to require consultation with the undertaker on the specific nature of the works of strengthening or repair which fall clearly within the responsibilities of the highway authority, the point by the noble Lord, Lord Clinton-Davis.
In the last resort, if there are unresolved disputes over claims for payment under this clause, there is provision for their determination by arbitration. I am grateful to the noble Lord, Lord Clinton-Davis, for reminding us of that point and for his word of thanks for the government amendment which brought about that provision. For those reasons, we cannot agree to my noble friend's amendment.
Lord Lucas of Chilworth: My Lords, I am most grateful to my noble friend the Minister, especially for explaining the purpose of the first amendment. I am also grateful to him for drawing attention to the provisions of Clause 48 in respect of the second amendment. He referred to a "responsible authority". Earlier I said that there was a sense of mischievousness in the second amendment when I suggested that there may be some authorities that are less than responsible. However, he has put the matter more firmly into perspective. I am grateful to him. I beg leave to withdraw the amendment.
Amendment, by leave, withdrawn.
[Amendment No. 123 not moved.]
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendment No. 124:
Page 40, line 1, leave out subsection (3).
The noble Lord said: My Lords, I spoke to this amendment with Amendment No. 50. I beg to move.
On Question, amendment agreed to.
Clause 127 [Liability for cost of use of alternative route]:
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendment No. 125:
Page 72, line 5, leave out subsection (4).
The noble Lord said: My Lords, I spoke to this amendment with Amendment No. 50. I beg to move.
On Question, amendment agreed to.
Clause 71 [Contributions to costs of making good long-term damage]:
Lord Clinton-Davis Lord Clinton-Davis moved Amendment No. 126:
Page 40, line 27, at end insert:
("(6) If the Secretary of State has not made regulations under this section within three years of the commencement of this Part he shall lay before each House of Parliament an report setting out his reasons for not doing so.").
The noble Lord said: My Lords, I move the amendment because we are seeking to make it mandatory for the Secretary of State to make a report to Parliament if, within three years of the commencement of Parts III and IV, he has not made regulations under Clause 71. That report would give him an opportunity to explain why he has declined to do so.
Clause 71 makes provision for the Secretary of State to make regulations requiring the utilities to make payments to the street authority concerning costs incurred by the authority when it reconstructs or resurfaces a street. The objective is to provide the way by which street authorities may be compensated for the long-term damage which may be done to streets by excavation and street work activities undertaken by the utilities.
The question of cumulative long-term damage is a vexed and controversial one. Indeed, it merited a subject of its own in the Horne Report. The review undertaken by Horne came to the conclusion that it would be premature to embark upon a general system of compensating street authorities for long-term damage:
"until experience showed how successful the proposals that we have made in this report for an overall improvement of reinstatement standards have been. For this reason we do not recommend any compensation for possible long-term damage, although we do regard as important a monitoring of the situation as it develops, using assessment procedures such as those discussed"—
That refers to this chapter—
"We therefore recommend that, after experience has been gained, a review should be made of the way in which the formal specifications and the warranty periods have operated in order to assess the extent to which the arrangements have succeeded in monitoring, limiting and correcting structural damage".
The Government accepted that recommendation, but they thought that the necessary powers should be included in legislation to allow undertakers to be required to pay the costs of making good long-term damage to the road, if it was shown that such arrangements were warranted. So we have Clause 71 included in the Bill. I am informed that the local authority associations welcome that provision, combined with the requirement that the first set of regulations made under the clause will be subject to the affirmative resolution procedure.
I understand, and no doubt the Minister will be able to confirm this position, that officials from his department have discussed with representatives of the HAUC arrangements for monitoring the impact of the Bill. I understand that the arrangements are proceeding satisfactorily. I want to stress that the Home review included a second recommendation on
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that very issue which is not referred to in the Notes on Clauses prepared by the Department of Transport and helpfully provided by the Minister.
Home recommended:
"Existing procedures for assessing the residual life of pavements and for the assessment of maintenance needs should be exploited to monitor the effects of utility reinstatement on road damage and maintenance needs and costs".
Then the report went on:
"We see a need for planned fundamental research on the problems of reinstatement including field tests on the efficacy of alternative materials and working practices. But since the variables and the factors affecting performance are extraordinarily wide, such research needs to be carefully planned and guided … so that it may be concentrated on the most important aspects".
Again the Government accepted the recommendation; they accepted the need for the sort of research contemplated by Home in the area we are discussing. What I should like to know from the Minister—I think that this amendment provides a suitable opportunity which I hope he will take—is where progress on this recommendation stands. In the context of the controversial nature of this issue when it was originally proposed, that is important so far as the local highway authorities are concerned.
In putting forward this amendment I am not seeking to compel the Secretary of State to make regulations under the clause. What I am seeking to do is to ensure that the area we are considering is not forgotten or overlooked. The amendment would simply require the Secretary of State to report on progress three years after the commencement of this part of the Bill. Having regard to the controversy to which this gave rise and the importance of the matter so far as local highway authorities are concerned, I think that is a perfectly reasonable request. I beg to move.
4 p.m.
Lord Brabazon of Tara: My Lords, the noble Lord, Lord Clinton-Davis, is quite correct when he says that we are on a somewhat controversial issue in the claims that have been made that openings in the road, however well they are reinstated, cause long-term damage to the structure of the road. The Horne Report recommended that existing procedures for assessing the residual life of pavements should be used to monitor the effect of utility reinstatements on road damage. I can confirm to the noble Lord that this is currently being done. It also proposed that the new specifications for reinstatements should be monitored to assess to what extent they succeed in limiting structural damage.
Clause 71 has been included to allow the introduction of a scheme for undertakers to contribute to the costs of highway authorities in rectifying such damage. The Secretary of State does not intend to make regulations requiring contributions from undertakers until the results are known of research into long-term damage to the structure of streets caused by excavation works. It will also be prudent to allow some time to evaluate the effects of the reinstatement specifications in limiting long-term

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damage to roads. A new compensation scheme would not in any case be introduced before full consultations have been conducted with those likely to be affected by it.
I can confirm to the noble Lord that the department has been consulting the Highway Authorities and Utilities Committee about the ongoing research into the link between utility works and long-term damage to roads. A review of the effect in practice of the new reinstatement specifications will be undertaken in association with the Highway Authorities and Utilities Committee. Therefore, I hope that I can satisfy the noble Lord that the use of the power under Clause 71 will be kept under continuous review.
In those circumstances, this amendment to insert an additional requirement to report on the reasons for not introducing a scheme would, I submit, serve little purpose. This area will certainly not be forgotten or overlooked. Of course it will be open to the noble Lord and others in this House and in another place to ask questions about how we are getting on in three years' time, or before or after.
Lord Clinton-Davis: My Lords, when the Minister says that the amendment would serve little purpose, that infers that it may serve some purpose. If he implies that I might forget to raise certain questions in three years' time, that is perfectly possible, most particularly as this badge says that I actually expire in three years' time. It gives me only until June 1993. I understand that some noble Lords have until 1995 and some have no limitation at all. Therefore, there is a possibility that it may not be open to me to raise such questions.
What I am more concerned with is whether the Minister, or more likely his successor, will remember. I cannot see that it places him under any undue obligation to make a report in the circumstances reflected in the amendment; nor has the Minister indicated why it would impose any undue burdens on him to do that. But he has so far declined, and no doubt it is a matter that will be pursued elsewhere. In those circumstances, I beg leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Clause 72 [Records of location of apparatus]:
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendment No. 127:
Page 41, line 6, at end insert:
("( ) The Secretary of State may by order—

(a) repeal or modify any enactment made or passed before the commencement of this Part which makes provision for the keeping of records of apparatus and appears to him to be superseded by or otherwise inconsistent with the provisions of this section; and

(b) make provision for applying in relation to records compiled under any such enactment the provisions of subsections (2) to (5) above and section 73 below.

An order under this subsection shall be made by statutory instrument which shall be subject to annulment in pursuance of a resolution of either House of Parliament.").
The noble Lord said: My Lords, with the leave of the House I should like to move Amendment No. 127
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and speak to Amendment No. 128. These amendments are necessary in order to allow existing requirements on undertakers to keep records of their buried apparatus to be modified where necessary. Clause 72 places a new duty on all undertakers to keep up-to-date records of their apparatus in streets in a form and manner to be prescribed in regulations. In order to ensure consistency between the statutory requirements as they apply to apparatus in streets, it will therefore be necessary to amend, where appropriate, the various existing requirements which are to be found in utilities' enabling legislation or licences. These amendments will enable this to be done more easily, by order. They will also allow existing records to be treated as having been compiled in accordance with the provisions of the Bill where this is appropriate. I beg to move.
Lord Tordoff: My Lords, do I understand that the Minister intends to undertake amendments to the appointments or licences, because the utilities are obviously somewhat worried by what is a perfectly sensible provision? I think noble Lords on all sides of the House would welcome the requirements for proper records to be kept as being a fundamental part of this whole process. One of the problems in the past has been that no one knew what lay under the road surface at any given point, and therefore this would be a step forward. However, the undertakers are a little worried that they might find themselves having to provide two sets of records —one under their appointments or licences and one under Clause 72. If the Government could reassure them on that subject it would be a great help.
Lord Clinton-Davis: My Lords, this is a perfectly reasonable amendment, particularly when one takes into account how important it is that there should be consistent records maintained right across the various utilities. The amendment is drafted in enabling form, and therefore the Secretary of State is permitted rather than required to repeal or modify existing legislation. Is the Minister able to confirm that it is his intention to use the powers provided by this clause in all circumstances where records are currently maintained in a different form under existing legislation?
Lord Brabazon of Tara: My Lords, the problem that we face is that there are a variety of existing statutory requirements for the keeping of records that apply to different utilities. For example, Regulation 36 of the Electricity Supply Regulations 1988 and Sections 165 and 166 of the Water Act are examples; but they are inconsistent, or silent, on matters such as the scaling of maps, the recording of service connections and the making available of records for inspection. Obviously it is important that this should be done on a consistent basis.
In reply to the noble Lord, Lord Tordoff, we shall consult the utilities before modifying any existing requirements. The practical consequences of having two different standards will be fully explored, and I hope that it will not be necessary for the utilities to continue to keep two different standards. I hope that that also answers the point which the noble Lord, Lord Clinton-Davis, raised.

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On Question, amendment agreed to.
Clause 129 [Records of location of apparatus]:
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendment No.128:
Page 73, line 9, at end insert:
("(6) The Secretary of State may by order—

(a) repeal or modify any enactment made or passed before the commencement of this Part which makes provision for the keeping of records of apparatus and appears to him to be superseded by or otherwise inconsistent with the provisions of this section; and

(b) make provision for applying in relation to records compiled under any such enactment the provisions of subsections (2) to (5) above and section 130 below.

An order under this subsection shall be made by statutory instrument which shall be subject to annulment in pursuance of a resolution of either House of Parliament.").
On Question, amendment agreed to.
Clause 76 [Works for road purposes likely to affect apparatus in the street]:
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendment No.129:
Page 42, line 41, leave out from beginning to ("are") and insert:
("( ) This section applies to works for road purposes other than major highway works (as to which see section 77 below).
( ) Where works to which this section applies").
The noble Lord said: My Lords, in moving Amendment No. 129 I shall speak at the same time to Amendment No. 131. These drafting amendments make clear the relationship between the clause on works for roads purposes and the following clause on major highway works. It is provided that where an undertaker's apparatus is affected by major highway works, the provisions of Clause 77 are to be followed. In such cases the requirements contained in Clause 76 could conflict with the provisions. The amendment therefore provides that where works for roads purposes are also major highway works, Clause 76 shall not apply.
Lord Underhill: My Lords, the Minister says that these are drafting amendments. From the information I have, they go beyond mere drafting. The Minister referred to the interaction between Clauses 76 and 77. I shall therefore refer to each of those clauses.
Clause 77 deals with "diversionary works", the circumstances in which utility apparatus has to be moved because of highway authority works, such as the realignment of a junction. The clause provides for cost sharing in such circumstances between the street authority and the undertaker. Clause 76 provides for a utility to instruct the street authority to take steps to protect utility apparatus when undertaking road works which are likely to affect that apparatus.
I understand that concern has been expressed by local highway authorities that, having reached an agreement with the street authority under Clause 77, including arrangements for the protection of utility apparatus while work is being undertaken, a utility could nevertheless issue further additional requirements under the provisions of Clause 76.
As I understand it, the principle behind this government amendment is supported by the local
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authority associations. However, there is one significant difficulty with the approach that has been adopted. The intention seems to be clearly that the utility should not be able to issue requirements under Clause 76 if the works in question have been subject to an agreement under Clause 77. I understand that problems could arise as a result of the use of the phrase "major highway works" both in Clause 77 and now in the new subsection (1) of Clause 76.
I understand that the whole question of diversionary works is subject to detailed negotiation between the highway authorities and the utilities through the Highway Authorities and Utilities Committee to which we have referred on previous occasions. The conclusion of satisfactory negotiations on this very controversial issue represents one of HAUC's major achievements. The HAUC diversionary works code of practice refers to "highway works" rather than "major highway works". The code of practice defines "highway works" as,
"involving any of the following or a combination thereof—widening, realignment and construction, alterations to carriageway width and the position of kerb lines".
I would appreciate the Minister's confirmation that the term "major highway works" in both Clauses 76 and 77 is intended to encompass all works which the diversionary works code of practice defined as constituting "highway works". In the amendment the words "major highway works" appear: the code of practice drawn up by the joint committee makes it absolutely clear that it refers to highway works. I should like clarification from the Minister on that important point.
Lord Brabazon of Tara: My Lords, I shall study in detail what the noble Lord has said. The code of practice will reflect the wording of the Bill on "major highway works", but obviously I wish to see whether I can add anything and perhaps write to the noble Lord.
On Question, amendment agreed to.
4.15 p.m.
Lord Lucas of Chilworth Lord Lucas of Chilworth moved Amendment No. 130:
Page 42, line 42, at end insert:

("(a) give the person to whom the apparatus belongs not less than 7 working days notice of its intention to commence such works, giving all relevant particulars of the works, and

(aa) give such person reasonable facilities for monitoring the execution of the works, and").

The noble Lord said: My Lords, Clause 76 was introduced by the Government in Committee. It resulted from genuine concern among the utilities about the protection of their effects in the streets. There remains outstanding a matter of practical importance under the clause as amended.
It is reasonable, as the Bill requires, that undertakers should give notification to highway authorities if they are to undertake certain works involving the highway. It seems equally fair therefore that in order to protect their equipment and their installations, the utilities should have advance

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warning of the highway authority's intentions to carry out works which may affect or upset the equipment of the utilities.
All that the amendment does is to provide for a reciprocal arrangement. It is necessary, on a practical basis, for utilities and undertakings to formulate special requirements that may be necessary under the clause, not only to protect their apparatus but also to secure access to it if there were an emergency and for them to monitor the work being undertaken by the highway authority which may affect such apparatus.
The amendment causes no dilution of the effect of the clause which is generally welcome. It provides a reciprocal arrangement that is necessary as a matter of practicability. I know that the Minister and his officials have received notice of the utilities' concern in this area. Discussions have taken place and it would not be improper for me again to reiterate my thanks to officials for the amount of work that has been done to meet the utilities, not only on this subject but on other parts of the Bill. I beg to move.
Lord Clinton-Davis: My Lords, I have no quarrel with the spirit of what the noble Lord, Lord Lucas, seeks to achieve. However, as drafted the amendment gives rise to a number of problems which I shall try to illustrate. First, when the Minister introduced the new clause in Committee he sought to emphasise that he intended to reproduce in the Bill, as concerns works for road purposes, the duties that were prescribed in Clause 62 on street works. However, that clause does not set out any statutory notice period. Therefore the amendment would go beyond what the Minister had indicated he intended to do. I wanted to make that point, although the noble Lord, Lord Lucas, is perfectly entitled to say that the situation as it obtains at the moment is unsatisfactory.
The second point I would make is that, as far as notice periods for streetworks are concerned, Clause 49 makes the provision that the normal notice period of not fewer than seven working days should obtain, but it permits different periods of notice to be prescribed for different descriptions of work, and the cases to be prescribed in which no notice at all is required. If notice periods were to be set out in relation to Clause 76, similar provisions to those contained in Clause 49 would be necessary.
Many works for road purposes likely to affect apparatus are the equivalent of the type of utility works which it has been accepted should be subject to three rather than seven days' notice. Moreover, there is a substantial volume of extremely minor highway authority works which the local authority associations would submit should not be subject to a statutory notice requirement.
The whole question of what categories of highway authority works should be subject to formal notice and what notice periods should apply to them is being examined presently by the HAUC notice periods working party.
It follows from that that we should allow this matter to be governed by the code of practice to be determined by the working party. If the Government
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deem it appropriate that formal notice periods should be set out in the Bill, a much more sophisticated set of provisions would be needed than those which are set out in these amendments. For those reasons, I would urge caution about them.
Lord Tordoff: My Lords, in response to the noble Lord, Lord Clinton-Davis, I would merely say that the noble Lord, Lord Lucas, and I are very unsophisticated chaps and if the Government, with their great sophistication, can come up with a better amendment, we should be only too pleased to support it.
Lord Brabazon of Tara: My Lords, I cannot promise to come up with an amendment on this particular issue.
Clause 76 requires a street authority carrying out works for road purposes to give any person with apparatus likely to be affected the opportunity to monitor the works. The street authority must also comply with the undertakers' requirements for the protection of the apparatus that are reasonably practicable having regard to the time when they are made. No time limit for consulting affected undertakers is given. This amendment would require an authority executing such works to give seven working days' notice to an undertaker whose apparatus the works were likely to affect.
However, it is intended that regulations made under Clause 47 will require works for road purposes to be entered on the street works register, thereby giving undertakers adequate advance warning of works which could affect them. It is therefore unnecessary to introduce a notice requirement into Clause 76.
I am grateful to my noble friend Lord Lucas and to the noble Lord, Lord Clinton-Davis, for pointing out that consultations are continuing in the Highway Authorities and Utilities Committee. I agree with the noble Lord, Lord Clinton-Davis, that that is in fact the best way forward in this matter.
Lord Lucas of Chilworth: My Lords, I am most grateful to my noble friend the Minister. I intend to let the matter rest there as the noble Lord, Lord Tordoff, has almost said it all.
I accept what the noble Lord, Lord Clinton-Davis, said. I have no wish to go beyond what the Government intended and am quite happy, as the noble Lord, Lord Clinton-Davis, suggested, to leave the matter to the working party on codes of practice to see what they come up with.
This has been an interesting debate which I think has probably secured the interest of everybody involved. I beg leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Clause 133 [Works for road purposes likely to affect apparatus in the road]:
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendment No. 131
Page 75, line 4, leave out from beginning to ("are") and insert:
("( ) This section applies to works for road purposes other than major works for road purposes (as to which see section 134 below).

