Lords Sitting of 14 April 1993

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

Motorway Service Areas: Repair Facilities
Lord Crickhowell Lord Crickhowell asked Her Majesty's Government:
Whether it is their intention to dispense with the requirement that the proprietors of motorway service areas must allow access to the patrols of the major motoring organisations and other recovery and repair agencies.
Viscount Goschen: My Lords, the Government are currently considering a number of representations on the matter.
Lord Crickhowell: My Lords, I declare an interest as a member of the committee of the AA. During his consideration of the issues, will my noble friend ensure that if his department is considering changing the long-established rules—as I believe it is—it will take proper account of the fact that if the motoring organisations and independent operators do not have the right of access to motorway service stations, motorists will be at the mercy of the motorway service operators? There will be a real risk of accidents being caused if motorists attempt to have repairs carried out on the hard shoulder or limp in their vehicles to the nearest exit so that they may have the services of the motoring organisations or independent garages.
Viscount Goschen: My Lords, safety remains the Government's top priority on motorways. However, we need to be convinced that there is a real safety problem. It has been suggested that if charges are imposed drivers will leave vehicles on the hard shoulder rather than struggle to safer motorway service areas. However, there is little hard evidence to support that so far.
Baroness Nicol: My Lords, does the Minister accept that when, last year, I was involved in a motorway accident, the police would not allow me to wait on the hard shoulder while the RAC came to my rescue? If I had been unable to go to a service area to be rescued, there might have been some difficulties. I hope that the Government will take a serious view of any changes.
Viscount Goschen: My Lords, we recognise the safety benefits of the motorway service areas. The whole aim of the deregulation policy is to provide more services more quickly.
Lord Clinton-Davis: My Lords, is there not another element attached to this? While we support the representations that have already been made by the AA and the RAC, is there not also the risk that
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motorists will be subject to extortionate demands from people, perhaps from the service stations, engaging in the work of repair? I hope, therefore, that the Minister will take back to his colleagues the anxieties that have been expressed by the noble Lord, Lord Crickhowell, and by those of us on the Opposition Benches about these matters. We fully support the motoring organisations in that regard.
Viscount Goschen: My Lords, I shall, of course, bring the anxieties expressed by the House today to the attention of my right honourable friend the Secretary of State. However, it will be for operators to decide whether and what to charge. The position is the same on non-motorway service areas and other private land and there is little evidence of problems there.
Lord Cocks of Hartcliffe: My Lords, I am chairman of the trustees of an employee share ownership scheme of one of the major motorway service organisers. Does the Minister realise that there is deep anxiety that the Government appear to be trying to shift the goal posts after the original contracts have been entered into?
Viscount Goschen: My Lords, I believe that the Question on the Order Paper refers specifically to access for the RAC and the AA to motorway service areas.
Lord Tordoff: My Lords, does the noble Viscount understand that the situation at motorway service stations is quite different from that on the open highway? The service stations are specifically service stations and not simply a method of making money for certain of the Minister's noble friends on the Back Benches.
Viscount Goschen: My Lords, we agree that motorways are a special case and that is why they are subject to special rules; for example, as to which vehicles may use them. The Department of Transport retains control over minimum standards at the motorway service areas. The question is whether special arrangements are needed over AA and RAC access.

Firearms Amnesties
2.41 p.m.
Baroness Macleod of Borve Baroness Macleod of Borve asked Her Majesty's Government:
How many police forces have offered an amnesty in the past three years to those who hand in guns and knives, and how many weapons have been recovered as a result.
The Minister of State, Home Office (Earl Ferrers): My Lords, firearms amnesties are organised on a national basis. The last amnesty was in 1988. Local operations by seven police forces in Great Britain have resulted in the surrender of 7,494 bladed weapons in the past three years.
Baroness Macleod of Borve: My Lords, I thank my noble friend for that reply although I had hoped that it would be more specific. Will the Minister undertake

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to ask his right honourable friend the Home Secretary whether he can instruct the police forces of this country to hold an amnesty? It is widely known that far more criminal offences now, and indeed going back over the past three years, involve the use of guns and knives.
Earl Ferrers: My Lords, the only amnesty possible is one that relates to firearms. My right honourable friend the Home Secretary has to ask his right honourable friend the Attorney-General not to prosecute those people who have broken the law in possessing weapons incorrectly. Clearly, if we have an amnesty too often it undermines the purpose of the law. Knives are in use every day and there is no such thing as an amnesty for them. It is for chief officers periodically to take such initiatives as they wish through which people may voluntarily give up their knives.
Lord Ewing of Kirkford: My Lords, can the noble Earl say whether the figures he gave include the recent amnesty by Strathclyde police force? Does he agree that one of the problems with an amnesty is that almost everyone who surrenders a knife has no intention of using it in the first place? Does he further agree that the problem lies with those who do not surrender knives and the ready availability of knives and weapons from various retail outlets in this country to irresponsible people? Can I encourage the noble Earl to look closely at that aspect and to try —I accept that it is difficult—to come up with some solution to the problem of supply rather than the problem of surrender?
Earl Ferrers: My Lords, the figures included Strathclyde where the police had an undertaking called Operation Blade and 4,600 knives were handed in. As to the second question, obviously one is always concerned to prevent people using knives. But the majority of knives are in common, every day use and it is therefore very difficult to prohibit them. Certain knives are prohibited under the Criminal Justice Act 1988, such as swordsticks, belt buckle knives, push daggers, butterfly knives, death stars, footclaws and hand claws. These and all sorts of other things are prohibited; as indeed are flick knives under the offensive weapons Act of 1959.
Lord McIntosh of Haringey: My Lords, my noble friend referred to the case of Strathclyde. Is it not the case that the law in Scotland regarding carrying knives is less strict than it is in England? Would it not be more to the point if the laws of England and Scotland were harmonised rather than more amnesties encouraged?
Earl Ferrers: My Lords, people often suggest that the laws of England and Scotland should be harmonised, but it does not always work out in practice.

Slaughter-houses: EC Regulations
2.45 p.m.
Lord Peyton of Yeovil Lord Peyton of Yeovil asked Her Majesty's Government:
Whether they are satisfied that the United Kingdom regulations on fresh meat hygiene are a fair reflection of the Community regulations on which they are based; and whether other member states have enforced the regulations in the same way.
The Parliamentary Secretary, Ministry of Agriculture, Fisheries and Food (Earl Howe): My Lords, I am satisfied that the Fresh Meat (Hygiene and Inspection) Regulations fairly reflect the requirements of the EC red meat directive and consolidate them with previous GB legislation. As one might expect, other member states have reached different stages of implementation but we have no evidence to indicate that their interpretation of specific requirements is different from that of the UK.
Lord Peyton of Yeovil: My Lords, are the Government trying to persuade us that a small number of large slaughter-houses rather than many small ones is a better bet for animals, for producers and for customers; that somehow or other veterinary inspection has a contribution to make which the EHOs were unable to make; and that the regulations in force here are a faithful echo of the directive and do not contain considerable ministerial guidance in addition? Is the Minister aware that his reference to previous legislation heightens my suspicions in that respect?
Earl Howe: My Lords, the Government have made extensive efforts to minimise the burdens and costs which small slaughter-houses have to bear. We take their problems very seriously. I believe that consumers would have cause to worry if they thought that animals in this country were slaughtered while in a diseased or unfit condition. Vets are uniquely qualified to spot symptoms of diseases in animals and conditions which have significant implications for public health but which may well not be visible at the post-mortem inspection. It is essential to spot and deal with such animals before they get into the human food chain. That is why veterinary supervision is the practice in all other major meat producing countries.
Lord Stoddart of Swindon: My Lords, is the noble Earl aware that I am bewildered, as I am sure are many other people, at the reply he has just given? Is he aware that slaughter-houses have operated in this country for donkeys' years—
Noble Lords: Oh!
Lord Stoddart of Swindon: —for a very long time with meat inspectors sent in by the local authorities who have done the job very successfully? Will he confirm that the word "veterinary" means something quite different on the Continent, and that in most

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abattoirs on the Continent they have unqualified inspectors and not people with veterinary qualifications as we know them?
Earl Howe: My Lords, veterinary surgeons' qualifications are harmonised throughout the EC and have been for many years. There is no distinction in qualification whether the directive refers to "veterin-ary officer" or "veterinary surgeon", and there is no difference in the standard of training. All member states require veterinary supervision ante mortem. The degree to which slaughter-houses are required to be subject to such supervision may vary, as it does in the UK, according to the size of the premises. Veterinary supervision is a prerequisite of world and intra-Community trade in meat, which is why for a number of years more than half the meat produced in this country, as well as all the meat which we import, is subject to veterinary supervision.
Lord Skelmersdale: My Lords, does my noble friend agree that veterinary inspections are only a part of this problem? Will he accept that the other part of the problem relates to the storage and keeping of meat under forms of refrigeration? Will he confirm that that also is a factor in the regulations? Can he say whether the local authorities and the environmental health officers do in fact go rather further than the regulations ever intended?
Earl Howe: My Lords, I believe I said in reply to a Question some time ago that we have to be alert to the possibility that local authorities may be enforcing the regulations inconsistently. However, my noble friend made a very good point. What counts as hygienic or unhygienic in terms of slaughtering practice has not changed in United Kingdom law. I am afraid that our previous legislation has not been properly enforced. There can be no compromise where filthy or unhygienic practices put at risk consumer safety.
Lord Bruce of Donington: My Lords, is the noble Earl aware that there is no difficulty in any of the member states in interpreting the regulations? Is it not the case that although the meaning of the regulations is fully understood, in some member states there is a deliberate endeavour not to enforce? Is that not the root of the problem, particularly among those countries in the EC, including some major states, that have corrupt administrations?
Earl Howe: My Lords, all member states except Great Britain already have veterinary supervision of abattoirs and therefore do not need to take action to implement that aspect of the directive. We looked carefully into the issue of uniform enforcement. All our inquiries indicate that the level of veterinary supervision required by MAFF guidance to local authorities is lower than in Germany, Denmark, Ireland and Italy and comparable with France and the Netherlands.
Lord Mackie of Benshie: My Lords, would the noble Earl care to say what the Government mean by "veterinary supervision"? Do they mean that every
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pig, hen or bullock slaughtered has to be inspected by a qualified veterinary surgeon with eight years of training?
Earl Howe: My Lords, my previous replies have indicated that the broad answer to that question is yes, certainly as regards ante mortem inspection. We have said to local authorities that the level of veterinary attendance should be proportionate to the through-put of the particular plant. We have sought to protect low through-put slaughter-houses by exempting them from inspection during slaughter and allowing them to use large animal practitioners—in other words, farm vets—for supervision if need be. But what we should not and will not now do is to relax the requirement for veterinary inspection ante mortem because that process ensures that public health is properly protected.
Lord Pearson of Rannoch: My Lords, is my noble friend aware that whether or not these regulations are harmonised, they may not be a very good idea in any case? Recent research shows that they have had the effect of driving away the normal bugs and microbes that usually inhabit a piece of raw meat. They have been replaced by new bugs and microbes of a much more virulent kind which are far more harmful to humans. Will he accept that since these regulations were introduced the result has been that cases of food poisoning from meat have increased by some 47 per cent.?
Earl Howe: My Lords, my noble friend referred to incidents of food poisoning but perhaps he should look at the causes of that poisoning. That has been laid at the door much more of culinary practices than of anything that happens in slaughter-houses.
Lord Monkswell: My Lords, did the Minister see last night the television programme which raised serious issues and anxiety about the practices in British slaughter-houses and the infection of the human food chain by BSE? Can he give an undertaking that the Government are seriously reviewing their restrictions on slaughter-house practice in respect of BSE? Can he give any indication of whether BSE is prevalent in any country in the EC other than the United Kingdom?
Earl Howe: My Lords, the last part of the noble Lord's question falls somewhat outside the Question on the Order Paper. We take the incidence of BSE extremely seriously. That is one of the main reasons why veterinary supervision ante mortem is so very important.
The Viscount of Oxfuird: My Lords, is the Minister aware that my noble friend Lord Boyd-Carpenter and I use the same butcher? He is a singular man by the name of Mr. Machonachie. He wears a straw hat and has an immense sense of humour. I visited him the other day only to discover that there was a "For Sale" notice outside his shop. On asking him why it was there, he said, "I have had enough of Brussels' legislation". I looked into the matter more deeply and acquired the statutory instrument concerned. Will the Minister confirm that the Explanatory Memorandum

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distinctly excludes butchers' shops? Does he agree that we are entering a state in which both the press and ill informed people dictate what happens even at the very lowest level?
Earl Howe: My Lords, I am sure that my noble friend is not alone in his concern for the small butcher's shop. There is nothing in the directive to which I referred in my original Answer which in any way impacts on the butcher's shop. The rules for hygiene in such premises have remained unchanged for many years.
The Countess of Mar: My Lords, could the noble Earl indicate the regulations after the meat has left the abattoir and before it is delivered to the butcher's shop? In the high street of our local town I frequently see a lorry with the back open and completely uncovered sides of pork hanging there, subjected to fumes, flies and everything else. That meat is then carried over the porter's shoulder, which is not necessarily as clean as it should be, into the butcher's shop. What protection do we have against infection which arises at that stage?
Earl Howe: My Lords, the circumstances described by the noble Countess appear prima facie to infringe the meat hygiene rules on the transportation of meat which have been in existence for many years.
Lord Carter: My Lords, is the Minister aware that the chief environmental health officer of the Department of Health stated in February that the regulations:
"have specific requirements which I frankly find it hard to believe are closely related to the protection of public health"?
Does the Minister's department agree with that statement?
Earl Howe: My Lords, the independent report which the Government recently commissioned from Dr. Johnston and Mr. Spurr confirmed that overall the requirements that the Government now impose did not go beyond what was needed to rectify structure-related hygiene problems. Indeed, it criti-cised MAFF in some instances for not being rigorous enough. So we are applying the rules sensibly, and that will continue.
Lord Carter: My Lords, I asked the Minister whether his department agreed with the statement of the chief environmental officer of the Department of Health who said that the regulations:
"have specific requirements which I frankly find it hard to believe are closely related to the protection of public health".
Will he reply to that question?
Earl Howe: My Lords, I fully agree with the conclusions in the report and the Government will look into them.
Lord Peyton of Yeovil: My Lords, will my noble friend make arrangements for translations of the orders published in other member countries to be placed in the Library so that noble Lords have a good opportunity to compare how far departments in each country make a contribution in amplifying those directives which is not justified?
Earl Howe: My Lords, I am happy to give my noble friend an undertaking that we shall do our best to acquire the regulations from all other member states. It may take a little time but, as and when we receive them, we shall place copies in the Library.

Mineral Hydrocarbons and Food Processing
3 p.m.
The Viscount of Falkland The Viscount of Falkland asked Her Majesty's Government:
Whether there is any health risk to consumers from the use of mineral hydrocarbons in food processing.
The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege): My Lords, no adverse effects on human health have been reported. Nevertheless, the Government are aware that long-term exposure to mineral hydrocarbons in the diet may cause problems. That is why the independent Scientific Committee on Toxicity is considering the latest data.
The Viscount of Falkland: My Lords, I thank the noble Baroness for her Answer. As she confirmed, the Government's committee on toxicity said that mineral hydrocarbons were unsuitable for use in food processing. Nevertheless, certain foods, such as chewing gum—if one may describe that as a food—and cheese with a waxy outside, such as Edam, still contain a high proportion. Most of us who chew gum can probably think of a more sensible way of disposing of it than to swallow it, but there are people who may nibble at the outside of a cheese. In commercial baking, where mineral hydrocarbons are used to spray machinery, would it not be fair to consumers—both of chewing gum and cheese—to put that fact on the label and so allow people to choose whether or not to buy it?
Baroness Cumberlege: My Lords, the noble Viscount makes an interesting suggestion. It is one that has not been considered by the committee advising on food and labelling. With pleasure I shall take the suggestion to the committee and seek its views.
Lord Molloy: My Lords, is the noble Baroness aware that her first Answer can only be regarded as encouraging? The Government are obviously concerned with the Question which must come under the heading of being a form of preventive medicine.
Baroness Cumberlege: Yes, my Lords.
Lord Wade of Chorlton: My Lords, does my noble friend not agree that wax has been used as a covering for a whole range of different varieties of cheese for many years and that there has never been any case of someone being taken ill as a result of eating it, if in fact they have been silly enough to do so?
Baroness Cumberlege: My Lords, I agree. It would take a great deal of determination to eat the covering of an Edam cheese.
Lord Desai: My Lords, given the seriousness of the Question, can the noble Baroness explain why, although a report was issued in 1989 regarding draft proposals on toxicity, nothing has been done by the Government to issue any directive in that regard for either consumers or shops?
Baroness Cumberlege: My Lords, the Scientific Committee on Toxicity suggested that the preparations should be banned. Consultation was then carried out by the Government which brought to light certain complications, including the use of mineral hydrocarbons in some pesticides and veterinary drugs. It became clear also that further relevant research on mineral hydrocarbons was already being undertaken and we were aware that manufacturers had already cut down on their usage. In the light of those developments it was considered wise to defer the planned restrictions until the additional research had been evaluated by the committee on toxicity.
Lord Tordoff: My Lords, how far are the Government looking into the use of technical white oil and its effect on the human body? I refer specifically to liquid paraffin which falls into that category. Is the noble Baroness aware that the human body is the one piece of equipment which, the more one lubricates it, the more noise it makes?
Baroness Cumberlege: My Lords, as a doctor's daughter I am well aware of that.

Business
Lord Hesketh: My Lords, after the debate on drug and alcohol abuse and before the debate on the forestry industry, my noble friend Lady Chalker of Wallasey will, with the leave of the House, repeat a Statement that is to be made in another place on Bosnia.
With the leave of the House, I should like to say a word about the two debates standing in the names of the noble Lords, Lord McNair and Lord Taylor of Gryfe. As the mover is allowed 15 minutes and as 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 McNair, the number of speakers is such that it is not necessary to propose any formal time limit. But I am sure that noble Lords will agree that it would conform with the spirit of these short debates if they would keep their speeches within the 15 minutes which apply to the mover of the Motion. In the case of the debate in the name of the noble Lord, Lord Taylor of Gryfe, it means that all other speeches should be limited to a maximum of five minutes. Should any noble Lord speak at greater length he would do so at the expense of subsequent speakers in the debate.

Drug and Alcohol Abuse
3.4 p.m.
Lord McNair Lord McNair rose to call attention to the social and legal implications of drug and alcohol abuse and to the case for increased facilities for residential care; and to move for Papers.
The noble Lord said: My Lords, I am grateful for the opportunity to discuss this serious matter and I hope that the effect of the debate will be to clarify some of the issues relating to drug and alcohol abuse and to make some progress towards resolving them. I included in the title reference to provision for residential care. Although such public provision is something of which I have neither much knowledge nor experience, there are many in your Lordships' House who do. I am glad to see that some of those are speaking today.
Before I start perhaps I may ask whether anyone else saw a small article in yesterday's Independent? If any other speaker intended to refer to it, I apologise for getting in first. It states:
"13 April 1816 Samuel Taylor Coleridge writes to James Gillman, a surgeon, accepting treatment for his opium addiction: 'No sixty hours have yet passed without my having taken Laudanum, tho' for the past week comparatively trifling doses. I have full belief that your anxiety will not extend beyond the first week, and for the first week I shall not, I must not be permitted to leave your house, unless I should walk out with you. Delicately or indelicately, this must be done; and the servant must receive an absolute command from you on no account to fetch anything for me. The stimulus of conversation suspends the terror that haunts my mind; but when I am alone, the horrors I have suffered from Laudanum, the degradation, the blighted utility, almost overwhelm me"'.
It appears that little has changed.
When we talk about drug and alcohol abuse we use language in a curious way because it is the person's body and his mind, and in fact his whole being, that are abused by the consumption of the substance. We regard the substance with differing degrees of seriousness depending on several factors: the effect on the person's behaviour; the degree of addiction and the speed with which addiction sets in; the legal background against which consumption takes place; the commercial environment in which the substance is used. For example, does it generate tax revenue? Is it available only on the black market? We consider also the toxic or health-threatening properties of the substance, current medical prescribing practice and what is regarded as acceptable in the culture.
I want to try to illuminate a little the world of the addict. In doing so I must confess that I have never had a drug or alcohol problem myself so that my interest is in a sense vicarious and my experience is a retelling of the experiences of professionals in the field and of former addicts whom I know.
I should like to spend some time on the problem of methadone. This is a synthetic opiate which was first developed by German chemists during the Second World War when Germany was unable to obtain supplies of either morphine or heroin to use as painkillers for their wounded. But its use as a substitute for heroin follows a pattern of unsuccessful substitution which started when morphine was first

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used to try to cure alcoholism. The resulting morphine addiction was then treated by substituting diamor-phine or heroin, which is a derivative, like morphine, of opium. Heroin addiction was fuelled by illicit supplies of heroin from Asia and by changing cultural attitudes and the lifestyles of young peoples' role models in the entertainment world.
Methadone is prescribed as a substitute for heroin. It is listed in MIMS as a painkiller, but a GP friend of mine told me that it is only ever used as a heroin substitute. I feel therefore that it would be useful to examine the effects of the drug and the results of the present prescribing regime. It is available both as a linctus and as injectables in ampoule form. It is wholly synthetic so that third world production and smuggling is not a problem, although there is a well established black market in prescribed methadone.
There is one major problem with substituting methadone for heroin. It is much more addictive than heroin and much more difficult to come off. While that is obviously good for the shareholders of Wellcome, the manufacturers, it is a disaster for thousands of heroin addicts who are persuaded to change from heroin to methadone. In the words of one former addict, "Methadone is less vicious but subtly more evil and destructive, both mentally and physically". That is from someone who has used both and who was reassured for years that methadone was harmless.
The same doctor explained to him that as he could no longer use the veins in his arms for injecting, he should inject it into the femoral vein, in the groin—a counsel of despair if ever there was one. It not infrequently happens that people who do this, and who lack adequate anatomical knowledge, manage to inject into the femoral artery, with disastrous results. That, of course, applies whatever substance is injected. Methadone, however, has many physical as well as mental effects, despite the doctors' reassurances. These include bloating of the torso, wasting of the muscles and heart irregularities.
Perhaps at this point I should go into detail about a particularly unpleasant aspect of the addiction industry. I recently discussed with former addicts their experiences of the methadone prescribing practice of certain doctors outside the NHS who are often located in Harley Street or thereabouts. I must stress that what I am about to say applies only to a few unscrupulous doctors. I do not include the sincere pioneers of maintenance prescribing, who are not motivated by profit, even if they are misguided. We calculated the throughput of patients at one surgery on the basis of an average of 10 minutes per patient —there is always a queue—and multiplied that by the average cost of a prescription and the number of patients that a doctor could see in a day. It should be borne in mind that these doctors do not actually have to handle the drugs. They are, if you like, well paid agents for the manufacturers. The prescription for which addicts pay the doctor is simply a permit to go to their chemist and pay two or three times as much as the prescription cost for the actual drugs.
We calculated that these practitioners are earning at the rate of about £300,000 a year. No doubt if
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questioned they would plead pitifully that the rents in Harley Street or Wimpole Street are so high, and so on. No doubt this would also be the reason given for their induction procedures and the reluctance to countenance a reduction in the amount of the addict's prescription, which is something that addicts have found. Apart from compliance with the regulations, their main concern when first consulted by a new patient is whether he or she can pay for the prescription on a regular basis. For those addicts who are able to maintain their employment, a job reference will suffice. For others, a bank statement is required. I should add here that it is usually the doctors working within the NHS who try to persuade the addicts to reduce their consumption.
I should be grateful if the Minister would tell the House—I have given her notice of this question— what has been the total volume of methadone prescribed each year for the past two years both inside and outside the NHS. I sincerely hope that the Minister will listen carefully to my criticisms of government policy regarding methadone and realise that they are based on the experiences of both former addicts and professionals in the field.
I conclude what I have to say about methadone with this. To encourage someone to change from heroin to methadone is to play upon that person the cruelest practical joke imaginable. Withdrawal from heroin takes three or four days. It may include involuntary muscle spasms and cramps, insomnia and nervousness. But methadone withdrawal can take weeks, during which time the person may experience diarrhoea, back pain, extremely severe abdominal pain and cramps, hot and cold flushes, insomnia, sweating and a deep pain in the bones. This has been described by some as a sensation that their bones are deteriorating. I hope that the Government will swiftly reverse this policy of substituting methadone for heroin. If maintenance prescribing is deemed necessary, then in my view it is better to maintain people on heroin.
There is another very serious situation about which little is spoken. This is the problem of tranquilliser addiction. It is estimated that 2 per cent. of the adult population takes tranquillisers regularly. The majority of people taking tranquillisers regularly would experience serious withdrawal symptoms if they stopped taking them.
Benzodiazepines are drugs of addiction par excellence and the body rapidly acclimatises to them so that progressively larger and larger doses are required not just to maintain the status quo but to prevent the onset of extremely unpleasant withdrawal symptoms even at the regular dose. These consist of a long list of very nasty physical and mental sensations. Stopping taking benzodiazepines brings on severe, intense and seemingly endless withdrawals. The reason why not much is heard of this problem is the incapacitating nature of the suffering. People suffering tranquilliser withdrawals are socially paralysed. They are often too terrified even to pick up the phone or write a letter. Their world seems to come crashing down on them. Thoughts of death and suicide haunt them. It is well nigh impossible for people in this state

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to link up with other sufferers to form common interest or pressure groups, so millions suffer in silence. But their suffering is real and the dangers of regular tranquilliser use should be more widely known. Will the Minister tell the House what research the Government have undertaken into this problem and what is the latest advice to doctors? I also have another suggestion which could be put in place in the case of suicides. I should like to see a recording of the prescribed drugs which the person who had committed suicide had been taking in the period leading up to his death.
I should now like to turn to the drug situation in prisons. Because of the unusual economic situation in prisons the inmates have come up with novel means of economic survival. Prisoners divide into those who use drugs and those who want nothing to do with them. However, drugs as well as cigarettes and even phone cards are used as currency in the prisoners' economic system. But, for whatever reason and in whatever way, drugs are freely available in prison. It has even been put to me that the prison authorities prefer to have a certain amount of opiates circulating because it reduces tension. I was told that the atmosphere gets very tense if they are not available.
I suggest that intervention with drug and alcohol rehabilitation in prisons is essential to break the vicious circle of drug induced crime. I know from reading Addiction Counselling World that some initiatives are currently being tried, and I welcome that. This should be a major focus of government policy in the prisons. If you think of the cost of a drug habit as being £500 per week, then in the space of a year the person has to come by a total of £26,000. And this will be repeated year after year. Effective drug rehabilitation, as described in the same publication, at a cost of about £7,000 to £10,000 per person then looks like a worthwhile investment. The cost would be less in prisons because accommodation is already provided.
It is worth noting that any drug is taken initially to produce a positive pleasurable effect. As with alcohol, the drug taker may come to depend on some other property of the drug—for example, anxiety reduction —and may then continue to take it in order to eliminate some negative effect; for example, depress-sion or the onset of withdrawal symptoms. Recognition of this change is often the event that prompts the drug user to seek help. Withdrawal, or "cold turkey", is greatly feared by addicts who, if they have not experienced it themselves, will certainly have discussed it with other addicts. I remember a meeting of the All-Party Group on Drug Misuse at which Dr. John Marks from Liverpool stated that addicts did not want to come off drugs and that they either grew out of their addiction or died, so either way they ceased to be a problem. The noble Lord, Lord Mancroft, and others at that meeting took exception to that callous and self-serving attitude, and former addicts to whom I have spoken all say that deep down all addicts do in fact want to get off drugs.
Something else has come to my attention which I should like the Department of Health to consider carefully. I believe I am right in saying that all
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currently available syringes have stamped on them a kind of government health warning to the effect that they should not be re-used. But they still can be re-used by anyone who decides to do so. I know of at least one perfectly practical design, with which I have no financial connection—I expect there are more—for a syringe that is impossible to re-use although it functions normally when used the first time. This is such an eminently sensible idea that I cannot imagine why it was not implemented when re-use of syringes first became a problem. It is something I intend to take up with the Department of Health though I do not expect a full answer when the Minister winds up the debate.
I feel very strongly that the Government should give equal emphasis to educational approaches to prevent children becoming involved with drugs in the first place as they do to the rehabilitation services side of the problem. Last time we debated this subject I spoke about TACADE, the Advisory Council on Alcohol and Drug Education. The noble Lord, Lord Russell of Liverpool, spoke about life education centres. I believe that the noble Baroness, Lady Masham of Ilton, will say something about TACADE today. I hope that I do not steal her thunder.
The activities of those two organisations seem to me to complement each other very well. Life education centres have 12 mobile audio-visual demonstration units which tour the country giving a lively presentation of the effects of different kinds of substance abuse and kindle in their young audience a sense of wonder at the way in which their bodies work and an awareness of their own uniqueness. Understanding the mechanisms of peer group pressures, they are better able to resist offers of drugs, alcohol and cigarettes. I have seen one of their mobile units in operation and was very impressed.
I must congratulate the Department of Health on its decision to give TACADE the Section 64 core funding for which it has been asking for the past three years. This funding, modest though welcome, is a recognition of the major contribution that TACADE has made to the educational life of the country. An evaluation of its programme, Skills for the Primary School Child, will be published this summer. However, indications from schools suggest that this programme is having an important, positive effect on the moral outlook of primary school children who are exposed to it. This takes the form of marked reductions in bullying and truancy and improvements in general behaviour, communication skills and the ability to form satisfactory relationships with others.
However, I should like to add a note of caution as regards the programme. It works best when and where it is applied fully after staff have been properly trained to deliver it. That is because the teachers need to understand fully the principles behind the programme and to reflect on their own attitudes and social skills.
The decline of moral values and the reduction in community spirit have been commented on by many people, including the Secretary of State for Education. Skills for the Primary School Child helps greatly to produce the attitudes which collectively make up those desirable attributes and produce the behaviour we

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want from our children; and it is in childhood that we need to learn to be good and kind, to respect others and to respect ourselves.
Traditional values were, it must be said, often enforced by a measure of fear, whereas now we need to inculcate positive values on the basis of an understanding that respecting others and oneself makes for a happy life. When society is falling apart all around them, it is doubly necessary to have a part of the school curriculum that makes it possible for children to learn how to grow into emotionally mature people. In that way, they will experience the natural high that is our birthright and will more easily resist the temptation to use drugs and abuse alcohol. I beg to move for Papers.
3.22 p.m.
Lord Mancroft: My Lords, we should be grateful to the noble Lord, Lord McNair, not only for putting the Motion down on the Order Paper but for using words which allow us to have a wide-ranging debate with a focus within it. There are tremendous legal and social implications. There are legal implications because there are social implications. The social implications connected with the misuse of drugs and alcohol in this country are because we, as a society, quite rightly came to the conclusion that excessive use of alcohol, or indeed any use of illicit drugs, is bad in two ways: it is bad for an individual's health; and it is bad for society as a whole. Both factors are very true. It is because such use is bad for society as a whole and because it is injurious to personal health that we have sought various methods to prevent it. That is where the legal implications come in. We have made it difficult to sell alcohol in the same way that one would sell other products. One sells alcohol through licensed premises and off-licences. That is a method of control.
We control other drugs too. I refer to "other drugs" because alcohol is a drug; it happens to be a rather popular social recreational drug which is an inherent part of western society. However, it is nevertheless a narcotic drug and a very poisonous one at that. Drugs such as cannabis, cocaine and heroin are controlled in another way. In this country we do not make them illegal for the most part; we control them. We have a Misuse of Drugs Act which seeks to prevent ordinary people from using those drugs. One can only obtain drugs such as heroin through a doctor and for very few medical reasons. But heroin is a very useful carefully prescribed medical drug. I have referred to one of the ways in which we control drugs in this country.
We have sanctions for people who do not stick to those rules. If, against our law, people wish to import drugs in large quantities into this country we pour an enormous amount of money into Customs to prevent them from doing that. We have the police to prevent people from possessing, buying or selling drugs or driving cars under the influence of drugs. An enormous amount of police time is taken up in trying to ensure that people keep those laws; on the whole they do not seem to.
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We have courts. We take people before the courts if they break those rules and the police catch them. Forty thousand people were taken to the courts last year for the possession of drugs. Only about 1,200 of those 40,000 actually went to prison, and that is probably not a bad thing because there are far more drugs in prison. The noble Lord, Lord McNair, touched upon the issue. The figures vary slightly depending upon whom one listens to, but the 1989 survey indicated that 43 per cent. of male prisoners had used drugs before and during the time they were in prison. Therefore, perhaps prison is not a good place in which to put people with drug problems.
We have another method of control: we tell doctors that they must inform the Home Office if they know that any of their patients use drugs. There are about 20,000 people on that list at present. The figure has increased 74 per cent. from 1987 to 1991, which is the latest figure that I have. The Home Office admits quite openly that probably only one-fifth of those who are addicted to drugs are on that list. The others escape merely because they give false names to the doctors or because the doctors do not choose to register them. I do not believe that the Home Office tries that hard to make sure that the list is accurate. Even accepting those figures, we must assume that there are at least 100,000 addicts in this country. That is what the Home Office believes. I ask noble Lords to remember that figure.
In connection with the law and the courts, we have a variety of other methods to try to stop people taking drugs. They are not always very satisfactory. It appears that most of those who are in prison for a variety of drug offences come out and reoffend. Taking drugs and possessing them is not the only reason for appearing before the courts. Of those who appear before the London magistrates, 83 per cent. have a drink or drug problem as a contributory factor in their offence. Although under the latest Criminal Justice Act there is a treatment provision, it is not often used because there are few treatment facilities to which one can send those people. They come out and reoffend. To keep allowing people to go round and round the system is very expensive. According to the Home Office the cost of drug-related street crime in the Metropolitan Police area currently runs at £1,850 million every single year: it costs you and me £1.85 billion as a result of people stealing to acquire illegal drugs. I am a simpleton in these matters, but my view is that that is an unacceptable figure. We should not accept it, yet we do. Year after year we allow that figure, and it is rising.
I stated that the Home Office admits to 100,000 addicts. Perhaps I may quote from an article in the Evening Standard of 25th January 1993 which states:
"Figures released last week reveal that Customs officers confiscated a record £545 million worth of drugs last year".
I do not know about other noble Lords but I do not believe that 100,000 people can afford to buy £545 million worth of drugs, in particular when we know that if a person steals a cassette player out of a car he will sell it for only £5. We do not need to do much

