Lords Sitting of 10 January 1996

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

Baroness Hayman
Mrs. Helen Valerie Hayman, having been created Baroness Hayman, of Dartmouth Park in the London Borough of Camden, for life—Was, in her robes, introduced between the Baroness Castle of Blackburn and the Baroness Jay of Paddington, and made the solemn Affirmation.

Lord Sewel
John Buttifant Sewel, Esquire, CBE, having been created Baron Sewel, of Gilcomstoun in the District of the City of Aberdeen, for life—Was, in his robes, introduced between the Lord Kirkhill and the Lord Carmichael of Kelvingrove.
Lord Grantchester Lord Grantchester—Sat first in Parliament after the death of his father.

War Widows' Pensions
2.58 p.m.
Baroness Strange Baroness Strange asked Her Majesty's Government:
How many widows have received the re-allocated pension under the provisions of the Pension Act 1995, and how many have applied.
The Minister of State, Department of Social Security (Lord Mackay of Ardbrecknish): My Lords, the Pensions Act provided that a war widow's pension, which is withdrawn on remarriage, may be reclaimed on the subsequent termination of a marriage or on judicial separation. So far, 11,737 claim forms have been received and over 2,000 pensions have been put into payment.
Baroness Strange: My Lords, I thank my noble friend the Minister for his accurate Answer as far as it goes. Is he aware that although 2,036 ladies have started to receive pensions, and 80 to 100 have been turned down, there are about 8,000 ladies who have not heard one way or another and are still in limbo? Would he not agree that hope deferred makes the heart sick, that few of these ladies are very young, and that some may even be dead before they receive their pension?
Lord Mackay of Ardbrecknish: My Lords, something like 4,000 widows or former widows have been notified that they will receive their pensions again. I am aware of the pressure on us to pay these pensions as quickly as we can, but we have to make some checks.
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Obviously we have to check that the actual conditions of entitlement are correct and that the person who has applied is eligible for a war widow's pension. Having done that, we have to check whether there are any other payments from the Department of Social Security and, if so, balance those to make sure that when we pay out we are paying out the correct amount. I assure my noble friend that we are dealing with this matter as expeditiously as we can.
Baroness Nicol: My Lords, does the Minister recall that the reason so many Members of your Lordships' House supported the insertion of this clause in the Bill was that we were made aware that there were a number of cases of real hardship? Is it not insensitive, to say the least, that it is now taking so long to settle some of these claims? I understand that some of these ladies are in real difficulty. Is there no way that this matter can be speeded up?
Lord Mackay of Ardbrecknish: My Lords, I think I explained that some checks have to be carried out when one receives an application form. Of course many of the records are over 50 years old and my department has to check them to determine whether the clams are genuine, justified and within the terms of the law. Thereafter there is the problem of balancing the claim with any other social security benefits that may be received. At Norcross in Blackpool we have taken on 48 staff who are totally dedicated to working on this issue. Indeed, shortly we shall be adding another 12 members of staff. We hope that all the pensions will he in payment by the end of this financial year; that is, the end of March.
Lord Craig of Radley: My Lords, is it not the case that war widows who have now had their pensions reinstated may nevertheless have some deductions made from other state pensions, particularly if their pensions have been enhanced by additional contributions from their second husbands? If that is the case, is it not dreadful that one is taking with one hand after giving with another?
Lord Mackay of Ardbrecknish: My Lords, there is a general rule in social security that the taxpayer does not pay twice and that benefits are matched. If a war widow has a category A retirement pension, namely, one for which she has qualified on the basis of her own national insurance contributions, that is unaffected by the pension of £140 a week being restored to her. However, if she has a category B pension, which is based on her late husband's contributions, then that is taken into account, as is, for example, income support. That does not only affect war widows, it affects everybody who receives any benefit of any kind from the department.
Baroness Gardner of Parkes: My Lords, can the Minister provide me with information? I am told that a number of applications, perhaps 80 or 90, have been refused. When an application is rejected is the applicant told why? Is there any ground for appeal or is the matter closed once and for all?
Lord Mackay of Ardbrecknish: My Lords, I understand that 78 applications have been rejected. I do not know on what grounds they were rejected. It is possible that the person applied thinking mistakenly that her first husband fell within the category caught by the

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amendments to the Pensions Act. I shall certainly check that an explanation has been given to the 78 applicants and to any others who are refused.
Baroness O'Cathain: My Lords, would it be possible to increase the number of people dealing with the issue? My noble friend says that currently 48 people are looking at this issue and that an additional 12 will be employed. He also stated that it was hoped that all outstanding questions and pensions would be dealt with by the end of this financial year. Would it be possible to employ say another 30 people on this work so that we can hasten the process and give these people, some of whom as my noble friend Lady Strange said could be dead before they receive their pensions, some hope of receiving the money more quickly?
Lord Mackay of Ardbrecknish: My Lords, as I said initially, we have 48 people working in this dedicated group and are adding another 12. However, the other work of the War Pensions Agency goes on. There are other war widows or pensioners who have disabilities resulting from the war who are applying for the first time. We have to ensure that that work goes on. We have to try and achieve a balance between getting on with this job and not damaging the ongoing work of dealing with new war widows or new war pensioners.
Lord Taylor of Blackburn: My Lords, is the Minister aware that there are quite a lot of unemployed people in the Blackpool area who would look forward to some temporary work helping out with this particular question?
Lord Mackay of Ardbrecknish: My Lords, we have a number of temporary employees in the agency helping out on a number of issues. There is also the other aspect that the War Pensions Agency has to live within its administrative budget. That means that one cannot just go out and hire new people regardless of the effect on the administrative budget.

Diesel Fuel and Pollution
3.6 p.m.
Lord Campbell of Croy Lord Campbell of Croy asked Her Majesty's Government:
What action they are taking to encourage the use of modified diesel fuel in order to reduce pollution of the atmosphere, especially by particulates.
The Parliamentary Under-Secretary of State, Department of Transport (Viscount Goschen): My Lords, the Government recognise that cleaner fuels have a role to play in reducing air pollution. We shall be reducing the maximum permitted sulphur content of diesel fuel by 75 per cent. from 1st October 1996.
Lord Campbell of Croy: My Lords, I am grateful to my noble friend for his reply and what he says about low sulphur fuels. In view of the recent increase in diesel road vehicles and the estimate that 80 per cent. of exhaust particulates now are emitted by diesels, will the
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Government do all they can to encourage the use of low sulphur fuel, bearing in mind the rapid success and widespread adoption of unleaded petrol, assisted in that case by a tax differential?
Viscount Goschen: Yes, my Lords. Low sulphur fuels have a significant role to play in the process of reducing emissions of particulates. However, it must be recognised that there are alternatives, sometimes involving additives to diesel fuel, which have a similar effect. We are also taking action on a number of other fronts to achieve the aim, addressing new vehicle standards and enforcement of existing standards and reducing the amount of sulphur permitted in diesel fuel.
Lord Jenkins of Putney: My Lords, would it be possible to secure a substantial increase in low pollutant diesels by reducing the tax on such fuels, thus making them more attractive to purchasers than the ordinary polluting diesel?
Viscount Goschen: My Lords, that is certainly one option, and one we shall keep under review. As I said, there are a number of other approaches to the problem which we are pursuing. Indeed, there are other fuels, including those using additives, which produce the same result and do not have the cost premium of low sulphur diesel.
Viscount Caldecote: My Lords, what action are the Government taking to prevent diesel-fuelled lorries producing unnecessary pollution because their engines are not properly maintained? Is it true that the fitting of filters to remove particulates from diesel-engined vehicles is easier than the fitting of catalytic converters for other fuels?
Viscount Goschen: My Lords, to answer my noble friend's first point, there is a two-strand approach to the problem. One is the regular test which all HGVs must undertake. There are stringent rules on emissions and levels of particulates that can be emitted by the engine. We are also pursuing an intensive programme of roadside checks. On the question of particulate filters, it is true that such filters can be put in place. Again, they have a significant role to play in reducing the emission of particulates but there is still a great deal of development work to be done on their use.
Lord Campbell of Alloway: My Lords, is there any other particulate other than diesel or sulphur emission? What is it all about?
Viscount Goschen: My Lords, without wishing to state the obvious, a particulate is a particle. It is a small piece of matter that is emitted by the process of fossil fuel combustion. In vehicles they are mainly composed of molecules of carbon on to which molecules of partly burned fuel and sulphates are readily attached. Sulphur, which we have discussed, is part of the problem but it is not the whole problem.
Lord Carmichael of Kelvingrove: My Lords, this is an important Question, particularly for city centres which receive the blast of diesel fumes. Unless I have wrongly read the report of the urban air review group, domestic pollution is probably greater than vehicle