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( ) Where works to which this section applies").
The noble Lord said: I have already spoken to this amendment with Amendment No. 129. I beg to move.
On Question, amendment agreed to.
Clause 78 [Sharing of cost of necessary measures]:
Lord Brougham and Vaux Lord Brougham and Vaux moved Amendment No. 132:
Page 44, line 2, after third ("works") insert ("82 per cent. of")
The noble Lord said: My Lords, in moving Amendment No. 132 standing in my name, I should also like to speak to Amendment No. 133. These are probing amendments.
I understand that the utilities and the highway authorities have together agreed the proportion of allowable costs which each will bear. These are enshrined in the draft code of practice prepared by HAUC. The purpose of the amendment is to show the agreed proportions on the face of the Bill. I beg to move.
Lord Clinton-Davis: My Lords, while it is true that this is a matter which has been discussed and on which agreement has been reached as far as the diversionary works code of practice is concerned, it is appropriate that the matter should be written on the face of the Bill, which is what the noble Lord is contending. I do not oppose it because I want to undo the working party's recommendations, but surely this is a matter where the percentage figures reached at the present time are likely to be varied at a future date. That would mean that we should have to have primary legislation to do that. With respect to the noble Lord, I feel that that is unnecessary. Consequently, I should have thought the best way of proceeding with this would be by way of regulations, which I suspect the Minister has in mind.
I should like the Minister to give the House an assurance that the regulations which would be issued under Clause 78 will implement the agreement reached in the working party. I am almost convinced that the answer must be in the affirmative.
Lord Brabazon of Tara: My Lords, as my noble friend said when moving the amendment, this would include on the face of the Bill the agreed proportions in which the costs of diversionary works associated with major highway works are to be borne by the authorities and the undertakers. Following a suggestion in the Government's response to the Horne Report, lengthy negotiations took place between the parties concerned. It was eventually agreed that 82 per cent. of the costs of diversionary works should be borne by the authority promoting the works and 18 per cent. by the undertaker affected by them. The Government have made clear that the proportions of 82 per cent. and 18 per cent. will be prescribed in the first regulations to be made under this clause. I can give that assurance to my noble friend and to the noble Lord, Lord Clinton-Davis.
However—and here I agree with the noble Lord, Lord Clinton-Davis—by including this provision on the face of the Bill, the amendment would have the unwelcome effect of making it very difficult to alter
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these proportions if it proved necessary or desirable to do so at a future date. The ability to prescribe these in regulations would retain a degree of flexibility which has been repeated elsewhere in the Bill.
With that assurance I hope that my noble friend will agree to withdraw his amendments.
Lord Tordoff: My Lords, before the noble Lord sits down, I take it that any subsequent variation would be anticipated to be by agreement between the parties; but if there were no agreement, would the arbitration provisions apply? I wonder whether the Minister could answer that.
Lord Brabazon of Tara: My Lords, I cannot give a categorical answer to that now. I would rather reflect on it. My impression is that they would. I hope that any change in the proportions would be made by agreement between the parties. I understand the negotiations were long and in no way easy, as may have been the impression given this afternoon. But I should prefer to check on the point made by the noble Lord.
Lord Brougham and Vaux: My Lords, I should like to thank the noble Lord, Lord Clinton-Davis, for his initial support for my amendment. I quite understand the problem that if something goes wrong we should need more legislation. That is the last thing we want, with the burden we have had in the past few years.
I thank my noble friend for his assurances. I am sure that everybody would be satisfied with the assurances that have been given. This has been a useful debate, and I beg leave to withdraw the amendment.
Amendment, by leave, withdrawn.
[Amendment No. 133 not moved.]
4.30 p.m.
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendment No. 134:
Page 44, line 20, leave out subsection (4).
The noble Lord said: My Lords, I spoke to Amendments Nos. 134 and 135 with Amendment No. 50. I beg to move.
On Question, amendment agreed to.
Clause 135 [Sharing of cost of necessary measures]:
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendment No. 135:
Page 76, line 28, leave out subsection (4).
On Question, amendment agreed to.
Clause 79 [Highway authorities, highways and related matters]:
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendments Nos. 136 to 139:
Page 44, line 31, leave out from ("highway") to end of line 32.
Page 44, line 40, at end insert:
("or works of any corresponding description executed in relation to a street which is not a highway.").
Page 44, line 42, leave out ("for road purposes").
Page 44, line 43, at end insert ("in relation to a highway which consists of or includes a carriageway").
The noble Lord said: My Lords, with the leave of the House I should like to move Amendments Nos. 136 to 139 en bloc and at the same time speak to Amendments Nos. 140 and 141. The amendments are necessary in order to correct an anomaly under Clause 79. They extend the meaning of "works for road purposes" to include maintenance and improvement works on all streets. Under Clause 79 as presently written works of that nature in highways which are not streets or which do not include a carriageway would be excluded from the controls under the Bill. That would have resulted in utilities being denied the protection afforded to them under Clause 76 where such works are carried out, for example, in private access roads or pedestrian zones. I beg to move.
On Question, amendments agreed to.
Clause 136 [Roads authorities, roads and related matters]
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendment Nos. 140 and 141:
Page 77, line 5, leave out ("for road purposes").
Page 77, line 6, at end insert ("in relation to a road which consists of or includes a carriageway").
On Question, amendments agreed to.
Clause 86 [Works affecting level crossings or tramways]
Lord Underhill Lord Underhill moved Amendment No. 142:
Page 48, line 20, at end insert ("or guided busway").
The noble Lord said: My Lords, in moving Amendment No. 142 I should like to speak to Amendment No. 143, also in the names of my noble friend Lord Clinton-Davis and the noble Lord, Lord Tordoff, and to government Amendments Nos. 172 to 175.
The purpose of the amendments is to ensure that the provisions of Clause 86 apply in relation to guided busways as well as to tramways. Noble Lords will recall that at Committee stage when the Government moved an amendment replacing the phrase "tramline" with "tramway" a query was raised as to whether the clause would cover guided busways as well as tramways. The amendments that I have put forward endeavour to resolve the problem by referring specifically to guided busways in Clause 86. The government amendments deal with the problem by including a definition of tramway in Clause 97, which is the definitions clause, and in the equivalent Scottish clause. That is helpful but there is one problem which is raised by the Government's definition and on which I should appreciate the views of the Minister.
The problem arises from a fundamental difference between tramways and guided busways. Both tramways and guided busways can be located along a conventional road, for example, along a central reservation. In many locations, when a tram is not using the tramlines the tramway can be occupied by any other road vehicle. That is not generally the case with a guided busway where the nature of the construction prevents it. Presumably, in deciding to incorporate guided busways within the definition of tramways the Government and their lawyers have
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considered that difference, but confirmation from the Government on that point would be extremely helpful.
I understand that the National Joint Utilities Group also feels that without a definition of a guided busway it is difficult to decide whether to support the amendment. The government amendments, with their definition, are extremely helpful but I should appreciate the Government's views on the problem that I have raised. I beg to move.
Lord Tordoff: My Lords, although I have added my name to the amendment I feel that the Government's amendments are more all-embracing. Subject to the reservations raised by the noble Lord, Lord Underhill, I believe that they are to be preferred to our amendments.
I was interested to hear the noble Lord, Lord Underhill, say that on many occasions when a tram is not using the tramlines the tramway can be occupied by another road vehicle. I hope that the converse is also true. It would be unwise for a vehicle to occupy a tramway when a tram is using it.
The utilities are right to say that there is a weakness in our amendment in that we do not spell out what a guided busway is. Because the Government's amendments are more all-embracing noble Lords would be wise to support them.
Lord Brabazon of Tara: My Lords, naturally I feel that the definition contained in the Government's amendments is better than that proposed by the noble Lord. Our definition of tramway is considered wide enough to embrace trams, trolley vehicles and street-running light railway systems as well as guided busways.
I can confirm to the noble Lord, Lord Underhill, that the definition of tramway in the government amendments meets his concerns. I hope that when we come to the government amendments they will be accepted.
Lord Underhill: My Lords, with that helpful explanation I beg leave to withdraw the amendment. I echo the views of the noble Lord, Lord Tordoff, and when we come to the government amendments we shall support them.
Amendment, by leave, withdrawn.
[Amendment No. 143 not moved.]
Clause 87 [Power of street authority to undertake street works]:
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendments Nos. 144 to 146:
Page 49, line 11, after ("authority") insert ("or district council").
Page 49, line 12, after ("authority") insert ("or council").
Page 49, line 17, leave out ("street authority") and insert ("authority or council").
The noble Lord said: My Lords, with the leave of the House I should like to move Amendments Nos. 144 to 146 and also speak to Amendments Nos. 147 to 149. The amendments build on an amendment that I moved at Committee stage in response to a point raised by the noble Lord, Lord Underhill, at Second

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Reading. They extend to non-metropolitan district councils the right to carry out street works on behalf of an undertaker. That will allow the direct services organisations of all district councils to tender for work if invited to do so by undertakers. In many cases non-metropolitan district councils which are not themselves street authorities act as agents for local highway authorities for the maintenance of roads. Where such councils have expertise in excavation and reinstatement work it is only right that they should be allowed to make it available to utilities on a commercial basis. I beg to move.
Lord Clinton-Davis: My Lords, I should like to place on record my appreciation of the way in which the Minister has responded to the representations which have been made to him, particularly by the Association of District Councils. His response in putting down the amendments is eloquent testimony to that.
On Question, amendments agreed to.
Clause 144 [Power of road works authority to undertake road works]:
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendments Nos. 147 to 149:
Page 81, line 11, after ("authority") insert ("or district council").
Page 81, line 12, after ("authority") insert ("or council").
Page 81, line 17, leave out ("road works authority") and insert ("authority or council").
On Question, amendments agreed to.
Clause 89 [Recovery of costs or expenses]:
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendment No.150:
Page 49, line 39, at end insert:
("( ) Where under any provision of this Part a person is entitled in certain circumstances to recover costs or expenses incurred by him in executing works or taking other steps, any dispute as to the existence of those circumstances or as to the amount recoverable shall be determined by arbitration.
This applies whether the provision is expressed as conferring a right to recover, or as imposing a liability to reimburse or indemnify or to bear the cost, but does not apply in relation to a provision expressed as providing for the charging of a fee or conferring a right to compensation or in relation to section 71 (contributions to cost of making good long-term damage to the street).").
The noble Lord said: My Lords, I spoke to Amendment No. 150 with Amendment No. 50. I beg to move.
On Question, amendment agreed to.
Clause 146 [Recovery of costs or expenses]:
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendment No.151:
Page 81, line 39, at end insert:
("( ) Where under any provision of this Part a person is entitled in certain circumstances to recover costs or expenses incurred by him in executing works or taking other steps, any dispute as to the existence of those circumstances or as to the amount recoverable shall be determined by arbitration.
This applies whether the provision is expressed as conferring a right to recover, or as imposing a liability to reimburse or indemnify or to bear the cost, but does not apply in relation to a provision expressed as providing for the
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charging of a fee or conferring a right to compensation or in relation to section 128 (contribution to the cost of making good long-term damage to the road).").
The noble Lord said: My Lords, I spoke to the amendment with Amendment No. 50. I beg to move.
On Question, amendment agreed to.
Clause 90 [Service of notices and other documents]:
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendment No.152:
Page 49, line 41, leave out from ("form") to end of line 35 on page 50 and insert:
("( ) The Secretary of State may make provision by regulations as to the manner of service of notices and other documents required or authorised to he served for the purposes of this Part.").
The noble Lord said: In moving Amendment No. 152 I should also like to speak to Amendment No. 153. The amendments replace the detailed provisions in subsections (2) to (6) of Clause 90 which lay down requirements concerning the service of notices and other documents under this part of the Bill. The requirements are similar to those contained in the 1950 Act and are mainly concerned with the detail of how written documents are to be served. Since the great majority of transactions will in future be required to be carried out electronically by means of the computerised street works register a substantial provision of this kind is not strictly necessary. In its place there will be a simple and flexible regulation-making power. That will allow requirements better to reflect technological developments and practice now and in the future as well as simplifying the statute. I beg to move.
On Question, amendment agreed to.
Clause 147 [Service of notices and other documents]:
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendment No.153:
Page 81, line 41, leave out from ("form") to end of line 36 on page 82 and insert:
("( ) The Secretary of State may make provision by regulations as to the manner of service of notices and other documents required or authorised to he served for the purposes of this Part.").
On Question, amendment agreed to.
Clause 94 [Exclusion of inconsistent special enactments, &c]:
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendments Nos. 154 to 156:
Page 52, line 6, at end insert:
(4A) The Secretary of State may by order amend or repeal, or make such provision as he thinks fit for preserving the effect of, any special enactment passed or made before the commencement of this Part (not being an enactment to which subsection (1), (2) or (3) applies) which proceeds by reference to any provision of the Public Utilities Street Works Act 1950 or any other enactment repealed by this Act.
Subject to any order under this subsection, any such enactment shall continue to have effect as if the provision referred to had not been repealed.").
Page 52, line 7, leave out subsection (5) and insert:
("(5) In this section "special enactment" includes a public general enactment—

(a) in relation to the passing of which any of the Standing Orders of the House of Lords or the House of Commons relating to Private Business applied, or

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(b) to the extent that it is incorporated or applied for the purposes of a special enactment.").

Page 52, line 11, leave out ("subsection (4)") and insert ("this section").
The noble Lord said: My Lords, with the leave of the House I shall move Amendments Nos. 154 to 156 inclusive and speak to Amendments Nos. 157 to 171. This group of amendments extends the provision relating to exclusion of inconsistent enactments to cover references to the 1950 Act which contain a wide variety of certain hybrid public general Acts. The revised Clause 94 would empower the Secretary of State to make orders amending, repealing or preserving the effect of any special enactment in which such reference is made. This would enable references to the 1950 Act to be dealt with as appropriate to preserve their effect after the Bill has become law.
Amendments Nos. 154 to 163 contain the order-making power, and Amendments Nos. 155 to 164 will allow private provisions of hybrid Acts to be treated as special enactments for the purpose of this clause. Amendments Nos. 156 and 165 will apply the negative resolution procedure and the provision of Schedule 5 to orders made under this power. There are six minor consequential amendments to Schedule 5 and the Scottish equivalent, Schedule 7. These are drafting amendments which correct or insert appropriate references to the main clause. I beg to move.
On Question, amendments agreed to.
Schedule 5 [Procedure for making orders under s.94]:
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendments Nos. 157 to 162:
Page 99, line 28, leave out ("(exclusion of inconsistent enactments, &c.)") and insert ("(effect of Part III on existing special enactments)").
Page 100, line 2, column 1, after ("Order") insert ("under section 94(4) (a)").
Page 100, line 6, column 1, after ("Order") insert ("under section 94(4) (b)").
Page 100, line 9, column 1, after ("Order") insert ("under section 94(4) (c)").
Page 100, line 12, column 1, after ("Order") insert ("under section 94(4) (d)").
Page 100, line 16, at end insert:
("Order under section 94(4A) amending or repealing or preserving effect of enactment referring to repealed enactment
Any person whose interests are affected by the proposed provision.")
On Question, amendments agreed to.
Clause 151 [Exclusion of inconsistent special enactments, &c.]:
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendments Nos. 163 to 165:
Page 84, line 12, at end insert:
("(4A) The Secretary of State may by order amend or repeal, or make such provision as he thinks fit for preserving the effect of, any special enactment passed or made before the commencement of this Part (not being an enactment to which subsection (1), (2) or (3) above applies) which proceeds by reference to any provision of the Public Utilities Street Works Act 1950 or any other enactment repealed by this Act.
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Subject to any order under this subsection, any such enactment shall continue to have effect as if the provision referred to had not been repealed.").
Page 84, line 13, leave out subsection (5) and insert:
("(5) In this section "special enactment" includes a public general enactment—

(a) in relation to the passing of which any of the Standing Orders of the House of Lords or the House of Commons relating to Private Business applied, or

(b) to the extent that it is incorporated or applied for the purposes of a special enactment.").

Page 84, line 17, leave out ("subsection (4)") and insert ("this section").
On Question, amendments agreed to.
Schedule 7 [Procedure for making orders under s.151]:
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendments Nos. 166 to 171:
Page 104, line 20, leave out ("(exclusion of existing enactments, &c.)") and insert ("(effect of Part IV on existing special enactments)").
Page 104, line 36, column 1, after ("Order") insert ("under section 151(4) (a)").
Page 104, line 40, column 1, after ("Order") insert ("under section 151(4) (b)").
Page 104, line 43, column 1, after ("Order") insert ("under section 151(4) (c)").
Page 104, line 46, column 1, after ("Order") insert ("under section 151(4) (d)").
Page 104, line 50, at end insert:
("Order under section 151(4A) amending or repealing or preserving effect of enactment referring to repealed enactment
Any person whose interests are affected by the proposed provision.")
On Question, amendments agreed to.
Clause 97 [Minor definitions]:
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendment Nos. 172 and 173:
Page 53, line 20, leave out ("paragraph (a) of").
Page 53, leave out lines 32 to 36 and insert:
(""tramway" means a system, mainly or exclusively for the carriage of passengers, using vehicles guided, or powered by energy transmitted, by rails or other fixed apparatus installed exclusively or mainly in a highway;").
The noble Lord said: My Lords, I beg to move Amendments Nos. 172 and 173. I spoke to these amendments with Amendment No. 142.
On Question, amendments agreed to.
Clause 154 [Minor definitions]:
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendments Nos. 174 and 175:
Page 85, line 27, leave out ("paragraph (a) of").
Page 85, leave out lines 38 to 42 and insert:
(""tramway" means a system, mainly or exclusively for the carriage of passengers, using vehicles guided, or powered by energy transmitted, by rails or other fixed apparatus installed exclusively or mainly in a road;").
On Question, amendments agreed to.
Clause 155 [Index of defined expressions]:
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendment No. 176:

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Page 86, line 40, leave out ("100(2)") and insert ("100(4)").
The noble Lord said: My Lords, this minor amendment is to correct the erroneous reference to the definition of road managers given in subsection (4), not subsection (2), of Clause 100. I beg to move this drafting amendment.
On Question, amendment agreed to.
Clause 156 [Offences by bodies corporate or Scottish partnerships]:
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendment No. 177:
Page 87, line 14, after ("of") insert (", or to be attributable to any neglect on the part of,").
The noble Lord said: My Lords, Amendment No. 177 is also a minor technical amendment which brings subsection (2) into line with subsection (1). I beg to move.
On Question, amendment agreed to.
4.45 p.m.
Lord Clinton-Davis Lord Clinton-Davis moved Amendment No. 178:
Page 87, line 16, at end insert:
("(2A) For the purposes of this section it shall be the duty of all undertakers to include in their annual Directors Report a list of all persons mentioned in subsection (1) above and their duties and responsibilities in relation to the management and control of the undertaking and in relation to any street works.
(2B) Failure to comply with the requirements of subsection (1) shall render the undertaker concerned liable to a fine not exceeding level 3 on the standard scale and to the forfeiture of any street works licence or licences held by them.
(2C) Section 43 of the Powers of Criminal Courts Act 1973 shall apply to subsection (2B) above.").
The noble Lord said: My Lords, we debated a similar issue to Amendment No. 178 on 6th December when I moved Amendment No. 193. The clause itself introduces legal liability for offences which may be committed by bodies corporate or Scottish partnerships. To include that provision as far as corporate bodies are concerned is to be welcomed, and it should have the effect of concentrating minds on questions of safety, efficiency and the quality of operations carried out in relation to roadworks.
There can be no doubt that the reason we have placed a great deal of emphasis in this Bill on these provisions is that we recognise the potential for danger to road users and road workers. What has happened is that similar accountability for the safety of workers is introduced by the Health and Safety at Work Act. Therefore, a parallel accountability to cover the safety of road users is very timely.
But there is a distinction to be drawn between corporate accountability and good practice emerging out of individual accountability. I am advised that an example of this is contained in a report of the county surveyor of Lancashire. He reported to his committee that a survey by his inspectors showed that only 32 per cent. of temporary traffic signals at roadworks were operating lawfully. Even worse, only one in 14 sets of traffic lights operated by public utilities were operating lawfully. The report said that this confirmed
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reservations which had been expressed about their operation in the past. If I may say so, it did so very vividly indeed.
In this amendment we seek to identify the officers who may be responsible within an organisation, to define their direct responsibilities concerning the safety and efficiency of street works carried out by the utility, and to publish them in the directors' annual report and accounts. The fact that a statement will be publicly available defining an individual's responsibilities would, in my view, go a very long way towards ensuring that safety and efficiency standards are upheld. I think the illustration I have given adds emphasis to the request we are making as far as the Government are concerned. I hope that the Minister will reply positively to what I have just said. I beg to move.
Lord Brabazon of Tara: My Lords, although the first part of this amendment is different in form from that moved by the noble Lord, Lord Clinton-Davis, in Committee, our objections to it remain much the same. In our view, it would not increase the accountability of large utility companies in any material way to impose a new requirement to include in undertakers' annual reports detailed information about the responsibilities of individual officers and employees. There is a whole series of criminal sanctions against an undertaker who fails to comply with his duties under the Bill. I dare say that most of those would cover the points which the noble Lord, Lord Clinton-Davis, gave in his example.
Clause 156 makes clear that where an offence by a body corporate is proved to have been committed with the consent, connivance, or through the neglect of, a certain individual, the individual and the body corporate are guilty of the offence and may be proceeded against. As regards the general public, the requirement under Clause 58 of the Bill to provide signs at the site of all roadworks stating who is responsible for the works and giving a 24-hour telephone contact number will do a great deal to improve accountability.
I hope that the utilities will also consider ways of making better known individual management responsibility for the execution of street works. I am afraid that the noble Lord's amendment would not achieve that or allow offences committed under the Bill to be attributed to particular individuals in practice. However, it would impose an administrative burden with little practical effect. Therefore, I hope that the noble Lord will understand our arguments and feel able to withdraw this amendment.
Lord Clinton-Davis: My Lords, it is a question of judgment: the Minister takes one view and I take another. I think it would redound to good practice within a corporate entity if these records were kept. What is more, I think it would redound to the advantage of the corporate entity in its public relations if that were done. I am sorry that the Minister takes a different view, but I do not intend to press the matter at this stage and therefore beg leave to withdraw the amendment.