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mathematics to realise that to produce that figure an awful lot more than 100,000 people must be taking drugs. The article continues:
"still the number of users and seizures by drug squads grows. Consequently, says Commander John O'Connor, the best way to tackle the problem is to reduce demand … In North America, the strategy of the Seventies and Eighties appeared to be to attack the source. But government-backed programmes of crop destruction have had little impact on the tide … that has saturated the US market".
In other words, we cannot control the supply, but we can try to control demand. There are two ways in which we can do that. The first is the prevention/education route, and the other is the treatment route. The noble Lord, Lord McNair, mentioned the two best organisations in the area of prevention and education: TACADE and the Life Education Centres. I. am sorry that the noble Lord, Lord Russell of Liverpool, is not in his place to talk about the Life Education Centres because he knows a great deal more about them than me. Those organisations are very effective. As the noble Lord, Lord McNair, said, they teach children to think positively about their health and about what they do with their bodies and minds but—and there is a really big "but" in this— there is no practical evidence that drug prevention in this way works. Just because one teaches people that drugs are not a good thing, it does not mean that they grow up not to take them. All the evidence points to the fact that they do. People cannot learn not to take drugs in the same way that they learn French irregular verbs. Drug taking is partly learned behaviour and the people from whom children learn it are the adults around them—their parents, teachers, and adult family friends. That is where people learn how to take drugs, and that is where we must stop them.
What we do know is that treatment works. If I say that with a certain amount of pique, it is because earlier this year we had European Drug Prevention Week which the Department of Health spent more than £250,000 publicising—I know that because I was told by the company that the department hired to publicise the event—when everybody in the indepen-dent sector told the department that it would not work. Indeed, the previous week the department reversed the community care proposals which allowed treatment to be properly funded. That galls slightly. In fact, that galls a great deal because treatment does work. We know that it works and we can show that it works. However, it only works if it is good treatment in much the same way as a good mechanic will mend one's car but, my God, a bad mechanic will ruin it. We need to make sure that we have some better mechanics.
Therefore, I welcome the report that I read in the Daily Telegraph last week that the Minister responsible, Dr. Mawhinney, has started a study into the way in which we treat drug and alcohol addiction in this country. That must be good. The whole row over community care and its funding took place because social services departments do not want the drug addicts and the alcoholics and neither do the health authorities. For 20 years they were bounced between one and the other, falling between two stools, with the result that this country still has only about
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2,000 in-patient beds. America has one such bed for every 2,000 per head of population, whereas in this country we still have only one bed for every 220,000 per head of population. We cannot allow that to continue because it is too expensive to leave those people untreated. We must change that.
There will, of course, be endless debates about whether we should prescribe methadone. The noble Lord, Lord McNair, described it carefully. I have severe doubts about methadone. It has a role, but only a very limited one. There is no doubt that the noble Lord is right that methadone is massively over-prescribed. It is very expensive and extremely dangerous. We need to think about it carefully. One does not swop somebody from one drug to another. It is not a good thing to do. It is possible to persuade people to stop drug use and to abstain. One could say to an addict when he comes through the door, "Listen old boy, we have two choices for you: either you can go next door and we can give you some stuff to keep you level and everything will he hunky-dory, or you can go into an abstinence programme which will he hard work and unpleasant". But what will be his reaction? He will say, "Thanks very much, guy, I think I'll have the drug". We should not give people who are weak and vulnerable such decisions to make because they are not in the right frame of mind for making them.
We do not need more huge amounts of public money, but we do need the money which is currently being spent to be spent properly. As yet, there are no qualifications for drug counsellors in this country and we have no registration of facilities. The existing facilities are registered either as nursing homes or psychiatric hospitals—and they are neither. Although psychiatrists seem to play an increasing role in this area—wrongly, in my view—we must remember that very nearly 100 years ago Sigmund Freud wrote that alcoholism is not a psychiatric illness. It is very important that we get these people off the psychiatrist's couch where no good is done them but where an awful lot of money is wasted.
It is true that there are not enough treatment beds. We need far more. Not only that, we need out-patient treatment; but we will not get that until we have good in-patient treatments. It is no good the Government saying, "It is up to the market and the treatment providers" when the treatment providers do not have enough money from the local authorities to provide the treatment. The Government must give a lead in helping these places to get going. They must give a lead in ensuring that they are properly registered and that they receive the correct amount of money and in ensuring that there are proper outcome studies to see how they work, to fine-tune them and to improve them.
The noble Lord, Lord McNair, mentioned treatment in prison. He was talking about the remarkable Addictive Diseases Trust programme at Downview Prison. Fourteen patients can be treated at any one time which is the equivalent of 120 each year. The cost of treating those equals the cost to the Home Office of one prisoner returning to the prison. Therefore, if only one of the patients being treated in

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any one month stays off drugs and does not come back to prison, that pays for the cost of the whole programme. That is cost-effective. That is the way in which we want to run treatment. That is the way in which it should be run.
In the remaining minute left to me, perhaps I may conclude by saying that it is very important to realise that historic attempts to control the supply of drugs have failed, will continue to fail, and will fail at an ever faster rate because drugs are entering this country ever more rapidly. Therefore, we should review the money that is spent on Customs and on the crop replacement schemes, which have proved absolutely useless. We must review the law, the way in which we control drugs, and the role of the courts and the prison system in drug control generally. We must not expect education and prevention to provide all the answers, although we do need to keep trying in that area. We do need to concentrate on treatment and to do so now, and hard. We need to combine drug and alcohol treatments. We do not need two sets of civil servants and two sets of experts. We should combine them.
There is an answer to the drug problem—and that answer is treatment. It is good, effective, cost-effective, in-patient treatment, followed by out-patient treat-ment. It does not require more money; it just requires a little bit of thought.
3.37 p.m.
Lord Ennals: My Lords, I, too, should like to thank the noble Lord, Lord McNair, for introducing the debate. That would be so even if the debate had provided only an opportunity for the noble Lord, Lord Mancroft, to make the excellent speech that he has just given. I found myself in profound agreement with much of what he said, especially with the view that treatment works. There is now a great body of experience which is perhaps at risk for financial reasons, but I shall come to that. I agree that drug and alcohol addiction is not a psychiatric problem. To confuse mental illness with alcoholism and drug addiction is not to understand the nature of mental illness or the other problems of addiction that this debate is all about.
The debate is well timed, coming just two weeks after local authorities have taken over their new responsibilities for community care. That care includes the two forms of abuse we are considering. Unlike the noble Lord, Lord McNair, who opened the debate, I want to concentrate on residential care, including treatment, and some of the related legal problems—not because I do not think that many of the other problems are important, but because the noble Lord has cast the debate so wide that it enables us to concentrate on other issues which seem more important to some of us.
The debate on community care, both nationally and locally, has concentrated on the largest groups for which local authorities have responsibility. I am thinking of the elderly, in particular the very elderly who need so much more care, including nursing care and appropriate housing care. The groups include also the disabled, those with some form of mental illness,
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and those with learning difficulties. I suppose that those categories will receive more attention from local authorities having responsibilities which they did not have previously rather than the care and treatment of those with drug and alcohol abuse problems.
It is my view—I have expressed it before in the presence of the Minister—that the local authorities have been funded inadequately by the Department of Health to the tune of £200 million or £250 million a year. What the figure is, and how right we are, as opposed to the Government's view, will be discovered in time. It may be discovered due to inadequate community care. I hope that that will not be the case. But we must watch the matter carefully. A big responsibility is rightly being put on the local authorities.
Today we are considering, or arguing, the case for one of the categories for which local authorities are responsible —those suffering from drug or alcohol abuse. It is interesting to consider the numbers. I was glad to hear the noble Lord, Lord Mancroft, deal with the figures. He asked a question. It is one that I wish to put in a positive way. What is the Government's assessment of the numbers with which we are dealing? The noble Lord, Lord Mancroft, mentioned 100,000. Is that a fair estimate? It is important that we should have the answer when we look at the inadequate number of residential treatment centres which are run mainly by voluntary organisations. As he said, the figure given may be far lower. But it is obviously increasing greatly.
As a junior Minister in the Home Office with responsibility, among others, for this problem—admittedly, it was the 1960s—I was horrified to discover that there were 4,700 registered addicts. I said then that whatever the number of registered addicts it would be a drop in the ocean. My first question is: what sort of numbers are we dealing with? To what extent are they increasing? Perhaps the Minister will say why they are increasing. For local authorities assuming these responsibilities, they are largely new problems.
Many will remember the progress of the National Health Service and Community Care Bill through this place. We passed an amendment about the ring-fencing of community care. Ministers in another place then made a change which did not touch upon the generality of community care but upon the aspect of drug and alcohol abuse. Mr. Kenneth Clarke, the then Secretary of State, tabled an amendment to the Bill which provided for the earmarking of cash for local authorities to be given only to drug and alcohol projects. He said that money would be ring-fenced and local authorities would be able to spend it only on grants to such bodies. That was a clear statement upon which voluntary organisations operated from then on.
On the same day, Virginia Bottomley, then Minister of State for Health, said:
"Specific grants shall be available for those who are drug addicts or alcoholics".
However, in October 1992 charities learned that ring-fencing had been abandoned. None of us should under estimate the importance of the decision the

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Government took not to ring-fence those sums that local authorities needed to provide the services about which we are talking today.
I wish to say a word about the London-based Alcohol Recovery Project which is seeking leave—or was two months ago—for a judicial review of the policy after a High Court judge accepted that Mrs. Bottomley may have acted unfairly when she reversed government policies to guarantee funding for voluntary drug and alcohol projects. I am afraid that I do not know the outcome of the case: I hope that the Minister will tell me. If everyone else here knows, I apologise for my ignorance. Mr. Justice Auld said that he was troubled that the reversal of policy had prejudiced the Alcohol Recovery Project financially because it had relied upon the word of Mrs. Bottomley and her predecessor that money for the projects would he ring-fenced or safeguarded. The judge agreed that the review should be arranged urgently after the Queen's Counsel appearing for the Department of Health said:
"The timetable targeted of April 1, 1993, (for the introduction of the new policy) will be put in jeopardy if there remains a degree of uncertainty".
I take another example. The problem of homeless people is still growing. The new community care arrangements may lead to an increase in the number of homeless people—I shall be interested to know whether the Government expect that to be the case —many of whom have drink and drug-related problems. They may have other social problems that explain their homelessness, but the fact that they are homeless has been established clearly. I was presiding recently at a conference in the Queen Elizabeth Conference Centre at which a Minister was speaking. It was a conference organised by Telethon and Centrepoint, Soho. It was considering the problem of young homeless people, many of whom had drug and alcohol-related problems. We were looking at the unsatisfactory way in which during the first 12 months of the implementation of the Children Act local authorities had been able to meet the needs of those homeless people. It would be helpful to know the Minister's view on that matter.
I understand—this was referred to by the noble Lord, Lord Mancroft—that there is to be a review of alcohol and drug treatment. I understand, as he said, that it is to be carried out by Dr. Brian Mawhinney who is worried that policies have grown in a haphazard fashion with no overall strategy. It is interesting to hear a Minister make that announcement about what his Government have been up to. It may be that it is an important survey to carry out at this time. I hope that there will be close co-operation and consultation with the local authorities and the voluntary organisations which have far more information about these issues than the statutory bodies themselves. It has often been bad and sad that the voluntary organisations have been told what is to affect them and have not been consulted adequately about what government policy should be. It is said that an independent, outside figure is expected to be asked to head the review. It will be charged with assessing the clinical effectiveness of the various drug and alcohol treatments and rehabilitation facilities.
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I hope that the terms of reference will include sustaining the residential treatment centres which both the noble Lord, Lord Mancroft, and I have emphasised are important, not just because of the experience that they have built up, which can be passed on to others, but because of the grave risk they now face. I hope that the noble Baroness, Lady Masham, will say something about her experience in the field. That includes an experience, which I share, of Phoenix House. Not long ago, as many as half of those treatment centres were expecting that they might have to close their doors because the local authorities will be, as they see it, giving a high priority to the care of the elderly and the other groups to which I have referred; the mentally ill and those with learning difficulties. As they have not yet had any experience of funding drug and alcohol abuse centres they might receive low priority and therefore suffer. I hope that the Minister will tell us what action has been taken in recent months to ensure that such dangerous results do not occur.
Sometimes one welcomes reviews but sometimes one is suspicious of them. I am often suspicious of the Government, every time they want to save money, deciding to have a review and calling it by any name other than "How we shall save money". When debating the Unstarred Question later this evening we shall discuss ways of changing the powers which doctors have for treating patients and for including the best treatments. A review has drawn the conclusion that there is a great deal of money to be saved. I hope that the forthcoming review, which is to be carried out by the department, will not have the same purpose. I heard on the "Today" programme that there is to be a new review into mental health. I do not know whether it will again take in the experience of the voluntary agencies—I must declare my interest as president of MIND—but I hope that there will be the fullest consultation because, frankly, the Government's record on consultation is not good.
I hope that in reply the Minister will find time to comment on the Mawhinney inquiry and on the mental health inquiry. Presumably that will not exclude the subjects that we are discussing today. I repeat my thanks to the noble Lord, Lord McNair, for introducing the debate and I look forward with great interest to hearing the information which the Minister will give in reply.
3.52 p.m.
Baroness Masham of Ilton: My Lords, I too wish to thank the noble Lord, Lord McNair, for giving us the opportunity to discuss this important subject. There is on today's Order Paper two debates on drugs; this, the first, is on the abuse of drugs and the second, the Unstarred Question, is on limiting some useful medications. Both debates are associated with The Health of the Nation but in different ways. I felt that I should say a few words in both debates as anxieties need to be aired. It is hoped that the Government will take note.
There is no doubt in my mind that people abuse their bodies not only with drugs and alcohol but with tobacco, which I also include as a drug of abuse and

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addiction. All those contribute to much ill health and I congratulate the Government on their White Paper, The Health of the Nation. Drugs, alcohol and smoking abuse are all contributory factors in the priority targets of the White Paper; those are coronary heart disease and strokes, cancers, mental illness, HIV/AIDS and sexual health, and accidents.
There is also a connection between alcohol, drugs and despair. At the root of abuse is an existential void, due to the absence of values and lack of self-confidence. This is a world problem but as we move into Europe anxieties about the adverse effects of alcohol consumption and the harm to European economic and social integration are expressed in the report of a working group of the World Health Organisation. Will the Minister tell the House today what the ministerial group is doing about the problem? What are its recommendations?
The report states that awareness of alcohol-related problems is greater at national level than at Community level and for most European countries integration will imply the relaxation of alcohol controls, lower taxes and more alcohol available on the market. Many of the control measures now in force will have to be lifted since they discriminate against foreign beverages.
Alcohol is particularly difficult because it is legal. Does the Minister believe that GPs have enough training about the problems and does she believe that some GPs perceive questions about alcohol as being embarrassing and intruding upon patients' privacy? Does the Minister agree that there is a problem of alcoholism among GPs? With so much emphasis on primary health care I wish to ask the Minister whether she discusses these problems with the medical colleges and the BMA.
In the North the spread of drug abuse came later than in the South. However, now the increase in crime is very evident and the public are most anxious especially at the growth in crime among young people. Some time ago a group of parents from Glasgow came to your Lordships' House to make some of us aware of the terrible problems that they were having in trying to keep their children away from drugs. One example they gave was of old-age pensioners who are prescribed free sleeping pills and tranquillisers and who sell them to children who mix the drugs and inject themselves. Such problems cannot be tackled by parents alone. They need the support of the health authorities, the social services, the probation service, the education authorities, the police and the voluntary agencies, which understand the problems. It was very disappointing when the Government rejected the amendment which I moved in the previous education Bill to make "life" skills a mandatory part of the school curriculum. That would have given emphasis to the vital need.
It was also worrying when last year the Government stopped the pump-priming grant for the provision of health education drug co-ordinators. Those posts were an important link between health and education and with so many changes in the health service that seemed the very worst time to be removing
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the security provided by the co-ordinators. No doubt the small-time local pushers who target young people are laughing.
On 3rd April this year The Times featured an article on a drug smuggler who stole a woman's identity. There were two pictures of a Nigerian woman who hijacked the life of Susan Cole, a blond young woman, in order to smuggle cocaine into Britain. Is it not time that everybody possessed an identity card with a photograph in order to stop such things happening? Many people working in security jobs now have such cards, but we are not facing up to the ever-growing dangers of drug smuggling which end up with the devastating results of drug abuse within families.
I turn now to the problems facing residential care houses dealing with drug and alcohol rehabilitation. I have heard from those running a small house in the New Forest which takes 20 adults and six children. Priority is given to Wessex residents but only about 10 per cent. are from Wessex. The largest proportion comes from London, with several people from Liverpool and Glasgow, among other areas. During the run-up to 1st April and care in the community, those running the centre became increasingly alarmed by the changes being made; that is, the changes in funding and in attitudes. They have been told that many London authorities will no longer be funding people wishing to enter a rehabilitation house outside London. That is just one example of the new policy.
There appears also to be an increase in the prescribing of methadone without the previous programme of dose reduction and eventual drug-free status. Does that mean that care in the community, in so far as it affects drug users, is coming to mean giving unlimited methadone but with no encouragement to give up drugs? Could that be seen as a cheaper option than residential care? I have heard that methadone addiction is more difficult to remedy than heroin addiction, as was said by the noble Lord, Lord McNair. Therefore, in the long run it may lead to increased drug abuse, increased crime to fund it, and the whole community paying dearly.
Obtaining sufficient funds has always been an uphill struggle for rehabilitation houses as drug users do not receive a good press. The young people who go to the home which I mentioned and to similar homes —many of whom are seriously deprived and some are parents with their young children—are not simply helped to break the drug-taking habit which has disrupted their lives but are trained in the many skills, both educational and "life", to enable them to return to the community as useful citizens and not as criminals.
It costs only £227 per week to keep a young person off the streets, not committing crimes and not going to prison and also learning how to improve his or her life for the future. Those who go with children are shown how to become better parents. All are shown how to live together in harmony. That home does not know how it will survive in the future. Is it not wise to have a choice of homes, because different people respond to different methods of treatment? It is possible that some of the best homes will have to close.

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Last year with some colleagues from Parliament I visited prisoners held in police cells here in London. Having seen with my own eyes a seriously alcoholic prisoner, I asked the doctor who was processing him through the system what would become of him. The doctor said, "If I could have one thing, it would be some secure detox centres to send people like him for treatment". The prisoner wished to try to reform but without facilities he will stay at risk to himself and others, going in and out of the prison system.
For many years I have been associated with Phoenix House, which has several drug rehabilitation and re-entry houses throughout England. Phoenix House has tackled that most difficult problem for years and has found a much better way of treatment than incarcerating people in prison who will not have faced up to their addiction while in prison but may have helped to spread both drugs and HIV to other prisoners within the system.
The major current concern as predicted by Phoenix House is the fate of those people leaving custody. Last year nearly 75 per cent. of the residents of Phoenix House came through the criminal justice system and it is by no means clear who is responsible for funding such people. An example is a man referred to Phoenix House nine months ago from a prison in Kent. He was sentenced four years ago from Lewisham and stayed in a total of four or five prisons across the country throughout the time of his sentence. The Parole Board agreed to parole him on the basis that he had a clear desire to leave prison and go to Phoenix House. Understandably, Kent is reluctant to pay for the funding, given that the man's only reason for being in Kent was because of a Home Office prison transfer. Lewisham is reluctant to fund him because four years out of the borough is a long time. It is probably worried about the precedent which that may set so early on in the light of the Act. The ridiculous position may arise where the man elects to remain in custody while that problem is being sorted out despite a release date having been identified for this week.
There is still no clear guidance from the Department of Health or indeed the Home Office despite the repeated requests for clarification on that issue. Perhaps the Minister will be able to do something about that. Unless government departments work closely in co-operation over these matters, the uncertainty will continue. That is neither cost effective for the taxpayer nor beneficial for the rehabilitation of the individual. The community care legislation may mean that a significant number of referrals will be made through the criminal justice system.
Last week's Yorkshire Post had the headline:
"Prisoners try to stay in jail because of drug supplies".
The article said that drug use in Britain's first private jail is rife. That is the Wolds remand prison at Everthorpe, North Humberside. It is rather worrying that that institution has not allowed the board of visitors from Wetherby young offenders institution, which is nearby, to visit, after two requests.
Members of the board of visitors are appointed by the Secretary of State and the Home Office. Several members of the Wetherby board of visitors are
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magistrates and the board members are responsible members of society. They are interested only in the well-being of the inmates and the institution. They were interested to visit the Wolds, as they are interested to visit other penal establishments. Perhaps the Minister will ask why the Wetherby board of visitors has not been made welcome. I should like to know also whether the Home Office will inquire into the alleged drug problem. Perhaps the Minister will pass on that request and reply to me by letter.
Unless all interested departments, agencies and individuals pull together to promote education against drug and alcohol abuse, there will not be the united front so desperately needed for good healthy living instead of the depressing deprivations of the drug culture.
4.5 p.m.
Lord Rea: My Lords, I thank the noble Lord, Lord McNair, for raising this vitally important topic. I believe that I should refer to the remarks made by the noble Baroness, Lady Masham. It is my great pleasure to congratulate her today because a little mole tells me that it is her birthday.
The noble Baroness is right to say that GPs have not been adequately trained in the past to deal with the problems of drug and alcohol abuse. That problem is now being addressed. The Royal College of General Practitioners is fully aware of that need, as are academic departments of general practice dealing with the training of undergraduate medical students throughout the country. In my practice we try hard to collaborate with the local drug treatment unit and alcohol advisory unit attached to University College Hospital, Middlesex.
There is a difficulty as regards training GPs throughout the country because to do the job properly it is necessary to collaborate with other counselling services in the local community. All too often they do not exist for GPs to collaborate with. That is particularly so with regard to out patient treatment units for people with drug problems.
As the noble Lord, Lord Mancroft, pointed out, there is little doubt that both alcohol and drug abuse is increasing in this country but there is also little doubt that both are more common in societies under stress. People turn to drugs and excessive use of alcohol to escape from uncomfortable feelings. Young people in Britain feel that they are rejected and unwanted by society. That applies to all unemployed people. Those who become addicted from all walks of life are of a more dependent personality than those who can drink appropriate amounts at appropriate times or use drugs occasionally or "recreationally" —I like that word. However, where there is mass unhappiness, more people turn to those means of relief and become enmeshed in what is a way of life with its own imperatives and values. Instead of developing skills which are of use to the whole of society, their ingenuity is devoted to outwitting that society because they feel that they are outside it—and with good reason.
I shall not describe the health impact of the misuse of these substances in any great detail. Suffice it to say

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that addiction to some drugs is fatal. Heroin has a mortality rate of 10 per cent. during a phase of addiction. However, unless an overdose is taken it is not the drug itself which kills; it is the way in which it is used that makes it so deadly. The problem is that street heroin is of variable strength and purity. The 10 or so recent deaths in the King's Cross district seem to have occurred—and this was described in the Independent newspaper article referred to by the noble Lord, Lord McNair—because a batch of unexpectedly high strength of heroin was sold on the street. Another explanation is that it had been cut or mixed—that is, diluted—with a poisonous substance as yet unidentified.
I saw three drug addicts in my surgery this morning. One of them said, "Some of the stuff they mix with heroin is lethal. I wouldn't be surprised if they didn't put some strychnine in this, or that someone had a wish to get rid of someone that they sold the drug to". I am not at all sure that that is not possible. However, in this particular case I think that it was an unexpectedly strong preparation of heroin that was the cause of the trouble.
Of course, as all noble Lords know, HIV infection and AIDS have now to be added to the dangers of the use of injected drugs.
The direct damage to health caused by excessive alcohol consumption is quite well known, but the indirect damage is more costly to the nation and to the National Health Service. Serious road accidents apart, many hospital admissions are due in part to the poor nutrition and self-neglect that are associated with alcohol abuse. One study found that 25 per cent. of acute admissions were at least in part alcohol related. While saying that, I do not deny—in fact, I fully accept—all the evidence which shows that light to moderate alcohol consumption is actually beneficial to health, particularly in relation to heart disease.
However, as other speakers have outlined, the social consequences far outweigh the damage to physical health. In the case of drug abuse the result is petty crime. The noble Lord, Lord Mancroft, repeated the figure that he gave us a year or so back of £1.8 billion worth of goods that are stolen by drug users to finance their habit. That is in the metropolitan area alone, and drugs are used all over the country. On the other hand, more often than not alcohol plays a part in violent crime and serious road accidents. However, more serious even than that is the damage it inflicts on family life, with harm possibly showing itself in the next generation.
What are we doing about all that? Action to prevent the problem needs to be considered first. I am following something along the lines of the noble Lord, Lord Mancroft. Primary prevention—to remove the underlying cause—is the basic need. Here the Government seem quite helpless. There are many steps that could be taken to give the youth of this country a greater sense that they are valued. If jobs cannot be created overnight, training courses could be extended and improved. Much more could be done to ensure that the courses lead to real jobs afterwards. I do not accept that because there is a recession the
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Government can sit by making only token and ineffectual gestures which sometimes serve only to increase the cynicism of youth—and of all unemployed people in Britain. All other methods to prevent drug and alcohol abuse are doomed to work against the current as long as a large proportion of the population has so little hope.
As the noble Lord, Lord Mancroft, pointed out, a great deal of time, money and ingenuity is devoted to trying to stop drug imports getting through, with much congratulation when a big haul is unearthed. But the ingenuity of the traffickers is very effective, and the sheer volume is such that far more always gets through than is discovered.
Much thought is also given to reducing demand, first by health education. However, most workers in the drugs field feel that the money spent on big advertising campaigns has been wasted and could have been better employed in the provision of more and better treatment and rehabilitation centres. (If I say on each occasion that the noble Lord, Lord Mancroft, has said what I am saying my speech will be rather longer than I mean it to be. But I thoroughly concur with many—although not all—of the views that he holds.) However, that is not to say that carefully targeted health education in schools, for instance, cannot be effective; but there has been remarkably little evaluation of the effect of any health education activities. I know that it is an extremely difficult area to tackle, but I wonder whether the noble Baroness, in her reply, can point to any research which has demonstrated that health education in the drugs and alcohol field actually works to reduce demand in any location where it is given.
That brings me to the second part of the Motion moved by the noble Lord, Lord McNair: what do we do about those in our midst who are afflicted? After all, they are the ones who are giving us a headache. Drug and alcohol treatment centres nearly all work on the principle of helping users to give up their habit smoothly, but nearly all have a very high relapse rate. There is often too high an expectation of success by the staff and a false optimism on the part of the users who may agree to treatment for a variety of reasons before they are really motivated to give up and to become abstinent.
Cynics may say that addicts often come off drugs or alcohol finally without help—they just grit their teeth and give themselves the cold turkey treatment, with the suffering that that entails. But I do not take such a Spartan view. There are drug users and alcoholics who, with much patience, can be helped. While they are being counselled (and in the case of drug users being given substitute drugs to relieve them of the necessity to raise £100 daily to finance their habit) the harm that they do to the rest of the community is much reduced.
The clinic run by Dr. John Marks in Liverpool (which has already been referred to) recognises that most addicts cannot give up until the right moment for them, which may be several years ahead. They receive maintenance treatment meanwhile, sometimes methadone; but in that clinic not only methadone. I agree with some of the worries expressed by the noble Lord,

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Lord McNair, about methadone. But I do not think it is quite as bad as he made out. In fact, while people are receiving it as maintenance treatment, many car radios and television sets are saved from being stolen.
As a result of the policy of Dr. John Marks's clinic, he has a much higher final success rate than most units, with the added advantage that the crime rate in Liverpool around his clinic has actually come down against the national trend of increasing crime, despite the area being one of the most deprived in the country. I do not think that the noble Lord, Lord McNair, is right to say that he has a callous approach. Far from it: I think that Dr. Marks actually has a much more realistic and effective approach. Indeed, if one talks to him one realises that he is not in the least callous; in fact, he is an extremely caring man.
Finally, I should like to talk about residential centres as they are referred to in the title of the Motion and other speakers have mentioned them. There is a proportion of alcoholics and drug abusers whose lifestyle is so chaotic that they cannot cope with out-patient treatment. They need to get away from their family or environmental setting to be able to start their rehabilitation. Some are sent to the centres by court order. If they can tolerate the regime they often make great progress only to relapse on or shortly after returning home—to the same circumstances from which they came. Several admissions may often be needed. That is why it is the most costly form of rehabilitation. Because of the relapse rate, there is some doubt as to whether residential centres are cost-effective. However, against that it should be remembered that those who go to the centres are often the most intractable cases who cause the most damage in the community, either by stealing goods from other people or by harm to their own families.
Several noble Lords have mentioned the financial difficulties which these centres are already experiencing and which they will certainly experience more and more this year. I wish to ask the noble Baroness, perhaps as a parting shot, if she will state whether, as has been suggested in some quarters, the Government feel that these units, which are nearly all run by the voluntary sector, are not cost-effective. Does she still think that they have a definite role in helping to curb the suffering of their clients and the communities in which they live? If so, I hope she will be able to reassure us that a satisfactory method of funding these residential units will be found and applied soon, before they start closing, as they surely will if this funding does not materialise.
4.20 p.m.
The Viscount of Falkland: My Lords, I thank my noble friend Lord McNair for tabling this debate today and for providing such a wide Motion. I cannot say that I looked forward to the debate. It is my intention to concentrate on the alcohol part of the Motion, and I have learnt over the eight or nine years that I have spent in your Lordships' House that one has to walk rather a tightrope when speaking about alcohol problems in order not to clear the Chamber. I shall try to avoid talking about the evils of drink. I have always tried to avoid doing so.
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One must nevertheless face the fact that there has always been a sizeable drink problem in this country. In most of the developed countries of the world there is a sizeable alcohol problem of one type or another. As regards the developing countries, it seems that the quicker they develop the more their alcohol problems increase. No one can say precisely why that is so. Alcohol is a socially acceptable mood-changing substance. On the good side it gives people a lot of comfort and happiness. It is used to celebrate events and to toast people. It is consumed on people's birthdays. At this stage I join in the good wishes paid to the noble Baroness, Lady Masham of Ilton, on her birthday which falls today. I thank her for the tireless work she does in this area.
A sum in excess of £50 million is spent on drink per day in this country. However, that is not really the problem. In France people spend double that amount per day on drink. Our actual consumption of raw alcohol is relatively modest. It is the pattern of abuse of alcohol in this country which is worrying. A number of important changes have occurred in recent times. The most helpful change—a cultural change —is in the attitude towards drink and driving. When I was a young man it was considered part of one's training to drink too much and to drive. One was considered rather a Jack-the-lad if one did so successfully. Nowadays I look back with horror at the experiences I had as a young man. I am glad that most people now accept that it is extremely dangerous to drink and drive. Young people in particular have been made aware of the rapid effect that drink can have on their handling of cars and other machinery. As a motor cyclist I know that it is almost impossible to ride a motor cycle with a feeling of security even after one drink. I am happy to say that few motor cyclists drink and ride.
A phrase that sticks with me was that uttered by the noble Lord, Lord Mancroft, when he said that treatment works. That is the truest statement I have heard today and in my opinion the most important aspect of our debate. Treatment works for those who abuse drugs and for those who abuse alcohol. Those who abuse both kinds of mood-changing substances are treated in approximately the same way. Enormous steps have been taken in the development of treatment which works quickly and which has a permanent effect. However, problems arise with the diagnosis of people in the first place and the ability to get them into treatment. When I first became involved in the matter it struck me that there was probably more argument, discussion and jealousy in the caring professions than in any other area apart from academia. I was amazed to discover the number of people involved in the field of alcohol abuse or the treatment of it who were not speaking to one another.
In preparation for the debate I rang the director of policy of a local authority. The authority has an important treatment centre within its boundaries and is making great efforts to make the new community care legislation work amid all the difficulties that that entails. The director said that one of his main problems was to obtain a common attitude within his local authority as regards the treatment of alcoholics

