Lords Sitting of 19 February 1992

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

Training and Enterprise Councils
Lord Dormand of Easington Lord Dormand of Easington asked Her Majesty's Government:
Whether they are satisfied with the progress being made by the training and eterprise councils.
Baroness Denton of Wakefield: My Lords, the Government are very satisfied with the progress being made by training and enterprise councils. TECs are turning their ambitious training and enterprise plans into practical action to improve training and business services in every part of the country.
Lord Dormand of Easington: My Lords, is the Minister aware that many of the TECs face a critical situation—and that is not an overstatement of the case —due to inadequate funding? Is she also aware that, as a result, there is a distinct possibility that the councils may not sign a contract with the Government for next year? Does not the continuing increase in unemployment make the problem even worse?
Baroness Denton of Wakefield: My Lords, I hesitate to say this, but I think that the noble Lord exaggerates the situation. It is speculative; negotiations for next year are still taking place. If we appoint leading and competent businessmen to run the training and enterprise councils, which they are doing with great commitment, we must also expect them to negotiate toughly with the regional officers.
Baroness Turner of Camden: My Lords, is the Minister aware that a recent report by the Association of Municipal Authorities states that, although some TECs have established themselves very well locally, others appear to be in decline? The reason appears to be financial pressures, exacerbated by unemployment. In the present situation many employers are unwilling to offer placements. Can the Minister say what can be done about the situation?
Baroness Denton of Wakefield: My Lords, I am unaware of the source to which the noble Baroness referred. However, TECs are accounted and measured. There is great concern that they should provide —as they were set up to provide—needs totally adapted to the local areas that they are servicing. That was the idea behind their formation. There is a total commitment on the part of the Government that training money should follow the needs of unemployment.
Baroness Seear: My Lords, in view of the report chaired by Professor Fred Bayliss, under the auspices of the National Council for Voluntary Organisations, which made it very clear that special training needs are
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not being met, what evidence does the Minister have that TECs are able to meet the training needs of special needs groups? If that was the situation six months ago when the report was issued, can the noble Baroness tell us how those needs will be met with the reduced funding which the TECs are receiving?
Baroness Denton of Wakefield: My Lords, there is a direct relationship between financing and the TECs meeting special needs. There are performance related bonuses which require TECs to achieve special targets on special needs before the payment is made. Therefore, their attention is very much focused on the matter. There may have been delays in some areas, but they are now being dealt with.
Lord Donaldson of Kingsbridge: My Lords, can the Minister assure the House that we shall not see similar cuts to those made last year as regards training for special needs? For example, NACRO had to cut 7,000 job training positions and stop 24 schemes. Is the noble Baroness also aware that people who have special needs, and who are therefore very unattractive to businessmen running schemes which are meant to balance, are finding it increasingly difficult to receive any training at all?
Baroness Denton of Wakefield: My Lords, I understand the noble Lord's concern. However, I believe that there is a climate out there within which businesses are recognising their responsibilities to the community. As I said, there is a definitive contract commitment to work in this area. The Government are planning to spend £2.8 billion on training, enterprise and vocational programmes.
Lord Mottistone: My Lords, is my noble friend aware that in the Isle of Wight the TEC is largely achieving the kind of aims that she told the noble Baroness, Lady Turner, she was hoping would be achieved? Is my noble friend also aware that, although they have had difficulties—as indeed everyone has—on the whole, both industry and the TEC are working well together, as they are with other local authorities?
Baroness Denton of Wakefield: My Lords, I thank my noble friend for that comment. Bearing in mind its situation, the Isle of Wight does not have one of the largest TEC budgets. However, my noble friend has emphasised the ability of TECs to work in partnership with education departments, local authorities, career services, employers and, where relevant, development corporations. The success is to be seen in many areas.
Baroness David: My Lords, is the Minister aware that, when a TEC from Cheshire gave evidence to EC Sub-Committee C about training, there was then a problem about having enough money to transport people, especially in rural areas, to places where they could receive such training? If the TECs are now even more short of money, will that not become a greater problem in the future?
Baroness Denton of Wakefield: My Lords, the TECs have their budgets agreed from their corporate plans. Therefore, it is for them to decide the effective use of those finances.
Lord Hylton: My Lords, can the noble Baroness confirm that at present in the county of Somerset there are about 500 17 and 18 year-olds without places on training schemes who therefore receive no social security and consequently get into trouble? What do the Government propose to do about that situation?
Baroness Denton of Wakefield: My Lords, I do not have evidence relating to specific areas, but I know that estimating the demand for the programme in specific areas has been somewhat difficult. Young people's true preferences have been hard to judge. It is clear, however, that the number of young people who are currently waiting to enter youth training is now considerably smaller. The Government are adjusting the figures to meet the needs.
Lord Rochester: My Lords, is it not regrettable that just after it has been announced that there has been an increase of 53,000 in the number of people who are unemployed, the Government have decided to reduce expenditure on training next year by £170 million in real terms? Can the noble Baroness, Lady Denton, deny that training and enterprise councils are most concerned about the little money that is available to them to finance both youth and employment training? I believe that the figure is £110 million.
Baroness Denton of Wakefield: My Lords, I have heard quoted the figure that the noble Lord has given of a reduction. However, the TECs' budget for next year will be increased by £196 million. The concern of their chairmen is part of their negotiating skills. Nevertheless, the turnover among those chairmen is lower than that in many parts of the private sector.
Lord Dormand of Easington: My Lords, perhaps I may assure the Minister that I am not condemning all 82 TECs. I am simply saying that many of them face a critical situation and that the Government are not facing reality. Will the Minister confirm that her department is transferring resources from the northern TECs to the southern TECs?
Baroness Denton of Wakefield: My Lords, I am happy to confirm that the principle behind the resources is that they follow the need of the clients' location. If the noble Lord is referring specifically to his region, one must also draw attention to the other resources in that region, including the development corporation, in which the noble Lord is involved and which has made substantial efforts in training. One must also say that the area is alive and well. It must be pleased to be celebrating the award of its new city status.
Lord Dormand of Easington: My Lords, the answer is yes.

House of Lords: Sitting Times
2.46 p.m.
Viscount Mountgarret Viscount Mountgarret asked the Leader of the House:
Whether a Select Committee could consider the sitting times of the House so as to permit legislation to be considered earlier in the day.
The Lord Privy Seal (Lord Waddington): My Lords, my noble friend will be aware that a Select Committee in another place has been looking into the sittings of the House of Commons. In addition, the report of our own Select Committee on the Committee Work of the House will be published shortly. Of course, it is within the power of this House to establish whatever committees it wishes—or indeed to change its sitting time without first setting up a committee—but it might be thought sensible to wait for each House to consider their respective reports before looking into my noble friend's suggestion.
Viscount Mountgarret: My Lords, I am grateful to my noble friend for that reply. Will the committee in question consider various matters? Is my noble friend aware that this unelected and largely unpaid House sits more hours and does more work than any other legislative chamber in the whole world other than another place? Does my noble friend agree that it helps the workings of the House if its voluntary element has a reasonable degree of knowledge of the business that is taking place? Does my noble friend further agree that there are many times when the programme is organised but, unfortunately, starts so late in the day that proper consideration cannot be given to it? The business is then deferred to another day, when it might be highly difficult and inconvenient for Members of your Lordships' House to attend.
Noble Lords: Speech!
Viscount Mountgarret: My Lords, perhaps I may draw my noble friend's attention to the Charities Bill, which we began to consider on a Thursday afternoon at 3.30 p.m. and which was designed to be finished in one day, but we then had to start it again at seven o'clock yesterday evening with no fewer than 105 amendments to consider. Does my noble friend agree that that is probably undesirable?
Lord Waddington: My Lords, I think that all noble Lords will agree with me when I say that the House is richer for having among its Members noble Lords who do very important jobs in society. We might lose the benefit of their wisdom if we were to sit in the mornings. However, difficult decisions have to be made.
So far as the two committees are concerned, I referred to the committee that is chaired by my noble friend Lord Jellicoe not because it is charged with the duty of considering the hours for which we sit in this Chamber, but because that committee is dealing with the committee structure. For that reason, it might be thought premature to set up a committee as was suggested by my noble friend. Of course, it is not for us to suggest what should be within the terms of

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reference of the committee that was set up in another place, which I understand is due to report on Friday this week.
Lord Cledwyn of Penrhos: My Lords, is there not every possibility that when the report of the Select Committee chaired by the noble Earl, Lord Jellicoe, is published we shall be able to debate it in the House? Secondly, does the noble Lord agree that the reference of the Charities Bill to a Standing Committee, which sat in the morning, was on the whole a success?
Lord Waddington: My Lords, I agree strongly with what the noble Lord, Lord Cledwyn, said about the Committee stage of the Charities Bill. Clearly, it is worth us considering carefully—it was not really an experiment—that attempt to make greater use of the Committee proceedings of the House. We shall all await with interest the report of the committee in another place. We are all grateful to my noble friend Lord Jellicoe for the work that he has done.
Lord Monson: My Lords, does the noble Lord the Leader of the House agree that if the House were to start sitting in the mornings regularly on a daily basis there is a distinct danger that Parkinson's Law would come into play, with the volume of debate expanding to fill the extra time available?
Lord Waddington: My Lords, the noble Lord has a good point, if I may say so. There is always the danger that if we were to sit earlier the House still would not rise that much earlier in the evening. However, we are a long way from that. All we are concerned with today is whether the matter should be studied at all in advance of the publication of the two reports to which I have referred. I suggest that it is far better for us to restrain ourselves for just a few days and then we may have an opportunity to debate the report of the committee that has sat under the chairmanship of my noble friend Lord Jellicoe. That—I say this in answer to the noble Lord, Lord Cledwyn—will be initially a matter for discussion through the usual channels.
Earl Jellicoe: My Lords, is my noble friend aware that I am most grateful to him and the noble Lord, Lord Cledwyn, for the kindly remarks they made about the committee which I have the honour to chair? I agree with what my noble friend said about restraint at the moment. Perhaps I may inform my noble friend Lord Mountgarret that I believe that the report of the committee will be published on Thursday week. I recommend it as a suitable bed companion to any of your Lordships who suffer from insomnia.
Lord Waddington: My Lords, we are all grateful to my noble friend Lord Jellicoe for giving us that information. I believe that the Jopling Committee Report will be published the day after tomorrow. I am grateful to my noble friend for telling us when his report will be published.
Lord Shackleton: My Lords, now that the noble Lord the Leader of the House is aware that the noble Earl, Lord Jellicoe, has finished his first task, should he book him now, before he goes away, to do the study for which the noble Viscount asked?
Lord Waddington: My Lords, the thoroughness with which my noble friend has approached the task which he was set has condemned him to many more similar onerous duties.

EC: Fish Catch Regulations
2.53 p.m.
Lord Bruce of Donington Lord Bruce of Donington asked Her Majesty's Government:
Whether, in respect of the submission to the European Communities of nominal fish catch statistics by member states fishing in the North-East and North-West Atlantic, as required by Council Regulations 3880/91 and 3881/91 of 19th December 1991, they will provide the estimated cost, and the administrative steps necessary, to ensure compliance.
The Minister of State, Ministry of Agriculture, Fisheries and Food (Baroness Trumpington): My Lords, the United Kingdom has been compiling this information both for its own purposes and to submit to international bodies for at least 20 years. These regulations convert long-established practice into Community legislation so that the Commission can meet its obligations under certain international conventions. It is not envisaged that compliance with the regulations will require additional costs or administrative steps for the United Kingdom.
Before I sit down I must offer the noble Lord, Lord Bruce of Donington, who is aware of my position, a deep apology. I apologise also to the House. Owing to circumstances beyond my control, I am not in a position to give supplementary answers today. I very much hope that the noble Lord, Lord Bruce of Donington, will put this Question down again when one of us will satisfy him to the best of our ability.
Lord Bruce of Donington: My Lords, I am most grateful to the Minister for her response and for her indication that the Government take these matters seriously and that they will give a considered reply. Will she undertake to bring to the attention of her right honourable friend that the real matters requiring answers relate to why some 31 pages of European regulations should be allowed by the Government to become incorporated into British law, especially in view of the fact that the information which the United Kingdom is now required to give to the European Commission is readily obtainable by the Commission picking up the telephone and speaking to the international organisations involved? Will the Minister also convey to her right honourable friend the fact that this country contributes some £9 million per annum towards this statistical section of the Community to enable it to gather information? Will she ask her right honourable friend whether he is satisfied that what the British taxpayer spends on this silly legislation is justified?
Baroness Trumpington: My Lords, I have taken note of the various points made by the noble Lord, and I shall pass them to my right honourable friend.

Legal Aid
2.56 p.m.
Viscount Hanworth Viscount Hanworth asked Her Majesty's Government:
Whether they will widen the scope of legal aid to assist those who otherwise could not meet the costs of defending an action in the High Court.
The Lord Chancellor (Lord Mackay of Clashfern): My Lords, legal aid is available to those defending an action in the High Court, provided that the Legal Aid Board is satisfied that there are reasonable grounds for defending the action and that the applicant's disposable income and capital are within the financial limits. The Government are concerned about those individuals who may be financially ineligible for legal aid yet who face high costs. They made various proposals for dealing with that problem in the recent consultation paper on eligibility for civil legal aid.
Viscount Hanworth: My Lords, I thank the noble and learned Lord for that reply. Does he agree that there nevertheless remains the problem which was encapsulated in my Question? I believe that he does. Secondly, will he confirm that everyone has the right to defend himself or herself in the High Court unless he or she is a vexatious litigant?
The Lord Chancellor: My Lords, I agree that there is a problem, and that is why the Government addressed it in the consultation paper to which I referred. On the second point, I confirm that any person has the right to defend himself or herself in the High Court.
Lord Hailsham of Saint Marylebone: My Lords, will my noble and learned friend confirm my belief that if a defendant wins his action against a legally aided plaintiff he receives his costs?
The Lord Chancellor: My Lords, there is a statutory limitation on the liability for costs for which the legally aided person may be liable. The court has to have regard to all the circumstances in assessing the amount of any liability. There are some circumstances in which the successful opponent of an assisted person may be able to have his costs refunded from the Legal Aid Board.
Lord Airedale: My Lords, is the noble and learned Lord aware that many of us in the House deplore the unruly and disorderly manner in which certain lawyers saw fit to receive his announcement of proposed changes to the legal aid system?
Noble Lords: Hear, hear!
The Lord Chancellor: My Lords, while I appreciate the sentiments that the noble Lord has expressed, that matter is somewhat wide of the Question on the Order Paper.
Lord Mishcon: My Lords, the House may be assured that I was not one of the lawyers involved. I am sure that the noble and learned Lord will agree that there is a problem as regards not only those who wish to defend actions in the High Court but those
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who rightfully wish to bring them. Is the noble and learned Lord aware that the Law Society and the Legal Action Group commissioned a survey last year as a result of which it was found that eligibility for advice and assistance dropped from 66 per cent. of the population, representing 36 million people, in 1979, to 37 per cent of the population, representing 20 million people, in 1990?
In personal injury cases, where as the noble and learned Lord knows the income limit is higher, in 1979 81 per cent. of the households were eligible. The figure has fallen to 57 per cent. in 1990. Is that not a worrying situation?
The Lord Chancellor: My Lords, these figures are estimates based on various assumptions. The reliability of the estimates depends on the accuracy of the assumptions, and many such assumptions can be made. While I read with interest the mathematics that lie behind these estimates, I am more concerned with what actually happens—the real figures. For example, in 1979–80, about 191,000 civil legal aid certificates were issued. By 1991, the figure had increased by 56 per cent. to over 297,000. It is clear that many more people today receive the benefit of legal aid than received it in 1979.
Lord Boyd-Carpenter: My Lords, will my noble and learned friend tell us what is the total expenditure on legal aid this year compared with what it was five years ago?
The Lord Chancellor: My Lords, the gross expenditure on legal aid for this financial year appears to be in excess of £1 billion. The figure has risen by more than 50 per cent. over the five-year period.
Lord Mackie of Benshie: My Lords, will the noble and learned Lord tell us whether the productivity of the legal profession has risen with the enormous rewards it receives?
The Lord Chancellor: My Lords, I believe that that question also is somewhat wide of the Question on the Order Paper.
Lord Mishcon: My Lords, in the light of the Question on the Order Paper, is it not the case that the problem is not that the poor may be suffering, as they may be covered, or that the rich are suffering, as they can afford it? Is not the real problem the people who come between the poor and the rich?
The Lord Chancellor: My Lords, there is no problem for those who are so wealthy that they can afford the fees they may be charged. The president of the Law Society last year warned his members that if they were involved in litigation they would not be able to afford their own fees. The situation of those in the intermediate level between what the noble Lord described as the poor and the rich is a problem. That is what our consultation paper addressed. It is difficult and so far as I know the problem has not yet been solved in any country in the world which has a legal system remotely like ours. In the consultation paper I

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put forward a number of proposals for solving the problem. None is ideal but I hope that we shall be able to make progress with it.
Lord Cocks of Hartcliffe: My Lords, the Question refers to the costs of defending an action. Is it not time that we looked closely at the charges of the legal profession? It has seemed to me since I came to the House that it is the strongest trade union in the country.
The Lord Chancellor: My Lords, I am interested, particularly on behalf of taxpayers, in the costs involved in litigation. The noble Lord will be aware that securing changes is not the easiest task with which I am confronted.

Business
Lord Hesketh: My Lords, after the short debate on the National Health Service and before the short debate on the public library system, my noble friend Lord Howe will, with the leave of the House, repeat a Statement that is to be made in another place on defence equipment.
I should like to say a word about this afternoon's debates standing in the names of the noble Lords, Lord Hunter of Newington and Lord Willis. As the mover is allowed 15 minutes and the Minister should rise to reply not less than 20 minutes before the scheduled end of the debate, in the case of the debate in the name of the noble Lord, Lord Hunter of Newington, it means that all other speeches should be limited to a maximum of nine minutes. If any noble Lord should speak at greater length he would do so at the expense of subsequent speakers in the debate. In the case of the debate in the name of the noble Lord, Lord Willis, the number of speakers is such that it is not necessary to propose a formal time limit but I am sure that noble Lords will agree that it would conform to the spirit of these short debates if they would keep their speeches within the 15 minutes which apply to the mover of the Motion.

National Health Service: R&D
3.5 p.m.
Lord Hunter of Newington Lord Hunter of Newington rose to call attention to the importance of research and development for the future of the National Health Service; and to move for Papers.
The noble Lord said: My Lords, major reforms were embedded in the National Health Service Act 1990. At the same time, the Government accepted the substance of the House of Lords Select Committee report on research in the National Health Service and decided to appoint a director of research and development and that he should be a member of the NHS management board. I am sorry that the noble Lord, Lord Nelson of Stafford, is not here today. As chairman of the Select Committee he has achieved a great deal and the success, I believe, is substantially due to him.
It is my intention to argue the case that the new research and advisory machinery introduced by the director should produce the information for change and also information about the cost of procedures. I have spoken to a number of consultants in different parts of the country and I do not think there is any doubt that he has stimulated them enormously and they are looking forward eagerly to participating in the schemes which are now being formulated.
There is no mention in the reforms that implies rationing of care, yet many are worried that we cannot continue to provide resources to meet health needs. Some of our health economists are thinking about these matters and the whole question of consensus rationing is being considered. I shall mention this again later.
At present authorities make decisions about the allocation of resources to different categories of care. Doctors decide about allocation to individual patients taking into account their detailed personal and medical circumstances. The size of the waiting list may mean that resources are not immediately available. The nature of the waiting list will be an important signal as long as this facility is available. If it is not available, the demand for adequate resources will be immediate.
Among the important challenges for the future there are two serious conditions that occur frequently. One is heart and vascular disease, the other cancer. Both have been linked to diet and personal habits, so much so that we are now urged to eat healthy foods and conduct our life-style in healthy ways.
Formidable problems have existed over past years and many of the specific causes of diseases have been discovered. When that has happened steps can be taken to treat or prevent the condition. One example is that we know that scurvy is due to a deficiency of vitamin C and that the first discovery of importance was that the juice of limes cured the condition. But the other factors supposed to contribute to the situation before this discovery bear a remarkable resemblance to today's cancer list. Here are some examples: diet, depression, infection, tobacco, damp, constitutional heredity and poor environment. All had supporters but scurvy was due only and entirely to a vitamin deficiency. That must constitute an important lesson for other fields such as the cancer field.
Inevitably, cancer and heart disease will present themselves as a challenge to the director and his staff. There are, of course, proven causes of cancer such as smoking and various chemicals, but what of the cancers thought to be associated with food intake? Overall there is insufficient evidence to recommend reducing fat or food consumption with the aim of reducing the risk of cancer. Yet the nature of cancer varies in different parts of the world where there are different lifestyles and environments.
The results of various investigations have suggested that a range of dietary measures have an impact on cancer, but the evidence of these factors is not conclusive enough to warrant recommendation. This is the view of the Royal College of Physicians. However, Sir Richard Doll in his book The Causes of Cancer links no less than one-third of cancers to diet.
The analysis of statistics around the world reveals that the incidence of different cancers is different in different countries—for example, breast and colon cancers occur in western society and stomach cancers in Japan. This could suggest that the cause must lie in some difference between societies, the most obvious of which is diet. The temptation has become overwhelming, and has spread rapidly in some sections of the medical profession, to suggest that food causes cancer and therefore the thing to do is to eat healthy food. The healthy food lobby has taken off and it is now considered to be part of the "new public health".
Attempts to treat vascular disease with diet, particularly through the control of sodium intake and low cholesterol diets, have not been very successful. To confirm that view one needs only to read the weekend's newspapers and last week's British Medical Journal. Certainly it is possible to reduce the salt to low levels with some alteration in blood pressure, but the consequences of this are uncertain. We also know that the cholesterol situation is more complicated from the biochemical point of view than was first thought. In contrast to this lack of progress in the treatment of vascular disease, remarkable progress has been made in the surgical treatment of vascular disease and this illustrates another important issue which faces the director of research and which requires monitoring and costing.
Ten years ago surgery was considered to be of limited use in the treatment of coronary artery disease and it was thought that perhaps treatment should be confined to those under the age of 50. Now it is known that satisfactory results can be achieved in respect of people in their 70s with reasonable life prospects. There is other evidence also to support the idea that age is no longer a contradiction to major surgery.
I wish to ask the Minister what machinery has existed in the past and whether it is suggested now to monitor situations where new or extended treatments are introduced, often at substantial costs. At least now it will be possible to have this kind of situation studied and to have the results of those studies placed before the management board and the health authorities. The situation can also be analysed from the point of view of the provider of equipment and accommodation. As I said, there is an increased awareness among staff at all levels as to the importance of these studies. I understand that the machinery to implement the studies will shortly be in place. The discovery and identification of treatments and their improvement is a vital part of an active dedicated service.
I wish to return briefly to the question of consensus management and of resources. The essence of the reforms under the 1990 health Act is the separation of the functions of purchasing health care by health authorities from the provision of care by providers such as hospitals or others. The two are linked by contracts. This has shifted some of the power to prescribe how resources will be allocated from doctors and nurses in favour of managers and health authorities. At the same time it is recognised that only doctors and nurses acting as general managers can really manage the use of resources for patients. It is
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obvious that to achieve a successful and efficient running of the NHS there should be a willing partnership between professional activity and management.
In 1972 I chaired a working party in the Department of Health which made recommendations about medical administrators in the NHS. Recommendations were made on how medical men could be retrained and how they could become involved in administrative matters. The response of the Government was to introduce a form of consensus management; at that stage it constituted an agreement between those providing the actual care. But for one reason or another this did not produce any real solution to the problem. I now believe this requires a two tier system with doctors represented at both levels. The system of providers and purchasers introduced by the Government in 1990 involves an element of financial control contributed to by managers and doctors at two levels. This does not go as far as the Oregon proposals in the United States which remove responsibilities from doctors and nurses by legislation and prevent treatment of certain categories of patients.
Some people have linked the concept of consensus management with the idea of quality adjusted life years (QALY) as a basis for allocating resources not to patients but to the more cost-effective procedures. Such a procedure removes from the individual doctor the possibility of making decisions only in the interests of the patient. I believe that the use of quality adjusted life years as a means of allocating resources is wrong.
From the early experience of the newly-introduced system under the 1990 Act, though there has been, as I have said, some shifting of power in the allocation of resources in favour of managers and health authorities this is relatively modest and I believe fully justified by the results. The medical profession does not object, as it undoubtedly would, to a number of other procedures that I have mentioned. The House would like to hear the Government's view on these matters, particularly on the matter of quality adjusted life years. My Lords, I beg to move for Papers.
3.19 p.m.
Lord Holderness: My Lords, we all owe a great debt to the noble Lord, Lord Hunter of Newington, for starting a debate in the course of which I hope the sum total of speeches will provide useful guidance to the Central Research and Development Committee. I speak only too obviously as a layman but one who has become convinced over the years of the important doors which health research has already opened for the health profession. I am also aware of the handicaps under which doctors and those in other disciplines work while many doors still remain firmly shut.
Research has an obvious part to play—the noble Lord, Lord Hunter, has already made this clear—in the prevention of illness and injury, and still more in their acute treatment. It equally has a role to play in the subsequent attempt to restore function which illness or injury has impaired. Therefore I wish to speak about rehabilitation research, and for two main

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reasons. First, I believe it can provide benefits equal to those gained through research into prevention or acute treatment. Secondly, this area of research, having suffered much neglect, now shows some signs of improvement. The number of relevant research papers is growing. Contributors to them come from a wider range of disciplines. In addition, half the membership of the important Society for Research in Rehabilitation is non-medical. That is important because collaborative research between disciplines has a value which goes beyond its contribution to the total amount of knowledge.
The contribution itself is of enormous importance. It ranges from the urgent need which we all recognise to reduce costs, both human and financial, right through the social claim which disabled people rightly make to play a greater part in the nation's activities, to the potential transformation of quality of life by more enlightened methods of rehabilitation and the availability and affordability of complex technological equipment.
Only a few days ago I was discussing the vast toll, both in human suffering and economic loss, exacted by disorders (often barely tolerable) in the functioning of our backs. Sadly, that is only one example of hundreds of afflictions which cause misery to those who suffer and to those who care for them as well as imposing a growing burden of cost on the nation.
Among all the conflicting claims there is no escape from the difficult task of setting priorities, not only between the different stages of health care—prevention, treatment, rehabilitation—but also between a goodly number of competitors in rehabilitation research alone.
My noble friend will know that many ideas have been put before her right honourable friend and her honourable friends in her department by the neurological charities and many others in their response to The Health of the Nation. To a layman it is all too evident that the right ordering of priorities for research presents a real challenge.
In that connection, I look with some confidence and even more hope at the fairly young Central Research and Development Committee of which I spoke earlier. In particular, in the context of the field which I am discussing, I look to my friend Professor Lindsay McLellan, one of its distinguished members and a champion of the claims of disabled people. I shall be surprised and disappointed if he does not press strongly for research for their benefit to be lifted high on the council's agenda.
I hope—but this may merely reflect the natural inclination of a layman—that careful consideration will be given to those areas of research which include a clear practical content. Such research would include, for instance, projects which are directed towards developing a man or woman's capacity for employment; towards enabling more disabled people to remain in their own homes; towards the recruitment of more therapists (which is a very urgent need); towards widening the skill and expertise of carers who look after the disabled; and towards
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providing a new stimulus for those in a position to produce much needed equipment, both simple and sophisticated.
Recent developments and news of changed attitudes, at a variety of research levels and across a spectrum of different disciplines, give me some grounds for hope. I shall be greatly encouraged if my noble friend, when she replies, can assure me that my hopes are well founded. In particular, I hope that she can assure me that Her Majesty's Government will give enthusiastic backing to rehabilitation research and development both through the Central Research and Development Committee and through the department's own programme. I understand that several of that programme's themes to which the department has recently given priority (and I speak particularly of research into the development of community care) could be of deep significance to disabled people.
3.24 p.m.
Lord Rea: My Lords, I should like to thank my noble friend Lord Hunter for choosing this topic because it allows the House to reflect further on the work of the Select Committee of the House which looked into priorities in medical research with particular reference to the needs of the National Health Service.
Noble Lords will remember that the Select Committee's report was published in March 1988. The Government finally responded to that report some 18 months later in December 1989. However, they rejected our central proposal to create a National Health Service research authority independent of but linked to the Department of Health which could ask its own questions. Instead, as my noble friend said, the Government have created the post of Director of Research and Development, the holder of which has a seat on the National Health Service Management Executive. That was achieved after some pressure, particularly during Questions in this House.
From the programmes developed under the aegis of the new DRD, Professor Michael Peckham, as described in the Government's document Research for Health, which was published in September last year, it appears that the research programme for the National Health Service, which sounds very ambitious, will be under the general control of the Department of Health, however devolved to regions the conduct of that research may be. The plans set out in that document place much emphasis on the delegation of the research and development to the regions with the aim of increasing overall the percentage of expenditure on research and development to 1.5 per cent. of the total National Health Service budget over a five year period.
I find it very hard to believe that that is feasible given that the Select Committee found that the National Health Service spends only 0.2 per cent. of its budget on research and development at present, based on a sum of £40 million. That sum was stretched to £60 million by a report on research in the National Health Service by the Parliamentary Office of Science and Technology. That still does not bring the