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Amendment, by leave, withdrawn.
Schedule 8 [Minor and consequential amendments]:
[Amendment No. 179 not moved.]
Lord Clinton-Davis Lord Clinton-Davis moved Amendment No. 180:
Page 106, line 21, at end insert:
("(c) for payment of an additional fee in cases where permission is not sought in advance or the terms of the conditions have not been fully complied with.").
The noble Lord said: My Lords, in this amendment we are seeking to permit the Minister to make provision by regulations for the payment of a fee over and above that charged for occupation of the highway by the owner of a skip, scaffolding or builders' materials in cases where previous permission is not sought from the local authority, or where the terms of the permission have simply not been complied with.
This amendment would give highway authorities the power to levy a penalty charge for positioning objects on the highway in situations which are dangerous. I believe that the threat of a charge of this character would provide an incentive to those who wish to place objects on the road to apply for a licence from the highway authority and, once having obtained that licence, to abide strictly by the conditions of the licence. The ability to levy a penalty charge would allow the authority to recover its costs in cases where it has to remove objects from the highway on grounds of road safety.
Under the law as it stands at the present, highway authorities have power to permit the deposit of items on the highway in a reasonable and safe fashion. They can also remove objects which are deposited in a way that is likely to be hazardous. However, if an authority removes items because it deems it appropriate to do so in the interests of road safety, the only way in which it can recover its costs is by litigation in the civil courts. That is costly, difficult and time-consuming. I believe that something ought to be done about that situation.
The amendment would permit highway authorities in effect to issue fixed penalty notices for failure to apply for prior permission or failure to comply with the conditions of a licence that has been granted. I believe that a penalty charge will provide some disincentive to aberrant activity of the kind that I have mentioned. If an object has to be removed from the highway and a charge by way of penalty imposed, the level of the charge can be fixed to ensure that the highway authority is able to cover the costs of enforcement. I believe that that is perfectly reasonable.
When the government amendment was debated at Committee stage the Minister was pressed to give an undertaking that any revenue generated by the fee for the occupation of the highway should be made available for additional transport investment and to cover the highway authority costs of administering the scheme Clearly, if there is a fixed penalty scheme the advantages would disappear unless local authorities were enabled to keep the fees. Therefore, I hope that the Minister will be in a position today to confirm that
1102
local authorities will be, at the very least, permitted to keep sufficient revenue to cover their administrative and enforcement costs. I beg to move.
Lord Brabazon of Tara: My Lords, these amendments seek to change the basis of the new provisions to be inserted in the Highways Act 1980 to charge builders and developers for their occupation of road space. They would allow the scheme for charging set out in regulations to include provision for the payment of additional fees where the occupation of the highway proceeded without permission or in contravention of the terms and conditions of a permission.
I have some sympathy with the thinking behind this amendment. It is clearly important that people placing skips, scaffolding or builders' materials in the road should not be allowed to escape paying any charges due. However, Sections 139, 160 and 171 of the Highways Act 1980 already make it an offence to place those things in a highway without the consent of the highway authority or without complying with certain conditions. In each case, appropriate penalties are provided for those guilty of an offence. For example, a person who erects scaffolding without authority which obstructs the highway is liable to a fine of up to £2,000. Therefore, it would not be appropriate to introduce a separate system of penalty fees under the charging scheme in those circumstances. I believe that there is already sufficient disincentive to misbehave on those concerned. I can confirm that local authorities will be allowed at least to cover their reasonable costs in administering any charging scheme. I hope that that is of some reassurance to the local authorities. With that explanation, I hope that the noble Lord will feel able to withdraw his amendment.
Lord Clinton-Davis: My Lords, I thank the Minister for that reply and most particularly for his concluding remarks which I think the authorities will find a very positive response. The question of appropriate penalties misses the point which I made earlier about the difficulties that can sometimes arise in practice not only of causing those penalties to take effect but also, I suspect, finding the people who are responsible and bringing them to court. Therefore, the whole process is long drawn out and costly. Indeed, it may be nugatory except for the removal of the offending item.
There may have been some value in being able to take immediate action. I do not say that all the difficulties will have disappeared by reason of that. Some of them will continue. Nevertheless, the immediacy of being able to do something would have been a more appropriate remedy in certain cases.
I have no doubt that this is an issue to which another place will return in due course. For the moment, I thank the Minister for the concluding part of his remarks and beg leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Lord Underhill Lord Underhill moved Amendment No. 181:
Page 106, line 45, leave out ("or").
The noble Lord said: My Lords, in moving this amendment, which is tabled in the names of my noble friend Lord Clinton-Davis and the noble Lord, Lord Tordoff, I shall, with the leave of the House, speak also to Amendment No. 182.
In the earlier debate reference was made to provision for highway authorities to be permitted to charge builders for the occupation of road space by skips, scaffolding and building materials. This amendment continues that discussion. The local authority associations consider that they should also be free to charge for the occupation of road space as a result of the erection of hoardings round a building site. These amendments are therefore very much of a probing category, because it is unclear whether Section 6 of Schedule 8 makes such a provision. It would be of assistance if the Minister could indicate whether charging for the occupation of road space as a result of the erection of hoardings is acceptable; whether it is currently provided for in Section 6 of Schedule 8 and, if not, whether he would be prepared to accept an amendment to clarify the position.
This is a small matter but one that the local authority associations consider to be rather important. It is again a matter of charging and whether Schedule 8 provides for it. If not, we ask whether the Minister will make provision for such an amendment. I beg to move.
Lord Brabazon of Tara: My Lords, I can satisfy the noble Lord very briefly on this matter. A hoarding that encroaches on the highway would fall within the definition of a relevant structure under Section 169 of the Highways Act and so would already be within the scope of the new Section 171A as drafted. Therefore the amendment is not necessary.
Lord Underhill: My Lords, I am grateful to the Minister for that assurance. Naturally I shall read carefully what he said. I beg leave to withdraw the amendment.
Amendment, by leave, withdrawn.
[Amendments Nos. 182 and 183 not moved.]
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendments Nos. 184 and 185:
Page 110, line 33, after ("section") insert ("4(1) or").
Page 111, line 30, after ("prohibit") insert ("temporarily").
The noble Lord said: My Lords, in moving these amendments I shall speak also to Amendments Nos. 190 to 196, 198, 199, 201 to 206 and 208. They are all minor technical amendments to improve the drafting of this rather complicated schedule. Some of them remove superfluous passages from the present version. Others are minor corrections of detail. I beg to move.
On Question, amendments agreed to.
5 p.m.
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendments Nos. 186 and 187:
Page 113, line 3, leave out from first ("Act") to end of line.
Page 113, line 5, leave out ("or directions").
The noble Lord said: My Lords, I shall speak also to Amendments Nos. 197, 200 and 219. These
1104
amendments represent further thoughts about speed limits on special roads. We may want to impose 30 mph limits on certain special roads—for example, tunnels—authorised under Part I of the Bill. However, we have concluded that the right way to do so is not by making them "restricted roads" under Section 81 of the Road Traffic Regulation Act 1984. I beg to move.
On Question, amendments agreed to.
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendments Nos. 188 and 189:
Page 114, line 1, leave out ("or") and insert (", the Countryside Council for Wales and").
Page 114, line 2, after ("may") insert ("each").
The noble Lord said: My Lords, I shall speak also to Amendment No. 221. These amendments bring the schedule into line with the Environmental Protection Act 1990 which, among many other things, established a Countryside Council for Wales and transferred to it powers of the Countryside Commission. I beg to move.
On Question, amendments agreed to.
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendments Nos. 190 to 196:
Page 114, line 28, at end insert ("and for "and to execute" substitute "and execute".").
Page 114, line 47, leave out paragraph 38 and insert:
("38. In section 31 of the Road Traffic Regulation Act 1984 (byelaws with respect to roads used as playgrounds), in subsection (1), for the words from "by a local authority" to "have power to" substitute "under section 29 of this Act, the local traffic authority may".").
Page 115, line 29, leave out ("(2)") and insert ("(3)").
Page 116, line 5, after ("to") insert (""highways" or, in Scotland,").
Page 117, line 19, leave out paragraph 52 and insert:
("52.—(1) Section 69 of the Road Traffic Regulation Act 1984 (placing of traffic signs in connection with exercise of other powers) is amended as follows.
(2) In subsection (1)—

(a) for "highway authority" or, in Scotland, "roads authority" substitute "traffic authority"; and

(b) for "the roads" or, in Scotland, "a road" substitute "the road".

(3) In subsection (2) for "highway authority" or, in Scotland, "roads authority" substitute "traffic authority".
(4) In subsection (3) for "highway authority" or, in Scotland, "local roads authority" substitute "local traffic authority".").
Page 117, leave out line 27 and insert (""local roads authority" substitute "local traffic authority".").
Page 117, line 30, leave out from ("Scotland,") to end and insert (" "local roads authority" substitute "local traffic authority".").
The noble Lord said: My Lords, I spoke to these amendments when speaking to Amendment No. 184. I beg to move.
On Question, amendments agreed to.
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendment No. 197:
Page 118, line 16, leave out sub-paragraph (4) and insert:
("(4) For subsection (3) substitute—
"(3) A special road is not a restricted road for the purposes of section 81 on or after the date declared by the traffic authority, by notice published in the

1105
prescribed manner, to be the date on which the special road, or the relevant part of the special road, is open for use as a special road.".").
The noble Lord said: My Lords, I spoke to this amendment with Amendment No. 186. I beg to move.
On Question, amendment agreed to.
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendments Nos. 198 to 206:
Page 118, leave out lines 26 to 28.
Page 118, leave out lines 37 to 39.
Page 119, line 6, at end insert:
("62A. In section 86 of the Road Traffic Regulation Act 1984 (speed limits for particular classes of vehicles), omit subsection (4) (which relates to special roads).").
Page 119 line 23, after ("any") insert ("other").
Page 119, line 24, after ("road") insert ("at that point").
Page 119, line 24, at end insert ("other").
Page 119, line 26, leave out ("local").
Page 119, line 26, leave out ("a local") and insert ("an").
Page 119, line 45, after ("Scotland") insert ("means").
The noble Lord said: My Lords, I spoke to these amendments when speaking to Amendment No. 184. I beg to move.
On Question, amendments agreed to.
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendment No. 207:
Page 120, leave out lines 9 to 23 and insert:
(""Traffic authorities.
121A .—(1) The Secretary of State is the traffic authorityߞ

(a) for every highway in England and Wales for which he is the highway authority within the meaning of the Highways Act 1980, and

(b) for every road in Scotland for which he is the roads authority within the meaning of the Roads (Scotland) Act 1984.

(2) In Greater London, the council of the London borough or the Common Council of the City of London are the traffic authority for all roads in the borough or, as the case may be, in the City for which the Secretary of State is not the traffic authority.
(3) In England and Wales outside Greater London, the, council of the county or metropolitan district are the traffic authority for all roads in the county or, as the case me y be, the district for which the Secretary of State is not the traffic authority.
(4) In Scotland, the regional or islands council are the traffic authority in relation to all roads within their area for which the Secretary of State is not the traffic authority.
5) In this Act "local traffic authority" means a traffic authority other than the Secretary of State.".").
The noble Lord said: My Lords, this amendment provides a better definition of a traffic authority. The significant difference from the provision as drafted is that a local traffic authority is responsible not only for highways but for any road in its area except a road for which the Secretary of State is the highway authority under the Highways Act 1980. Local authorities' current powers under Sections 1, 6 and 9 of the Road Traffic Regulation Act 1984 extend to certain roads which are not highways. The new section 121A places beyond doubt that they still do. In Scotland the effect is the same although the terminology is different.
On Question, amendment agreed to.
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendment No. 208:
Page 121, line 30, after ("(3)") insert (", and in paragraph 3(2),").
The noble Lord said: My Lords, I spoke to this amendment when speaking to Amendment No. 184. I beg to move.
On Question, amendment agreed to.
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendments Nos. 209 to 218:
Page 128, line 24, at end insert:
("( ) In section 23 (power to lay mains), at end insert—
"(4) In the case of works in respect of which notice is required to be given under section 106 of the New Roads and Street Works Act 1991 (notice of starting date of road works), notice duly given to a person in accordance with that section and section 147 of that Act (service of notice) shall be treated as reasonable notice for the purposes of subsection (1) above.".").
Page 128, line 27, at end insert:
("( ) In section 103 (requirement for all notices to be in writing), after "shall" insert ", subject to section 23(4) of and paragraph 4(1) of Schedule 3 to this Act,"").
Page 128, line 28, leave out ("paragraph 2(2) of").
Page 128, line 29, after ("pipes)") insert ("—
(a) in paragraph 2(2)").
Page 128, line 31, at end insert:
("(b) in paragraph 4(1) for the words "not less than 72 hours'" substitute the word "such" and, the end of that sub-paragraph add the words "as would require to be given by an undertaker under section 106 of the New Roads and Street Works Act 1991 (notice of starting date of works) in accordance with that section and with section 147 of that Act (service of notice)".").
Page 129, line 19, leave out from ("In") to ("sub-paragraph") in line 21 and insert ("Schedule 2 to the Telecommunications Act 1984 (the telecommunications code), paragraph 1 (interpretation) is amended as follows.
(2) In").
Page 129, line 39, after ("In") insert ("the same Schedule, in").
Page 130, line 3, leave out ("paragraph 9 (street works), in sub-paragraph (1)") and insert ("the same Schedule, paragraph 9 (street works) is amended as follows.
(2) In sub-paragraph (1), after "over," insert "upon,", and").
Page 130, line 10, at end insert:
(" .—(1) In the same Schedule, paragraph 23 (undertaker's works affecting telecommunication apparatus) is amended as follows.
(2) After sub-paragraph (2) (notice to be given to operator of telecommunication system) insert—
"(2A) In the case of works in respect of which notice is required to be given under section 49 or 106 of the New Roads and Street Works Act 1991 (notice of starting date of street works or, in Scotland, road works), notice duly given to a person under that section shall be treated as a notice duly given to him under sub-paragraph (2) above.".")
(3) At the end of sub-paragraph (4) (counter-notice by operator) insert—
"Where by virtue of sub-paragraph (2A) above notice of less than 10 days is treated as a notice duly given under sub-paragraph (2), a counter-notice may not be given after the works have been substantially begun.".").
Page 132, line 20, at end insert:
(".—(1) In the same Schedule, paragraph 3 (execution of works affecting certain descriptions of apparatus) is amended as follows.
(2) After sub-paragraph (3) (notice to be given to undertaker) insert—
"(3A) In the case of works in respect of which notice is required to be given under section 49 or 106 of the New Roads and Street Works Act 1991 (notice of starting date of street works or, in Scotland, road works), notice duly given to a person under that section shall be treated as a notice duly given to him under sub-paragraph (3) above.".
(3) At the end of sub-paragraph (5) (counter-notice by undertaker) insert—
"Where by virtue of sub-paragraph (3A) above notice of less than seven days is treated as a notice duly given under sub-paragraph (3), a counter-notice may not be given after the works have been substantially begun.".").
The noble Lord said: My Lords, these 10 minor amendments are necessary in order to remove some inconsistencies between the street works provisions of the Bill and the utilities' enabling legislation. The five amendments standing in my name only apply to England, Wales and Scotland. They will allow a notice given under Clause 49 (Clause 106 for Scotland) to be deemed as duly given for the purposes of notice requirements in the relevant telecommunications and electricity legislation. They will also allow telecommunications and electricity undertakers to serve the counter-notices provided for in their enabling legislation within the timescale provided for under the Bill in cases where this is at variance with the individual notice requirements that they contain.
The five amendments standing in the name of my noble friend Lord Strathclyde apply to Scotland only and make similar provision in relation to the Water (Scotland) Act 1980. The amendments to telecommunications legislation will also bring the definition in the telecommunications code of telecommunications apparatus "in" a street in line with the definition of "in" in Clause 97. I beg to move.
On Question, amendments agreed to.
Schedule 9 [Repeals]:
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendment No. 219:
Page 134, line 15, column 3, leave out ("82(3)") and insert ("86(4)").
The noble Lord said: My Lords, I spoke to this amendment when speaking to Amendment No. 186. I beg to move.
On Question, amendment agreed to.
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendment No. 220:
Page 135, line 5, at end insert:
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("1988c. 53.

Road Traffic Offenders Act 1988

In Part I of Schedule 2, the entry relating to section 30(5) of the Road Traffic Regulation Act 1984.

In Schedule 3—

(a) in the entry relating to section 29(3) of the Road Traffic Regulation Act 1984, the words "outside Greater London";

(b) the entry relating to section 30(5) of that Act.").

The noble Lord said: My Lords, this amendment is consequential on the changes to the Road Traffic Regulation Act 1984 under paragraph 37 of Schedule 8. It extends Section 29 to roads in London as well as outside and removes Section 30. I beg to move.
On Question, amendment agreed to.
Lord Brabazon of Tara Lord Brabazon of Tara moved Amendment No. 221:
Page 135, line 24, at end insert:

("1990 c. 43.

Environmental Protection Act 1990.

In Schedule 8, in para—graph 7, the words from "and in subsection (4)" to the end.")

The noble Lord said: My Lords, I spoke to this amendment when speaking to Amendment No. 188. I beg to move.
On Question, amendment agreed to.