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pollution with something like I per cent. arising from diesel cars, 9 per cent. from petrol and light goods vehicles, 1 per cent. from heavy goods vehicles and 47 per cent. from domestic fuel. Are we getting things out of balance? Can the Government give a simple explanation as to whether pollution from diesel vehicles is all that much worse than from a diesel central heating plant?
Viscount Goschen: My Lords, my information is that the emission of particulates from road vehicles of all types accounts for some 26 per cent. of the total emission of particulates into the atmosphere of this country. It is extremely important that we take action on all fronts. The road vehicles category is clearly important. We can make progress; it is important that we concentrate our efforts on that.
Baroness Seear: My Lords, will the noble Viscount take action to provide information about the issue to the country in general? Originally we were told that diesel was environmentally friendly. Some of us have now experienced—I speak as one who has—considerable adverse affects from being exposed to diesel. I do not believe that the public are sufficiently aware of the dangers involved.
Viscount Goschen: My Lords, the noble Baroness makes an important point. Assessing whether there is advantage in having petrol or diesel engined vehicles is a very complex issue. One puts out more emissions of one type and the other of another type. Clearly, diesel vehicles offer better fuel economy and they have an important advantage in terms of the total quantity of pollutants that they emit. However, they have a significant difficulty with the high level of particulate emissions.
Lord Stoddart of Swindon: My Lords, is the noble Viscount aware of the experiments in Reading regarding alternative fuels which have proved very successful? If so, will he take heed of the plea to reduce the tax on those alternative fuels which would be very much in favour of the environment? Are the Government also examining ways and means of bringing back the trolley bus to our streets? It is the cleanest, best and most efficient form of public transport that we have ever invented.
Viscount Goschen: My Lords, on the latter question, a considerable number of public transport initiatives are taking place using innovative means. I am not aware of the specific tests in Reading to which the noble Lord referred. However, I can tell the noble Lord that the duty on road fuel gases—that is, compressed natural gas and liquefied petroleum gas—was frozen in two 1994 Budgets and reduced by 15 per cent. in the 1995 Budget. The thrust of his question is the duty imposed on alternative fuels. I hope that that answers it.

Long-term Unemployment
3.14 p.m.
Lord McCarthy Lord McCarthy asked Her Majesty's Government:
What steps have been taken to implement the Workstart scheme and the one-year national insurance holiday, proposals to assist the long-term unemployed, set out in the Budget Statement of 29th November 1994.
The Minister of State, Department for Education and Employment (Lord Henley): My Lords, draft regulations to introduce the national insurance holiday for employers were laid before both Houses on 12th December last year and, subject to parliamentary approval, this measure will start from April 1996.
The second group of Workstart pilots, which were announced in the 1994 Budget Statement, began in April this year and recruitment will end in March 1996. A full evaluation will be carried out. Workstart subsidies will also be available to those participating in the Project Work pilots in Medway and Maidstone, and Hull.
Lord McCarthy: My Lords, does the noble Lord agree that this is a remarkable change in government policy? In 1994 the Chancellor announced both those policies as a matter of urgency. Nothing has yet been done to implement either of them. The Government have received a study of the Workstart programme which indicates that six out of 10 of the people on that programme benefited from it. Therefore, for £2,340 we can save £5,700. As a result of that, surely the Government should introduce Workstart on a much wider scale than another pilot suggests.
Finally, what is the cost of the one-year holiday scheme? Will that cost £2,340, or less or more? How many people do the Government think will be covered by that scheme.
Lord Henley: My Lords, what the noble Lord states is nonsense. We have done a great deal. We have started and finished two of the pilots, as the noble Lord well knows, and evaluation of those two pilots has now taken place. Initially evaluation suggests, as the noble Lord was prepared to admit, that it had a positive effect on employers' willingness to recruit long-term unemployed people. Obviously we shall learn more from the second stage. That is the point of the pilots. That is why we pilot those programmes.
The national insurance contribution holiday took a little more time to be brought into effect because of the complications of the rules relating to national insurance contributions. However, as the noble Lord knows, it will come into effect subject to parliamentary approval in April of this year, as I made clear in my original Answer. It is designed to help around 130,000 people and will offer to business about £50 million in reduced labour costs.
Lord Clark of Kempston: My Lords, does my noble friend agree that whatever the success of the

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Workstart scheme it would be impaired if we were to subscribe to the social chapter or have a minimum wage?
Lord Henley: My Lords, I can assure my noble friend that we have no intention of subscribing to the social chapter or having a minimum wage.
The important point is that the schemes are pilots and not whether or not they are a success. They test out new, innovative approaches to dealing with the problems of the long-term unemployed. As a result of those tests, we hope to come forward with appropriate solutions to that problem.
Lord Barnett: My Lords, my noble friend the Leader of the Labour Party in the House of Lords was told yesterday that the Government do not believe that there is any way in which they can help to create jobs. Is not this scheme one way, or have the Government changed their policy since yesterday?
Lord Henley: My Lords, that is not what I said yesterday to the noble Lord the Leader of the Opposition. I said that it was not the business of the Government to create jobs. It is the business of the Government to create the right environment in which jobs can grow. It is not the aim of the schemes to create jobs. They are designed to help the long-term unemployed back into work. Because the long-term unemployed are more greatly divorced from the labour market, their problems are that much greater than those who are recently unemployed.
Lord Rochester: My Lords, aside from the two schemes to which the noble Lord, Lord McCarthy, referred, are the Government considering any other measures—for example, in the field of training—aimed at alleviating the plight of the long-term unemployed?
Lord Henley: My Lords, I could rattle off a whole list of different schemes in which the Department for Education and Employment has been engaged for a long time. Perhaps it would be best if I merely concentrate on the latest one which I also mentioned in my initial Answer. It is Project Work, a scheme designed again to help the long-term unemployed by a system whereby their benefits will be at risk if they do not take part in certain schemes. That will be available for those who are unemployed for over two years. That scheme will start as a pilot in Medway and Maidstone, and Hull, shortly.
Baroness Turner of Camden: My Lords, is the Minister aware that in areas in which there was once heavy industry long-term unemployment, in particular among males, is now a serious social problem? First, is anything specific being done for those areas in which long-term unemployment mostly among males is high?
Secondly, is the noble Lord aware that according to research undertaken on the pilot it appears that small employers have been mainly involved and
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concerned with Workstart schemes? Is anything being done to ensure that larger employers become more interested in these schemes?
Lord Henley: My Lords, we targeted some of the schemes at areas of the kind to which the noble Baroness referred. I can assure her that the latest two Workstart pilot schemes are targeted at the West Midlands, particularly the metropolitan area, Greater Manchester and Sheffield. Those areas fit into the category to which the noble Baroness referred. I shall look at the other point of whether the pilots are biased overmuch in favour of the smaller employer and are not reaching the larger employer. Obviously it would be right that, so far as possible, we should reach all employers.
Lord Dormand of Easington: My Lords, the Minister mentioned evaluation. Did not the IES survey carry out an evaluation of the pilot schemes in the summer of 1994? When are we to see the results of that evaluation? Are the schemes proving unsatisfactory? I am sure that the whole House would want to have that information. The scheme was primarily aimed at long-term unemployment. Is there any evidence at all at this stage that it is getting the long-term unemployed back to work?
Lord Henley: My Lords, the schemes have not reached quite as many people as we initially hoped. The evaluation certainly seems to suggest that as a result of the schemes employers have a willingness to take on the long-term unemployed. More important, there seems to be a willingness on the part of those employers to retain people at the end of the period, whatever it is. That is the important point. No good is served by merely taking people on for a certain length of time if the employers are then going to dismiss them at the end of that period. We find that there seems to be an intention by the employers to retain the employees.
Lord Dormand of Easington: My Lords, may I ask whether the evaluation has been published?
Lord Henley: My Lords, so far as I am aware it was published at the end of December 1994.
The Clerk of the Parliaments: The Lord Bruce of Donington.
Lord McCarthy: My Lords, may I just—
Noble Lords: Order!
Lord Strathclyde: My Lords, the Clerk of the Parliaments has already called the next Question. Perhaps in view of the time we ought to carry on with the fourth Question.