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percentage to very much more than 0.2 per cent. of the budget, whereas figure 2 in the department's document estimates expenditure on research and development by the National Health Service and the Department of Health at £225 million in 1989–90—about 1 per cent. of the whole. I can only suggest that that larger sum has been arrived at because some of the items included in that figure are not strictly research activities and possibly not strictly funded by the National Health Service. Be that as it may, an increase to 1.5 per cent. over a five year period requires a major expansion of research activities, particularly if we take the present percentage to be 0.2 per cent. rather than 1 per cent. as suggested in the document.
I wonder whether the Government are not being a little unrealistic. Good research and development into the workings of the National Health Service cannot be achieved overnight. There are relatively few research workers who are experienced and competent in health services research because there are only a few centres of excellence in the country which attract staff of the right calibre and train them in the methodologies required.
An essential characteristic of health services research or public health medicine research is that, to be effective, it has to be a team effort. The team must be multi-disciplinary. For example, when inquiring into the reasons why patients behave as they do or use services in a certain way it is not sufficient for research to be designed or carried out by clinically trained doctors alone. There is also a need for input from behavioural scientists such as anthropologists, medical sociologists, psychologists as well as health economists, demographers and statisticians.
To build a team of such experts requires time and patience. The stability of the unit housing the team is important because each of the experts comes from a different home discipline. If they are not given security in their health services research unit they will tend to desert it and go back to the security of their own academic base. That is why the committee put emphasis on the creation and funding of research programmes lasting over a period of five to 10 years or more with a guaranteed core funding element rather than projects which are temporary and intended to answer specific questions.
For that reason I hope that the noble Baroness will be able to assure the House that programmes of research will be backed and not merely projects. The Select Committee felt that it was important to build on the three or four existing centres of excellence in health services research which could act as nuclei for the training of future researchers as well as administrators who would then have a real grasp of the dynamics of how health services operate. In the Government's document I do not see any recognition of the fact that health service research workers need to be trained.
In that document there is a directive that each region should appoint a director of research and development and that regional R&D plans should be published by September this year. I am worried that such plans may be put together hurriedly and without adequate reflection. Are there sufficient high caliber
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candidates to supply all the regions in such a short time? Academic units will have to be consulted when drawing up such plans. I very much hope that they will be consulted; otherwise, even more data may be collected—which is hard to conceive of—without any clear purpose. It will be called research rather than simply the collection of statistics.
Turning from what sounds a rather critical remark, I understand the need for information technology. Some of the information that has been collected about health service activities since the new Bill became an Act has been useful. But there is a lot of work involving data collection which we could do without. I have a feeling that if the target of 1.5 per cent. NHS expenditure is reached too hurriedly the money may not be well spent. At worst it may even detract from patient care rather than improve it because of a diversion of funds. There is an impression that some of the best academic units in public health medicine in primary care will still be struggling for survival when public funds may be spent on relatively low quality research in the regions to achieve regional research and development targets. I very much hope that I am wrong. I plead for full support and collaboration with the few centres of high quality health services research that exist. I mention no names. I could do so but that would be invidious at this stage.
I should like to ask the noble Baroness two questions. Does she know of any definitive research which has been commissioned to follow up the recent questions raised by the department's inquiries into health care needs? There were some five or six, including diabetes, stroke, hip replacement, renal problems, and so on. Many of us are critical of the Government's decision to press ahead with the NHS reforms in advance of any pilot studies. We were assured that the first wave of trusts or fund holders would be studied and would act as pilot schemes. Can the Minister tell us how the National Health Service changes are now being evaluated? Can she answer the criticism that the first wave candidates and the best organised and therefore most likely to be able to cope with the changes? Are the data which we are being given only those which reflect the credit side and not the debit side of the changes? For instance, how much money is being spent by certain fund holding general practices on private sector facilities, thus leaving the National Health Service with less money to fund its own provider units?
I have run out of time. I had intended to discuss health promotion and research to some extent. However, I know that my noble friend Lord Butterfield will cover that area and I leave it to him to do so.
3.35 p.m.
The Viscount of Falkland: My Lords, all noble Lords taking part in this debate will be aware that it was not originally my intention to speak. The noble Baroness, Lady Robson, who has considerable experience in the field of cancer research—her work for the Imperial Cancer Research Fund is well known —had intended to speak from these Benches. We felt that it was important to put forward a speaker. We

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attach enormous importance to research and development, particularly in the area which directly concerns patients and which is referred to as clinical research. On behalf of the noble Baroness, Lady Robson, and all of us on these Benches, I should like to thank the noble Lord, Lord Hunter of Newington, for giving us the opportunity to discuss this subject.
I understand from the notes which I hastily took from my noble friend, who knows much more about this subject than I do, that the taxpayer directly through the Medical Research Council funds research up to slightly more than £200 million a year. A similar sum comes from the voluntary sector. It appears that only about 25 per cent. of research funded through the Medical Research Council directly involves patients and the benefits to patients.
The three points that my noble friend wanted to raise come under the heading of clinical research: first, the optimum use of nursing resources; secondly, health needs in particular districts; and, thirdly, research into care of the elderly, a topic which touches many people like myself who are in the middle of middle age and lucky enough still to have an elderly parent.
My noble friend came across a quotation which is worth repeating. There is no doubt that a great deal of research which directly involves the patient takes place after the stage of development. It is rather putting the coach before the horses. For reasons which are perfectly well understood but widely criticised, the Government have sought to introduce changes in the way in which patients receive attention. They have changed the emphasis from care directly in the hospitals to care in the community. They have taken a business approach.
The Life and Times of Dr. Thomas Hodgkin is a book which describes an eminent physician who practised in what I might call Dickensian London. He did a lot of work for the poor in Guy's Hospital. He attacked the method of providing medical care for the destitute, in which he was much involved, whereby contracts were let for specified periods of time to the lowest bidder. He charged the arrangement with faulty assessment; namely, that business techniques could be used to obtain care at the most efficient price. He argued that in business the quality of the delivered product could be assessed and a determination could be made of whether the lowest bidder had delivered the object of the bid in an acceptable form. He stated that in medicine, however, the public had no adequate means of testing the comparative value of the advice offered or the amount of services rendered. I suggest that that point is as relevant today as it was in the days of Dickens.
To return to the three points that I wanted to cover in respect of clinical research, I pick up the issue of research into the best use of nursing resources. There is no doubt that there has been a great deal of discussion and experimentation in the substitution which has shown benefit to patients and considerable benefits in terms of cost reductions. The studies are all, no doubt, very valuable individually. However, perhaps in her reply to the debate, the Minister will be
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able to say whether there is a plan to gather comprehensively together all the results in order that the overall picture may be assessed.
We are talking about the balance between cost savings and the benefit for patients. There is the substitution of nursing staff for medical staff and nurse practitioners. There is also the substitution between nursing staff and other health service occupations and professions and the overlap in the community with social workers, and so on. It is an area in which a great deal is being done. However, a great deal needs to be done to collect the information in order that it may be acted upon where necessary.
The second point that my noble friend wished to touch upon is the health needs in particular districts. They are obvious if one walks through London. It is quite clear that as a result of the Government's policies with regard to taking people out of hospital and placing them in the community, there are many people who are not in the best of mental health. In such areas as Tower Hamlets an area which is characterised by a number of cheap hostels and a home run by the Salvation Army, there are a great number of people who are in need of a specific health service. That would not be the case in rural areas. Indeed, the health requirements in urban areas such as London, Manchester, Liverpool or Glasgow are clearly distinctly different, even to the layman, from those in less dense areas in terms of age difference if nothing else. Some areas have concentrations of elderly people. In others there is a greater number of young people.
My noble friend's third point is dear to my heart. I have an elderly mother who recently had an operation to replace a kneecap. When I brought my mother home from hospital it was quite clear that if I had not been able to arrange some very able, almost full-time, help in order to rehabilitate her over a number of weeks she would have had great difficulty. At that time I considered the position of some elderly people—conditions vary from area to area—who, after having excellent treatment in hospital, go straight back to their homes in which they will not have supervision for exercise or physiotherapy, let alone diet. How much research has been done in that area? How much research has been collated and disseminated?
I am sure that I have not done justice to the points that my noble friend wished to raise. However, I have at least made the point that clinical research is an issue in which we on these Benches are much interested and about which we are much concerned. As I said only the other day on another subject, as time goes by there will be more and more elderly people in our society. I believe that today a new magazine is published called the Oldie. Whether or not that publication will last for long is difficult to judge, but it emphasises that it is even to the forefront of journalists' minds that the balance of society is changing between old and young.
I conclude on that point. I look forward to the noble Baroness giving a reply which will make us optimistic about the changes that are taking place and the benefits that will come from them in the near future.
3.45 p.m.
The Lord Bishop of Norwich: My Lords, I never ascend the steps of a pulpit, even in the smallest country parish, without a certain nervousness. My trepidation on this occasion can therefore be imagined.
I too am grateful to the noble Lord, Lord Hunter, for initiating a debate on this important subject. It is a cause for profound thanksgiving that advances in medical knowledge gained through research have led to the alleviation of a great deal of suffering. It is obviously right both to encourage that research and to honour those engaged in it. Equally, there is common consent that medical research should always be accompanied by reflection on the implications of the knowledge that is gained and, as a consequence, by regulations which control the use to which the knowledge is put.
Those matters were discussed in this House at length and with very great authority two years ago during the passage of the Human Fertilisation and Embryology Bill. It would be impertinent of me to think that I could in any way aspire to the wisdom and experience which were demonstrated on that occasion. But whenever questions concerning medical research are raised, I believe that it is right to remind ourselves of the need to pay close attention to the ethical issues which inevitably arise.
We are all aware that, as the frontiers of knowledge are extended, some of the possibilities arising out of that knowledge are not always in the best interests of humanity and the natural world. Furthermore, it seems to be in the nature of research that it will always push to the very limit of the controls that are set. That is why quite rightly both Houses of Parliament have taken pains to ensure that proper regulations and advisory bodies have been established to keep pace with advances in medical research.
There are three points that I should briefly like to make. Last autumn at the invitation of the Norwich Medico Chirurgical Society I took part in a debate about in vitro fertilisation and embryo research. I was impressed not only by the advances in knowledge and technique that had been achieved, but more particularly by the sensitivity and compassion with which its members spoke of their work. As one would expect, we could not agree about a number of issues, but I greatly admired the profound and sensitive care being demonstrated for the people they were helping.
Nevertheless, I remained uneasy. The reason was based on a Christian assessment of human nature, an assessment which I believe is also inherently rational: that is, that human nature is corruptible, our motives easily mixed and that we are not always capable by ourselves of judging what is best for the human race. That is why controls are always necessary and why, like many in my profession, I remain cautious and conservative in such matters.
The second point arises from another meeting of the Norwich Medico Chirurgical Society when, during its annual dinner three years ago, I asked a senior consultant about the composition of the local ethical committee. Several names were mentioned whom I knew to be expert in their field of medicine, thoughtful
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and some of them committed Christians. But none of them had any formal training in the field of ethics. It was characteristic of their generosity that subsequently I was invited to nominate a representative who had expertise in this area, and one of my clergy who has studied medical ethics for many years became a member of the committee and is now its chairman.
The point is this. When establishing regulating bodies to advise upon research, it is necessary not merely to make sure that the terms of reference are well balanced but also that the membership of such bodies includes those who have professional expertise in the field of moral judgments. Of course we are all engaged most days in asking ourselves about what is right and wrong—at least I hope we are—but for those in my profession it is also part of the work for which we are trained.
I have twice used the example of the Norwich Medico Chirurgical Society, which may not be a body well known to everyone. It was founded in 1867, I think as much a dining club as a gathering for academic discussion. They used to meet on the night of the full moon so that they could see the road better on their way home. If any of your Lordships is ever invited to address the society, I strongly advise acceptance. The company is good, the food excellent and instead of a fee they present their speakers with a case of very good claret.
My final point is more general. During the Second Reading of the Human Fertilisation and Embryology Bill the noble Lord, Lord Zuckerman—a valued neighbour of mine in Norfolk—said:
"Science will never provide the answers to the ultimate questions: the question of what brought about what we call life and what it is that gives man his unique quality in the world of living organisms".—[Official Report, 7/12/89; col. 1041.]
I hope that I am not stretching those words beyond their proper meaning by saying that there is implicit in that humble agnosticism which is a characteristic of the greatest scientists the conviction that other disciplines, not least theology, have much to contribute in the search for truth and wholeness. However, in order to do so they must be in dialogue with one another and preferably in partnership. It is also necessary that each discipline practises the virtue of humility. That is the only proper attitude towards a search for truth, which is ultimately beyond the grasp of any single branch of knowledge.
It is in that spirit that I offer these brief thoughts concerning the vital relationship between the medical profession and my own and between the insights of scientific research and theological reflection. I wish to add finally that, as well as being conscious of the great privilege of belonging to this House I am most grateful for the kindness and generosity that have been shown to me as a new Member. I thank your Lordships for the courtesy with which you have listened to me on this first and somewhat terrifying occasion.
3.51 p.m.
Lord Auckland: My Lords, in the 33 years during which I have been a Member of your Lordships' House this is the first occasion on which I have had the privilege of congratulating a maiden speaker.

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"Privilege" is not merely a conventional word; not only is it a privilege but it is an honour to follow such a distinguished, humane and wise speech. At a time when the Church is under a great deal of criticism —some of it not entirely unjustified—it would be good for those who criticise it to study well the speech to which we have just listened. The right reverend Prelate has a distinguished record. He trained at the Royal Military Academy, Sandhurst and in the Church as a whole. He is Bishop of a beautiful city which I know only as a result of time spent there when in the Territorial Army. The inhabitants of Norwich are extremely fortunate in having a bishop of such distinction. The more often the right reverend Prelate is able to address your Lordships' House, the richer it and the country at large will be.
I am a long-standing member of the all-party parliamentary chemical industry group. I was detailed into it by a Member of your Lordships' House, but time prevents me from giving a longer explanation. I pointed out that, as one who had spent his working life in the controversial world of insurance, my knowledge of chemistry and pharmaceuticals was less than nil. However, membership has enabled me to visit a number of pharmaceutical companies. I also have a young daughter who is a nursing sister and who sometimes keeps me on the straight and narrow. Therefore, I believe that the noble Lord, Lord Hunter of Newington, has, not for the first time, given your Lordships the opportunity to discuss an important subject. The pharmaceutical industry is responsible for 21 per cent. of the work carried out in research and development. According to a most interesting article in The Times supplement, a little more than £1 billion was spent in 1990 on research and development.
Perhaps I may recount briefly a personal experience. In 1941 I had a virulent attack of measles followed by a mastoid in both ears. Penicillin had not then been discovered and I had to rely on M&B. A nephew of ours has also suffered from a bad mastoid since Sir Alexander Fleming's great discovery. He is not completely cured, nor am I. However, I believe that those who criticise the pharmaceutical industry and have reservations about research and development—we are all entitled to our views—should bear in mind that those illnesses would not have been overcome if it had not been for research and development.
On two occasions I have had the pleasure of visiting Terlings Park near Harlow where an enormous amount is being done on Alzheimer's disease, Parkinson's disease and so forth. My wife and I have a friend aged 60 who is in the terminal stages of Parkinson's disease. As members of the medical profession will know, it is a most distressing sight. It makes one recognise the vital importance of the pharmaceutical industry.
The operative word in the noble Lord's Motion is "future". Due to the enormous amount of progress made in R&D and in the pharmaceutical industry, stays in hospital are short. I know that from an experience four years ago when I had my gall-bladder removed. If I had had the operation 25 years ago goodness knows how long I would have been in
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hospital. However, I stayed for only nine days. Short stays are due in no uncertain terms to the excellent work which people in this country have undertaken in research and development.
As progress is made we see breakthroughs in illnesses such as leukaemia. We have read about the child of one of our distinguished citizens who may have to wait four years before knowing whether the leukaemia has been cured. The more that is done in research and development, the more promising is the outlook for youngsters and elderly people.
Again, I congratulate the right reverend Prelate on a notable maiden speech and I thank the noble Lord, Lord Hunter, for initiating the debate. I am sure that at a time when the National Health Service has become a political football, my noble friend the Minister will note that this House has debated a Motion which even these days can hardly become the subject of party politics.
3.59 p.m.
Lord Ennals: My Lords, I too thank the noble Lord, Lord Hunter of Newington, who, as on so many occasions, has given the House the opportunity of debating such an important subject. In particular, I wish to express my thanks and admiration to the right reverend Prelate the Bishop of Norwich. I greatly enjoyed his speech. I shall be in his diocese this weekend and I ask him to convey to members of the learned society of which he spoke my open offer to address them. If he does so I shall share the cask with him.
As time is short I wish to concentrate entirely on Alzheimer's disease, which was touched upon by the noble Lord, Lord Auckland. The principal demographic changes of the 1990s will not be an overall increase in the number of pensioners but a rapid increase in the number of elderly people, in particular those over the age of 85. The OPCS estimate is that the number aged 85 and over will increase from 865,000 in 1991 to 1,146,000 at the turn of the century. That is an extremely large number and an extremely rapid increase. It is that age group in which so many sufferers from dementia are to be found.
The people who are most likely to suffer are the very elderly. The number of people with Alzheimer's disease in the United Kingdom has been estimated to be about half a million. Dementia is usually a disease of old age although it occasionally affects middle-aged people. It is spread equally across all groups of society and does not appear to be linked with sex, social class, ethnic groups, geographic locations, or anything else. Recent surveys have revealed that the prevalence of dementia in the population is as follows: aged 40–65, less than one in a 1,000; aged 65–70, two in 100; aged 70–80, five in 100; aged over 80, 20 in 100. Therefore, we are talking about roughly 1 per cent. of our population and that is likely to increase. Therefore, it is extremely urgent that Alzheimer's disease is looked at not only as a medical problem but as a social problem. If there are half a million sufferers of Alzheimer's disease, there are at least another half a million caring for those people—mostly at home, but there are many in hospitals and nursing homes.

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I am proud to be closely associated with the Alzheimer's Disease Society. I greatly admire the work that it does and the work carried out by its research team. Not only do I admire the way in which families of those suffering from Alzheimer's disease are supported but I also admire the work carried out by its research team; in particular by Professor Wilcock who is a professor of care of the elderly at Frenchay Hospital in Bristol and chairman of the research panel of the Alzheimer's Disease Society.
The problems are great. Many of your Lordships will have recently seen the report that a leading research team at St. Mary's Paddington has been split up and that Dr. John Hardy and other outstanding researchers have moved to the United States. Of course, that will undermine some of the work being done at St. Mary's. That is an extremely sad situation.
Why are we suffering from the departure of some of our most able scientists to other parts of the world and especially to the United States? Perhaps I may mention a few reasons for that. First, there is the problem of university funding. Whatever the Government say about more money than ever being poured into universities, there is no doubt that the budgets for research are decreasing in real terms. Research which can be linked to industry is being encouraged but industry will not pay and medical research will not be encouraged unless there is a short-term financial spin-off. That is an unfortunate social approach to take to research.
Secondly, the Government would have us believe that they have increased adequately the Medical Research Council's funding. It is difficult to reconcile that with the increasingly alarming stories of the MRC's inability to fund projects which they have rated highly as important work which they wish to support.
There are problems also as regards remuneration. Salaries of research workers are poor compared with those available in industry and commerce. Many researchers earn considerably higher salaries if they accept an offer to work at, for example, a pharmaceutical company. I give an example of a PhD student. He undertakes three or four years as an undergraduate living on a grant. He is then expected to live on about £5,000 per year for the next three years while he undertakes his PhD. At the end of that time the researcher knows that the prospect of a job relevant to his PhD training is quite small because of the difficulties of funding. That discrepancy in salaries between research and industry is now so great, and the incentives for staying in university posts are so diminished, that it is no wonder that many are now looking across the Atlantic and, increasingly, to Europe for their future.
There are problems in the newly-constructed National Health Service. If we look at the situation of the purchasers and providers, the establishment of health trusts with strong commercial interests creates a possibility of conflict between the costs of immediate health service provision and the equally important need for facilities for clinical research. It would be disastrous if trusts started to charge more than
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justifiable overheads to those carrying out research, particularly if that research is being carried out by charitable bodies in health service properties.
How can we improve the situation? Much Alzheimer's disease research in this country is paid for by medical charities rather than by universities or the Medical Research Council. More resources are required and the universities should be dissuaded from charging charities the overhead costs which they currently demand from industry. Industry may make a profit in the long term but charities are not in the marketplace to make a profit. I should like to see the establishment of designated Alzheimer's disease research centres in different parts of the country. Certainly the problem demands that. A modest increase in resources could be used to establish regional research centres; for example, in Bristol, Oxford, Cambridge, Newcastle and London.
The problems which many of those researchers face are considerable. I take the example of Bristol. There is a team of 18 people with a spectrum of interests ranging from clinical research to the use of the techniques of molecular technology applied to the development of new therapeutic avenues. Fourteen of those people are employed on a temporary basis. Therefore, there is always the temptation for them to look elsewhere for permanent jobs. The accommodation is inadequate. One person is based in a kitchen of a Portakabin. The equipment is basic and much needed modern technology is simply not available because of the shortage of resources. In one laboratory seven research workers have to share an office space meant for two. That is almost as bad as the way in which some of us have to share office space in the House of Lords. Perhaps that is an exaggeration.
Finally, I am certain that we need greater Department of Health commitment to the problems of those with dementia. Much useful research could be undertaken if health authorities and trusts were charged with assessing the needs of those in the community suffering from dementia and with providing the resources to evaluate the most effective way of linking together the efforts of the National Health Service, the social services and the voluntary and private sectors. It is not just funding which is needed but also commitment and leadership from the centre.
4.8 p.m.
Lord Walton of Detchant: My Lords, I join in the thanks and congratulations offered by many of your Lordships to the noble Lord, Lord Hunter of Newington, for initiating this debate. I join also in the warm and totally well justified congratulations to the right reverend Prelate on his quite superb and moving maiden speech. Having spoken to the Norwich Medico Chirurgical Society in the past, I echo his admiration for that organisation.
I apologise to your Lordships, to the noble Lord, Lord Hunter, and to the Minister for the fact that I may not be able to stay until the end of the debate because some weeks ago, before I knew of the debate,

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I agreed to speak to an all-party parliamentary group on complementary medicine at 5 p.m. elsewhere in the Palace of Westminster.
In this country we have a most notable record in medical research in our universities and our National Health Service hospitals. Much of that has been based upon developments in basic science, not least in recent years upon new techniques of imaging, molecular biology, immunology, pharmacology, and many more. It has been justly said that today's discoveries in basic medical science bring tomorrow's practical developments in patient care.
Many of the most crucial contributions towards such research come from consultants in our National Health Service who work in an increasingly close partnership with scientists in hospitals, in MRC units, in units funded by our charities and foundations, and in partnership with the clinical academic staff in our universities. They do so to such an extent that in many medical schools and their associated hospitals, clinical and academic staff who see and treat patients and consultants who teach, provide services which are virtually indistinguishable in relation not only to patient care but to teaching and research. They do so under the long hallowed "knock for knock" agreement between universities and hospitals—one of the cornerstones of work in research in this country.
Some of the finest research has come from our NHS hospitals and those who work in them. It is important to make the point also that, contrary to popular view, much of the work funded by the Medical Research Council is not basic laboratory research but is clinical research. I can only quote, for example, the extraordinarily competent trial of chiropractic versus outpatient hospital treatment in the management of low back pain and the more recent trial demonstrating the benefits of surgery on the carotid artery in the prevention of stroke. I could quote many more.
Some of the major developments come not just from our universities, MRC units and hospitals, but also—as the noble Lord, Lord Auckland, said—from our pharmaceutical industry which, in a previous debate, I called the jewel in Britain's industrial crown. Those developments are extraordinarily expensive. For example, the drug erythropoetin, which has been shown to be a rapid and effective means of controlling the anaemia of chronic renal failure, is enormously expensive. The treatment of migraine now made possible by the drug sumatriptan as a treatment for acute attacks is immensely costly. It was developed by basic research by Glaxo, Britain's leading industrial company, but it costs £20 for each injection.
We are now seeing tremendous developments in gene identification leading to major new progress in preventive medicine. I have spoken in your Lordships' House about the discoveries emanating from the isolation and characterisation of the Duchenne muscular dystrophy gene some years ago, not least in antenatal diagnosis but also in relation to the benefits of embryo research. Only two weeks ago from Charing Cross Hospital and in the Welsh National School of Medicine reports came that the gene responsible for another form of muscular dystrophy, adult myotonic dystrophy, has been isolated and
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characterised. That will unquestionably bring major benefit to the families of those patients, not only in prevention but in leading us closer to the prospect of gene therapy.
In saying something about gene therapy perhaps I can welcome the Clothier Report recently published by the Department of Health which gives us a lead in that direction and which will be helped enormously by the establishment of the supervisory committee which the Department of Health proposes to establish. In my view there is no doubt that gene therapy is becoming a real prospect as a means of treating effectively inherited disease. I venture to suggest that within the next 10 years in many of our worst and most crippling inherited diseases it will become a reality.
Those developments are not cheap and I ask whether society, whether government of any political party will swallow and accept the inevitable financial consequences. There are many clouds on the horizon. Are we to face explicit rationing of health care and of these new developments, as in Oregon, or is it to be implicit as it is inevitably in certain circumstances at the present time? I have spoken before about what I believe to be the extraordinarily short-sighted decision to remove the research infrastructure money from our universities and to hand it over to the research councils. I understand the reasons, but believe that it is a misguided decision which will be reversed in the same way as the Rothschild decision some years ago to take money from the Medical Research Council and hand it over to government departments had to be reversed. I hope that this will similarly be reversed. I learnt only two weeks ago that in the University of Oxford two of the brightest and most distinguished research departments are being faced with cuts. One will suffer a cut of £41,000 in the budget which provides that infrastructure of staff, secretaries and technicians so crucial to their research programme, and the other with a cut of £113,000 because of that decision.
In the National Health Service we have SIFTR—the service increment for teaching and research. That is part of a dual support system which enables research to be carried out in our NHS hospitals. Is it adequate? The costings of various procedures in some of our teaching hospitals suggest that the adequacy of that component is in doubt. Perhaps I may echo also the point made by the noble Lord, Lord Ennals, that if the removal of the research infrastructure money from our universities results in the universities being compelled to charge charities overheads on research grants, it will have a devastating effect on the money hard-earned by many of those bodies throughout the United Kingdom.
My final point relates to staffing. I speak as president of the World Federation of Neurology. We had a symposium at the Pan European Congress in December, talking about the American Congress's decision to call the 1990s, "The decade of the Brain". It discussed the establishment of consultants in neurology throughout the world—10,100 accredited neurologists in the United States, 4,500 in Japan, 1,100 in Germany, 179 in the United Kingdom and only Ireland, with six, fares worse in the developed