The HIV/AIDS Epidemic
5.7 p.m.
Lord Kilmarnock Lord Kilmarnock rose to call attention to the current state of the HIV/AIDS epidemic worldwide and to the measures required to limit its spread in the United Kingdom; and to move for Papers.
The noble Lord said: This is the third debate that I have introduced in your Lordships' House on the subject of HIV and AIDS. The last occasion was 3rd February 1988; therefore, a further review of the subject is appropriate if not overdue. I am grateful to the Chief Whip for making the time available.
I assume that most noble Lords present, and members of the Government in particular, are aware of the global and national picture. I shall keep my statistical remarks short, but I must briefly set the scene. At the end of 1990 the World Health Organisation estimated that about 1 million cases of adult AIDS had occurred worldwide. There were an estimated 8 million to 10 million cases of adult HIV infection across the globe. It is estimated that more than 5 million of those infections have occurred in sub-Saharan Africa where heterosexual transmission is the predominant mode of spread. Globally, heterosexual transmission by vaginal intercourse accounts for the largest number of infections.
The World Health Organisation predicts that by the year 2000 approximately 25 to 35 million people will have been infected with HIV, including 10 million children. On average children born with HIV become sick more rapidly than infected adults so that most of

1109
those 10 million will be dead before the decade is out. Many children born to infected mothers are not themselves infected but face a different problem. They will be orphaned and will require support, care and education. I believe that the right reverend Prelate the Bishop of Southwark will touch on that subject in relation to the horrendous figures in Uganda. I believe the Overseas Development Agency is playing an important role; I shall be grateful if the Minister will tell the House about that. Will she also tell us the level of support provided by the Government to the WHO global programme on AIDS and say whether it will be continued at a comparable level?
Worryingly, HIV is spreading to areas not thought previously to have been much affected; that is, the Middle East and South East Asia, especially Thailand. Thailand saw its first AIDS case only in 1984. Prostitutes and injecting drug users have been the main channels there. India is also becoming seriously affected. More than 100,000 US citizens have died from AIDS since the disease was first recognised in 1981 and approximately 1 million in the United States are currently infected by HIV.
Projections of cumulative AIDS cases within the EC to the end of 1991 lie in the region of 60,000 to 78,000. Comparisons with other European Community countries show that the United Kingdom, with 55 AIDS cases per million of population, comes well behind France, Italy and Spain and well below the EC average of 99 per million. That is a cause for congratulation but not complacency. According to the last set of quarterly figures released for the United Kingdom on 21st January, the cumulative total of AIDS cases reported is 4,098. Of those, 2,256, or 55 per cent. are known to have died. The cumulative total of HIV positive reports for the United Kingdom is 15,166 which is likely to be substantially less than the true number of infected people.
Within those raw figures, there lurk some interesting developments which we must watch carefully. First, the number of new cases of AIDS reported in the fourth quarter of last year—namely, 300—is less than for the previous quarter. At the same time, one should note that the average survival time from the onset of full AIDS has increased from 10 to 20 months. That is probably due to earlier and increasingly sophisticated use of therapeutic drugs, principally AZT. That has important implications for the pattern of treatment and the distribution of funds to which I shall refer shortly.
The next point is that in the UK, Europe and the USA, the proportion of cases acquired through heterosexual intercourse is increasing every year. In the UK alone the most recent CDSC figures indicate that the number of heterosexually acquired AIDS cases rose by 85 per cent. from 145 to 268 and accounted for 9.6 per cent. of newly reported cases in the UK in 1990. During the same period the total of positive HIV tests attributable to heterosexual contact rose by 50 per cent. from 829 to 1,247. It is also significant that over 1,500 women have now been reported HIV positive in the UK. Cases of AIDS in women increased during 1990 by 78 per cent. from 114 to 203.
As your Lordships will be aware, there has been some controversy in the press and the media as regards the heterosexual figures. They have been assailed as insignificant or misleading. I have no intention of being apocalyptic. One has to be clear that they represent a gradually increasing proportion of overall totals which are mercifully less than originally forecast.
There is an argument that the threat to heterosexuals is much increased by the presence of other sexually transmitted diseases—the so-called co-factors—which are prevalent in sub-Saharan Africa and to a lesser extent here. That is true. However, it should not blind us to the fact that transmission can and does take place without such co-factors. The All-Party Parliamentary Group on AIDS produced a pamphlet which gives a dispassionate and objective view. I shall be happy to send a copy to any noble Lord who has not received one. Obviously the conclusion one reaches is an important determinant of the messages sent to young people and the population at large.
Having outlined the general and national picture, I wish to turn to some specific problems. There are a number and I can touch upon them only cursorily. However, I believe that other noble Lords may develop some of them more fully. I shall ask the noble Baroness one or two questions.
First, as regards the strategy and organisation of our AIDS approach, it has always been argued by government that AIDS should be contained within the NHS and that there is no need for a strategic body like the National AIDS Commission in the USA. I remember advancing the contrary view to Tony Newton in a debate back in 1986 at London University, without success. It is true that we are extremely fortunate to have the NHS which enables us to confront this deadly disease. On the other hand, AIDS undoubtedly faces us with issues broader than those contained within our health service. Local authorities and voluntary bodies play an increasing part and there are also problems as regards education, the law, employment and criminal justice which do not fit within the NHS model.
It is true that there are a number of advisory committees, the principal of which are the Expert Advisory Group on AIDS, the Interdepartmental Group on AIDS, Co-ordination of AIDS Public Education and the AIDS Services Working Group. All that is coming perilously near to alphabet soup and none of those bodies has anything like the clout of the now disbanded Cabinet committee of the noble Viscount, Lord Whitelaw. They are merely advisory to the Department of Health.
Without becoming involved in the game of supremos and blueprints, to which we are allergic as a nation, I should like to suggest to the Government that there is at least a case for a national co-ordinating committee drawn from political, academic and community service sources on the lines of the US commission. That may help to avoid some of the shortfall and overlaps which I am sure will emerge in this debate. I do not expect the noble Baroness to hand

1111
me such a body across the Dispatch Box but I want her to say that she and her right honourable and honourable friends will look at the matter.
On funding, the British Government's record has been relatively good. It is difficult to make comparisons because one is often not comparing like with like. However, from what I can ascertain, Britain is well up in the European league table, both absolutely and proportionately, in total government resources earmarked for HIV/AIDS. I know that the figures for funds for 1990–91 will shortly be superseded but I give them by way of illustration. For the NHS —that is, for England and Wales—they amounted to £127.5 million; for local authority social services, £9.8 million; for Scottish health boards, £7.8 million; and for special help for Scotland, £7.1 million. That makes a total so far of £152.2 million. In addition, approximately £20 million goes to the MRC, European Community programmes and the Public Health Laboratory Service; £10 million to the HEA; and £1.8 million to the voluntary sector. I shall only remark in passing—I shall return to it later—that central government support of the voluntary sector seems remarkably low at only about one hundredth of the total of £184 million.
So far so good, or fairly good. However, the noble Baroness will certainly be aware of the criticisms levelled by Keith Tolley and Professor Alan Maynard of the York Centre for Health Economics in their paper Government Funding of HIV' AIDS, Medical and Social Care. Without going into details, the basis of the charge is that the present method leads to great disparities between regions; for example, £16,000 per head in South West Region and as much as £70,000 in North East Thames. That is due to the calculation on the basis of live AIDS cases at the end of the previous year. I have referred already to the rise in life expectancy and change in patterns of treatment of AIDS cases. In another paper by Dr. Bentley and Professor Adler, the authors refer to the increased use of anti-retroviral therapy and prophylaxis against opportunistic infections for pre-AIDS treatment. That will alter the ratio of AIDS to pre-AIDS cases. More resources for zidovudine, DDI, CD4 counts, monitoring and the more frequent attendances by pre-AIDS cases will also alter the balance of costs. Those authors say that financial problems will arise if allocations continue to be made on the basis of the number of AIDS cases at the beginning of a financial year. They suggest that projected mid-year numbers should be used instead.
The arguments are rather technical. I shall not pursue them further because the noble Baroness will have them at her fingertips. However, at this point I wish to ask her two questions. Can she assure me that the increased use of therapeutic drugs for both HIV positive and AIDS patients will continue to be supported? She will be aware that the Wellcome Foundation has made two 20 per cent. price cuts of AZT in the UK and has not adjusted fully for inflation for three years. That, with the decrease in dosage, has
1112
brought the cost of AZT treatment down to 38 per cent. of its original level. I hope that the Minister can give me the assurance I seek.
Will the Minister also say that the method of allocation of earmarked AIDS funds will be looked at? She will be aware of the letter written to me by her noble friend Lord Strathclyde on 21st December in which he says that the Scottish Office is reviewing the present method of distribution. Of course, the Scots tend to claim that they order things better north of the Border. That is no reason why we should drag our feet here. There are strong grounds for a more sophisticated system of allocation here which takes into account the identified HIV positive population of any region and the pre-AIDS treatment being provided.
While on financial matters, I must revert to the future funding under the new contract system of the genito-urinary medicine clinics which provide an open access service on a confidential basis to all-comers, regardless of origin. They are an essential bulwark in the control of all sexually transmitted diseases. They have been recognised as such since the introduction of the Venereal Disease Regulations of 1914. They saw 1.5 million people last year and their importance has increased since the onset of HIV/AIDS.
I rehearsed the arguments for their protection and continuance at some length during debates on the National Health Service and Community Care Bill. I received some assurances from the noble Baroness, Lady Blatch, on 25th July last year (at cols. 1352 to 1359) but these have not allayed all fears. The Monks Enquiry Report recommended that the clinics should become "designated services" to be provided in all districts, but it is not clear how they are to be funded; nor is it clear whether confidentiality would still apply to patients who had not entered the hospital through self-referral but through the accident and emergency department. When Mrs. Bottomley addressed the All-Party Parliamentary Group on 27th November last year she agreed that there seemed to be a need for further guidance on these issues. I am hoping that the Minister will take that matter a step further this evening.
As always time is the enemy. I shall now rush through a shopping list, neither the brevity nor the order of which in any way reflects the importance of the issues. I hope that other noble Lords and noble Baronesses will put some flesh on the bones. I shall end on a more philosophical theme which seems to me to be important.
The first item on my shopping list concerns the voluntary sector. In the HIV/AIDS field this sector—a cold word, so perhaps I should say that remarkable assortment of human beings—has been unrivalled in the speed, sensitivity, imagination, innovativeness and the effectiveness of its response. At international gatherings people ask, "How did you get this movement? How can we get one too?" It is not an easy question to answer without being swollen-headed. The immediate question is how it is to survive. It receives only one-hundredth of central government funding, as I have already mentioned. It is also supported by health and local authorities. However,

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as all AIDS allocations for 1991–92 have been cut well below the rate of
inflation it is doubtful how far they can continue their support. I believe that the noble Lord, Lord Ennals, will elaborate on that point and I shall say no more except that neither this nor any other social problem in the country could have a hope of solution without the voluntary movement.
The next item on my shopping list concerns the Medical Research Council. It is working on vaccines for prevention, drugs for treatment and the design and monitoring of the epidemiological research through named and anonymised testing. I wish that the noble Earl, Lord Jellicoe, who for eight years until recently was chairman of the MRC, were here this evening. Unfortunately he is abroad; otherwise I am sure that he would have spoken. He told me that when he first went to the Whitelaw Committee for AIDS funds he and his colleagues received what they asked for. Is there another wind blowing? I am not sure. However, there is one important point. The response of British science would not have been possible without the strength of its basic research in virology, biochemistry, molecular biology, immunology and epidemiology. Thus it is not only a question of earmarked funds for AIDS. There is a serious concern that the fundamental sciences which underpin the AIDS programmes and on which the research depends are starting to lag behind due to shortage of funds. I hope that the Minister will address that problem.
The shopping list is getting out of hand. It is amazing how one epidemic, albeit a complex one, can give rise to so many heads of concern and have such a devastating effect in so many walks of life. I would have been tempted to dwell on the drugs scene, which is a key link in the HIV chain, had it not been debated thoroughly the other day in your Lordships' House on a Motion ably introduced by the noble Lord, Lord Rodney. I suspect also that that topic will be covered by one or more noble Lords in this debate.
There is the related question of prisons and prisoners, which I am sure that the noble Baroness, Lady Masham, will tackle. Our country is one of the most retrograde in that respect. It surely must give us pause for thought that in Spain, the country of Philip II, the Counter-Reformation, more popish than the Pope, the government have taken on the Church, issued condoms to prisoners and undertaken a nationwide condom-based safer sex campaign.
While on that subject I want to ask the noble Baroness whether, in view of the cutback in family planning services in many districts, the Government will make it possible for GPs to issue free condoms, particularly where no family planning clinic exists. In regard to kitemarking to ensure the quality and effectiveness of condoms based on British Standards and to keep cowboy suppliers out, I understand that the Government are prepared to look at the problem seriously. I hope that the noble Baroness will confirm that and give me some indication of what is being done.
I would have touched on the question of life insurance, which is an important one in the AIDS world. However, I was relieved to learn from the noble Viscount, Lord Falkland, only five minutes before I
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entered the Chamber, that he is proposing to deal with the subject. I shall therefore remove it from my shopping list and add it to his. I shall nonetheless listen with great interest to what the Minister has to say. The matter was taken up vigorously with the industry by Mr. Robert Key before he became a Minister, and Mrs. Bottomley has also pursued it. I therefore look forward to hearing from the Government and the noble Viscount on that point.
I have reserved a little breath and firepower for education and prevention, and for my peroration—which must now be ardently desired. Education in its widest sense as performed for the public as a whole by the HEA is the most potent weapon we have against the spread of HIV and AIDS. I understand that the response to the latest series of short TV personal testimonials has increased the average weekly calls to the national AIDS helpline from 8,000–10,000 to 22,000 per week. Is the Minister pleased with that? Will the Government continue to authorise and fund similar broadcasts?
In schools the matter is more difficult. Sex education is only a small part of health education, which in turn is only a cross-curricular theme that has to find an uneasy lodgement in other subjects of the National Curriculum. The noble Lord, Lord Rea, would have liked to attend the debate but cannot. He sent me a note indicating his concern on that point. Governors also have the ultimate say in schools on whether there should be any sex education at all. Has the department, in conjunction with the DES, thought of issuing guidance to governors? To my knowledge there is a parent-governors association which might be receptive.
I wish to address only one other topic. It concerns public health and private morals. This is the most important political issue facing any government in a matter like this. It affects the expenditure society will sanction and the official messages that can be sent out by the HEA, whether in schools or over the broadcasting channels. With the very large costs attached to any HIV/AIDS scenario, however minimalist, it is obviously in the interests of government and taxpayers that every conceivable precaution should be taken. It is clear to me that "safer sex" is not only in the interest of the individual but also of the public. That is a straight piece of utilitarianism well within the British empirical tradition.
However, religious and family mores of an older stamp cannot simply be dismissed. Indeed, the Government have faced criticism of the "safer sex" campaign on the grounds that it encourages promiscuity. I understand that. But I believe it to be ill-directed. The Government are above all the custodian of public health during an epidemic and not of private morals, which are up to individuals. That public health role is one which none but the Government can fill. I am not against continence, abstinence or fidelity; but it is up to the Churches and other ethical bodies to make the case for them.
I am delighted that the right reverend Prelate the Bishop of Southwark will be speaking this evening. I expect him to make just such a case and shall respect

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him for it. But it is the Government's duty to protect the well-being of the people as a whole, regardless of creed and custom. Creed and custom—the ethical approach, if you like—constitute another track which can and no doubt should be pursued vigorously. But they do not fall within the province of Government, whose duty is to achieve disease control with all the means at their disposal. At the onset of the epidemic the Government took a commendably nonjudgmental and unmoralistic stance. I hope that the noble Baroness will confirm that that is still what animates official thinking.
We have been fortunate in our leadership on AIDS. Mr. Fowler, as he then was, Mr. Newton and now Mrs. Bottomley have all taken the epidemic deeply to heart, as I am sure does the noble Baroness. I am sure Mr. Waldegrave will do the same. All have benefited, and I hope that they will continue to do so, from the wise guidance of the Chief Medical Officer, Sir Donald Acheson and I cannot refrain from applauding the dedication with which Her Royal Highness the Princess of Wales has brought comfort and understanding to AIDS sufferers. Hers is an impressive example. But we still have a lot of work to do. There are still gaps, shortcomings and instances of pure wrongheadedness in our policy. I have endeavoured to point some of those out.
I hope that the noble Baroness will take my remarks in the constructive spirit in which they were intended and answer as many questions as she can this evening. I look forward to her reply and to all the other contributions to the debate. I beg to move for Papers.
5.30 p.m.
Lord Ennals: My Lords, the whole House owes a debt of gratitude to the noble Lord, Lord Kilmarnock, not only for initiating this debate but for the two previous debates which he opened and for his energy and enthusiasm in sustaining the work of the all-party Parliamentary group which provided us with invaluable research material on this subject. I, too, am personally grateful to him.
I have the deepest sympathy for all who are directly involved—that is, the doctors, nurses, carers and family members—but most of all, for the victims of AIDS and HIV. It is not just the feeling of hopelessness which must come to those who are afflicted and suddenly discover that they are AIDS victims, but the fear and rejection by so many members of society. I believe that part of our educational role is to try to gain understanding for those who, whether or not by some act of their own, have contracted this sad disease. I so much agree with the noble Lord, Lord Kilmarnock, that by her constant contact, which has sometimes included physical contact, Her Royal Highness the Princess of Wales has made a notable contribution to this kind of understanding.
Of course we need more education not only in a preventive sense but in society as a whole. The noble Lord, Lord Kilmarnock, has dealt with the overseas statistics. I am also grateful to the noble Lord, Lord
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Rees-Mogg—I hope that he arrives in time to take part in this debate—who had a notable article published in the Independent on Monday. It looked at the whole world picture. Taking the situation in Britain, the best available estimate I have is that possibly up to 46,000 people in England and Wales had been infected with HIV by the end of 1990. Although homosexual men have accounted for most cases of AIDS to date, the rate of increase is much higher for other groups. In particular, the number of cases attributed to heterosexual intercourse increased by 98 per cent. during 1990; from 135 to 268. Over the same period, the number of cases attributable to the sharing of injecting equipment increased by 100 per cent.; from 80 to 161.
AIDS does not develop until, on average, around 10 years after a person is infected with HIV. Therefore, these figures reflect past rather than current patterns of the spread of HIV for which it is almost impossible to produce a conclusive figure. The rate of increase in reported HIV-positive cases among heterosexuals is rising faster than for any other groups. It was up by 61 per cent. during 1990. As that reflects only those individuals who have been tested, it may also not give an accurate picture of the epidemic. The question of testing is very controversial. My personal view is that if someone has a blood test for some other reason I do not see why that blood test should not also tell them whether or not they have an infection. It is important that people themselves should know. I am not saying that others should be given the results. I am certain that a great deal of cross-infection arises from the fact that people are unaware of their own situation. We still have a massive and growing problem. Broadly speaking, the Government have tackled the situation well; but we should not let down our guard. That is my principal fear. There is much cause for concern.
I have listened, as I am certain other noble Lords have, to conversations among young men and women, boys and girls. A frighteningly high proportion of those involved in casual sex are prepared to take a risk and have sex with a partner without the protection of a condom because, inevitably, they have no knowledge about their own danger or the possibility of infection by their partner. They say, "Sex is fun and it is not likely to happen to me". People always say that it is not likely to happen to them. We still have an enormous way to go in order to persuade young heterosexuals of the risks of having casual sex without the use of condoms. Little do they know that they may already be carriers. It is a wildly irresponsible attitude, risking their own lives and that of their sexual partners.
My main contacts are through the voluntary sector; the Terrence Higgins Trust, Crusaid, Phoenix House, of which the noble Baroness Lady Masham is the chairman and I am a member of her committee; London Lighthouse, which does a remarkably important job; the National AIDS Trust and the Mildmay Mission hospital. All are greatly to be commended. I commend to your Lordships a new book on terminal care for people with AIDS by two people who work at the Mildmay Mission hospital.