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and drug addicts. He said that there was a difference of philosophy among various people acting within that area. The matter has been highlighted by other noble Lords who have mentioned GPs who often face the difficult task—one must acknowledge that it is difficult—of dealing with a patient who appears to be anxious and depressed and who shows no outward signs of being a misuser either of drugs or of alcohol. The GP then prescribes certain drugs to deal with the perceived anxiety and depression.
Recently a study was conducted in Ireland in a home for women alcoholics. The study showed that 94 women had been at first diagnosed as clinically depressed and had been treated. It was subsequently discovered, when they were treated, that only one of the 94 was clinically depressed. I am not saying that would happen here but I have consulted specialists this morning and they tell me that that is the problem they face.
One of the problems in this area is the conventional wisdom that detoxification and medical intervention are acceptable but counselling is not. There is a distinct resistance on the part of some people in the medical profession and some psychiatrists to counselling. It appears they object to any moral content in the counselling. That also applies to what one might call the primary care agencies. Social workers are often loath to deal with what they perceive and know to be an alcohol problem in this way. They use various terms to describe what they face; for example, role legitimacy and role adequacy. Some noble Lords may understand those terms better than I. As I understand it, they mean that if one is a social worker and one drinks, one feels it is improper to bring judgment to bear on someone who is clearly abusing drink and one avoids doing so.
Women drinkers give rise to particular concern. There has been a marked rise in drinking among women, mostly among women who have been the victims of a family break-up. They may have been abandoned or divorced and seem to turn to drink as a means of enhancing the feeling of their own identity which they have lost. They have lost their sense of identity as wives or mothers. Increasing numbers of young women in the age group 25 to 40, many of them successful, are independent and competing in a man's world. Often they drink as part of that lifestyle without realising the difficulties which they face because of their physical inability as women to tolerate the same amount of alcohol as men.
Another important problem which needs to be addressed seriously is the increase in criminal behaviour among juveniles. It is not possible to say exactly how many under age children are drinking but it is a large number. A recent study of children of secondary school age showed that at least 90,000 children in that age group are drinking more than the amounts prescribed in respect of the public at large, namely 14 units for a female and 21 units for a male. That is a serious figure. It does not take into account those who have not yet reached that dangerous level of intake. It is often reported that some children arrive in classrooms suffering from the effects of drink or even
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drunk. The link between criminal behaviour and drink is clear. It is a problem which all those involved with law enforcement and social work have to deal with every day.
It is unnecessary to complain again about the community care legislation, disappointed though we were that the ring-fencing of funds for care related to drug and alcohol problems was moved into the general area of local authority control. There has been an indication that there will be helpful and serious monitoring. I am fearful that while that monitoring is taking place many residential homes will close. I am afraid that it will be too late to save a number of them.
The fact that many people suffering from these problems are often hostile to the moral content of counselling within the residential environment is a further disadvantage. We shall have to address that problem later because I am sure that it will be raised as a result of the monitoring process.
It is not helpful to continue the endless debate about the distinction between heavy social drinkers and alcoholics. Such a distinction is meaningless. We all know people who abuse drink. We all know people who are clearly alcoholics. There are many people with problems, many of them helpless and vulnerable. The Government are making the right noises. I hope that in her summing up the noble Baroness will be able to give us some encouragement to believe that this enormously difficult problem will be approached and dealt with more successfully than in the past.
4.34 p.m.
Lord Desai: My Lords, I join other noble Lords in thanking the noble Lord, Lord McNair, for giving us this opportunity for a wide-ranging debate on the subject before the House. I also join other noble Lords in congratulating the noble Baroness, Lady Masham, on her birthday.
Because the Motion has been formulated so broadly, and following so many good speeches, I shall take the opportunity to devote the first half of my speech to the broad social and legal implications of drug and alcohol abuse and then move on to the more particular and urgent problem of residential care. It may be helpful to start with the example which the noble Viscount, Lord Falkland, gave concerning the way in which legal changes can make actions which were not previously criminal illegal or decriminalise acts which were previously thought to be criminal. A good example is drinking and driving. Something which was socially acceptable, if not boasted about, was made criminal by a careful law which no subsequent government have repealed. Tight enforcement of that law has now produced a fundamental change in social attitudes towards drinking and driving. Therefore, activities which were not previously criminal can be criminalised if we consider them to be harmful. Similarly, activities which were previously thought to be criminal can be decrimi-nalised, as in the case of homosexual behaviour among consenting adults. Therefore, we have to distinguish between what is physically and socially

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harmful, whether or not it is illegal, and activities which can be made legal or illegal in line with current convention and practice.
I do not propose that we ought to change the law in any of these matters, but I should like the Government at some stage to take a broader look at activities relating to the possession and use of drugs which are currently criminal offences and consider whether there are aspects which could be decrimi-nalised and which it would not be desirable to decriminalise. I believe that that is a question which ought to be brought out into the open.
I have no views on the matter and we have no policy on the subject, but the question of drug abuse and crime is important. If, for example, we decided that smoking would be banned because it was individually and socially harmful or we decided that the drinking of alcohol would be banned except under prescription for health reasons, we would have a very different society. I do not advocate such changes, but in the United States, for example, the debate about passive smoking has altered certain forms of behaviour.
Therefore, when we discuss the social and legal implications of drug and alcohol abuse we should remember that the context can change rapidly and can be made to change rapidly. What we call a crime today we may not call a crime tomorrow, and we may make certain activities criminal. Therefore, perhaps at some stage we should have a more wide-ranging debate on or an inquiry into the social and legal implications of drug and alcohol abuse. We have not had such a debate recently.
That leads me to the interesting question of the extent of alcohol and drug abuse which the noble Lord, Lord Mancroft, raised in his interesting speech. He said that figures relating to the number of drug addicts admitted by the Home Office (100,000) and the value of drugs seized by Customs (roughly £0.5 billion) do not accurately reflect the extent of the problem. The inquiry announced by a Minister in another place will not cover that aspect, but we ought to take up the question.
As a statistician I imagine that those figures are both serious underestimates. The figures for the number of admitted drug addicts, the amount of drugs seized and the amount stolen by drug addicts are all serious underestimates, in differing proportions. For our own information we should take up the question of how many drug addicts there are in society and what that is costing society.
I believe that the economics of the matter should be looked at in a much broader way, as the noble Lord, Lord Mancroft, said. It is not just narrowly the amount of money which we spend on drug and alcohol abuse as part of a certain budget, but also the ramifications in the Home Office budget; the unreported thefts; the unreported costs of drug and alcohol abuse visited upon citizens who are mugged or have something stolen from them. Those are additional costs and we ought to ask ourselves whether there are better ways of treatment and of implementing or changing the law which will minimise
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the current heavy costs on people. We may not call it drug abuse but crime or theft, yet it may all be interlinked.
The true cost-effectiveness of treatment of one form or another—it may be prevention or effective counselling rather than treatment—ought not to be looked at in the narrow economic sense of costs per bed but of costs saved by preventing the return of one person to drug addiction. Again, the noble Lord, Lord Mancroft, pointed that out.
In that regard we could justify a much more carefully worked out and better resourced programme to do something about drug and alcohol abuse than we have had so far. I agree that it may be difficult to alter the supply of drugs, except for synthetic drugs like methadone, which was mentioned by the noble Lord, Lord McNair. I assume that most other drugs are imported because they are not home-produced. If that is the case, it would be difficult to affect the supply of those drugs. One should try to do one's best about the demand for them, but that is not easy in the short run. It is difficult to alter people's habits in the short run.
We may try to concentrate on preventing people from entering the phase of becoming drug or alcohol abusers, but it is difficult to diminish the demand from people already addicted because the drugs are habit-forming. However, it may be possible by treatment to prevent people returning to being drug abusers. That is the way the Government ought to move, looking at the effectiveness of the money spent on drug and alcohol abuse.
The second part of the Motion calls attention,
"to the case for increased facilities for residential care".
I particularly thank the noble Lord, Lord McNair, for including that because, as many noble Lords have pointed out, the situation is now that residential care facilities are under great threat. I honestly believe that this was not intended by the Government. There was no knowingly evil intention on their part. However, the fact that the ring-fencing on drug and alcohol abuse has been dropped has raised serious anxiety in the minds of the people who are active in the field.
I am involved in one drug intervention agency, City Roads, so I must declare an interest. People who work in the area are dedicated. They work under the most difficult circumstances, in jobs which are not badly paid but are certainly not well paid. The social value of what they do far exceeds the income they receive and they work very hard. There is serious anxiety among them, as was shown by a survey conducted by Alcohol Concern and SCODA. Many agencies feel that they are likely to have to shut down because of the change in the rules for funding. That may be alarmist but I should like to know the Government's assessment of the situation.
Given that there is this feeling, are the Government doing anything urgently to avoid the situation where the few residential care facilities that we have are shut down? They are inadequate, as the noble Lord, Lord Mancroft, pointed out, in relation to those in the United States. Once the facilities are shut down they

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will be difficult to re-open because people's acquired skills in the field will be lost. They will find jobs elsewhere and soon the skills will not be available.
From that point of view, yes, I should like increased facilities for residential care. But right now what are the Government doing to prevent the erosion of facilities for residential care, which is likely given the change in the rules? I have been out of the country for two weeks and a revolution may have happened in the meantime in those matters, but I should like to know what is going on. I should also like to know whether there is any prospect of an increase in resources in the field. Such funding as is available is not good enough. The rise in the figures for crime and drug abuse, which are not unconnected with the problem, make me feel that perhaps more resources devoted to residential care may be a better crime-fighting tactic than firmer policing, which is not to be sneezed at. I should like to know from the noble Baroness the Government's latest position on the matter.
Given that local authorities have not had adequate time to prepare their programmes, with the change in the rules which came rather late, and given that often drug and alcohol abusers do not have priority in the local authority's mind —there certainly is not a strong lobby on their side—to obtain resources from the local authority budget, will the Government consider issuing directives rather than just guidelines? Those would tell the local authority how to assess and meet needs as they arise. Currently the problem is very serious. I concede that there is no intention on the part of the Government to affect the sector adversely, but we may be doing so unintentionally. I should like us to avoid the unintended consequences of a late change in policy. I wish that the Minister would give me some hope when she replies. I thank all noble Lords for the excellent debate and look forward to the reply from the Minister.
4.47 p.m.
Baroness Cumberlege: My Lords, I too should like to thank the noble Lord, Lord McNair, for initiating this debate and enabling people with enormous knowledge and expertise on the subject to express their views in your Lordships' House and for me to have the opportunity to restate the Government's commitment in this important area.
There is a great deal of common ground between noble Lords, particularly those who have spoken today, and the Government. I should like to start by stressing the very high priority which the Government have in tackling the problems associated with the misuse of alcohol and drugs. We recognise the terrible loss and waste of young lives which can occur when young people succumb to these temptations, particularly drug abuse, and the misery and anguish it causes not only to misusers but to their families and friends, diminishing society as a whole. Prevention is always better than cure, but when prevention fails then residential treatment and rehabilitation play an important part; but it is only a part, and over the years the Government have evolved a comprehensive strategy to tackle alcohol and drug misuse.
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The drugs strategy involves co-ordinated action on five main fronts: first, to improve international co-operation in order to reduce supplies from abroad; secondly, to increase the effectiveness of police and Customs enforcement; thirdly, to maintain effective deterrents and tight domestic controls; fourthly, to develop prevention publicity and education; and last, but not least, to improve treatment and rehabilitation.
My noble friend Lord Mancroft mentioned the range of sanctions employed to control drugs. He urged us to accept the supply but reduce the demand. I fear that that is a counsel of despair and I think that it is right that we should also try to reduce the supply so far as possible.
Indeed, we have introduced tough penalties to deter drug traffickers and dealers, including a maximum penalty of life imprisonment for supplying or having possession with intent to supply Class A substances such as heroin, and 14 years for a substance such as cannabis. Drug trafficking is an international problem and has been described as the biggest commercial and criminal business in the world. Enforcement is a key component and the latest statistics show that the number of people dealt with for drugs offences rose to 54,000 in 1991: an increase of 3,600 over the previous year. That gives some encouragement to those determined to contain and eventually to conquer this serious crime.
Alcohol is a different matter and noble Lords will know that its consumption in sensible quantities and in appropriate circumstances provides many people with enjoyment. I share that view, expressed also by the noble Viscount, Lord Falkland; indeed I am prompted at this moment to drink a toast to the noble Baroness, Lady Masham, on her birthday —alas, on the Front Bench I have only water.
Although drinking can be pleasurable, in excess it can cause not only harm to health—progressively increasing the risk of raised blood pressure and strokes, and other conditions such as cancers and liver cirrhosis—but alcohol consumption on inappropriate occasions can lead to accidents, particularly on the roads, and to reduced concentration and efficiency at work. Heavy drinking is also often associated with violent and sexual crimes, family break-up and disorderly behaviour.
The White Paper The Health of the Nation reflects the importance the Government attach to tackling health problems associated with both alcohol and drug misuse, and includes targets for both. The White Paper also emphasises that government, at both national and local level, has a role to play in ensuring that there continues to be a comprehensive range of services to meet the needs of alcohol and drug misusers.
It is against that background that the future of residential treatment and rehabilitation needs to be seen. There are at present around 2,000 places in residential centres, very nearly all of them provided by the independent sector. I can assure the noble Lords, Lord Rea, and Lord Desai, that the Government recognise and value the contribution which they and

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non-residential centres make, and are committed to developing further services for people with alcohol and drug problems.
In 1991 we introduced a specific grant which enables local authorities to make payments to voluntary organisations. In the three years since its introduction the grant has supported a wide range of services. For example, The Richmond Fellowship has now received three years' support for the development of services for women substance misusers and their pre-school children. Turning Point, whose Griffin project was opened in September 1992 by the Princess of Wales, received a grant of £160,000 to provide a service for drug misusers who are HIV positive.
The noble Lord, Lord McNair, specifically mentioned the work of TACADE. As he indicated, it is a very effective and valuable organisation, one of many which are supported by the Government. With regard to the importance of drugs education in schools, the noble Lord may be interested to know that the Advisory Council on the Misuse of Drugs will shortly publish a report on drugs education in schools to which the Government will give careful consideration.
I turn now to the specific grant. In the two years of the grant, £3.5 million was provided by the Department of Health and other local sources provided a further £1.5 million; 176 awards were made, and over £2 million was spent on residential care. The rest was allocated to non-residential services, either to increase the effectiveness of the residential services or for training.
In the current year the grant has been increased by 9 per cent., with £2.3 million to be provided by the Department of Health. Residential services will continue to receive £1.6 million, but the scope of the grant has been widened to ensure that adequate and suitable community-based services will also be available for those drug misusers who do not need residential care.
The community care arrangements, introduced this month, ensure that local authorities will have the lead responsibility for the assessment of people who may be in need of care and, where appropriate, to make arrangements and pay for the social care costs. The network of residential services will therefore need to be responsive to local needs. A total of £565 million has been transferred to local authorities, ring-fenced for the implementation of community care.
I know that the noble Lord, Lord Ennals, has frequently sparred on the subject of ring-fencing. His view is that there should be a specific sum of money. But the Government decided not to ring-fence funds solely for drugs and alcohol abuse, but to ring-fence a total amount for community care. That view and decision were supported by the judicial review which took place. The application of that judicial review was dismissed. The court upheld the action of the Secretary of State to ring-fence the entire sum of money. The £565 million includes resources for the purchase of services for alcohol and drug misusers. As the noble Lord, Lord Ennals, suggests, the Government recognise that alcohol and drug misusers have not traditionally looked to statutory bodies for
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help; many will have no settled address and may lead transient lifestyles. I hope that I can reassure him and the noble Baroness, Lady Masham of Ilton, when I say that we have now issued special guidance to local authorities which encourages them to make sure that eligibility criteria and assessment procedures are sensitive to the particular needs of alcohol and drug misusers, including those recently released from prison.
At our request, the Local Government Drugs Forum has been working with the local authority associations to draw up advice on "fast track" assessments, which will ensure that people in urgent need of care, whether living in their home area, away from home, or without settled accommodation, and for whom a delay may result in increased harm to them or their families, receive a rapid response to their needs. The advice to local authorities was issued by the Local Government Drugs Forum at the end of March.
I can reassure the noble Lord, Lord Desai, and other noble Lords, that the Government have also listened to the concerns expressed by those in the independent sector who provide services. Due to the relatively short length of stay in alcohol and drug rehabilitation and residential homes, any changes in referral patterns or delays as the new community care arrangements settle down could have a disproportionate effect on those services. We have therefore decided to establish special monitoring arrangements through Goldsmith's College to identify local authority referral patterns, and occupancy levels in residential homes.
The noble Lords, Lord McNair and Lord Ennals, my noble friend Lord Mancroft, and the noble Baroness, Lady Masham of Ilton, raised reservations about the use of methadone. I understand those reservations. Abstinence must remain our ultimate goal in drug treatment. But prescribing substitute drugs such as methadone can be a useful tool in helping to change the behaviour of some drug misusers. The aim is to reduce the injecting substances which, as the noble Lord, Lord Rea, suggested, puts users at risk of acquiring HIV and spreading it among drug users, and from them to the wider population. Provision of methadone should be part of a planned programme of treatment.
The noble Lord asked how much methadone is prescribed. Approximately 300 million milligrammes of oral methadone was prescribed by regional health and family health service authorities in 1991–92. Around 1 million ampoules of methadone was also prescribed. He also asked for the cost of the prescription. The cost of methadone prescribed in 1991–92 was £4.4 million. That sum will be increased by the usual prescribing costs, which include the time of the doctor and the relevant fees. Figures for 1992–93 are not yet available.
Concerning the leakage of methadone into the black market, figures of police drug seizures show that very little methadone is seized. The view of the Home Office drugs inspectorate is that leakage is small. Methadone mixture is not generally considered by drug misusers to be a particularly attractive street drug.

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The noble Lord, Lord McNair, asked what advice is given to doctors on prescribing tranquillisers. Advice to doctors encourages them to limit the prescribing of tranquillisers to short periods to arrest acute symptoms. Guidelines on clinical management of drug misuse have been issued to all doctors, covering treatment and management of misuse of all drugs.
I am pleased that the intention of my honourable friend the Minister to carry out a comprehensive review has been welcomed in your Lordships' House. I am sure that he will consider the views expressed, including those of the noble Lord, Lord Desai. The details of the review have not yet been finalised but I shall ensure that your Lordships are kept informed as the proposals develop.
With regard to the first ever national survey of mental illness in Britain, announced today, field work on the survey will start a week today to try to discover the true extent of psychiatric illness among the adult population. Among other things, it will try to measure the smoking, drinking and drug-taking habits of people with mental illness.
The noble Lords, Lord Ennals and Lord Desai, asked how many drug addicts there were. It is difficult to assess the scale of a problem which is essentially an illegal activity. The Home Office addicts index, to which the noble Lord, Lord Ennals, referred, currently shows about 20,000 addicts registered. That index relies on the notification by doctors of people who attend their clinics and who they consider are dependent on a range of controlled drugs. Clearly, therefore, it is an underestimate of the true numbers of addicts, many of whom will not have seen a doctor and may not be in touch with any services.
As I said, drug misuse is an illegal and clandestine activity. We need more information. The results of a large-scale Home Office survey will be published later this year and will give us a better feel for the scale of misuse.
The noble Baroness, Lady Masham, advocated a range of treatment options to meet the needs of alcohol and drug misusers. There is a wide range of treatment options available. Under the community care arrangements, local authorities are responsible for assessing individual needs and drawing up packages of care to meet the needs of each individual person. Local authorities will be free to purchase that care from whichever service provider is most suitable. The noble Baroness also suggested that identity cards would be of use. That issue has been considered several times in recent years. However, it has been recognised that it would be enormously expensive to set up and maintain a viable system. The noble Baroness asked a series of questions, many of them very detailed and important. I shall write to her in reply.
The noble Viscount, Lord Falkland, questioned the value of publicity campaigns. National publicity campaigns can be effective in drawing public awareness to the problems of drug misuse. However, since 1991–92 the Department of Health has shifted
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the emphasis away from major national campaigns to encourage regional campaigns, which can better target local problems.
I shall quickly mention in this context the Home Office drug abuse prevention initiative. It is now established in 20 areas in England, Scotland and Wales, where there is considered to be a substantial risk from the threat of drug misuse. In each location there is a team helping to reinforce, harness and stimulate community action against drugs. An important element of the initiative is that the effectiveness of the prevention programmes being put in place is closely monitored and they are assessed to see what lessons can be learned.
In conclusion, the Government attach a high priority to the provision of suitable services within community care for alcohol and drug misusers. Local authority representatives made clear that they share the view of the Government and your Lordships' House that those services should receive a high priority. There is therefore every reason to expect local authorities to meet their responsibilities for that important client group. We remain confident that local authority commitment and the special measures that we have put in place will ensure that the valuable network of both residential and non-residential services will continue to develop.
5.4 p.m.
Lord McNair: My Lords, we have had an interesting and very wide-ranging debate. I know that your Lordships are anxious for the business to proceed and I shall not keep the House for very long. I am grateful to all those who have spoken.
I agree with the noble Lord, Lord Mancroft, that treatment works. Moreover, it is relatively easy to measure the effectiveness of treatment programmes. The successful participant, marked out by previous court and hospital appearances, does not reoffend or fall sick.
I feel that the noble Lord was less than fair to education for prevention. Life education centres are carrying out both independent and in-house outcome surveys. The problem is that such surveys take a long time. It is argued that someone who has reached the age of 21 and not yet taken drugs probably will not take them; but proof of the effectiveness of prevention programmes will take 10 to 15 years to appear. The evaluation of TACADE's primary schools programme, to which I referred, will be interesting. As I tried to point out, if it affects positively a cluster of related behaviours and shows that the children who benefit from such a programme are in their lives winning socially and academically and developing high self-esteem, it can be inferred that such children are less likely to become involved in substance abuse, in which the most significant personality trait is low self-esteem.
I was interested to hear of the review of treatment services planned by the Minister of State, Dr. Brian Mawhinney. I hope that the reservations expressed by the noble Lord, Lord Ennals, are not justified, although I share his suspicions. It was also interesting to hear several speakers emphasise that alcohol and

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drug addiction in themselves are not mental illnesses and do not benefit from the intervention of psychiatrists.
I thank all noble Lords who have taken part in the debate and beg leave to withdraw the Motion.
Motion for Papers, by leave, withdrawn.

Bosnia
5.7 p.m.
The Minister of State, Foreign and Commonwealth Office (Baroness Chalker of Wallasey): My Lords, with the leave of the House I should like to repeat a Statement which is being made in another place by my right honourable friend the Secretary of State for Defence. The Statement is as follows:
"The House will share the Government's feelings of outrage at the artillery attack on Srebrenica on Monday, in which according to reports at least 56 people were killed and 70 wounded. This was a new milestone of inhumanity in a conflict which had already spawned many atrocities. On this occasion, as on many others, the Bosnian Serbs appear to have been responsible. We should remember that the Serbs in Bosnia are not uniquely guilty, though they bear the main responsibility for current events in Bosnia. The other parties too have committed crimes. Indeed, the British soldier who was killed in January while escorting a convoy of sick and wounded did not fall to a Serbian bullet.
"It is not for want of effort by the international community that these horrors continue. The Government have been at the forefront of these efforts. The London conference last August, co-chaired by my right honourable friend the Prime Minister, renewed the search for a negotiated settlement of the conflicts in former Yugoslavia—not only in Bosnia. Since then the Government have given their fullest support to the efforts of Lord Owen and Mr. Vance to achieve such a settlement. Success seemed in sight three weeks ago when the Bosnian Moslems joined the Bosnian Croats in signing all the elements of the Owen-Vance peace plan. It is a matter of the deepest regret that the Bosnian Serbs have not yet been prepared to sign. I hope that even at this late stage, and despite all that has happened, they will be prepared to reconsider.
"Meanwhile, our armed forces have been playing a leading and distinguished part both in bringing relief to the suffering in Bosnia and in enforcing the arms embargo against the whole of former Yugoslavia and the wider sanctions against the Federal Republic of Yugoslavia. Since November the Cheshire battalion group has escorted over 33,000 tonnes of food and other humanitarian aid to destinations in Bosnia. RAF Hercules aircraft have flown 427 sorties to Sarajevo and delivered nearly 6,000 tonnes of aid. Ships of the Royal Navy, assisted by airborne early warning and maritime patrol aircraft of the RAF, have patrolled the Adriatic and its surrounding airspace, alongside allies in NATO and the Western
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European Union, to enforce the embargo and the sanctions. Earlier this week pressure on the warring factions was increased when NATO aircraft began patrolling Bosnian airspace to enforce the no-fly zone in accordance with Security Council Resolution 816. RAF Tornado F3s and tankers are on standby to fly to bases in Italy to join in this operation when called forward by SACEUR to do so.
"The Government fully share the widespread frustration that diplomacy and military pressure have not yet succeeded and that the suffering still continues. Other weapons are available. The sanctions noose is being drawn tighter against Serbia, whose future is grim; she faces isolation and economic ruin.
"At the same time the House will recognise that there are no easy solutions to a conflict in which all three ethnic groups have willingly engaged and which has many of the characteristics of a civil war. If there had been the international community would have applied them long ago. Some argue that, if the outside world is not prepared to intervene militarily, it should at least refrain from enforcing an arms embargo which is bound to favour the Serbs since they have access to the arsenals of the Yugoslav National Army. That is an understandable argument, but we should be clear where it leads.
"Removal of the United Nations arms embargo would certainly result in the Bosnian Moslems being free to acquire all the weapons that they needed. Presumably the Bosnian Serbs for their part would also seek more arms from other countries. The result would be to prolong the conflict and to make it ever bloodier and more vicious than it is today, bringing continuing suffering to innocent civilians. In those circumstances it is difficult to see how UNPROFOR's humanitarian mission could continue. The chances of negotiating aid through the front lines, as at present, would be sharply diminished. Meanwhile the international consensus would almost certainly have been lost.
"The United Nations' efforts in former Yugoslavia so far have been made possible by Russian willingness to support the necessary resolutions and to put pressure on the Serbs. That co-operation has been invaluable, but given the internal situation in Russia it cannot be taken for granted. It would be unlikely to survive an escalation of the conflict through the removal of the arms embargo.
"There have also been calls for the use of air strikes to enforce a peace settlement. There could be circumstances in which the selective use of air power would be relevant. NATO, at the request of the United Nations, is enforcing the no-fly zone at the present time. But the clear military advice received by the Government is that air strikes unsupported by substantial numbers of troops on the ground would be unlikely to be effective given the nature of the conflict, the weapons deployed and the terrain. The chances of civilian casualties

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would be high. Meanwhile the risks to British and other United Nations troops, and to the success of the humanitarian relief operation, would remain. While one should not rule out that expedient absolutely, it is one which would change in a fundamental way the role of the United Nations and bring it into the heart of the conflict as a combatant.
"The right course to pursue is the current policy, thankless and frustrating as it is. Diplomacy must continue. Pressure on those responsible for prolonging the conflict must be increased. The plight of the suffering must be alleviated. The international consensus necessary to do all those things must be maintained. Those will continue to be the Government's objectives."
My Lords, that concludes the Statement.
5.14 p.m.
Lord Williams of Elvel: My Lords, the House is grateful to the noble Baroness for repeating the Statement made in another place. The noble Baroness will undoubtedly recognise, as did the Statement she repeated, the widespread frustration that is felt not only in this country but throughout the Community, and, as we read from today's press, in the United States, at the failure of the United Nations policy in the former Yugoslavia.
Is it not the case that the United Nations policy seems to be in some sort of disarray at the moment? Are we clear exactly what the aims are? Are we even clear about the aims of the European Community? Can the noble Baroness respond and say what is the unanimity of view inside the European Community on the former Yugoslavia and the horrific events taking place there at the moment?
I should like to ask the noble Baroness two sets of questions, one political and the other on defence matters. First, in the Statement she repeated she referred to the Owen-Vance solution. How many times must we go on with that? Is it now engraved in stone that there is agreement among some parties and not others? Do we wait until, by some magic, the others agree? Are there any fallback solutions that the United Nations has in mind? Does the new negotiator have any further thoughts he wishes to put forward? I recognise the difficulties of confidentiality that must be maintained. But has the noble Baroness any comments she would like to make on those points this afternoon?
Secondly, are the sanctions against Serbia really being enforced to their limit? That seems to me to be the crux of the matter. We are told that the sanctions are being broken almost daily. If that is happening on the Danube or elsewhere, should not both the European Community and the United Nations be taking strenuous action to ensure that those sanctions apply and indeed are strengthened?
I come now to my questions on the military advice that the Government have received. I echo the Statement's views on the contribution made by our armed forces to humanitarian relief in Bosnia, under enormous difficulty and great danger, as the noble
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Baroness pointed out. We congratulate them on what they have done. But are they not simply sitting ducks in the light of the fact that there is no military involvement at all? I refer to the point in the last part of the Statement repeated by the noble Baroness which says,
"There could be circumstances in which the selective use of air power would be relevant".
Can the noble Baroness say what advice the Government are receiving from the chiefs of staff on the circumstances in which such selective use of air power could be relevant? Do we have the air power? Does it need the United States to take out, for instance, Serbian artillery that even this morning was shelling Srebrenica with cluster shells that kill and maim children? What military advice are the Government receiving on that?
Lastly, we support the policy outlined in the Statement. But we must recognise that there is a growing section of public opinion that is frustrated and fed up with the lack of progress being made in the former Yugoslavia. We continue to see on our television screens scenes which we have not seen almost since the Second World War. We never saw them direct on television at that time, which is what we are seeing now. We are seeing pictures of children blinded by the effects of the cluster shells that the Serbs are pouring into Srebrenica. Public opinion will not for ever be calmed—we hope that it is calm but it will not for ever be calmed—by the Statement repeated by the noble Baroness this afternoon.
Lord Bonham-Carter: My Lords, I thank the noble Baroness for repeating the Statement made by her right honourable friend in another place. I associate myself with the tributes being paid to our troops for taking on the difficult and dangerous task in which they are involved.
In that connection, amid the many frustrations which the whole operation has provoked, we should not forget the important achievement of humanitarian aid in averting famine. However, there have been reports over the weekend that food supplies and/or money to purchase food for the United Nations are running out. Is that truly the case? Will the Minister comment on that and say what steps are being taken to prevent that happening?
One is obviously concerned at the Russian request to delay the vote in the Security Council on new sanctions to be imposed on Serbia, but I share the view of the noble Lord, Lord Williams of Elvel. What steps are being taken to enforce more rigorously the sanctions that are already in place? It is widely reported that oil is being transported down the Danube in large quantities. It is widely reported that arms are being obtained by the Serbs from Greece and from other countries. It is not very sensible to worry about new sanctions if existing sanctions are not being enforced. I should very much like to hear what the noble Baroness has to say on that topic.
Obviously the events reported this week in Srebrenica are appalling and shocking and add to the feelings of frustration that have been widely expressed here and elsewhere. In the face of those horrors one understands the response of those who say that