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world as matters stand at the moment. It is therefore not surprising that neurologists find it difficult, in the face of the load of patient care that they inevitably carry, to carry out the research of which many are capable.
I trust that the Government's programme of expanding the consultant establishment in this and in many other disciplines—so crucial to the future of medical research in our hospitals—is something that will gather pace. We could double the number of consultants, inevitably reducing in consequence outpatient waiting times to see them, bearing in mind the numbers of patients they are required to see at the moment. I am a passionate believer in the National Health Service. It has the potential to contribute in an extraordinarily effective way to future research leading to major developments in patient care in this country. But it is something that will need increasing attention not least in a financial sense.
4.17 p.m.
Viscount Bridgeman: My Lords, as a layman perhaps I may add my thanks to the noble Lord, Lord Hunter, for initiating this debate to which such distinction has been added by the maiden speech of the right reverend Prelate the Bishop of Norwich.
The noble Lords, Lord Hunter and Lord Rea, and the noble Viscount, Lord Falkland, mentioned the need to address the needs of the patient. The point I wish to bring to your Lordships' attention is a simple and I hope a brief one. It concerns the necessity to strike the right balance between the centres of excellence in research and those parts of the country where the burden of disease is greatest.
The largest centres of excellence may be said to be London, Oxford, Cambridge and in Scotland. In the case of England alone—I address these remarks only to England—it is presumably an accidental but interesting fact that the regions covering those centres —namely, the four Thames regions, Oxford and East Anglia—accounted for six out of the eight regions with the lowest mortality rates (and the three lowest overall) for persons under the age of 75 in the period 1985 to 1989. The six lying at the other end of the scale were the six northernmost regions of England.
If your Lordships will bear with me, I have one more significant statistic. In 1989–90, the latest year for which figures are available, the four Thames regions, Oxford and East Anglia accounted for 39 per cent. of the population but received 77 per cent. of the external medical research moneys administered by the universities. The remaining eight, including those with the highest mortality rates—namely, the West Midlands, Trent, Mersey, Yorkshire, the North and the North West—with 61 per cent. of the population received only 23 per cent. of the external medical moneys.
I have to declare an interest in that as a special trustee of the Hammersmith Hospital I have a connection with the Royal Postgraduate Medical School which is well and truly in what one might call the better endowed group. Nevertheless, I hope that my noble friend the Minister and her colleagues in the
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Department of Education and Science will consider that there may be a case for making available a greater share of the research budget to those high quality centres of medicine in the Midlands and in the North of England which have the advantage in medical terms of lying in the heartlands of those parts of the country where the burden of disease and relatively high mortality are greatest.
4.20 p.m.
Baroness McFarlane of Llandaff: My Lords, I too would like to thank my noble friend Lord Hunter for giving us the opportunity to discuss this vital subject, and I congratulate the right reverend Prelate the Bishop of Norwich on his maiden speech. I for one have an ethical dilemma as to whether I should be in this House this afternoon or over the road in Church House with the General Synod discussing the care of the mentally ill. I am so glad that I chose to be here and to hear such a distinguished address with such sensitive, ethical and theological insights.
Great progress has been made in a relatively short time since the Select Committee on Science and Technology reported on priorities in medical research. The appointment of a director of research and development has given us a basis for great progress. I believe that I can do no better than quote what he said at the beginning of his Francis Fraser lecture to the Royal College of Physicians in which he reported the state that he found. He said:
"Over four decades the National Health Service (NHS) has responded to a huge range of innovations. Some have been durable, others have been transient; some have been evaluated but many have not. Often new developments have been superimposed on existing practice, creating a kind of medical archaeology where the remnants of earlier practices are discernible among the newer acquisitions".
He said:
"the best use of human and other resources, and the contribution of medical interventions to the health status of individuals and the population",
needs to be studied. He continued:
"The challenge now is to introduce a sensible mechanism for handling within the NHS the output of basic and applied research and to apply research methods to examine the content and delivery of health care".
I admire the speed with which the director has set up a strategy for developing research and development in the National Health Service, first, with the central research and development committee and the infrastructure at regional level. He is right in his analysis that there is need for a whole range of types of research, from the pure or academic research to applied research, development and evaluation research.
My purpose in participating in the debate is to attempt to underline that the NHS is a very large-scale organisation in which all kinds of professional practice, function and occupations have to be melded together for the care of the patient. Additionally, we have to look at the use of buildings, their design, the use of equipment and high technology. All these aspects need to be researched and developed in the interests of the National Health Service.
So research and development in the National Health Service cannot be limited to the medical function. Great emphasis has been placed on the

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importance of that aspect this afternoon, and that is right and proper. But there are many other factors involved in the National Health Service. Perhaps I can illustrate that best by reference to the need for research and development in my own profession of nursing. In doing so I shall make the case for other professions in the National Health Service such as physiotherapy and clinical psychology.
It is plain that nursing gives 90 per cent. of the care in the National Health Service. Nurses represent 50.9 per cent. of the National Health Service workforce and 45 per cent. of the wages bill. I believe it follows that the effectiveness of nursing intervention and the efficiency and effectiveness of the nursing service profoundly affect the total performance of the National Health Service.
But nursing has come late to the research scene. Some of the first pieces of clinical research were sponsored by the then Ministry of Health in the mid-1960s. Although there has been generous funding by the Department of Health and other funding sources for the past 25 years, there has been relatively little basic work which can inform nursing practice authoritatively. Therefore, I look at the way in which we practise nursing. For the most part, it is born of tradition or perhaps unsystemised experience on the part of ward sisters. All that, as in many other professions in medicine, needs to be subjected to analysis and research.
Fortunately, a strategy for nursing research and development is now evolving which should complement and be part of the strategy for research and development in the National Health Service. In 1990 the Secretary of State for Health endorsed the report on a strategy for nursing which indicated that research was an integral part of all the target areas in nursing—in clinical practice, manpower, education, leadership and management. The Advisory Committee on Nursing Research took the matter further, and, again under the aegis of the chief nursing officer, a multi-disciplinary group gathered at Wonersh last year to develop a strategy for nursing research.
In its report the group draws attention to the context in which a strategy for nursing research is being developed; that is, the new organisation of the NHS and the implications of the purchaser-provider approach. The research is taking place in the context of the national research and development strategy for the NHS and of rapid development in research into matters of audit. It is also taking place in the context of reforms in nursing education and Project 2000 and in the context of the regional structure and its effect on generating priorities.
At the Wonersh seminar we drew attention to the fact that research was needed over the whole continuum, from basic to theoretical research in nursing. We needed to look at application, development and dissemination of research results. We recognised that a wide range of methodologies would be required. Above all, we looked at the importance of collaborative and multi-disciplinary research. It was seen that the purchaser-provider approach to health service delivery was an opportunity for us to look at outcome measures in far more
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detail so that the expected standards of nursing care could be stated. The development of standards for contracting for nursing care and the need to update and educate staff now become a managerial imperative, and research has to contribute to that. So I look forward with confidence to improvements in research and development in that area of the health service.
4.30 p.m.
Lord Molloy: My Lords, in offering my thanks to the noble Lord, Lord Hunter of Newington, for providing us with the opportunity to have this worthwhile debate I also congratulate him on his speech. It was somewhat poignant and realistic when he mentioned that research one day—I think that is what he meant—might even cure cancer, Parkinson's disease and all of the terrible ailments which still exist and which perturb us greatly.
I hope the Minister will be able to answer a point that I want to make immediately. When changes take place in the National Health Service in research, and so on, I hope that some endeavour will be made to inform the general public of what is happening so that they can have confidence in those changes. It is very difficult for people to realise that at one time there was not even an organised ambulance corps. That has developed and improved over the years until in this country it is first class. No longer are drivers merely drivers; they can do all sorts of wonderful things. But some people resent it when a driver wants to help while getting them into the ambulance on the grounds that because he is not a doctor he does not know what he is doing. In fact, as the General Secretary of the Confederation of Health Service Employees said some time ago—as did a noble Lord from the Benches opposite—an ambulance driver can be very useful in helping doctors and surgeons. Therefore, I hope that finance will be a priority for research and development in our NHS because in the end it will pay for itself.
I should like to congratulate the right reverend Prelate the Bishop of Norwich. His speech on ethics was very important. It took me back to the days when, in the Gallery of this place as a young soldier, I listened to another great Christian—a somewhat fiery Baptist Welshman—who through all his life maintained the ethic that to make money out of disease and suffering is devoid of any ethics whatever, let alone the Christian ethic. Nye Bevan was right then and he is absolutely right today.
I ask the Minister to realise that most people who work in the National Health Service appreciate the fact that ever since the inception of the NHS this country has been in the forefront of all forms of research and development. In world history it is amazing what research and development has achieved, despite it being somewhat haphazard. However, it did not become properly organised until we had our NHS; and recent Government endeavours have been well worthy in this respect.
The World Health Organisation has underlined that the philosophy of improving health with broad strategies for improvement are vital. Therefore, I believe that with political support emphasising the

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role of specialist education—that is important—we can improve on the research in which we already lead most other countries. I believe that this is not merely a matter of research and development. The results of research and development must be made available to all our people. The development of the National Health Service—it has been a great development —in British social history is the culmination of a great ideal; it endeavours to be comprehensive and wholly available to all people at all times. That is the ethic that we have to maintain with our research and development.
Referring again to ambulance drivers and similar workers research and development in medical engineering and medical mechanical devices is still needed. It is very important to have the right kind of equipment to move a person, who needs to be moved gently, from one floor to another, especially if a lift is unavailable. All these aspects are very important to our health service.
The importance of public health with preventive programmes, including attack on poverty, poor housing and industrial dangers, must be looked at. I come from a part of our country where it was quite normal to hear someone say, "Poor old soul, he died. He was only 48, you know, but he had the dust so early". A coal miner who had worked for about 12 or 15 years had died because the dust from the coal underground where he was working killed him. There may be other things knocking about which are an industrial danger. I know that the Minister will accept that we must have some form of research and development into occupations which are dangerous and which create great hazards.
There is a need for change and restructure to prove the efficiency and availability of the NHS. The General Medical Services Committee produced a valuable strategy paper called Building your own Future. The paper covers a vital aspect of the NHS and its relationship to the community as a whole. That document, coming from a great organisation, I feel sure will have the attention of the department. The Government responded to the House of Lords Select Committee very well and said that the NHS needed coherent research and development. That was a good response from the Government. I ask the Minister to see that they continue with that approach to R&D.
The NHS needs results and resources. It still needs vital skilled manpower. If we are to have research and development and create wonderful new machines and wonderful ways of doing this, that, and the other, then we have to make sure that we provide the training for those who operate the results of R&D so that they do so in an efficient manner. That is what I meant when I spoke in this House recently on the valuable contribution that can be made by all the staff associations like the Confederation of Health Service Employees, the British Medical Association and those of British nurses. All those organisations can contribute by saying what they require, which the brains of the researchers can do their best to provide. That calls for great teamwork between the intelligentsia of research and development. They in turn must
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listen to the doctors, consultants, nurses, and so on, as to their requirements. That will help us enormously. Doctors sometimes find it difficult to keep up with R&D. I hope the Minister will bear that in mind. I think that the Government should be a little more generous towards GPs with post-graduate expenses and to all other staff who are temporarily taken out of their jobs to study the possibilities of better R&D.
This debate is of vital importance to all aspects of our nation's endeavours: to industry, commerce, defence and education. Research and development in the NHS—possibly not in our lifetime—can erase much suffering and disease. I believe that R&D in the NHS will be good for our children and for our future.
I should like to conclude with one point. It was this nation that created this great National Health Service, which became the envy of the world and which I am pleased to say is now being copied by other countries and has resulted in an interchange of ideas between our country, America, parts of the Commonwealth and parts of Europe. That could never have happened without the National Health Service. My ultimate plea is that in doing all these things I hope that we can also provide help to the suffering and deprived humanity in the third world. In this country we are well on our way to a very good society in regard to health but the third world has not yet got to first base. Perhaps through our endeavours in research and development we can contribute to the alleviation of the suffering and the awful anxieties and worries of the third world.
4.39 p.m.
Lord Butterfield: My Lords, I too should like to thank my noble friend Lord Hunter for initiating this fascinating debate which has ranged all over the world. I should also like to congratulate the right reverend Prelate the Bishop of Norwich on his superb maiden speech. Of course, the Cambridge University Medical School falls in the neighbouring diocese. Like my noble friend Lord Walton, I have also had the privilege of addressing the Norwich Medico Chirurgical Society. I guess that it is a sign of my Alzheimer's disease that I cannot actually remember receiving any wine from the society 20 years ago. However, that may be the fault of my memory.
I should also like to tell the right reverend Prelate that in most ethical committees the presence of a layman is demanded. In Cambridge we have been greatly helped by lay members. Indeed, there is a close association between the clinical school and the religious people who attend the Addenbrooke's Hospital. I hope that we shall not get into serious situations in that connection because it is very important. In fact, I am known among some of the medical students as the man who believes that we need to go back into history to the time when religion and medicine walked arm in arm down the corridors of hospitals.
I am most grateful to my noble friend Lord Hunter for tabling the Motion at this time. I hope that it is not inappropriate if I say how good it was to see Professor Michael Peckham in his proverbial bow tie earlier today. I am sure that he will read all our messages in Hansard. I know that we all wish him well in his vitally

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important task. We thank the department for setting up such an arrangement. It is marvellous to realise, as the noble Baroness, Lady McFarlane, said, that he is beginning to build a pan-national framework of research and development committees.
I feel that I should remind your Lordships where all the research and development goes and mention one or two of the problems about which some of the people in this great chain are worrying. Of course much of the work must take place in universities. We are very proud of our work in Cambridge. Indeed, one might argue that medical research began in Key's College when a man called William Harvey, by doing some remarkable biological experiments, discovered how blood was circulated. The noble Lord, Lord Molloy, made the wonderful point that we have maintained a world leadership in such matters.
Only yesterday I visited William Harvey's hospital, St. Bartholomew's. I listened to people talking about research of the cells which actually envelop the circulating blood—the so-called endothelium. Is it not extraordinary that those same men, and those in other parts of the world, have been able to show that a very simple gas—namely nitric oxide—is probably the gas which dilates the blood vessels when they need to dilate. It is opening up an enormous amount of very important research and may lead to the development of new kinds of medicine for dilating blood vessels after people have suffered coronaries.
Of course there are problems in the universities which I should not conceal from your Lordships. Those concerned are worried that their medical teaching hospital departments may suffer from the new form of funding on a per capita basis. I very much agree with the noble Viscount, Lord Bridgeman, about the importance of ensuring that funds for research and development get through to the apparently less privileged parts of the country.
It has been pointed out that research councils are in difficulties. They have coming towards them now this wonderful tide of brilliant young people who are really experiencing difficulties in prosecuting their careers. I do not know how we can solve the problem because such young people have an almost exponential growth of brilliant new ideas which need developing. Perhaps we must teach them to walk barefooted and to live on bread and water—they will certainly need all their spare money to buy the necessary apparatus—or, alternatively, perhaps they will have to learn to share their apparatus in order to manage.
The research work that I observed yesterday at St. Bartholomew's is multiplying further investigations. No one can say which of those investigations will hit the jackpot. That is one of the big problems about research. The noble Lord, Lord Todd, when saying farewell as president of the Royal Society, made a great and wonderful remark which I frequently quote to students. I shall repeat it in my Scottish accent. He said, "Aye, there is only one thing that you can be sure of in research and that is that the results will surprise you". That factor is very important for the reputation of the research councils. I agree with my noble friend Lord Walton about the pharmaceutical industry being the jewel in our industrial crown. The work it carries
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out in research and development in this field is a great credit to the scientists who undertake the work and to the people who offer the leadership.
We should also remember the very important interactions which are essential in research and development. I shall deal presently with my personal concern and commitment for health promotion. That is not a very topical topic in some quarters; but it seems to me to be quite important. It will be greatly helped by the research into the genetic code —the human geno research. If we are to identify who is really at risk from smoking, it will probably come from that kind of approach. Then, as the professor, I shall not have to wonder how I can answer the student who says to the assembled company, "Well, Prof, it is all very well you saying don't smoke, but my grandfather smoked heavily until he was 102 and then died under a bus". I hope that the geno boys will be able to tell us who is the man who will die under the bus.
I want noble Lords to know that in The Patient's Charter there are two lovely quotations. The first says that the patient should be,
"guaranteed admission for treatment no later than two years,"
after the day that he or she sees the hospital doctor. We all know that there is terrible pressure on the National Health Service. The second quotation is to be found on page 21. It points out to the patient that he or she will be given help and taught,
"how to maintain and improve your own health".
That seems to me to be a great reason for encouraging health promotion.
I worked in health education for a long time. However, I am afraid that the lessons tend to be dull. We need to enliven them: research can enliven them. We have certain ways of achieving a great leap forward in health promotion. The first example that comes to my mind is the terrible tragedy which took place at King's Cross tube station where many people died. The Underground authorities were immediately given the opportunity to impose a "No smoking" ban on the Tube. It is part of a most wonderful sea change, a level of consciousness change, in our country about the risks of smoking.
Of course, it must be said that obesity, which was a very dull subject 20 years ago, was greatly helped by a French company. It realised that the subject of obesity could be most interesting for general practitioners if they received new research information about it which would keep them, in their discussions with their fat patients, a little ahead on the information front. Those are areas where I believe that health promotion research could provide assistance to help people maintain their own health and thus reduce the pressure on the health service. That will become increasingly important as there are so many elderly people today.
I have one last point to make. I apologise to the House for having exceeded my time. I cannot escape the conclusion that health promotion is all pervasive in education, in transport, in health and in food. I hope that the Secretary of State will be given the

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authority to form a kind of health Cabinet to ensure that the various departments work together in the way suggested by the noble Lord, Lord Molloy.
4.49 p.m.
Lord Clifford of Chudleigh: My Lords, I begin by thanking the right reverend Prelate the Bishop of Norwich for his maiden speech and congratulating him on it. I congratulate also the noble Lord, Lord Hunter of Newington, on enabling us to have this brief debate on a subject of enormous importance.
I should like to concentrate on the issue of research and development. The national health system benefits from the research that is carried out by alternative and complementary medical colleges, such as those of the chiropractors and osteopaths among other alternative medical groups. The results of chiropractic research into the importance of the spine as a channel of fluids and on the nervous system are of enormous help to people who are attempting to diagnose the cause of cot-deaths. My noble friend Lord Walton, among others, has promoted National Health Service recognition of such alternative medical groups. As was stated by the noble Lord, Lord Holderness, collaborative research is essential if the population as a whole is to benefit from the National Health Service.
Finally, I wish to back my noble friend Lord Walton in promoting further funds for neurosurgery and neurology as a whole. Without British neurosurgeons and neurologists, I would not have the three of my 1 million nerves that go from my optical cerebrum to my two retina. I thoroughly support the Motion.
4.51 p.m.
Lord Carter: My Lords, like all speakers, I should like to thank the noble Lord, Lord Hunter, for tabling this Motion and giving us a chance to debate this important subject. There have been many excellent speeches but none better than the maiden speech of the right reverend Prelate the Bishop of Norwich, who gave us a timely reminder of the importance of ethics in our considerations of medical research. He referred to the Human Fertilisation and Embryology Act. All of us who participated in debates on that Bill agree with everything that he said about the importance of ethics in our consideration of medical research.
If health research is to be successful, it must have the three elements of innovation, prevention and evaluation. Innovation is necessary to cure diseases, to save people's lives and to improve the quality of life. Prevention is necessary to find out what makes people stay healthy. Evaluation is the measurement of the effectiveness of the treatment and of changes in life-style.
I am sure that we would all agree that research and development must be seen as part of an overall health strategy. The prime function of the health service is to help people to stay healthy and, if that fails, to cure them as quickly and as effectively as possible.
I should like to raise a particular point with the Minister on the question of innovation. An important part of innovation is to protect the effective patent life
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of new medicines. Paragraph 6.8 of the Third Report of the House of Lords Select Committee on Science and Technology entitled Priorities in Medical Research, which has already been referred to, states:
"The Government should ensure that the patent protection available to the pharmaceutical industry in the United Kingdom in practice affords levels of protection similar to that afforded by the patent laws in major competing countries, both in Europe and in the United States and Japan".
Paragraph 2.3 of the Government's response to that report states:
"further progress in protection of pharmaceutical patents would require collective action by a number of European countries".
The House will be interested to know the latest state of play on that, whether the Government have been able to make any progress and the influence of the European Community's draft directive on dispensing which is to be effective from January 1994.
Only the other day I was discussing the environment for research and development in this country with the directors of a drug company that is a subsidiary of a major international group. They were not wholly optimistic, partly because of the pressures on the science base but also because of the problem of the protection of patent life and the knock-on effect on research and development.
Turning to prevention, my party is proposing a health initiative with specific targets and the Government have issued their health promotion White Paper. A number of your Lordships have referred to the importance of the environment not only in relation to research and development but in relation also to tobacco advertising, random breath testing and nutritional guidelines for school meals. One problem that we have hardly addressed is the effect of poverty on health and the differences in health that are due to inequalities, such as the difference in the incidence of disease between the social classes.
We must balance health education with treatment. There is now a shift towards providing much more treatment at the primary care level. In considering evaluation, the new developments in medical technology offer dramatic improvements in patient care. I refer, for example, to lithotriptors which are used to smash gallstones; to laser and fibre-optic technology; to the move from intrusive to key-hole surgery and the move towards day surgery. All those changes need to be evaluated and monitored. Indeed, concern has already been expressed about the need for after-care with day surgery. That is research and development at the practical level. The Opposition believe that, in terms of evaluation, there should be a freedom-to-publish clause in the contracts of Department of Health researchers. Indeed, my party is committed to a freedom of information Act. It would be interesting if the Minister could comment on that recommendation and on the concept of a freedom-topublish clause.
The excellent Priorities in Medical Research report included powerful arguments that reveal just what needs to be done if we are to meet the research and development needs of the health service. However, several doctors who have been in touch with me have expressed concern that, with all the current changes in

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the health service, the needs of research and development may well be squeezed out at the most basic level. I should like to quote from a letter that has been sent to me by a leading cardiologist which states:
"On a personal note, one thing which saddens me is that the increased amount of administrative work that I am having to do (I think about 10 to 12 hours a week) means that I have had to give up any attempts at research work. I have 6 'papers' which 1 could and should be writing, either alone or with junior colleagues, and I see no prospect of doing anything about them before May next year when I expect that I shall take early retirement at the age of 60".
That is not the best use of scarce research resources.
The department has produced good documents on research and on health in the regions. Strong emphasis needs to be placed on the role of the regions in research and development. Are the Government entirely satisfied that there will not be a dissipation of the research effort away from our centres of excellence, given this shift towards regional research and development? What evaluation is taking place to ensure that the research effort is not dissipated away from our well-known centres of excellence which sometimes have a world reputation?
Turning to development, I should like to touch on a subject which has not yet been discussed. I refer to community care because that is part of our health service. I have searched all the various documents that relate to research and development but I cannot find any reference to research and development into community care. The Motion refers to "development" as well as to "research", and that includes training. The implementation of the community care plans in April 1993 is a topical subject, so perhaps I may ask the Minister what research is being carried out into that area. What research is planned, and who is responsible for it?
As I have said, development can include training. Indeed, the best R&D in the world is of little help if there are no properly trained people to put it into effect. As I mentioned this to the Minister before the debate, may I ask her now whether the Government are satisfied with the current efforts in terms of research and development and training for community care in both the private and the public sectors? What are the training arrangements? Where does the ultimate responsibility lie for R&D and for training standards? Does the director of R&D in the health service have any responsibility in this area?
I have been asked by several organisations about the national vocational qualifications—the NVQs—in social care and health care. What is the research base for the development of and training in community care? What use is made of NVQs in that area, and are they to be expanded? I have heard only recently that the Audit Commission is to produce three reports on community care. Which areas of community care will be covered by those reports, and will they deal with research and development?
Also on the subject of care, the noble Baroness, Lady McFarlane, mentioned nursing. An excellent report for the Royal College of Nursing was undertaken by the Institute of Manpower Studies. It was a first-rate analysis of the problems facing the RCN. There is the problem, of which we are all aware, that, while the workload has increased as broadly
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measured by the number of patients treated and by the higher average dependency level of those patients, the number of nursing staff employed in the NHS (whole-time equivalent) has remained comparatively static, with little real increase since the early 1980s. An increased workload, with static staffing means an increase in stress and an increased dependence upon support workers in nursing. It appears that not much work has been done on the cost-benefit ratio for nursing care, the costing methodologies, the organisation of nursing, skill mix, skill substitution and specific nursing intervention.
The report concludes:
"This review has revealed that much research based work has been undertaken to monitor and measure the 'value' of nursing. However, the work is fragmented and mainly rooted in a US context. Given the current attention to cost containment in UK healthcare, it is evident that further research is required which develops common methodologies and links costs to outcome in order to ensure that cost effectiveness is not overlooked in the drive for cost savings".
I should be interested to hear the Minister comment upon that.
That quotation mentions the outcome of treatment. We now have a great deal of information about throughput and we have some information about costs. The health service debate has become a battle of statistics about waiting lists, the number of patients treated, the utilisation of beds and so forth. All that says little about the outcome of treatment—to use the jargon, the cost/benefit ratio. The noble Lord, Lord Hunter, referred to the use of quality adjusted life years. He thought that that was the wrong approach. I agree with him, because that approach depends upon costing procedures and a knowledge of costs.
I have spent all my working life in a specialised area of management accounting. All cost accounting is a mixture of convention, heroic assumption and arbitrary allocation. That is all right when one is costing a widget. But I agree with the noble Lord about the danger of' using the concept of quality adjusted life years when someone's life depends upon it. He remarked about consensus management. We can all agree with that. I wonder how we are now to practise consensus management with the commercial confidentiality of the purchaser-provider contracts, the confidentiality of the business plans and so forth and the denial of freedom of speech for the people involved who are not allowed to comment upon them. How are we to build up consensus management in that area?
As I have said, we have had an excellent debate. As is often the way with these debates, we have asked many more questions than we have answered. We are looking forward to hearing the Minister's reply. I hope that she will be able to agree with all noble Lords on the vital importance of research and development if the health service is to perform the tasks that the nation demands of it.
5.3 p.m.
The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper): My Lords, I too am grateful to the noble Lord, Lord Hunter of Newington, and to all noble Lords who have contributed to the debate, for giving me the

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opportunity to give what is, in effect, a first year's report on developments in the important area of research and development in the NHS. As the director, Professor Peckham, has been very vigorous, a great deal has been achieved. The debate has also given us the opportunity to hear from the noble Lord, Lord Carter, something about his party's plans in this area. I shall read, study and evaluate his comments with great interest.
I first wish to add my congratulations and thanks to the right reverend Prelate on hitting the right note with his maiden speech. Ethical considerations add an important dimension to all that we have been discussing. He will be pleased to know that we have pre-empted some of the issues he raised by issuing new guidance to local research ethics committees.
I shall preface my remarks about some of the main issues raised in the debate by referring to some good news. First, the health departments have just reached agreement with the Medical Research Council at working level on a new five-year concordat governing co-operation between those major government funders of medical research. The agreement awaits only formal ratification. The MRC has been very responsive to the need to take greater account of health problems of concern to health departments and the NHS, without losing sight of scientific opportunity. Agreement was reached cordially and without major disagreement. This augurs well for the success of the concordat.
Secondly, we promised in our response to your Lordships' report Priorities in Medical Research that we would take steps to enhance the exchange of information with other research funders. In addition to normal working contacts, we have promoted and encouraged the creation of research liaison committees that bring together funders in particular areas, building on the experience of the United Kingdom Co-ordinating Committee on Cancer Research. One has started work on cardiovascular disease and stroke, and another is being set up on respiratory disease. We shall carefully consider the creation of others as the need arises.
The noble Lord, Lord Rea, was the first of your Lordships to ask about funding. In announcing the R&D strategy for the NHS in April last year, we made a commitment to increase the proportion of NHS spending on R&D to 1.5 per cent. over five years. We have started to move towards that increased investment by including £7 million of "tasked" money in regional health authorities' allocations for the coming year. That is designed particularly to enable them to develop the systems and structures which they will need in order to implement the strategy. That is just a beginning.
Something over £1.5 billion is spent each year on health R&D from all sources. The Government spend over £500 million currently, and the NHS spends over £225 million. That amounts to about 1 per cent. of total NHS spend. The Government intend to raise that figure, as I have said, to 1.5 per cent. over five years.
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The main aim of the strategy is to ensure that the content and delivery of care in the NHS are based on high quality research relevant to improving the health of the nation. We intend to see R&D become an integral part of health care so that clinicians, managers and other staff find it natural to rely upon the results of R&D in their day-to-day decision making and longer-term strategic planning. That is an ambitious goal and will take some time to achieve. Looking back on the past year, I am confident that we have laid firm foundations upon which to build. Those foundations include the establishment of a Central Research and Development Committee, to which reference has already been made. It is chaired by Professor Peckham, and has the prime task of advising on priorities of the NHS R&D programme and establishing a framework for the development of regional R&D plans.
The CRDC brings together senior NHS managers, leading researchers from the universities—so preserving the contact with centres of excellence about which the noble Lord, Lord Carter, asked—and from elsewhere, including lay members, and others with experience in industry. The CRDC has held two successful meetings, and will advise us on areas in which R&D will be of value to the National Health Service. It will distinguish between areas of national priority which merit central National Health Service funding, a larger number of areas of national importance on which National Health Service R&D should focus and health service needs which might be drawn to the attention of other funders, such as the Medical Research Council. This would be reflected in the proceedings of the new concordat.
Identifying a suitable list of priorities from among the many possible areas of health-related R&D, as your Lordships' contributions this afternoon have emphasised, presents a mammoth task and one as regards which none of us, I am sure, would envy the CRDC. I believe that it will contribute to the consensus rationing to which the noble Lord, Lord Hunter, referred. One of the first principles that the central committee has established is that its business should be conducted as openly as possible. CRDC papers are already circulated widely throughout the National Health Service and the research world. The CRDC's business programme will include consultation and open discussion of its work. I feel sure that this approach will be welcomed. Indeed, it is a prerequisite of sound priority setting.
On the subject of the freedom to publish research, within the National Health Service research and development programme—a point raised by the noble Lord, Lord Carter—researchers will be encouraged to publish research findings and there will be emphasis on the free sharing of the results of individual projects.
The CRDC will explore four broad areas when considering NHS R&D priorities. These are: disease-related work; organisation and management of services, including operational research; client groups, including disabled people—I can reassure my noble friend Lord Holderness on that point—and last but far from least, consumer groups. We have already started one disease-related work programme with a