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The London Lighthouse is a national resource for people with HIV. It provides care and support to over 4,000 people a year. As London Lighthouse currently obtains 80 per cent. of its income from statutory bodies, it has a number of anxieties relating to the recent legislative changes in the NHS which are due to take effect in April 1991.
In particular, London Lighthouse is worried about the implications these changes have regarding treatment for people affected by HIV-AIDS and their freedom to choose which service they wish to receive. Its primary concern is to ensure that open access is maintained for all the services when contractual agreements come into force. It is also concerned that as catchment areas develop it may have funding only to provide services to people living within district health authorities with whom it has a contract. Consequently, access to people from districts without a contract will be restricted. Already non-Thames district health authorities have denied their residents access to their services due to the refusal or inability of authorities to pay. I hope that the Minister will look very carefully at this matter. It would be a tragedy if, with the introduction of the contractual system from 1st April, it were made any more difficult for patients to be able to receive the treatment, particularly where it is available to them.
I now say a few words about the voluntary sector. Its response to HIV-AIDS has been rapid and innovative. The diversity of organisations illustrates many needs which have arisen in relation to HIV-AIDS. I am glad that the noble Lord, Lord Kilmarnock, paid tribute to the voluntary organisations. Many of them have good working relations with the statutory sector, but funding does pose a real problem. There is great concern over the ability of projects to maintain services at current levels, let alone expand them to meet new needs.
I draw the attention of the Minister specifically to the fact that the AIDS support grant for 1991–92 has been increased to local authorities by only 4 per cent. and to health authorities by 6 per cent. As the noble Lord, Lord Kilmarnock, said, both of those figures are below the level of inflation. That presents very severe problems to the voluntary sector. Despite a strong funding contribution from some regional health authorities, much of the statutory sector funding available to the voluntary sector has been from local authorities. If the local authorities are pegged then the money is simply not going to be available for the voluntary organisations to do the jobs which they do so very well.
The AIDS support grant to local authorities for 1991–92 means that many local authorities will be unable to cover their own costs and will certainly not be able to fund the voluntary sector. Therefore, on behalf of the voluntary sector I must tell the Minister that there are real dangers which the Government must face unless we are to see a slipping back rather than a stepping forward.
I refer now to the NHS. Although the provision of new resources only began in 1986–87 the major allocation was not made until 1988–89. Hence, many
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of the services are very new and still vulnerable in a National Health Service which faces major financial and managerial constraints. That is all the more so because of the historic marginal position of units like health education. If these new services are to be consolidated, protected and expanded, earmarked funding must continue. It is important that the Government should recognise that a commitment must be a commitment.
The underlying principle behind the provision of earmarked money for HIV development was that it be ring-fenced. It was not to be used for purposes unrelated to HIV and particularly not to help offset wider NHS deficits. Given the financial problems facing the NHS it has been difficult for some managers to resist using this money for other purposes. A number of notable examples of this have been reported recently, of which the Minister is no doubt aware. This has given rise to some suspicion that the HIV issue has been allocated too much money and that not all the allocation was required. That view must be changed. In that respect, I want an assurance from the Minister on the situation as it affects the National Health Service.
The situation is serious. The policy being pursued by the Government is simply not acceptable. Penny pinching now is endangering the lives of tens of thousands of people in years to come. The local authority associations' officer working group on AIDS, from which department of health funding has recently been withdrawn—I hope we can have an explanation for that—has drawn up a programme of training and development for AIDS co-ordinators and liaison officers with a strategic emphasis which will go some way towards meeting these key officers' training needs. In order to provide the best possible advice and to ensure high quality service provision in their local communities these officers need specific training and development input in a variety of relevant subject areas. One crucial consequence of this withdrawal of NHS funding is that local authorities are increasingly unable to fund important voluntary sector initiatives. Some community charge capped authorities have stated clearly that they will not be in a position to fund any voluntary sector initiatives in this financial year and probably not in the following year. Perhaps I may give Kensington and Chelsea as an example in case the Minister thinks that only Labour authorities face this problem.
Bodies in the voluntary sector are rightly recognised as playing a fundamentally important role in the further prevention of the spread of HIV infection in our communities. Their ability to continue to do so is already beginning to be severely hampered. Their difficulties are exacerbated by their own needs for specific areas of training and development, not least in relation to the importance of developing skills and expertise in contributing to contracts for social care and in developing agreements in relation to the provision of services.
I hope that this debate will cause the Government to think again. Two courses of action are needed. First, there should be an immediate increase in the

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level of AIDS support grant in line with inflation, or above it, to allow projects to continue to exist; and where projects have not yet begun, to allow them to make a start. Secondly, there should be an increased recognition that joint funding arrangements—the whole future of which is still, so far as I know, uncertain—are nevertheless the key to the continued development of high quality service provision and of education.
The local authorities have shown themselves to be highly committed to making a major contribution to the further prevention of the spread of HIV infection and to the provision of high quality services for those already affected by the virus. This increasingly harsh financial climate is tying their hands and demoralising their workers at a time when all expert advice tells us that the number of people affected is consistently increasing and when many view levels of complacency to be higher than ever. I hope that this debate will bring home to the Government and the House the message that not only is there no room for complacency but that there is room for great anxiety about the extent to which we as a society are fulfilling our obligations. The consequences of any failures now may not be seen immediately—it is perhaps 10 years from now that we will see the folly of our ways—so I urge the Government to continue as well as they started and maintain the pressure for services, and the funding of services, which the cause so urgently needs.
5.45 p.m.
The Viscount of Falkland: My Lords, I should like to address the question of the connection between HIV testing and the life assurance industry. There are two main reasons why people should seek a test to find out whether they are HIV positive. The first is obvious: should they turn out to be HIV positive they would quite rightly wish to take steps to make sure that the disease does not spread to others. The second reason is that recent advances in medical science have made it possible to delay the development of HIV into AIDS by the use of certain drugs and it is therefore necessary for the HIV positive result to be obtained at an early stage.
Those who have taken an HIV test which was negative will encounter delays if not difficulties if they seek to fill in a proposal form for life assurance. Those who are HIV positive are bound not to get the life assurance cover they seek. Those who have been for a test in any case, whether it is negative or positive, are in serious difficulties. If they are negative, the companies will inevitably require them, because they have taken the test, to answer further questions. It is the subject of the further questions which at this stage is a little worrying.
I have before me a fairly standard additional form from a leading insurance company. The form is short and brief. The Terrence Higgins Trust would describe it as crude. It is called a lifestyle questionnaire. Those who have taken a test, even though it be negative, are required to say whether they are part of five clearly defined groups: a homosexual, a bisexual, an
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intravenous user of drugs, a haemophiliac or someone who has sexual partners who are connected with any of those groups.
The noble Lord, Lord Ennals referred to an excellent article, written by the noble Lord, Lord Rees-Mogg, which appeared in the Independent. I do not see the noble Lord in the Chamber but I hope he will be here later. It was full of information and was extremely interesting to read. An important point relating to the attitude of life assurance companies was made early in the article: 60 per cent. of those who suffer from AIDS contracted their disease from heterosexual sources in the first place.
The article went on to state that there is authoritative evidence which shows that by 1993 at least two-thirds of new AIDS sufferers in this country will have contracted the disease from heterosexual contact rather than from homosexual contact. Therefore, not only is the insurance companies' line of questioning about one's lifestyle brief and crude: it is also not based upon reality. Many of those who are vulnerable are not covered at all because they have provided the additional information required and this in turn leaves an important gap in their lives.
As I said, if you are in a high risk group, you will not be able to obtain insurance cover. However, if you had not taken the test in the first place, and admitted so doing, you would not have had to fill in the extra form. I suggest to your Lordships that the people who are most at risk are those who are most discouraged from taking the test. Of course, there is another option: one can always lie on the insurance form. Such a course of action should be avoided at all costs. I say that because anyone who does so runs the risk of losing any premiums and benefits which may have accrued.
As noble Lords will be aware, insurance companies can consult your doctor when you apply for the insurance cover. Of course, you have to give your permission; but if you do not do so, again, that will affect your proposal. In such a situation your doctor is bound to pass on any information he has about you and about what is termed your "lifestyle". The same applies to any other doctors whom you may have consulted and whose names you are required to put on the form.
The present situation is unsatisfactory. That fact has been confirmed to me by many doctors. I am informed that doctors will often advise against taking an HIV test because of the damage which it may cause financially by prejudicing the chances of obtaining life insurance. Indeed, I was discussing the matter only today with someone with two female friends who had both consulted their doctor. Each one had been given such advice and, at the same time, the doctor concerned had advised each girl that he would keep their conversation off the record so as not to prejudice any chances of getting life insurance cover.
As I said, the situation is extremely unsatisfactory. I should very much like to hear the Government's view on the matter. I say that because, without labouring the point, there are many people who are at risk and who are being prevented and discouraged from taking tests which may save lives in the long run. In my view,

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the matter needs to be addressed as it has been in the United States, although I dare say that the situation there is somewhat different. Indeed, the Association of British Insurers believes that the reason one is not asked the question, "Have you had an HIV test?" but is asked instead, "Are you HIV positive?" in the United States is because Americans all have blood tests throughout their lives, whereas in this country one generally has a blood test only when something appears to be wrong. For reasons of which I am unaware, although other noble Lords may well have the answer, it is actually against the law in the United States to ask the question, "Have you had an HIV test?" It is interesting to note that the asking of such a question is not against the law in Canada. However, that country has opted to go the American way. People are asked, "Are you HIV positive?" They are not asked, "Have you had an HIV test?" That is done voluntarily because it is felt to be more satisfactory.
I shall leave the matter there. I hope that I have focused your Lordships' attention on this particular area. I also hope that I have not upset the insurance industry by what I have said. Indeed, I dare say that the industry runs its affairs very competently. However, it seems to me that it has taken an historical view of the disease which is extremely limited and which concentrates mainly on experience in this country. The early experience of the disease related largely to homosexuals. Enormous and admirable efforts have been made by the homosexual community to ensure that such people are less at risk, as the noble Lord, Lord Rees-Mogg, pointed out in his newspaper article. That is the group of people which has made the greatest efforts to ensure that the disease does not spread in its community. I see that the noble Lord, Lord Ennals, wishes to intervene. I am happy for him to do so.
Lord Ennals: My Lords, I have followed with great interest the remarks made by the noble Viscount. I wonder whether he can give his own view on one aspect of the matter. It seems to me that it is one thing to have a test which is available to the insurance company, but it is another thing to have a test which is available to yourself. Can the noble Viscount give the House his view on that complicated issue?
The Viscount of Falkland: My Lords, I must be honest and say that, before speaking in the debate, I had been concentrating rather exclusively on the insurance aspect of the matter. However, because of the discussions which I had with various people before entering the Chamber, I am under the impression that many young women are very conscious of the change in thinking which has now been recognised. I refer to the fact that heterosexual contact now seems more and more to be the cause of the disease. But that view is not held among young men. They seem to have gone into conventional thinking along the lines that it is only homosexuals who are at risk.
When a young women is entering a new relationship she may be worried about a previous boyfriend. She may have had one or two affairs, but this is a sign of the age in which we live. She may consider that a previous boyfriend was promiscuous
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and she may wish to reassure herself and the new man in her life in this respect. It is only fair that she should feel quite secure in the knowledge that she can go and take the test in order to find out about her state of health without prejudicing herself as regards obtaining life insurance cover.
5.58 p.m.
The Lord Bishop of Southwark: My Lords, I want to make my way into the debate via Uganda. It is clear that Uganda is one of the countries on the African continent worst affected by AIDS and HIV infection: the latest estimate is probably about 1.3 million out of a population of some 20 million. Yet, despite the obvious differences, I believe that there is much to be learned already from the responses which the Churches and other organisations in that country are trying to make to the problem.
What follows is based mainly on my conversation with someone who has recently returned from a visit to Uganda and who is himself a Ugandan priest now working in the diocese of Southwark. He spent a week in the diocese of Namirembe, which is a large diocese severely afflicted by AIDS and HIV infection. He was able to talk with the bishop and others who are directly concerned. After much discussion I understand that the Ugandan Churches, along with the government, have come down in favour of widespread testing. Noble Lords will be interested to hear that test centres are being set up, in particular near churches. Persuasion and not coercion is stressed, but of course against a background of growing awareness about the extreme seriousness of the epidemic in that country.
Testing is confidential. It is recognised that a positive result will have serious consequences for the individual concerned and for members of his or her family if they are told. The Bishop of Namirembe has appointed four counsellors. On one occasion my informant saw 60 people waiting to see two of them. By our standards, that is an impossible case load, but one has to do what one can in a country with so few trained resources; and at least the need is recognised. The overriding argument in favour of testing is that the situation must be faced openly, and that will only be so when people begin to realise their own responsibility and involvement and develop a sense of urgency in coming to terms with what is happening.
Much agonising has gone into the debate about what we call safer sex and the use of condoms, as one might imagine. Church leaders there, as here, are not in the business of encouraging promiscuity; we are in the business of encouraging chastity, self-discipline and faithfulness to a partner. But Church leaders there, as here, also try to be realists. We are well aware that not everyone accepts the Christian ethic, and in Uganda there is also a legacy from polygamy which makes faithfulness to one wife more difficult. The culture is hostile to male contraceptives, and there is the question of cost and reliability.
The outcome of the Churches' debate in Uganda is an interesting one. It has been to propose to government and others that condoms should be made freely available only to those who are HIV positive. I

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doubt whether that is a realistic way forward, but at least it is a serious attempt to send out a signal which is consistent with the view that the best way forward is to teach and practise chastity and not to encourage promiscuity.
My informant told me that he was amazed by the way in which the Churches are trying to meet the desperate needs of orphans and children who are HIV positive or dying of AIDS. I understand that the time gap between being positive and getting the disease is much shorter with children. They have day clinics which in that diocese are being funded by grants from the German Lutherans, who provide food, clothing and other help to enable the children to be cared for as much as possible by the extended family if their own parents have died or are too weak to cope.
The significant point about that development is that children are not being swept out of sight in some remote institution, as happened, for example, in Romania. Villages divided by civil war and other sufferings are coming together again in a common recognition of need and acceptance. They remember after all, some of them, what happened to lepers. There is an upsurge of loving concern in many villages which gives cause for hope in face of the fear that AIDS induces.
In this country we are still in a different situation from Uganda, but there are useful and important parallels to be drawn. If the disease progresses here, the case for widespread testing must be strengthened. How else shall we learn how serious is the situation that we face and take the steps necessary, both individually and corporately, to meet the threats that may emerge?
The importance of counselling is plain to see. A wealthy community can afford to put far more resources into appropriate training and numbers than a third world country; but the interesting point about the Ugandan experience is that such counsellors need to be easy to reach. They have to be voluntary. They have to do their work in a way which makes them accessible to people of varied background and culture and be able to counter the common misunderstandings about the spread of the disease. Sometimes our counselling becomes so professional that it is not readily in touch with many ordinary folk.
In this country', public education has focused almost entirely upon the safer sex route, with its implicit assumption that that is the only way worth considering. The Church of England Board for Social Responsibility in its submission to the Social Services Committee of another place in 1986 made it clear that:
"It is the teaching of the Church that all individuals should practise chastity before, during and outside marriage … Pairing and bonding are normally part of human nature, and promiscuity is contrary to it".
That is not to deny in any way that sex is fun. But we all know that there is more to be said. I am very much aware of the difficulties, especially the point made by the noble Lord, Lord Kilmarnock, about the responsibility of government for health rather than for morality as such. But I believe that there are still many
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people who would welcome a more positive emphasis on that alternative way of preventing the spread of AIDS, because that is what we are talking about tonight, especially perhaps in guidance for health education in schools. I shall be interested to hear whether the Minister can comment on that point.
Finally, we should note how strongly the Ugandan Churches are trying to foster open and honest recognition of what is happening and are working with and through their local communities to care for and accept the victims of HIV infection and AIDS and not to turn away from them in apathy or condemnation or because they think that someone else should cope. They know that there will be no large government funds available in that country, and I guess that sooner or later we shall have to come to terms with the fact that ours too are limited.
One of the suggestions that we have often heard—I believe that it is important—is that there need to be more special hospices, such as the Mildmay Hospital or the London Lighthouse. That may well be right, so long as we recognise that AIDS sufferers also need to stay in the community and at work for as long as possible—and that relates to the insurance issue. It is vital for them and for us that we do not fall into a 20th century version of the rejection of lepers. The Churches still have an important role to play in this, probably not widely understood as yet, and it is good that in many places the local churches, usually acting together and ecumenically, are beginning to support advisers, advice centres and support groups such as Time for Support in Manchester.
In my diocese, Brixton Prison has a small hospital. I am aware, because I have seen it, that an extension has been built to house AIDS patients. Judge Tumim's recent report on the prison and the hospital did not encourage us to think that the level of care would be very great, given Home Office constraints on funding and staffing. When people are dying of AIDS, is it necessary for them to end their days in a prison hospital? Could there not be a hospice for dying prisoners, with simple security, where relatives might have greater access for those last few weeks and months and where reconciliation with one another and with God might be easier and more humane?
6.8 p.m.
Lord Butterfield: My Lords, I begin by expressing my gratitude to the noble Lord, Lord Kilmarnock, for bringing the debate to the Floor of the House. In the same breath, perhaps I may apologise to him and to the noble Lord, Lord Ennals, for being late in reaching the Chamber. I inquired in a certain office and was given the information that the debate would probably start at about 5.30 p.m. I stepped into the Chamber at 5.31 p.m. I apologise to your Lordships for being late.
I want to speak in the debate because there are two sides of my life which are deeply concerned with the subject. One is that I have spent a good deal of time in education, and there is a major health promotion and health education challenge in this terrible epidemic that we face. The second is of course that my

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first degree was in medicine. I may stray into the clinical vocabulary as I have not written out all my words in detail. If they become rather torrid I hope your Lordships will excuse me. It is not my intention to try to shock or offend.
I want to begin, as I am sure the noble Lords, Lord Kilmarnock and Lord Ennals, probably emphasised, by saying what a great change has come about in this epidemic. When it started I am sure from my personal observations that there was a good deal of prejudice about those suffering from acquired immunodeficiency state diseases because of the link with homosexuality, which runs against the grain for many folk. But it is terribly important that we all leave this debate clear in our minds that it is no longer correct to consider the epidemic in those terms.
The World Health Organisation stated firmly in a publication on 15th December:
"heterosexual transmission of the human immunodeficiency virus that causes AIDS is becoming the predominant mode of spread".
I wanted to go on to say that there are projections—and we have no reason to doubt their accuracy—that the number of people who may he suffering from this dreadful condition (I will tell you in a moment why I regard it as so dreadful) is going to be of the order of 25 to 30 million in the early part of the next century. I am sure that that figure has probably already been drawn in, but I do not apologise for re-emphasising it.
If you are immunodeficient you are very susceptible to a whole range of infections. In connection with this debate I was talking on Sunday to an English nurse just back from a spell in New York. She said, "There are two things I would tell you, Professor. One is that we are now seeing many women with AIDS in New York, and the other is that the number of patients with tuberculosis as a result of AIDS is rising and rising, and that is a very uncomfortable sort of case to have to nurse".
There is a further point that I should like to make. One of the things that happens to you when you are a retired professor is that you perhaps see more of your students. I am going to describe two things that former students have said to me. First, a lady doctor reported to me the sort of distressing cases which have been drawn into this terrible web. She knows of young mothers from the Middle East who were delivered and had a small haemorrhage at the time of delivery. Their obstetricians, anxious to provide the best level of service, topped them up with a little transfusion of blood, a bout 150 millilitres. Unfortunately a lot of the blood in the Middle East 10, seven, five years ago came from New York and was contaminated with the virus. Therefore, as a result of what was hoped at the time to be good medical practice, this doctor has seen several young mothers in London in the terminal stages of AIDS with all the resulting problems of degeneration of the central nervous system. There is a lesson there that we need to learn.
Not long ago I was in the Soviet Union. The doctors there were all worrying that so many children—several hundred in one epidemic—in small hospitals
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and in orphanages had been infected by repeated use of the same needle. The prediction is that there are going to be probably 10 million orphans worldwide within the next 20 to 30 years. The mothers and fathers, brothers and sisters, will die and leave them as a dangerous and serious social and political problem.
Those youngsters are bound to become streetwise. I cannot believe that they will not have hard children's hearts. It is one of the things that I worry about. I hope that we do not find among them some who are prepared to step on anybody in their way to success in their lives as they would judge it. Of course one fears that some of them may follow a military career and lead countries to war.
That touches a point that I should like to make quickly. I am full of admiration for our Secretary of State for Foreign Affairs, Mr. Hurd. He is right to worry about conferences after the Gulf War is brought to a conclusion, and it is to be hoped that that will be soon. Perhaps I may say, however, that there are some of us in this Chamber—and I believe that the right reverend Prelate the Bishop of Southwark will be one of them—who will be pressing that before the end of the century there will be more international conferences about what is going to be needed for the survivors of this epidemic. I suggest that we need to worry particularly about those 10 million orphans.
The second part of Lord Kilmarnock's Motion concerned the measures required to limit the spread in the United Kingdom, and I should like to talk about that for a few moments. First, I must on your Lordships' behalf offer our congratulations to the many people who have been so busy and successful in combating this epidemic in this country. The Chief Medical Officer and the Department of Health deserve our thanks and congratulations. Many people have come forward to help there—it is usually young men at this stage—in the terminal stages of the disease.
The world medical fraternity has stepped up its efforts as have our pharmaceutical companies too. I know that there has been difficulty about the question of insurance, and I have been led to believe that a joint survey is being conducted by the Association of British Insurers and the Department of Health. Perhaps the Minister will tell us in due course if that is so and how it is getting on?
We know that the numbers in this country are alarming. For example, in Edinburgh one pregnant woman in every 250; in Dundee one in every 1,500; and in London one in every 2,000 is HIV positive when she comes to the clinic. Those are pretty alarming numbers.
Lord Winstanley: My Lords, will the noble Lord allow me to intervene for a moment? I find most interesting the figures he has just given about the number of pregnant women who are HIV positive. How is this known? Presumably blood tests were carried out. What consent was given specifically by all those women for the test for HIV?
Lord Butterfield: My Lords, I am afraid I cannot answer that. These figures came to me through the offices of the Medical Research Council, which I should also like to congratulate on its wonderful