European Parliament: Control of Expenditure
3.21 p.m.
Lord Bruce of Donington Lord Bruce of Donington asked Her Majesty's Government:
What are the circumstances in which (a) the European Commission and (b) the Council of Ministers is able to control and, if necessary, limit the annual expenditure of the European Parliament within its own budget.
Lord Mackay of Ardbrecknish: My Lords, I am tempted to say that I refer the noble Lord to the Answer I gave him on 21st November. However, in the spirit of the new year, I shall answer him again. On (a), the Commission may attach a divergent opinion to the estimates for expenditure put forward at the beginning of the budgetary process. On (b), there is an understanding between the Council of Ministers and the European Parliament under which neither amends the other's draft budget.
Lord Bruce of Donington: My Lords, I am most grateful to the Minister for that reply. I trust that when it is published in the Official Report it will not require any further correction by him. Is he aware that what he is really saying is that Article 203, paragraph 6 of the Maastricht Treaty confirms exactly what I suspected in the first instance? It is that the Council of Ministers, which includes Her Majesty's Government or the representatives of Her Majesty's Government, approved or at least did not deny the funds for the monstrous expenditure by the European Parliament on new buildings in both Brussels and Strasbourg. They have cost the British taxpayer—yes, the British taxpayer—some £40 million. Is the Minister aware that that fact will not be received with any kind of approval by all those in the United Kingdom who want to exercise the utmost economy in the expenditure of public funds? What are the Government going to do about it?
Lord Mackay of Ardbrecknish: My Lords, as I think I answered on 21st November, Her Majesty's Government do not necessarily approve of all the expenditure of the European Parliament or what it does. Indeed, we believe that a more sensible decision on the siting question would save a great deal of money. However, the point remains that, so long as the European Parliament operates within the ceilings agreed, we believe that: it is a matter for the European Parliament to defend the position on its expenditure.
As I understand that the noble Lord's friends in the European Parliament form the biggest single group, perhaps he might address his questions to them.
Lord Tebbit: My Lords, could my noble friend help us all by giving an assurance that no taxpayers' money will be used for purposes which have not been explicitly approved by the House of Commons?
Lord Mackay of Ardbrecknish: My Lords, I am not entirely sure what my noble friend is driving at there. The totality of contributions to the European budget is
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agreed by the other place. Within that, there are cash ceilings under seven different headings in the European budget which we have agreed at the Council of Ministers. These are contained within the global ceiling which we and the other place have agreed when approving the expenditure. As my noble friend knows, since 1979 we have fought hard to ensure that the Community spends wisely and that our share of the budget is not disproportionate.
Lord Stoddart of Swindon: My Lords, is the noble Lord aware that, if he did not understand what his noble friend Lord Tebbit was getting at, most people in this House, including myself, did? However, I shall not try to explain it to him, he will have to find out after Question Time. Is the Minister aware that people are extremely concerned at the profligate expenditure by the European Parliament? Is he further aware that it now amounts to over £1 million per member? That is three times the amount spent on the House of Commons and the House of Lords. It is a matter for great concern and surely the Government ought to try to do something about it.
Lord Mackay of Ardbrecknish: My Lords, as I have already explained, we have agreed the total cash ceiling for administration in all the institutions of the Community. If the Parliament takes more than its share, then other legs of the institution have to take less. The Parliament has to work within those kinds of restrictions.
However, I return to the point which I made earlier. I believe that, if it is a democratically elected parliament—as it is—then the members of that parliament ought to be, and are, answerable to the electorate for the expenditure on which they decide. I say to the noble Lord what I said to his noble friend. He might talk to his colleagues, who, as I understand it, form the biggest single group in the European Parliament.
Lord Peston: My Lords, may I ask the Minister whether he could at least—
Baroness Elles: My Lords, will my noble friend agree that the majority of the European Parliament voted strongly against having any new buildings for the European Parliament? The decision was forced through by the French Government and the Council of Ministers to have the extra buildings constructed which European parliamentarians did not want.
Lord Mackay of Ardbrecknish: My Lords, we know that the French were fairly keen on keeping the two-site arrangement. However, I believe that if the European Parliament wishes to reduce the use it makes of one of those two sites, it could stay at one site much longer than it does, unless it is a toothless organisation.
Lord Bruce of Donington: My Lords, is the Minister aware that his answers this afternoon have only gone to confirm the accuracy of the observations passed by the noble Baroness, Lady Elles? The report of the budget committee dated 16th December states that there is confirmation of the gentleman's agreement between the Council and the Parliament as to the expenditure. Is the

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Minister further aware that the Court of Auditors has declined to give approval to the regularity and reliability of the 1994 accounts? The Government already have the report of the Court of Auditors in their possession.
Lord Mackay of Ardbrecknish: My Lords, we are always concerned about expenditures which the European Court of Auditors highlights as not being expenditures of which they can approve at that stage. However, I return to my original point. I know that the noble Lord will not agree with me, but so long as the European Parliament acts within the cash ceilings agreed across the whole field of the European budget, it seems to me that, if we have a European Parliament which is directly elected, it is that Parliament's responsibility. I should not be asked whether I approve or disapprove, any more than every other elector in the country is asked to do so.

Business of the House: Debate, 18th January
Lord Strathclyde: My Lords, on behalf of my noble friend I beg to move the Motion standing in his name on the Order Paper.
Moved, That Standing Order 38 (Arrangement of the Order Paper) be dispensed with to enable the Motion standing in his name to be taken before the Arbitration Bill on Thursday 18th January.—(Lord Strathclyde.)
Question, Motion agreed to.

Non-conventional Medical Treatment
3.30 p.m.
Earl Baldwin of Bewdley Earl Baldwin of Bewdley rose to call attention to the benefits of non-conventional medical treatment for the health of the nation; and to move for Papers.
The noble Earl said: My Lords, I am deeply grateful for the opportunity to introduce the subject of non-conventional medical treatment in your Lordships' House this afternoon. It is close on six years since we last visited this field. I am encouraged by the number of speakers who have put their names down for this debate, and I know that we all look forward to hearing the maiden speeches of the noble and most reverend Lord, Lord Eames, and the noble Lord, Lord Winston. I am sure, also, that we all send our sympathy to the noble Baroness, Lady Cumberlege, who has been prevented by sudden illness from replying to this debate. We all wish her a speedy recovery. The noble Lord, Lord Kindersley, and my noble friends Lord St John of Bletso and Lord Walton of Detchant have told me of their disappointment at not being able to contribute today. But if all noble colleagues who have told me that their lives have been changed by a healer or an osteopath had decided to speak today, I doubt if we should have been allotted more than two minutes each!
I speak as a patient myself and as one who has studied the field for a number of years. I declare an interest as part-time chairman of the British Acupuncture
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Accreditation Board, and I am also joint chairman of the Parliamentary Group for and Complementary Medicine.
I believe this is an opportune time to take stock, to try to assess what non-conventional treatments can contribute, and to see how we can take the agenda forward. Much has changed in the last six years. I shall not recite all the statistics which show the vastly increased uptake and acceptance of complementary treatments. It is not just a British phenomenon. While a few of the old guard still speak of it in terms of a belief in magic, or a flight from science, what the surveys show is rather more prosaic. These patients, by and large, are not getting well with conventional treatment, do not like what those treatments are doing to them, and are getting better with non-conventional approaches.
A recent letter to the British Journal of General Practice makes the point. The chairman of the Royal College of General Practitioners' examination board wrote to tell of how a sudden attack of low back pain forced him to hold a telephone discussion with his senior colleagues, including,
"four regional advisers, senior RCGP officers, a couple of professors, and other leaders of our profession. Of the 12 doctors I spoke to, 10 advised me to see an osteopath. When you think how doctors have thought about and talked about complementary therapists in only the relatively recent past, this advice is quite astonishing and shows a dramatic change in mainstream medical thinking".
He goes on to say:
"I did see an osteopath, and he worked wonders".
In calling attention to the benefits of treatments outside the mainstream I shall have to be selective. What I want to do is highlight a few major areas where the evidence is strongly suggestive. I intend to concentrate on the more serious end of the scale, both for the benefit of those who still believe that complementary medicine is useful only for minor allergies and psychosomatic complaints and, more important, because we urgently need solutions and cannot afford to neglect any avenues that might bring results. I began by categorising examples according to the key areas of the 1992 White Paper, The Health of the Nation; but I quickly came up against the factor that most complementary practitioners will be familiar with, but which often bedevils understanding with conventionally trained doctors: the more truly holistic your therapy, the less you can claim that it may cure A, but has no role in B, C, or D. While some of my examples are linked to specific outcomes, others cover a much broader spectrum.
Coronary heart disease is still the major killer in the Western world. A few years ago a doctor in San Francisco, Dean Ornish, published a remarkable study. It sprang from his observation that by-pass surgery was a kind of metaphor for "by-passing" the real problem. He enrolled his patients in a controlled programme involving a low-fat vegetarian diet, yoga with relaxation, meditation and visualisation, moderate exercise, and regular support groups. At the end of a year even severely blocked arteries were becoming unblocked, a process previously thought impossible. Contrary to expectation, Ornish found no great problem in recruiting patients for this demanding regime. The difficulties have been more with the medical community and with funding.
In the realm of reproductive health Professor Barker in Southampton has been showing how malnutrition in the womb can affect health in later life. But few people know of the pioneering work of a small organisation called Foresight, which for years has been targeting the health of couples before conception. In this country one quarter of all pregnancies ends in miscarriage, one baby in 11 is born prematurely, one in 17 is malformed, to say nothing of those many couples who are unable to conceive at all. Foresight's doctors attend to the parents' diets, especially their micronutrient levels, to the possibility of toxic overload with lead or other substances, and to symptom-less genito-urinary infections.
In a recent uncontrolled trial involving 367 couples, 89 per cent. of the women became pregnant soon after, and every one of the 327 children was born healthy and without problems, including a high proportion to parents who had previously suffered from infertility or other difficulties. When you consider all that is involved in in vitro fertilisation you would think that some encouragement might be given to a low-cost alternative, instead of the demand that Foresight should fund and conduct a double-blind trial which by the nature of the treatment is an impossibility. Here we have a classic example of the mismatch between orthodox research tools and non-conventional approaches which sometimes blocks progress in promising fields. If the department of the noble Baroness the Minister could perhaps underwrite the need for appropriate evaluation criteria in such cases then we might be able to gain a better idea of the place for innovative treatments in overall health care provision.
I pass with reluctance over the AIDS scene, not because patients do not report being helped by a wide range of complementary approaches, but because the really promising development, from a naturopathic college in the States offering herbs, hydrotherapy and other treatments, has not had the funding to produce results beyond what were published five years ago.
Mental health suffers from the grip of the psychiatrists, whose orientation does not usually equip them to recognise those cases where brain functioning is affected by wrong nutrition, or toxic substances, or both. There is now a fairly ample literature to show that hyperactivity and even delinquency can be cured in some cases by diet; and food allergy as a factor in some so-called mental illness is not a new idea either. I have a close relative who was put on lithium for manic depression: she came off it, which she was told was unprecedented, as soon as she learnt to avoid wheat. It was as simple as that for her. It often is.
Meditation is still scarcely more mainstream. Yet there is now a substantial literature to show its benefits, not just in depression, anxiety and other conditions of the mind, but across a whole range of physical conditions. I would particularly commend the evidence for transcendental meditation, drawn from over 500 studies conducted at more than 200 research institutions and published in leading scientific journals. These show among other things dramatic reductions in hospital admissions in all disease categories, reduction of high blood pressure and cholesterol, weight reduction for the
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obese, together with an over 50 per cent. reduction in overall needs for health care. If only half of this were true it would deserve to be written in gold in every doctor's surgery in the land.
Finally, my Lords, cancer. There is far more of interest here than I have time for, ranging from the long-term trial of Chinese herbs to increase survival rates, to the anti-oxidant vitamin study in China which showed a marked reduction in deaths from all cancers, and indeed from all causes, to the recent Oxford study which suggests a 40 per cent. reduction in cancer deaths among vegetarians. The Bristol Cancer Help Centre is a beacon of light in this field, but I know other noble Lords will speak on that. I want to draw attention to one recently published study which, though retrospective, offers fascinating possibilities for a curative role for a non-conventional approach to cancer.
One hundred and fifty-three patients with malignant melanoma were surveyed in the United States for their five-year survival rates on the Gerson therapy, which is the oldest and most rigorous of the major nutritional treatments, involving an organic vegetarian diet and frequent fruit and vegetable juices. The survival advantage over orthodox treatment in the categories which were statistically significant, which involved the more seriously ill patients, was so massive that it is hard to see what kind of bias could account for it. Certainly, one of America's leading epidemiologists has declared himself satisfied that a real treatment effect has been shown.
If that is substantiated in further trials, it will represent one of the most striking advances since the war in an area which has not been conspicuous for orthodox success, despite the untold billions of pounds poured into cancer treatment and research. If it is not pursued, it will represent a betrayal of patients who have had to wait too long for genuine breakthroughs. Perhaps the noble Baroness the Minister, through the noble Lord the Chief Whip, would be good enough to bring that study to the notice of the Chief Medical Officer, as I should be very interested to hear his view on it.
Those are just a few examples of unorthodox approaches to serious disease which I have picked out, on the basis of evidence to date, as offering, I believe, realistic promise. There is a whole host of other areas—Chinese herbs for eczema, vegan diet and fasting for arthritis, acupuncture for nausea and substance abuse, and healing and homoeopathy across the board, not to mention the whole crucial area of environmental medicine in a polluted world—which I have been unable to cover but which I am sure other noble Lords will pick up. It is interesting to observe the strong role that nutrition plays in those examples. Yet this is still the Cinderella of the medical curriculum, unglamorous and long neglected, despite all the evidence which has gone to confirm what Gerson and the naturopaths have told us all along.
The other interesting feature is that so many of the examples involve self-help. Surely it must be right for people to take more responsibility for their own health rather than just go to a doctor to have things done to them. It is an approach which has enormous