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mental health research advisory group which is working to identify priorities in the field. It will report to the CRDC within the next two months. This will cover the subject of Alzheimer's disease, to which the noble Lord, Lord Ennals, specifically drew our attention.
Other reviews are planned for later in the year, including one in the area covered by the organisation and management of services, and a review of research needs in the field of cardiovascular disease.
An advisory group on health technology assessment has already produced a report for consideration and doubtless that, too, will cover some of the points raised by the noble Lord, Lord Molloy.
The second key element of the strategy is the devolution of most of the management of R&D to regional health authorities. We have asked each regional health authority to identify a member responsible for R&D. We have also asked RHAs to appoint regional directors of research and development early in the coming financial year. Four regional directors have already been appointed. The other 10 are well on the way to appointment and it is extremely gratifying that these research and development posts are attracting high calibre appointees, strengthening the links with centres of excellence.
Each regional authority has also been asked to appoint a multi-disciplinary regional research and development committee early in 1992–93, to advise the region on the content of its R&D plan and on the region's input to the Central Research and Development Committee. It will also ensure the quality of that research and I believe that this approach will go a long way to meet some of the specific anxieties raised in the course of the debate.
For the first time we are asking regions to identify their own research and development priorities. We fully appreciate that this is a new and difficult task and we do not expect them to come up with the perfect regional strategy all at once. However, we expect them to do the best they can and to continue to refine and improve their regional R&D plans year by year. It is essential that they do so if research and development is to fulfil its raison d'etre of serving the needs of the National Health Service.
The research which the RHAs commission will fall into three main categories. First, they will be able to bid for central finance to manage research in areas of national priority identified by the central committee. Regions will develop research programmes in those areas and let contracts to research bodies. Secondly, regional health authorities will use their own funds to let contracts for research in areas of national importance identified by the CRDC.
Thirdly, regions will let contracts for research in areas which they themselves have identified as priorities. These may be matters of local as well as of national concern. They will obviously be concerned about the patterns of health within their own regions and will address them as part of their R&D plans. We intend that they will, however, be free to commission research from those centres within or outside their own region best placed to undertake the highest quality work. I hope that this will reassure my noble
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friend Lord Bridgeman. We very much intend that there will be a free flow of information under this strategy so that regions can also use the results of appropriate research and development undertaken elsewhere.
Perhaps I may also refer to the role of the London postgraduate special health authorities in the strategy. They and their associated institutes will continue to be major providers of research and development for the National Health Service. They will be able to hid alongside regions for the management of programmes of centrally-funded R&D, and may undertake R&D on contract. They will also continue to carry out their own R&D activity so that there will be continuity.
SHAs have provided us and the CRDC with position statements of their R&D plans. Each paired special health authority and institute is also jointly nominating a senior member of staff who can fulfil the role of director of research and development for that organisation.
We also see a major role for the regional directors of research and development, with a representative from the special health authority/institute directors of research and development, in working as a group with Professor Peckham to manage a co-ordinated national programme.
We are currently establishing an information systems strategy for research and development. The objective is to ensure that National Health Service resources are deployed to maximum effectiveness. This will be achieved by developing systems which provide comprehensive and up-to-date R&D information on matters of direct relevance to patient care services. This information will be extremely important to many people, including, for example, clinicians and managers involved in placing contracts to purchase services.
I have been encouraged by the positive reactions from the National Health Service to our strategy. Regions in particular have grasped the importance of ensuring that R&D is integrated into the management agenda. We are working with them to help them develop the infrastructure that they will need in order to take on the research and development management task. We held a successful workshop for regions on 4th December, from which many helpful ideas emerged.
Perhaps I may attempt to answer some of the many specific points and in advance I hope that noble Lords will understand if I do not cover them all. The noble Lord, Lord Hunter, questioned the Government's view of the use of quality adjusted life years. I can tell the noble Lord that measures of quality adjusted life years, or QALYs as they are sometimes called, can provide useful information on health outcomes. However, there are concerns about some of the uses to which it has been suggested they might be put. The noble Lord remarked on that. The department is funding a programme of work to develop and evaluate those measures further.
The noble Lord, Lord Rea, asked how our National Health Service reforms are being evaluated. We are learning by experience and we are looking at quality of care, value for money and more

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responsiveness to individual patients, for example, through the reduction of waiting times and waiting lists. The first six-months report, which was issued just a few weeks ago, provides a good indication of how well the National Health Service is responding. The noble Lord also asked about research to follow up Department of Health inquiries into health care needs. We have commissioned a range of research to support the new purchasing role of district health authorities. This includes a series of epidemiologically based needs assessments governing topics such as diabetes and a series of bulletins summarising what is known about the effectiveness of interventions for particular conditions.
On the subject of research into the needs of elderly people, I can reassure the noble Viscount, Lord Falkland, that one of the members of the central committee, Professor Kay-Tee Khaw, is a professor of clinical gerontology with expertise in the interface between basic research and community based epidemiological studies. The elderly are an important client group in that respect.
The noble Lord, Lord Walton, referred to the adequacy of the service increment for teaching and research (SIFTR). Again, the department is undertaking a review of SIFTR. The steering group on undergraduate medical and dental education and research chaired by the Permanent Secretary of the department is taking a close continuing interest in that. The noble Lord, Lord Walton, also asked about the impact of changes in dual support on charities. We have tried to make it clear that dual support transfer is not intended to alter the basis on which charities commission their research in higher education institutes. The Government do not wish to see any reduction in the present level of public funding to underpin research projects sponsored by charities. I know the UFC is currently considering transitional arrangements to avoid any problems.
The noble Baroness, Lady McFarlane of Llandaff, spoke about multi-disciplinary research and in particular nursing research. I can reassure her that multi-disciplinary research will be actively promoted within the National Health Service R&D strategy. I understand that two members of the central committee are nurses and a group is now being established to develop a strategy for nursing research which will create a profession which can articulate the need for research, participate in carrying it out, and use research results to change practice. Members of the group will include both members of the central committee who have a nursing background and others with expertise in nursing and midwifery research, social policy and health services research and National Health Service management. It is intended that the strategy will be endorsed by the chief nursing officer, the director of research and development and by the nursing, midwifery and health visitor professions.
The noble Lord, Lord Butterfield, made a number of interesting points and mentioned specifically careers for researchers. In departmental terms, that is a matter for the Department of Education and Science and for the research councils. However, we are asking
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the regional health authorities to let us have their views about the provision of researchers as part of their R&D plans.
The matter of training was also referred to, particularly training in community care. The Government recognise the importance of training in improving the quality of social services for older people, children at risk and families caring for dependent relatives. We are providing funds for training. This year, 1992–93, the funds amount to some £56 million. Those funds are intended to ensure that all social services staff are equipped for their new task bearing in mind the terms of the Children Act and the community care aspect of our reforms.
I have perhaps taken a good deal of time to recount the background of the developments of the new system of National Health Service research and development strategy. However, the success of this strategy will lie not in any systems and structures which it engenders but rather in the development of an evaluative culture. In saying that, I echo the opening remarks of the noble Lord, Lord Hunter. We need to encourage managers, clinicians and everyone else concerned to identify the areas in which R&D can help them to deliver a better service. We need to help them to recognise the importance of asking the right questions so that the answers can be really useful to them. We need to ensure National Health Service ownership of the strategy so that more valuable research and development results are translated into action. Ultimately the success of the strategy will lie in the improvement of the health of the population. I am confident that this strategy will achieve those wider aims.
5.28 p.m.
Lord Hunter of Newington: My Lords, I only have time to express my thanks in three respects. First, I thank the Minister for giving us a remarkable account in a relatively short time. She has encouraged every one of us here, as well as many people in the health service, and also someone who is sitting behind me at the Bar, to get on with this matter. Secondly, the right reverend Prelate the Bishop of Norwich has earned a place in this House as he has established himself as an authority in a special and important field. I am sure everyone in the House would wish to encourage him to keep on advising us and to keep us on course. Thirdly, I thank everyone who has taken part in this interesting debate. I beg leave to withdraw the Motion.
Motion for Papers, by leave, withdrawn.

Defence Equipment
5.29 p.m.
Earl Howe: My Lords, with the leave of the House, I shall now repeat a Statement made in another place this afternoon by my right honourable friend the Minister of State for Defence Procurement. The Statement is as follows:
"With permission Mr. Speaker, I wish to make a Statement on a number of new equipment projects for the Armed Forces. The House will recall that in

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my Statement last week on amphibious forces I said that a corner-stone of our policy in developing `smaller but better' armed forces is the enhancement of flexibility and mobility.
"For the Royal Air Force, one of the proven methods of achieving this, demonstrated both during the Falklands conflict and more recently in the liberation of Kuwait, is air-to-air refuelling. It became clear after the Falklands conflict that an increase in the RAF's tanker assets was vital and a programme was set in train to augment and eventually replace the Victor tanker fleet. So far nine VC 10s and six Tristars have been added to the RAF tanker fleet and a further 13 VC10 conversions are now in progress.
"I am now pleased to announce that we have decided to award a contract to British Aerospace to give the remaining five VC10 transport aircraft a tanker capability. The work is expected to be done at BAe's Filton site with significant elements sub-contracted to Flight Refuelling at Hurn.
"The existing programme already provided the RAF with a capability in this area greater than that of any of our European allies. These additional aircraft will give the RAF the reach and flexibility it needs to meet the challenges and uncertainties of the future.
"The effectiveness of air power is determined not only by the performance of the aircraft but also by their ability to defend themselves and suppress enemy air defences in a hostile environment. To these ends, we have decided to order a new defensive aids system for the Tornado F3 air defence variant, combining chaff and flares. Contract negotiations are under way with British Aerospace which, as prime contractor, will be responsible for system integration. The flare dispensers and system control equipment have been designed, and will be supplied, by Vinten Military Systems Ltd. of Bury St. Edmunds.
"Additionally, we intend to order from British Aerospace, subject to the agreement of satisfactory contract terms, a further batch of ALARM missiles to replenish stocks expended during the Gulf War. Among the sub-contractors who will benefit from this order are Marconi Defence Systems, Portsmouth; Lucas Aerospace, Bradford; Irving of Letchworth; and Thorn EMI of Hayes.
"The Gulf war also re-emphasised how essential good communications are to the success of military operations. We have decided to extend the successful Skynet 4 satellite communications programme. The three satellites currently in operation are expected to approach the end of their orbit life by 1997 and a further batch of new satellites will be ordered for launch in that year. This will extend the life of our current communications satellite system into the next century.
"A firm price project definition phase for Skynet 4, Stage 2, will be conducted by the team responsible for the Stage 1 satellites; namely, British Aerospace Space Systems at Stevenage as prime contractor, with Matra Marconi Space at Portsmouth as the major sub-contractor.
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"I turn now to helicopters. We intend, subject to the agreement of acceptable contractual terms, to place a contract with Westland to convert the Royal Navy's Lynx Mark 3 helicopter to the more capable Mark 8 standard.
"The core of the Lynx Mark 8 update will be a central tactical system which has been developed by Racal Avionics in Raynes Park. The contract will provide for the conversion of seven airframes to the Mark 8 standard, and the supply of tooling and modification kits to enable conversions of further aircraft to be undertaken by the Royal Navy.
"The House will recall that we have been considering the purchase of additional Sea Kings for the SAR role. I am pleased to announce that we intend to order a further six Sea King helicopters and a Sea King simulator for the Royal Air Force. This will enable us to replace the ageing United Kingdom based Wessex in the search and rescue role with this longer range and generally more capable helicopter. In line with our policy of moving to tauter contractual conditions for non-competitive procurement, the contract with Westland for the helicopters will be subject to prior agreement of an acceptable firm price. Competitive tenders will be invited for the simulator.
"Finally, I can confirm to the House our plans for further trainer aircraft for our successful Harrier force. Subject to the agreement of satisfactory contractual terms with British Aerospace, we intend to purchase 13 new Harrier T10 two-seat trainers for the RAF and to convert five Harrier T4 aircraft to the more capable T8 standard for the Royal Navy.
"The total value of these orders for the Royal Air Force and the Royal Navy will be some £500 million. These proposals are within our existing defence expenditure plans and provide yet further demonstration of the Government's firm commitment to ensuring that the Armed Forces, although smaller in overall numbers, will be better equipped than ever before".
My Lords, that completes the Statement.
Lord Williams of Elvel: My Lords, the House will be grateful to the noble Earl for repeating the Statement made in another place. It will certainly come as a relief to British Aerospace, which has been going through troubled times recently. In general, we welcome the Statement.
However, I note the sentence in the Statement that the RAF will be given,
"the reach and flexibility it needs to meet the challenges and uncertainties of the future".
What is the Government's assessment of the challenges and uncertainties of the future? It is no good saying that the RAF will have that capability without knowing the Government's view on what those challenges and uncertainties are.
Then we are told:
"The effectiveness of air power is determined not only by the performance of the aircraft but also by their ability to defend themselves and suppress enemy air defences in a hostile environment".
Which enemy do the Government have in mind? On what basis are those calculations made? Has there

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been a thorough defence review? If there has not been a thorough defence review should there not be one? We do not believe that Options for Change, which has led to all this, was a thorough defence review.
Secondly, are Her Majesty's Government placing an order for new helicopters or simply making a statement of intent? I should be grateful if the noble Earl would answer that question.
Thirdly, when will Her Majesty's Government order the advanced short-range air-to-air missile? That is a project which will occupy and affect thousands of jobs in both Stevenage and Bristol.
Next, I should like to ask the Minister whether he will elaborate on the satellite programme. Can he confirm whether or not Her Majesty's Government are prepared to allow our military satellites to be launched by the country which submits the lowest tender for launching? If not, who will launch the satellites and under what programme? Can he also confirm that the satellites which are proposed will be independent of the US satellite network? We all know that in both the Falklands and Operation Granby we were heavily dependent on US satellite and AWACS equipment. How far in general will we be dependent on the US? How far does the noble Earl think that this country can launch any operation of a Falklands nature now without the active military rather than merely political support of the US?
Even if there is a defence review—and we do not know what the Government's assessment of the probabilities, uncertainties and future enemies might be—in the noble Earl's mind is there any possibility that we could act independently of the US? If that is not the case—and we must accept the fact that we are not a world power or a world policeman—and we rely on the US, should we not tailor our expenditure to that fact?
Finally I should like to ask the noble Earl a question about the last sentence in the Statement:
"These proposals are within our existing defence expenditure plans".
We have had many debates in your Lordships' House about whether it is proper that the Government should tailor their defence expenditure to the requirements of the Treasury or whether they should tailor their requirements to the defence of the United Kingdom. We are in no doubt that the latter alternative is the right one, but in the many debates we have had we have not been satisfied that that condition has been met.
I should be most grateful if the noble Earl would respond to my questions. In the meantime, I thank him for repeating the Statement. I very much hope that he will not engage in the sort of party political knockabout which took place in another place when the Statement was made.
Lord Mayhew: My Lords, the proposals appear to arise directly from experience in the Gulf War and the Falklands War. That is good and we welcome it.
I do not feel much happiness about the extension of refuelling capability. The noble Lord, Lord Williams, asked the Government what it is for; but it is all too plain. Even as things are now, we have a more
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powerful refuelling capability than any of our NATO allies. The reason that the Government propose to extend it further is in order to cater for Britain's out-of-area unilateral commitments. If I feel uneasy about that, it is perhaps partly because I have flown in a Buccaneer being refuelled in the air. It was a most unnerving experience.
But mainly my worry is that the Government are settling down to a permanent acceptance of our out-of-area unilateral commitments. On these Benches we believe that that is a wrong policy. We feel that the Foreign Office ought to do far more than it does now to ensure that those commitments are either shared with our allies or negotiated away. In my view, that should be the attitude of the Government.
I shall ask the noble Earl a single question. We are told that the £500 million can be found within the existing budget. What does that mean? Does it mean that the budget with which we were presented in Options for Change was inflated, or have economies been made? What are those economies? I should be grateful if the noble Earl would answer that point.
Earl Howe: My Lords, I thank the noble Lords, Lord Williams and Lord Mayhew, for welcoming the Statement.
The noble Lord, Lord Williams, asked me for the Government's assessment of the challenges and uncertainties that face us over the next few years. That is rather like asking me to be certain about uncertainties. The answer is that we have seen over the past few months the demise of the Warsaw Pact, but we do not know what future developments will take place within the old Soviet Union. We must also be mindful of the potential for instability outside Europe. After all, not so long ago we fought an unexpected war in the Gulf. We must be ready for any eventuality that we and our allies may face across the globe.
Lord Williams of Elvel: My Lords, I am grateful to the noble Earl. There is one point on which I should like clarification. I did not ask him what the uncertainties were; I asked him what was the Government's assessment of the uncertainties.
Earl Howe: My Lords, I confess that I am baffled by the distinction which the noble Lord has drawn. I apologise for being obtuse. As he well knows—if his party is in office in a few months' time it will have to take the same view as we do constantly—there is a constant reassessment of our capabilities and the situation around the world which our Armed Forces may be called upon to address. We need to be sure that our Armed Forces have the equipment that they need in any area of the world in which they find themselves.
The noble Lord asked me about the helicopters and whether we would be placing an order. We are in the process of negotiating the contracts with Westland with a view to placing the orders. The value of those contracts has not yet been precisely costed but is in the region of £20 million. The Wessex helicopters that are being replaced by Sea Kings will come into service over the next three to four years. We expect the first aircraft to be delivered in 1995. Again, however, those orders are subject to contract.

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The noble Lord asked me about short-range air-to-air missiles, which in fact I did not mention in the Statement. An announcement about those missiles will be made in due course. He then went on to ask me about the launch of the satellites and who will launch them. Once the launch date approaches there will be a competition for the contractor. Obviously I cannot comment on the result of that exercise in advance of the competition.
The noble Lord asked me whether our satellites would be independent of the US network. It is fair to say that, when we deploy satellites of that kind, we do so in consultation with our allies. We are often given access to the satellites of our allies. It is a collaborative effort.
The expenditure figures that I have given are within the plans that we had before us last autumn, as foreshadowed in the Autumn Statement of my right honourable friend the Chancellor of the Exchequer. The noble Lord, Lord Mayhew, asked specifically about those budgets. That expenditure will fall within the defence budget over the next two to three years between now and the mid-1990s. We have allowed for capital expenditure of that order in our budgeting. Now that we are firming up those plans, we can come to the House and say what we intend to do.
If I have failed to cover any particular points, I shall write to noble Lords. I hope that I have at least covered the main points that were raised.
5.47 p.m.
Lord Boyd-Carpenter: My Lords, I am grateful to my noble friend for repeating the Statement. I am particularly glad that it has been repeated, unlike the one on naval developments which, unhappily, last week for some reason was not repeated in this House.
I am sure that my noble friend appreciates from the questions that have already been put to him the interest that your Lordships' House has in this important matter. It is right that the Statement should be repeated in this Chamber. Perhaps I may also say how much I disagree with the noble Lord, Lord Mayhew, when he criticised the improvements in the refuelling facilities for the RAF. We live in an immensely uncertain world and one in which trouble may blow up in many places. It is no use shutting our eyes to trouble because it arises some distance away. The Government are doing the proper thing; namely, increasing the refuelling facilities of the RAF so that it can be an effective instrument in the case of trouble which arises at a considerable distance. Most of us will find it encouraging that the Government have emphasised that point with these improvements.
Is my noble friend aware that we are very much encouraged by the care which is now being taken to improve the Royal Air Force and naval aircraft provision? We are hopeful that it is an indication that the Government will not be lulled by people who try to convince themselves that we live in a safe or easy world.
Earl Howe: My Lords, I am most grateful to my noble friend and agree wholeheartedly with his comments. I need hardly say that the qualities that we
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all look for in our Armed Forces are flexibility and the capacity to react quickly as well as with professionalism. The refuelling capacity for our aircraft is a key ingredient. There is an uncertain situation around the world. We need to be ready to respond to any emergency which may arise.
Lord Judd: My Lords, the noble Lord emphasised the importance of flexibility which lies behind these orders, but I understand that one of the other principles on which our defence policy is based is the closest possible integration with our allies. If that is to be effective, both operationally and in terms of economic management of the resources available to the alliance in total, it is important that significant renewals of equipment are the best and most sensible renewals for the alliance as a whole. Can the noble Lord assure us that there have been full consultations with our allies and that this very significant new order makes rational sense in terms of the alliance as a whole as well as in terms of our narrower national interest?
Earl Howe: My Lords, yes. I am happy to give the noble Lord those assurances.
Lord Renton: My Lords, I too welcome the Statement. Perhaps I may ask my noble friend two questions. First, to what extent will the cost involved benefit British firms; and to what extent will it be money spent overseas? Secondly, will the further equipment that the armed forces will receive, as he has announced, involve any variation in the manpower proposals in Options for Change?
Earl Howe: My Lords, in terms of who will receive those orders, the benefit will fall almost entirely on the UK industry. There are one or two overseas subcontractors, but by and large it is the UK industry which will benefit.
The announcements that I have made have no implications for manpower.
Lord Bruce of Donington: My Lords, will the noble Earl assure the House that the capital amount of the expenditure involved will be borne out of the public sector borrowing requirement, or is it the Government's intention that it should be borne out of general receipts into revenue?
Earl Howe: My Lords, any element of government expenditure is allowed for out of the receipts that they may have over a period of years, whether they be borrowings or receipts from the general fund. It is part of the defence budget. I can go no further.
The Earl of Selkirk: My Lords, what the noble Earl has said will be received with great satisfaction by a large number of people. The point made by the noble Lord, Lord Williams, is out of date now. We are living in a world of astonishing uncertainty. There is almost no part of the world with any immediate, clear picture of the future. We do not know which way people will move. Some people wish to divide their countries into a lot of little bits; some want to join huge countries together. No one knows how to do it. That is the position that we are in.

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I am glad that money should be spent on aviation. Every war has required new types of aeroplanes. The use of the latest type of aeroplane has in many cases been decisive. Those who do not have such aeroplanes lose their way. It is astonishing to me that the noble Lord, Lord Williams, considers that we have to rely on the United States of America. Do we have to give up our arms and let them provide our defence? That is unlikely to be a sound proposition. The United States will support those who help themselves. If we do not help ourselves, the United States will not consider us for one moment.
The noble Earl's Statement has given great satisfaction to this country. I am delighted to have heard it.
Earl Howe: My Lords, I am most grateful to my noble friend.
Lord Mayhew: My Lords, is the noble Earl aware that no one has challenged the view—
Lord Harmar-Nicholls: My Lords, we had criticisms earlier———
Noble Lords: Order!
Lord Harmar-Nicholls: My Lords, having rectified my seating position on the Benches, I wish to raise a point of order. The rules that we agreed were that during questions on the Statement one intervention should be allowed. If we are worried about the time spent in this regard we ought to adhere to our own rules.
Lord Mayhew: My Lords, I take the point that is now made from a proper place in the Chamber. However, I understand that it is possible to ask for elucidation of an answer that the Minister has given. I am glad to have the assent evidently of the Leader of the House.
Lord Waddington: My Lords, that is correct. One can rise on a point of elucidation.
Lord Mayhew: My Lords, perhaps I may ask the noble Earl to explain his reply to me about refuelling. Is he aware that no one has suggested that while we hold unilateral out-of-area commitments refuelling extra capacity is necessary? Are the Government now seeking either to share with our allies or to renegotiate those out-of-area commitments, or do they intend to keep them indefinitely? That appears to be the view of the noble Earl's supporters.
Earl Howe: My Lords, that question deserves a considered reply. I do not have the answer at my fingertips. If the noble Lord will allow me to write to him, I shall certainly do so.