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something must be done and who suggest among other things that we should arm the Bosnian Moslems. I would only say to that, as has already been said by someone—I cannot quite remember who—that one does not put out a fire by throwing petrol on it. What will happen if Srebrenica falls? It is in the Moslem zone. What will happen then to the Owen-Vance plan? After that, the heat will be turned on to Sarajevo, or Zepa or Goradze. What steps are we taking to ensure that they do not fall also? That is a legitimate question to ask. If those Moslem towns are all occupied, where will that leave the plan on which so many hopes have been pinned?
Baroness Chalker of Wallasey: My Lords, I thank both noble Lords for their questions. I do not believe that the UN policy is in disarray. It is perfectly true that there has been difficulty in persuading the Russians over the enforcement of the no-fly zone and subsequently over the implementation of a tougher sanctions regime. I understand that what happened late last night in New York was that, with the 15-day delay in the enforcement of a tougher sanctions regime, this would take us beyond the date in Moscow when certain very important events are to take place. The discussions which are going on between my right honourable friend the Foreign Secretary, the Foreign Ministers of the other G7 nations and the Russian Foreign Minister today may give us more information about the difficulties that the Russians were having with this. But those discussions will also be used to persuade the Russians to get the Serbs to sign up to the Vance-Owen peace plan.
We are quite clear about the UN aims and EC aims, which are to enforce the sanctions, to deliver humanitarian aid and to bring as much relief to the suffering as we can. Of that there is no doubt. The noble Lord, Lord Williams, asked how long we should go along with the Vance-Owen peace plan. We have at least to work through the next fortnight to try to make sure that, if there is any chance of getting not only the Bosnian Serbs to sign up to the Vance-Owen peace plan but also of ensuring that it is implemented, we should try that. The steps that have been suggested by some are extremely serious and take us down a path which the noble Lord, Lord Williams of Elvel, did not advocate but which we all understand is a very natural human reaction to this desperate situation. Goodness me, I have seen it with my own eyes. There is no way in which I shall ever stand by if anything can reasonably be done to halt this.
The noble Lords, Lord Williams and Lord Bonham-Carter, asked whether we are enforcing sanctions to the limit. The sanctions missions that are in place—the EC and CSCE sanctions missions—in Romania, Hungary, Bulgaria, Croatia, Macedonia and Ukraine are working much better. We have highlighted several loopholes. We have advised those governments how to close them and monitoring is going on to make sure that that happens. We are also about to establish a new EC/CSCE mission in Albania in case sanctions are being broken there. We have had discussions between the WEU Council and the riparian states on the establishment of the Western European Union flotilla to enforce sanctions on the
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Danube. The NATO and WEU monitoring exercise in the Adriatic is making a valuable contribution. We have offered £100,000 to assist with the tightening of sanctions as they are at the moment, and if the stronger sanctions are brought in by UN resolution in a couple of weeks' time all efforts will be made to ensure that the riparian states can implement those sanctions. That indeed has been one of the problems.
I was asked about the Armed Forces' contribution in Bosnia. They are indeed making a tremendous contribution. The noble Lord, Lord Bonham-Carter, referred to the importance of humanitarian aid. I must remember more than 100 of my own employed staff who are working on the humanitarian convoys, of which there have been more than 400 in Bosnia since November. They are tremendously helped by our Armed Forces. From my own observations and the reports we receive I do not believe that our military are sitting ducks, as the noble Lord described them. However, I do believe that they work extremely carefully in the central Bosnia area. We are not in Eastern Bosnia where the latest terrible atrocities have occurred. We have regular advice on a daily basis from our chiefs of staff. It would not be for me to give that advice in public but we are well aware of the limitations. I would remind the House that we could not evict the Iraqis from Kuwait by air power alone. We had also to have the allies on the ground in order to do it. I therefore ask all those who think that an air strike system might solve the problem of Eastern Bosnia to realise that in a much more accessible military situation in Kuwait we needed ground troops there as well.
I am grateful to the noble Lord, Lord Bonham-Carter, in many ways. I can assure him that the food supplies are not running out. Britain was the first donor to respond to the latest UN appeal with a further contribution of more than £15 million, bringing total UK humanitarian aid to more than £92 million. Others have yet to make similar pledges but are beginning to do so. The scale of the problem is huge. The European Commission is looking urgently at making further funds available but there have been some difficulties in the supply line. There is no lack of money and the difficulties in the supply line are being dealt with.
The noble Lord, Lord Bonham-Carter, asked me to speculate on what would happen if Srebrenica fell. He asked about the outcome of the Vance-Owen peace plan and how we would protect other plans. No one can envisage exactly what would happen and certainly it is not my job at this Dispatch Box to speculate. All I can say is that both the British Government and all the other governments who want to see an end to this slaughter are determined that that shall happen. We shall work to that end.
5.30 p.m.
Baroness Thatcher: My Lords, I thank my noble friend for the Statement that she has been kind enough to make. I ask her two questions although it may take a little time to put them.
First, let us bear in mind that the present policies of food aid, medical aid, plus negotiations, plus

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sanctions have been in place for about a year; that the sanctions have been in place in Iraq for two-and-a-half years and have not worked; and that the no-fly zone authority does not permit us to attack a ground target even though it is mortar bombing selectively hospitals and schools. Bearing in mind, therefore, that all of those factors have left the people at the mercy of the Serbs, subject to ethnic cleansing, 2 million refugees subject to massacre and slaughter, with something like 130,000 murdered, is it the Government's stance, as I thought from the noble Baroness's Statement, to leave those things to continue as they are without changing policy? That means the continuing suffering of the Moslem people which we would not tolerate in this country. Alternatively, is it, as I thought I heard the noble Baroness half say in her reply, that we shall give the Bosnian Serbs a fortnight to decide to accept the Vance-Owen proposals and implement them? No one will take their word for anything. If they do not accept the proposals we shall then pursue a more active policy which demonstrates more resolve. Which is it? I submit that we cannot continue with a policy which says to the Moslems, "You must submit and surrender".
My second question is this. The right of self-defence was not invented with the United Nations Charter but is as old as mankind itself. That right is recognised by Article 51 of the Charter which states that,
"nothing in the present Charter shall impair the inherent right of individual or collective self-defence".
Bearing those factors in mind, why have the Government left the people, although they have a right of self-defence, without tile means of implementing that right against a vicious aggressor? We would not stand for that in this country. In answering the question, will the noble Baroness bear in mind that there is nothing moral or right about leaving a people defenceless in the path of a determined dictator aggressor?
Baroness Chalker of Wallasey: My Lords, I understand fully what my noble friend Lady Thatcher said and why she put it in the terms that she did. However, it would simply do no good for Britain alone to act on the basis of the very strong emotion which every person in this House and in another place feels. Let us have no doubts about that. What we must have is a practical resolution. There is no lack of resolve. I have probably spent more hours on the situation in Bosnia than on any other single situation requiring our frequent attention at this present time, and the same is true for every member of the Government involved. But it is the question of the practicality of action.
The first thing that we must not do is to risk worsening and extending the action. As I made clear in answer to the earlier questions from the Front Benches opposite, we have to take careful note that in Kuwait air strikes did not solve the situation. Ground troops also were needed. This is a much more difficult terrain where we have far less intelligence, where much of the Serb armaments are at times hidden in the hills and cannot be detected. Therefore whatever we do, we
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have to do it to help those poor people and also to make sure that what we do works, and works at an affordable risk.
We also need to maintain the broadest international front against Serbian aggression. I have to say to my noble friend that it would become impossible to sustain the humanitarian operation if we were to follow the course which she advocated yesterday on the television. I have had repeated discussions with Mrs. Ogata, the High Commissioner for Refugees, and other leading members of the UN and I am convinced that we should not lightly jeopardise an operation which has saved the lives of hundreds of thousands of people, not over the past year but over the past six months since the British troops were involved on the ground in Bosnia.
I well understand the frustration that sanctions have not brought about an end to the confrontation, but I can assure my noble friend and this House that sanctions are bringing about a very severe financial situation in Serbia. Tightening those sanctions, and indeed extending them, is what we certainly may need to do. It is not a question of leaving people unprotected. It is a question of making sure that we work together to stop an all-out war which many of the solutions advocated by my noble friend could well cause.
The question of using air power is not one that has been totally rejected; but we must indeed ask the questions about humanitarian relief. We must also ask whether using air power would cause the Serbs to desist. There are many ways in which we can continue to help and we shall take whatever steps the Government, in co-operation with all their partners, deem necessary to bring this slaughter to a speedy end.
Lord Merlyn-Rees: My Lords, I approve of Government policy, perhaps because I was in that area 50 years ago when a civil war was taking place and perhaps because I visited Vietnam and saw the mistakes that the Americans made when they tried to deal with a guerilla war situation with the slaughter of heavy bombing and long distance strikes—the sort of action that is being asked for now—and they lost. Guerilla warfare requires a different method of fighting wars and usually the great powers lose.
It is a hateful civil war. The hateful civil war aspect is not new in that part of the world. I have never been back because on all sides the children and women suffer—God only knows—but nobody is right. History hangs heavily in that part of the world and we have to understand it.
I wish to raise two matters. First, on the number of troops, let us remember that when the opportunity arose in 1943 the allies did not go into Yugoslavia with large numbers of soldiers. It would have been easy to do so, but it would have been a grave mistake. The Germans learnt the mistake the hard way. They had as many as 13 divisions—it is true that some were at half strength; let us say that there were seven divisions—but they were beaten by guerilla warfare. With regard to the European Community, do not expect German soldiers to be in Yugoslavia. That aspect of civil war is written into the life blood of the people of that country.

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The Americans talk glibly in the UN about long distance strikes. That is different from close support for the army, as the noble Baroness stated. But one requires large numbers of soldiers. One needs close support every five or 10 minutes of the day, picking out the artillery just over the horizon. That will not come from long distance fighter bombers coming from Verona, Treviso or anywhere like that. The chiefs of staff are absolutely right to pour cold water on that. If it is a matter of bombing Belgrade or the other towns in the area from a great height, that would look good on the television, but there are some matters for which there are no solutions. This is one of them. It takes time. I wish the Government well in what they are doing.
Baroness Chalker of Wallasey: My Lords, I am grateful to the noble Lord for what he has said. He is so right when he says that the civil war has long gone on. Our 2,000 plus troops in Bosnia are escorting humanitarian aid and maintaining the peace at many checkpoints. They are doing a fantastic job, along with all the aid workers. The noble Lord is also right that long-distance air strikes would not succeed without ground support. The desperate truth about bombing is that it always creates even more civilian casualties. I ask the House not to forget that the EC monitoring mission has some 350 brave people, from 16 countries, monitoring the ceasefires where they exist and seeking to promote dialogue and to assist the humanitarian activity. There is a great deal going on on the ground which is keeping at least some of the peace.
Lord Boyd-Carpenter: My Lords, I declare an interest as the father of a serving soldier. May I ask my noble friend to confirm that it is the policy of Her Majesty's Government not to expose British troops to casualties even in dealing with those horrible people in that horrible country?
Baroness Chalker of Wallasey: My Lords, my noble friend is absolutely right.
Lord Hylton: My Lords, can the noble Baroness confirm reports that the President of the United States has indicated to the Serbian side that the Bosnians will be rearmed unless the Vance-Owen proposals are signed?
Baroness Chalker of Wallasey: My Lords, I cannot speak for the President of the United States, but there has been press comment to that effect.
Lord Stoddart of Swindon: My Lords, does the noble Baroness agree that the premature recognition of Bosnia-Herzegovina, which has never really been a sovereign state, should teach us that impatience is a bad counsellor? Can she also say just how many troops she believes would be required to back up any air bombardment of the Serbs (or anybody else for that matter) because—does she not agree?—atrocities are being committed by Moslems and Croats as well as by Serbs? Finally, can we have her assurance that, before any military commitment takes place in the
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former Yugoslavia, this House and the House of Commons will be consulted and empowered to make a decision?
Baroness Chalker of Wallasey: My Lords, perhaps I should say first to the noble Lord that I well understand his impatience. He is right that taking decisions hastily in a matter as serious as this is very poor counsel. He asked how many thousands of troops might be involved. I can only tell him that it would be hundreds of thousands of troops on the ground because of the terrain. Driving over it, as we did for seven and a half hours to reach the headquarters of the British troops, I saw some of the most mountainous country that I have ever seen outside Nepal. It would be an almost impossible job without hundreds of thousands of troops.
Perhaps I may add that atrocities are being committed by Moslems and Croats as well as by Serbs. There is no doubt of that. Today we have launched some help for the women who have suffered in those atrocities. The help will go to Bosnia to assist them there. Any military activity would certainly not be taken by Britain alone. Any military activity would have to be discussed in the United Nations and NATO, so the noble Lord can be assured that there would be discussions both here and in another place.
The Earl of Lauderdale: My Lords, I wonder whether my noble friend can enlarge upon one point that she has made. She referred to the WEU flotilla on the Danube. Can she say a bit more about it, bearing in mind that the Danube and the Black Sea areas are of great interest and sensitivity to the Ukraine and Russia?
Baroness Chalker of Wallasey: My Lords, I cannot give my noble friend a great deal more detail except to say that we have found that one of the reasons why the sanctions work was so difficult for the riparian states to implement was the lack of an adequate radio communications network. That is why we are considering giving them the means which will help them to enforce the sanctions even more tightly on the Danube. I well understand the concern of the neighbouring states, but the point must be that if the United Nations has decided on these sanctions—rightly, we believe—they must be fully implemented.
Lord Mackie of Benshie: My Lords, does the Minister agree that this is not a guerilla war; this is Milosevic, in charge of a large and powerful group which he is holding together, successfully attacking ethnic groups in territory that he wants to occupy? Does she also agree that these circumstances are entirely different from what happened in Iraq in that we are dealing with a man who could be persuaded? I know that she will not agree, but would she agree, or perhaps consider, that the tone of the questions, answers and Statement will be of tremendous encouragement to Milosevic in that he has at least a month to continue his appalling work?
Baroness Chalker of Wallasey: My Lords, no. The noble Lord is quite wrong to put that interpretation on anything in the Statement that I have repeated in

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this House today, on anything that I have said or on anything that my right honourable friend the Secretary of State for Defence has said in the media. It is an entirely different situation from Kuwait, which Iraq invaded. It is a civil war—and it is a civil war that is being played out in the most disgusting way against innocent people. However, there is no way in which even the United Nations (or part of the United Nations or NATO) can rapidly move in, as some have advocated. As the Leader of the Liberal Democrat Party in another place has said, that would be adding fuel to the existing flames. I ask the noble Lord to be extremely careful in placing interpretations on what is one of the most difficult of times when it comes to knowing how best to help the innocents in Bosnia.
Lord Campbell of Croy: My Lords, while most people in this country will be experiencing horror and frustration (and I trust that the Government will take fully into account the points that have been raised by my noble friend Lady Thatcher), does my noble friend agree that there is a vast difference between intervening in a civil war involving at least three factions in ambiguously held territories and in defending Britain's shores against one obvious single enemy in the world war in 1940, a time that some of us who were in the Armed Forces then remember very well?
Baroness Chalker of Wallasey: My Lords, my noble friend could not be more right. This is a very complicated civil war. On my own visits there I found Croats fighting Moslems, Moslems fighting Serbs, Croats and Serbs fighting within Bosnia and battles being played out even within those groups. That is entirely different from defending our shores or even from defending the shores of the Falklands, as my noble friend Lady Thatcher did so wisely. It is a very different situation.
Lord Ewing of Kirkford: My Lords, I wonder whether I may gently chide the noble Baroness about her use of the phrase "a perfectly understandable human reaction" in relation to the noble Baroness, Lady Thatcher, expressing the views that she expressed so forcibly yesterday. Is the Minister aware that, like every other Member of your Lordships' House, I speak only for myself and I can assure the noble Baroness that it is not "a perfectly understandable human reaction" on my part to arm people and to allow them to shoot, maim and kill each other almost daily? It is that kind of response—the Minister saying that that is a perfectly understandable human reaction—that gives credibility to the views of the noble Baroness, Lady Thatcher. We ought not underestimate the degree of support which the noble Baroness and her views have in the country at present. May I also ask the Minister to explain to the noble Baroness that Article 51 of the United Nations treaty refers to "nation states" not to "civil wars"?
Baroness Chalker of Wallasey: My Lords, I think that the noble Lord is purposely misunderstanding me. I believe that it is right that ordinary people are horrified—perfectly understandably—by what is
1110
going on in Bosnia. That was the use of the phrase that I made, not the one that was attributed to me. No one wishes to increase the number of arms in this already unruly place, and certainly not the British Government.
Lord Harmar-Nicholls: My Lords—
Lord Hesketh: My Lords, the 20 minutes, as recommended in the Companion, are now exhausted, and I believe that the House will wish to begin the debate on forestry.

The Forestry Industry
5.50 p.m.
Lord Taylor of Gryfe Lord Taylor of Gryfe rose to call attention to the present position of, and the future prospects for, the forestry industry; and to move for Papers.
The noble Lord said: My Lords, we have waited long for this debate, but those of us who are engaged in forestry are very patient people and, as it happens, forestry is a long-term business, and this debate could not have come at a more appropriate time since the Government have just announced another review of forestry. I hope that the debate will have some influence on those proceedings. I trust that there will be no major departure from the statement issued in September 1991 which reads as follows:
"The main aims are sustainable management of our existing woods and forests and a steady expansion of tree cover to increase the main diverse benefits that forests provide".
In March 1991, the noble Lord, Lord Strathclyde, said:
"I have every confidence that the industry itself will increase the number of plantings in the next few years".
The noble and learned Lord who is to reply to the debate today, confronted with the mounting balance of payments problems, stated in November 1992:
"That is why it remains the Government's policy to expand forestry wherever possible".
Despite those optimistic assurances here are the facts: 20 years ago 42,000 hectares were planted in the UK. That has fallen to 14,000 hectares last year. The Forestry Commission planting in the same period fell from 23,000 hectares to 3,000 hectares last year. In its latest corporate plan it envisages dropping to a total planting programme of 1,000 hectares. So much for the promised expansion.
Noble Lords will be interested to note that, thanks to generous grants, 45 per cent. of new planting in the private sector last year was in hardwoods. While that will enhance the environment for future generations, it will contribute little or nothing to our economic well-being and to the balance of payments deficit which now accounts for over £5 billion per annum. I know that the Government spend a great deal of effort and money on promoting exports, and that is commendable, but the reduction of imports is equally important in terms of our balance of payments. I do not suggest that we shall ever be self-sufficient in timber and timber products, but millions could be saved by an aggressive planting programme.
The recent devaluation of sterling will increase our import bill. The cutback in logging in the United

1111
States, transport difficulties in the Soviet Union and the conservation of forests in other parts of the world will all create shortages and make us more and more vulnerable to higher prices. Britain's growing domestic market and the anticipated supply of high quality timber from British forests have attracted no less than £1 billion of new investment in the manufacturing industry in the past eight years. Close to where I live, the Caledonian Paper Company has invested over £215 million—the biggest inward industrial development in Scotland's history. It would be disastrous if we did not maintain a planting programme now to supply its future needs. Exporting countries are less inclined to supply logs—as they used to do—to the UK market. They all want added value in their products. So pulp and processed timber will be offered to us, and we shall lose the manufacturing capacity.
The UK is only 13 per cent. self-sufficient in timber. Let me remind noble Lords, especially those who are worried about the spread of conifer plantations, that apart from Ireland we are the least afforested country in Europe. Only 10 per cent. of our land has woodland cover, as against 30 per cent. in Germany and 27 per cent. in France. Yet we have the soil, the land, the expertise and the market to develop an important manufacturing and productive industry. Our processing sector is already the technological equal of anything in Europe.
In a recent debate in the House great anxiety was expressed about the decline in rural employment. Contraction of forestry can be a major contributor to that decline. People who live in remote areas have few opportunities for retraining for alternative employment. Forestry is not just about planting conifers; it is also about conservation and the provision for recreation. In the past few years, as everyone has observed, there has been a phenomenal increase in hill-walking and countryside pursuits. That is healthy. Many families seek to escape from the dreariness of big cities. The provision of nature trails, wild life protection, camp sites and bird-watching hides are all part of good forestry management. It is an immense contributor to the nation's health and well-being.
Last year there were no fewer than 50 million day visits to the Forestry Commission's estates. That places a substantial demand upon management skills. The Forestry Commission's staff have handled that with commitment and sensitivity as they respond to the public demand for recreation and at the same time protect the countryside. As a young man I lived in Glasgow. We used to go walking in the Trossachs which were within 20 miles of the City of Glasgow. It is an area of great natural beauty, but at each end of the estate the Duke of Montrose had erected toll barriers to provide access to that estate. That estate is now known as the Duke's Pass, but it is also known as the Queen Elizabeth Forest Park, owned and managed by the Forestry Commission, with free access. Last year, 1 million day visits were paid to that estate. That story can be repeated in many parts of the United Kingdom.
It is unfortunate that the Forestry Commission's critics have ready access to a biased and prejudiced
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media. It has not received the credit that it requires and which is justified by what it is doing. As a result, politicians have reacted to such pressure by diminishing the role of an organisation of which we should be proud. First, there was the sell off of parts of the estate, which began as a tidying-up operation. However, now the commission is under instruction to dispose of 100,000 hectares of land before the end of the century. In fact, since 1981, 172,000 hectares have been sold to the private sector. Secondly, the planting programme has been slashed from more than 20,000 hectares, which was the figure during my period as chairman and when my noble friend Lord John-Mackie was chairman, to the 1,000 hectares visualised next year.
Perhaps I may say a word or two about the history of the commission. It was established after the First World War because our woodlands had been depleted by the requirements of militarism and industrialisa-tion. We discovered therefore that we were vulnerable and the Forestry Commission was set up. We had to import pit props, for example, to keep the mining industry going. The commission was instructed to plant trees rapidly on land which was unsuitable and not useful for agricultural purposes.
Sitka spruce met those requirements and hardwoods could not be grown on the marginal land which was available to the Forestry Commission. Naturally many of the plantations had a similar age profile and not enough attention was paid to the environmental impact of square blocks of a single species. The Forestry Commission has recognised those early mistakes and now its woodlands enhance the landscape with proper provision for the existing flora and fauna.
I believe that the commission has been hardly judged by many who are resistant to change in the countryside. I have never met a forester who is unconcerned about the environment. That is why they choose such employment; it is because they love the countryside in all its diversities, the richness of the wildlife and the variety of flowers and other plants. The commission has had few opportunities of planting hardwoods, but wherever possible it has sought to protect our ancient native woodlands. New conifer plantations are made more attractive by the sprinkling of larch and the roadside corridors of beech.
Since its inception the Forestry Commission has enjoyed a happy and productive relationship with the private sector. It has been a good neighbour in pest control and a useful guide in research and training. I beg the Government to resume the partnership which contributed so much to the development of our forestry enterprise. People should not be so worried about environmental problems, because 10 per cent. of our countryside is now covered by SSSIs. In the Highlands 40 per cent. is covered by SSSIs. I am also happy to say that in Scotland indicative forestry strategies have been developed with local authorities, local interests and local environmental groups. They are now proceeding.
On 30th March the Government issued a statement setting up an inter-departmental committee to look again at forestry incentives. That is to he welcomed

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since the present arrangements have failed to achieve the declared target of 33,000 hectares. However, the statement also contained this ominous reference:
"To review options for the ownership of Forestry Commission woodlands".
This suggests that privatisation is still part of government thinking. The policy would contribute nothing to the expansion of the forestry programme. It would certainly jeopardise the excellent work which is being done in recreation, access and conservation. I beg the Government therefore to banish the spectre of privatisation from the consideration of the committee which is being set up.
The commission was reorganised three years ago following a Select Committee investigation. Here we go again—another committee. The Government should realise that since forestry is a long-term investment it requires conservation and stability, which should be provided. I beg to move for Papers.
6.5 p.m.
Viscount Addison: My Lords, I thank the noble Lord, Lord Taylor of Gryfe, for bringing to the attention of the House the position of the forestry industry. I agree that forestry is a positive land use which can be beneficial to local and national economies and to the environment. The United Kingdom has a comparatively low percentage of land under forestry and there is scope whereby more land could usefully be put into productive forestry. However, in all cases policy should respect the landowners' right to make decisions and to manage land within the law.
It is important when planning forestry enterprises to ensure that the objectives are clear. Forestry can provide various outputs including the production of quality timber; the generation of income and employment in rural areas; alternative use for agricultural land; habitats for wildlife, access (both actual and visual) and recreation; reducing the impact of global warming; and a stock of environmentally sound capital to pass on to future generations.
Deciduous and mixed species forests attract a greater spread of wildlife (both flora and fauna) than conifer or monoculture forests, whose habitats for different types of wildlife might be more in demand. Mixed and deciduous woodland also attracts more deer than conifer forests. Many would see deer as a positive addition to rural areas. However, these animals are often difficult to manage, and left to their own devices they can do extensive damage to young trees and farm crops.
The major environmental impact of forestry occurs when trees are planted on new land, and other environmental effects are relatively minor when compared to this initial impact. However, afforesta-tion in appropriate areas can have other important environmental benefits; for example, forests can act as buffer zones to stop nitrate run-off into waterways, lock up carbon in a stable form, help to filter carbon dioxide from the air and, therefore, on a global scale can help towards stemming the advance of global warming.
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The forestry enterprise has managed the woodland in its ownership to a high standard, including the management of wildlife within those forests and of access. Management at this level can be quite costly and new owners of these forests may not be able to afford management without assistance of some kind. It is important that when these forests are sold continued good management is ensured. Financial assistance from the Government may be necessary either in the form of management grants or tax incentives. While this is important for all types of forest it is particularly important for amenity forests, which are run primarily on a cost basis only as it is difficult to realise realistic returns from this type of woodland.
The CAP reform measures, particularly set-aside, provide both a challenge and an opportunity for the productive use of redundant crop land. There is a strong case for the full utilisation of the new forestry measures proposed in the CAP reform. While both the Ministry of Agriculture, Fisheries and Food and the Department of the Environment have a role to play in forestry policy, the Forestry Commission could be the focus for all forestry policy taking account of MAFF and DoE schemes and initiatives. In essence, there should be a "one stop shop" for advice. It is important that all schemes and initiatives are balanced with regard to the various outputs that forests can provide and are "user friendly" for landowners and farmers. The countryside stewardship scheme is a useful model to follow when designing any new scheme for forestry as it allows the greatest flexibility for all parties concerned and ensures that environmental goods and public access are provided where they are demanded.
Environmental land management services—which although nothing to do with the Dutch shortens down quite nicely to ELMS, a grim reminder of the continued threat to efforts to bring back the mature elm to the English countryside—act as an umbrella under which landowners can enter into contracts with public or private organisations to provide environmental services in return for cash payments.
The schemes for encouraging forestry in the United Kingdom tend to stress broadleaves rather than conifers and amenity rather than commercial forestry. It is vital that commercial forestry is not neglected by government policy. It is possible for commercial forestry to provide environmental benefits and high quality timber so long as forests are managed correctly. That can be expensive, especially as returns from forestry are long-term. Therefore, it is important that there should be a balance in the allocation of government funds between commercial timber production and other uses of woodland and between broadleaves and conifers.
One area in which forestry could provide positive benefits both to the individual landowner and to the nation as a whole is on set-aside land. Currently the provisions on set-aside land are purely rotational on an annual basis only. Therefore, at present there is no scope for using that land for forestry. It is important that the Government should allow for a non-rotational scheme that would allow landowners to use non-productive land for forestry. Within that

1115
flexibility a balance must be maintained between rotational and non-rotational set-aside and the uses of non-rotational set-aside to achieve diversity in the rural economy and the environment. There must also be flexibility for land to be switched back into production should a food shortage situation arise.
In conclusion, landowners need to be assured of adequate financial incentives to enable them to meet the long-term heavy cost of establishing and managing forests for the national benefit. It is vital that a clear national strategy is developed for forestry in the United Kingdom linked with adequate financial incentives for the establishment and future manage-ment of woodland. That is essential because of the extent of market failure in forestry. Returns from commercial timber production are long term and yearly management is costly. That is a significant barrier to entry.
6.12 p.m.
Lord Geraint: My Lords, I am sure your Lordships will agree that we have just heard an excellent maiden speech from the noble Viscount, Lord Addison. Some of your Lordships may not be aware that the noble Viscount's father, as Leader of the House, and the father of the noble Viscount's mother, as the then Bishop of London, have both been Members of this House. As something of an endangered species, the noble Viscount has much to be proud of. I thank the noble Viscount on behalf of the whole House for an excellent maiden speech full of constructive ideas. We wish him well in the future.
I am extremely grateful to the noble Lord, Lord Taylor, for giving us the opportunity to discuss forestry today. I am something of a forester, although only in a very modest way. I have, however, planted a few hundred trees in my time. I am roughly the same age as the Forestry Commission and I have observed closely all its policies as implemented in many parts of Wales over the years.
There is great potential in forestry. After all, we produce only some 10 per cent. of our timber needs within the United Kingdom and, given an ideal climate, particularly in parts of Wales and Scotland, we could and should double our present hectarage.
I was disturbed to see figures showing that in recent years the Forestry Commission has introduced no new planting whatever in Wales although it has restocked 1,800 hectares. Private planting is increasing at only 370 hectares per annum. My party and I are fully supportive of private enterprise in forestry but we are against the privatisation of the commission because we believe that to maintain a coherent policy of encouraging the growth of the industry and ensuring proper research and development we need the commission in public ownership. We view with great dismay the piecemeal selling off of woodland which has been taking place with no regard to future development.
In a recent statement the forestry Minister proclaimed that there would be further consultations before any changes took place in forestry policy. However, it seems that those consultations are to take place between government Ministers and their
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departments. I should like to see open consultation with all interested parties—farmers' unions and countryside groups—before any decisions are made. Forestry is a great national asset which should not be squandered.
I should like to make one further point about the situation in Wales. Forestry can be an important employer. I believe that at present the public and private sectors employ some 5,000 people. However, what is lacking is the opportunity for training. It has been pointed out to me that there is no course in Wales for training middle management. I should like to see that omission rectified in the near future to ensure that we have the trained staff which we need in this extremely important industry.
6.17 p.m.
Lord Barber of Tewkesbury: My Lords, I seek the usual kind indulgence of your Lordships when a maiden speech is afoot. I thank the noble Lord, Lord Taylor of Gryfe, for giving us the opportunity to offer a few thoughts on forestry. I must declare an interest. I chair a board which acts as a kind of mother hen—mainly an environmental mother hen—to a forestry and woodland management company. I also chair the National Forest Advisory Board which is intent upon establishing a multi-use forest in the Midlands.
I should like to try to help the debate by speaking on one or two outside issues which do not receive much attention. There are two cultures abroad in our countryside which are having a powerful influence on what we do and how we do it. The first is best described as the non-commercial culture. It has developed swiftly in relation to both forestry and farming with which there are strong parallels. It is an issue but it is rarely discussed openly and frankly.
To many countrymen and women with a living to earn, public opinion—that important incubator of political action—seems to have moved so far down the road of environmental virtue that the commercial imperatives of the two industries have become, in the public mind, almost of secondary importance compared with the need to create and maintain what is primarily an access, recreation and landscape and wildlife resource.
I do not make that point lightly. A very revealing litmus paper of public opinion is public meetings. In the past 10 years I must have addressed scores of such meetings. I find that public opinion has changed little in the past 15 years or so. Both industries—forestry and agriculture—are deceiving themselves if they believe that their PR programmes have made headway with the person in the street.
It is still a widespread and passionate view that commercial coniferous forestry is confined to dark satanic woods of wall to wall spruce, ruining the vista, impeding walkers and single-handedly killing off salmon fishing. In tandem, it is believed that modern agriculture is essentially corrupt with high tech farming inevitably a destroying influence. In some quarters even GATT is under fire for getting in the way of an Arcadian countryside where commerce is vile. I know that I exaggerate, but it is worth doing so.