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implications for the health budget at a time of spiralling costs in high-tech medicine. Cost-effectiveness, in the long if not the short run, will probably turn out to be one of the major benefits of complementary health care.
In concentrating, as I have done, on the clinical benefits, I can only mention in passing the question of the side-effects of treatment. It is a subject worthy of a whole debate in itself. The statistics for conventional medicine are positively frightening, and I believe that they play a greater part in patients' attitudes than most doctors will admit. While complementary practitioners cannot afford to be complacent, and there is work to be done in some areas, any damage there is of a wholly different order. In terms of costs and suffering, this is indeed a major benefit.
We need these new approaches. Patients demand and deserve them, in the face of medical science's lack of success with so many chronic diseases. Yet few if any of them are being followed through to see whether they can be validated and, if so, exactly what their role should be. Why is that? It is partly a matter of attitudes and beliefs in a deeply conservative medical profession. But it is also to do with resources.
There is not the money for healers and homoeopaths to fund good research out of their own pockets. Nor do they yet have the organisation nor the expertise. The Medical Research Council, when the chips are down, prefers the devils it knows. The drugs companies, which fund some two-thirds of all medical research and development, are not interested. There is nothing in it for them. That was vividly brought home to me by a friend, who, 10 years ago, conducted a very successful trial of acupuncture for breathlessness. His statistician told him, on studying the results, that had it been a drug trial, he could have guaranteed him £15 million in funding by the end of the week.
So, if we are to learn what we need to learn about the efficacy, the costs, and even the safety of some of these therapies that are already out in the market place, and in many cases now delivered by a health service whose watchwords include cost-effectiveness and evidence-based medicine, I see no alternative to government support. That is not a strange concept to the Americans, who even have an Office of Alternative Medicine with funding of many millions of dollars, or to many other countries. Perhaps I might make one or two suggestions to the noble Baroness, through the noble Lord the Chief Whip, for directions which might be explored in the near future, without necessarily pressing for concrete answers this afternoon.
At the top of the list would come help with basic medical audit. It need not involve a lot of new money. There are examples around and they need to be encouraged and built on. Studies of potential cost benefits could be a part of that.
Of course, too, we need more basic research, with appropriate methodologies. I understand that the idea of some ring-fenced funding would be favourably received in some medical circles.
Any support for training would pay dividends, whether toward an academic infrastructure for therapists, as an encouragement to research, or for familiarisation for doctors. Many difficulties arise through doctors not knowing enough about the terrain, and that applies nowhere more crucially than at the level of the MCA and its committees. In all this, help for the emerging professions to help themselves is probably the best kind of support.
May I end with a plea to the Government to encourage plurality in medicine? We have much to learn from other cultures. As to how much, I believe that we have hardly scratched the surface. I wish to express heartfelt gratitude for the Government's stance of benign neutrality, in contrast to the lack of medical freedom in many other countries. But I should like to repeat my plea of six years ago with even more emphasis: that for the sake of the health of the nation, for which they bear responsibility, the Government should now be a bit more benign and a bit less neutral. It is time to move forward.
My Lords, I beg to move for Papers.
3.47 p.m.
Lord Colwyn: My Lords, I am delighted that the noble Earl, Lord Baldwin of Bewdley, managed to secure some time for a debate on the subject of complementary medicine. I congratulate him on the clear and concise way in which he introduced the subject. I put down a similar Motion for the whole of the last Session without having any success at all. Obviously, there are some advantages in being on the Cross Benches. I should declare an interest as president of the All-Party Parliamentary Group for Alternative and Complementary Medicine. At this point perhaps I may say how sorry I am that Lord Ennals is no longer with us. He was joint president with me. I am also president of the Natural Medicines Society and patron of the Research Council for Complementary Medicine. As a practising dentist I use complementary therapies whenever appropriate for my patients.
As president of those two groups, I am able to look at the use of complementary medicine from two viewpoints: as a parliamentarian and as a patient representative. The Government and the public want accountability. Both want a guaranteed minimum standard of safety and an assurance that proper liability is available. Those who practise medicine must he properly trained and those who manufacture health care products must ensure the quality of their products in the interests of public protection.
The number of speakers in our debate is a guide to the interest in this subject shown in your Lordships' House. The public have expressed their interest by increased demand for such treatment. This afternoon, I should like to speak briefly on behalf of the consumers and their right to the treatment of their choice by the practitioners of their choice. The issue of freedom of choice in medicine is at the very heart of the Natural Medicines Society's aims. Yet it is also very aware that a total free-for-all is not in the public interest. By "free-for-all" I mean a situation in which products are