Public Library System
5.56 p.m.
Lord Willis: My Lords, when I put my name down in the ballot for this debate and began to prepare for it in the certain knowledge that my name would come up, I realised that there was an omission in my entry
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in Dod's Parliamentary Companion and Who's Who. It states rather baldly that I was educated at Tottenham Central School and left there when I was 15. It should have read, "Educated at Tottenham Central School and Tottenham Municipal Libraries" for, like millions of others who had to leave school too soon, I continued to learn in the public libraries and I am still learning. I owe our library system a debt that I can never repay.
Tottenham ran a marvellous library system in the 1930s when I was a boy. It was a poor borough—poor in terms of money but rich in spirit. Our town councillors understood the value of knowledge. There was the central library, numerous branches, a mobile library, a hospital service and a range of cultural and educational activities. In successive winters as a lad I attended a series of lectures on classical music appreciation—a foreign country to me then—another series on the English poets and one on the Greek philosophers which was even more foreign. Wonderful! It was like a succession of doors opening in my mind on great vistas of understanding.
The most important aspect was the books. Row upon row of books by the living and the dead smiled silently down upon you waiting to offer up their treasures. There were books upon almost every subject under the sun—novels, reference works, art books and non-fiction from architecture through acupuncture to zoo and Zionism.
I remember still my first ever visit to our central library. I had the feeling that I was entering a temple where the librarians were like acolytes, speaking in hushed voices in a silence that added to my sense of awe and respect. I did not have two ha'pennies to rub together, yet all this, the books, the buildings, the staff were there to serve me and people like me. I began to plunder those shelves immediately, starting as I remember with Stanley Weyman's adventure yarns, working my way through Stevenson to Tolstoy and taking in on the way such esoteric works as The Moral Discourses of Epictetus—though I cannot claim that any of the morality rubbed off on me.
Your Lordships might take some gratification from the knowledge that our magnificent public library system, which is the envy of so many other countries and which we take so much for granted, was born here in the Palace of Westminster. It was William Ewart (after whose father Gladstone was named) who in 1850 pushed through in another place the laws which allowed some local authorities to establish free public libraries. It was an ancestor of our colleague the noble Lord, Lord Avebury, who took up the banner and extended the legislation, and we owe an enormous debt to Andrew Carnegie who in his later years—perhaps fired by a guilty conscience or by memories of his own poverty-stricken childhood—set out on a personal mission to provide library buildings all over the world at huge cost.
We take this inheritance so much for granted that we are in severe danger of overlooking the threat to the system presented by today's public expenditure restraints, and certainly those over the past 20 years. The sad and brutal fact is that our wonderful public library system, though still one of the best in the

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world, is in a state of persistent decline. That must cause alarm to all of us. It has happened at the worst possible time—a time when we are deeply concerned about fostering good reading habits among the young, about literacy and about the need to provide access not only to literary culture but to all kinds of information resources.
The total cost of the public library system represents about 1.5 per cent. of local authority expenditure. It amounts to about 23p per head of the population per week or about the cost of half of one daily newspaper. That covers not only the books and other materials which libraries stock but also the cost of the buildings and of the staff. It is a fantastic bargain and the public recognises that.
When financial constraints lead a local authority to try to close down a library, the public rises up in protest. For example, recently the authority concerned decided to close the famous Fulham Reference Library. Obituaries about the library were already being written in the local press but the local people rose up in tremendous anger. They compiled a petition of more than 7,000 signatures and the decision was reversed. That has also happened in several other places.
When surveys are undertaken about which public services are most appreciated, the public library system always comes out top or near the top. It is reckoned that about one-third of the population makes regular use of their public library. That makes it probably the most used public service in the country and is clear proof of its value. The number of borrowings in 1991 was 568 million. That equals 10 borrowings per person—every man, woman, child and babe in arms in the country. That means that regular users of the system are also big users of the system, borrowing about 30 books a year, which is a gigantic figure.
There are some people—including some who shamelessly defile the name of Adam Smith by adopting it for their own narrow political motives—who say that a free public library system may have been important in the 19th century but is not needed today. That is absolute rubbish. Of course we should all buy books as well as borrow them. All research indicates—surprise, surprise—that the people who borrow books also buy them. But we would all have to be a great deal richer if we were to buy every book we wanted to read. It makes practical sense therefore to create pools of books in what are called libraries which we can all use.
I am happy to acknowledge that most Ministers for the Arts —who have responsibility for the public library system at least in England—have firmly acknowledged their commitment to a free public library service. That is about all that they have acknowledged, but I suppose we should be grateful for small mercies. But I have to say that the threats to this service during the past 10 or 20 years have been severe. For example, if public libraries are to be fully utilised they need to be open for longer than normal office hours. Just taking the figures for England and Wales, the number of libraries open for more than 60 hours
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a week has fallen from 229 in 1974–75 to only 18 in the present year. They are open at inconvenient hours from the point of view of the public.
The professional librarians who run the system—and we should give credit to them because they are marvellous people—naturally try to ensure that that restriction in hours is done in a way which allows people to visit their libraries outside working hours. But that is not always possible and the decline in the number of branches open for as long as they used to be is serious.
There have also been a significant number of closures of branches. I admit of course that branches need to be closed and moved in accordance with movements of population. There is nothing wrong with that. But what we have seen recently is the closing of branches simply in order to save money because of severe financial constraints.
Finally, we have many cases where the book fund —I suppose that we should now call it the materials fund because it is used to buy not only books but cassettes, videos and other materials that libraries supply—has been severely cut. The consequence is that libraries are not able to afford as much new material as in the past, nor is their scope as wide.
Although public libraries are the direct responsibility of local authorities, there is strong legal supervision from the centre. Under the Public Libraries and Museums Act 1964 the Minister for the Arts in England and the Secretary of State for Wales have a duty, not just a power, to,
"superintend, and promote the improvement of, the public library service provided by local authorities in England and Wales".
The Act requires local authorities to provide a "comprehensive and efficient service" and it gives the Minister full powers to ensure that they do so. But have those powers been used? The answer is no. Successive Ministers for the Arts have rushed to exercise their duties in this respect with all the speed and enthusiasm of a school of arthritic tortoises. Their indifference in this area is matched only by their indolence.
The Library Association, which is the professional body for librarians and other information specialists, with 25,000 members throughout the UK, has constantly pressed successive Ministers to exercise real supervision over the system and to intervene when local authorities are not carrying out their duties. It has had a pretty dusty answer from most Ministers. I must admit that the present Minister, Mr. Renton, used his powers to demand an explanation from Derbyshire County Council when last year it closed 11 branches. The council reacted by appointing its own tribunal to investigate whether it was carrying out its legal duties. The report of the tribunal was presented just before Christmas. The verdict was guilty. I am glad to say that the Minister has intervened again and asked Derbyshire County Council to put the matter right.
I must say in parenthesis that the letter which the Minister sent, and which was quoted in the press statement issued by the Minister for the Arts, was written in such jargon that I wonder that Derbyshire county councillors could understand it. I urge the

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Minister to issue to his staff, and in particular to his publicity staff, a copy of Sir Ernest Gowers' Plain Words so that they learn how to write clear, precise and intelligible statements.
The action by Derbyshire County Council in closing 11 branches is only one of many recent examples. Three libraries were closed in Greenwich. In Hackney three branch and two reference libraries were closed. Two libraries were closed in Manchester. In Kirklees two branch libraries and one mobile library were closed. Hammersmith is proposing to "restructure" its services—an ominous word—and there is even talk of privatisation. What are we coming to? How on earth can we privatise a public library without betraying all that it stands for?
Let us consider another threat—these cuts in book funds. Derbyshire has made a 50 per cent. cut in the money available for books and materials; Somerset has made a 20 per cent. cut; Warwickshire a 20 per cent. cut; Islington a 10 per cent. cut; and Liverpool a cut of £100,000. In Camden no new books are to be bought after September 1991. If that is not evidence of the pressure that is being put on our library system and the threat to this great institution I do not know what is. During the past 10 years in particular, but also during the past 20 years in truth, there has been a steady decline in the scope and quality of our libraries. It has all been done in the name of efficiency and cost-effectiveness and the system has been put at risk.
Not only public libraries are affected; school libraries are facing severe difficulties because of cuts. Good school libraries depend not only on having a good individual library within each school but on providing a common school library service. That used to be the practice of most education authorities. But with the so-called devolution of management and budgeting of schools to head teachers and governors, those common services are under serious threat. The school library services are often provided on an agency basis by the public library service. That will not survive in certain areas because some schools simply will not co-operate.
There are problems elsewhere in the library world. Something which worries me out of my wits is that the university libraries, including some of the most prestigious, are selling off some of their treasures to finance current consumption. They have no right to do that. Those treasures do not belong to them. They belong to the country, to our tradition and to our history. It is a scandal that in order to make ends meet universities should even consider selling off those treasures. That has happened recently with Manchester's John Rylands library and at the Edinburgh University library. I ask the Minister to intervene to stop that.
In the days before the coming general election we shall hear a great deal about the quality of life. I believe that our public libraries have contributed more to the quality of life than anything else in our national life except perhaps the BBC. Both are public services and to some extent they cannot be judged by ordinary commercial standards. Of course they must be efficient. They must make the best use of limited
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resources. But they should not be expected to show a profit or cut services to provide some local authorities or the Government with a budget victory. They should not become victims of economic dogma.
In essence, I am talking about books—probably the most important invention and development in the entire history of mankind. Where should we be without books? They are our friends, companions, guides, teachers and entertainers. Is it not true that you can measure the degree of freedom in a country by its attitude to books? Where they burn books or ban them you have dictatorship. Dictators are afraid of books because they carry ideas and ideas threaten dictatorships. When you kill a book you are killing reason.
Books have changed the world. Harriet Beecher Stowe's book Uncle Tom's Cabin sold in the shops for 50 cents but it changed a generation's attitude towards slavery. Tom Paine's The Rights of Man ushered in a new era of democratic thought. Karl Marx's Communist Manifesto became one of the most influential books ever produced. Perhaps the most influential book of all is the Bible. How do you put a value on those and other books? In the modern commercial jargon which is increasingly creeping into local government and local services, how do you measure the cost-effectiveness of books?
The answer is that you cannot any more than you can measure the cost-effectiveness of a Mozart concerto, a Beethoven symphony or a Shakespeare sonnet. Nor can you put into a balance sheet or a local authority budget the true value of our public libraries. It is inestimable. That is why we must reverse those cuts and stand on guard to protect the public library system. The public library system is not ours. It was created by our forefathers and it is our duty to hand it on in good condition to our children. It has taken over 100 years to build and it can be destroyed in a decade if we are not careful. My Lords, I beg to move for Papers.
6.13 p.m.
Lord Quinton: My Lords, first, I apologise for the fact that if the debate takes the full two-and-a-half hours allocated to it, I may have to leave because of an appointment from which I cannot extricate myself.
Like the noble Lord, Lord Willis, I shall concentrate on two aspects: first, the general evidence of decline in the public library system to which he drew attention; and, secondly, in a little more detail, the problem as regards disposal. I am not quite as anxious about the sale of expensive treasures as I am about careless chucking out of the basic standard equipment of libraries of which there is some evidence.
I begin with the evidence of decline. In an article by Mr. George Cunningham, the chief executive of the Library Association, in a recent number of the Bookseller there are two very useful diagrams or tables. One indicates—and this was alluded to by the noble Lord, Lord Willis—that the number of libraries open for more than 60 hours per week has declined from 229 to 18 over a period of 18 years. That is an extremely steep decline. However, 60 hours is quite a lot. Like many of your Lordships I am a happy,

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continuous and grossly self-indulgent user of the London Library. That is open for 50 hours per week and I do not believe that it has ever been open for longer. It is open from 9.30 to 5.30 on six days per week, and is open for two extra hours on Thursdays. Therefore, I suspect that the picture may not be quite so bad. Nevertheless, that is not to deny the general tendency to which the noble Lord, Lord Willis, referred. It is quite obvious that, brutally speaking, the public library system is starved of resources, as are many other valuable and important services.
The other connected phenomenon to which the noble Lord also drew attention is the decline in use from 650 million withdrawals five years ago to 570 million withdrawals in the latest recorded year. That is a rather significant fact in its correlation with the diminution of services testified to by that reduction in the number of libraries open for more than 60 hours. There are many other indications; namely, the closures of which the noble Lord spoke, and so on. There is a connection between those two factors, but although the decline in resources is related to the diminution of use, there seem to me to be two long-term factors which should also be taken into account—large tides which are to some extent running against the public library as a continuing institution.
The first such factor has been with us for a long time; that is, the paperback revolution. That certainly transformed book buying practices. It made the idea of buying books a reality to an enormously large constituency. When paperback books first hit the market in England with the original five Penguins—Ariel by André Maurois and one or two others—they were 6d each. In the light of the subsequent increase in the RPI, they would now be 75p or 15 shillings. In fact, you are lucky to get away with £2.99, and £3.99 or £4.99 are much more common prices for fairly mass market paperback books. Nevertheless, it remains true that they are in the order of one-third or less of the price of a hardback book. Many more people own a substantial number of books than used to be the case.
I must take a small literary excursion. It would not be proper in a debate of this nature if there were not one. Readers of Hardy and, in particular, Far From the Madding Crowd will remember the arrangement in the wagon or caravan of that admirable figure Gabriel Oak, the shepherd. He owned about eight books—the Bible, Bunyan's Pilgrim's Progress and something called Walkingame's Arithmetic, which was an 18th century arithmetic text. That is not an unrealistic picture. Gabriel Oak was a skilled man as a shepherd. In some ways he was ambitious, and nowadays we would say that he was an upwardly mobile man. I do not for a moment doubt the essential correctness of Hardy's view that such a man, even as a reader, would have an extremely small number of books.
The large number of people who now graduate from universities tend to have quite a lot of books even if they are rather tattered and, because of paper decay, are rather gingery around the edges. It is a good tide if some of the reading needs of the citizens are met by that ready and inexpensive availability of books.
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The other tendency is not to my mind—and perhaps that is because of senility—in any way as attractive. I refer to the overwhelming of text by sound and image. I suppose we must put up with that in the community as a whole. What depresses me is the invasion of public libraries by large illustrated books not properly stacked on the shelves but stood sideways so that the glamorous shiny outer cover of people surfing on Bondi beach or whatever it might be, is clearly visible to the users of the library. In the same way libraries set out stocks of video cassettes and items of that nature which their users can borrow. I view all that with some anxiety. My general picture of what is happening is that material of even lower quality than much of what is borrowed from libraries in the traditional style is being circulated.
Early last week I was in a library in a small town in the South of England where much of my own education went on. I was astounded how it had changed. It had originally been a corn exchange, but such are the historic mutations up with which we have to put. It was a handsome dignified George Eliot type of building, even if it was in Hampshire. It used to be filled with cases and one navigated around the cases and found the books. Now it is open-plan and everything is in bright and brilliant colours. It is an effort to draw people in but I wonder whether it is well advised.
Confronting the problem of the shortage of resources, the noble Lord, Lord Willis, said that there needed to be more finance and the free library system should be continued. But we should envisage the possibility of dividing the services of the public library system into two parts—that is, an educational part which will be provided free and a recreational part which will not. There is a mass of passive escapist reading of low-grade material by such authors as Wilbur Smith. I for one have no wish to prevent people reading it or even supplying it to them on easy terms. The idea of their making some small payment —for instance, 10 p for each withdrawal—for those works, with suitable fines for holding the books too long, seems to be entirely reasonable. It would probably generate around £40 million a year which would do a great deal for the restoration, for example, of book purchase.
I am partly driven to that conclusion by a deep consciousness that the more rhetorical, sentimental and emotional feeling one has about public libraries —I share that with the noble Lord, Lord Willis—is in my case a little choosy, perhaps snobbish. It goes towards the books that are genuinely of an educational character and not towards Victoria Holt. I do not know how the line should be drawn. All drawing of lines is relatively arbitrary. I suggest quite simply fiction published in the 20th Century and supplementary things like purely joke books—volumes of Viz and so forth—always supposing public libraries stock them.
At any rate, we have allowed public libraries to be financed purely out of public funds when to a large extent they do not foster the kind of thing that Andrew Carnegie, for example, had in mind, which was self-improvement. They foster what I suggest is

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anything but innocuous. Impassive and innocuous fantasy satisfaction should not be provided on the back of the serious provision of educational material —in the broadest sense of "educational".
I have spoken for a long time and I must close fairly rapidly with a few words on the issue of disposal. There is an interesting little book by a man called W.J. West who has hastened round secondhand shops and identified a large number of books that libraries have thrown out. They are not Audubon prints and so on out of which a university could make a fortune, but humble, humdrum books—histories of Rome and the like—which would be part of the basic educational stock of a public library. He quotes one public librarian as saying, "I am in business here and want the stock to turn over".
That is not a good idea. It is not part of the educational conception of a public library; it is part of the conception of a recreational library. In a recreational library, the stuff loses its currency fairly quickly. The favoured passive satisfying authors go out of fashion and new ones come in. Therefore disposal is something at which one needs to look closely.
I am slightly less worried by the managerial librarian who wants the stock to turn over quickly and condemns the book that has not been borrowed x number of times a year, than by the politically correct lady somewhere who filleted the shelves of her library of material she felt to be politically incorrect. That is a kind of ideological prudery comparable to that which kept out James Joyce's Ulysses, but now rather more humble volumes like Little Black Sambo are consigned to oblivion.
I do not know how that is to be controlled except by ventilating the fact that it is happening and by people vociferously complaining about it. I am suspicious of any attempt to restore the resources of public libraries through local government. The local government authorities which have most cut their public library resources are the ones which, on ideological grounds, refuse earmarked library money because they do not have money for something else that they want more. I do not understand that there is any direct way in which the Minister can cope with the problem except directly and not by some indirect presentation of money.
Lord Wyatt of Weeford: My Lords, perhaps the noble Lord will allow me to intervene. He is a great librarian. What does the noble Lord consider should be done about the practice of turning over stock when in that stock are often rare books which cannot be replaced? The books are sent around the countryside when they should be preserved and owned by the library concerned, whether it is a university or public library. Is there not a law which can be brought to bear on that kind of disposal?
Lord Quinton: My Lords, here I turn into the managerial person. I believe that the books should be kept in libraries where the arrangements are such that they can be consulted. Sometimes a library is totally incongruous with some of its holdings. They are not
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equipped to allow people to see the holdings; they have them locked up with complicated arrangements whereby perhaps somebody in a supervised way can be allowed to see them.
I suspect a lot of the items are in a way dead, although they are not of the highest value in the library. I do not believe there is a general answer. I shall make one point on the matter of disposal before I sit down. The acquisition of a book by a library is like marriage; a certain amount of initial expenditure is involved in bringing it off but that pales into insignificance in comparison to the haemorrhage of money that occurs after the marriage has taken place —or after the book is installed in the library. Much of it is once and for all—the bibliographic entry; but much is concerned with the storage and maintenance conditions for it.
With 65,000 titles being published each year, the idea that libraries should have any large part of it is difficult to square with any kind of rational management. The fountain of new material is so great that something must be brought out or, absurdly, vast areas will be covered or undermined by library basements. The disposal issue is a real one. One cannot say that the disposal is frivolous and irresponsible; much of it is inevitable because of the congestion and the expense to which it leads in the publishing industry.
6.29 p.m.
Baroness White: My Lords, I feel distinctly embarrassed in intervening in this debate at all, particularly after two such eloquent speeches by my noble friend Lord Willis and the noble Lord, Lord Quinton.
I looked with interest at the entry on the Order Paper and the subject chosen by my noble friend Lord Willis. I felt glad that someone intended to raise the issue. I thought that I might intervene modestly for a few minutes towards the tail end of a long list of distinguished speakers in your Lordships' House. Quite frankly, I am shocked at the small number of those taking part in what is an important debate. It was not until the day before yesterday that I went into the Whips' Office to look at the list of names. I was astonished.
My own contribution, to which I shall come in a moment, was intended to raise a small but important issue in what I had hoped would be an outstanding debate, which is what it should be. The debate was opened in an admirable way by my noble friend and most interestingly continued by the noble Lord, Lord Quinton.
However, I must make my intervention in due course, on a particular aspect which will not surprise noble Lords when I come to it. I have always been interested in books. I grew up in a household which had an ample supply of them. After taking an Oxford degree and not knowing what to do, for some time I was a temporary and unpaid reader's adviser in the New York Public Library on 42nd Street. One could not find a more prestigious and exciting library anywhere in the world. It not only had priceless

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volumes on the upper floors in the music and drama libraries, but there were also the collections of the Astor, Tilden and Lennox Foundations.
We were also the administrative centre for the circulating libraries of Manhattan and the Bronx. Working in that library, I learnt more about New York than most New Yorkers themselves knew about their own city. It was a wonderful experience. Later on I was at the Library of Congress, not working but just looking around. I was bred with the highest quality of public libraries!
I must not pursue all that. This afternoon I hope to put a few questions and suggestions to my noble friend Lord Morris of Castle Morris, who will take part later in the debate, concerning the position in the Principality of Wales to which most noble Lords are aware I am dedicated. Most of the speeches in the debate today will be dedicated to the problems besetting public libraries in England and the troubles that their staffs are having to face. That has been vividly described by my noble friend Lord Willis. It is natural that that should be so because in recent times the greatest difficulties have been experienced, particularly in areas such as Derbyshire, which has been specially mentioned. Some of the difficulties have been very serious indeed.
The 1964 Act, which provides the main statutory basis for our public library service, covers Wales as well as England although with some significant differences. Over the past decade or so Wales has not experienced the dramatic closures and diminution of services and hours of opening and so forth, which have been described by my noble friend Lord Willis. My inquiries in the immediate past indicate that although we do not feel disposed to have a campaign to save our libraries, which I believe is now being organised, nevertheless there are areas of disquiet. The responses to my inquiries refer to slow erosion rather than dramatic closures and to lower basic standards. There is nothing exciting, but there are fewer professional posts and a decline in other posts. There is some decline in book stocks and less is spent per head of population and so forth.
There appear to be two main areas of anxiety. The first is urgent: it is to ensure that we have a highly dynamic and active service in our library system in Wales which will combine modern and up-to-date information services with the traditional cultural and recreational uses of public libraries, as discussed in the two preceding speeches. In Wales we have our own excellent National Library of Wales at Aberystwyth. Close by we have what used to be the College of Librarianship which is now restructured and integrated with the University of Wales as the Department of Information and Library Studies.
We now need to develop new services in partnership with the Welsh development agencies, possibly in some areas with the private sector, to service some of the small industries and businesses, particularly in rural Wales, where we need up-to-date information technology. I understand that progress on these lines has already been attempted particularly in East Anglia, Norfolk, Suffolk and Cambridgeshire. We need something similar in the Principality. The
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public library service is also an information service. In Wales we now link library and information activity, which is a sensible development and should be encouraged.
If the East Anglian experience is as successful as I have been led to suppose it to be, it could be valuable for us. We must overcome the daunting employment problems which have arisen in rural Wales in the past year or two and for which it is very difficult to find adequate solutions. We want this dynamic and active approach and that requires the requisite resources.
That is one area in which one is anxious that on the Welsh scene we should be able not only to maintain the popular public library service but to combine and develop it in a way which is appropriate to modern practice. However, the major preoccupation among the staff and those responsible for the administration of the public libraries, is what is going to happen in the Principality under local government reorganisation. At the present time the pattern in Wales is that for the most part we have county libraries, with the Secretary of State for Wales, as my noble friend Lord Willis mentioned, holding particular responsibility for the public library service in the Principality.
There are exceptions. There are five district areas which, with the specific consent of the Secretary of State for Wales, which is statutorily required, have obtained their own individual administration. I refer to Llanelli, Merthyr Tydfil, Cynon Valley, the Rhondda and, more recently, Newport. Our Secretary of State has to undertake a decennial review of this and other aspects of the library service. He also has a statutory duty to superintend and promote the library service in the Principality.
The whole pattern may completely change if we have certain Government-proposed local government reorganisation which may mean that we shall have a number of separate units which could be much smaller than the existing counties. Who will advise the Secretary of State as to the most desirable pattern of public library provision in those circumstances? Will that advice be adequate?
As I understand it, at present there is no power of inspection by the Welsh Office to evaluate in detail the strengths and weaknesses of the individual county library services. There is a body, appointed and serviced by the Welsh Office, called the Libraries and Information Service Council—LICS for short—which has been enjoined to prepare a Libraries and Information Plan (LIP)—I use capital letters. There is also in Wales a branch of the professional Library Association with approximately 1,000 members, about one-third of whom are from the public library service, the others being mostly from university or school libraries. How effective will the advice be on which the Secretary of State for Wales, of whatever persuasion, can rely, which ever pattern of local government is to be promoted in Wales?
There is some monitoring of the five district council libraries to which I have referred, but there seems to be no top grade professional inspection on which a major reorganisation might be based. What used to be a strong professional advisory team at the Department of Education and Science in England has, I

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understand, been whittled down to one person. In Wales reliance appears to rest on the part-time services of the recently retired in-house librarian at the Welsh Office—someone certainly of great experience but perhaps not best placed to stimulate a Secretary of State who has much else on his mind.
I make this brief intervention because we have a different system in Wales and I am anxious that proper regard should be paid to the values and the potential of the public library service in the Principality.
I look forward to hearing any comments which the noble Lord, Lord Morris, may make from his considerable knowledge of the library organisation in Wales. I hope that he will indicate what his thoughts may be on the situation which I have described. So far as concerns the noble Viscount on the Government Front Bench, I shall excuse him because I did not give him notice that I was going to raise Welsh matters. I doubt whether he has an instant knowledge of the library situation in the Principality. However, if he cares to visit us at some time, we shall be very happy to educate him.
6.43 p.m.
Lord Beaumont of Whitley: My Lords, I have in the capacious bag which I lug about your Lordships' House at any given time, at least three books, sometimes more. Today—I looked before I came in to your Lordships' House—there is an American thriller by Mr. William G. Tapply, there is the autobiography of my noble friend the Leader of my party, Lord Jenkins of Hillhead, and there is a specialist book on "Preaching in Context".
I suppose I can start to draw lines, which the noble Lord, Lord Quinton, suggested that we might, between educational and recreational books from the ones that I read day in and day out. He will know far better than I how very difficult it is to draw distinctions of that kind.
The autobiography of my noble friend Lord Jenkins of Hillhead is no doubt a highly educational work, but I am reading it purely for entertainment. If one sinks to the lower end of the range, to those books which we sometimes are unkind about because they are written for a mass romantically-minded market, I wonder where one would put the novels of Georgette Heyer, which although undoubtedly written for that market and extremely popular as a result, are in fact intensively researched and extremely accurate about the periods with which they deal. That is an interesting aspect raised by the noble Lord, Lord Quinton, who made an extremely stimulating speech, which I shall certainly read in great detail.
The books that I read differ widely in price and differ widely in the use to which I put them. The ones that I have at the moment are all good books and they are all provided by the free library service of this country—one of them brought down by Express Bookworm, all the way from Kirklees Library I see, looking inside.
I speak as a compulsive reader with an omnivorous appetite; one who, when I was at school and they tried
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to find something for which I could take responsibility, was made a librarian. When the Army could not find anything better for me to do than make me an education sergeant, I looked after the local unit library. Since then I have never bought a book until I have read it and know that I want to read it again and keep it. (However, I do assure the noble Lord, Lord Willis, who is keen that we should all buy books, that when I find treasures of books I give them as presents to my friends).
I am therefore a grateful and devoted fan of our library system. I have recently, in addition to using the well conducted facilities of your Lordships' House—and like the noble Lord, Lord Quinton, the London Library, usually when I need some kind of specialist book—I have had occasion to use three local libraries: Richmond, Westminster and Lambeth, all of which have highly courteous and devoted staff. Two of them are highly efficient and the third has been sent by an inefficient council into a descending spiral of poor resources and inefficiency in organisation out of which I do not know how it is ever going to climb.
Nevertheless, all these libraries should be supported and it is the least good of those libraries which is the one that most needs support because it has more people out of work using it and it has more disadvantaged people in the borough.
What are the threats to these libraries? Mainly it is money. The extraordinary system of local government finance which has emerged from the decisions, if one can call them that, of this Government over the past 13 years forces even the best councils to economise on book buying and to flinch from the buying of expensive books, which are sometimes the ones that they should most have on their shelves.
Then there is the coming threat of compulsory competitive tendering. There may be some areas in the library system where compulsory competitive tendering is beneficial. However, it is quite clear that there are other areas where it is not and one of those is the acquisition of stock. That should be a matter for the combined wisdom of those who know the area, the people and their needs. Noble Lords who are of my age and sex will remember the unit libraries in the Army which had, wherever one went, exactly the same —I think it was 169 volumes if my memory serves me right. All of us in our generation are, as a result, exceptionally well read in The Good Companions. There was no hope that if one was posted one would find a different selection. One started The Good Companions all over again. One longed for the quirks and quiddities of individual selection.
If you cannot hand over selection to outside mechanical providers, nor can you do simple sums about choice. Twelve copies of the latest Jeffrey Archer novel are not a substitute for one copy of the autobiography of the noble Lord, Lord Jenkins, selling at £20, even if the 12 are taken out more often than the autobiography.
That is the second threat; namely, that of compulsory competitive tendering. I believe that the third threat is the possible abolition of the net book agreement. The seemingly rational idea of doing away with resale price maintenance in this field will have the