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It would be surprising if that were not the public mood given the media policy of keeping up a barrage of horror stories. I am bound to say that I look forward with profound dismay to the tedious prospect of the saga of the flow country, however culpable it was, running on smartly into the next century.
We are all well aware of the problems of projecting an accurate forestry image. The professionalism of the past now seen as a mistake—the rectangular bath-mat designs in the wrong sites, the brutal monocultures—is still with us. The new brilliant forest compositions and inspired new managements still have too new a face on them for people to understand that the leopard is changing its spots. I support the noble Lord, Lord Taylor of Gryfe, so far as concerns the Forestry Commission: it has done absolute wonders in Kielder and Thetford.
But as with agriculture, it is no good leaving everything to the organisations to influence public misconceptions. Everyone with a stake in forestry should regard him or herself as an ambassador and go out and shout from the housetops to anyone who will listen that we are marvellously efficient timber producers; that our United Kingdom trees actually grow twice as fast as those of our traditional suppliers; that our timber processing is world competitive; and that our contribution to trade deficits could in the future be even more compelling than it is today.
I mentioned two cultures. The second is the dependency culture—a close relative of the noncommercial one. More and more money moves into the countryside from public sources. A dependency culture, as exemplified by cascades of public money, also gives rise to concern. It takes us away from the market place where, under GATT and a liberalised world trade, we shall be earning our living in more rigorous commercial circumstances.
I was delighted to hear that the Government are setting up an interdepartmental committee. I believe that its remit includes looking at the options for incentives. I know that if I am controversial I run the risk of receiving a mild rebuke, but I should like to say that it is quite remarkable how effective fiscal reliefs were in comparison to the present grant system. We are all on the side of the angels. We all wish to see an ever more beautiful countryside. I applaud most warmly the fact that the Countryside Commission has just announced that it hopes to see the tree cover extended. It is absolutely marvellous that environmentally sensitive areas have really got off the ground, and I am proud to have had a small originating hand in their coming into being.
Over the past 25 years, first as a founder of the Farming and Wild Life Advisory Group and, secondly, as chairman of the council of the Royal Society for the Protection of Birds and latterly chairing what was then the Countryside Commission for England and Wales, I have watched with a growing sense of elation the brilliant progress made on those environmental fronts. The success has been beyond our wildest dreams. Now, like some others with a similar background, I have a sense of unease as the market place, commercial component, both in the
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public mind and elsewhere, seems to be slipping increasingly into the background of countryside politics.
My offering is a simple one. There is a need to re-state and maintain the dignity and status of the commercial ethic in our countryside affairs. I thank noble Lords for their patience.
6.22 p.m.
Lord John-Mackie: My Lords, I could not be more pleased about anything than standing up first and foremost to congratulate my old friend the noble Lord, Lord Barber. I should have liked to have been official and referred to him as my noble friend, but he has gone to the other side so I cannot do so. I have known the noble Lord for many years. I think that what he said today will convince your Lordships that he will be a great asset to the House. His perspective in looking at the situation and putting it the way that he did was very good. I think that we must all congratulate him most heartily and look forward to hearing more from him in the near future.
The five-minute time limit on speeches makes it very difficult for me to say all that I should like to have said. Like my noble friend, I am a former chairman of the Forestry Commission. I should like to make just one point. On the whole, commercial forestry is found in the thinly populated areas of the country—Wales, the north of England, and the north and west of Scotland. Those are the typical areas of commercial forestry. In many areas it is the only industry. I believe that my noble friend Lord Taylor pointed out that the processing industries are moving to where the raw materials are to be found. That is good. But in the meantime, and generally speaking, it is in those areas that forestry as such is the only industry.
I should like to concentrate on the position in Scotland. My noble friend touched on the main figures for the country. I should like to put forward the figures for Scotland which very much emphasise the situation. Since the Conservative Government took over in 1979 the average deficiency per year in Scotland for the 12 years after they took over, and for the 12 years before, is 8,828 hectares. The average labour force required to look after 1,000 hectares is about 10 foresters. The unemployment figure for the west and north of Scotland is 16.3 per cent., which is far above the average in the rest of Scotland. That is 16.3 per cent. of the workforce. The drop in planting has meant that about 1,000 men do not have a job. I have also worked out figures for the private sector for the three years since the Government stopped the tax benefit. It works out at about 7,000 acres per year. That is a loss of 70 jobs a year. In my opinion it is a very serious situation.
Some time ago I asked a Minister when the Government would make good that loss of planting. His reply was, "What's 10 years in the life of a tree?" I am sorry that that Minister is not present on the Front Bench today to reply to the following question. What is 12 years in the life of an unemployed forester? I think that that is something that should be thought about very carefully. The present depreciation in planting trees has created many unemployed foresters

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in such areas. I hope that the Minister who is to reply will convey that fact to the Minister who was supposed to have been on the Front Bench.
There are many rumours about what the Government will do about forestry and the commission, but one of them is not a rumour: it is evident that they are to stop the farm woodland premium scheme in Scotland. Indeed, that was announced recently. That seems to be a very retrograde step. I hope that an explanation will be forthcoming from the Minister.
Quite frankly, I suggest that the Government have interfered plenty and that they should leave things alone. So far as I can see, the knowledge that seems to be obvious to everyone does not seem to be obvious to them. The remarks of my noble friend and those of other people should make them think very deeply—otherwise, they should leave things as they are at present.
6.28 p.m.
Lord Gibson-Watt: My Lords, I believe that we should all thank the noble Lord, Lord Taylor, for initiating the debate. We should also congratulate the two maiden speakers, my noble friend Lord Addison and the noble Lord, Lord Barber of Tewkesbury, for their contributions. If I may say so, the latter, having done so much for the countryside and having been chairman of the Countryside Commission in Britain, was always one of those people who was never against forestry as such. He quite rightly pointed out his opposition to badly shaped patterns of conifers. However, he also said the Forestry Commission had learnt a lot in that respect. He attended an outing one day as a guest of the Forestry Commission. He told us that we should sell our conifer policy rather better than we did. That was possibly a difficult thing for the chairman of the Countryside Commission to say. I respect him very much for saying that.
I wish to mention the immense amount of new machinery that has been installed in the forestry industry since the 1980s. That process was, of course, helped by government grant. However, the industry needs a large and continuing supply of timber to operate. I wish we could provide more of that timber from our home forests. As has already been said, timber imports in 1991 were costing £4.5 billion. That represented a significant part of our balance of payments deficit which at that date was running at £14 billion. No doubt the Chancellor is more than aware of that fact.
What is limiting the acreage of conifer forests? We are near the bottom of the European league table in this area. It is well known that most of the demand today is for softwood rather than broadleaved timber. New planting has shrunk from 29,500 hectares in 1989 to 17,300 hectares in 1992. The Government's target is still over double that figure.
Since 1988 people in the private sector of forestry have known that the Schedule D option was to come to an end. Last week that occurred. It is too early yet to judge whether the increased grants will do the trick. However, my own apprehension is that they will not. It is important that confidence in that side of the
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industry is renewed. In 1988 the Treasury had a great deal of support for abolishing the Schedule D option —it had wanted to abolish it for many years—from the then Secretary of State for the Environment, Lord Ridley, who was against conifers.
I wish to refer specifically to planting in Wales—this subject has been mentioned by the noble Lord, Lord Geraint —and the effect this has on employment. New planting in Wales is down to a few hundred hectares and yet there is so much bracken-covered land that is suitable for planting. I know that if conifers are planted near watercourses the acidification problem arises, but there is a great deal of land that is situated a long way from watercourses that could be planted. I hope the Government will do what they can to increase the amount of planting in Wales. After all, today local authorities, in conjunction with the Forestry Commission, have strict approval regulations.
The working group has already been referred to. I approve of the review of the incentives for forestry investment but I am certainly opposed to privatisation of the Forestry Commission. One reason I oppose that step is that the private sector of forestry simply cannot provide the assured supply of timber that the industry needs. That arises because private forests are too fragmented and the owners of private forests follow the market a little more carefully than perhaps is the case with the Forestry Commission. The Forestry Commission has committed itself to assured supplies and assured prices.
I approve of the present policy of selling small areas of uneconomic woods belonging to the Forestry Commission. That process has done a great deal to encourage small forestry owners. A Conservative Government should be in favour of such a policy. As the noble Lord, Lord Taylor, said, over the past few years 171,000 hectares have been absorbed by the market in this way. However, if the Forestry Commission is sold outright that would mean, to my way of thinking, that too much woodland would come onto the market at the same time. Most of that woodland would be bought by people from overseas and that would place in jeopardy the new processing industry that has been established.
6.35 p.m.
The Earl of Radnor: My Lords, we are grateful to the noble Lord, Lord Taylor of Gryfe, for raising the subject of the forestry industry and its future prospects. I know he has waited a long time for the opportunity to table this debate. However, as the noble Lord himself said, this debate has occurred at a fortuitous time as a review of this matter is to take place. I hope that my noble and learned friend will take back a fairly strong message from this debate to whoever is to review our forestry industry and our forestry policy.
Perhaps I should start by considering the forestry industry at present and its prospects for the future if we pursue our present course. As has already been said in this debate, we are not planting nearly enough trees. The Forestry Commission has been threatened and its future, which has always been a slightly grey area, is

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in doubt. I hope we shall obtain a clear indication at the end of this debate that there is no question of privatising the Forestry Commission. As I have said in previous debates, the Forestry Commission is the backbone of our forestry industry.
If we continue our present course, our production, leaning on past planting, will increase for a certain time and then, quite understandably, it will decrease over a long time, long after we have lost interest in it. There is therefore a tremendous incentive to develop this industry properly. The reasons for doing so are perfectly simple. First of all, we import 80 per cent. of our timber. That is rather ridiculous. Secondly, we have been forced to place 15 per cent. of our agricultural land out of commission as regards agricultural crops. Therefore there is plenty of land available now without taking land in the Highlands or other areas of special beauty or in areas inhabited by special species.
Perhaps the most important reason for increasing the area of land that is planted is to reduce the agricultural unemployment that exists throughout the country as a result of the set-aside policy and descending farm profits over the years. That matter is of enormous importance to agricultural workers and their children. Those people are on the whole oriented towards agricultural work rather than other areas. However, there is no policy of increased planting at present. As I have said, there must be more planting. This is not just a matter of tinkering about with grants. At present the grants are too many and too complicated, although they play their part in agriculture. As I said before, I believe they should be indexed because that is the only reasonable way to deal with a grant which may stretch over 20 years as it is only after that period that a tree will make money for its owner.
The really damaging blow to the forestry industry was the ending of what I shall call corporate forestry. That occurred in the Budget of 1988 when tax relief was removed from forestry. That was a blow to the private sector in forestry. If it is unacceptable to reinstate that relief, some way must be found of organising corporate forestry to establish large and efficient forests and so enable companies to play their part in forestry along with private individuals. Inevitably the forests of private individuals are fragmented. That does not lead to an efficient industry. Companies should at least be treated on an equal footing with individuals. They should really be treated better than individuals. We need large forests as well as pretty little woods all over the place, which are hard to organise. It is also hard to sell the timber from those small woods in an efficient way.
Finally, I do not believe for one moment that forestry on such a large scale is incompatible with the environment. I am sure that by regulations or laws the two could be made to work well together and that the matter could be well enforced.
6.39 p.m.
Lord Wade of Chorlton: My Lords, I should like to congratulate the two maiden speakers in the debate. It was a pleasure and privilege to hear their views. I should also like to thank the noble Lord, Lord Taylor, for introducing the debate. I agree very much with everything he said, except for the last part, to which I shall refer shortly. He analysed the importance of the forestry industry and the opportunity for wealth creation which it provides throughout the British economy, not only nationally because of the reduction in imports but also at the level of the rural economy, in which I am particularly interested.
I believe that the right way ahead is that suggested by the Government and which the Government are now reviewing, namely, to privatise the forestry industry and Forest Enterprise. It is clear from the way in which forestry production has taken place over the past few years that we are reducing an industry which in other circumstances ought to be increasing. Surely we have all now learnt that one does not achieve the best productivity, the best opportunities, the greatest enthusiasm and the greatest drive to create wealth within government-controlled organisations; that is achieved within the private sector. I am delighted that the Government are now undertaking the review and have already made it clear that the potential for privatising forestry is under discussion.
I should like the Government to consider a number of options. It would be possible to introduce fresh finance into the forestry industry by financing the trees. The Government could no doubt devise an interesting method of raising money by considering that option while retaining the ownership of the land.
Another option would be to create a series of agencies—as the Government have already done—to deal with various parts of the forestry industry. The first step would be to create agencies. Those agencies could then be allowed to be privatised, either through management buy-outs or by bringing fresh money into those agencies. There would be a series of organisations owning forestry throughout the United Kingdom. Alternatively, the Government could put the whole lot up for sale as a whole or in lots to attract a wide range of investment from different sources.
The purpose would be to encourage the growth of the forestry industry, as other noble Lords have suggested, on lower lying land where the opportunity for efficient growth of wood in this country is enormous. It could be grown much more efficiently and economically than in many other parts of the world. That would improve our economy.
I am aware that there is considerable anxiety that such a move to the private sector would act against the interests of the environmental benefits of forestry for the rest of society. That does not seem to be an argument in other areas. As has already been stated, forestry covers 10 per cent. of our land and agriculture covers about 75 per cent. of our land. We have not thought it necessary to privatise all the land in order to ensure the environmental benefits of agricultural land. We have been able to do that by pushing farmers

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in one direction by grants or in another by regulations and have achieved a better balance of the economic and environmental benefits to society.
I believe that within the forestry industry we could also create the right balance which is necessary to make forestry available for leisure opportunities, for people to see and use it, to live within it and benefit from it as part of our society. We could do that just as well within the private sector, as in any other business.
There are great opportunities to link forestry and planning and development much more effectively. Why should we not say to some people who cannot develop land because of environmental restrictions that if they were to create forests they could do things within the forest area that they could not do on open land? Such environments would be so much more enjoyable to work and be in. Some noble Lords may be aware that in Herefordshire a planning application has been made to create a burial ground in a forest. That seems a very innovative and interesting use of the forest. It would be a more attractive place to lie than in a bare environment.
Diversity of ownership will create diversity of forest. It is diversity which produces the environmental interest. I believe that opportunities are now available to create wealth from our forests. Those are opportunities which the Government must not miss. I congratulate them on their new initiative and hope that they will now take positive action to create money from those opportunities.
6.44 p.m.
The Earl of Swinton: My Lords, a two-and-a-half hour debate with 22 speakers on the subject of forestry gives new meaning to the word "backwoodsman".
The disallowance of the facility for private landowners to opt for taxation of woodlands under Schedule D may well have stopped tax abuse by some rather greedy but well-known pop stars and media personalities, but it has discouraged the planting of new woodlands, with a consequent reduction of the labour force—drastic in some cases—that will affect essential maintenance over the years and lead to poorer crops eventually. It struck me as highly ironic that that change in the tax law came into force less than a week after the press release relating to the Countryside Commission's excellent policy statement England's Woods and Trees. I can assure noble Lords who have not seen the document that it is available in the PPO. If they have to pay for it it will cost them £2, which will not break them.
I should stress that the document deals with England's woods and trees. We have heard a great deal today about the tree coverage in Scotland and Wales. If it was not for that, the tree coverage of the whole of the British Isles would be even more pathetic than it is now because, compared with Scotland and Wales, England suffers from far and away the least tree cover.
As I am sure noble Lords are aware, the Countryside Commission is the Government's official adviser on the countryside. It tries to promote forestry itself. Perhaps I may give a special plug to the new national forest. I was delighted to hear the maiden
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speech today of the noble Lord, Lord Barber of Tewkesbury, which was constructive and well worth listening to. He has contributed enormously to getting the new national forest project off the ground. The Countryside Commission also helps with work on community forests and countryside stewardship. I was also glad to hear my noble friend Lord Addison refer to that in his excellent maiden speech.
The main objective set out in the policy document is to see England's acreage of woodland doubled by the middle of the next century. Noble Lords may think that that is pie-in-the-sky. I hope that it is not. It is an excellent aim. The Countryside Commission is perhaps inclined more towards amenity forestry than towards the industry, but I believe that there must be the closest possible co-operation between the amenity planters and commercial forestry interests, be they the Forestry Commission, large companies or national growers. If we squabble among ourselves over the type of forestry and where it will be we shall never achieve that object. If we work together to persuade the Government to be more generous in their incentives towards forestry we can achieve that admirable object.
6.48 p.m.
Baroness Nicol: My Lords, I congratulate my noble friend Lord Taylor of Gryfe not only on his choice of subject but, as others have said, on the appropriate time at which it has come forward.
Five minutes is not enough to deal with everything that needs to be said, but I must respond to one remark of the noble Lord, Lord Wade of Chorlton. The Forestry Commission has no monopoly on the planting of forests. If the private sector had so desired there is no reason why it could not have gone ahead and done everything which the noble Lord said it is capable of doing. I wish there was time to develop that point but I shall have to leave it there.
There has been a great deal of speculation about the possible privatisation of the Forestry Commission, couched in terms which seem to indicate that we shall have legislation before us to carry out that promise—or threat, depending on one's point of view. My understanding, however, is that the Secretary of State now has the power to sell all 2 million acres of forest, if he so wishes, without coming back to Parliament for legislation or, indeed, informing Parliament if he feels that way about it. No doubt the Minister who is to sum up will correct me on that if I am wrong.
We have heard from my noble friend Lord Taylor about the amount of land which has been sold and is earmarked for sale between now and the end of the century. In a speech last November, Mr. Dorrell, the Financial Secretary to the Treasury, was reported as saying:
"The conventional question was 'What can we sell?' Now we should ask ourselves 'What must we keep?"
Against that background, it seems to me that the Forestry Commission holdings are very vulnerable.
We have also heard from my noble friend Lord Taylor of Gryfe about the proposed interdepartmental body. I welcome it, but I have a number of straight questions to put to the Minister to which I hope to receive answers. It is vital that the group considers all

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aspects of possible disposals, as my noble friend said. First, will interested organisations and individuals be able to submit evidence to the group? Secondly, will the group's proposals be made the subject of public consultation before they are adopted by Ministers? Thirdly, will the management and improvement of existing woodlands be part of the discussion, or are they only concerned with new forestry? Fourthly, do the Government consider management for wildlife an important objective? If so, will the statutory conservation bodies be involved in the discussions with the new group?
Some may ask: why does it matter who owns our forests? The answer is that it need not matter if the Government are prepared to establish and enforce a sensible forestry strategy. It would have to be a strategy backed up, where necessary, by financial help, as many other noble Lords have said. But the strategy would have to be a sensible one and it would need to be enforced. It would have to encompass all aspects of the industry, not just the economic ones. It would have to encompass the environmental, social and recreational aspects as well.
The report from the Select Committee in another place, which was published on 10th March this year, stresses the importance of involving local communities in developing new forests and managing existing ones. Do the Government support that approach? The environmental and recreational benefits of forestry, as many of us have said, are as important as the economic benefits. The German approach to managing forests in the interests of all aspects is well known. Given the will, there is no reason why we could not do as well.
The record on public access to previous Forestry Commission holdings so far is abysmal. Only one access agreement has been signed since the new legislation came into force in 1991. It must become firm policy that access to previously held Forestry Commission land must be maintained and the only way to do that is by establishing rights of way. I know that that is not a popular suggestion, but it is the only certain way under our present laws to keep access safe for the public.
I have run out of time, but I should like briefly to mention a subject which I have raised on previous occasions—the care, maintenance and planting of motorway verges. There seems to be a certain amount of confusion about who is responsible. Will the Minister say whether that is to be one of the responsibilities of the new interdepartmental group?
6.54 p.m.
Lord Clinton: My Lords, it is a privilege and pleasure to congratulate the two maiden speakers on their contrasting speeches. I found myself very much in agreement with the noble Lord, Lord Addison, and not quite so much with the noble Lord, Lord Barber. However, it was a great privilege for me to receive a plantation competition prize at the Royal Show when the noble Lord, Lord Barber, was president of the show last year. That was certainly a commercial plantation planted.
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Nearly 700 years ago, believe it or not, the first Lord Clinton planted trees and harvested them for one reason only —it was probably commercial. My great-grandfather, the second chairman of the commission, rushed down from London the night after the first meeting of the commission and planted a tree in Eggesford Forest in Devon to commemorate the first tree to be planted by the commission. That tree was a Douglas fir, a conifer, as it was to become part of the conifer forest on that site, some of which even stands today. Several years ago I had the privilege to go to the same site to commemorate the 50th anniversary of the commission and planted a Douglas fir.
The point of those two stories is to emphasise, first, that the right trees should be planted on the right sites; and, secondly, that we should not lose sight of the fact that growing timber is a commercial exercise. It is also to show my wholehearted support for the Forestry Commission. The first Lord Clinton, I am sure, planted and harvested oak for its many uses. Today we plant conifers for the same commercial reasons.
I must emphasise that good silviculture should be given a high priority to make sure that the right trees on the right soils and for the right purposes are planted. We should realise at the same time that commercial forestry can be practised sympathetically.
The balance has now, in my opinion, gone away from that end and has been dissipated too much towards amenity considerations. To see that happening in agriculture was to me bad enough, with set-aside and quotas, but one must accept that there was over-production in the industry. But surely not in timber. Surely it has been recognised time and time again in this debate and elsewhere that some of the land which we are talking about—over 1 million hectares —could be taken up and planted with trees. At the moment the lack of information as to the conditions of set-aside under the reform of the CAP is holding back that planting.
I believe that there are two priorities: one is a strong forestry body to make sure that timber production is given the highest priority, both in its planting and in its harvesting, especially in the private sector. Secondly, one Minister of the Crown and a department of state should be responsible for carrying this out. On one side, I see too many admirals trying to organise things and, on the other, perhaps too many conservationists who may not know the difference between a lemon tree and a lime tree. That cannot be right; there is obviously a place for both.
However, I see for the future little hope unless we can learn from the past. One message which comes across loud and clear is the damage which was done by politicians who have often not taken the trouble to consult the industry before making very important decisions.
We need a proper, industry-led national forestry strategy which is able to deliver government policy. That, in turn, must be well thought through and left in place for succeeding generations. Stating the obvious in your Lordships' House, especially at what used to be called "this late hour", needs no apology. However, we have to remind ourselves quite often that the final

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crop in forestty—I am talking about the conifer—has a life of a little over or a little under that of the average human being. The average term of a government is five years. That means that during that lifetime forestry policy could change at least 10 to 12 times. Once a tree is planted there is not much to say about it. However, the forester who has to manage the forest enterprise for the long term must have planning for it. That is important. Sixty years is a long time and it requires a long-term policy. It should be possible for a government to provide that as the policy should be long-term, non-political and give stability to the industry.
The forestry policy for Great Britain is set out in appendix VI to the 72nd annual report of the Forestry Commission. Paragraph 2, which is headed "Aims", gives again more emphasis to the rural environment. I think that that is a pity; but it then goes on to say:
"Our forestry industry makes a substantial and increasing contribution to meeting the growing national demand for timber and provides … employment to people living in rural communities".
Surely our forestry industry should have that priority. Our future depends upon it, especially as there is so much interest and enthusiasm within the industry to carry that out. We must arrest that confusion and muddle and support commercial forestry again before it is too late. There have been successes (as has already been mentioned) in the extended use of home-grown timber at the Caledonian mill and in Wales which have brought to Britain some of the most advanced wood processing technologies available in the world. Timber will continually be needed for such technologies. We must build on this and other research. Without a robust woodland, managed to produce good quality timber of the right kind in the right place, all will be lost and nothing gained.
7 p.m.
Lord Marlesford: My Lords, a number of noble Lords have referred both to the environmental and the economic aspects of forestry—or the forestry industry, as it is referred to in the Motion of the noble Lord, Lord Taylor of Gryfe. I believe that in many ways those are two sides of the same coin. We have heard about the importance of growing more trees as import substitution of timber. But I would also suggest that forestry has in its environmental dimension a very real import/export role. After all, it encourages visitors to this country—which is clearly an export. It also encourages British people to take their holidays in Britain, which is clearly import substitution. So I do not think that we should regard them necessarily as separate. The employment dimension also applies equally to both.
It was a particular pleasure for me to hear the noble Lord, Lord Barber of Tewkesbury, in his maiden speech on the subject cover and touch both angles. I was lucky enough to sit as a member of the Countryside Commission for 10 years under his chairmanship. He was the most brilliant chairman I have ever sat under. I know the great benefits he will bring to membership of your Lordships' House.
I should like to go a little more into the taxation angle, which was referred to by my noble friend Lord
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Radnor. As we all know, the change in the forestry taxation regime which was announced in his 1988 Budget by my noble friend Lord Lawson came into effect this month. One understands why that change was made. I am ambivalent as to whether it was on balance desirable to remove the taxation privileges from commercial forestry. I am worried that under the new tax regime there is a real danger that the proper maintenance of non-commercial farm woodland will be lost. We could get zealous tax inspectors dissecting farm and estate accounts and disallowing all expenditure on the maintenance of the amenity farm woodlands.
It is much easier to make a distinction between commercial forestry and amenity woodland than it is between one form of amenity woodland and another. Does one stop at the amenity wood, or the copse, or the spinney, or the big hedge, or the single important trees? I contend that expenditure on the maintenance of those features, which are a crucial part of the countryside, is therefore of great economic significance.
Such maintenance is part of good stewardship by the individual land-holder, whether he be a farmer or a landowner. We are not talking here necessarily about the operations for which grants are given. I support the amenity grants that are given. The new initiatives of the Countryside Commission, to which my noble friend Lord Swinton referred, are to be welcomed. But much maintenance of the countryside is carried out by land-holders through ordinary, everyday good business practice. I hope that my noble friend the Minister will tell us whether the committee which the Secretary of State for Scotland announced last week could look at this so that we get a clear ruling. It should not depend on ad hoc decisions by different tax inspectors in different parts of the country. It would certainly be very damaging to the beauty of the rural environment if the maintenance of the countryside were allowed to suffer from a fall in the cash-flow from people making what is effectively a private contribution with only the tax element as a public contribution.
Finally, I should like to say one word on the privatisation of the Forestry Commission. Traditionally, the political parties in this country—the Labour Party and the Conservative Party (the Liberal Party is always somewhere in the middle on the matter)—have been divided on the question of privatisation. I fear that the privatisation of the Forestry Commission would divide the Conservative Party. My noble friend the Minister has probably received that message already. There are certain areas where privatisation or the selling off of parts of the Forestry Commission estate are desirable, particularly the small woodlands. In many cases the Forestry Commission has not looked after them very well. Anybody who goes to see the woodland where John Makepeace now does his stuff in Dorset will know what I mean.
I believe that there would be real risks to public benefit in a massive sell-off of the publicly-owned forest. The reason is that it is a national asset in more than a "growing of trees" sense. It is an asset in terms

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of public access. We know that the Treasury would be loath to allow a sale with covenants requiring public access. Therefore I suggest that the Government continue with what I think is called in local government reform an organic process; it is sensible to sell bits off, but keep the hard core of the Forestry Commission estate intact.
7.6 p.m.
The Earl of Lindsay: My Lords, I am grateful to the noble Lord, Lord Taylor of Gryfe, for raising this debate and also to the two noble Lords for their excellent maiden speeches. I speak today both as a farmer and a woodland owner and also as an environmentalist involved in the various disciplines that attach to landscape and land use. Outside this House it is often forgotten that we have some of the finest conditions in Europe for growing trees. Our forgetfulness is perhaps understandable, as other noble Lords have pointed out, as we have one of the lowest tree densities in Europe and we import some 86 per cent. of our timber needs at a cost of billions of pounds to our balance of payments. However, what should not be obscured is that forestry in the UK remains a strategic asset of considerable and diverse potential. Its impact depends upon the extent to which woodland schemes and incentives are realistically integrated with other land-use policies.
Nowhere is the need for integration more crucial than in relation to EC agricultural policies. Set-aside is creating a massive stockpile of wasting acres and lost jobs. The cost to the taxpayer of set-aside payments in this financial year alone is £940,000 million. At the same time, the urgent need for increased woodland planting is funded by just £25 million to £30 million per annum. Compared with the £1 billion set-aside scheme, the woodland budget is not only disproportionately modest, given its wider benefits, but—a point of the greatest importance—the woodland schemes themselves are too often a less viable option.
My experience of new woodland planting being discouraged by EC schemes is not untypical. Three years ago I planned to put 30 acres of arable ground into a new broadleaf planting scheme involving some 30,000 trees, rides, glades, proper woodland edges and so forth. However, new EC set-aside and crop subsidy rules acted as a disincentive to the grant-aided woodland scheme. This year that ground sits idle in set-aside. It is very depressing. The ground is better suited to growing trees than arable crops yet now remains in agriculture. It would have removed an encouraging 6 per cent. of our 500 arable acres out of arable cropping; and, like many others pondering current trends, had that new planting gone well it would certainly have tempted more.
The conclusions of such an aborted exercise are inescapable. Until new farm woodlands can be included as part of set-aside and until planting incentives are properly competitive in a wider context, initiatives such as the farm woodland premium scheme will not be a commercial alternative use for that land. Therefore the Government must fight their
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corner in the forthcoming EC review in order that such schemes will in future count towards set-aside. The benefits to everyone, including the taxpayer, are numerous. New woodland planting can provide an alternative use for an otherwise wasting asset. It can provide a crop that we need, as evidenced by the huge amount we spend on imported timber. It has notable benefits for rural employment, being labour intensive, and also for the environment.
The contribution to the environment is vital but is too diverse to go into in the time that has been allowed today. Suffice it to say that modern multi-purpose forestry can now simultaneously achieve both commercial objectives and environmental features in terms of land management, landscaping, the creation of habitat, the conservation of species and so forth.
I would also, like my noble friend Lord Addison, mention the link between forestry and the environment. It is estimated that one hectare of trees in this country can now absorb 10 tonnes of carbon dioxide. Ten tonnes of carbon dioxide per annum may sound small; but so is one hectare. If we doubled the area of woodland in this country we should lock up another 23 million tonnes of carbon dioxide every year.
Given the obvious benefits of forestry and of encouraging new and better woodlands, especially on idle arable acres, I question the wisdom of the recent review that left woodland planting grants unchanged. I also question the very low rate of management grants and the degree to which their eligibility is restricted. The form filling which attaches to grant applications can still clog the machinery right at the very start. New initiatives need to be kept free from morale sapping delays.
I should like to make one simple practical suggestion and would appreciate a response from my noble friend the Minister. Why not allow some grants to be applied for retrospectively? Their eligibility could be restricted perhaps to restocking, perhaps to areas of less than a certain size, say, 10 hectares or 20 hectares. If one wanted the grant, one would inevitably of one's own free will plant in accordance with the accepted guidelines.
A more fundamental concern is the sweeping fiscal reaction to previous abuses of Schedule D that now prevents all owners from offsetting woodland costs against other incomes. That has undermined many woodlands or conservation countryside management policies, especially those pursued by traditional estates that integrate farmland and woodland. Surely it would be sensible at the very least for a farm or estate to be able to offset its woodland oriented costs against incomes arising from other parts of that same farm or estate.
In conclusion, I urge my noble friend to give us the following assurances: that the Secretary of State will not return from Brussels until the farm premium woodland scheme or other such schemes can count toward set-aside acreage; that woodland planting and management grants will be made more competitive with other land-use policies; that retrospective grant applications will be considered as a sensible option in certain circumstances; that the manner in which the grant system encourages most broadleaf planting to