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efforts in this epidemic. I believe that it has become the custom to test pregnant women in clinics in case there are problems with blood transfusion needs. I believe that is the basis for the testing. The figures are alarming.
I should just like briefly to talk about the question of prevention. There is a great and wonderful story in my profession about Professor Bywaters, who was once asked by his students about safe contraception. He said, "There is only one safe oral contraceptive and that is a firm, `No'". Whether we are going to be able to bring about that level of continence among young people is one of the great challenges which face us. There is no doubt that people are keen on condoms. Perhaps I may mention that I have heard from health educators in Japan, which I visited recently, that the approach adopted there is to encourage the girl partner to put the condom on her young man. This apparently increases the chances that condoms will be used. The girl's excuse for it is that she is twice as likely—if the pair do not know their HIV status—as the boy to contract the disease from promiscuous intercourse.
Lastly, I would not wish noble Lords to leave the Chamber without being made aware of the work on vaccination which is going on in this country. We can hold our heads high and I am grateful to my friends and colleagues in the Medical Research Council and elsewhere in the research world for the information that I shall give briefly.
In this country we have a great tradition as regards vaccination. Edward Jenner started vaccination in the grounds of Berkeley Castle and I think his first boy was vaccinated in 1796. The question now arises: how shall we find something like the vaccinia virus, the cowpox virus against smallpox, to use against the AIDS virus? Our clever young men and women will know about the proteins in the HIV virus.
As examples of the devotion shown by our young research workers who are committed to the problem, I shall mention two points. First, there has been successful vaccination of a small number of monkeys through collaboration with the Zoo. Secondly, now that it is known that protection can be obtained with fragments of the virus protein, certain people, young men at St. Mary's Hospital and a professor at the University of Cambridge, are allowing themselves to be inoculated every month with one of the proteins which might be a useful vaccine. They expect their blood to be taken and the antibody to be separated, labelled and given to patients with AIDS. It is labelled so that estimates can be made of the rate at which the antibodies are being used up. At the moment, no one knows whether the antibodies are low in AIDS patients because they are used up more quickly or because the T-cell, the immunological defence, is unable to make the antibodies.
I apologise for running over my time but I wanted noble Lords to know of the strenuous efforts being made by all those at the research interface with the AIDS problem. Their efforts are a reminder to us of the size of the problem we face and how important it is that we recognise that we shall have great
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responsibilities in Southern Africa, parts of the Sahara and the Far East. We may have responsibilities for health there as great as the challenges we are meeting in the Gulf war.
6.23 p.m.
Lord Colwyn: My Lords, I also must apologise for being late for the start of the debate. When I telephoned the House at half past four I was told that the debate would start at about 6.15 p.m. That would give me time to attend the all-party football committee annual general meeting at six o'clock and also hear the opening speeches. As it happens, I have missed all those speeches and I am now missing the football meeting.
Telling people that AIDS is always fatal is both untrue and misguided. It ignores the fact that many patients have experienced significant remissions and now lead normal lives. It is also an entirely negative approach for, as I propose to show, AIDS patients must be able to live in a wholly positive atmosphere in which their self-healing capacity is encouraged and enhanced.
The AIDS virus, as we have heard, reduces the efficiency of the immune system, particularly the T-4 helper cells which organise the killer cells of the body's defence mechanisms, leaving the victim susceptible to infections which are normally naturally controlled. Your Lordships will know of my interest in the natural methods of healing. I declare an interest as president of the Natural Medicines Society, joint president, with the noble Lord, Lord Ennals, of the All-Party Parliamentary Group for Alternative and Complementary Medicine, and a patron of the Research Council for Complementary Medicine. I also acknowledge this evening the help I have received from papers by Branko Bokun and Chris Thomson.
It must be logical to spend some time and money on research into how to improve the efficiency of our natural defence systems. Even if scientific research eventually finds a cure for AIDS, without improving the efficiency of our immunity, other lethal viruses or different forms of AIDS could become active.
We all carry thousands of innate or acquired viruses in our bodies which remain inactive if our immune system is in good shape. Could it not be that AIDS develops when someone's immunodeficiency, perhaps caused by another infection, descends to a particularly low level, to the point where it becomes incapable of any defensive action? Perhaps our defence mechanisms have a sliding scale of deficiency and at a certain point on that scale, varying between different individuals, we become susceptible to certain infections.
In our present environment we are permanently subjected to all manner of micro-organisms which often lie dormant for our whole life, if our immune system is in good order. There is no doubt that it is possible to catch and carry AIDS for many years, perhaps even a lifetime, without any ill effects if our immune system works correctly. Millions of people carry the herpes virus in a quiescent state, only

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showing symptoms when the immune system descends to the level of its deficiency at which herpes becomes active.
Scientific researchers invariably insist that most carriers of AIDS will develop the disease and die within five to seven years. There is no proof but as that kind of statement produces panic and stress, the chances are that it is true. Panic and stress lower the immunity to the disease and death is more likely. Fears and anxieties stimulate the hypothalamus, increasing the activity of the sympathetic nervous system. The more protracted this alert state, the more damage is created to the immunity. When the state continues for long periods, as it would invariably do when individuals are told that they have the AIDS virus, various hematological abnormalities occur, of which the most common is the reduction in the number of leucocytes—the very cells responsible for the body's defence against pathogens.
I believe that male homosexuals are more susceptible to AIDS not due to their sexual promiscuity—although this may help to spread the disease—but because of the factors that are part of their lifestyle: anxiety, agitation and restlessness produced by the instability of their state of existence created by mental attitudes. In general, male homosexuals have a lower immunity than average, thus making them more susceptible than others to opportunistic infections.
Drug addicts, by the nature of the abuse to their bodies, develop immunodeficiency, which exposes them to many infections including AIDS. In any society, there will always be young people who develop irrational anxieties. They mainly stem from successful parents or a community where success is praised and failure is a stigma. At an age when they face reality, responsibilities and the values created by healthier and tougher generations, these youngsters instead develop anxieties and fear of failure, which is diminished by the use of drugs.
Like any escape, drug addiction increases fear and anxiety which in turn reduces the efficiency of the immune system. Those who suggest giving addicts free sterilised needles and syringes in order to prevent spreading AIDS do not understand the psychology of drug addicts. Sharing the needle consolidates togetherness and belonging, which are far more important to those people than anything else.
Could the rapid spread of AIDS in central Africa—where signs of the anxiety and stress in the western style of life and its cures using drugs, alcohol and sex, are becoming more evident—be due to the fact that the imitation and adaptation to this new lifestyle is particularly strenuous?
The main agent which facilitates the spreading of an epidemic is the fear of that disease. Fear reduces immunodeficiency dramatically. Dramatised statements from the media cannot but spread AIDS, opportunistic infections, AIDS related complex or cancers. Vague speculations and forecasts can create such terror among the virus carriers as to transform the speculations into truth. The real truth is that AIDS
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virus carriers could live to a normal age if they concentrated on keeping their immunity at its optimal range.
People are becoming increasingly frightened at the first sign of physical or mental disorder. More people are rushing to their doctors in search of the quickest and most effective drug remedy, prescribed in most cases to please patients. Many strong drugs, particularly antibiotics, inhibit the body's immunity, and certain drugs, particularly the corticosteroids, positively reduce the immune reaction.
I am in possession of papers which show that HIV patients and patients with AIDS-related complex can be helped dramatically by treatment with a combination of mainly natural therapies. The current edition of the Journal of Alternative and Complementary Medicine gives details of an American trial which has shown 100 per cent. survival and no progression to full blown AIDS in 16 HIV-positive patients over a 12-month period. That compares with a 93 per cent. survival rate and 28 per cent. progression to full-blown AIDS in a study of patients using AZT therapy. I am also aware of the beneficial effects of treatment with sodium ascorbate, or Vitamin C. A recently published paper from the Linus Pauling Institute confirms reports from doctors who are having considerable success treating AIDS patients with large non-toxic amounts of Vitamin C. I am trying to show that it is inherent immunity which is the vital factor in AIDS.
I have been a member of the All-Party Parliamentary Group on AIDS for several years. I have failed to persuade its members to take any notice of, or to invite presentations from, complementary practitioners working with AIDS patients. Perhaps my noble friend the Minister will have a sufficiently open mind this evening to take serious note of what I have said and to bring my remarks to the attention of her right honourable friend in another place. I should be most grateful for some indication in the winding up speech of my noble friend of the Government's feelings towards the matters I have raised.
6.30 p.m.
Baroness Masham of Ilton: My Lords, first of all I must apologise because, like the noble Lord, Lord Kilmarnock, I have a very bad cold, so if I suddenly stop speaking it will be to breathe. Perhaps I shall ask the noble Lord, Lord Colwyn, for some of his treatment.
I am most grateful to the noble Lord, Lord Kilmarnock, for giving us the opportunity to debate this subject this evening. Much has happened since 1983 when there was the first Question on AIDS in your Lordships' House. As far as the noble Lord and I have been concerned, this matter has always had very high priority.
If we turn back to 18th March 1985 when there was the first debate on an Unstarred Question on the subject in this House, the Minister answering said that in 1985 there were 132 confirmed cases, of which 58 had died. AIDS is now the greatest cause of death in New York City. In very many countries of the world

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the problem is greater than it is in Britain. I have known two people who have died of AIDS and one who is now dying. It will not be long before many more people will know somebody with AIDS. It is difficult to explain what it feels like to know that someone whom one loves has AIDS. When one fully realises, it is a sorrow that one has to hold and manage as life has to go on. The AIDS virus creates much emotion. There is a strange cloak of silence that comes down which can be lifted only on rare occasions. Many people have now gone through the mourning process, having shed many tears in private.
As chairman of the all-party parliamentary group, the noble Lord, Lord Kilmarnock, must be congratulated on his dedicated hard work. I have the honour to be one of the group's vice-chairmen and should like to pay tribute to the research workers and others who have served the group and to the helpful information which results from having such a group in Parliament dealing with this important matter.
There is no doubt that the British Government have done a great deal to try to prevent the spread of this cruel virus. Many very difficult decisions have had to be taken. Most people take a responsible line, but there are always a few who may spread the virus on purpose because of a grudge and a bitterness against society. Knowing what the results of AIDS can be, I would say that there is no greater priority than to try to do everything possible to stem the spread. Surely one of the biggest problems is that there must be many people who do not know that they are HIV-positive, who perhaps even shut out the thought of any possibility; they just do not want to know, especially if there are no benefits to knowing but only disadvantages. Now, with the increase in women finding themselves HIV-positive there is a fear that their children might be put into care or on the risk register. These people need help from those they can trust and they need to be where they will feel safe.
I have the honour to be a council member of the London Lighthouse. I am a new member, having joined in September. I also have connections with the Mildmay Mission hospital, which the noble Baroness, Lady Hooper, has visited, and with ACET, AIDS Care Education and Training. These organisations are all doing vital work, giving people with AIDS a safe place where they are understood and looked after as human beings or giving them care and support in their own homes.
On an estimate of 85 per cent. occupancy, it costs about £260 per day for a resident at the Lighthouse. Home care is much cheaper. ACET estimates that it costs around £10 per day. During 1990–91 it received 320 referrals in London, of which 157 were for full home care. One of the ever-increasing problems is that organisations such as ACET have to negotiate with 30 to 60 authorities in London alone. That is why ring-fence money is vital. ACET also provides help elsewhere: in Scotland; with the devastating problems in Africa; and with education programmes in Romania.
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With the ever-increasing number of AIDS cases some organisations are reaching crisis point. The World Health Organisation estimates that the current level of infection is 8 to 10 million and the projected level by year 2000 is over 20 million.
Working in the field of AIDS may have its sorrowful and difficult side but there are some quite exceptionally good and dedicated people who are providing models of care which could be used in the community in respect to other groups such as severely physically disabled people and cancer patients. There is a wonderful section of volunteers working for both the London Lighthouse and ACET as well as for many other projects. The use of volunteers in any organisation means that if it is to work well they must be reliable; the support for them must be good; and they should be well managed. For AIDS sufferers, having paid staff and volunteers working side by side seems on the whole to work very well.
The challenges posed by HIV and AIDS demand a well co-ordinated response from all sections of the health service as well as from the social services and the non-govermental organisations. The nursing contribution to that response is already significant but it has not yet reached its full potential. The role of the nurse as carer is already well defined, but the role of the nurse as educator, informing the public about HIV, could be further developed. More nurses need educating. At present only one AIDS course unit for nurses exists offering a basic introduction to HIV and its epidemiology, and to issues of sexuality and prejudice and bereavement counselling. That is a good start but the course is available at only 36 centres in England.
So far 3,000 nurses have undertaken the course. There are 28,000 district nurses and health visitors throughout the UK. HIV poses the greatest single challenge to public health this century. Some people who become ill with AIDS may move around the country, perhaps to relatives in rural areas where people with AIDS might not be expected to live. HIV demands a high degree of awareness among nursing staff. It is not restricted to so-called high risk groups. The ability of the virus to strike any person regardless of sex or age means that the disease can spread through all sections of the population. Community nurses, occupational health nurses or practice nurses need to be properly prepared to meet that challenge.
Perhaps the Minister will be able to tell your Lordships how community nursing teams will be organised. Will they be monitored and evaluated by family health service authorities? How will collaboration between local authorities work? With the involvement of local authorities, FHSAs, health authorities and voluntary agencies and the need for confidentiality there are question marks. Good practice must be worked out so that there is a clear strategy and framework for the provision of community health services in general and wider access to education and training for staff specifically on AIDS.
Last week I attended the launch of a book Terminal Care for People with AIDS at the Mildmay Hospital. It has been produced by Ruth Sims, a nurse, and

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Veronica Moss, a doctor, and should be of great help to GPs, nurses and other carers. The book was mentioned by the noble Lord, Lord Ennals.
There is concern about future funding for some people who are HIV positive, who come to this country, particularly from Italy, Spain, Brazil and Africa, and who then become ill and need treatment and care. Perhaps they come here because we have better facilities. Perhaps the World Health Organisation could hold a contingency fund so that the country which cares for those unfortunate people can be reimbursed. My noble friend Lady Hooper is expert in Spanish and has a special relationship with Spain. Does she agree that that suggestion is worth considering? Otherwise, who will provide the necessary funds?
There is concern about the way in which prisoners with AIDS are treated in our prisons. I have been told that prisoners who have been taking drugs for the virus have been moved to other prisons without their drugs and without the knowledge of the doctor whose care they are under. The health service and the prison service should work closely together. Can the noble Baroness reassure the House that prisoners will not be moved from one prison to another without their medication? I agree with the right reverend Prelate the Bishop of Southwark that it would be much more humane for prisoners with AIDS to be allowed to go outside the prison walls and to die in hospice-type care when the time comes for them to die.
I am sure that the Minister will tell us that the Government have given a great deal of money to deal with AIDS. That is true, but health care has become very expensive indeed. The AIDS dilemma moves very fast. There is still a great deal to do and learn. It is important that there is co-operation and a helpful attitude among those working in the field. When there is a shortage of money there may be the danger that the problem will be denied.
The spread of AIDS by injecting drug users has been and still is a great problem. The good needle exchange schemes seem to be paying off. Liverpool has one of the lowest figures for HIV in the country and should be congratulated. I chair an organisation called Phoenix House which rehabilitates drug addicts. HIV has not helped morale. We are now establishing a safe house for people with AIDS called the Fountain House.
All of those facilities cost money. It is encouraging that there are generous people raising money for so many needs. Tribute should be paid to organisations such as Crusaid and the people from the arts world who have done so much. As has been said, Her Royal Highness the Princess of Wales, through her frequent presence at events and centres for AIDS, helps to keep up much needed morale. Her Royal Highness Princess Margaret has also helped.
I end with a plea to the Minister. Recently it has been reported in the press that in the USA three patients caught AIDS from their dentists. It is important that the Department of Health looks at that question and makes it known how the infection was spread as there will be many worried people. The
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report in the Evening Standard was vague about how the infection was spread. Every precaution should be taken to stem the spread of AIDS.
6.46 p.m.
Lord Rees-Mogg: My Lords, I should like to join with other noble Lords who have apologised for missing the first few speeches in the debate. Like them, I thought that I was early for a six o'clock debate but found that I was late for a five o'clock debate.
I am very grateful to the noble Lord, Lord Kilmarnock, for introducing the debate. I should like also to express my thanks to several noble Lords who have referred in friendly terms to my article in the Independent.
I am very conscious that this debate is taking place at a time of crisis in the Gulf and of the contrast between the two crises. It is certain that even this year the number of casualties the human race will suffer from AIDS will be a multiple of the number of casualties the human race will suffer from war. Whereas we know that this war will end within a reasonable time, we have to look forward to an AIDS epidemic which in all probability will kill increasing numbers of people through many, if not all, of the decades of the next century.
It is remarkably difficult to understand what is happening. The AIDS virus seems to have a psychological advantage because of the average 10-year delay between infection with HIV and contraction of the full-scale disease. If even now people were thinking rather of the infections taking place in 1991 than of the deaths, which amount to perhaps only a tenth of those infections, some of which were contracted as far back as the late 1970s, there would be much stronger public awareness of what is happening and a much stronger public reaction. I believe that we shall need a public reaction appropriate to the 1990s and not, as we have now, a public reaction which is only as alert as the infections of the early 1980s have made it.
Last week I went to the World Health Organisation and had a meeting with Dr. Merson, head of the appropriate department. I have also had an opportunity to have discussions with various experts in Britain, including Professor Anderson. He is a very distinguished world authority on AIDS and the HIV virus. There are certain conclusions which seem to me to be pretty generally agreed. These conclusions have been referred to in the debate, and in some cases I am repeating what other noble Lords have already said.
The first conclusion is that we are indeed dealing with a long-term, worldwide, pandemic disease. In America and in Europe the disease originally tended to have homosexual transmission. This undoubtedly misled the public in the United States and Europe into believing that it is primarily a homosexual disease. It is no such thing. At least 60 per cent. of present cases were contracted by heterosexual contact, and that percentage seems certain to continue to rise and is likely to end up at 80 to 90 per cent. or more.
The second point which I believe is universally agreed is the truly terrible situation that exists in