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placed on the market without any guarantee of quality or for which medicinal claims are made without substantiating bibliographical evidence, or where anyone can offer a medical treatment to patients without being appropriately trained.
Public safety is of paramount concern. There is a need to convince not only the medical establishment but also parliamentarians and the public of the practitioner's competence and ability to treat patients safely. The standard of training for doctors is high. The majority of people are reassured when seeking medical advice because they know the level and length of medical training. There is no justification for assuming that practitioners of complementary medicine should be allowed to treat patients without undergoing the same high standards of training, albeit of a different kind, if they want the responsibility and authority to practise their medicine. If professional practitioners wish to be considered on a par with doctors, the standard of training has to match theirs.
In Europe there have been calls to recognise the importance of alternative and complementary medicine and the non-medically qualified practitioner. In 1994 a report on the status of complementary medicine was presented by the Committee on the Environment, Public Health and Consumer Protection to the European Parliament. Although it failed to obtain a hearing at that time, it says much for the strength of feeling on these issues that the rapporteur, Paul Lannoye, was given permission to revise and re-submit a new report on the subject which is to be presented to the Environment Committee later this month. If approved, that report could pave the way for the recognition of alternative and complementary medicine throughout Europe.
In January 1995 the Natural Medicines Society initiated a move to unite the natural medicine community in the UK—involving practitioners, manufacturers, retailers and consumers—to work together to produce a position paper on the report from what is now known as the UK Forum for Alternative and Complementary Medicine.
That was a remarkable accomplishment. Never before had the industry joined forces to work together for mutual development. The strategy of a joint response from the UK organisations succeeded in gaining a weight and credibility that individual submissions would not otherwise have carried. M. Lannoye was impressed by the co-ordinated response, particularly as no other member country had achieved that. Many of the amendments suggested through the position paper have been incorporated into the new report.
For those noble Lords not familiar with the report on the status of complementary medicine in Europe, its primary objective is,
"To guarantee patients freedom of access to the treatment of their choice, whilst ensuring their safety, and at the same time allowing practitioners freedom of establishment and freedom to provide services. However these must be accompanied by effective guarantees to protect patients".
To achieve that the report suggests expert representation and appropriate research criteria for the various disciplines. It states that there should be clarification of the definitions associated with the various disciplines,
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recommending appropriate research criteria and expert representation at European level, including a directive on food supplements which are on the borderline between dietetic foods and medicinal products. A European committee of experts would be responsible for assessing the clinical efficacy of the different methods of treatment and would also advise on recognising the various systems.
The report also recommends that adequate financial resources be made available for research in each branch of complementary medicine, carried out in close co-operation with experts in the field. It indicates a figure of 10 million ecus for a period of five years. In calling for the regulation and recognition of complementary practitioners, the report suggests that each discipline should belong to its own organisation with standardised training, codes of practice and a professional register. Each therapy, once organised appropriately, should be legally recognised and there should be a committee of experts to advise on it.
If the report receives approval from the Committee on the Environment and moves to the European Parliament for debate, I urge the British Government to give it their support. Those working in the field of complementary medicine need to accept that there are challenges ahead that must be met to provide the public with the necessary assurances. A challenge to provide new evaluation criteria appropriate to the therapy and the products used is work being undertaken by the Natural Medicines Society's medicines advisory research committee. There is a challenge to practitioners to prove their knowledge and skill and, to the manufacturers, to provide good quality and safe products. Finally, there is a challenge to the legislators and the medical profession to widen the conceptual framework within which their scientific theories are constructed.
I am sure that many noble Lords will have noticed the current series of articles in The Times on health. Yesterday's dealt with new ideas in relation to the detrimental effect of free radicals and the benefits of antioxidant therapy using simple substances like vitamins C and E and sticking to some basic nutritional schemes. Those of us who work with natural medicine have known about this for many years. I have spoken about the benefits of nutrition and the need to enhance our immune systems in health debates on many occasions for perhaps 15 or 20 years and have had my advice regularly dismissed by the Front. Bench as a load of nonsense.
We are right. Nutrition and natural therapies work. The only reason why no one takes any notice is that the treatments do not involve expensive medicaments. There is no interest among the large pharmaceutical companies who need to earn money by selling drugs.
Finally, the benefits of alternative and complementary medicines have been recognised by the public. There is an increasing demand for such treatments in the private sector and calls for wider availability through the NHS. It is up to the Government to respond with a respect for the individual's freedom of choice. I hope that the Government meet that demand with prompt and positive action.
3.54 p.m.
Lord Winston: My Lords, I rise to my feet in great fear and trembling for several reasons: first, because, I am told that I must in no way be controversial, and I always find that difficult; secondly, because the Leader of the House the Lord Privy Seal gave us grave admonition yesterday about what would happen to us if we overran our time. Having listened to the debate yesterday and seen how people overran their time, I am slightly less worried than I was.
I am also concerned about the idea of a new year's resolution. However, I feel that I am excluded from that as this is the first time I have risen to my feet in this House. As a maiden speaker I am perhaps uniquely qualified to speak in this debate because I know very little about alternative medicine. My area is fertility and contraception. I set up my plate in your Lordships' House just before Christmas and am disappointed to find that no one has yet consulted me on those issues.
The noble Earl is absolutely right; complementary medicine is definitely important. I would not argue with that. However, I should add that some areas of complementary medicine are already implemented in the health service. Acupuncture is now quite widely used; indeed, we refer patients for acupuncture. There is no doubt that controlled studies have been done which show that it works extremely well in specific cases.
Osteopathic treatment is another example of where alternative treatments are taking off. I have been called a member of the medical establishment, though I doubt that I am in fact a member of it, but I take some issue with the noble Earl. It would be ridiculous for me to criticise complementary medicine. My wife had excellent osteopathic treatment which undoubtedly helped and my late mother-in-law, Dr. Golomb, was a practitioner of homoeopathy. However, she was also medically qualified and that is a relevant point. I want to come back to that issue in a moment.
I fear, regrettably, that for much alternative medicine the evidence that it actually works is extremely anecdotal. Your Lordships will forgive me if I say that patients may well feel better, but I believe that they may well feel better because of the placebo effect. There is no doubt that when somebody listens sympathetically to what one is saying and relieves the stress of what is happening, one feels an undoubted benefit. Sadly, far too many medical practitioners are failing in their duty to talk to their patients properly.
What is the placebo effect? Let me describe two examples to your Lordships. When I was a medical student I remember being told about a study in the Welsh mining areas. A new drug had come onto the market and was thought by the drug manufacturers to be excellent for coughs. The drug was handed out to three groups of general practitioners. The first group thought that the drug was wonderful; it would be the answer to chronic cough and lung conditions. The second group was not so certain; it was equivocal about its effect. The third group felt that the drug was clearly a case of exploitation and was being foisted on them by a specific drug company.
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A large number of patients—several hundred—went through those three practices. At the end of that time the patients were independently assessed by a panel of doctors who did not know to which practice the patients belonged. It was a blind, controlled study. The patients who went to the first group had an 87 per cent. improvement in symptoms; the patients who went to the second group had a 48 per cent. improvement in symptoms and the patients who went to the doctors who did not believe in the drug had something like a 17 per cent. improvement in symptoms. That is what I mean by the placebo effect.
The placebo effect can work in all sorts of ways. I can give an example of a study recently completed by my group at Hammersmith Hospital. We have been looking at the effect of growth hormone on the human ovary in patients who have repeatedly failed to ovulate. We had patients who were, by all standards, virtually sterile. The study was funded—admittedly, it was not a cheap study—and after ethical approval we gave one group of patients sterile water and the other growth hormone. None of the patients knew which they were receiving. I must tell your Lordships that it made no difference at all whether the patients received the growth hormone or sterile water injections. Both groups of patients had a much higher pregnancy rate than could possibly be expected. Therefore alternative medicine may work, but the placebo effect is remarkably powerful.
This is important. Professor Peckham, as he was retiring last week, pointed out that in the National Health Service at the moment more than £1 billion is wasted on medicine which is not properly evidence-based. We have to recognise that. The noble Earl, Lord Baldwin, referred to Foresight, the group examining mineral deficiency in pregnancy and miscarriage. But can we really believe in the concept of mineral deficiency? If mineral deficiency was a cause of infertility, does it not occur to Foresight that the burgeoning populations of Ethiopia, Bangladesh and India would be what they are? There is no evidence at all that these vitamin deficiencies play a serious role in human reproduction. The truth is that most miscarriages and most causes of infertility are due to defects in the human embryo. The sad thing is that I have seen patients who have gone through these treatments and whose proper treatment has in consequence been delayed. One knows the consequence of an older woman trying to seek treatment under the National Health Service. It becomes increasingly difficult and the delay in treatment makes her management more difficult to do.
Finally, perhaps I may take another example of complementary medicine. It is a ridiculous one but one which illustrates my concerns. Some noble Lords will be aware of the sex selection clinics. In fact, the noble Baroness, Lady Warnock, once mentioned sex selection as being a possibly useful thing for some Members of this House. Indeed, perhaps in another place there might be an urgent need to consider sex selection now that so many electoral difficulties are facing one of the major parties. There is a clinic in Hendon which has been set up to sex select. It filters sperm through a column which is supposed to produce either males or females and then