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be at the least density, thus producing the least benefits, will be reviewed; and, finally, that the fiscal arrangements will be revised in a calm and constructive fashion so that those good practices which have been lost will be restored.
Those are just some of the issues that a committed forestry strategy must address if its benefits are to be widespread and long-lasting.
7.12 p.m.
Viscount Mountgarret: My Lords, we are all very grateful to the noble Lord, Lord Taylor of Gryfe, for having initiated this debate and bringing to it two excellent maiden speakers who know their briefs extremely well. We look forward to hearing a great deal more from them on this and many other subjects.
I should like to say quickly—there are 22 speakers on the list—how much I support the remarks made by my noble friend Lord Marlesford about the taxation system. It is a little ironic that we are at the beginning of a new financial year and for the first time forestry expenses have been taken out of the taxation system. That may be a good omen. I hope very much that my noble friend will take the point on board and consider it. It is quite serious. The euphoric hopes that have been expressed so well by many speakers with regard to the further expansion of forestry and the fulfilment of all that we—noble Lords, the public and country lovers—wish to see will be frustrated if we do not have some meaningful allowance put back into the taxation system.
My noble friend Lord Addison was concerned about the possibility of using set-aside land for development of forestry, if not for wildlife. I wanted to comment on what he said but I shall be out of order if I do so. Other speakers have referred to the development of forestry and set-aside land. I should like to utter a word of caution in this area. It is not only forestry and woodlands that encourage habitat and wildlife but also plain, bare fallow land. Indeed, this year I was pleasantly surprised to see a rather larger number than usual of yellow hammers and barn owls around at home which I believe have been encouraged by the proliferation of set-aside. I should not like my noble friend to be carried away with the thought that we must develop forestry on bare land purely because of habitat.
Another danger is that the set-aside arrangements may not continue for long. One does not know. I do not argue the case for or against set-aside but merely state the fact. As many noble Lords know, if one plants virgin land, the difficulties of restoring it to agriculture are compounded. No one should rush into planting new woodlands on virgin land. The matter has to be treated with great caution. Our traditional woodlands, whether they be large commercial woodlands or amenity woodlands planted by our forefathers, were all planted in areas that were basically unsuitable for use as agricultural land. Those areas grew possibly better timber, being on rather higher ground. The trees grown in this country—I do not speak of Scotland, which is obviously higher, or indeed Wales, which is undulating country, but of the north of England more or less—and planted on virgin
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agricultural soil do not produce timber of good enough quality for the purposes for which many people want to use it. That is why we import so much Norwegian timber and why Scotland produces excellent larch and first-class timber. It is limited to those sorts of areas. So we must not be carried away by the fact that we could grow a lot more timber or that it would necessarily cut our imports and so on.
I should like to say in a few quick words—I was a little stopped in my track earlier and probably quite rightly—that the age of the planner and the bureaucrat is very much with us. There is a creeping paralysis which, if we are not careful, will overtake the private enterprise that has served us so well in the past. I refer to tree preservation orders. The orders were based originally on individual trees rather than large blocks or areas. I have the dubious privilege—certainly I had 30 years ago—of having the largest tree preservation order on a block of woods in this country. The result has been a running battle with the planners and the tree preservation order people to be allowed to carry out a proper silvicultural policy. I have tried to do the best that I could, but wind blow has occurred. Trees could not be felled because I was not allowed to fell them and others have now blown over. The next thing that can happen is that another lot will blow over.
My time has run out. If we are to develop our private industry, let us have some of the shackles of bureaucratic imposition taken away from us.
7.19 p.m.
The Duke of Somerset: My Lords, we need to examine why we need forestry in the United Kingdom and whether, despite the criticism, both government and industry are not after all striving in the same direction. To do so we must distinguish between industrial timber supply and amenity/sporting/farm woodland. The last two cases are very fine and important. They are worthy of the many grants that are currently available. But they will not serve the appetite of the processors who have made large investments in this country.
It has been stated elsewhere that we need to aim for a sustained production target of about 20 million tonnes per annum. That aim should be achievable by the traditional mixed estate together with the forest enterprise and by the broadening of public participation. The former provider, one of which I own, needs confidence restored by a long-term policy looked after by one Ministry. It needs financial impetus provided by a judicious mixture of grants and common fiscal treatment with other land users, maintaining the present tax-neutral status of timber production. However, associated costs of common works of infrastructure and agricultural integration, like roads and fences, ditches and ponds, should qualify for ordinary tax relief and not be covered by the woodland grant scheme. That scheme would be directed specifically at tree planting.
The second provider of timber—new planting—could be achieved by the broadening of participation through the shareholding public, as in other industries. Minor enabling legislation would permit

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the marketing of forestry portfolio schemes based on transferable shares wherein shareholders would be allowed the same tax treatment—neutrality—as individual investors. Those ideas would not involve additional Exchequer costs. The Government should target the intervention better. Intervention is bound to be necessary because of the distortion caused by agricultural subsidies and BES-type schemes.
I believe that the industry's objectives are similar to those of the Government. The industry wants to increase the quality of the resource—mostly industrial roundwood; to manage on a sustainable basis; and to provide a wide range of products and benefits for society. The Government want to stimulate agricultural diversification, rural investment and employment as well as provide social and environmental benefits. Arising from Rio, they also have the obligation to long-term resource creation.
All those aims would be achievable under a system which encouraged new investment but also reassured existing owners. It is vital that the forestry industry does not seek endless public subsidies. A strong flourishing processing sector could lead to better prices and therefore profitability for the landowner. However, part of the equation includes pitching the grants—that is, the incentives—at a realistic level.
The growth of native hardwoods in the UK is hampered by two factors with which the Government could help. The first is the damage done by grey squirrels. I wonder whether the Government have any plans for a co-ordinated publicity action campaign to thwart those horrid animals. The second is the relative lack of progress on genetics and breeding. It is no good growing a tree for 150 years if it is only going to be good for firewood at the end. Is the Minister confident that enough resources are being directed at improving hardwood form? Growing trees without growing timber is to suggest to our children that the world owes us a living, as we do by importing over 80 per cent. of our needs.
Finally, is the Minister aware of the work done by the Forestry Trust for conservation and education, of which I am a trustee. Last year the trust was instrumental in establishing the forest education initiative. This spring it published a handbook of woodlands open to the public with considerable help from the Forestry Commission and the Countryside Commission. However, further funds are needed to sustain the work of that valuable charity in the future.
7.23 p.m.
Lord Lyell: My Lords, I begin by thanking the noble Lord, Lord Taylor of Gryfe, for giving us the opportunity—it seems to occur so rarely—to discuss this industry. Secondly, I wish to declare my interest since I have spent all my life in the county of Angus —so well known to my noble and learned friend on the Front Bench and indeed to my noble neighbour Lord Mackie. I recall enormous timber operations, clear felling, during World War Two. I recall what was virtually a clear fell during the hurricane of 1953—Coronation year. I recall my school years when it seemed that all we did around Kinnordy was clear up
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the damage of the 1953 hurricane. Even at the time I left school, at the time of Suez and Hungary in 1956, we were still clearing up and trying to level out before we even started thinking of replanting.
Schedules B and D of the tax tables were part of my bed-time reading both as a forester and inhabitant of Angus as well as an aspiring member of the chartered accountants of Scotland. But in 1966 we were able to go ahead with some major planting. I am not sure of the acreage. I am told it was 47 hectares of Sitka, spruce and larch. In those 27 years we have noticed a doubling of the roe deer population and a trebling in the number of foxes in the area. However, it seems that we have done our bit for nature conservation. This year we planted close on 40 hectares of hill land, but under new regulations, which we have had to obey, for spacing and for percentage of hardwood, at the same time taking care of an old Pictish settlement. Nevertheless, we did not use military, regimented square blocks. We have what I hope will be a lasting monument to what can be done in mixing both silviculture and nature conservation as well as conservation of birds and wildlife.
My noble friend Lord Addison, in a notable maiden speech, mentioned amenity planting. We seem to have achieved harmony as regards broad leaves with the various planning authorities who sought to guide us in our activities.
Your Lordships will be aware that 1984 was the year of George Orwell. It was also exactly nine years ago today that my noble friend the then Prime Minister suggested that I go to Northern Ireland to administer its Department of Agriculture. That department was responsible for forestry operations. I recall four figures that were dinned into my head day and night. Indeed, they have been referred to by the noble Lord, Lord Taylor of Gryfe. I was advised that Northern Ireland's afforested land was 5 per cent.; in Great Britain—England, Scotland and Wales—it was 9 per cent.; in the Federal Republic of Germany it was 24 per cent.; and in France, 24 per cent. The noble Lord, Lord Taylor of Gryfe, has updated those figures. For goodness sake, Great Britain is 10 per cent; the Federal Republic of Germany, together with what I presume is the former East Germany, is 30 per cent.; and France is 27 per cent. They are therefore pulling ahead of what we are doing.
The thrust of today's debate is to encourage whatever methods are necessary—private or public —to close the gap. If there is one thing that my noble and learned friend can do it is to take the message to his right honourable friend the Secretary of State to encourage reafforestation, private or public, but to do it.
One of my noble friends mentioned all kinds of activities that may take place in forests, among which he included cemeteries. I looked at the noble Lord, Lord Taylor, and perhaps a monument to him may be there. But my noble neighbour Lord Mackie will be aware that not a mile from his house there is a beautiful cemetery, the Piper Hillock cemetery in a little forest glade in Cortachy. So it is mentioned in your Lordships' House, and we have it in Angus!

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Before I came into your Lordships' House I was given a leaflet referred to by the noble Lord, Lord John-Mackie, regarding the farm woodland premium scheme in Scotland. I mentioned earlier that I had the honour to serve in Northern Ireland and I know that occasionally Ministers make decisions which they later regret. If what the noble Lord, Lord John-Mackie, said is true, perhaps he will consult the little red book which is next door to the noble Lord, Lord Carmichael. If he consults St. John's Gospel Chapter 8, verse 7, he will see that it says,
"He that is without sin … let him first cast a stone".
I shall not do that. My time is up. However, I will repeat the figures: 5 per cent. now 10 per cent.; the Federal Republic of Germany, 30 per cent.; and France 27 per cent. If my noble and learned friend will encourage the forestry industry, public or private, to close that gap, then our message will have been heard.
7.29 p.m.
Lord Lucas: My Lords, I should like to use the opportunity very kindly provided by the noble Lord, Lord Taylor of Gryfe, to argue for increased and co-ordinated government support for users of low grade hardwoods. The opportunity, and indeed the need, is clear. There is a vast amount of such material —large areas of unmanaged woodland that were ravaged in the two world wars; thinnings from commercial forestry; and old coppices. There is very little market for most of it and the consequence is dereliction and decay. It is much more efficient for the Government to support an industry, where 10p of government support might buy £1 of work, than to support a landowner, where one would have to pay him at least £1 to do £1 of work.
There are three industries at or near market which might make use of this material. First, there is charcoal. We import most of our charcoal from South East Asia, which must add to the forest devastation there, but some of it comes from the United States and Spain, which shows that a charcoal industry can be successful in the developed world. There are some small charcoal companies in the UK but, by and large, the industry is fed from imports. There is much interest in the Forestry Commission in introducing new charcoal businesses—the Anglian Woodlands Project comes to mind—but much further help is needed in kiln technology, in the training of the workforce, in helping to co-ordinate the marketing of charcoal produced by many small producers and perhaps through some initial grants to overcome the bad infrastructure.
Secondly, there is power. The Energy Technology Support Unit of the DTI has demonstrated some successful uses of timber in heating where there are local sources of such timber. There are some encouraging figures on the costs of the operation. It now has a project called Borders Biofuels which is intended to generate electrical power from willow coppice and waste wood chips. The project is at a stage where what is needed now is government action, first, in sorting out their position under the non-fossil fuels obligation, and, secondly, in sorting out their position under set-aside. It will be crucial to use set-aside land
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for willow coppice. Once that is done, as I am sure the Government will manage to do, a demonstration plant will need to be funded.
Lastly, there is the industry in wood chips and pulp. It is at present the only established user of low grade hardwoods. Most small mills have disappeared. There are two or three large users left, for which a new line would cost perhaps £25 million. However, this would be a major contributor to the uses of such timber because it would absorb about 200,000 tonnes a year. At the moment we appear to be losing such new industrial projects to Europe because they receive better grants. That appears to be because the grants in this country take into account only the employment in the mill and not the employment in the forestry needed to feed that mill.
What we need now is a co-ordinated commitment by government —the one-stop shop approach mentioned in the excellent maiden speech of my noble friend Lord Addison. We need that because so many aspects of government are involved in forestry. There are so many spin-offs in different areas; for example, in employment. Employment in the forestry industry is often appropriate for people who are very hard to employ elsewhere. If one is prepared to sit out all night watching a charcoal kiln one is probably not someone who will enjoy an office or shop job. It is important for the balance of payments, which has been mentioned many times. It is important for the non-fossil fuels obligation and for the environment, let alone for forestry. It is a very efficient use of the Government's money to support a user industry rather than just the work in the forest.
The commercial opportunities are at a critical stage. They seem marginal at the moment because of the high uncertainty —there are no existing businesses that can be drawn on for comparisons—and because of the lack of infrastructure in this country for using low grade hardwood timber. They need impetus, demonstration projects and solid support from the Government. If they have that, we may well see the establishment of new industries which in due time can be weaned off government support.
7.34 p.m.
Lord Jeffreys: My Lords, I too thank the noble Lord, Lord Taylor of Gryfe, for bringing this debate to the House and congratulate our two maiden speakers on their excellent contributions.
In the limited time available I should like to refer to the environmental and recreational benefits of forestry in Britain today. I link these two important areas because, for an increasing number of our people, the pleasure gleaned from visiting our woodland areas is in direct relationship to the environmental benefits that are seen to be at work there.
It is a fact of life that accountability, either corporate or political, necessitates that forestry be managed in a cost effective way. There are, of course, two major problems. First, cost effectiveness does not always work to the benefit of the environment; and, secondly, in an industry where time scales can be very protracted, who can really predict what will be commercially viable in, say, 40 or 50 years time?

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I believe that some of the financial risks involved in forestry projects can be stripped out through a greater degree of public participation, at local level, in forestry planting or conservation projects. Perhaps tax breaks could be given to individuals who are not landowners but who wish to invest in local forestry projects and collective planting schemes. That in its turn might allow for a less intensive approach.
As an excellent example of public participation, often at a local level, I commend to your Lordships the work of the Woodland Trust, which, through its 150,000 subscribers, has been able to purchase and manage a number of important tracts of vulnerable woodland around the country. Multi-purpose forestry must be encouraged. Increasingly it is recognised that the commercial viability of forestry is not limited to its eventual timber value. Recreational value can also play a major part. In particular, I am thinking of the period between planting and maturity when funds are required for active management.
The Forestry Commission, along with other commercial growers, has been accused in the past of environmentally damaging policies, particularly with regard to the intensive planting of conifers. I fully support the much greater move that has been seen in recent years towards the planting of native hardwoods. Our climate is much more suited to this type of woodland and of course it does have a greater environmental and recreational appeal. That has very much been taken on board by private landowners, albeit through changes in the grant system. The Government would do well to give that a further boost perhaps through the abolition of inheritance taxes payable on woodland areas, particularly those that give access to the public.
One of the most important by-products of the Forestry Commission's activities is its granting of public access. Whatever happens to the commission it is vital that these rights be maintained. We live in a small, densely populated country with intense recreational demands. If the commission is privatised then problems of access will undoubtedly be raised. On balance, therefore, I am for its retention.
I should like to see forestry policy being co-ordinated at a much more local level. I see no reason at all why a series of "privatised" woodland ares could not be created with priority rights for local shareholders. I would even suggest that the public might be prepared to pay for the use of these parks either through a shareholder scheme or perhaps via a membership format. That would enable a more "user friendly" planting policy and ensure public access in the years to come.
Lastly, I should just like to say a word about set-aside. I am one of those—and this includes many farmers—who find it difficult to accept that any business should be paid to do more or less nothing with a portion of its assets, although I accept that in some respects food production is a special case. Would it not be possible to permit, say, 10 or 20 per cent. of the rotational set-aside to be put over to the planting
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of permanent woodland? I understand that that needs to be tackled at European level, but perhaps my noble and learned friend can give me some guidance on that.
7.40 p.m.
Lord Burton: My Lords, I too congratulate the two maiden speakers and express my deep gratitude to the noble Lord, Lord Taylor of Gryfe, upon having initiated the debate.
If one looks at the history of the country's forestry, one finds a general drift from one extreme to another. First, our woods were devastated by the two world wars. There was then the Schedule D phase, which was ruined by the abuse by forestry companies where excessive areas of sitka and contorta were planted, sometimes by greedy pop stars. The countryside is now bedevilled by poor prices for our timber and by a desire to placate the often mistaken views of our urban dwellers. Forestry is being treated to the same nonsense as the farmers with regard to form-filling bureaucracy, dictation from planners, health and safety regulations and so-called conservationists, ramblers and the like who frequently know little of what is best for the countryside, let alone forestry, and certainly know nothing of rural economics.
I know of several instances where forestry has suffered from wrong decisions by these people, but time does not permit me to quote them today. Harvesting woods is a major problem. It does not seem to be appreciated that forestry depends on harvesting crops. A farmer would not be told that he could not cut his wheat or his barley because it looked nice waving in the breeze, but a forester is told that he cannot cut his crop which he has matured over many years because that might spoil the scenery.
Now that Schedule D tax recovery has mistakenly been removed, we are at the mercy of complicated grant schemes. However, when one such scheme is having the desired effect and is being successful—I refer to the farm woodland grant scheme—we are told today that the money has run out for the scheme in Scotland. That is a sobering thought. It is the one grant that has really been taken up. I should like to know from my noble friend how long we shall be without it.
Let us take another example. The top amount of grant is not available if any softwoods are planted. That seems ridiculous. The situation presumably arose out of complaints from environmentalists about the blanket planting by forestry companies in Caithness and Sunderland of contorta pine. However, one of the best methods of growing hardwoods is to have a nurse crop of Scots pine to push up the hardwoods into nice, clean stems. Anyone who has seen mature hardwoods in the snow will know what cold, draughty places they are. Can woods with no evergreens be the best environment for wild life? Surely it is better to have a mix with some softwood to provide roosting for birds in the new plantation.
There is increasing pressure for more access to the woods of the country. But a large proportion of those already taking access use the opportunity to exercise their dogs. Woodlands will absorb considerably more human beings than the open hill, but some control

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over dogs must be available. The harassment and pulling down of deer by dogs being exercised in the woods is substantial around urban areas. Our last surviving hen capercailzie has now left us. She tried to nest for three years and was put off her nest every time by dogs. The forest enterprise receives a recreational grant but the private sector has no help in catering for the public.
Why is the forestry enterprise being allowed to fell plantations which are at the first thinning stage? I gather that the Audit Commission, whose report is shortly to be published, has strongly criticised that practice, which has cost the country millions of pounds. A committee in another place has recently queried the practice. It has been told that the intention was to bring plantations into a more even age classification for environmental reasons. I maintain that that is no excuse. Yesterday I drove from Inverness and passed what used to be well grown plantations which have now reached their first thinning stage. I was horrified to find that instead of thinning, large chunks had been cut out of the plantations, letting in the wind, which has already blown down a considerable number of the remaining trees.
When the Audit Commission has already criticised the practice, why is the vandalism being allowed to continue? Are the Government and forest enterprises so frightened or influenced by the environmental lobby that they can no longer do the right and sensible thing? Are the Government prepared to see millions of pounds of public money being thrown away to please that lobby?
7.45 p.m.
Lord Mackie of Benshie: My Lords, the majority of people have kept to their time well. I might therefore take an extra minute but no more. There is no need for me to thank the noble Lord, Lord Taylor of Gryfe, for initiating the debate. When he drew the ballot, nothing would have stopped him. In fact one could not have got him to talk on anything else. However, I do congratulate the two maiden speakers. Without any disrespect to the excellent speech of the noble Viscount, Lord Addison, it is good that the noble Lord, Lord Barber, has broken his duck and that we shall now hear him on many occasions in the House.
It has been an interesting debate with one common theme: that the Government must do better. If the Minister will permit me to say so, the Government need to do better. The 1988 change in taxation was an unmitigated disaster. I understand that they are now putting that right. Noble Lords have quoted the figures. From 20,000 hectares privately planted, the figure came down to under 9,000. Therefore the Government have a great deal to put right. I trust that they are facing up to the position with their far from customary zeal.
The withdrawal of the farm woodland grant scheme in Scotland seems extraordinary. Has there been such an enormous take up that the Government could not stretch the money a little? No doubt the Minister will tell us when he replies.
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During the past week I have talked to farmers and foresters. It seems extraordinary that despite representations from the Country Landowners' Association, the Government still insist on compart-mentalising the taxation on different enterprises in an estate. It is quite ludicrous that if one has a good year with regard to grouse one cannot put that against an enterprise on which one makes a loss. Surely a Conservative Government should consider the issue so that the large estates can balance one enterprise against another.
If one is lucky and makes a good job of it, at best the return on money is about 2 per cent. One needs to be a dedicated man to accept such a return when one could certainly put the money into the Alliance Trust in Dundee and guarantee that one's heirs would be extremely well off even paying 40 per cent. taxation. We need some consistency from the Government that they will maintain the advantages. There is nothing better than bribing a rich man to expand the assets of the country, both for the beauty and for the wealth of the country, the control of imports and so on. But the position has to be consistent; otherwise the device does not work. That was exactly the position in 1988: it was not maintained consistently and it did not work.
About 40 per cent. of the land in Britain is still owned and operated by large estates. The figure might be a little lower or a little higher. About 60 per cent. is owner occupied. Much of that will be in fairly large blocks which could tackle forestry in a logical manner. There are therefore two factors. A great deal of propaganda needs to be put out about the present grants. A speaker has already made the point about indexation of grants. With luck and good management, if the grants will be available in the future, with tax advantages, an excellent investment could be made by a farmer or owner. A good deal of work needs to be done on this issue.
Again, the Government made a total mess of getting outside money into the industry. There is no reason on earth why Terry Wogan should not put money in. The great fault was that the people doing this and taking the money were trying to plant in impossible areas. In fact, the whole thing was badly done. Everybody knew that it would never work in parts of Caithness. That is why we need the Forestry Commission. Because those concerned were not taking the grants but were doing it out of income, they needed only a simple licence, and the Forestry Commission did not vet the sort of planting that they were doing or the land that they were planting on. That is one reason why we need the Forestry Commission.
If the Forestry Commission is to be a good advisory and administrative body, it needs to have its own estates well managed (they could be criticised by everyone, including the noble Lord, Lord Burton), but if it is relegated to being an advisory body only, it will not carry the necessary weight. Therefore, it is vital that the Forestry Commission is kept in national ownership. I trust that the Minister is listening closely to his noble friend Lord Marlesford and others and ignoring the doctrinaire advice of the noble Lord,

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Lord Wade of Chorlton. The Forestry Commission is necessary for the well-being of the industry, and I trust that the Government will continue to think so.
7.51 p.m.
Lord Carmichael of Kelvingrove: My Lords, I should first congratulate the noble Viscount, Lord Addison, and the noble Lord, Lord Barber of Tewkesbury, on their maiden speeches. Both showed that they are well informed about the subject, perhaps in slightly different ways. They added to the quality of the debate, which is not always the case with maiden speeches. I certainly learned a great deal from them.
I congratulate also my noble friend Lord Taylor of Gryfe on initiating the debate. It has excited a great deal of interest outside the House. I have received many briefs from extremely good outside bodies. It is only fair to mention that they include the Scottish Wildlife Fund, Countryside Link, the World Wide Fund for Nature, the Royal Society for the Protection of Birds, and the Countryside Commission. Perhaps most of all I am grateful for the excellent report on forestry produced by the House of Commons Select Committee on the Environment. It is a pity that it dealt only with English forestry. However, as the report states, the committee's remit is the environ-ment. It could not therefore consider Scotland and Wales: it had to confine itself to England. Perhaps that could be considered in any future reconstruction of Whitehall. We may need a national body to look after rural affairs instead of proceeding as we do at present.
I spent a large part of the recess reading those reports and enjoyed the experience. However, given the short time that is allowed to me in this debate, perhaps I should put my reading of those reports and the excellent speeches that I have heard down to self-improvement.
Tax relief has been mentioned a number of times. As has been said, the 1988 Finance Act ended a tax incentive which, whatever else it did to forestry, was ultimately very badly received by the public. Perhaps that was because of the bad publicity it received. In a debate on 20th March 1988, when explaining why the incentives were being discouraged, John MacGregor said that he was meeting the public's desire that such a scheme should be stopped.
Perhaps the woodland grant scheme should be looked at again to see whether it is adequate to meet the increased plantings we need. That is a more honest way to run our forestry. It has the advantage that the proper choices of tree species can be planted to suit an overall forestry strategy. Under the old tax relief scheme, there was a feeling that there had to be quick returns, which obviously did not help a good forestry strategy.
A number of noble Lords have referred to the fact that the Scottish farm woodland premium scheme has been suspended. My information is that it has been suspended only until October this year. But why only in Scotland when one considers that new plantings are at their lowest levels for 40 years and that forestry is normally funded on a Great Britain basis? Surely, government policy is to encourage farm woodlands as
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a means of reducing agricultural overproduction. EC policy to encourage farm woodlands allows national governments to be reimbursed a proportion of the farm woodland grant schemes. Scotland is the only region among all EC member countries where the farm woodlands policy appears to show some sign of working. It would be to everyone's benefit and in everyone's interest if the Minister could explain why the scheme applies only to Scotland.
I turn to the subject of access. I was very pleased to note that noble Lords who have spoken, all of them very knowledgeable about forestry, have with one exception agreed with the idea that one of the benefits of a national forestry policy should be wider public access to forests. If the public have paid for grants —I am not objecting to that because there must be grants for forestry—the public should then have certain rights of access.
In a Written Answer on 30th March the Secretary of State for Scotland said:
"We have established a small group of officials, with representatives of the Treasury," —
that is always ominous—
"Ministry of Agriculture, Fisheries and Food, Welsh Office, Department of the Environment and the Forestry Commission, under Scottish Office chairmanship, to review the effectiveness of the current incentives for forestry investment, to review options for the ownership and management of Forestry Commission woodlands and to make proposals for changes which would improve the effectiveness of the delivery of the Government's forestry policy objectives, having regard to the Government's other economic and environmental policies".—[Official Report, Commons, 30/3/93; col. 150.]
Is that a preliminary step to some big privatisation of the Forestry Commission? The general consensus among noble Lords who have spoken today is that we need the Forestry Commission. Would it not have been better if a statement such as that had been made publicly in the House?
This has been a most interesting debate. Perhaps I shall spend a few days reading up on it before I forget all that I have learnt in the past couple of weeks from the very good briefings that I have been given. It would be helpful if the Minister could enlighten the House on a number of points that have been raised, not only by myself but, much more pertinently, by many others.
8 p.m.
The Minister of State, Scottish Office (Lord Fraser of Carmyllie): My Lords, in responding to the debate it falls to me, initially, to congratulate those who have made their maiden speeches. First, I add my congratulations to those given to my noble friend Lord Addison on a constructive, eloquent and clearly knowledgeable speech. I extend the same congratula-tions to the noble Lord, Lord Barber of Tewkesbury, who brought to the debate a wealth of experience and, without being controversial, introduced a refreshing balance of perspective to a complicated debate. I hope that it will not be another two years before they have the opportunity to contribute to a forestry debate. I appreciate all too well how frustrating that has been for the noble Lord, Lord Taylor of Gryfe, who secured this debate.

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As the noble Lord observed during the debate on the social and economic needs of rural areas on 3rd March, he has been waiting for two years to have the debate. The debate has come at an important time, when internationally forestry has a higher profile than it has ever had, following the Rio conference. And, closer to home, it has come at a time when the Government have recently announced their intention to look into ways of improving the effectiveness of their forestry policy. It is therefore desirable that such a debate should take place in the House.
Anyone who has listened to all or part of the debate, or reads all or part of it, cannot fail to be impressed by the depth of knowledge on this important matter which resides in your Lordships' House. The noble Lord, Lord Taylor of Gryfe, is well versed in the subject having at one time, as have other noble Lords, been an eminent chairman of the Forestry Commission. That he still keeps his finger on the pulse is shown by the fact that in his opening speech he voiced a number of concerns—concerns which have been echoed in the House by many noble Lords during the debate.
I can understand those concerns, but I certainly do not share the pessimistic outlook which some noble Lords have displayed. We believe that the forestry industry in this country has an excellent future. The most satisfying consensus reached during the debate is that we in Britain continue to need to plant more trees. It continues to be our policy to encourage the expansion of woodland cover in Great Britain for the many diverse benefits that forests provide. That policy is based upon the realisation of multiple objectives. The noble Lord, Lord Barber, I think it was, said that the leopard has changed its spots. It is perhaps unfortunate that in the way that he meant it that is not yet a matter of as wide a public appreciation as it might be.
I accept what the noble Lord, Lord Taylor of Gryfe, said about the possible long-term effects on wood processors if new planting levels remain depressed. But I am sure that he would be the first to acknowledge that we cannot, and should not, take a short-term view of forestry. Although we may have started from a low base, as a nation we have done more than any other country to build up our forestry area. We have doubled our forest area over the past 70 years. Nearly 250,000 hectares of new forests have been created over the past decade alone, mainly by the enterprise and initiative of private owners. I am grateful to my noble friend Lord Lyell for making his small contribution to the improvement of the braes of Angus.
We shall continue to build upon those resources in the future. A number of noble Lords referred to the effect that removal of the tax reliefs for forestry had on new planting levels in the private sector and on the ability of traditional woodland owners to offset maintenance expenditure. A number of your Lordships pointed to the fact that the five-year transitional period for existing woodlands ended recently.
The removal of forestry tax reliefs was done with the best interests of the forestry industry in mind. It
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was doing the industry no good to be seen merely as a tax haven, not just in terms of the public perception of what the industry was about but in the way it worked. The changes made in 1988 and subsequently have put the industry on a much sounder and more acceptable footing. The removal of tax reliefs was matched by a substantial rise in grant levels under the woodland grant scheme. They are substantial. They range from £615 per hectare to £1,575 per hectare. We have made important improvements to the grant system over the past five years. In some cases we have improved it, and will do so increasingly, by simplifying the forms to be used. In 1988 we introduced a better land supplement of £200 per hectare to encourage more planting of better quality land. That may not meet with the approval of my noble friend Lord Mountgarret, but we believe the right trees on the right sites mean that better land on lower levels can be better used. That should encourage more planting on that better quality land.
In 1990 we increased the value of that supplement to £400 per hectare for conifers and £600 for broadleaves. In 1992 we introduced management grants to encourage the positive management of woodlands and forests by a special, higher rate of grant for woodlands of special environmental value. Also in 1992 we introduced a community woodland supplement of £950 per hectare for establishing new woodlands open to the public and within easy reach of towns and cities. Again, if there was a consensus in the debate its purpose to encourage planting on the urban fringe, adding to the amenity and to the overall amount of planting in this country, seemed to be accepted. We have taken initiatives, to which there was some reference, to create major new forests in the English Midlands and the central belt of Scotland.
Our policy for broadleaves, introduced in 1985, has resulted in big increases in broadleaved planting. In 1985, the total broadleaved planting totalled less than 2,000 hectares. By 1992, this had risen to 11,000 hectares. Our native pinewood scheme in the Highlands of Scotland encourages owners to manage their existing valuable remnants of native pinewoods and to create new ones to emulate the native pinewood ecosystems. In just four years the area of native pinewoods has increased very significantly. We have therefore taken steps to target the forestry incentives to deliver our forestry policy objectives.
Let me be quite clear, however, that I share the disappointment expressed by noble Lords that the level of new planting continues to be depressed. In many ways that was only to be expected, given the re-adjustments being asked of the industry. However, we must also bear in mind that the general economic climate has not been conducive to encouraging investment in such a very long-term business as forestry. Given the economic backdrop, it is encouraging that landowners are planting as many new woodlands as they are.
The Government acknowledge the concerns of many—inside and outside the forestry industry—that not enough is being done to encourage the planting of the right trees in the right places and for the right reasons. We have a manifesto commitment to look at

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the incentives for planting. In pursuance of this, my right honourable friend the Secretary of State for Scotland announced before Easter that he had set up a working group of officials charged with reviewing the effectiveness of the current incentives for forestry investment. We are anxious to see that the best possible use is made of limited public funds by concentrating our efforts where they are most needed. The review will be completed by the end of the year. It will take account of the many concerns voiced by my noble friends Lord Swinton, Lord Radnor and Lord Marlesford and the noble Lord, Lord Geraint. As it reviews the incentives, the working group will be looking at a number of the tax issues that have been mentioned.
The noble Baroness, Lady Nicol, raised a number of detailed points with regard to evidence and consultation. It is still early days in the analysis to be done by the working group, but consultation on some issues is a distinct possibility. I can confirm that the management of existing woodlands will be covered by the review and that wildlife and conservation are, and remain, an integral part of our forestry policy.
The working group has also been asked to review the options for the ownership and management of Forestry Commission woodlands. The noble Lord, Lord Taylor of Gryfe, and other noble Lords referred to that. In view of the opinions expressed tonight on the Forestry Commission perhaps I may make it clear that there is no predetermined outcome of the review. I say to my noble friend Lord Wade of Chorlton that obviously a number of proposals might come forward. In addition, a number of sensitive issues have been touched on; for instance, access to Forestry Commission woodlands. Clearly those must be addressed in the context of the review.
We have stated on many occasions that there are no present plans for the privatisation of the Forestry Commission. That remains the case. However, noble Lords will be aware that all activities of government are being reviewed and this examination is part of the process. I heard the contributions of the noble Lord, Lord Gibson-Watt, and other noble Lords indicating their hostility. But I repeat that there is simply a review without a predetermined outcome.
In looking at the incentives and the commission's holdings, the working group's remit is to make proposals for change which will improve the effectiveness of the delivery of the Government's forestry policy objectives having regard to their other economic and environmental policies. The movement of Forest Enterprise to the private sector is not ruled out but neither is it a foregone conclusion. If changes are proposed as a result of the review the nature and timing will be decided by the Government with the aim of serving the best interests of British forestry.
A number of references were made to the desirability of encouraging greater planting on agricultural land. The Government are certainly keen to see that as a means of taking land out of agricultural production. The farm woodland scheme which was introduced in 1988 has produced more than 11,500 hectares of new planting on farms. It has sowed
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the seeds and has encouraged farmers to talk about trees on farms. It was replaced last year by the farm woodland premium scheme which has higher grants and is simpler to understand. It has made an excellent start, with applications so far totalling some 10,000 hectares.
A number of queries stemmed from an announcement or an understanding that a particular scheme in Scotland has come to an end because the money has run out. I am pleased to say that the scheme in Scotland was particularly successful. All that I can say to noble Lords at present is that we are currently considering whether it will be necessary to close the scheme to further applications for the rest of the year. As I understand it, planting will end by the end of next month. However, if such a step has to be taken it will not be taken lightly. We must ensure that sufficient resources are available—
Lord Carmichael of Kelvingrove: My Lords, will the Minister—
Lord Fraser of Carmyllie: My Lords, no, if the noble Lord will allow me, I have little time to answer 23 contributions. I wish briefly to refer to matters raised by my noble friends Lord Lindsay and Lord Addison with regard to tree planting in relation to non-rotational set-aside. The European Commission has not yet decided whether tree planting will be an option on land set aside as part of the farmers' obligations under the new EC arable regime. However, I hope that I can reassure the House without difficulty that the Government will continue to press strongly for such woodland planting to be an acceptable option. We are grateful for the indications of support given to that approach.
The wood-processing sector has invested some £1 billion in new processing plant during the past decade. The new mills and plants incorporate the very latest in new technologies in paper-making, panel production and saw milling. I listened with interest to alternative proposals; for instance, those put forward by my noble friend Lord Lucas with regard to low-grade hardwoods. Wood production from new forests created this century has doubled since 1970 and is set to double again during the next 20 years. As has been said, our timber is of high quality and is in demand by our domestic wood-processing industries. All that has been made possible by that doubling.
After years of restricting woodlands to the poorer soils of the uplands we now have policies in place to encourage the creation of woodlands on better land. We have measures to encourage the development of community woodlands. New opportunities are opening up for the planting of broadleaves and mixed woodlands and in Scotland native pinewoods.
The debate has been long and complicated. I appreciate that a number of specific questions were asked but during the time available to me I have not had an opportunity to answer in detail. I shall scrutinise in Hansard what has been said and where I can identify particular questions I shall ensure that replies are received by noble Lords. I conclude by thanking the noble Lord, Lord Taylor, for introducing the debate. I also thank noble Lords who

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contributed for showing a real expertise and, more important, a great concern for the future of the forestry industry.
Lord Taylor of Gryfe: My Lords, I thank the Minister but I am sorry that his commitment in relation to privatisation and other issues which have been raised was not as concise as I had hoped. Nevertheless, I am sure that he was impressed by the views expressed in the House, in particular by all the practising foresters who stated them so clearly.
I also thank all noble Lords who participated in the debate. Most of them travelled long distances and arrived in the House only to discover that they had five minutes to speak. I admire their discipline in observing the five-minute rule, during which time they were able to make their anxieties well heard. The message is loud and clear—that foresters in this country want, first, expansion and, secondly, the partnership between the private sector and the state sector to be maintained. I hope that the Minister has received that message loud and clear. I believe that all noble Lords on all sides of the House have conveyed the message in no uncertain terms. I beg leave to withdraw the Motion for Papers.
Motion for Papers, by leave, withdrawn.