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Africa. The disease spread through central Africa and is now spreading through western Africa. The problem is not so serious in Islamic North Africa—the Arab lands—or in South Africa. However, the effect is devastating across central and western Africa. The situation there is that the rate of infection with HIV has already passed the 5 million mark. Nobody knows for sure how many HIV infections there are in Africa. The estimate is 5 million. But it is worth bearing in mind that that estimate has had to be doubled in the last three years, and a rate of doubling in three years offers a truly grim forecast for the future.
The World Health Organisation believe that approximately one in 40 of all adults in that part of Africa are now infected, and the rate of infection is approximately equal as between men and women. As a result of transmission from mothers they expect that 10 million children will be infected with HIV in the course of the 1990s. Of all the current statistics, this strikes one as perhaps the most tragic. On top of the 10 million children in Africa infected with HIV, almost all of whom will die within five years—because the disease takes a much more rapid course in children—there will be 10 million left as orphans. This is happening in a continent which is already poor and which does not have the resources to deal with this disease or indeed with its other existing medical problems. There is a real danger that as the disease, which started mainly in the cities, spreads to the villages irreparable damage will be done to the social structure of these African nations as the very people who are running these societies are destroyed.
It is also agreed that the disease is beginning to spread to that part of the world which so far has hardly been infected. As we all know, the disease exists across North America and Western Europe. It does not feature very much on the other side of what used to be the Berlin Wall. It is very prevalent in Africa; it is seriously prevalent in the Caribbean; and it is prevalent, and getting worse, in Latin America. But it is now beginning to spread into the main land mass of Asia. The first evidence of it apparently came from Thailand, which seems to have been infected by its tourist trade and through the tourist brothels.
The infection has also spread to India. Tests which have been done on the population of prostitutes in many of the major Indian cities—Delhi, Calcutta, Madras, Bombay, and so on—show that rates of infection of between 30 and 70 per cent. are to be found in those groups. In India, as in Africa, there are large numbers of labourers who leave their villages either as single men or leaving their wives behind, and who have a strong tendency to use those prostitutes while they are in their work status before returning home. There are said to be 4 million such men in Bombay, and 50 per cent. of the 100,000 prostitutes in Bombay are said to be HIV positive.
In addition, we have the first warnings coming from China. We now have the disease marching forward into the land mass of Asia. Asia contains 60 per cent. of the world's population. In terms of AIDS cases, it has less than half of 1 per cent. at the moment.
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Therefore, I think we must expect that on the most favourable basis Asia is going to become infected in the 1990s in the same kind of way, though not necessarily to the same degree throughout, as Europe was infected in the 1980s. Asia is approximately 10 years only behind us.
This world problem is going to have to be met by world measures. We have shown—rightly, I think—what a world response through the United Nations we can make, to meeting a political and military crisis of aggression, but is that not disproportionate to the world efforts being made to confront what is a much greater threat to mankind?
I should like to add a couple of reflections about the situation in this country. There is a misconception among the public, fostered to a degree by some of the sensational press, which does not always give us the most accurate information, that somehow we are at the centre of affairs in this matter. We are not. We are part of a particular phase of the epidemic, and we are part of the European part. We match the pattern of northern European countries, and we have a percentage of HIV infection very similar to that of Belgium or Germany. Fortunately, we are considerably below that of southern Europe, where, because of shared needles, there has been a more serious epidemic. We are relatively fortunate in the development of the epidemic so far in this country. From the point of view of world health we are not a particularly sensational case.
So far, we have taken only the first steps which are natural and appropriate to deal with so dangerous and lethal a disease. I believe that we must undertake further public health education, particularly in the schools. It must be right that every schoolchild on a national basis should be fully informed about the risks that he or she will have inevitably to face in adult life. In my view they should be informed on a basis of science. They should be told the facts. They should be told the steps which can be taken to make their own lives more safe. Those steps include limiting their sexual partners. The only real safety will be fidelity to their sexual partner. Nevertheless limitation is of vital importance. Unless we have adequate health education in schools, we shall have unnecessary cases of this disease as it spreads from its initial homosexual orientation into the heterosexual community.
I am completely convinced that if we knew where we already stand, attitudes toward testing, counselling of those tested and tracing would be radically different to those which exist at present. I do not believe that the medical community, though itself divided, will be willing, as the percentage of HIV infected people in the population grows, to go on treating everybody alike, tested and untested. One already hears of cases of people doing medical work who are extremely reluctant to treat high risk patients who have not been tested if they do not know whether they are dealing with the active disease. Therefore I am certain that during the 1990s we shall have to move in a thoroughgoing way toward testing, counselling and tracing. I believe that, if we have to make that move, the earlier we bring ourselves to make it, the better it

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will be. We must remember that because of the delay inherent in the latency period of the disease in HIV and AIDS, it is always 10 years later than we think.
7.2 p.m.
Lord McColl of Dulwich: My Lords, I should like to add my thanks to the noble Lord, Lord Kilmarnock, for initiating this important debate. I must also give my apologies to the House for not being present at the beginning of the debate, which was due to hospital commitments.
My involvement in this subject is as president of the Mildmay Mission hospital, which was a NHS hospital serving the people of Hackney until it was closed in 1982, being surplus to requirements. The hospital was allowed to reopen three years later as an early version of the self-governing hospital. Thereafter we had much closer co-operation with health authorities. In 1988 within the hospital we opened a hospice for those dying of AIDS. It turned out to be the first of its kind in Europe.
Mildmay deaconesses first cared for people dying of cholera in 1866. The hospital today is particularly well suited to that kind of work—treating people with AIDS who are considered by some to be like the lepers of old. Many have been thrown out of their homes, sacked from their jobs and even rejected by their friends. There have been many distinguished visitors to the hospital; they have been deeply moved by the plight of the people there. They have also been impressed by the dedicated and superb care that is given. The attitude of most distinguished visitors is noticeably changed when they meet people who are living with AIDS.
The hospital provides continuing and terminal care for those with advanced disease. Many patients are admitted apparently dying. But when their infections are treated and the symptoms controlled they recover and leave the hospital, although often returning later having suffered a relapse. So the establishment differs from the usual type of hospice where active treatment would not normally be appropriate.
Respite care is another important aspect of the work. The aim is to have as many as possible of the patients nursed at home. A smaller percentage may need rehabilitation after suffering the effects of a stroke as a complication of the disease. Such patients respond very well to intensive rehabilitation treatment.
Education is another important activity of the hospital. It trains other National Health Service personnel and people from abroad in how to deal with AIDS patients who are being cared for at home as well as those in hospital. There is an ever increasing number of mothers who have AIDS and of children with AIDS. The hospital tries to cater for that need but facilities will need to be improved. It has been reckoned in New York that within a few years it will have 78,000 children with AIDS. The mothers are reluctant to come into hospital and leave behind their children as the children would have to go into care.
We are very grateful to the many people from all parts of the country who have loyally supported the hospital. We are particularly grateful to the Member
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of Parliament, Mr. Peter Shore, who has been an absolute tower of strength throughout the years with all the help that he has given. We also thank the regional health authority and the Department of Health which, as usual, are being constructive and practical in helping to make the hospital the success that it is. But very much more remains to be done.
I underline what my noble friend Lord Butterfield said about the Chief Medical Officer, Sir Donald Acheson. He played a crucial role in alerting the country to the danger of AIDS at a time when very few people were taking any notice. He went on and on until they did take notice—all credit to him.
As the noble Viscount, Lord Falkland, said, there is a stigma attached to having the HIV test, even if it proves negative. The Minister for Health is working hard to put that matter right. Some people have difficulty obtaining life insurance just because they have had the AIDS test. The fact that it was negative and that the reason for the test was a blood transfusion given at a time when donor blood was not being tested does not seem to carry any weight.
The tragedy of the disease is that many people need not develop it at all provided that they change their behaviour. Sadly, even if behaviour in many developing countries were to be changed overnight, those countries will still lose one third of their populations. In some countries the number will be even higher. That is the same order of mortality which obtained during the plagues in the Middle Ages. Changing the behaviour of mankind seems to be exceptionally difficult. It is imperative that much more effort and funding are put into developing further the excellent work of the Health Education Authority. More money must be found for research and for supporting the caring work of the many institutions which are involved and which will be needed increasingly in the future. Education is of great importance. However, as was said by the right reverend Prelate the Bishop of Southwark, there is more to the issue than education. There is a spiritual dimension which we ignore at our peril.
7.10 p.m.
Lord Winstanley: My Lords, I, too, sought advice from the usual channels about the time at which the debate would start. However, unlike certain other noble Lords, I did not heed the advice and was able to be in my place to hear the entire speech delivered by the noble Lord, Lord Kilmarnock. Other noble Lords may learn not to be as credulous in the future.
The noble Lord, Lord Kilmarnock, has been indefatigable in his efforts to spread knowledge of this serious disease not merely in this House but among Government circles and elsewhere. He is right to turn our attention to the subject when we are pre-occupied with other lethal events elsewhere. I wholly agree with the noble Lord, Lord Rees-Mogg, that however many lives are lost in the Middle East it will be as nothing compared with the number of lives lost as a result of this disease. In saying that, I do not ignore the words of the noble Lord, Lord Colwyn. He told us that natural defences might re-emerge to combat the

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disease, that it does not necessarily have to be fatal and that the virus might modify itself in time, as has been the case in respect of many other viruses.
I was delighted to read the article in the Independent by the noble Lord, Lord Rees-Mogg. I was delighted not only by its contents but because it appeared in the Independent which is not the usual publication in which his words appear. The fact that they have suggests a move to more liberal attitudes than those which he has previously held. The article covered the subject extremely effectively, as did the speech of the noble Lord, Lord Kilmarnock. However, both omitted to disclose the extent of the infection in Great Britain. The reason is that they do not know. We ought to know, and it is a matter to which I shall turn presently.
I do not intend to go over ground that has already been covered so well by many distinguished speakers but to ask one or two questions before coming to my main point which concerns testing. Reference has been made to the need for AIDS sufferers to have employment where possible. Does the Government's policy remain the same? When AIDS first became a common talking point and we knew of the dangers I was delighted to hear Mr. Kenneth Clarke—who I believe was then Minister for Employment—state that if someone were to be dismissed from employment due to being found to be HIV positive he or she would have good grounds for taking the case to an industrial tribunal, and winning. I commend his statement but ask the Minister whether that remains the Government's view. If so, will they express it with the same clarity?
A great deal has been said about funds. The noble Lord, Lord Ennals, was right in saying that funds are insufficient and that they must be increased. However, the total amount does not matter; what matters is what is done with them. We must decide on the best way of using the funds that become available for dealing with AIDS. Research is essential. However, in this country a great deal of the research rests on the shoulders of people who have clinical responsibility for the care of AIDS patients. It is not carried out by people elsewhere in the research field who have time to do it. I believe that we are being overtaken by the United States where funds and resources for research are greater. I hope that we are able to compete with the United States on equal terms in discovering an effective therapeutic agent and an effective vaccine. They have not yet been discovered and a great deal of money will be required in order to do so.
Money is also needed for counselling. Many noble Lords have mentioned the importance of the work done by the voluntary sector. The right reverend Prelate the Bishop of Southwark believes that counselling in this country is a little too professional. Perhaps he will forgive me if I disagree with him, though I know what he meant. I believe that counselling cannot be too professional. The right reverend Prelate believes that people need someone with the common touch to whom they can speak. They need to feel that the counsellor is not a
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professional. However, properly trained professional counsellors will conduct themselves in such a manner that patients will not feel that they are dealing with a professional.
It is important to remember that the shortage of social workers and the inadequacy of their training means that counselling people with AIDS can be psychologically damaging and dangerous to the counsellor. The counsellor becomes attached to a patient and gradually develops a relationship with him as he cares for him through a long illness. When in the fullness of time the patient dies the counsellor moves on to another patient to whom he will become equally attached. Again, that relationship will build and progress for months. That patient will eventually die and the counsellor will again move on. Careful professional training is required to enable a social worker to escape from psychological damage. I hope that the Minister will tell the House that adequate funds will be made available for the training and provision of counsellors.
I hope that the debate does more than merely spread additional knowledge about this important subject. I repeat my thanks to the noble Lord, Lord Kilmarnock, for introducing it. I remember that the first debate on the subject in this House was an Unstarred Question tabled by the noble Baroness, Lady Cox. A number of noble Lords who have spoken today also spoke on that occasion. I said that five questions needed to be answered. For example we need to know the nature and identity of the virus responsible, the method of transmission, and more about the incubation period. Four of my questions have been answered but one has not. It is the extent of the invasion of the virus into British society. We do not know, and will not know, the answer until we have a proper system of testing.
During Question Time in this House recently I stated that when, as a doctor, I have taken blood for testing the patient has first given general consent to the blood being tested. Indeed, one never takes blood without asking the patient for consent. When blood is tested, say, ante-natally, before an operation or for many routine purposes, the doctor does not ask the patient whether he or she is agreeable to a sample being taken. He does not then ask whether he can count the patient's red cells, white cells and platelets. The particulars of the testing are not specified; consent is consent. I believe that we have reached the time when samples of blood having been taken for testing, one must assume that the patient's consent allows the blood to be tested for anything, including HIV.
The difficulty is that several people believe that to test the blood for HIV without having obtained the patient's specific consent would amount to an assault. I do not agree with that. I am not an authority on common law but that view has never been tested in the courts. However, it is a fact that the General Medical Council, the body responsible for medical ethics, has given such advice.
I am sorry that the noble Lord, Lord Walton of Detchant, the distinguished president of the GMC, is not in the Chamber. He was a short while ago. He had

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that matter very much in his hands at one time. Advice was given to doctors that they must not test for HIV without the specific consent of the patient. I believe that advice to be wrong and that it is high time for it to be amended. I should like to ask the noble Baroness to address herself specifically to that point when she replies. What progress is being made to enable doctors, without fear of any possible legal or other consequences, to carry out tests for HIV on all blood samples taken from patients in all circumstances?
When that is done we shall have a real knowledge of the extent of the problem. We can guess, as noble Lords have done throughout this debate, at what the figure will be by the year 2010. We should know, and until we do know I do not believe that we will make the necessary progress with these vital matters.
I am not quite as wedded to education as is everybody else. I do not honestly believe that education will diminish the popularity of sexual intercourse among the young. I agree with the right reverend Prelate who said that sex is fun. Young people know that. I know that I should prefer them to play cricket and that we were perhaps rather more selective. However, I do not believe that education will do the trick.
Noble Lords may remember that there was an epidemic of venereal disease during the Second World War. There was a massive government education programme. About what could they educate? They could merely educate people not to have sexual intercourse with people suffering from syphilis. That was not an easy educational platform. The real results were obtained when we found a therapeutic agent to cure those diseases or, what was more important, to render the patient non-infective once under treatment. That was the vital step in getting rid of pulmonary tuberculosis. Once patients were under treatment, they ceased to be infective. Having ceased to be infective, the number of cases in society was gradually reduced. Therefore, the first step is to find an effective method of treatment which not merely delays or cures the process of the disease but renders patients non-infective.
Secondly, we must make progress with pioneering and developing a vaccine which will prevent people developing the disease. In order to do that, it is necessary to find out the extent of the problem. Only when that has been done will the necessary funds be made available, particularly in a society which at present is market led.
I know that the pharmaceutical companies are very conscious of the fact that there will be a huge market for a new drug which cures AIDS, renders patients non-infective or protects them from infection. However, we really need to know the extent of the problem.
I do not wish people to feel that there is an element of compulsion about this. I believe that the noble Lord, Lord Butterfield, referred to the Vaccination Act of 1889. That is a long time ago. It was not
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repealed until the National Health Act 1946. There are a whole number of vaccination Acts which made vaccination compulsory.
Noble Lords may remember that during the Second World War, when there was an epidemic of venereal disease, certain statutes were passed whereby any person who became infected was obliged by law to give the identity of the person from whom the infection had been contracted. The person named was summoned in for treatment. There was a law which provided for compulsory treatment. It was not terribly effective; at least however it was a precedent. So there have been statutes. Is it not time therefore that we looked at this matter? Is it not time that the noble Baroness was able to tell us that a campaign will be carried out—not necessarily a voluntary campaign although that would be more successful than a compulsory one—so that all blood taken for any purpose is automatically tested for the presence of HIV?
If it is tested and an individual sample is found positive, then there is the further problem of what to do with the results. Clearly they must remain confidential and should be revealed only to the patient. Certain steps must also be taken thereafter to protect the patient. Until that step is taken, we shall not have taken a positive step at all. If we take that step, then I believe that very positive results will emerge from this debate initiated by the noble Lord, Lord Kilmarnock.
7.27 p.m.
The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper): My Lords, this has been a thoughtful and constructive debate. We have been privileged, as so often in your Lordships' House, that so many noble Lords have spoken from personal knowledge and expertise.
The Government welcome the opportunity given to us by the noble Lord, Lord Kilmarnock, to take stock of the situation worldwide as regards the HIV and AIDS pandemic and to report the action which the UK Government have taken in support of the World Health Organisation in its fight to contain the spread of HIV and AIDS through its global programme on AIDS.
We all recognise the sterling work of the noble Lord, Lord Kilmarnock, as chairman of the all-party parliamentary group on AIDS. This group has done much in support of the UK strategy on AIDS and we are grateful to the noble Lord and his colleagues for their efforts to help maintain HIV and AIDS high on the national and parliamentary agenda. Indeed, my honourable friend, the Minister for Health has, I understand, recently written to the noble Lord, expressing her appreciation for the work of the all-party parliamentary group.
Perhaps it would be helpful if I were to remind your Lordships briefly of the elements of the Government's strategy and in broad terms of our approach to them, as the noble Lord, Lord Kilmarnock, asked me to do. Clearly our primary objective must be to curb so far as is possible the spread of HIV infection here and

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abroad. But in addition the Government have taken steps to ensure that appropriate services are available to meet the needs of people infected with HIV or with AIDS itself. To achieve these aims we have instituted campaigns to educate and inform the public and those whose behaviour may place them at special risk; we have set up monitoring and surveillance programmes to assess the progress of the epidemic within the UK; we have contributed to the research effort both here and worldwide, primarily in the important area emphasised by noble Lords in the course of the debate, to find a vaccine against HIV infection and a cure for the disease itself; and we have given substantial earmarked funds amounting to almost £150 million in the current year to the NHS and organisations within the statutory and voluntary sectors as the Government's contribution towards the costs of preventing the further spread of HIV and of providing appropriate diagnostic, treatment, care and support services.
There are few areas of government that are not concerned with the HIV/AIDS epidemic. For this reason, we have taken steps to ensure the closest co-operation between interested government departments. This is reflected at ministerial level by discussions through the usual arrangements and at official level by an inter-departmental group and a further official group to co-ordinate educational work across government. We also have access to scientific and professional advice through the Chief Medical Officers' Expert Advisory Group on AIDS. I am grateful to all noble Lords who have commended the work of that group.
The UK Government have ensured that the social, legal and ethical issues associated with HIV disease are addressed with care and sensitivity and in the context of the human rights of people with HIV and AIDS and without intervening unnecessarily in the ethical and moral issues to which the noble Lord, Lord Kilmarnock, and others referred. On that I was pleased to hear the views of the right reverend Prelate.
As regards public education and prevention, the UK was one of the first countries to mount a mass media AIDS public education campaign aimed at raising levels of knowledge and awareness among the public at large. I am pleased at the acknowledgment of the success of that campaign and confirm that the Health Education Authority will continue to seek to find the best way of conveying the important message of prevention.
In the field of care and treatment both the voluntary sector and the National Health Service have provided centres of excellence and innovation. Examples have been mentioned during the course of the debate so perhaps I need refer only to those within the National Health Service, which include the Kobler Centre, St. Mary's Hospital Home Care Team and the Newcastle Community Care Centre. The work in the voluntary sector is very much admired and respected by all.
The United Kingdom's strategy and our achievements so far are highly regarded internationally. The
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public at large, the health service, those who work in the other statutory agencies concerned and the volunteers who have worked tirelessly to assist and care for people with HIV infection, and indeed the Government, can be justified in feeling a sense of pride in our achievements both to prevent wider spread and to provide care and treatment with compassion and understanding for those who are infected or have become ill. In saying that, I do not wish in any way to suggest complacency. There is clearly a need to keep all our achievements under constant review.
Perhaps I may turn to the situation worldwide. The debate has recognised that the HIV and AIDS pandemic continues to worsen, particularly in sub-Saharan Africa, South America and Asia. I am grateful to the noble Lord, Lord Rees-Mogg, for his contribution on this part of the theme. The World Health Organisation has recently completed a detailed review and now estimates that some 8 to 10 million people may be infected with HIV. WHO further estimates that by the year 2000 some 25 to 30 million people may be infected, 10 million or more of them children. So far over 95 per cent. of reported cases have been in younger adults between the ages of 20 and 49 years. As the noble Lord referred specifically to Asia, I should also confirm that the World Health Organisation had previously estimated that the figures would be 1 to 1.5 million infected in that region. In the light of recent data, that now appears to be a substantial underestimate.
We are also aware of the Ugandan situation, on which the right reverend Prelate spoke so knowledgeably. It is important that we draw what lessons we can from the experiences of others.
In helping to combat the global epidemic the Government have so far committed some £30 million to programmes to prevent the spread of HIV and given wholehearted support to the WHO global programme on AIDS which takes the leading role in co-ordinating and implementing international action. AIDS is also high on the agenda of the European Community, which has set up a working group to formulate a Europe-wide strategy. Both within the European Community and further afield the Government have taken every opportunity to encourage international debate and the exchange of information about all aspects of HIV and AIDS. Many noble Lords will, for example, recall that in January 1988 we jointly hosted with the World Health Organisation a world summit of health ministers on programmes of AIDS prevention. That was an unprecedented and highly successful event attended by ministers from 147 countries. In addition we shared in our day-to-day contacts with other countries the experience we gained from our programme of public education and prevention.
I agree that in this very difficult area that programme of public education and prevention is vital. It is particularly true, as has been said, that in the absence of a cure for the disease or a vaccine against infection education and prevention must remain the cornerstone of our strategy. The first phase of the UK-wide public information campaign began in early