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patients are given this treatment. However, research in several places—at Hammersmith, and with my colleagues at University College, London, in Barcelona, in Belgium, in Israel and in Australia—quite clearly shows that this method of sex selection produces exactly a 50:50 ratio. Of course, some people will be satisfied because they get a baby of the desired sex but I submit that they would have done anyway.
Why does it matter? Leaving aside the moral issue, the matter for concern is this. At the moment one can practise in alternative medicine without a medical qualification. There is no regulation to stop that. Any one of your Lordships could set up a plate provided he is not medically qualified, and he could conduct his practice without any kind of rigorous method of appraisal. That should be considered and possibly there needs to be some thought to legislation about the issue.
4.3 p.m.
Lord Butterfield: My Lords, it is an immense pleasure to rise in the wake of a man who is obviously a very powerful contributor and educator and who has done such important work in the very important field of fertility studies. The noble Lord, Lord Winston, can be quite sure that we shall be listening with great interest to what I hope will be many more speeches to the House.
I remind the House that the noble Lord has been a visiting professor in the United States and Europe and that noble Lords may have seen him on many occasions looking at the whole problem of people's lives in doctors' hands, where he was the presenter for many years. The noble Lord has won the coveted Victor Bonney prize of the Royal College of Surgeons. We are delighted to embrace him and welcome him as a member of the medical profession to this House. I am not quite sure whether we shall turn so much to his expertise but we shall be delighted by his observations on the affairs of life.
Perhaps I may next say that I am fresh returned from the Far East. I have asked the noble Earl, Lord Baldwin, whether I may withdraw before the end of the debate because it appears that I am expected to be in Cambridge shortly after six o'clock to welcome some visiting Americans who are here for the night and tomorrow. I apologise to the House for this rudeness.
I should like to thank the noble Earl, Lord Baldwin, as I know all the other noble Lords who are to speak today will wish to thank him. I have been interested in unconventional medicine for all my professional life. The purpose of my communication this afternoon is to convey to the House that since around 650 BC conventional doctors have been concerned about the wisdom they have in attributing what they attribute to conventional treatments and have been looking at the whole question of evaluating conventional and non-conventional treatment. There is a famous aphorism attributed to Hippocrates. We do not know whether it is one man, Hippocrates, or whether there was a practice of them in Kos. The aphorism is that life is short; the art, the science or the technic is long—it takes a long time to learn it; the opportunity for doing good is
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fleeting; experiment, whenever one wants to undertake it, is hazardous; and—here is my important point—judgment in medicine is immensely difficult.
The noble Earl, Lord Baldwin, referred to the vast range of new non-conventional therapies that are appearing in our midst. I am very much in favour of that and I am sure that the noble Lord, Lore, Winston, is too. As we become more affluent, as there is better newspaper reporting, as there are better vehicles through the media to relay new pieces of information, things will spread more quickly. It took a long time for digitalis, reported to a professor in Birmingham, to become a world treatment for heart failure. I do not know anyone in conventional medicine who is opposed to the examination of the new therapies and to listening to the results that are coming through.
What we are all concerned about was touched on by the noble Lord, Lord Winston. I refer to the importance of accurate validation of the results. We have been very lucky in this country. In a physician called Gilbert we have had a great deal of the earliest work on experimental philosophy. Harvey unravelled circulation. Francis Bacon started the whole system of inductive logic. Incidentally, Bacon published a remark by which I am intrigued:
"Where there is much controversy there is, at many times, little inquiry".
That is what is changing with alternative medicine today. There is much more inquiry and I am very much in favour of that.
Not all the philosophers have come from the doctors. For example, Voltaire was very concerned because he thought that,
"Doctors pour medicines"—
he called it physic—
"about which they know little or nothing into bodies about which they know even less".
So the doctors have not had it all their own way, even if they have been qualified.
We are fortunate in this country that. we have had in our midst a man who evolved a system for testing new ideas and new therapies, whether they were conventional or unconventional. His name was Archie Cochrane. He looked like James I and I think that privately he thought he probably was. He was a wildish man; he fought in the Spanish Civil War; he worked among the pneumoconiosis people in South Wales and he had a Chair at the University of Cardiff. He established a whole system of interrogation for new ideas which he called the randomised controlled clinical trial. The word "controlled" was to ensure that one diminished the false detection of the placebo effect. The word "randomised" was in order to ensure that one did not select patients who would automatically get better or not get better. One had to be very careful randomly to choose the people in the different: groups. If one could, one changed the treatment from being, one hoped, active to being the placebo in the middle of the trial.
Suffice it to say that that is being used more and more widely all over the world. It is being used with many conventional medicines. It is now being used for many

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treatments which have been regarded as conventional for a long time. The noble Lord, Lord Winston, pointed out that there are many things that we do that we are not really quite sure about. This is the method that is being used to unravel what I hope we shall all come to realise is a new and important development of informed, knowledge-based medicine.
There is now at Oxford a Cochrane Centre where this kind of endeavour is going forward and to which a lot of results are being referred. So, basically, there is a great broadening of unconventional medicine. There is a great widening of the methods of examining it. It is my hope that by degrees we shall get a safer and safer pursuit of the profession and the complementary professions with it.
4.12 p.m.
Baroness Rawlings: My Lords, I too would like to thank the noble Earl, Lord Baldwin of Bewdley, who is so knowledgeable on this subject, for initiating such an important debate today and for opening it with such eloquence and clarity. There is great and growing interest in non-conventional medicine today as we can see by the long list of speakers. I congratulate the noble Lord, Lord Winston, on his fascinating speech and I look forward to the maiden speech of the noble Lord, Lord Barnes. I, too, like my noble friend Lord Colwyn, tried for a debate on this subject, but unsuccessfully.
At this stage I would like to declare an interest as a director and member of the board of the Foundation for Integrated Medicine, a registered charity. I believe that I should add, in the present climate, another interest in this field, as having nursed and been an active member of the British Red Cross Society for 25 years.
The noble Lord, Lord Baldwin, initiated a previous debate on this large and complex subject in May 1990. So much has happened in the past six years in this field that it is most timely for this debate today. Medicine is changing so rapidly with new, exciting discoveries every day. That is a far cry from, as Moliere described it in the 17th century, when discussing the heart and liver:
"`It seems to me you are locating them wrongly: the heart is on the left and the liver is on the right' said Geronte.`Yes, in the old ways that was so, but we have changed all that, and we now practise medicine by a completely new method' answered Sganarelle".
Wonderful new discoveries are saving more and more lives daily. Modern medicine has achieved outstanding results. However, there are increasing limitations and escalating costs. There are now real fears that the demands being placed upon the conventional health services may generate burdens which could prove impossible to meet. There is also some concern about the potential side effects of treatment. More could be achieved in our health care system, and often at lower cost, if effective complementary therapies were integrated into the existing practice.
Existing health care systems are experiencing growing difficulty in addressing 20th century illnesses, many of which are due to the effects of modern society. Even though Benjamin Franklin said,
"The best of all medicines are resting and fasting",
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which may be true with sleep of course, but often the pace and pressures of today no longer allow just this luxury. This is where the integration of orthodox and complementary medicine can really help.
Over the centuries vast experience has been gained all over the world from the use of traditional treatments. It is vital today that we safeguard the knowledge that has been handed down from generation to generation relatively untouched by our modern developments in countries like India and Brazil. Many of these treatments need to be researched so that the benefits can be enjoyed by people everywhere. These forms of treatment are becoming more and more popular, yet to be used on a large commercial scale further research is needed into effectiveness, safety, cost-effectiveness, and alas, as we all know, that costs money.
Complementary medicine should not be seen as a threat to conventional medicine. More and more doctors are interested in its potential and many people suffering ill health are using different therapies. A partnership is possible where all will benefit. Several "Establishment" bodies, some with full, others with partial government funding, like the BMA and the royal colleges, and some independent ones like the Research Council for Complementary Medicine and our own Parliamentary Group for Alternative and Complementary Medicine, are doing a magnificent job. This is surely a good moment for more recognition where national funding would be really popular. The most recent figures that we have are from 1991–92, when the National Health Service spent £1 million out of its £37 billion budget. I know that this is a vast area of medicine and there have been areas of recognition by an Act of Parliament both in osteopathy and chiropractic, as the noble Lord, Lord Winston, said in his maiden speech. But there is still a very long way to go. The figures are impressive: 2,500 osteopaths working all round Britain treating over 20,000 patients every working day—well over 5 million consultations a year.
Nurses are also pioneering the expansion of the use of complementary therapies. In approximately 80 per cent. of cases where policies in this field have been developed in the health services around the UK they have been spearheaded by nurses. A future nurses' formulary might contain complementary therapies such as herbal medicines, essential oils for internal use and homoeopathy for those who are trained.
Greater priority and funding is needed for research so that consumers can be given the information and reassurance that they require. Several other governments around the world are recognising the benefits of integrating orthodox medicine with complementary medicine. As we have heard, in the United States they set up in 1993 the Office of Alternative Medicine, which receives considerable funding and is proving a great success. The German Parliament entrusted the government with the task of assisting the scientific evaluation and future development in this area by means of targeted research support and in Switzerland the Swiss Government in 1990 launched a national research programme on complementary medicine.