Selected List Prescribing Scheme: Extension
8.18 p.m.
Lord Hacking Lord Hacking rose to ask Her Majesty's Government what effect the extension of the selected list scheme will have on the attainment of targets contained in the Health of the Nation White Paper, especially in relation to mental illness.
The noble Lord said: My Lords, on 12th November last year the Government announced their intention to extend the selected list scheme, which was originally implemented in 1985 for seven therapeutic categories of drugs, to a further 10 therapeutic categories. These include drugs for the treatment of, for example, anxiety and mental illness, skin diseases, women's vaginal infections and contraceptives.
As with the earlier selected list scheme, the intended result is substantially to reduce the number of drugs in these categories which will be available for prescription under the National Health Service. Altogether some 549 drugs are affected. The Department of Health is not only the regulator of the United Kingdom pharmaceutical industry but it is also effectively the monopolistic buyer of its goods. Therefore, the immediate impact of the measures will fall upon the pharmaceutical industry. It will be serious —very serious—for the industry. The net sales of those 549 drugs to the NHS amount to about £450 million per annum. Therefore, it is estimated that the reduction in volume of those sales is likely to be in the region of £250 million to £300 million; in other words, sales will be lost to the industry to that degree.
According to a survey carried out by the ABPI from answers received from 46 out of 65 companies, consequential job losses to the industry will be in the region of 3,000 people and there will be a cut-back on
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capital investment in the UK in the pharmaceutical industry of up to £400 million in production and/or research and development. The impact on some companies will be quite devastating. It affects some companies to the degree of 47 per cent., 64 per cent. or 83 per cent. of their total sales. Indeed, five United Kingdom companies whose sales will be affected by up to 100 per cent. literally face extinction.
Serious harm must also be contemplated for overseas companies manufacturing and/or selling their products in this country. There are also serious implications for the United Kingdom economy. The pharmaceutical industry's exports are currently just under £3 billion per annum with a surplus of exports at about £1.3 billion. The pharmaceutical industry is second only as an exporter to the power generating machine industry and is ahead of the oil industry with all its fields in the North Sea. Therefore, who can doubt that the result will be a significant drop in the inward investment into the United Kingdom for one of our prime and most successful industries?
It has been, and is, particularly difficult for the pharmaceutical industry because, as openly stated by the Minister of State in another place, these measures were announced without consultation and without warning. The industry asks, "Are we not meant to be working in co-operation with the Government on the PPRS scheme and elsewhere? Are we not meant to be working with the Government in the interests of patients?" It asks also, "What next?"
In my years in your Lordships' House, particularly during the past 10 years when I have involved myself in matters concerning the pharmaceutical industry, I have never known that industry to be more upset. I am anxious to get on with my speech but I could quote to your Lordships a letter that was written by the chairman of one major pharmaceutical company to the Secretary of State in which he expressed anguish at the decision.
It is often said that the industry is profitable and prosperous and that cries from it are cries of wolf. Perhaps I may cite what has happened to one company at the time of the last selected list scheme in 1985. After development costs of about £75 million, it produced a drug which was able to treat both anxiety and depression. In 11 months it achieved a 6.2 per cent. share of that sector of the United Kingdom market. It was then black-listed at the stroke of a pen. I should add that in the meantime, outside the United Kingdom, that particular drug became a world leader.
I cite also what happened in Canada since it adopted some 20 years ago a cheap drug policy. It moved from being a net exporter to a net importer of pharmaceuticals and almost entirely lost its R&D industry. Perhaps my noble friend will come with me to the end of the story of the little boy and the wolf because it is my recollection that at the end of the story there was a wolf and it is my further recollection that, in the rather macabre account of that tale, the wolf ate the little boy.
I put on record the position of the pharmaceutical industry because I believe that it is right to do so. The serious impact of the selected list scheme should be a matter of grave concern to us all. However, the greater

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question which we are debating this evening is the impact which the selected list scheme, as now proposed in its extended form, will have on the Government's own policies.
Again, as openly stated by the Minister of State in another place, this is a cost-cutting exercise. Pharmaceuticals account for about 10 per cent. only of the total NHS budget but, quite rightly, the Secretary of State is entitled to look for cuts in costs where it is proper to do so. No part of public expenditure should be immune from cuts. Her Majesty's Treasury should not be treated as, or seen as, the Devil. It acts ultimately on our own behalf.
That brings me to the Health of the Nation. That is an excellent piece of work for which profound congratulations should go to my noble friend and her colleagues in the Department of Health. It sets out an excellent strategy with clear and obtainable objectives. We are also brought to the central and sound policy of this Government, which I fully support, to shift where possible patient care from secondary and more costly hospital care to primary care by general practitioners. For example, I refer to the King's Fund Report on London health care and to the Tomlinson Report, which we debated recently in this House and to Making London Better, the Government's response to the Tomlinson report in February of this year.
However, the inevitable and proper result of that shift to primary care is an increase in the drugs bill because drugs represent the main and less costly means of treatment by GPs. Therefore, the question is whether that extension of the selected list scheme can be achieved without adversely affecting, in the words of the Secretary of State in her announcement on 12th November last year,
"Patients' ability to receive the medicines they need when they need them and for as long as they need them".
The Government believe that that can be achieved. Almost all of those who wrote to me believe that it cannot be achieved. The National Eczema Society wrote to me about the 11.6 million sufferers from eczema and dermatitis. The letter said:
"For many patients a long process of trial and error has been involved before finding the right product for their condition. Unlike tablets and other systematically administered forms of drugs, topical formulations cannot readily be compared with, or substituted for, one another".
I received a letter from the Birth Control Campaign, which wrote to me about the use of contraceptives prescribed in the Well Women's clinics and the difficulty of finding the appropriate contraceptives with acceptable side-effects. The Royal College of Nursing wrote to me about contraceptives, skin drugs and drugs for mental illness. It concluded:
"The RCN believes that the widely endorsed targets set out in the Health of the Nation may be jeopardised by the extension of the selected drugs list. If patients cannot be prescribed products in which they have confidence, patients' compliance will be adversely affected. This may lead to increased morbidity and a subsequent increase in hospital admissions. If the interests of patients are not put first, the reduction of the drugs bill through extension of the selected list may be outweighed by greater costs to the NHS".
I have yet a further example. A survey of GPs reveals
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that 62 per cent. of them believe that under the selected list scheme there will be an adverse effect on patient care.
That brings me to the treatment of mental health —a matter of particular concern to the Secretary of State. I refer to her recent speech to the Royal College of Physicians. It is also a particular care in the Health of the Nation because mental health is one of the chosen targets in that fine document. Yet following in the tracks of the benzodiazepines (used for the treatment of anxiety) appearing in the first selected list scheme, there now appear anxiolytics (which again are crucial drugs for the treatment of anxiety but which do not carry the disadvantages of benzodiazepines—concerning, for example, side-effects, interaction with alcohol and major abuse problems), this despite the noble words in paragraph C.21 on page 90 of the Health of the Nation which advocate "further effort" to find replacement drugs for treatment of mental health. It is therefore very worrying that the Government have chosen this particular health-cutting exercise.
No one who has studied the escalating cost of health care can deny that the Government, as custodian of the health of the nation, are facing a very serious problem. In the footsteps of my noble friend Lord Jenkin of Roding, two years ago I addressed the Federation of European Pharmaceutical Companies. In that address, a copy of which I have given to my noble friend, I quoted the fearful escalating figures of the cost of health care. There is much to congratulate the Secretary of State and my noble friend on achievements in the field of health care. Actually the United Kingdom has done very well and provided better standards of health care at lower costs than almost any other Western country. Yet the National Health Service simply cannot survive into the 21st century without radical changes. In a sentence: the burden will be too great for future generations to bear. The main cause is the fine demographic changes which are taking place that enable all of us, and most particularly your Lordships, to live longer, but to live longer at the greater cost of health care.
What can be done? I shall put forward—and I shall be bold about it—a few ideas. More private prescribing. My noble friend will know that under Section 1 of the National Health Service Act 1977 there is a limitation on doctors prescribing National Health Service patients with private drugs. Indeed, the only exception made for the selected list came into effect shortly after the list came out in 1985. My noble friend will also be aware of the problems of the pharmaceutical surcharge for private prescribing. That is one area that could perhaps fruitfully be looked at.
Perhaps another area which could be fruitfully looked into is the categories of exemptions for National Health Service prescription charges. Why —and I am being bold—are there free drugs for those who can afford to pay for them? Why are there free consultations for those who can afford to pay for them? Further, why are all drugs for the disorders listed treated as exempt well beyond those essential drugs —and I am not quarrelling with that—for the

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treatment of those with say, diabetes? Why not, for example, a separate health tax which matches reasonable income with reasonable expenditure?
Perhaps I may cite France as an example. In that country acute or life-threatening illnesses receive 100 per cent. contribution from the state. Middle illnesses, such as ulcers, receive about a 75 per cent. contribution. But for self-limiting illnesses—for example, colds, flu and so on—there is no contribution from the state.
Finally I should like to speak about the relationship between government and the pharmaceutical industry. It can and does work well. Let us take, for instance, the massive savings to the NHS for the two drugs, both developed in the United Kingdom, for the treatment of ulcers. I know that when my wife was a young doctor, not very far away from here in St. Thomas's Hospital, she can remember that something like three in every five surgical operations were operations concerning ulcers. It was a risky and very costly operation. All of that has gone and has meant a massive benefit to the NHS.
When I was standing in the footsteps of my noble friend Lord Jenkin of Roding at Interlaken in May of 1991 I asked pharmaceutical companies to understand the problems of government. I now ask government to understand the problems of the pharmaceutical industry.
8.36 p.m.
Lord Lovell-Davis: My Lords, I accept that there must be some limit to the number of drugs which may be freely prescribed by GPs and paid for by the National Health Service. As a one-time member of a district health authority, I have always supported moves by hospitals and GPS to prescribe generically whenever practicable and possible.
Much as the pharmaceutical industry may wish to have no restrictions imposed upon its activities, it is simply unreal to envisage a situation in which the NHS has no control over the drugs—many of them grossly expensive—which consultants and GPs are free to prescribe. I believe that any reasonable person accepts that there has to be a limited list. In fact I doubt whether there continues to be serious informed opposition to the present selected list with its seven categories.
However, the 10 new categories which the Department of Health proposes to add to the selected list are birds of a different feather. They are much more significant and far reaching in their implications, not least for the vast number of sufferers concerned. The new categories require much closer and most careful consideration.
It would be interesting to know, in passing, who decided upon the extra categories and by what process they arrived at a decision acceptable to the Secretary of State. Perhaps the Minister can enlighten us. I cannot pretend to have expert knowledge of all, or any, of the new categories listed. But coming from a family prone to allergic conditions and disorders of he skin, I know about the reduced quality of life and the distress that these can cause, particularly to
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children and the elderly. I recognise the need for a properly integrated, often long-term, treatment based on the availability of a wide range of medicaments.
A drastic reduction in the drugs prescribable by the GP for, say, eczema would in no way fulfil the Secretary of State's absolute assurance that,
"patients will continue to receive the medicines they receive for as long as they are needed, under the new measures"
unless, of course, they spend their lives in hospital, face the costly and counter-productive prospect of continually journeying to and from hospital to collect their prescription or buy the whole package privately, a course completely outside the scope of any but the most well heeled. However, perhaps that is what the Secretary of State means.
I shall go no further into the specific implications of the Government's proposals, except to say that, if they are misjudged, those implications could be extensive —affecting the quality of patient care, the cost to the NHS in terms of flare-ups of disease and hospitalisa-tion and the negative impact on the development of new treatments. Unless the outcome of whatever actions follow on the recommendations of the committee, with its extended membership, is very carefully assessed and allowed for, millions of our people who already lack faith in what this Government blandly reassure us will be in our best interest will simply have their distrust confirmed.
As I said at the start of my argument, there has to be some control over the number of drugs that the NHS can afford to, or should, provide. However, as the Secretary of State herself agrees, there has also to be a sufficient range of medicines to meet the needs of patients for as long as they are needed. Frankly, I am getting so used to the double-talk of this Government that I hope I have not missed some underlying and totally different meaning to her words.
Another recently stated government policy for the NHS, with which I wholly agree, is shift of emphasis from hospital to general practitioner care. I take again the example of skin disorders. Many patients need a dermatologist to diagnose and try out different medications. As some may not work for certain patients and may even produce painful allergic reactions, the appropriate treatment can be found only by trial and error. Once a cream which reduces or contains the condition, for instance eczema, has been identified, why should the patient have to keep going back to the hospital when a GP could follow up the case? But there would, of course, have to be sufficient treatments available for the GP to prescribe. Surely such an arrangement would be an important element in developing the seamless care between hospital-based services and primary care which is one of the Government's stated aims.
In drawing up the selected list which may be appropriate for the majority of cases, I hope that the committee will give special attention to accommodating those patients who may need a particular and/or unusual drug but who are not able to pay for it. Surely, when such drugs are prescribed by a hospital physician there should be opportunities for discussion between primary and secondary levels of care as to the best interests of the patient. The alternative is that

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such patients will want to stay with the hospital. That is a very expensive way of providing care and contrary to other aspects of government policy.
When the Minister replies, will she tell the House —the noble Lord, Lord Hacking, mentioned this matter but from a very different point of view—how the Government reconcile their advocacy of shared care between hospital consultants and general practitioners, and agreed protocols, with the extension of the selected lists for GPs?
8.43 p.m.
Baroness Masham of Ilton: My Lords, I wish to take this opportunity to thank the Minister and noble Lords for their kind birthday wishes in the first debate this afternoon. I do not think I would be here today if it were not for antibiotics. I have personal experience of just how important the correct drug can be. The noble Lord, Lord Hacking, has done a great service in bringing this important matter to the notice of your Lordships this evening. Like the noble Lord, I appreciate the difficulty the Government are having in containing the ever-rising costs of the National Health Service. But I, like many other people associated with various groups of patients, share their concern that extending the selected list scheme may be detrimental to many individual patients and to complicated conditions and research.
The debate in the name of the noble Lord, Lord Hacking, is very well timed. The selected list whereby certain medicines in seven therapeutic areas are not reimbursable under the NHS was first introduced in 1985 to contain government spending on health care. The Government, in a further move to curb rising health costs, are proposing to extend it to a further 10 categories, as the noble Lord, Lord Hacking, so clearly said. These new therapeutic areas will be assessed during 1993 by the advisory committee on NHS drugs. I wish to ask the Minister whether evidence can be given by interested parties before the committee makes recommendations to Ministers. This debate will, I hope, alert some people to the fact that this is taking place and they will then be able to put evidence forward.
A prescribed medicine that is not put on the selected list could continue to be prescribed by GPs but patients would have to pay the full cost and many, particularly those on low incomes, might not wish or be able to do so. If sales fall dramatically, a manufacturing company would need to consider whether it would be justified in keeping the medicine on the market. It would be wrong to concentrate on the cost of medicines alone. Many medicines reduce expensive hospital care and can improve the quality of life for patients.
Many GPs are opposed to the selected list extension. I am concerned that patients may suffer if they do not have an adequate choice. Patients and their conditions and response to treatment can be very different. Some patients respond well to a certain treatment. However, some cannot tolerate it and others would not respond but would respond to
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another treatment. As patients differ in their response to treatments, medicine is made much more interesting and challenging but also more expensive.
Before extending the limited list, I think the Government would have been much more popular with patients if they had looked closely at the escalating costs of management, who are not in the direct line of patient care and treatment. For some time I have been president of the Psoriasis Association. I am lucky as I have never been afflicted by a serious skin problem, but I am well aware of both the physical and mental distress caused to those who suffer from such conditions. They need support and advice, which the association gives them. This association fears that if the proposed drugs blacklist goes ahead there will be a decrease in the variety and availability of treatments for this chronic skin condition. Psoriasis is a very individual condition. What suits one person does not necessarily suit another, or indeed that individual all the time.
The emollients and other preparations could be too expensive for many patients to buy over the counter. Pharmaceutical companies could therefore be discouraged from researching and developing new, safer and more cosmetically acceptable treatments. Pharmaceutical companies could also withdraw financial assistance to other research centres.
Now many GPs are finding that when they give several prescriptions to patients who have to pay the prescription charges the patients ask them, "Doctor, which one is the most important because I can only afford one?". Does the Minister agree that conditions such as severe eczema, which often affects children, can be agonising and should be taken seriously? The Minister is helpful and understanding in these matters. The Patient's Charter stresses that patients should receive treatment when they need it. Is that charter being taken into consideration in this matter?
The noble Lord, Lord Hacking, is right to stress the importance of the treatment of the mentally ill. The Health of the Nation has a whole green book on mental illness. There is anxiety among many people that under so-called "care in the community" and with the closure of so many hospital beds those ill people will not receive adequate treatment. Am I not right in saying that in mental illness the balance of the right drugs and the monitoring of their effect on the patient are most important?
With so many patients needing primary health care does the Minister not agree that it is wise to ensure that there is adequate postgraduate training and refresher courses for general practitioners? Many current courses are sponsored by the drug industries, which may not continue to pay for them if the companies move from the British market.
The financial cost of mental illness to industry has been estimated at over £3.7 billion a year. The benzodiazepines which are used for the treatment of anxiety have, one hears, caused many problems of addiction and abuse. It is feared that safer alternatives may be taken off the white list because they are more expensive. Will that be cost-effective in the long run?
There is also a fear that various products especially targeted at women will go. With both the Secretary of

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State for Health and the Minister in this House being women I hope that they will look closely at the well-being of women, who are now often the breadwinners as well as the child bearers.
8.51 p.m.
Lord Jenkin of Roding: My Lords, in the past I have tended to believe that it is right to place constraints on the drug budget in the National Health Service. Indeed, when I was Secretary of State I strengthened the pharmaceutical price regulation scheme and encouraged officials to operate it strenuously. When Sir Norman Fowler introduced the selected list scheme in 1985 it seemed to me a very reasonable step. It seemed wise to substitute generic products for much more expensive branded products provided that that was done carefully and did not lead to the dangers which my noble friend Lord Hacking so graphically outlined for the pharmaceutical industry. However, the more I have studied the effect of introducing the selected list at that time and how it has worked in practice the more I have come to doubt whether it is a sensible measure.
I begin by quoting from an editorial in the professional journal the Prescriber which said:
"It is disappointing that the DoH has not realised that the introduction of the limited list in 1985 had no effect on the ever-rising costs of drugs in the NHS. A study of the graph of the costs of drugs to the NHS over the past 10 years shows very little short-term change in 1985–86 and no change over the longer period".
That seemed to me a disturbing view, so I asked the medical director of the trust of which I am chairman —the Forest Healthcare Trust—for advice. She wrote me a very helpful note in which she said:
"The vast majority of patients were changed to a generic equivalent i.e. an unbranded version of the blacklisted product or to a therapeutic equivalent, i.e. a different drug from the same therapeutic class. The introduction of the Limited List resulted in a short term fall in the number of NHS prescriptions written (and presumably savings on the NHS drugs bill), but this fall has not been sustained and the widespread view is that it was an inconvenience which Doctors have learnt to avoid. In some instances it will have produced an increase in prescribing costs".
That struck me as an interesting and disturbing conclusion.
I asked for further and better particulars and whether the scheme actually led to a rise in drug costs. I have been provided with a note by the pharmaceutical adviser to our local family health services authority. He took the particular example of antacids, which were put on the list in 1985. Before the blacklist, large numbers of branded antacids were available on the FP10. There were 37 brand names, most of which came in two or three formulations. Most cost between 50p and £1 per 100 millilitres. The British Pharmacopoeia products such as magnesium trisilicate and aluminium hydroxide gel all cost less than 20p. The blacklist aimed to cut prescribing of the big selling branded products such as Asilone and to get GPs to prescribe British Pharmacopoeia products. However, the door was left ajar by not blacklisting everything. Some branded products remained available. Those included Maalox and Mucogel, which were combinations of magnesium and aluminium, Actonorm, which is again magnesium and aluminium
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with dimethicone, Mu caine, magnesium and aluminium with anaesthetic, and Gaviscon and Gastrocote, respectively an antacid and alginate for reflux.
When the blacklist was introduced sales of Gaviscon were probably quite small compared with the big selling antacids such as Asilone, Aludrox, Polycrol etc. It cost much the same. However, instead of moving to the cheaper BP products the GPs quickly learnt the names of the branded products that could still be prescribed on FP10 and used those instead. That must have delighted the manufacturers of such products as Maalox, which most people had never heard of until the blacklist and which was no cheaper than the blacklisted products.
The chief beneficiary of all this was Gaviscon because it was the one brand name still available with which most GPs were already familiar. Sales increased dramatically, supported by an advertising campaign which, I am sure my noble friend knows, continues until this day. Eventually the manufacturers of Asilone and some of the other blacklisted products dropped their prices and were allowed back on to the permitted list. Gaviscon was left as the clear market leader with a price far higher than any of the competition.
Whether that entire saga resulted in any change in prescribing expenditure on antacids is anybody's guess. What probably happened was that, first, many people who needed only simple antacids ended up on Gaviscon, a product designed specifically for reflux. Secondly, there was no significant change in the prescribing rates of simple BP antacids because GPs prefer to use brand names unless forced to do otherwise, for example, with diazepam. Thirdly, there was a significant drop in the price of the branded antacids but the unfamiliarity of the brand names combined with the familiarity of the Gaviscon meant that they never achieved the same market shares as those enjoyed by the brand products. The blacklisting of large numbers of familiar branded antacids may have fuelled the growing tendency to use 112 antagonists for even the slightest hint of indigestion. As my noble friend will be aware, those are drugs for the very much more serious condition of gastric ulcers, to which my noble friend Lord Hacking referred.
That was not an isolated case. The same happened with decongestants. Everything except Sudafed was blacklisted, resulting in a bonanza for Wellcome. Sudafed was no cheaper than any of the blacklisted products. The same will be true of the new blacklist categories unless whole categories are banned. To blacklist five out of six topical NSAIDs will simply result in everyone shifting their prescribing to the remaining product, which then has a monopoly.
My noble friend may find that a disturbing story, as I did. The British Government are not alone. That is happening all over the developed world. Governments are picking off the 10 per cent. of their national health costs represented by the drugs budget because that seems to be an easy target. They do not appear to recognise that many drugs prescribed by family doctors are saving far more than their costs by keeping patients out of hospital. The best example was quoted

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by my noble friend Lord Hacking, and I shall quote it again, namely, the H2-receptor blocking agents such as Tagamet and Zantac. One survey showed that those medicines increased drug costs for ulcer patients sixfold but have reduced total treatment costs by 66 per cent. It is madness to pick on the drugs budget if we have an example like that where the invention and prescribing of new expensive drugs saves far more than their cost in keeping patients out of hospital. It is misleading simply to judge matters by the increase in the cost of drugs when the overall saving can be much greater.
I read the other day that the Office of Health Economics has calculated that as a result of the reduction in hospital bed days, savings from seven groups of diseases had amounted to nearly £4 billion a year by 1991. By contrast, the cost of all medicines prescribed in general practice for all diseases in that year was only £3.3 billion.
The overall message has to be that medicines are a very cost-effective way of spending on health care resources. My noble friend Lord Hacking pointed out that new categories of drugs are going on to the black list: for example, anxiolytics for mental health patients. What will happen to the Government's mental health targets in the Health of the Nation? Contraceptives are going on the list, yet the Government have set a target for the reduction of teenage pregnancies. It just does not make sense.
Then there are appetite suppressants. What is the consequence of untreated obesity if it is not the danger of heart disease and many other conditions, as I am sure my noble friend the Whip on the Front Bench knows? She is tempting me to go further but I shall not be tempted.
My noble friend Lady Cumberlege spelt out to me in a letter the very careful steps that the Government are taking before the new black list is drawn up. I hope that they will proceed with extreme caution in this field. There can be no possible justification for black listing if it does not save costs. I have to tell the Minister that from the studies I have made I have no evidence whatever that the figures which Ministers lightly bandy about of savings of, some say, £65 million or £75 million a year have been achieved. There is some evidence that black listing has led to an increase in costs. So when she comes to answer the Question put by my noble friend Lord Hacking, I hope that the Minister will address those arguments because they are causing widespread anxiety in the health service.
9.2 p.m.
Lord Butterfield: My Lords, I rise because I have been informed that the noble Lord, Lord Rea, is unable to be here tonight. I hope that he is not unwell but, if he is, I hope he is in good medical hands. I wish to thank the noble Lord, Lord Hacking, very much for introducing the debate, which is timely. I have just returned from the Far East and was therefore in a position to hear the one o'clock news in Cambridge
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before driving here. Apparently the pharmaceutical industry is among the leaders in increased industrial production over the past three months.
I wish to associate myself with the philosophies expressed right down the line by all speakers until now, which imply that the pharmaceutical industry deserves special protection because it is very successful. The wording of the Unstarred Question links pharmaceutical products with Health of the Nation, to which I shall come in a moment. To start with, perhaps I should declare an interest. The noble Lord, Lord Jenkin of Roding, referred to a recent publication by the Office of Health Economics and for about a decade I was chairman of the editorial committee of the office. I was grateful to him for his good reviews of articles which we published. I wish to make it clear that the Office of Health Economics publications and books are based on research themes. They are a means of putting out information, especially to general practitioners as they go about their business.
I have done a little research and am pleased to be able to quote figures which indicate that our general practitioners are better friends of the Government and of health expenditure in regard to pharmaceutical prescriptions than those in most other countries. For example, in Germany the prescription rate is £122 a year per head; in Italy, it is £107; in France, it is £105 per year, whereas the prescribing rate of our general practitioners is only £70 per head per year. To me that shows that, rather along the lines mentioned by the noble Lord, Lord Jenkin, general practitioners may not be the first people whom we should pick out for major economies: they have a good track record. I find that they have an even better track record when it comes to the prescribing of new medicines, which is presumably what lies behind the new regulation. I find that in the use of new medicines our doctors spend per head about £6 a year, whereas those in Germany spend £21 a year. In France, it is £14 and I have mislaid the figure for Italy but it is very much in excess of our figure—about £30. If I could read my prescription-prone handwriting, I should be able to tell the House more clearly.
Stepping into this arena when I recently returned from the Far East, I got the impression that the Health of the Nation is an important statement. I agree very much with the recognition of it by the noble Lord, Lord Hacking, and wish to add my congratulations to the Department of Health, which has produced such an important document. I think that the new President of the United States of America would be pleased if such a document had emerged in his country and had the level of backing that it has here.
The integration into this document of the health services, local authorities and various other organisa-tions which are associated with health is a wonderful example of first-class public health planning. Personally, I am particularly pleased with the establishment of the ministerial committee, which means that the idea of health is reaching out beyond the hospitals and general practice into the workplace and everywhere else. Indeed, it is much in the minds of people who work in the health service.