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effect of making cheap books cheaper and the more expensive books much more expensive. Moreover, it will probably price many books out of publication altogether; in other words, it will price out of publication a large proportion of really valuable books.
In the previous debate, the right reverend Prelate the Bishop of Norwich in his maiden speech talked about the value of ethics and of having trained experts in the matter in public life. There is not much money in publishing books on ethics. Under such a system, fewer books on ethics would be published.
There are ways out of such problems and away from such threats. I should like to pay a tribute to Mr. Timothy Renton who I think is a sensitive and caring Minister; but I do not pay a tribute to the general policies of his party in the fields of competition and local government. I believe that there needs to be a major change either in the Government of this country, or in the thinking of the Government of the country, before we shall be able to arrest a decline in the libraries.
One method which is available to combat such problems is that concerning the efforts to make money from the additional services which the libraries provide. For example, Sutton, which has a reputation backed up by figures as one of the best and most efficient library authorities in the country, manages to make all its extra services pay—that is, the ones for which it is allowed to charge—and that helps to fund the more basic work of providing books, which is what really matters. I certainly agree with the noble Lord, Lord Quinton, in that respect.
One of the most important tasks is to ensure that we value the library system and thereby use it more. That would be a valuable contribution to which, perhaps I may say in shorthand, the rich can contribute. The Members of your Lordships' House who have stayed for the debate, especially those who are taking part, are obviously people who know their local library systems. However, there are many people, including, I imagine, many in this House, who do not even know where their local library is and who, if they want a book, simply buy it. That is very good for authors and publishers. I do not say much against it. However, if it turns the library into a service solely for the poor, it very soon becomes a poor service. It is important that the library system should be cherished by the literate classes of the country. And if there are any classes in the country which are not literate, we must cherish the library system in order to help make them so. I say that because, as we know, illiteracy is one of the major problems of today.
The BBC and the library system—and I put those two together as the noble Lord, Lord Quinton, did —are good examples of the institutions which I think we can genuinely say are the envy of the rest of the world. The institutions which are the envy of the world are, for some reason which is very difficult to fathom, always the most tempting prey for the barbarians within our gates. Culture and civilisation need defenders. It is for that reason that I particularly thank the noble Lord, Lord Willis, for instituting the
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debate, even though I share with the noble Baroness, Lady White, the dismay that so few of your Lordships have chosen to take part in it.
6.55 p.m.
Lord Morris of Castle Morris: My Lords, I am sure that the House will be grateful to my noble friend Lord Willis for providing this opportunity to discuss the library system without, for once, concentrating on the British Library building which I regard as one of the finest and most exciting building projects of the 20th century and which others mock as the great pink whale stranded in St. Pancras.
"Public libraries are in their worst state since the system was founded about 150 years ago. Libraries are closing, reducing opening hours, trimming services and cutting jobs because of dwindling grants from local authorities".
So says the Library Association as quoted in The Times of Tuesday 18th February 1992. Who will dare say that the association is wrong? The Government may well reply that this is entirely a matter for local authorities and that they must set their priorities and apportion scarce resources as seems best to them. But there is more to it than that. Public libraries are part of a complex reticulation of services provided by local authorities. Their problems are not single; they are multiple and inter-related. Perhaps I may be permitted to give your Lordships a few examples.
Librarians are currently being plagued by the threat of the Government's favourite idea; namely, compulsory competitive tendering. That was nicely analysed by the noble Lord, Lord Beaumont of Whitley, in his speech. I agree with the statements. It should be obvious to the meanest intelligence that there is little scope for CCT in public libraries; and, where there is, they have been doing it for years. Stock selection and stock management, as the noble Lord said, cannot be contracted out. That is what librarians are trained and paid for. Acquisition of stock is something that most library authorities already contract out to library supply companies. They switch between firms to get the best deals. That flexibility would be lost under the proposed system with authorities locked into contracts with suppliers of between four and six years.
Similarly, the net book agreement—which, as the noble Lord, Lord Beaumont of Whitley said, is no bad thing—means that library suppliers are unable to compete on price and so CCT does not apply. As regards processing and cataloguing, what is not already contracted out could not be contracted out except at additional cost. It is the firm opinion of the Library Association that CCT for support services would have a major, deleterious effect on the organisation of public library services as most of them are integrated services with a high premium on staff flexibility. That flexibility would be imperilled by CCT, and the alternative provisions would be expensive and less effective.
The final proof that CCT is a non-starter in the public library system is provided by the fact that no one seems able to identify a market in library support services. For example, Westminster City Council and Cambridgeshire County Council have both voluntarily tried contracting out library support services,

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but they failed to find appropriate bidders. Similarly, Devon, Kensington and Chelsea and Suffolk have tried to contract out video supply, but no one wants to know. Compulsory competitive tendering for libraries is a deeply dead duck and should be contracted out —to the dustbin.
A second extraneous problem that librarians face comes from the local management of schools initiative. One of the most effective areas of the public library system has long been the common service for school libraries. That is now likely to be severely undermined by the LMS procedures. The result will be that
"from him that hath not, shall be taken away even that which he hath"
because the weakest, most deprived schools will lose the benefit of common services. Goodness knows, the overall level is already appallingly low. A recent survey showed that four out of five schools have fewer than 10 books per pupil. The gallant attempts that library authorities have made to supplement the often disgraceful shortcomings of school libraries are currently in peril from the new educational ideology.
Thirdly, local government reorganisation poses severe problems for the public libraries. As my noble friend Lady White has pointed out, there is acute concern in places such as Wales. My noble friend was right that monitoring and advisory services to the Secretary of State on the issue of reorganisation should be a high priority in Wales, as should the tendering of advice and the tender concern for the problems of the Welsh language in a bilingual community which is not bilingual across the whole of its area. Those are urgent problems for Wales, but there are plenty such problems elsewhere.
It seems clear to the disinterested observer that, on the whole, the large library authorities are very efficient. Leicestershire's county library service is generally thought to be one of the very best, but many library authorities could end up as a series of little district library services, with all cohesion gone and all economies of scale lost. Those are all matters that are totally beyond the control of librarians, but which have the most serious consequences for the national public library system.
Within their own authorities, librarians also have to face the most severe problems. As my noble friend Lady White pointed out, those problems are less severe in Wales where we can point to perhaps less dramatic cuts, but the process of slow erosion, as she described it, is one with which we are all too familiar.
Over the past 10 years, cuts to the library service have produced a deepening crisis. Occasionally the cuts have been dramatic, but usually in both England and Wales—I do not speak for Scotland—it has been a slow haemorrhaging of resources year upon year. As the noble Lord, Lord Quinton, pointed out, opening hours have been slashed. My noble friend Lord Willis said that the number of libraries that are open for 60 hours a week or more in England and Wales has dropped—I make no apology for repeating his figure —from 229 in 1974–75 to 18 in 1991–92. Indeed, 60
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hours a week is not a ridiculous figure. Many supermarkets are open for 60 hours a week, so why should a public library not be able to open for as long?
Those cuts in hours have an enormously damaging effect on the library habit, which must be acquired —we are not born with it. As has been wisely said:
"We cannot raise a literate generation, or improve reading standards, if people keep finding their libraries shut."
In the financial year 1991–92, Sheffield has cut the opening hours of its community libraries by 25 per cent. and North Tyneside has imposed an overall cut of 62 per cent., leaving all its branch libraries open for only 10 hours per week. Camden library authority has bought no new books since September 1991. The dreary list goes on and on.
Even the good and successful initiatives have been enfeebled by this long process of blood-letting. The library and information plan scheme, jointly run by the British Library and the Office of Arts and Libraries, is highly commendable. Linked with it is the public library development initiative scheme, which awards £250,000 a year to a wide variety of innovative library schemes. But only 40 per cent. of the funding for that scheme is provided by the Government, leaving 60 per cent. to be found by the librarians from other sources. Sponsors do not come easily. Andrew Carnegie is long dead. The money is simply not there.
Against that dismal background, it is hardly surprising that public library book issues have declined. Mr. John Sumsion of Loughborough University has derived some useful statistics from analysis of the public lending right, which he has done so much to implement successfully. The Government may take some comfort from the knowledge that, in issues per capita, the United Kingdom stands third in the world league at 9.9, surpassed only by Denmark at 15.2 and the Netherlands at 11.7. Britain has double the issues per capita of the USA, and six times that of France. However, United Kingdom book issues are declining sharply. In 1981–82 there were 649 million issues; in 1989–90 that had dropped to 565 million. After 1986, the issue statistics show a noticeable decline, which accelerates as we get into the 1990s.
The public lending right statistics show, however, that the decline in issue figures has affected fiction far more than children's books. It seems that children's librarians have been lobbying hard and successfully to avoid cuts to their service. The draft report of the Library and Information Services Council (England) shows that since 1982–83 the decline in issues has been 8 per cent. for adult non-fiction; 20 per cent. for adult fiction and 0 per cent. for children's books. It gives me great pleasure to note that in public libraries Mills and Boon books are in decline and that Enid Blyton rules OK. It seems that, even in the context of steadily reducing resources, librarians have successfully maintained one vital part of their educational responsibility. All praise for that is due to the librarians; no thanks can be given to the Government.
As I said earlier, the Government may well say, "This is entirely a matter for the local authorities. They must order their priorities as they think best." The Government will adopt a hands-off, arms-length, non-interventionist posture and will blandly survey

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the inexorable logic of the law of supply and demand. I must put it to the noble Viscount, Lord Astor, that the Government's responsibilities may not be shrugged off so easily. As my noble friend Lord Willis has said, Section 1 of the Public Libraries and Museums Act 1964 makes that clear, stating:
"From the commencement of this Act it shall be the duty of the Secretary of State to superintend, and promote the improvement of, the public library service provided by local authorities in England and Wales, and to secure the proper discharge by local authorities of the functions in relation to libraries conferred on them as library authorities by or under this Act."
I believe that the ultimate responsibility now rests with the Lord President of the Council, for England, and with the Secretary of State for Wales but that, in practice, it devolves on to the Minister for the Arts. It will be interesting to hear—if the noble Viscount, Lord Astor, can tell us—how the Government have "promoted the improvement" of the public library service and how they have ensured that each library authority provides
"a comprehensive and efficient library service for all persons desiring to make use thereof",
as is required by Section 7(1) of the Act. The Library Association had some doubt last year about whether the Minister had fulfilled what the Act described as his "duty" when it considered taking him to court.
To be fair—and we on these Benches always try to be fair —the present Minister seems to be more aware of his duty in this area than perhaps some of his predecessors. My noble friend Lord Willis has reminded us that the Minister has taken action over the alarming closure of 11 libraries in Derbyshire. The county authorities there pre-empted more decisive measures by appointing an inquiry team which reported just before last Christmas. Since then, the Minister appears to be superintending the activities of the library authority in a brisk and proper fashion. However, as Derbyshire is a famous target for government intervention, I ask the noble Viscount, Lord Astor, whether the Government have a similar intention to intervene in Warwickshire which, I believe, is a Conservative-controlled council, and which has decided to have no national daily newspapers in any branch public libraries in its area —save two. One has a trust fund of its own, and in the other the town council has agreed to pay. Surely the provision of national daily newspapers is close to the centre of any modern information service, and it is difficult to see how any library authority which deliberately decides not to provide them can be said to be giving a
"comprehensive and efficient library service".
I look forward to hearing what action the Minister proposes to take in Warwickshire.
So far as concerns the public library service in this country, we can only say, in the words of the poet John Pudney,
"Complaints is many and various",
though it must be said that the complaints come largely from the librarians and not from the readers. We should be building on achievements, expanding access to library services, buying more books, developing new branches, bringing in new readers,
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and creating and satisfying their thirst for knowledge and understanding. Instead of that, since 1979 more than 340 libraries in England and Wales have closed.
7.11 p.m.
Viscount Astor: My Lords, I am delighted that this debate is taking place. The noble Lord, Lord Willis, has provided us with an opportunity to consider, and applaud, what is a popular and well-used public service.
Perhaps I may, for a moment, take your Lordships back to 1927, when the Kenyon Committee wrote:
"The public interest in libraries has greatly increased and we believe that there is now a far healthier belief in the value of knowledge and in the importance of intellectual life in all the busy centres of national activity than in any previous period of history. In such centres the public library is no longer regarded as a means of providing casual recreation of an innocent but somewhat unimportant character; it is recognised as an engine of great potentialities for national welfare and as the essential foundation for the progress in education and culture without which no people can hold its own in the struggle for existence".
What was said then applies with even greater force today. I am sure that all your Lordships will agree with that.
The public library service has come a long way since the Public Libraries and Museums Act 1964. There has been considerable change, improvement and development. Public libraries have become a major information resource, allowing everyone full access to books, periodicals and now other materials such as CDs and videos. Their role is to support and serve the needs of their communities for information, individual education, culture and leisure. Public libraries play a major part in maintaining and improving literacy. In pursuit of their statutory duty, public libraries provide books and non-book materials, for lending and reference to both adults and children, through service points ranging from the largest city centre libraries to small village part-time centres and mobile libraries.
There are nearly 137 million books available in UK public libraries, through 4,063 central and branch libraries and 735 mobile libraries. In addition, there are 789 small branch libraries and 18,297 outlets in homes and hospitals. That is impressive. Public libraries do much more, however, than just lend books. They provide reference and inquiry services, study facilities and a wide range of specialised services for special client groups within the community, such as schools, hospitals, prisons, the housebound, the handicapped, and many others. In 1989–90, for example, nearly 46 million inquiries for information were made in UK public libraries—nearly a million per week.
Public libraries have a leading role to play in the provision of community information. Where appropriate, extensive collections of business and commercial information, including standards, patents and specifications, and access to on-line information services are provided as part of information services to the local commerce and business community. In 1989–90, 1,024 computer terminals were available for use by or on behalf of the public. That is a rapidly expanding area through which new services can be provided. For example, we have just funded an

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experiment to place terminals in village shops in remote areas and thereby give access to the local public library computer network. In 1989–90, public libraries handled 8.5 million reservations for books and recordings. They are also often the first point of contact between the general public and the wide range of special, academic and national libraries.
The Government's commitment to the public library service is demonstrated clearly by the improvements we have brought about in recent years —for example, by investment—in library and information plans, and the public library development incentive scheme. Expenditure on the service remains high and that is matched by high levels of use. As noble Lords have said, the public library service is one of our most popular public services. When questions about library use were included in the 1987 general household survey, in the four weeks before interview just over a quarter of all adults had used public library services. That excluded visits just to accompany a child. Eighty-one per cent. of users, and particularly older people, had borrowed or returned books. Visitors in the younger age groups were more likely than others to have used the services associated with study, to have looked at reference books, used a photocopier or used the library as a place of study.
A different perspective of use can be gained from public lending right figures. They indicate that the number of registered authors has risen from 17,594 in February 1990 to 20,203 one year later. In 1992, 81 authors—26 more than in 1991—qualified for the £6,000 maximum payment under PLR. A further 16,783 writers over the whole range of adults' and childrens' fiction and non-fiction qualified for some form of payment. Other statistics from PLR show a marked increase in loans of junior non-fiction and in hobbies, do-it-yourself, transport and computers; and, to a lesser extent, travel and general fiction.
Not surprisingly, let me turn to the Government's record in supporting public libraries. Net expenditure (that is, expenditure after deducting income) on public libraries in England has risen by 14 per cent. in real terms over the past 10 years. The figures for gross expenditure (that is, before deducting income), which may be a fairer reflection of library activity, show an even higher increase in the order of 18 per cent. as a result of increasing income from library activities.
In order to assist public libraries to improve the efficiency of their services, the Minister for the Arts has commissioned three management tools. The first, a model costing system for public libraries, was published in 1987; the second, a manual on performance indicators, which was published in 1990; and the third was published at the very end of last year and deals with objectives for public libraries. We hope that those aids to good management will help library authorities and librarians with the planning and measuring of their services while promoting cost-effectiveness in the public library service.
The public library development incentive scheme was established in 1987. Its purpose is to encourage new enterprise in public libraries that will extend or improve services. The scheme is now in its second
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three-year term and up to £250,000 per annum is available. Since the scheme began, 37 awards totalling about £800,000 have been made. Awards, of course, cover up to 40 per cent only of project costs, with winners providing the remainder. An independent evaluation of the scheme, to be published later this year, shows that it has achieved some significant successes. In addition, many applications which could not be funded have led to projects progressing with funding from other sources.
No library can be self-sufficient in stock or expertise. Various formal and informal co-operation arrangements have therefore been developed between libraries of all kinds. To develop and strengthen this co-operation, the Government have supported, with funding, the development of library and information plans. Those are three to five-year plans, based upon public library authority areas and designed to create a framework within which library and information organisations of all types within the areas can make the best use of available resources. In geographic terms, about 50 per cent. of the UK is covered by LIPs. Collectively, and individually, the plans are a great success.
At the beginning of this year, the library regulations came into effect. They are concerned with the charging powers of library authorities and clarify the relevant section of the Public Libraries and Museums Act 1964. They also introduce modest new charging powers, which reflect the new type of library facilities commonly provided since the introduction of the 1964 Act. Through these regulations, the Government have provided library authorities with flexibility as to the charges they wish to make and with access to some additional sources of revenue.
There are some authorities which generate as much as 9 per cent. of their expenditure through charges. This has enabled them to support a wider range of services. In saying this, I wish to remind noble Lords of an important safeguard for free access to the library service which was built into the provisions of the 1964 Act as amended by the Local Government and Housing Act 1989. The Government have safeguarded the central core of the free public library service: the borrowing and consultation of books and other printed material.
In 1989–90, the latest year for which statistics are available, income increased by 23 per cent. over the previous year in real terms, and by 71 per cent. over 10 years. Broadly speaking, income from fines and fees has not changed significantly; there is an increase in income from letting, hire of materials and equipment and ticket sales. But by far the largest and most significant increases have been in such things as income from photocopies, withdrawn book sales and snack bars. These figures are very encouraging.
When the Green Paper on public library financing was published in 1988, many respondents expressed concern that public libraries did not always benefit from the income they raised. My right honourable friend the then Minister for the Arts commissioned a survey. The resulting report, which was circulated to all chief librarians in England, revealed that over 80 per cent. of those authorities investigated managed to

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reinvest at least some of their income in the library service. This was also encouraging, and the report has helped library managers to seek an increase in the amount made available by their authorities for reinvestment.
Other valuable work takes place through the Library and Information Services Council. To take but one example, the council is currently examining sponsorship for libraries. Through a research project guidelines are being developed on the role that sponsorship can play in the provision of library services and how to do it well. That is for both sponsors and librarians.
Lord Morris of Castle Morris: My Lords, I am grateful to the noble Viscount for giving way. I wonder whether he can help me. Is it the case that the new regulations which he has been so eloquently describing vary hardly at all the powers which libraries have under the 1964 Act? If they vary them significantly, in what way do they do so?
Viscount Astor: My Lords, the noble Lord, Lord Morris, will remember, as I do, that we were here on the night when the provision on library charges was discussed and passed. As the noble Lord knows, libraries may make certain charges if they wish. As I have said before, it does not affect the central core of the service.
To return to the council, I am pleased to tell your Lordships that it has just established a new study of services to children and young people. I understand that the Department of Education has recently announced help for school libraries. This is not the record of a government with no interest in the public library service.
Much has been made of the decline in issues over the past few years—too much, I think—quite apart from the fact that, as I have already emphasised, public libraries are about much more than issuing books. The public library service in England still issues the equivalent of 1.3 million books per day, and across the UK the figure rises to 1.6 million.
Preliminary figures from the counties for 1990–91 suggest that the decline may have bottomed out. Even in the figures for 1989–90, it is possible to identify some authorities that have bucked the trend. The rate of decline in 1989–90 was about 1.2 per cent. compared with 3.5 per cent. in each of the previous two years. Over the 10 years to 1989–90, issues per capita have fallen from 12.1 to 10.2. It is true that this represents a substantial drop of over 15 per cent. but this phenomenon has apparently been noticed in almost every other country of the world that boasts a well developed network of public libraries.
One reason for the decline in book issues may be the increasing use of other types of material by libraries. Certainly the statistics for sound and video recordings show strong upward trends in total stock, annual additions and issues per capita. The increase is 60 to 70 per cent. over the nine years to 1990.
The decline in book issues could be due to a range of factors outside the control of library services. Not least is the competition. For example, information is now readily available through CEEFAX and Oracle
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direct to the public. Libraries face the challenge of how to continue to attract individuals, particularly the young, who have not been brought up in a tradition of reading books. But as we have seen tonight, and as the noble Lord, Lord Morris, has told us, they still use the service and it attracts them to come regularly into the libraries. We must be very pleased about that. There is competition in television, through direct broadcasting and through videos, and libraries will obviously have to face that challenge.
I recognise the widespread concern about cuts in public library services made by authorities last year, and planned for the next year. Although, as I said earlier, net expenditure on public libraries has risen substantially over the past 10 years, the Government have to set priorities and ensure the control of public spending, including that of local government. This means that some authorities, especially the high spenders, have to look critically at all the services they offer.
Standard spending assessments are set at levels to allow effectively managed and efficiently administered local authorities to maintain their spending on the range of statutory and non-statutory services. The best local authorities offer sound management of resources. Others, I am afraid, do not always do so. In 1989–90, local authorities in the United Kingdom spent £642 million on the provision of the public library service. This is not an insignificant amount.
It is, however, up to the authorities concerned how they achieve any necessary economies. My right honourable friend the Minister for the Arts has no powers under the 1964 Act to interfere in the day-to-day management of a library authority, which itself has the statutory duty under the same Act to provide a library service. That applies not least to opening hours. It is for library authorities to decide when to open their libraries in response to local needs. They know best what their local needs are. I have to say that 60 hours is not a magic figure. It is for the local authorities, the local library service, to decide what are those local needs.
Nevertheless, the Government are not in the least pleased to hear about inappropriate library closures or unnecessary reductions in services. Where cuts appear to strike at basic services and statutory responsibilities, my right honourable friend the Minister is prepared to step in. He has clearly demonstrated his resolve in the case of Derbyshire County Council and its closure of 11 branch libraries. He has also looked carefully at the actual and proposed cuts in the library services in several other authorities but, with this one exception, has found no clear evidence that any authority is in breach of its statutory responsibilities. I have to tell the noble Lord, Lord Morris, that we have not received any complaints on Warwickshire. From information known to us, it does not appear that Warwickshire is in breach of its duty under the 1964 Act.
My right honourable friend the Minister for the Arts and I appreciate the competing pressures on local authority resources; but some authorities may need to

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use their resources better and libraries should not bear a disproportionate share of any cuts. We must be clear on that.
There have been many improvements in the public library service since 1964. There have been many changes in the world since then and libraries have needed to adapt and change with them. They have been and, I believe, will be successful and that is demonstrated by our debate today. There are larger, better equipped branches; a wider selection of material, including sound and video recordings, and a range of books to meet the specialised needs of different sections of the community. Information services have been developed for local needs, drawing on a wide range of national and international sources. We have a library service and library professionals of which we can be proud.
Perhaps I may turn to specific points. My noble friend Lord Quinton mentioned the article in The Bookseller. He drew attention to the diagram and tables in that article. I have to tell him that he obviously read the article, as I did, but he did not study the graph as I did. If he had done so, he would have found that it was totally distorted in scale. I am afraid that the publishers need a lesson in proper mathematics as the graph totally distorted the figures. As I said, I have read the article, as did my noble friend, and it is an interesting article which we take note of. As always, I enjoyed my noble friend's speech and the interesting points he made. He always interests noble Lords when he talks on matters concerning the arts. I shall bring his remarks to the attention of my right honourable friend the Minister for the Arts.
The noble Baroness, Lady White, gave us the benefit of her expertise on Wales. She showed her knowledge of the Principality. As regards this debate and the number of speakers, I must say to the noble Baroness that quality has made up for quantity. The noble Baroness mentioned the New York Public Library. She even remembered that my family name is above the door. I am quite proud of that fact. I suppose I should declare an interest at this stage as I still have a strong association with the New York Public Library.
The noble Baroness asked me about local government reorganisation. I cannot respond to many of the questions asked by the noble Baroness as that is a matter of looking into the future. However, I shall ensure that my right honourable frieŉd the Secretary of State for Wales reads what has been said tonight.
The Secretary of State for Wales has set out his proposals for unitary authorities. I cannot anticipate the work of the Local Government Commission but the Government will issue guidance to the commission about library services. The noble Lord, Lord Beaumont of Whitley, paid an important tribute to my right honourable friend the Minister for the Arts. He and I share the concerns about libraries expressed by noble Lords. However, as I said earlier, the library service is an exceptional service and one of which we can be proud.
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The noble Lord, Lord Morris of Castle Morris, talked about competitive tendering. The Government published a consultation paper on compulsory competitive tendering on Tuesday 5th November. Among other things the consultation paper asked for comments on the proposals to extend competition to local authority library support services. As the noble Lord, Lord Morris, pointed out, it is already the case that a number of authorities have contracted out some of their public library support services and have found a ready market, not least among the library support companies. The Government consider there is a good case for requiring all local authorities with library responsibilities to expose the support work to competition.
The Government do not propose to extend CCT to the network of library service points. The period of consultation ended on 31st January of this year. The responses that have been received are being analysed, after which a decision will be made on the value of extending CCT to library support services. The only purpose of contracting out is to produce as good a service at less cost or a better service at the same price.
As we have heard tonight, there are difficulties for some library authorities as they have to adjust their priorities to take account of economic realities. In doing this, however, public libraries should seize the opportunities that the Government are creating, thereby developing new services and charging for them, taking into account the views of consumers, and attracting and retaining users. The Government wish to see libraries rise to these challenges. We must continue to give them the right opportunities. The record of this Government has shown we have done that.
7.33 p.m.
Lord Willis: My Lords, I wish to make a few points before the end of the debate. I wish to take up a point made by the noble Lord, Lord Quinton, about the possibility of dividing borrowings between education and entertainment as it were, and making some kind of charge for borrowings. I hope that never happens as it would represent the thin end of the wedge. We would also enter a dangerous area of value judgments. Who will make those judgments? I believe that the young lady who wants to read Victoria Holt novels is just as entitled to borrow such books from her local library—which should stock those books—as the man who wants to read books by Tolstoy or John Fowles. We must not make judgments about other people's reading tastes. Once one starts to do that, one enters dangerous territory. Once one starts to charge for lending books, no matter how small the charge may be when one first initiates it, it is the thin end of the wedge.
When the Minister replied to the debate, I had a feeling we were discussing different institutions. The Minister painted a marvellously rosy picture of the library service. Much of what the Minister said was true, but he must be aware—unless he and the Minister for the Arts have their heads in the sand—that there is genuine alarm among librarians. That alarm is echoed in almost every publication on this

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matter that one can think of. Tomorrow week a "save the libraries day" will take place. That shows how concerned librarians are. There is to be a big meeting in the Jubilee Room in another place to discuss this matter. The Minister must be aware that there is genuine alarm among librarians. He should investigate that and not be complacent about the present situation. I hope that the Minister will forgive me for saying that. Librarians fear they are being turned into shopkeepers. They are expected to sell this and hire that and run snack bars. That is taking a skilled profession a long way down a rather shady lane.
However, the Minister was correct to say that although there were few speakers in this debate we had quality rather than quantity in the speeches we heard tonight. I was shocked when I saw the small number of speakers who wished to speak in the debate. There is a large number of academics in this House. I should have thought that they at least would be interested in books and the reading of books. I am rather surprised that they were not represented in the debate. Having said that, I wish to thank all speakers for their contributions. I beg leave to withdraw the Motion.
Motion for Papers, by leave, withdrawn.

Bingo Bill [H.L.]
7.38 p.m.
Report received.