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It is surely not only in the Government's interest but also for the health of all their citizens to promote health and well-being in addition to treating illness. Integrated medicine tries to deal with people as whole individuals, obtaining their confidence and trust, building inner strength for the treatment of illness and finally to restore to people their feeling of self-worth and esteem through active participation in their own treatment, as the noble Earl, Lord Baldwin, stressed. That is often essential for recovery.
His Royal Highness the Prince of Wales, who has been so supportive for many years in this field, said in 1994:
"Sharing responsibility for the care of patients by integrating properly trained and registered complementary therapists alongside what are considered to be more conventional practitioners could provide exciting long term benefits".
I hope that today will have stimulated debate on this topical and important subject and, more importantly, that complementary therapy can be further integrated within the National Health Service, providing positive benefits to patients. As in an old Arabian proverb:
"He who has health, has hope; and he who has hope, has everything".
4.19 p.m.
Lord Eames: My Lords, I greatly welcome the debate this afternoon and support the proposition so ably put to the House by my noble friend Lord Baldwin. In particular, like many of the speakers so far, I welcome the very sympathetic and practical approach that he adopted towards the subject. While I share the trepidation of the noble Lord, Lord Winston, on this occasion, it will soon become obvious that I certainly do not share his expertise. In fact, I am reminded of, and would share with the House, the report made of the fictitious cadet at Sandhurst who, having completed a rather haphazard career through that esteemed establishment, had written across his final report by an examiner, "Should this candidate ever become an officer in the British Army, I am convinced that his soldiers will follow him not out of loyalty, but out of a sense of curiosity".
It is for that reason that we can safely say that we live at a time when there is immense concern and interest across the nation about all aspects of medical treatment. Perhaps I may remind your Lordships that hardly a day passes when some aspect of medical care or medical concern does not fill the headlines. We have become a people aware as never before of the concerns of the medical profession and of the difficulties and yet opportunities which face it.
However. I also recognise that the whole subject of alternative or non-conventional medical treatment has become a somewhat sensitive issue for many of my friends and colleagues in the medical profession. I speak from a lifetime of experience of pastoral ministry to the people of Northern Ireland. I can assure your Lordships that, particularly over the past 25 years of violence, and of the suffering caused to so many because of violence, I have come to have a new appreciation of the value,
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integrity and professionalism of the medical profession in Northern Ireland. I gladly pay tribute to its members on the occasion of my maiden speech.
Perhaps I may presume in this debate to draw attention to a part of the subject before us which I do not feel receives adequate attention—certainly not to the extent that it deserves. On the one hand, as we have been told, we have structured professional medical care in hospitals and at bedsides in ordinary homes; on the other hand, we have that myriad of parallel and supportive work which we must surely recognise today as an integral part of healing. More and more, the phrase "pastoral care" is being used. Although it involves, in a rather narrow sense, members of my profession, it clearly has implications right across the board in new and exciting ways. Health is much more than a physical problem. As the noble Lord, Lord Winston, reminded us, the attitude of the patient to his or her illness is more and more becoming a vital feature in the healing process.
More than one writer has drawn our attention to the submission that much more attention must be paid to the relationship of modern medicine to healing. Too often we unfortunately have to conclude that scientific information has become the end rather than the means to the end of human service to human people. Eric Cassell wrote recently in one of his books of the danger of physicians viewing their job exclusively as the curing of disease and thereby being prevented from effectively making a lasting impact on the health, the overall health, of the nation.
That problem, which was highlighted by my noble friend in his opening speech, is of particular concern to the Church. Many efforts have been made in this century to bridge the gap between pastoral care and the expertise exercised by the Church and the work of medical practitioners. As your Lordships will recall, a major step forward was taken in 1947 when the British Medical Association approved a statement which said:
"Medicine and the Church working together should encourage a dynamic philosophy of health which would enable every citizen to find a way of life based on moral principle and on a sound knowledge of the factors which promote health and well-being".
It is said that Chinese Mandarins used to pay physicians only so long as they remained well. Surely we need to learn the wisdom of that approach—for the caring professions are in the business of preserving health, not in addressing illness alone.
My plea today is that when we consider non-conventional medicine we give full recognition to the need, indeed the priority, of encouraging the fullest co-operation between the actual practice of medicine and the growing importance of pastoral care, pastoral support and pastoral concern for the health of our nation. This is a wide field and is one which, as I tried to say earlier, involves much more than the clergy. "Counselling" is a word which, like Topsy, has grown and grown. I, for one, am never quite certain what it means. However, that is part of a subject which is of immense importance and which is the real reason why I beg to presume to make a contribution today.

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I plead for full acceptance that this co-operative process should become the norm. Tension and suspicion between the two aspects of medicine must be avoided at all costs. Each has its role. In the overall context of the health of the country, I believe that together the two professions can discover a new dimension to the compassion and wholeness which should be the real substance of a healthy nation. Perhaps I may conclude by reminding your Lordships of a remark made to me by a seven year-old child who fell out of bed when he was supposed to be asleep. He said, "I think that I fell out of bed because I stayed too near where I got in".
4.27 p.m.
Lord Desai: My Lords, it is my privilege and pleasure to congratulate the noble Lord, Lord Eames, on his remarkably witty and informative speech. The noble Lord brings a variety of talents to your Lordships' House. He is non-conventional enough to be a bishop but is to be found sitting far from where the Bishops normally sit. He is a lawyer; he is therefore not merely a "most reverend" but also a "learned" noble Lord. We know that he has brought a humane touch to what has been a very torn and sad part of our country. We all look forward very much to his future contributions.
I must spend a little more of my scarce time in welcoming my noble friend Lord Winston who made an excellent speech. I have known my noble friend for many years and shall say only that if he continues as he has begun he will surely be one of best heard speakers in our House.
I have no qualifications whatever for speaking this afternoon; I am not even a very good example of someone who has benefited from medicine, much less administered it. However, I merely wanted to say that among non-conventional medicines are systems from India and from China which we must take seriously as alternative systems of medicine. I refer to the Ayurvedic system, the Unani system and the Chinese system. Those systems of medicine do not have the same reasoned structure or scientific traditions as conventional medicine. But there is no reason why one could not use the same randomised, controlled clinical trial technique on all those medicine systems; why we could not see to it that if the local population, be it from South Asia, be it Hindus, be it Moslems, be it Chinese, wants to use these alternative systems of medicine, they should be confident that they will receive as good and as practised a person if they go to an Ayurvedic doctor as they would from a conventional doctor. My one plea is for research into whether we have ways of certifying and ensuring that that minimal guarantee of good practice is assured to all patients.
As other noble Lords have said, systems of medicine have much to learn from one another. There is no such thing as scientific medicine as such. We should not have just one view of science—A is science and B is not science. If a scientific method is practised, we can improve the performance of conventional medicine and non-conventional medicine.
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As many noble Lords have pointed out, one thing we have learnt is that in the relationship between the doctor and the patient there are two active agents and not just one. It is not merely the doctor who is doing something to the patient; the patient himself or herself brings a whole host of attitudes, qualifications and beliefs, which could either be a help or a hindrance. We do not understand why that is. Much more research is needed.
When someone who practises Ayurvedic medicine tells me that he has a holistic approach, what he is trying to say in a way is that there are aspects of that relationship which are not fully understood, at least on a scientific basis as we understand science.
It would be a good practice, either through the NHS or some private foundation, to do comparative research on the effectiveness of different schools of medicine either on the same disease or complementary approaches to curing certain diseases. Again, as the noble Lord, Lord Eames, pointed out, it is not just a matter of curing patients; it is a matter of health. If we are to enhance the health of the nation, we shall have to learn to profit from as many different approaches as possible which boost the health of the nation in a variety of ways. I congratulate the noble Earl, Lord Baldwin of Bewdley, on giving us the opportunity to discuss the matter.
4.33 p.m.
Lord Menuhin: My Lords, I seem to be the third maiden today.
"There are more things in heaven and earth, Horatio, than are dreamt of in our philosophy".
An item I read on the occasion of my mother's 100th birthday a few days ago (6th January) in the San Francisco Chronicle stated that King's County, Washington State, has approved a nature clinic supported by taxpayer's money. This is encouraging news.
I should like to give four instances from my own experience of therapies which would fall into what we call alternative practices in medicine. Pastoral care is certainly one. Music is, by definition, therapy. Music offers the only way to establish a dialogue with autistic children. That is well-documented, established, and available on film. I have seen it myself. It is hardly practised. The moment when the child begins to imitate, in this case, the pianist instead of the pianist imitating the child, is one of the most inspiring experiences in life.
My second example: I am engaged in a European Community project directed by my foundation which seeks out the most difficult schools in nine different countries. By "difficult" I mean riddled with prejudice and violence. As soon as the children begin to sing and dance together, as soon as the lungs and the heart act for the whole body, normality sets in. They become trusting of one another, of their teachers and the atmosphere is co-operative, positive and fruitful in terms of all other studies as well.
The London school is the Oxford Garden Primary School. In Brussels we have found a wonderful teacher of mime as well. When we move into the teen-aged schools we will include a martial art, for as soon as the chaotic energy is drawn to a goal of visible perfection