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I had rather hoped that in the near future we would hear that the pharmaceutical industry would be called—it may already have been called, and, if so, I hope that the Minister will bang me down—to one of the ministerial Cabinet Committee meetings. If one looks through the document, one sees that 10 per cent. of our NHS activity, namely the pharmaceutical industry's part in our affairs, is not referred to at all. It is a terrible thing for a practising doctor who has relied so much on the pharmaceutical industry to say, but it reads like a document produced by the public health chaps who have their graphs and statistics and are busy, quite rightly, in giving advice on how to improve the shapes of the graphs and the tables.
What concerns me is that, when I read the document—and I read it again in the past 24 hours—I was very conscious that there were all kinds of ways in which progressive pharmaceutical people could make contributions to the health of the nation through achievement of the targets—not only on the question of anxiolytics, which is terribly important. I have received a letter from a company which has developed a non-diazepine anxiolytic and is worried that it may not be able to get it into the "white list". It is obvious that there will be developments in the treatment of circulatory diseases (coronary heart disease and others) related to the great new pharmacological development, the finding of the importance of the gas nitric oxide in dilating the blood vessels of the skin and the heart. I wonder whether we shall have a chance of incorporating that in our attempts to achieve the targets for coronary heart disease.
Another factor which will help coronary heart disease is the control of over-weight. I believe that the pharmaceutical industry could well be brought in for discussions to help with that problem. I am sure that all who are in health promotion—that is one of my lines of business—are thoroughly aware of the importance of exercise. Among elderly people, swimming is a very important form of exercise but is very often inhibited by the inadequacy of our anti-rheumatic therapeutics. I hope that the pharmaceutical industry may be drawn into that area. I am slightly ashamed to say that while I was in America, I was talking to one of their leading authors, who, I knew, used to be a chain smoker. His name is Willie Gaddis. He said, in an American accent which I shall not try to reveal to noble Lords: "I have to tell you how grateful I am to the pharmaceutical industry for the development of nicotine patches. I have been able to give up smoking through this development". Might it not be a good idea, if the conference that I hope to stimulate comes about, for those who are concerned with nicotine patches—and there will, I am sure, be better developments from the industry than nicotine patches—to come forward and help us to cut down smoking and so achieve our target in that field?
I am astonished that in the anxiety we all have to try to control the spread of the AIDS virus, there has not been more interest in the possibility of a viricide which would work in the way ascorbic acid is supposed to work in the case of the common cold—namely, to be taken before people risked exposure. At the moment,
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we use the physical means of the condom as our only approach. I would hope that, if the Department of Health could take part in the conference, that kind of idea would be explored.
I have been well aware since I was chairman of the Medicines Commission of the very great importance of the PPRS (the Pharmaceutical Price Regulation Scheme). It was explained to me 10, 12 or 15 years ago that its central theme was like a coin which had two sides. The one side is what we are all worried about in this House—namely, good value for the public from the products of the pharmaceutical industry. But the pharmaceutical industry was interested in the PPRS because it got an assurance that the department would take note of its great dependence on research and development. If, as an innovative industry, it is choked of the possibilities for research and development, it will perish.
The point has already been made by many speakers that this is an industry which depends upon innovation. I am very worried that any changes in our arrangements for prescribing will interfere with the development of the pharmaceutical industry. It is a very important industry not only because it makes a positive balance of payments each year of about £1 billion, but also because it offers young people leaving sixth-form colleges and schools generally the chance to go into a modern, clean industry which uses the brainpower of our young scientists as well as those skilful in marketing.
I hope that it is not too late but it may be too late. On these Cross-Benches we believe that we can improve things. I should like to suggest that some kind of conference—a two-day or even a whole day conference—should be held between the various people who are concerned with trying to achieve our targets. If we are in a position to show the world that we can achieve those targets, national status will rise and the National Health Service will emerge from any shadows in which it has lately stood.
It is to be hoped that we can bring together to work for the health of the nation all the parties, including the brilliant brains of those in the pharmaceutical industry and of the administrators in the Department of Health, in such a way as to produce good and prompt action to find out what we need and to transfer it from the industry into the hands of the general practitioners.
9.16 p.m.
Lord Ennals: My Lords, I am very happy to follow the noble Lord, Lord Butterfield. I totally support his idea of a very widely representative conference to look at The Health of the Nation and to see how in particular the five target areas set out in that very important document can be promoted. It would be nice to have some reaction to that suggestion from the Minister when she comes to reply.
One of my concerns is that so much is done by this Government—and much is done by this Government in the health field—without consultation with the people who are principally affected. I thank the noble Lord, Lord Hacking, for putting his Question and opening the debate. I was quite staggered to hear—I

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shall be corrected if I am wrong—that the ABPI was not consulted about the preparation of the list. Since the ABPI was not consulted, I should like to know just who was consulted about the preparation of the list. I know that it is for examination and that there is an advisory committee, on which additional members will sit, on borderline substances. However, I suspect that certain matters are written in stone, one of which is this list of 10 categories. There may be some argument about which medicines appear in one category or another, but the principal consultation ought to have been about the categories. The people who drew up the categories either had not read The Health of the Nation or did not believe that it was an important document.
I am glad that the interests of the pharmaceutical industry have been put forward. As the noble Lord, Lord Butterfield, is aware, I was the Secretary of State in 1977 who signed the PPRS and I did so with a pharmaceutical industry that I tremendously admired. At the time I hoped that it was a reciprocal admiration society. The case need not be put for the pharmaceutical industry but it has been powerfully made. I disagree with some of the conclusions reached by the noble Lord, Lord Hacking, but I do not disagree with anything that he said about the pharmaceutical industry.
I wonder what consultation there has been with the doctors. As a nation we now quite rightly believe that people should be treated more and more in primary health care. We want fewer people to stay in hospitals and more to be looked after by their general practitioner and within the field of community care. One of the ways in which the Government intend to strengthen the role of the doctor is to encourage all doctors eventually to have their own budget and to decide for themselves how they spend it. If that is to happen and doctors are to be given the right and power to decide for themselves how to use the money put at their disposal, it makes no sense at all to present to general practitioners and other medical practitioners such a list with all its weaknesses.
I hope that the Minister will explain where, within the philosophy of the future of the health service, comes the thought that doctors are not to be given more choice; that they are to be given less choice. One of my anxieties in regard to the new list is that doctors—GPs, those who know best about most of the treatments in this country—are being denied what they believe to be the best form of treatment for purely financial reasons.
I would say the same about the nurses. I too received a note from the Royal College of Nursing which I saw only this evening. I have tremendous respect for nurses and for the RCN. I am delighted that the nurses are being given, as part of the medical teams, more opportunity to do their own prescribing and to advise their doctors on the sort of prescribing that they should do in cases where the nurses do not have the power. The nurses are opposed in principle not only to the idea of the list but also to the particular categories.
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I want to ask the Minister to report fully to the Secretary of State. A tremendously powerful case has been made by those involved in research, those who are in contact with the pharmaceutical industry and those who are involved with the running of the health service at trust level, together with a couple of former Secretaries of State who are not totally ignorant about these matters. I believe that the Government have made a profound error and should think again. I do not finish there. I may repeat that in my final words.
I am particularly concerned with one aspect of the list. We have been reminded that mental health is one of the five key areas targeted for action in the Health of the Nation. The White Paper advocates a range of measures to improve the diagnosis and treatment of mentally ill people. It proposes a switch from benzodiazepines, which, in my view, are currently prescribed far too widely, to psycho-therapeutic methods of treatment and, where appropriate, other medicines. The White Paper speaks of "other medicines" which do not have the disadvantage of benzodiazepines. To go along with the proposal that the list should include anxiolytics as well as hypnotics is absolutely contrary to what the White Paper is saying about how we can better treat mentally ill people.
We need the most modern and effective medicines that do not have the side effects which over the years people have found the benzodiazepines to have. The selected list scheme addresses only the direct costs of medicines and not the overall costs and benefits of a treatment regime of which pharmaceuticals are only one part. In the case of anxiety and depression, that means medicines and psychotherapy or counselling. It is possible that restricting the range of medicines will have the effect of increasing the net expense. Without the benefit of at least some study in that regard the Government may not even achieve a short-term saving. Even a limited piece of work to get this right would surely be worth while.
I was fascinated by the evidence given to the House and to the Minister by the noble Lord, Lord Jenkin of Roding, who succeeded me as Secretary of State for Health. With all his background experience, his immediate experience and the research of his colleagues upon which he is able to draw, he is saying that the first list did not save anything. Perhaps it did for six months or one year. But, when one looks at the run, it did not save anything. That was a list that many of us were prepared to support because of the nature of the cases that were on the list.
In the present list I have already touched upon the cases that affect mental health. Other noble Lords have spoken about drugs for allergic disorders and drugs to suppress appetite. I want to touch on contraceptives, since I do not think anyone has yet done so. It would be an absolute tragedy if the Government limited the range of contraceptives which general practitioners can prescribe. The advisory committee on NHS drugs is currently reviewing the range of contraceptives available on NHS prescription. This has caused widespread concern among healthcare professionals. The concern is felt not only by the RCN but also by the Royal College of

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Obstetricians and Gynaecologists, the Birth Control Trust and the Family Planning Association, with which I have an involvement. I wonder how many of those organisations were consulted before contraceptives were put on the list. What advice did they give to the Ministry? What advice has the Ministry received about the effect of limiting contraceptives in that way?
In the United Kingdom approximately one-quarter to one-third of sexually active women use what is the cheapest form—the COCP—as their chosen method of contraception. Its usage in younger women is widespread. It is the most effective and appropriate contraceptive for most women. The COCP pill contains oestrogen and progesterone and, when taken on a cyclical basis, inhibits ovulation and thereby prevents conception. If those pills are removed from the list there will of course be another range of alternatives, but another range of alternatives which are much less likely to be effective.
I hope the Minister will tell us why contraceptives were included in the list. If we look at Health of the Nation we see that another of the targets is to decrease the number of unwanted children and to reduce the number of abortions. The more unwanted children we have, the more abortions we have, to the moral horror, the health horror and every other horror of the nation. I believe that the Government have got this seriously wrong. I trust that, once the arguments that have just been touched upon by noble Lords from all parts of the House—in fact all noble Lords who have spoken—are deployed by the real experts, the case for the list will be torn up. It will be shown to be nonsense. I do not think that there will be a saving. What is proposed could be disastrous for the health of the nation. I hope that the Government will think again when taking their decisions.
9.28 p.m.
The Viscount of Falkland: My Lords, I have thoroughly enjoyed the debate. I became so absorbed in listening to it that I almost forgot that I was down to speak. I shall not say very much because I feel somewhat at a loss among so many distinguished speakers on the subject of health. In fact, if the noble Baroness, Lady Robson of Kiddington, had been present, she would have spoken from the point of view of her long experience of nursing and other health matters.
I am entirely convinced by what I have heard. I thank the noble Lord, Lord Hacking, for giving us the chance to discuss the subject. He expressed his views with great clarity. That may help me make up my own mind, which certainly was not made up when I entered the Chamber. The noble Lord, Lord Jenkin of Roding, expressed scepticism about the effectiveness of the list and the noble Lord, Lord Butterfield, revealed that we come well down the list of countries as regards the cost of prescriptions by doctors.
I echo the views expressed by the noble Lord, Lord Ennals, and others. From where have the Government got their ideas to produce the lists? The health of the nation is as important, if not more important, than any commercial activity. The aims of the Government's White Paper, Health of the Nation, are
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admirable. But as with any commercial operation, research and development are essential. I am utterly convinced by the arguments that the effect of lists and the reduction in the amount of choice given to general practitioners and nurses to prescribe on research and development by pharmaceutical companies will be restrictive. I am utterly convinced by the argument that it may well not be cost effective in the long run.
I speak because the debate dovetails with the discussion in which many of us took part on drug addiction and alcoholism. From my experience as trustee of two residential centres for drug and alcohol abuse, there is great difficulty for general practitioners with regard to mental health. Numbers of patients complain of being depressed and anxious. They are diagnosed by doctors quite understandably as being anxious and depressed. However, many of those patients are drug addicts or alcoholics. I have sympathy with doctors who ask the patient questions. I have met some of those patients; they deny that they are abusers of substances. They are prescribed drugs which seriously aggravate their problems, creating complicated addictions which are extremely difficult to treat when they go into care in residential centres which happily are still open, although, given the Government's community care arrangements, somewhat under threat at present.
I should hate to think that the effect of the Government's selected list with regard to benzodiazepines and anxiolytics mean that we shall not be able to develop drugs which, whether prescribed correctly or incorrectly, would not create serious side effects. A Member of your Lordships' House who spoke very convincingly in the last debate told me that if such drugs as valium or librium are taken together with other drugs the effect is to multiply by a factor of three the serious effects of the combination of the two drugs. The noble Baroness, Lady Masham, referred to the appalling accounts that we have read of sleeping pills—they may not have been pills—which were taken apart and injected. I refer to Temazepam. Clearly, there are issues that have to be addressed and the list can be nothing but restrictive.
It has been a fascinating debate. I look forward to hearing the noble Baroness. She has some serious and well articulated charges to answer. The noble Lord, Lord Hacking, produced an utterly sensible idea. In France, as I understand it, funding is applied according to the seriousness of the illness. I would only say to him that that sounds sensible to me. On the two or three occasions in your Lordships' House that I have referred to the French experience in other subjects, it has turned out to be surprisingly unproductive. It may have something to do with the idea that the French eat horses or that their children go to bed late, or something of that kind. Such examples never produce any great effect on the Government. Having said that, I very much look forward to the Minister's comments and thank noble Lords for allowing me to participate in this most interesting debate.
9.35 p.m.
Lord Desai: My Lords, perhaps I should say first that, by and large, we on these Benches support the Government's initiative. Although with some qualifications, to which I shall come later, by and large, I think that it is a good idea for the Government to examine every aspect of a large budget for cost-effectiveness. The fact that we are talking about only 10 per cent. of that budget is neither here nor there. Indeed, even if we were talking about only 5 per cent., 5 per cent. of £30 billion is a lot of money and we must examine things for cost-effectiveness. Having said that, we have reservations which I shall come to later. Perhaps I should add too that I have checked what I am saying with my Front Bench in another place because the other day I embarrassed the leader of my party in another place when the Prime Minister quoted me against him on the subject of VAT. This time what I am saying is genuinely the party's view. It is not some kite that I am flying but something that I have checked out.
I should like to deal with some of the many things that have been said about the sort of harm that might be done to the pharmaceutical industry and about the fact that such a strategy might not save money and might affect research and development. I admit immediately that I am not a great medical expert, but luckily I am an economist and economists are used to being able to theorise from the abstract on almost anything. It seems to me that, although it is true that the Government are a monopoly buyer, the sellers whom they face are not competitive. They are an oligopoly. The Government must face powerful pharmaceutical firms. It is not as if a very powerful buyer is facing some very weak sellers because the other side comprises powerful sellers. Those powerful sellers have argued that somehow what they do is right and cost-effective and that therefore no restrictions should be placed on their activities.
I am a relative newcomer to these matters, but it seems to me that what the Government are proposing is a consultation exercise—no decisions have yet been made. Putting 10 more items on a list is not really the end of the world as people are pretending it is. If the pharmaceutical industry is as successful as people claim it is—and I know that it is, although I shall not go down in history as a great friend of the pharmaceutical industry, but that is another matter—I think that it is a dubious argument to say that such a small extension to the list of drugs will cause great havoc. I do not think that it pays to say that our successful industries need as much protection as our unsuccessful industries. If that were so, by God, then everybody would get protection and then where should we be?
I am not persuaded that this particular limited list—it is a consultation list and I shall come to the matter of consultation in a moment—poses as great a problem to R&D as has been made out. I admit that I could be wrong, but more and greater things will have to be said before I, as an economist, am convinced that extending the limited list of drugs on the selected list will cause such great damage to R&D.
If it is going to do so, however—let us suppose that
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it will—we must ask: what is the right way to correct it? Is it to leave the list unrestricted or to have more selective targeted policies to protect R&D while at the same time saving on NHS drugs bills? When it comes to helping the poor, we are all for targeting. When it comes to taxing the rich, we are also for targeting. If R&D expenditure is the problem in this case—and it could be—the correct way of dealing with that problem is not to go soft on it but to figure out the correct incentives for R&D expenditure. There are ways of doing that. I am not in favour of the unselective, broad-brush strategy.
The noble Lord, Lord Jenkin, with his great knowledge in this field, gave a good example of how the 1985 policy did not work. One could derive various lessons from that. The lesson I derive from it is not that the policy should not be tried again but that, if we want to control costs, we must think carefully about the strategy and not leave out one or two branded drugs just because they have a small market share and the company has five out of seven drugs. Because people will obviously go for branded drugs. This is a oligopolistic industry in which branding a generic drug gives a great deal of extra profit. We go for generic substitution because it tells us that the effectiveness of a medicine does not depend upon its brand name. The brand name is a function of the oligopolistic structure of the industry and is used in order to make extra profits. That may be all right. This has been known to economists for about 50 years. I am not saying anything new.
If it is true that a brand name is not an extra label but is genuinely an innovation, that is fine: there will be no substitutes. There will be no difference between a generic prescription and a brand prescription, but, if there is a cost saving to be made from generic prescription as compared with brand prescription, it behoves a large public agent, such as the NHS, to pursue that saving, to the extent that it does not affect patients' health.
From that point of view, the strategy of controlling costs would be to say, "If you go for generic prescription, you go for ordinary prescription". I should add at this stage that in economics there has been great progress in such thinking, and that perhaps the Government should avail themselves, if they have not already done so, of the new research into what is called industrial organisation. I can supply names in that regard. This is a methodology where people think out carefully the problems of pricing, R&D strategies and such things. We of course want to do things which simultaneously save the public purse and do not affect R&D. I agree with that. I do not agree that criticising the proposed extension of the selected list is necessarily the answer to our problems.
I wish now to deal with the two or three qualifications of the selected list which I have and which some noble Lords have already mentioned. The first is the issue of choice. We all know that medicine is a peculiar area in which consumers can have only a limited choice because they do not know what they want. They must rely on the producers to provide the choices that they need and the doctors to tell them what they need. However, in cases such as

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contraception, which was mentioned by my noble friend Lord Ennals, there may be an element of consumer choice but it is restricted—consumer choice may not be sovereign because the consumer may not know what is good for him or her. However, to the extent that there are different items which different people may need we may wish to qualify the items on the selected list.
Apart from the issues mentioned by my noble friend Lord Ennals relating to who is being consulted, I wish to know how wide the consultation has been especially in respect of patient groups. I should like to think that before the final decision is made the Government will consult as widely as possible so that there is no feeling among patients that somehow they are being given the cheap option, though just because an option is cheap it is not necessarily less effective. Let us be sure that the option is cheap and effective. To that extent it would be proper for the Government to consult patient organisations and to include patients in the process more vigorously than has been the case. In that respect the subject of contraceptives raised an anxiety which was mentioned by my noble friend Lord Ennals. I shall not go into detail, therefore, but I hope that the Minister will comment on it.
I have nothing in particular to say about mental illness except to recall that during our earlier debate on drug and alcohol abuse there was a considerable question about whether certain prescribed drugs mentioned by the noble Viscount, Lord Falkland, were on the borderline of being addictive as well as effective. A careful line must be drawn in that regard.
I apologise on behalf of my noble friend Lord Rea, who was to speak in the debate but who was taken unwell during the day. He wished to make one or two points which perhaps I may mention at this stage. First, he believes that many special interest groups are loudly pleading their case. They should be heard but not judged by their decibels. My noble friend believes that the decision should be made on scientific and clinical grounds alone, and I agree with that view.
My noble friend also mentioned the education of GPs. It is a subject about which I know nothing and so I shall merely pass on his views. He mentioned PACT—prescribing, analysis and costs—which is a service for GPs. They need to be educated about the cost-effectiveness of drugs. My noble friend found the service to be so useful that if possible it should be further extended.
Finally, he mentioned the interesting problem of incentives. If the aim of the Government is to save the drugs bill of the NHS, which is an entirely noble aim and which I support, GPs must be given incentives to reduce costs. To the extent to which GPs are effectively reducing costs, especially in prescriptions, some formula should be found to give them rewards for achieving savings without affecting patient care.
I know that the problem is difficult. We do not wish to cut corners as regards patients' health and we do not wish to affect patient choice. We should like not to affect R&D. I am not convinced, although many people more expert than I will not agree, that what the Government are doing is as wrong as it is made out to
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be. I am waiting to hear the Minister's reply but cautiously, although somewhat critically, we are with the Government as regards this policy.
Lord Hacking: My Lords, I listened with great care to the noble Lord's speech. At no time did he mention the publication Health of the Nation. I find it difficult to follow what guidance he is giving to your Lordships this evening when the Question before the House is what effect the extension of the selected list scheme will have on the Health of the Nation.
Lord Desai: My Lords, it is true that I did not mention the Health of the Nation. I know that I should not really say this but I regard all White Papers as containing many good ideas but very little detail. I am worried about the contraception problem. However, I do not believe that this small category of drugs which are to be put on the selected list will have as drastic an effect on the targets in the Health of the Nation as some seem to believe. I hope that I am not being rude but I do not believe that anybody has demonstrated this evening that it will have such a serious effect.
9.51 p.m.
Baroness Cumberlege: My Lords, I am grateful to my noble friend Lord Hacking for initiating this debate. He is, I know, one of the best informed on this subject and is an international speaker of high reputation as are many of your Lordships. We not only heard from two former Secretaries of State for Social Services, who I believe also share the joint presidency of MIND, but we heard also from a noble Lord who is former vice-chancellor of two universities and past chairman of the Medicines Commission. Other noble Lords have other areas of expertise and personal experience. I believe that the hallmark of the debate has been compassion and concern for others. I am sorry that the noble Lord, Lord Rea, is not here this evening especially since, as far as I know, he is the only Peer in your Lordships' House who is actually in possession of a prescription pad.
I shall try to make the Government's position clear on the Health of the Nation targets for mental illness on the one hand and the selected list scheme on the other, and the relationships between the two.
I am grateful to my noble friend Lord Hacking and to the noble Lord, Lord Butterfield, for their generous comments about the Health of the Nation White Paper. I hope that we shall win over the noble Lord, Lord Desai in due course.
The Health of the Nation White Paper provides for the first time an explicit, coherent strategy for improving and maintaining people's health; and we start from a sound base. Health in this country has never been better. Many diseases have been brought under control and some eliminated. Life expectancy at birth is now 73 years for men and 79 for women, whereas 100 years ago it was 44 for both. But too many people still die prematurely or have the quality of their lives, especially in their later years, impaired by avoidable ill-health. An overall objective of any nation must be to add not only years to life, but life to years.

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A leading cause of sickness and disability is mental illness, and it has therefore been included in one of the five key areas for action set out in the White Paper. In the course of a year about one-in-10 of the population suffers from some sort of mental illness. It is three times as common as cancer, and accounts for about 14 per cent. of the certificated sickness absence and roughly the same proportion of NHS in-patient costs. Fifty-one million days are lost from work and mental illness accounts for 18,200 deaths in any single year. But the cost in human misery and suffering to individuals and their families is incalculable.
There is no doubt that the development of new drugs over the past 40 years has revolutionised the treatment of a whole range of psychiatric illnesses. As the noble Baroness, Lady Masham of Ilton, rightly said, drug regimes need careful monitoring. That has enabled the vast majority of patients to be treated in the community and for thousands to hold down jobs successfully; people who in former years would have been detained in large forbidding mental institutions "put away for life".
Drugs are a powerful and effective therapeutic weapon to be used against many different kinds of illnesses. But they cost the NHS a lot of money. The biggest element in overall NHS expenditure is of course pay, which is responsible for around 70 per cent. of the total. However, once that is stripped out, the drugs bill accounts for about one-third of total NHS costs. It is, therefore, an element of expenditure which needs to be kept under continuing close scrutiny, to ensure maximum cost effectiveness.
My noble friend Lord Hacking mentioned the hair-raising cost of drugs. He is right. I also welcome the support received from the Opposition Front Bench that the bill needs to be controlled. Over the past 10 years, the total drugs bill for the NHS in England rose from £1.2 billion to £2.9 billion—an increase of 132 per cent. in cash terms, and 39 per cent. in real terms. In the financial year which has just ended, we estimate that the family health services drugs bill will have risen by another 14 per cent. That at a time when inflation is running at under 2 per cent. and NHS staff are being asked to settle for a ceiling in pay of 1.5 per cent.
It is, therefore, not surprising that the Government are concerned, as the noble Lord, Lord Desai, said, in their vulnerable position as the monopoly buyer, at the speed and scale at which the drugs bill has increased and the fear that, without check, the momentum will continue at the expense of other NHS services.
It is against that background that we need to be alert to ensure maximum cost effectiveness in prescribing. One important development is clearly the GP fundholding scheme. GP fundholders have a direct interest in improving the cost effectiveness of prescribing. They can retain any savings on drugs to reduce the demand on the hospital referral element of their budget. That is not just a theory. In 1991–92 fundholders' prescribing costs increased by an average of 3 per cent. less than those of other GPs, and without any loss of quality.
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The scheme is being extended to other practices in terms of incentives. Hospital formularies have also shown how savings can be made without diminishing patient care. From my chairmanship of the Brighton Health Authority I know how effective that can be.
The noble Lord, Lord Lovell-Davis, mentioned the problem of cost shifting from hospital drug budgets to those of GPs. Our view is quite clear: it is unacceptable to shift prescribing costs in that way. We have always applied the rule that the responsibility for prescribing rests with the doctor who holds clinical responsibility for treating the patient.
The selected list scheme, to which I now turn, should therefore be seen as only one element in a wider strategy to control the rise in the NHS drugs bill. As my noble friend Lord Hacking and the noble Lord, Lord Lovell-Davis, mentioned, the scheme was originally introduced as long ago as 1985 and included seven therapeutic categories of drugs. Initially there was scepticism and indeed downright hostility. There was hostility from the pharmaceutical industry but the doom and gloom scenarios were not enacted.
My noble friend Lord Hacking made some surprising predictions—surprising because we cannot say how many products will be listed. That depends upon the independent advisory committee to which I shall turn my attention in a moment. However, I should like to reassure noble Lords that there is no preset target. Any possible effects on employment cannot be estimated at this stage. Wild allegations on the impact on patient care also cannot be founded on fact.
I agree with my noble friend, Lord Jenkin of Roding, that keeping people in hospital is expensive. It is not only cheaper but much better to have them in the community. However, that does not necessarily mean that we have to accept an uncontrollable rise in pharmaceutical costs. Controls on some drugs does not mean that a hospital stay is the alternative. We have seen drugs substituted with good effect and no detriment to patients. Many noble Lords have expressed concern at the huge sums of public money that are spent to sustain the NHS. The noble Lord, Lord Desai, was correct to say that it is a question of choices. I find it hard to defend a paracetamol which is prescribed at 20 times the price of a standard product of the same efficacy. That particular drug was included in the original selected list and has now been withdrawn without any ill effects.
Fears were expressed that substitution could also lead to more expensive or indeed more inappropriate drug prescribing. In that case the advisory committee on drugs can revisit the category and make further recommendations to prevent such inappropriate prescribing. Unlike the position in 1985, companies now will be consulted and may reduce prices to keep their products prescribable. That is an important difference which should go a long way to avoiding inappropriate substitution. Hostility was also forthcoming from the then chairman of the General Medical Services Committee who said that the limited list of categories represented,
"a serious reduction in the services available to patients"
and would he "a bureaucratic nightmare".

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Neither of those prophesies has been fulfilled. Experience with the scheme has demonstrated that downward pressure can be applied to the drugs bill without detriment to patients. Contrary to the fears of the noble Viscount, Lord Falkland, and the assertions of the noble Lord, Lord Ennals, in the first year of the scheme, savings of £75 million alone were realised. It therefore seemed right to extend the scheme to 10 further categories of drugs. The noble Lord, Lord Lovell-Davis, asked how these were chosen. The categories were chosen on the basis that they covered a range of products at varying price levels and therefore offered potential scope for savings while enabling all clinical needs to continue to be met.
There are three aspects of the selected list scheme which I wish to emphasise. They address the question raised by the noble Lord, Lord Lovell-Davis, as to the procedure which enables my right honourable friend the Secretary of State for Health to reach her decisions. First, the decisions on which individual drugs may no longer be available on NHS prescription are taken only on the basis of advice from the Advisory Committee on NHS Drugs (ACD). This is an independent body of experienced doctors, dentists and pharmacists appointed following consultation with the relevant professional organisations.
Secondly, the ACD's remit is to ensure that drugs to meet all real clinical need can be provided as economically as possible under the NHS. This means that drugs will not be rejected purely on grounds of cost. The committee will take full account both of the therapeutic value of the drugs under review and of patients' needs. Thirdly, the committee will ensure that manufacturers are informed as soon as possible if their products are to be considered. Manufacturers will also be given an opportunity to make representations to the committee against any provisional view that a product should not be prescribable under the NHS.
The noble Baroness, Lady Masham of Ilton, asked how interested parties will be able to present their arguments. Companies whose products will be affected will have at least two opportunities to make representations before a decision is made. The committee may also ask advice from other sources if it chooses, and it will certainly take full account of patients' needs in its review. The manufacturers of products which the committee has considered for possible inclusion in the selected list will have been notified and invited to provide details of the drugs under consideration.
The membership of the committee has been extended to reflect its new remit. The enlarged committee has met on two occasions. It has considered the preliminary reports from the subgroups on the first three categories of drugs, which are topical anti-rheumatics, anti-diarrhoeal drugs and appetite suppressants, and drugs for vaginal and vulval conditions. The manufacturers of products which the committee then recommends for inclusion in the list will be notified and given an opportunity to make representations before final decisions are taken.
On 6th May the committee will also be considering preliminary reports from the subgroups on hypnotics
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and anxiolytics, drugs used in anaemia and topical corticosteroids. The committee will receive reports from the subgroups on the remaining categories at its meetings in June and July. The industry will have further opportunities to make representations and the final decisions will be taken by the Secretary of State later in the year.
My noble friend Lord Hacking suggested that some additional ways of reducing the high cost of drugs could be examined. I should like to do that and I shall write to my noble friend in due course.
The noble Lord, Lord Butterfield, mentioned European comparisons. I can assure the House that the changes we are introducing mirror measures being taken throughout Europe to limit growth in the drugs bill.
The noble Lord mentioned nicotine patches as an aid to giving up smoking. I should like to make the point that smoking is a very costly business—£2.20, I am assured, for a packet. I would therefore have thought that smokers might be able to fund their own patches.
The noble Lord, Lord Butterfield, also mentioned the profitability of the industry. The Government are concerned that companies can make a fair return on their sales to the NHS after allowing for research, capital and other expenses. At the same time companies' worldwide returns are holding up well. According to the Financial Times, Glaxo made a 38 per cent. return on capital worldwide last year and Smith Kline Beecham 45 per cent. after research and development costs.
The noble Lord also suggested that a conference should be held to discuss the Health of the Nation and how its targets could be achieved. Fourteen conferences have already been held in all 14 regional health authorities. I apologise to your Lordships' House because clearly the right people were not invited.
The noble Lord, Lord Butterfield, and the noble Lord, Lord Ennals, were concerned that there had not been sufficient discussion with the pharmaceutical industry. We have established a strategy working group of officials from the DTI, the Treasury, the Department of Health and the pharmaceutical industry to take a long-term view of the contribution made by pharmaceutical products to health care and the future development of the industry. The first meeting of that working group was held this morning.
Some of your Lordships raised particular concerns about benzodiazepines. The Health of the Nation stresses the need for further effort to review the use of benzodiazepines and replace them as necessary with behavioural, cognitive and other psychotherapeutic methods of treatment and, if appropriate, antidepressants. Benzodiazepines, sedatives and tranquil-lisers have, of course, been within the scope of the selected list scheme since its inception. That reflected the Government's continuing concern, shared by the noble Lord, Lord Ennals, about the dangers of long-term and indiscriminate prescribing of benzodiazepines. Although drug treatment with those drugs can be effective in relieving anxiety in the short

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term, their effectiveness decreases over time. Long-term use can lead to dependency and they can mask the underlying symptoms of depression which may then remain untreated. Benzodiazepines can still be prescribed under the NHS on a generic basis but, interestingly, the number of prescriptions which were dispensed fell in England by 35 per cent. between 1980 and 1991.
I have listened with great interest to the debate tonight and particularly to the views expressed by my noble friend Lord Jenkin of Roding. I should like to read Hansard carefully and take into account all the points he made and perhaps come back to him at a later date.
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In conclusion, we have taken great care that while we control the growth in the drugs bill we also safeguard the ability of patients to receive the medicines they need, when they need them and for as long as they need them. As guardians of the public purse we have a duty to ensure that the resources available to the health service are used more effectively in order to treat yet more patients. It is only by achieving these twin objectives that we shall be able to contain expenditure and, more importantly, achieve the valuable goals set out in the Health of the Nation White Paper.
House adjourned at ten minutes past ten o'clock.