Children's Homes: Care and After-Care
7.39 p.m.
Lord Ennals Lord Ennals rose to ask Her Majesty's Government whether they are satisfied with the care provided for children in children's homes and with their after-care.
The noble Lord said: My Lords, I must first of all say how sorry I am to be asking this Question because, as noble Lords will know, the Question had been tabled by my noble friend Lord Longford. I have the deepest respect for the noble Earl and that is why I feel honoured to be standing in his place as an inadequate substitute for him.
In my view the nobility constitutes titles. However, in the case of the noble Earl, Lord Longford, it is a true description of his life and character. We do not always have to agree with the noble Earl, but I am sure that all of us would wish to pay tribute to him. He is a remarkable man and he will continue to be a remarkable man. The noble Earl has had an accident and has had an operation from which he is making a good recovery. I am sure that all noble Lords wish to send their good wishes to the noble Earl. As I have said, I recognise that I am an inadequate substitute for the noble Earl in this debate. However, I am delighted to see that there is a large number of speakers in this debate and I am delighted that such experienced noble Lords are to take part.
This week I have been studying a report that is soon to be published. It has been produced by the Co-operative Movement and it is entitled Teenagers at Risk. The report explores the attitudes of children and young people towards features of modern society
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which concern them. Those features also concern us. The report examines such features of modern society as violence, bullying at school, drinking and driving, the dangers of irresponsible sex, smoking hazards and solvent abuse. I am sure that we shall all find that the report makes interesting reading. I hope it will encourage the Government to be more proactive in tackling some of the problems that affect young people today.
Most children, of course, rely on their parents to give them a good start in life. In our society today an increasing number of children are brought up in homes where there is only one parent. That is a great disadvantage, although the single parent involved may be fulfilling his role as a parent as best as any human being can do. Circumstances are hard. High levels of unemployment and poverty do not help. In many cases the family is unable to fulfil the responsibilities which normally go with parenthood. For some, therefore, the state has to take on the role of parent. What a heavy and difficult responsibility that is.
Increasingly, evidence suggests that too often the state is failing the children entrusted to it. That is not a criticism of any particular group of people. It is very difficult to be a substitute parent and to provide an institution which is able to act as a substitute parent.
It is encouraging that the number of children in residential homes now totals only 13,000. I remember when it was 51,000. That is a very important step forward. I welcome that, and I played some part in bringing it about. The way in which foster parents have stepped in is extremely important. There has been important progress.
However, I do not have to remind your Lordships of the succession of reports on the quality, or lack of quality in some isolated cases, of child care. "Pindown" revealed some of the worst elements of institutional control. There have been many such reports. I shall not summarise any of them because we have often debated them. They all reveal a particular situation which existed at a certain place at a certain time and certain people who may have been responsible. None of us would say that those cases represent the generality, but nevertheless there is deep concern about the quality of child care.
So what is to be done? There is no one single answer. No one would know that better than the noble Baroness, Lady Faithfull, who I am delighted is to speak in the debate. It is not only a question of finance and resources. There are many ways in which one can try to improve the situation. In the same way as when I was Secretary of State I appointed a Minister for the disabled, in my view and in the view of my party, there should be a Minister for children and an independent children's rights commissioner to monitor and investigate the exercise of children's rights and the way in which services are provided for children in care and for other children in need. I should like to add how much I welcome the fact that the Government have now ratified the UN convention on the rights of the child. That is something for which we are all grateful. Such a Minister and commissioner would have an important role to play. They would evaluate the role of the Social Services Inspectorate. The report of Sir

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William Utting was important, and I pay tribute to him and his contribution to the social services during his time in the department. I believe that the task of a Minister and a commissioner would also be to watch over the way in which local authorities carry out their responsibilities in order to monitor and ensure the effective implementation of legislation.
Another improvement is the fact that the Children Act is now on the statute book. That was also a very important step forward.
The fact that the numbers in residential care is small may add to the problems of those who are in residential care. In my view residential child care is the Cinderella of social services. Staff are often undervalued, undertrained and under stress. The children themselves, the consumers of a personal social service which can take the form of a home run by the local authority, under licence by a local voluntary organisation or by a private company, have little say in how their lives are organised. I believe that Government, local authorities and Members of Parliament in both Houses should be more willing to listen to the views of children and understand their attitudes towards the situation in which they exist. When I was a member of the Social Services Select Committee in another place considering child care I was much impressed by the quality of some of the youngsters in the National Association of Young People in Care. They did a fine job.
Many children in residential care are unhappy. The Children's Society estimates that 98,000 children run away from home every year. Over 40 per cent. of those are running away from residential care. Many are persistent absconders. A recent study revealed that one-third of young homeless people aged 16 to 19 had been in care. Two further studies showed that 50 per cent. of youngsters begging in the streets—which is something we see far too often these days—and 66 per cent. of young male prostitutes had a care background. Young men fresh from care are over-represented in our prisons and remand centres. If that is the end product of years within the care system clearly something is very wrong.
All too often young people experience residential care as a form of dumping ground. That may be a consequence of poor planning, faulty decision making and insensitivity to the individual needs of the children themselves. All too often residential care seems to be the last resort when all else has failed. All too often it is provided by inexperienced and unqualified staff in settings which are geographically remote and isolated from the children's own local community. It is often an exercise in containment, not of character development.
We have to ask ourselves why, after years of accumulated experience, official inquiries and legislation and the enduring commitment of most residential care staff—and we would all wish to pay tribute to those who carry out a very difficult task and who are not usually well paid—we have failed to develop residential services which offer children a positive
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experience. We know that the smaller the numbers in care the more likely it is that they are the most difficult children to cope with.
One of the reasons must be that we do not value highly enough the people—the consumers and providers—within the service. We do not consult the children on their experience within the care system. Nor do we place a high value on quality staff by insisting on appropriate training and rewarding them with appropriate salary levels. Neither is it properly recognised that the economic and social pressures resulting from the last decade of this Government have presented real planning problems to those entrusted with providing quality services.
The statutory instruments governing residential care issued by the Department of Health in July (Nos. 1505 and 1506 of 1991) have been criticised by children in care for being too vague. They talk of "adequate" standards, accommodation "suitable for the children's needs" and food in "adequate quantities" and "properly prepared". Where they are specific, little seems to have changed. Children can still be held in secure accommodation for up to 72 hours without the sanction of a court compared to the limit placed on the police of 36 hours' detention for adults without court authority.
There are many problems which have to be faced. I should like to spend a few minutes considering some solutions and how we might improve the quality of care which is provided and making suggestions to which the Minister may be able to react.
Every local authority should provide a simple guide to the rights of children in residential care. The Government are committed to patients' rights, so I am sure that they will want to look at the question of children's rights. Such a guide should state the rights of children and explain how children can complain if those rights are infringed.
In my view every local authority should appoint a children's rights officer. Most local authorities have welfare rights officers. Two of my own children are welfare rights officers and both have worked for local authorities. Every local authority should appoint local panels to assist in monitoring standards. It is most important that the community itself should understand the problems of children in care and should seek to help by providing some of that care. They need advice, help and family support. Support and encouragement should be given to groups that directly represent young people in care, such as NAYPIC, which I mentioned a moment ago.
Parents should be encouraged to become actively involved in the care process. The Children Act provides for parents to retain parental responsibility even when a court order has been made committing children to care. In many cases continuing contact between children and parents is very important. Parents may well have views about the quality of care that their child receives. I am sure that we all wish to encourage the involvement of parents in the welfare of their children. Involvement is absolutely crucial.
A deadline needs to be set by which time all staff working in residential care should be trained. There are many other proposals but time does not allow me

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to mention them. When I was Secretary of State, I launched the project Intermediate Treatment to avoid, where possible, the need for children to go into care. That was based on my experience with a voluntary organisation of which I was chairman. I warmly welcome the work being done by several Members of this House to promote Intermediate Treatment. I mention only the noble Lord, Lord Henderson, who I am delighted to see will speak in this debate, the noble Baroness, Lady Seear, and the noble Lord, Lord Elton.
It disturbs me to hear that the Government intend to phase out all financial support for Intermediate Treatment. That is very unfortunate. I hope that the Minister will say something about that matter. If she confirms that such is the case, I urge the Government to think again. I look forward to hearing the Government's policy and the Minister's answer.
I understand that the Prime Minister does not want to appoint a Minister for Children or an independent commission. I hope that we can persuade him to change his mind. If not, we may be able to take the decisions that need to be taken. I am glad to have had this opportunity to raise the matter. I have not used the same words as my noble friend Lord Longford would have used. He would have spoken from his warmth and experience much better than I have done. However, if no one else reads this discussion, I am sure that he will read everything that we have said. It has been an honour for me to open the debate. I feel sure that the remaining speeches will be of a higher quality than mine.
7.53 p.m.
Lord Henderson of Brompton: My Lords, I know that the noble Lord, Lord Ennals, will not mind when I say that I regret having to follow his speech. I should very much have liked—I am sure that all noble Lords would have preferred—to have heard the noble Earl, Lord Longford, ask this Question, but he could not have found a better substitute. I hope that this debate will cheer him on in hospital. We all hope to see him back in his place very soon. He spent much time and trouble in preparing this debate and is particularly unhappy at not being here to open it.
The noble Lord, Lord Ennals, concentrated mainly but not entirely on children in care. I shall concentrate my remarks almost entirely on children after they have left care. As the noble Lord so kindly said, I have an interest in his initiative of the IT fund and also in its continuance. I am also chairman of a group called Action on Youth Crime which brings together the statutory and voluntary services in an endeavour to keep young people out of prison.
First and foremost, therefore, I look at the issue from that point of view. It is very unnerving to find that in prison there is a disproportionate number of young people who have been in care. The noble Baroness will be glad to hear that I do not in any way wish to attack the Government. In some ways I wish to pay them a compliment. I want to stimulate them into fulfilling their obligations—indeed, the obligations of us all—under Section 24 of the Children Act. Those obligations should be fulfilled.
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Incidentally, in passing I should like to pay tribute to the Home Office. It recently sent round a circular which gives young people leaving care as an example of a possible project under the heading "Preventing Criminality". That is one of its key themes for 1992–93 when giving grants for innovative projects on crime and criminality. That document emerges from the programme unit of the Home Office. I give the Home Office all credit for it. It is clearly conscious of the problem.
The noble Lord, Lord Ennals, mentioned that the percentage of prisoners who have been in care is disturbingly high. He did not give the percentages, which I can now do. In the prison population those who have been in care are hugely over-represented. They represent 23 per cent. of the adult population of prisoners and, I regret to say, 38 per cent. of young prisoners. That is a deplorable statistic. On the other hand, although the percentages are high, the number of young people leaving care is small enough for the Government —I should like to stress on an interdepartmental basis—to concentrate on and help effectively. In the year to 31st March 1989 just over 6,000 young people in the United Kingdom left care on reaching the age of 18. Another 5,000 or so left care at the age of 16 or 17. The total number in that year was 11,000, which is not an unmanageable figure.
That small group is extremely vulnerable. Those young people face a level of disadvantage much higher than school-leavers of their age. In 1986 one study (I can give the reference if required) found that 80 per cent. of young people leaving care were unemployed after two and a half years. That is a deplorable revelation. A more recent and as yet unpublished study found that 40 per cent. of those leaving care were unemployed after two years. That is one measure of their disadvantage. That latter study also found that one quarter of children leaving care did not have any educational qualification. That compares with 89 per cent. of school-leavers in the areas studied. Again it is a measure of their disadvantage.
What are we to do to help those young people who are clearly disadvantaged and who leave care without having any family support, which is yet another disadvantage that they suffer. I mentioned the need for the Government to co-ordinate some proactive initiative. I adopt the adjective of the noble Lord, Lord Ennals. Departments should get together to tackle the problems of those leaving care and seek solutions. To my mind the departments concerned are the Home Office, housing, health, social security, education and employment. Nothing less than those departments getting together will do. They should concentrate on that special group and have power to allocate enough resources for the after-care budget. Those people need our help and that can only be given effectively by a positive interdepartmental drive. Only in that way will the social services—the main agent for putting the necessary action into place—be enabled to do so and thus fulfil all our obligations, in particular those of government and social services under Section 24 of the Children Act.
I believe that there is an officially approved representative to whom children in care can turn. I

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strongly support the plea made by the noble Lord, Lord Ennals, that a children's rights commissioner, armed by statutory authority, should have powers to look after children's interests in the broad way that the noble Lord, Lord Ennals, outlined. That is the best way to follow our agreement to the United Nations conventions on the rights of the child.
In addition, I should like to see a direction from central government that housing or hostels should be available for those leaving care. I heard only recently from the Stonham Housing Trust that where it has housing available for single people it is now no longer able to provide it for young people leaving care partly because of the perfectly understandable pressure by local authorities to put families in bed-and-breakfast accommodation into those single housing units, thus depriving single young people coming out of care of the very accommodation which was meant for them. It is a serious situation which only aggravates their difficulties.
I am sure that everyone in the House agrees that we shall never tackle the disadvantages of children leaving care unless they are given enough to live on. The denial of income support to young people unless they have a placement in education or training must be put right. It is tragic that one in 10 of those who claim for severe hardship have been in care. What a start to life in the big wide world. We must do better for them.
I have not touched on problems in care because they have been so well dealt with by the noble Lord who opened the debate. However, clearly the statistics that I gave earlier about education mean that young people in care must have better access to suitable education. They must have education in life skills for when they leave care. There must be some relief from the sense of isolation from the community which those young people experience when they are in residential care. Children in residential care clearly need befriending. They need to be befriended by sympathetic outsiders who cannot only give them a day out but perhaps become a substitute for the parents whom they lack.
I was amused by and sympathetic to the splendid phrase used by the Minister for Health when she said that such young persons really need street-wise grannies. I rather like that phrase. I am sure that there are large numbers of street-wise grannies who would be only too happy to put their declining years at the service of those people, to take them out or to be available to talk to them on the telephone and so on.
In conclusion, I have asked for an interdepartmental proactive initiative. I can think of no one better to lead that initiative than the present Minister for Health, Mrs. Virginia Bottomley.
I hope that the noble Baroness who will reply will agree that I have not attacked the Government. I have paid them a compliment at the beginning and end of my speech. I hope that my speech will be accepted in that spirit.
8.7 p.m.
Baroness Brigstocke: My Lords, I too send my good wishes to the noble Earl, Lord Longford. I should love him to hear that we miss him but we are doing our best in his absence. I congratulate the noble Lord, Lord Ennals, for the able way he opened the debate. Like the noble Lord, Lord Henderson, I wish to concentrate on the after-care of children who have been in children's homes.
It may seem an obvious point to make but it is worth emphasising that children in an institution—however loving and caring those running it may be —miss not only the love of parents but also the training in daily life. The noble Lord called it "life skills". I refer to mundane items such as shopping for food, running errands, or even the responsibility for a pet such as children might have in their own family unit.
Parker and Millam put it well in the introduction to their research Organisation and Accountability for State Intervention, which was published in 1989. The report stated:
"The characteristic of parental love is that it is partisan, unconditional, does not cease, does not have cut off points, is long suffering and does not evaluate. The state cannot replicate this, few parents are indifferent to their children, but the state with its emphasis on fairness and equality cannot get too emotionally involved".
The lack of preparation for life after being in care is poignantly expressed in a poem by a young man called Peter who belongs to an in care group, part of the Who Cares project, the National Association of Young People in Care (NAYPIC). Peter writes:
"Constant years of very tight held hand and dominant guidance.
Following bewildered on the red tape lead of Borough policies.
Systematically filed, regularly tested.
Separate safely to a distant spot,
Suckling an eager breast of care,
Sympathetically cuddled, caressed, enclosed, to what end this mothering protection?
To produce a weak, unprepared inexperienced child, to face a hostile world."
Young people who have taken part in the Who Cares project have spoken of being a child until one is 18 and not being prepared for the world outside. Children come into care in widely differing circumstances. A few have been abandoned as babies. Some are in a crisis of adolescence. Many have been neglected or offended against. What they have in common is the need for the care or control normally given by a parent.
Care leavers are not a homogenous group in terms of their care histories, needs, culture and ethnic backgrounds. Care may have been valued by young people. It may have helped them. But it may also have contributed to other problems including problems of identity stemming from a separation from and a lack of knowledge of their past. That may be amplified for black young people brought up in a predominantly white care system. On leaving care between the ages of 16 and 18—paradoxically much younger than non-care young people leave home—loneliness,

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isolation, unemployment, poverty, homelessness, movement and drift are likely to feature significantly in many of their lives.
A number of studies have suggested that about one-third (that is, 33 per cent.) of young, homeless people aged between 16 and 19 have been in care. That represents a significant over-representation of young people from care in the homeless population because less than 0.75 per cent. of all young people have been in care. When care leavers become homeless, they are exposed to danger from ill-health, crime and prostitution. There is also disturbing evidence to show that a high proportion of beggars (50 per cent.) and, as the noble Lord said, of male prostitutes (66 per cent.) have had experience of local authority care. A number of studies have demonstrated a strong link between care and offending.
Despite all the problems, imaginative and effective projects are being developed. I shall mention three rays of hope. The first is The Children's Society. It is a national voluntary childcare organisation which runs more than 150 projects throughout England and Wales. They include ordinary housing for young people with disabilities and representation for young people in court proceedings through its guardian ad litem schemes. It has recently begun to organise a series of workshops and meetings for some of the young people leaving care in preparation for their independent living projects. In addition, it is responsible for projects which are working face to face, providing accommodation, support and advice for young people who are literally on the streets. It also undertakes projects for those who are leaving the care of local authority social services departments.
Secondly, there are a number of agencies which work with the single homeless in central London. One of those is The London Connection. It was recently awarded a grant of £29,000 by the 1990 Thames Television Telethon. It was to help to tackle the problem of homelessness facing single young people leaving care. I was chairman of that 1990 Telethon. I also worked closely with the Peabody Trust and the London Enterprise Agency which are working on a most exciting project in the Waterloo area of London. The project guarantees accommodation, training and employment in the Waterloo area. When in 1993 it is complete, it will provide the opportunity for 220 young people at any one time to break through that vicious circle of no home therefore no job; no job therefore no home. They have no money to pay the rent.
The £9 million capital project of the Peabody Trust and the London Enterprise Agency received its initial funding by way of a grant of £800,000 from the Telethon. That encouraged Her Majesty's Government to invest £3.7 million of its single homelessness initiative in the project. The Corporation of London, in addition to selling the two sites to the Peabody Trust, has pledged £1.6 million as a grant to make the project a reality. I am delighted to tell your Lordships that the land is about to be purchased and the building contract let.
I wish to pay tribute to the Children Act. It provides an opportunity to establish a genuine
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multi-agency partnership at local level which can ensure effective and flexible service delivery to young people in need who would otherwise be homeless. Finally, I must say that if there is to be a list for streetwise grannies, I should love to have my name added to it.
8.15 p.m.
Lord Murray of Epping Forest: My Lords, recently children's homes have had a bad press and they are in danger of getting a worse name than they deserve. We are rightly worried about the instances of abuse and cruelty that have been uncovered. They have occurred because of the ability of perverts and cranks to find employment in some children's homes. I am grateful to the noble Earl, Lord Longford, whose absence I too regret, for giving the House the opportunity of putting into perspective the excellent work which children's homes carry out. We pay tribute to the staff whose esteem and morale has too often been unreasonably and improperly damaged. They do a sterling job in looking after the children and young people committed to their care.
The noble Lord, Lord Ennals, referred to the decline in the number of community and voluntary homes. At present there are some 13,000 youngsters in residential care; about one-third of the number 10 years ago. He described that as encouraging. It is encouraging only up to a point because the reasons for the decline are a mixture of good and bad. On the good side is the desire to move away from the institutional flavour of large, multi-purpose children's homes. There is a desire to keep children within the community, where possible in their own homes or in foster homes, attending their own schools and playing with their friends. That must be good, but we must recognise that it is not a cheap alternative to residential accommodation. The shift away from large multi-purpose homes to small, specialised normal homes should be welcomed in an unqualified way.
However, one of the bad reasons underlying some of that development has been the desire of some local authorities to save money. Their wish to do so is understandable. The pressures that they face as a result of the poll tax, rate capping and even the imposition of new duties to provide community care are understandable. However, the fall in numbers, the closure of homes and the decline in the number of referrals illustrate not only the desire to improve the position of the child within the community but also the desire to save money. I suspect that at present the closure of homes is occurring more precipitately than is good for the children.
I am vice-chairman of the National Children's Home which during the past six months has closed two major children's homes. We are not alone in that respect. The closure of two children's homes means the loss of between 100 and 120 places for youngsters. The costs of providing places in those homes have risen sharply in recent years. It costs a great deal more to keep a child in a good residential home than to send him to Eton. The costs have risen because not only the

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NCH but also local authorities, which refer children to those homes, have been insisting—and rightly insisting—on extremely high standards.
Not only are those changes difficult to finance and manage if the process of acceleration is too rapid, but one wonders what is happening to the children who are kept in the community or who are returned to their communities. There are no centralised records of what is happening to them. I suspect that it will be possible to draw conclusions from exclusions from schools and from juvenile court records unless those children are carefully and sensitively managed in their communities.
Therefore, the emphasis has become more concentrated on meeting two types of need, as has been said already: first, the care of troubled and troublesome youngsters. Most children in children's homes are not tiny tots but are mostly teenagers, and 12-plus is a typical age. As the noble Lord, Lord Henderson, so graphically pointed out, they are emotionally disturbed. They are damaged and often abused. They are aggressive and in desperate need of help. They often come into residential care in their early teens from broken homes or because they have been rejected from other placements. By the age of 11 or 12 they have become unmanageable. Receptions into NCH homes with a background of 10 breakdowns in care and foster care are by no means unusual. Those youngsters feel rejected by society and, in turn, they reject the values of society. They seek their identity in offending and in bucking the system. They need highly skilled care and, indeed, a one-to-one staffing ratio is by no means excessive for such youngsters.
On the other hand, there are the children who are profoundly handicapped—mentally, physically or both. They are often ex-long-stay hospital patients who also need one-to-one staffing ratios, which is a characteristic of most of the homes provided by the NCH. Those youngsters may be long-stay or in need of respite care. However, the need is for small specialised homes catering for three, four, five or six children and adapted for those special needs.
Therefore, as has been so well said already, the average youngster in care is much more demanding than was previously the case whether because of handicap or behaviour. That is the case at a time when resources are being squeezed out of the system and voluntary organisations are caught between the two millstones of falling funds from voluntary sources because of the recession and falling funds from local authorities because of government pressure, the growth of other demands and the desire to keep down the rates. The result is that we are trying to run our children's home system on the cheap, in particular as regards staffing.
I very much welcome the committee which has been established under the chairmanship of Lady Howe to look at salaries and conditions of employment. We must start by looking at what are the needs of the young people. That must be the starting point for all inquiries, as it is the starting point for the Children Act.
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We must ask what is the pattern of working hours which is necessary. At present they are geared to industrial hours. Surely we need a means of providing total cover and a response to children who may need a response at any hour of the day or night. That means working unsociable hours; and that means increasing pay and reversing the present situation. Pay systems must be introduced in which workers in residential homes are paid more, rather than less, than field workers, as is the case at present. Above all, salary levels are needed which will retain staff and give stability in a situation where stability is critical to the care of those young people. If staff are better paid it will be possible to demand a better performance.
Central to that is the question of higher qualifications and proper training. I understand that something like one quarter of employees in children's residential homes at present have professional qualifications. I hasten to say that the figure is much higher for the National Children's Home. It must be right that as a minimum the head must have a Diploma in Social Work plus a management training qualification. The noble Lord, Lord Henderson, and my noble friend Lord Ennals are right to say that we must set a target for increasing the number of employees with a Diploma of Social Work and a NVQ. Indeed, some homes—homes which specialise in the handling of seriously sexually abused children—will need 100 per cent. highly trained and qualified staff. Therefore, training must be a high priority.
In the NCH 4 per cent. of the staffing budget is spent on training. We have our own training centre. However, we are a target for those who do little training themselves. They take our staff who have been trained. We are spreading benefits throughout the community in that way but that is rather hard. The Government should consider a system of government grants or a grant levy system may be appropriate involving local authorities and quality organisations which carry out their own training.
If staff are to be more expensive, perhaps local authorities and voluntary organisations will be more careful as regards recruitment. How do they avoid recruiting the Frank Becks of this world who are often impressive can-do, hands-on operators? Sadly there will never be a guarantee, but the methods of interviewing and examination need to be improved. They also need to be backed up, as has been said by the noble Lord, Lord Henderson, by effective monitoring and effective complaints procedures.
Complaints procedures must be independent and acceptable to young people. They must be separate from the management structure. Young people and staff must have access to someone whom they trust. Again I cite the NCH as an example. We have a complaints procedure which is run by an employee of Barnardo's who is seconded to us whom we pay. He is totally independent from the management structure. However, I remind your Lordships that Leicester had a complaints procedure for seven years and that did not produce the results which one would have liked to see. Therefore, there can be no guarantee. Certainly complaints procedures must be reinforced by effective inspectorate work and by local authority intervention.

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One other area which I should like to address—and the noble Lord, Lord Henderson, emphasised it—is education provision. That is an area in which many homes have fallen seriously short. Children in care generally have a poor record of achievement at school. In residential care in particular they have a raw deal. Many suffer not only as a result of their own deprived background, often distressing and traumatic, but also from the low expectations of staff, who regrettably are often poorly educated, and from inadequate liaison with schools.
A research project by Sonia Jackson at the end of the 1980s came to the conclusion that each child should be given a key worker whose responsibility it would be to liaise with the school and who would be an educational advocate for the child and that each home should have an education liaison officer charged with supervising the activities of the key workers. We introduced that system. I am sure that if we place more emphasis, as the noble Lord, Lord Henderson, said, on education and training, it will be the beginning of giving the children a better chance when they come out of care.
I do not wish to traverse the ground already covered so well by others. However, I should like to emphasise that in relation to after-care we need to ask what our own children and grandchildren expect when they leave home. They want somewhere to live; they want work or further education; they want and expect to receive advice and support during the transition from home to living in the community; and they want somewhere to return to when they encounter a problem. They may need somewhere to spend time in the vacations from college training, for example. We take all that for granted as parents and grandparents. But we should seek to make the same provisions for young people leaving care. It is difficult; it is probably unattainable, but that should be our target and should guide our actions—to provide the standard of care that the child would receive in a normal loving home.
We are talking about a relatively small number of youngsters but youngsters who are in desperate need. Unless we respond, they will be a threat to themselves and society. It is not simply a matter of throwing money at the problem. Resources are scarce and need to be spent effectively and with care. However, as other speakers have said, resources, premises and skilled staff must be found if we are to provide proper support in the community for those who are no longer referred for residential care, if we are to provide the capital and running costs of purpose-built or adapted homes and if we are to support young people as they take up an independent life in the community of which both they and we are a part.
8.32 p.m.
Baroness Faithfull: My Lords, I should like to thank the noble Lord, Lord Ennals, for initiating this debate. It was splendid of him to take over from the noble Earl, Lord Longford. The noble Earl came to me before Christmas and told me of his plan to visit children's homes throughout the country in order to
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inform himself of the conditions. For that reason we feel extraordinarily sorry not to benefit from what he learned in the homes that he visited.
The answer to the Question of the noble Lord, Lord Ennals, is clearly that Her Majesty's Government are not satisfied —and rightly so—with the care provided for children in children's homes. Otherwise, Her Majesty's Government would not have asked Sir William Utting, the then Chief Inspector of Social Services, to produce a report following the inquiry in Staffordshire. Her Majesty's Government are aware of the after-care needs of children, otherwise they would not have financed the National Leaving Care Council Advisory Service known as First Key. I shall come to that later.
In the arena of residential care for children all parties—the Civil Service and local authorities—must bear a heavy responsibility for the unfortunate events which have occurred in some local authorities over the past few years, perhaps notably in Staffordshire and Leicestershire. For at least 30 years residential work has not received the recognition it deserves. The system deserves better training and pay for field staff.
The present Government are tackling better care for children in children's homes and their after-care. However, throughout the country there are staff in residential establishments doing splendid work often unacknowledged and their praises often unsung. I shall not go into the wise recommendations made in the Utting Report. I cannot comment on the report not yet published of the committee chaired by Lady Howe looking into the pay and conditions of service of residential staff. My comments in this speech are based on my past experience as a children's officer, as a director of social services, and my present experience as a governor of two residential establishments, a vice-chairman of Barnardo's and a patron of a group of homes in the private sector.
The type of child or young person coming into the care of a local authority or voluntary organisation who has received love, affection and security in early life is more likely to be able to sustain close personal relationships. Those children are now fostered or cared for by a child minder. Older children coming before the courts can now live at home and attend intermediate treatment centres, as was stated by the noble Lord, Lord Henderson. I believe that the noble Lord also said that the present government policy, started by the noble Lord, Lord Ennals, has reduced the number of child offenders in residential care by 50 per cent.
The children and young people who have not received love, affection, stability or security in their babyhood or young years, but who have been cruelly treated, sexually abused or who are emotionally deprived, often present disruptive, indeed wild, behaviour. They experience difficulty in sustaining personal relationships and are emotionally deprived. They are troubled children and troublesome children. For those children a residential establishment meets their needs provided that the staff are people of quality who have been trained and are skilled to deal with those difficult children. I say again that it cannot be underestimated how difficult those children are.