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1986. That was followed in early 1987 by the highly successful and widely supported mass media campaign which ran under the banner of "Don't Die of Ignorance". These campaigns and those which have since been developed by the Health Education Authority have raised and maintained to a high degree public awareness and knowledge of the risks of HIV infection, how the virus is transmitted and the measures people can take to protect themselves and others.
Noble Lords may recall that in November 1989 the Department of Health and the HEA jointly convened an expert symposium to assess the prospects for the wider spread of HIV in the UK. Three key conclusions were reached at that symposium: first, that all three main modes of transmission were well established—by penetrative sexual intercourse, by drug misusers sharing contaminated injecting equipment, who can of course additionally then pass the virus onto their sexual partners and from mother to unborn infant. Secondly, the symposium concluded that HIV continued to pose a serious threat to the health of the nation. Thirdly, it concluded that the potential for the wide-spread dissemination of HIV in the general population exists, particularly among heterosexuals and injecting drug users. The symposium and the television campaign of expert testimony that followed in early 1990 can have left no one in any doubt of that.
Our figures show—indeed the contributions to the debate this evening show also—that there has been a rapid increase in cases of HIV and AIDS among women. The noble Lord, Lord Butterfield, drew attention specifically to that point. As an indication of this, a recent survey in the Home Counties showed that in inner London one in 2,000 women recently delivered of a child was infected with HIV. In outer London the figure was one in 3,000, and outside those areas, one in 20,000. The noble Lord, Lord Butterfield, quoted figures from Scotland.
Figures have been attained by anonymised screening of Guthrie cards, which are also used to screen new born babies. A leaflet was issued to explain that procedure which emphasises that if the patient concerned has any questions or objections to the baby's left-over blood or urine being used for that purpose, the doctor, nurse or midwife would be happy to speak in confidence. There is emphasis that the wishes of the patient will be respected.
With those increasing figures in mind, it was particularly appropriate that the theme for World AIDS Day on 1st December last year was "Women and AIDS". This country responded magnificently and included many national and local events accompanied by welcome and helpful coverage by the broadcasting and press media. In that context a notable example is the work that Margaret Johnston is carrying forward at the Royal Free Hospital in encouraging women to come forward for help and in giving them access to appropriate services. I also applaud the work of Positively Women, a self-help group for women who are HIV positive. The group's new centre and offices were recently opened by Her
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Royal Highness the Princess of Wales. I am pleased to be able to say that the Government were able to contribute to the funding of the new premises.
In the latest phase of the mass media campaign, launched shortly after World AIDS Day, we focused on the testimony of people who have become infected. The objective is to increase people's personal perception of the risks so that they will translate awareness and knowledge into personal action. The intention is not to alarm and scare unnecessarily, although I take the point made by my noble friend Lord Colwyn in that respect. That is why we recognise the importance of counselling.
Mass media work is now being supported by HIV prevention work at local level. Health authorities have been asked to work with local government authorities and the voluntary sector to develop prevention initiatives geared to local needs and aimed at encouraging changes in personal behaviour. Coordinators are being appointed in districts to help carry forward that work. Support from the centre will be provided by the Department of Health and the Health Education Authority. In November last year, we convened a national seminar as a first step in the exchange of ideas and information and to help co-ordinators place their work in a national context.
In addition to campaign work at national and local level aimed at the general public, specific campaigns will continue to be directed to sections of the population whose behaviour may place them at special risk and to those where particular educational approaches may be required. To this effect we are discussing with the Health Education Authority the approaches needed to ensure the continued success of our national campaign work. Other governmental departments will also continue to develop educational work connected with their particular fields of interest. This of course includes educational material for children and young people in and out of schools. The Department of Health will continue to work closely with the Department of Education and Science to ensure that up-to-date and appropriate materials are available for use in schools.
We shall also continue to monitor carefully the spread of HIV in the United Kingdom by means including our programme of anonymised serosurveys under the direction of the Medical Research Council. We hope that the results of these surveys will help us in planning services for those infected with HIV or with AIDS and in targeting national and local prevention work. We continue to spend more in the area of HIV and AIDS public education than any other single health promotion programme. This is a measure of the importance we attach, and shall continue to attach, to reducing the impact of this disease on the population of this country.
A number of themes, as it were, came up in the course of the debate on which questions were specifically put. One of them was insurance. Perhaps I may quote my honourable friend the Minister for Health who said in another place recently:
"We occasionally hear of letters from insurers which imply, or are taken to imply, that the Government require

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insurers to send supplementary life style questionnaires to applicants for life insurance. This is not the case, and we bring cases that come to our attention to the Association of British Insurers so that it can take the matter up with the company involved. We no longer refer to risk groups, as it is a person's behaviour which determines whether they are at risk of contracting HIV, not their membership of a particular group in society. Our public education campaign messages reflect this".—[Official Report, Commons, 19/12/90; col. 241.]
Again, my honourable friend is discussing with the Association of British Insurers the effect of the HIV test questions which insurers ask on the proposal forms for life insurance. We are concerned that these questions should not prejudice public health concerns. The British Market Research Bureau has been jointly commissioned by the Department of Health and the ABT to carry out a survey of public perceptions. The survey is made up of four constituent surveys of experts, advice workers and others, the general public and young adults.
The bureau carried out the interviewing late last year and we have just received the draft report, which will inform our further discussions. A point was made by the noble Viscount, Lord Falkland, about the situation in the United States and Canada as regards insurance. The position of the United States is more complicated because of the need for most people to have private health insurance. Canadian guidelines for insurers are not altogether clear. The guidance produced by the Canadian Health and Life-Insurance Association, which has been sent to us, suggests that insurers can be justified in asking about prior negative tests in this respect.
That brings me to the other main theme concerning testing. The view of the expert advisory group on AIDS is now that if people think they have been at risk they should consider seeking a test and having counselling. That reflects recent studies which suggest that certain asymptomatic people benefit from early treatment. I was asked why this testing should not be made more routine. The decision to take an HIV test is one that must be considered very carefully. Legal advice obtained by the BMA advised that specific consent to HIV testing was needed in addition to the consent obtained for any other medical intervention carried out at the same time.
The Royal College of Surgeons has issued guidelines this very January. The council says that it would be impracticable and illogical at the present time to call for routine testing of all patients for HIV before each of the 3.3 million surgical operations that are performed in England and Wales each year. Nevertheless, the council strongly endorses the recently expressed view of the chief medical officers that members of the public who consider themselves to be at risk of HIV infection should submit to voluntary testing.
As regards the question of anonymised surveys which I touched on earlier, information is urgently needed in this country about the level of HIV infection in the population. These surveys have been designed to provide invaluable information on the overall prevalence of HIV infection by age and sex among the population as a whole and in different parts of the
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country and also the rate at which it is increasing in the population at large. We need this information and so do the statutory and voluntary sectors. It is needed to plan for appropriate services and preventive initiatives. Information about the level of HIV in the general population cannot be extrapolated from people who voluntarily seek a named test.
As regards contact tracing, which was raised by the noble Lord, Lord Rees-Mogg, the issue of contact tracing of people with HIV is a delicate one, as the noble Lord acknowledged. There is good evidence that a number of people will not come forward for help if they consider that pressures will be put on them to name their partners. However, there may now be an advantage for people to know whether they are positive or not. It has always been the policy of the staff of genito-urinary medicine clinics to counsel people who are HIV positive on the desirability of informing their partners, but handling must be at the discretion of the staff of the clinics. There can be no doubt that the wishes of the persons concerned are and must remain paramount.
It was also suggested that some doctors might refuse to treat people with HIV positive tests. That is something that we must leave with the General Medical Council, which has indicated that it expects doctors to treat all patients.
I now move to the third main theme, which is funding. I am happy to agree with the noble Lord, Lord Winstanley, that we should be concerned with not so much the funds but what we do with them. I believe it was the noble Lord, Lord Ennals, who referred to the misuse of ring-fenced AIDS moneys by certain regional and district health authorities. I can reassure him that these matters which emerged from the department's scrutiny of AIDS reports have been fully followed up. The authorities in question have taken corrective action. Next year guidance on the use of money will make it quite clear that the virement of money for the purposes of cash management is not acceptable.
Reference was also made to local authority spending being increased by only 4 per cent. That does not take into account the additional help that we have given this year by continuing joint finance money to certain inner London boroughs even though their funding was always due to cease this year. The extra £1 million brings the real additional level of resources to 14 per cent.
We recognise too that the complexity of any future contracting arrangements might affect services for people with AIDS or HIV and therefore we need to ensure that a confidential self-referral system is maintained and that highly expensive services, which in some places are at an early stage of planning and are not yet embedded in the health service infrastructure, are continued and maintained. In response to this we have ensured that the earmarked funding will continue in 1991–92. It will continue to be provided, as now, on a catchment basis rather than on a district of residence basis. A working party will be established to resolve problems of preserving confidentiality and freedom of access to services while operating district of

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residence-based funding—a very important consideration in this area. This should ensure that AIDS services will be in a strong position to flourish and develop in a system of managed competition.
The noble Lord, Lord Ennals, also referred to the local authority associations' officer working group and the removal from it of central government funding. Funding to this group was provided on a pump priming basis for three years, by which time local authorities ought to have developed sufficient concern for AIDS services to be willing to pay for the group themselves. It is sad that they do not want to do so. We are currently considering a bid from the associations for a revised working group. We want to be certain that the work of this group will be taken seriously through the whole country and will influence those who take managed decisions relating to the delivery of services. Officials will be writing to the associations shortly.
A great many questions were asked. Perhaps noble Lords will bear with me as I try to cover as many of them as possible. On the question of AIDS among prisoners, the Government attach a high priority to measures designed to prevent the transmission of HIV in prisons and other custodial settings. To this end two educational packages have been produced and the video AIDS Inside and Out" for prison inmates has been widely acclaimed. Governors have been urged to use it extensively. The Home Office has also encouraged prison administrations to liaise with health authorities in setting up local prevention initiatives for prisoners, including those on release.
Both the noble Baroness, Lady Masham, and the right reverend Prelate sought certain assurances. I can confirm that my colleagues in the Home Office are concerned to ensure that prisoners who are moved from one prison to another do not experience any interruption in their medical care and treatment. Furthermore, Home Office policy for the management and care of prisoners with AIDS envisages that they will be looked after by the prison medical service at times when they are relatively well and removed to an outside hospital during acute phases of their illness.
The PMS has already received co-operation from NHS hospitals in treating the 21 AIDS patients it has had to date. Eight of those patients have died in custody but all were in an outside hospital at the time of death. Seven other patients were receiving care in a hospital or hospice at the time of their release—in some cases early release—from prison. It seems to me that these figures are an encouraging indication that the services concerned are collaborating successfully to ensure that prisoners receive specialised care when they need it and that when sadly they become terminally ill they do not die in prison. I entirely agree that a prisoner has as much right as any other citizen to be able to die with dignity.
In October 1990 the report of an efficiency scrutiny of the prison medical service was published. Department of Health officials participated in the scrutiny and in the steering group which was set up to prepare an action plan. While the report looks at the
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whole of the PMS, it also looks specifically at special groups of prisoners, including prisoners with HIV and AIDS, and should also inform our future discussions.
The effect of stress on the immune system was emphasised by my noble friend Lord Colwyn. He also referred to the place of complementary medicines. I have taken careful note of what he said and will ensure that his remarks are brought to the attention of appropriate people in the department.
The noble Lord, Lord Kilmarnock, asked me, on his extensive shopping list, about the availability of condoms via GPs' prescriptions. I can assure him that GPs are able to prescribe condoms within the known budget limits of their health authority.
On the question of dental transmission of HIV—the United States case—we have received a copy of the report of January this year in which the three possible cases of transmission are discussed. We are seeking expert advice on the possibilities it suggests. As for the National Aids Help Line, to which the noble Lord, Lord Kilmarnock, referred, since 1987 a number of successful and well regarded telephone information and advice services have been in place to provide free and confidential information to anyone in the United Kingdom concerned about HIV and AIDS. Most notable amongst these is the National Aids Help Line, operating from London and Glasgow, which is available 24 hours a day, every day. In 1990 it received nearly ¾ million calls. The help line and the other services are an invaluable and essential adjunct to the public education campaign work.
The noble Baroness, Lady Masham, made a number of points about the importance of community nurses and the vital part they can play as part of a co-ordinated response to AIDS. I shall write in detail on the points raised but I should like to make it clear that we in government share her appreciation of the key role of the community nurse in the delivery of effective community care to people with AIDS. My noble friend will also be interested to learn that we have commissioned seven educational videos for nurses in this respect. They are highly regarded.
On counselling, we have funded a joint study by the British Association of Counselling and the University of Durham to report on the availability throughout the country of counselling services for people with HIV or AIDS and to make recommendations as to training and management. The study was started in January 1990 and is due to be published this spring. We shall consider its findings carefully.
On the question of AIDS and employment, guidance was produced in March of last year which refers to the dismissal point brought up by the noble Lord, Lord Winstanley. I can certainly supply him with a copy of the document.
In case I have not covered all the questions raised —that is quite possible since there were so many—I can assure the House that I shall study Hansard carefully and ensure that all the issues are considered within the department or, where appropriate, brought to the notice of other departments, bodies and individuals concerned. Much has been done in this

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difficult and crucially important area of health but as a result of the debate we are all more than ever aware that much remains to be done.
7.58 p.m.
Lord Kilmarnock: My Lords, I should like to express my gratitude to all noble Lords who have spoken in the debate. I express that gratitude not only to those who have spoken but to those who have listened. We have had quite a large number of listeners, which has been very encouraging indeed. I should like too to apologise for having told noble Lords who excused themselves to me for arriving late that I thought the debate would start at six o'clock, which is what I was informed would be the case. Their lateness is partly my fault.
There was one omission from my shopping list. The noble Baroness cannot reply to it now but I want to put it on the record. I skated over it because I thought I was running out of time. I refer to the tardy settlement of the claim of the haemophiliacs infected by contaminated blood products. I say no more about that because obviously we very much welcome the Government's conversion to the ex gratia payment. But there is also the further point in relation to non-haemophiliacs who were similarly infected through blood products or transfusions. I believe that the cost of compensating them would be in the region of 4 to 5 per cent. of what will be paid out to the haemophiliacs. The principle does not seem to be different. The effect on them and their families has been no less devastating than on the haemophiliacs and their families. I very much hope that the Government will look at that point again.
On the question of insurance, which, as the noble Baroness said, was one of the themes of the debate and which was ably introduced by the noble Viscount, Lord Falkland, and referred to by the noble Lords, Lord McColl and Lord Butterfield, I am encouraged to hear that Mrs. Bottomley is pursuing the matter seriously with the industry. In my view, the situation is most unsatisfactory. I say that because there are many reasons why people may take such a test; for example, responsible young people may wish to take the test prior to getting married, as may someone who has had a blood transfusion, possibly abroad. The fact that taking such a test may be marked against them by potential insurers is a great mistake. I very much hope that the Government will pursue the matter vigorously. I should point out that the matter was solved in the Netherlands by the government threatening to impose legislation. Perhaps a handy little draft Bill stored safely somewhere may be helpful in securing success in the negotiations with the industry.
I agree with the right reverend Prelate, who said that we should not concentrate only on "safer sex". He acknowledged that this is the responsibility of the Government as they are responsible for health, though not responsible for morals. Then, as I expected him to do—and quite rightly —he went on to advocate the other track of chastity and faithfulness. I commend to your Lordships that we should approach the matter
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on a dual-track basis; that is, that the Government should do their business, which is related to public health, and the Churches and other ethical bodies and individuals should do their business, which relates to private morality. If we approach the problem on that twin-track basis, we are much more likely to succeed. I hope that the Government noted the right reverend Prelate's rather moving remarks on the extension to the Brixton prison hospital and his idea for a hospice for prisoners.
The noble Lord, Lord Colwyn, seemed to be criticising me for not having arranged a meeting for him at which he could air his views on natural medicine. I should like to put on record the fact that, if he chooses to approach me, I shall be happy to do so, provided that he is prepared to speak at such a meeting.
I am extremely grateful for the tributes that have been made to me and to the all-party group. I believe that one such tribute came from the noble Lord, Lord Winstanley. I should point out to him that, according to my recollection, the pre-history of the group was that it emerged from a small causerie of doctors which he himself organised in the very early stages, when we knew nothing of the disease, in order to inform us about it. Therefore, if anyone is the real progenitor of the group, it is the noble Lord, Lord Winstanley.
I was glad to hear the noble Baroness say that the Government are dedicated to curbing the spread of the disease both in this country and abroad. She actually used the word "abroad" and I believe that that probably relates to the work of the ODA in the horrifying conditions in Africa about which we heard from the noble Lord, Lord Rees-Mogg, and the right reverend Prelate.
The noble Baroness set out some of the Government's achievements. She was quite right to do so. I should like to pay tribute to them. As she said, she could not possibly deal with all the points raised during the debate, but no doubt she will write to us on those that were left unanswered. On the education aspect of the matter, I made one or two additional points about whether we could harness the efforts of school governors and parent governors. I hope she will follow them up.
As regards funding, the noble Baroness referred to the fact that no virement of ring-fenced funds would be permitted in future. I welcome that statement. I also hope that she will consider the point I made about looking at a possible new distribution formula for ring-fenced funds. I think that I was glad to hear what she said on the issue of open access clinics in the genito-urinary medicine field. She said that they would be continued and maintained. I believe that the words which fell from her lips were that they would be maintained on a catchment-area basis. Obviously we shall look at that proposal. It is indeed an important matter, to which reference has been made many times in your Lordships' House. We simply must keep such clinics going. I shall read what she has said with care.
I shall not make another speech, as I do not wish to take up any more of your Lordships' time. However, I should like to repeat my thanks to all speakers who have taken part in the debate and all noble Lords who

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have listened. I should also like to thank the noble Baroness for making a truly memorable effort to meet all our anxieties. I am sure that she will be writing to us to cover all the points which she was not able to deal with tonight. I beg leave to withdraw the Motion.
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Motion for Papers, by leave, withdrawn.
House adjourned at five minutes past eight o'clock.