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What are their needs and how are they to be met? First, we need a staff structure. I totally agree with the noble Lord, Lord Murray, in that regard. If staff are to experience satisfaction in their work, achieving a measure of success, their conditions of service must meet the needs of the children and young people. That was a point well made by the noble Lord, Lord Murray. For instance, my committee in Oxford gave each member of staff two days and three nights a week off work; the rest of the week they were on duty. The children knew when the staff were away and when they would return and could therefore contain their worries and anxieties.
I remember visiting a children's home and meeting a child miserably sitting in the corner. I asked whether there was anything I could do to help. She said, "No. I want Auntie Sylvia but Auntie Sylvia is coming back on Friday and I will tell her all about it then". The system of staff working to the pattern of nurses in a hospital does not do. For staff to be on duty some hours and off others means that children do not know when they will see the members of staff they want to see. When they know that on certain days a member of staff will not be there they can contain their anxieties. That is important. Perhaps I can also say, on behalf of the staff, that when they go off duty one night and are off duty for the following two days, coming back in time for breakfast on the third day, it means that they have time, say, to go to a tennis club or to be in their own homes; they are sustained and rested. Both the children and the staff must be considered.
Secondly, a child or young person needs to have a personal relationship with someone who is not on the staff of the home—I underline "personal relationship". Sadly, the local authority's social workers who place children in homes no longer visit the child or take the child out and they do not sustain a relationship with the child. That is a real loss in the child care service. In one establishment with which I am connected, the Caldecott Community, we have a psychiatrist who visits on a sessional basis to discuss with staff the handling of difficult children. We have a psychologist from the University of Kent who visits and talks to the children. They know him and love him. He is not on the staff and the children know that. A complaints procedure is, of course, valuable, but what is required is a personal relationship between the child and someone outside the home. That did not happen in Staffordshire or in Leicestershire. No children's home should be an island unto itself.
My third point concerns the homes adviser on the staff of the local authority. That post is crucial. Sadly, in some instances such advisers are themselves untrained. The adviser should be a constant visitor to the home. He or she should be known to the children and have a supportive relationship with the staff. He or she should attend the case conferences which should be held in the children's home with the child and, if possible, the parents—though often that is not possible—as well as with the staff.
My fourth point concerns training and pay. I am given to understand that Her Majesty's Government are dealing with the training of residential staff. I
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believe that the Council for Education and Training in Social Work is also looking into this closely. Residential staff have one of the most difficult tasks to perform and yet in training, status and pay they are rated below that of field staff. It is a cause for concern that the excellent advanced course for residential staff run by Mr. Christopher Beedell at Bristol University closed down. We inquired why that outstanding course, which enriched all those who attended it, had been closed down and were told that it was because the local authorities would not pay residential staff to go on the course.
I am perhaps going outside the terms of reference of this debate in saying that the field staff have only two years' training. That is less than any other country in Europe. I regret bitterly that they have not got a three-year training course. They are given a two-year training course, go back to the local authority and then take a post-training course. That is failing because the local authorities do not release the staff and will not pay for them to continue training.
My fifth point concerns the role of the local authority. In the management structure the council, through its social services committee and director of social services, is responsible for the work of the department. It is the duty of councillors on the social services committee to visit the residential establishments. I am not going to give examples except to say that at one children's home the councillor visits after he has played golf on a Sunday. He just drops by. That will not do.
That brings me to my sixth point which concerns the public inquiries which have been held by local authorities. I do not include the Butler-Sloss inquiry. I pay tribute to those who have conducted or who are conducting those inquiries. However, I question with diffidence the justice of the reports which, while criticising the roles of the councillors, nevertheless placed blame on the individual social workers in no uncertain terms. For instance, in the case of Staffordshire the director, now retired, and the committee placed complete confidence in the social worker responsible for the "Pindown" procedure. Indeed, he was promoted three times between 1983 and 1991. I should have thought that he had the right to think that he had the confidence of his committee and staff. However, when the report was published the blame fell far more heavily on the social workers than it did on the councillors and the local authority. Many of the staff—I do not necessarily disagree with this —have been dismissed. As regards Staffordshire, what about the chairman of the council? He is still in post and yet the people for whom he was supposed to be responsible have been dismissed. That is the management structure turned upside down. We will not recruit good social workers, and parents will not want their children to be social workers, if that kind of pillorying attitude is taken. We should look very carefully as to how we are going to deal with such situations.
That leads me to my seventh point. As I said, the requirements of the present method of public inquiries set up to deal with malpractices in residential children's homes —and perhaps as importantly,

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preventing the necessity for such inquiries—could be met by the setting up of a general social work council. The work of such a council would be to promote good practice, to register and to discipline and, where necessary, to strike off the register staff who do not conform to good practice.
Professor Roy Parker of Bristol University produced a valuable report two years ago which was funded by the Rowntree Trust. He recommended that there were strong grounds for consideration of a regulatory body for the social services. I pay tribute to Her Majesty's Government because they gave £30,000 to an action committee, based on the National Institute for Social Work, to look into the specific proposals and carry out a feasibility study. At present there is no body charged with monitoring and enforcing professional standards in the profession and neither is there a body in the profession which deals with ethics and values in the social services. That should be done by the social workers themselves.
The doctors have the British Medical Association, the Law Society has its own regulatory body and I have lately learnt that the nurses, midwives and health visitors have their council. It is true that the teachers do not have a council, but many of them want it. I am sure that they are working towards it. As regards residential care and children's homes, all these points must he met.
I now come to after-care. My noble friend Lord Brentford makes his apologies to the Minister and to the House. He put down his name to speak in this debate, but he cannot be here. I promised that I would say what he would have said had he been here. He says, "I am very concerned about the high proportion of homeless teenagers who have been in care. Is the Minister satisfied with the preparation given by children's homes to teenagers before leaving care? On the surface, it does not appear adequate. Do we not need a committee of Parliament to review the cause and condition of the homeless young?"
I have to say—and I agree with other noble Lords who have spoken—that the real difficulty is that there are many people involved. First, there is the preparation of the children leaving children's homes. I count myself at fault. On one occasion a boy was found drunk and the police brought him to me. When he came round he said, "Well it's all your fault. You never taught me not to mix my drinks". Another boy came to me and said, "What am I to do? I have won the football pools". He had, too, but he said, "I don't know what to do with the money. How do you open a bank account?" I had not taught him how to open a bank account. There are many very basic things which we fail to teach the children in our children's homes.
From the point of view of the present situation I support what other noble Lords have said. There are several ministries involved. There is the Department of Health which is responsible for the care of the children; the Department of the Environment which is responsible for their housing; and the Department of Social Security. I support the noble Lord, Lord Henderson, when he says that these children are not paid enough. My noble friend Lady Brigstocke also
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referred to that. There is also the Department of Employment. There is a great need for all those departments to get together to work out a policy for young people—all young people—but especially for young people in care.
There is one point that I wanted to make which as yet I have not made. I should like to pay tribute to the Department of Health for financing the National Leaving Care Advisory Service called First Key. It is an organisation financed by the ministry to help local authorities to set up good schemes in their authorities for helping children who are leaving care. I pay tribute to that organisation.
I believe that Her Majesty's Government have made great strides in providing better care in this country for children, particularly under the Children Act 1989. I know that they are anxious, and willing, and want to improve conditions in children's homes and in the after-care system.
8.53 p.m.
Lord Meston: My Lords, we are grateful to the noble Lord, Lord Ennals, for pursuing this Question. Like other noble Lords I wish the noble Earl, Lord Longford, a swift recovery.
It is valuable to have such a debate, especially as it is not taking place in the immediate aftermath of some crisis, some scandal, that has come to the surface, or after the publication of a report on some such scandal or failure in the child care system. On those occasions we tend to concentrate on things that have gone wrong. As several noble Lords have quite rightly pointed out, things do not always go wrong. There is a large number of dedicated social workers working day and night, literally, to make sure that things go right, within the resources available to them. There are people such as those referred to by the noble Baroness, Lady Faithfull—outsiders who are approved "befrienders" of children in care. That is a particularly valuable service which I hope all local authorities will encourage.
The Question asks whether the Government are satisfied with the care provided in children's homes and with after-care. So far as children's homes are concerned, I hope the answer will be that the Government are never satisfied, because no Government, however vigilant, can ever be sure that proper standards are consistently maintained in all homes where children are cared for. It is never possible to be sure that unacceptable practices are not going on somewhere. Obviously there should be no room for complacency. That is not to criticise the responsible reaction of the Government to the Staffordshire child care inquiry.
In some ways it was fortunate that at the time of the inquiry into the Staffordshire situation the Children Act 1989 had been enacted, but much of it and much of the subordinate legislation had yet to come into force. Thus it was that the Children's Homes Regulations 1991 were able to be adopted to take in some of the recommendations of the "Pindown" report. The Children Act 1989 has also introduced a much improved legal framework and a much improved ethos for all those involved in the care of

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children. I should like to pay particular tribute to the initiatives of the National Children's Bureau in seeking to increase awareness of the principles of the Act among those responsible for children's homes.
The Government, too, have produced valuable guidance and I hope that they will indicate what machinery they have, or will have, to ensure that the policies and procedures of the modern legislation are followed consistently by local authorities in the future. Indeed, I want to broaden that question to ask the Minister to state how the Government see their role and their responsibilities in relation to children's homes. If one reads, or rereads, the debates in another place on the 3rd June last year, just after the "Pindown" report, it is clear that the Government were putting much of the blame for the failures of the past and the problems of the present on local authorities. A large part of the problem in Staffordshire was the failure of the local authority. As the noble Baroness has just said, it was a serious management failure at various levels of that authority. That was clearly stated in the "Pindown" report. But if such failures arise out of poor and weak local authority management, the need for firm direction and support from central Government becomes all the more necessary.
The calibre and training of social workers are also directly influenced by central government. Workers in homes have to work long hours in not always attractive circumstances. I agree entirely with the noble Lord, Lord Murray, that the Government must recognise, as I hope they do, that pay and conditions will always be highly relevant to the recruitment and retention of residential social workers. In the debate in another place in June last year the Minister acknowledged that too many social workers see residential care work as a stepping stone to a career elsewhere. I hope that the Government will always see it as their concern to ensure that there are enough social workers of the right quality in post in residential homes.
The "Pindown" report also showed failures of inspection. I hope that the Minister can indicate what improvements in inspection have been introduced as a result of the shortfalls demonstrated all too clearly by "Pindown". It is vital that there should be a truly independent element in inspections. It is also vital that there should be unannounced spot checks on children's homes. Any hint of a cosy relationship between the inspectors and the inspected must go. Again, the Government have an important role in supporting the powers and the morale of the SSI.
Finally, the Question asks about after-care. I do not wish to repeat what has already been so well said; but again, the "Pindown" report shows clearly that in every home, or group of homes, there must be someone responsible for looking ahead and for career development. The dismal alternative is that children leave children's homes to join the homeless and become part of the crime statistics. It is deeply depressing—if it is correct—that 40 per cent. of young people become homeless after leaving care. I agree with the model of parental care, albeit an ideal,
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suggested by the noble Lord, Lord Murray, in a conventional family setting. Parental concern does not just dissolve when the children reach 16, 18 or some other artificial age; it is a continuing process.
The most depressing article that I have read for a very long time appears in the latest edition of Childright. It analyses how the severe hardship provision fails to provide an adequate safety net for many of the most vulnerable young people in society. I refer to the 16 to 17 year-olds who are without homes, jobs, family support or qualifications and often without basic self-esteem. At the end of the depressing article the authors make the point that was made earlier by the noble Lord, Lord Henderson:
"The question is not whether, in the short term, we as a society can afford to restore Income Support to 16 and 17 year-olds, but whether we, in the long term, can afford not to".
9 p.m.
Baroness Turner of Camden: My Lords, I am grateful for the opportunity to respond from these Benches to the debate on the Unstarred Question tabled by my noble friend Lord Ennals. As he said, he has taken over the matter from my noble friend Lord Longford who is unfortunately unwell following a recent accident. I join with other noble Lords in sending him very good wishes and hoping that he will soon be restored to us. Of course, we miss his compassion and his commitment on such issues.
Children in care, and particularly in residential care, are among the most vulnerable in our society. They are only in care because their own families are unable or unwilling to care for them. The necessary care and security has to be provided somewhere else. But children in care need love and security just as much—perhaps even more—than children growing up in their own families. Too often that love and security is not provided, although I acknowledge what my noble friend Lord Murray said about the numbers of committed staff who look after children in care and provide a very good service.
Nevertheless, as my noble friend Lord Ennals said, many children in residential care are very unhappy. But sometimes that only surfaces when there is a nasty scandal such as the "Pindown" affair. The children subjected to that system suffered the desperate humiliation of the forfeiture of all their personal possessions; they endured isolation and the frustration and boredom of being separated from all communication and companionship. It was institutional control of the worst possible kind. It was a real attempt to make non-persons of the children entrusted to the care of those in charge of that residential home.
My noble friend Lord Ennals made reference to the statistics provided by the Children's Society to the effect that about 90,000 children run away from home each year and that about 40 per cent. of them are running away from residential homes. That must give us cause for a great deal of anxiety. Apparently many of them are persistent absconders. It has already been mentioned that about 50 per cent. of youngsters begging on the streets today have a care background

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as do many young males who are in prisons and remand homes. We must all be most worried about such statistics.
However, it is hardly surprising that a child subjected to the sort of "Pindown" regime, or similar, should grow to maturity with a grudge against the kind of society that allows this to happen. When young people are brought up not to value themselves very highly, it is not surprising that they drift into prostitution or petty crime. It seems fairly clear that at least parts of the present system are not working very well. Instead of setting up further inquiries, perhaps we should look at what our past experience already tells us; and, in particular, what children would tell us themselves if ever they were asked.
It so happens that some groups have made it their business to find out what children really think. Very often the care provided is by way of containment—awkward children are simply being "tidied away". Sometimes the care is provided by inexperienced and overworked staff in settings that are some way away from the children's own communities. That further emphasises the sense of isolation that the children must feel.
My noble friend Lord Ennals made reference to the statutory instruments governing residential care issued by the Department of Health in July. He criticised them as being too vague and referred to the fact that they talk about "adequate" standards; accommodation "suitable for the child's need"; and food in "adequate quantities which is properly prepared".
My noble friend said that that sounded rather vague. I agree with him. He also pointed out that children can still be held in secure accommodation for up to 72 hours without the sanction of a court, compared to the police limit of 36 hours' detention for adults without court authority.
There is a case for asking children what they want and listening to what they say. Often all they want are the things that many of us take for granted; for example, privacy, a space of their own where they can have books and pictures, some pocket money, a choice of clothes and meals, a homelike atmosphere and a sense of being cared for and bothered about.
There should be a code of practice for caring for children which accepts that children in residential care have the same rights and the same needs as other children. We should look at why the image of children's homes is so poor so that residential care is seen as a last resort. Quite clearly, that must affect the way children see themselves and their future prospects. They are in residential care and not seen as important; they simply feel that they have been dumped. Residential care ought to be a positive rather than a negative option.
We ought to look at the role of the social services inspectorate and local authorities in monitoring and inspection. That point was made by several speakers, including the noble Lord, Lord Meston. There should be locally-based panels which look critically at homes within the area and report on children's views and worries as well as the traditional areas of inspection. Those panels might consist of a local child care
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solicitor, a paediatrician, a local justice of the peace, a social worker, a child psychologist and perhaps a member of a group representing young people. Such a panel should operate publicly and openly and publish its reports.
Local authorities should become more fully involved. I share the views of the noble Baroness, Lady Faithfull, about the obligation on local authorities in this regard. They should provide a user-friendly guide to the rights of children in residential care, explaining how to proceed if those rights appear to have been infringed. I also agree that every local authority should have a children's rights officer.
Furthermore, all staff should receive proper training. I concur with the view that was expressed by both my noble friend Lord Ennals and the noble Lord, Lord Henderson, that a deadline should be set by which that training should be completed. The staff must be properly remunerated because a proper system of remuneration encourages the right kind of people to come forward for training. The right sort of career prospects and career progression are also needed so that the staff recognise that the profession is regarded as worthwhile and that it enjoys a great deal of social respect, as it should.
Programmes need to be instituted so that the transition from a home to the world outside can be accomplished effectively. Information about benefits, housing, further education and training should be made available so that every encouragement is given to enable those young people to make the transition to the adult world. Again, I support what has been said in that regard by several of your Lordships. The children concerned need to have adequate financial support. From these Benches, I have repeatedly opposed the Government's policy of not providing adequate income support for 16 to 18 year-olds on the basis that there is a youth training placement for everybody who wants one. We know that that is not the case. Proper financial support must be provided. I believe that all those who have spoken have emphasised that point, and I should like to do so again.
Staff in residential homes should be vetted prior to appointment to provide a basic measure of protection. Individuals and companies applying to set up children's homes should be required to supply extensive background information before they are allowed to do so.
An improved system of residential care will need adequate resourcing, but substantial savings could be made following a thorough audit of the residential care system, including the expanding private sector, to ensure that unjustifiable profits are not made at the expense of the local authority and the children. In any event, such expenditure—whatever it is—must be worthwhile. No one likes to see youngsters sleeping rough or begging on the streets. No one would live like that if any other option appeared available. The fact that so many of those youngsters have previously been in care should cause us to look critically at the system not only of providing care for children who cannot for whatever reason obtain it in their own homes but also

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for ensuring that there is sufficient aftercare to make sure that those young people can take up an independent place in society as part of our community, not as outcasts.
I join other noble Lords in commending the Government on the Children Act 1989, which we supported. We on these Benches have a specific programme in this area. We have said that we should like a Minister for Children to be appointed so that these issues can be dealt with at the highest level. Other noble Lords have referred to the fact that responsibilities in this area are split between a number of departments. We should like a Minister to bring all that together and to be responsible for it.
We also believe in the appointment of an independent children's rights commissioner to monitor and investigate the exercise of children's rights and the delivery of services for children. As I have repeatedly said, we believe in consulting the children themselves. We should like to ensure that support and encouragement is available for youngsters leaving care as a first step in their achieving independence. That is the kind of framework that we should like to see. I commend it to the House and await the Minister's response with interest.
9.13 p.m.
The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper): My Lords, I join the whole House in wishing the noble Earl, Lord Longford, a speedy recovery following his recent fall. I thank him for instigating this debate. It once again demonstrates the concern for vulnerable members of our society for which the noble Earl is so well known and respected. Thanks are due also to the noble Lord, Lord Ennals, for stepping into the breach and to all noble Lords for their informed and valuable contributions to the debate.
It is true that the disclosures of abuses in recent months in Staffordshire and Leicestershire have left many of us almost shell-shocked in disbelief. Our distress at those events is of course as nothing compared to the trauma suffered by the children.
We have been reminded—and it is well that that is so—that the stress also affects the staff of children's homes. In the past decade or two their world has undergone what is probably best described as a metamorphosis. There are now far fewer children in care—a smaller proportion of these are in homes—there are fewer homes and there are fewer residents in each home. Qualified social workers have tended to move on quickly to the more mainstream fieldwork. At the same time, children have tended to enter care at an older age and in circumstances where they have, as has been acknowledged by many of your Lordships, been too difficult to be coped with in the preferred family placement. Where those children are being looked after by unqualified, inexperienced staff, often not much older than themselves, there has almost inevitably been trouble, whether resulting from too little control, as in Grove Park Home, Camberwell, or too much control as in "Pindown" and Leicestershire.
Coping with children in those circumstances is an
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extremely demanding task. I have no hesitation in agreeing wholeheartedly with the proposition put forward by many of your Lordships that the dedicated staff of children's homes are performing an irreplaceable service and need help. But what kind of help? Training is an obvious answer, as has been said. The department's training support programme, under which £29 million will be available in 1992–93 has as a focus the training of residential child-care staff. A special aim is to secure that all officers in charge of children's homes are qualified to the level of a diploma in social work; and £2.5 million has been provisionally reserved for that special initiative in 199–93. In that respect I say to my noble friend Lady Faithfull that the decision to limit qualifying training for social workers to two years was not taken solely on the grounds of cost, although the resource implication of the three-year qualification would have been considerable, but because we judged it preferable to seek a balanced programme of training improvement for all sections of the social services workforce at both vocational and professional levels.
We firmly believe that training should not end at qualification but should extend throughout a career. Our investment in post-qualifying training through the training strategy enables that to take place. While I agree that sustained care is essential and that paper qualifications, even when obtained by courses of study that include practical work, are not enough in themselves, on balance we believe that it is important that staff should be properly qualified to undertake that difficult work and that at least those in charge of homes should be expected to be qualified as a matter of course.
Staff in homes, including the officers in charge, also need support from those who have management responsibility for them. That is where the new regime of regulation and guidance under the Children Act —which came into force last year, as has been said —emphasises the need for the proper management and supervision of homes, as well as providing helpful and practical guidelines for staff. Those guidelines, for example, encourage the good practice of involving children in mundane matters such as shopping, washing and cooking referred to by my noble friend Lady Brigstocke. I agree that that is important. When I visited a home in Westminster recently the children there were encouraged to take part in the domestic tasks I have mentioned. That is obviously important to help them prepare for the day when they will have to run their own homes.
While on the subject of guidance, the noble Lord, Lord Ennals, suggested that local authorities should provide guidance on children's rights as well as appointing more children's rights officers. Guidance on the Children Act advises that every child looked after by a local authority should be given an information pack about his or her rights and how they can complain if they have a problem. I am pleased that more children's rights officers are being appointed.
Regarding children who have no contact with their families and parents, the Children Act also requires that independent visitors be appointed. As for monitoring the implementation of the Children Act

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—a point made by the noble Lord, Lord Meston—the department will monitor its implementation, including the regulations on children's homes, with a view to reporting on the first nine months of the working of the Children Act to Parliament around the turn of the year. So the points reiterated by the noble Baroness, Lady Turner of Camden, about vagueness may or may not be substantiated.
The noble Lord, Lord Murray of Epping Forest, and others suggested that residential care staff are underpaid. He recognised, however, that the Department of Health is not the employer of staff in these homes. The local authorities are the employer. The national joint council for local authorities' administrative, professional, technical and clerical services has appointed an inquiry under the chairmanship of Lady Howe. It will examine pay and conditions of service for residential care workers and various other management issues. We expect its findings to be valuable.
On the subject of resources, I do not wish to rehearse the well-known figures, but it is a fact that expenditure on personal social services overall has increased by 59 per cent. in real terms since 1978–79. In saying that, I recognise that additional responsibilities have been placed on local authorities by the Children Act, but substantial additional funding has been included in the settlements for 1991–92 and subsequent years. Not all the different new duties require additional expenditure.
In his report last year Sir William Utting said that pay and conditions of service are not the most serious matters affecting residential care. The major problem, he said, is that residential care of children is regarded as an unimportant residual activity. That is one of the problems which we have to tackle.
Regarding after-care, which was dwelt on by the noble Lord, Lord Henderson of Brompton, and my noble friend Lady Brigstocke, as well as others, the Children Act brought improvements in the provisions governing this important area. Those responsible for homes have a clear duty to prepare all the children whom they accommodate for the time when they will leave care. There are powers to make grants towards education and training, to which the noble Lord, Lord Henderson, referred, and towards accommodation expenses. Clear guidance has been issued by the department on how those responsible should undertake their after-care responsibilities. We are also grant-aiding the new national leaving care advisory service provided by the organisation First Key, to which my noble friend Lady Faithfull referred.
Nevertheless, every child leaving care is an individual with different needs and problems. Some will have been looked after by local authorities for only a brief period, others will return to a stable home environment. It is only a minority who leave care each year who for a variety of circumstances have to live independently. Nevertheless, we feel it would not have been appropriate for us to have—
Lord Ennals: My Lords, I am most grateful to the noble Baroness for giving way. Has she any figures? My impression is that there is a high proportion of children leaving care who have no home to go back to.
Baroness Hooper: My Lords, I do not have the precise figures now. However, I have been informed that it is only a minority who go on to live independently. It was for that reason that it was considered inappropriate to impose any blanket duty on local authorities, irrespective of the child's individual circumstances. Similarly, if one is going to impose a duty on local authorities to give grants, that would not mean anything unless one also dictated the minimum level of the grants. What we have done is to provide local authorities with a clear, comprehensive framework within which they can tailor the financial assistance they can give to those who have left care which will be appropriate to the individual child's needs. That matter will be considered as part of the overall monitoring exercise referred to in the Children Act.
Reference was also made to the rules governing income support, particularly for those aged 16 and 17. The Government believe that in general it is better to give young people the positive options of education, employment or training instead of the negative option of reliance on benefits. Young people who are vulnerable, such as those who have been in care before their 16th birthday, are entitled to income support for up to 16 weeks after leaving school. There are also provisions under which income support can be provided at any time for any 16 or 17 year-old who is at risk of unavoidable hardship. In addition, the Government propose to introduce legislation to provide that care leavers who are living independently and continuing in full-time education will become automatically entitled to income support.
On the question of housing, the Children Act puts the responsibility on social services departments to provide accommodation for any child in need aged 16 or 17 whose welfare is likely to be seriously prejudiced if they do not provide him or her with accommodation. Local housing authorities may be requested by social services departments to provide accommodation on occasion. The Housing Corporation allocated £13.8 million to schemes that will assist young people at risk in 1991–92. That compares with £4.66 million allocated to such schemes in 1990–91.
As a specific contribution to the alleviation of homelessness among young people—this matter was referred to by my noble friend Lady Faithfull and others—the Department of Health last year launched its single homeless young people initiative under which £3 million is being made available over three years. Some 14 individual projects will be funded under that initiative and they will provide help of various kinds in their local areas to young people at risk of homelessness when they leave home or care. In addition, we have given a grant to Centrepoint, Soho's national development unit, to produce and publish a regional resource checklist. That information pack will be launched in the spring and is designed to stimulate and guide the development of services to prevent homelessness.
The noble Lord, Lord Henderson of Brompton, also made reference to the new arrangements to divert young offenders from prison under the Criminal Justice Act 1991. I understand that, in practice, only

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some 50 to 100 juveniles are remanded to penal establishments at any one time. Nevertheless, a national steering group has been set up to address issues of developing alternative arrangements within the community and within the child care system.
A number of noble Lords have referred to Sir William Utting's report entitled Children in the Public Care - A Review of Residential Child Care in which he made recommendations for action to improve standards of public care. Some of the recommendations are for central government consideration while others are for the consideration of local government and training bodies. Authorities have already been advised that the Government accept the main recommendations in the report and they have been asked to undertake the groundwork for preparation of children's services plans, the inspection of children's homes, training and management. A joint implementation group has been set up to monitor the taking forward of Sir William's recommendations.
I must also refer to the inquiry set up by the department following the Beck incident and other incidents in Leicestershire under the chairmanship of Norman Warner to consider the selection and appointment methods and criteria for staff working in children's homes. The inquiry is due to report its recommendations to my right honourable friend the Secretary of State by July 1992.
The noble Lord, Lord Ennals, and the noble Baroness, Lady Turner, referred to a Minister for children. In the past we have not seen a need for interdepartmental machinery on children's issues in general but there are a number of regular meetings on particular subjects. Those are at present child abuse, under-fives and juvenile delinquency. There is also the family law administration working party and a group on the world summit for children.
Now that the United Nations convention on the rights of the child has been ratified we are looking at the possibility of a forum in which progress can be reviewed interdepartmentally. Under the articles of the convention we are obliged to send a report two years after ratification to an interdepartmental monitoring committee which has been set up to examine the progress made by signatory states towards meeting the obligations imposed by the convention. Most aspects of the monitoring of the Children Act will be covered in those fora, but
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Ministers here would not rule out the need for further action on particular subjects to fulfil their remit on co-ordination in relation to the Act as noted in the Prime Minister's minute.
The noble Lord, Lord Ennals, referred to the department's decision to phase out its financial support for the Intermediate Treatment Fund. The original agreement between the department and the Rayner Foundation to establish the Intermediate Treatment Fund in 1978 included a government commitment of three years' financial support. In fact we shall have consistently grant-aided the fund for 15 years when our current three-year grant totalling just over £1 million expires in March 1993.
During that period the fund has become increasingly successful in securing additional funds for intermediate treatment projects from non-government sources. Local authorities have increased their expenditure on intermediate treatment from some £3 million in 1978–79 to some £36 million in the period 1990–91. My honourable friend the Minister for Health met the chairman and representatives of the members and officers of the fund on 6th March last year to discuss arrangements. She offered a further meeting this autumn to review the matter in the light of the fund's progress in securing alternative sources of funding to meet its core costs.
The noble Lord, Lord Meston, asked about independent inspection. I confirm that the local authorities' inspection units are independent of those responsible for the operational management of children's homes.
I hope that I have succeeded in giving an update on government thinking in this area, as the noble Lord, Lord Meston, in particular requested. I believe that I can say with justification that, while recognising that no amount of legislation or resources can be guaranteed to remove the possibility of abuse or neglect, the Government consider that their policies and programmes in relation to children's homes, including after-care, demonstrate the high priority we give to this hitherto rather neglected area of social service provision. I hope that the various measures introduced will result in the provision of greater protection of children in homes, a very vulnerable group in our society and one deserving our closest attention.
House adjourned at twenty-five minutes before ten o'clock.