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and command, the energy becomes focused and there is virtually no more violence. That is also documented. It is the most effective treatment there is for juvenile delinquency.
The third example is a cheap and easy electronic acupuncture treatment involving practically no withdrawal symptoms. The patient is clinically free of any addiction within seven days. The treatment itself is done two or three times daily for a few minutes. It is pleasurable without being addictive. We owe it to every human being who has succumbed to the illegal and vast drug industry to enforce this cure. It is important that following the cure a good environment be provided so as to forestall any reversion to the addictive habit.
My fourth example is, of course, homoeopathy which is safe and effective and avoids every iatrogenic disease. What is it therefore that militates against a large investment in alternative prophylactic preventive medicine that could ultimately reduce the national health budget by a half, because at least half the population would be well instead of sick? I wonder whether noble Lords will allow me to explore what might appear to be a digression; that is, the very concept of "alternative". To discuss the subject of "alternative medicine" we must try to understand more clearly the role of alternative thinking in our general well-being. I think that it is the same mechanism at play. Alternative implies choice. Choice can only be based on memory together with objective assessment.
Man's brain is the triumph of choice over restriction. Genetically determined insects have no choice. Our own brain, with its innumerable network of nerves is a result of infinite possibilities of checks and counter checks, for we are equipped to take calculated risks and decisions. Then what is it that stands in the way? I shall list some of the human menaces that inhibit choice: prejudice annuls the faculty of choice in opinion and reduces the gift of objective analysis. Sometimes it is merely an old, cumbersome, bad habit. Short-sighted self and vested interests destroy those choices which are required for the general well-being. Those curiously often appear as open-mindedness. Dictatorships suppress choice and debase the life of the population in all aspects, impeding progress.
The feeling of exclusivity which enables a half truth to pretend to be a whole truth, which allows a theory to be enshrined as gospel, militates against the exercise of choice. Capitalist economies, with their free enterprise and free trade, find that they must curb monopolies, for we recognise that a monopoly, which is an exclusivity, reduces free choice. We cannot allow any one value to become obsessive at the expense of all other basic values. Choice is selective and is a school for subtlety. Brutality is unsubtle, unselective and therefore uncivilised.
People believe in police and prisons rather than in music, dance, mime, the martial arts, crafts, art and good education. "Lock them up" and "law and order" are convenient rallying points and are even necessary in the very short term. However, they are poisonously counterproductive. Those forceful measures have control and act as punishment but are of no permanent,
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social, intellectual aesthetic or therapeutic value. Few people understand that the gaolers and the gaoled became locked into each other's images and together they enhance the contagion of violence.
Only the sheerest hypocrisy can pretend that the media are not crime-provoking. Yet television, newspapers and pulp literature take no responsibility for guidance, education or crime. Universal truths must be allowed to speak for themselves. A defence of truth does not require propaganda or police but it requires all our hearts, minds and courage. By the way, my mother looks after herself very well.
4.41 p.m.
Baroness Masham of Ilton: My Lords, I thank my noble friend Lord Baldwin of Bewdley for this debate. My noble friend has much experience of, and enthusiasm for, this interesting subject.
Herbal medicine has enjoyed a great revival for both humans and animals. It seems that while herbal medicine is not usually the best first treatment in the case of severe accidents or acute illness, it may do a great deal to support conventional therapy. The herbalists would say that they are not just treating symptoms but are treating the patient holistically. A herb like garlic is used beneficially for both humans and horses. Yesterday I was given a box of pills for my dog who is losing his coat. The box stated that it contained a traditional herbal remedy for the relief of arthritis and kidney, eczema and common skin compaints in cats and dogs. It was produced by Natural Pet Care Limited. I shall watch and hope for improvement.
In recent years, there has been a great increase in the sale of herbal teas, enjoyed by many people. Not always are the ingredients written on the packet. There is concern that some may contain camphor, which may damage the liver. Perhaps, if there is such a risk, the Minister will ask the department to look into the matter.
My noble kinsman, my husband—I have his permission to mention this—had a problem last September when we went to Italy on noliday. One of his English doctors had told him that he could take his ted stockings off, which he had used since developing a deep-vein thrombosis after a stroke. When in Italy his leg became even more swollen than usual. I fetched a doctor to see him. He was also having bad cramps at night. Apart from elevating the leg and keeping him on bed rest for some time, the doctor gave him some tablets—Daflon 500 mg—to reduce the swelling and alleviate night cramps. The tablets contain natural products derived from plant sources. They are made in Italy, France, Spain, Belgium, Germany and Switzerland. As they helped, we are now provided with them by a doctor friend in France. As we are now in the European Union, it seems that we should also be able to share that sort of medication.
It is interesting to see the recent report on complementary therapy at Lewisham hospital. Evaluation and research is extremely important to help doctors, therapists and patients. I hope that that initiative is welcomed by the Department of Health.

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I serve on the council of the London Lighthouse which looks after and helps people with HIV and AIDS. I have also been in touch with the Sanctuary in Bournemouth which provides similar support. I am also a member of the all-Party Parliamentary Group for HIV and AIDS. Non-conventional medical treatment is used alongside conventional medicine for those unfortunate patients with the agreement and co-operation of the patient, doctor or hospital unit.
Complementary therapies are able to provide comfort, emotional support, reassurance, relaxation, strengthening and balancing of the compromised immune system and help with working on opportunistic infections through the immune system. Many therapies are used which have been found helpful. The most usual are aromatherapy, reflexology, shiatsu, diet and nutrition, counselling and the use of a snoezelen room.
Aromatherapy clients are helped to minimise stress by the use of essential oils together with massage, inhalations, compresses, baths and diffusion. That can also help to balance the physical aspect—to stimulate the blood and lymphatic system which encourages the elimination of toxic waste from the body.
Doctors at London's Chelsea and Westminster Hospital, reported recently that 44 per cent. of outpatients attending the Kobler Centre were using at least one alternative or complementary therapy. Out of 375 separate treatments, 89.3 per cent. were described as being beneficial; 10.4 per cent. as having no effect; and 0.3 per cent., which was only one episode of one therapy in one patient, as having been harmful.
It has been found that complementary therapies are particularly attractive to counter some of the unwanted effects of essential medication. For example, someone who has been receiving chemotherapy for Kaposi's Sarcoma with anti-retroviral drug treatment may use massage and aromatherapy to relieve the pain in the hands and feet caused by neuropathy.
Less serious infections can be controlled with complementary forms of treatment, some of which have been tested and shown to be just as effective as standard drug treatments. Fungal infections, skin problems and night sweats are examples of the problems with which herbalists, acupuncturists and homoeopathists say they have considerable success in relieving. No doubt if those treatments were available and patients could afford them, they would be of value to many more people with serious illnesses and chronic disabilities.
Many people throughout the country are using complementary or non-conventional medicine. In some cases, advantage may be taken of those people. What codes of practice are there? Is there sufficient regulation to ensure that consumers of non-conventional medicine are protected?
4.48 p.m.
Viscount Addison: My Lords, I too thank the noble Earl, Lord Baldwin of Bewdley, for initiating today's debate. In the debate on the National Health Service and
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the role of the private sector on 8th June 1993 I spoke of the plight of aromatherapy. Today's debate offers me the opportunity to bolster that view.
Aromatherapy presently enjoys a popularity which seems to grow all the time. Its roots stem from thousands of years of plant medicine which has supported human and animal life alike. To be able to appreciate aromatherapy in its totality, it is vital to look at how aromatic plants develop from their natural environment. Aromatic plants, like many other organisms on the planet, are dependent on sunlight, water and oxygen for their growth. They grow in particular habitats which tend to influence their characteristics and they play an interactive part in the life of various insects, animals and humans.
An example of that is shown in the ancient practice of storing hay cut from hedges where wild aromatic plants such as fennel, angelica or dill are abundant. The hay was fed to sheep and cattle in the springtime to increase lactation and generally keep the animals healthy throughout the winter. That must have been a factor in keeping the food chain healthy without having to use too many dangerous substances, as is often the case today in industrial farming.
How do aromatic plants differ from any other plants? They are recognisable by their distinct smells which place them in a category of their own in the plant world. As breathing is a vital function in our life and smelling is something which we cannot easily prevent, we are in fact experiencing aromatherapy without thinking about it on countless occasions. Scents automatically enter the body while we breathe and provide us with interesting sensations.
There is no doubt that for most people the earthy smells of trees, flowers or wood evoke something natural and peaceful as they appease our sensitive nature. The feelings that we derive from open spaces such as meadows, forests or even a garden always seem to equate with an easier frame of mind and abandonment of worldly responsibilities.
Our perception of the world relies a lot on three of our senses: vision, hearing and smell, with the latter being the most intriguing as it links up with irrational regions of ourselves. Our sense of smell has a reputation for bringing up to the surface our most primitive survival instincts. Smells are well known to trigger memories from long-forgotten events, awakening many lost sensations. The relationship between the two is a source of fascination to every dedicated aromatherapist. The fact that people like nice smells and associate them with feeling good is what makes aromatherapy so popular.
Unfortunately, that "smell-good, feel-good factor" is in danger of being lost as it is still totally ignored by many medical authorities. Those authorities, in their zeal to look for professional and financial diversity, are trying to absorb aromatherapy into the allopathic medical system. It is hoped by some parties with strong vested interests that essential oils will be placed under the same regulations as apply to pharmaceutical products. That would effectively put essential oils out of the reach of a non-medical practitioner and would

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reduce greatly the multi-dimensional effect essential oils can offer. If that were allowed to happen, it would immediately send us back to the Dark Ages when human beings were treated like machines, devoid of sensations or feelings.
A scent is not something that can be easily pinned down or defined. However, aromatic plants can be made to yield their scent by transforming them from a gaseous state into a fluid substance. An essential oil is a hit like the genie in the bottle with many therapeutic, magical properties.
For their therapeutic properties to be active, essential oils need to be extracted in the correct manner. The right botanical species have to be picked and stored in proper conditions. More sophisticated and industrial methods of extraction are not suitable as they tend to destroy the integrity of the essential oils. The lifespan of essential oils is variable and one cannot expect a great deal of therapeutic impact if using a product which is past its sell-by date. Only a well experienced aromatherapist will be able to tell whether an essential oil is past its prime.
In practice, most aromatherapists use small amounts of essential oils diluted in a suitable medium, applied directly to the body by massaging the skin with the blend. That seems to be enough to initiate a change in mood and general health of the receiver. The latest explanation for the working of aromatherapy is that essential oils are easily absorbed in tiny quantities by the respiratory mucous membranes, the skin and the membranes of olfactory receptors. That seems to affect the activity of the membranes in a similar way to steroids.
A competent aromatherapist will work towards improving the state of mind of a person as that bears some relation to the natural healing process of the body. The role of an aromatherapist is very difficult to define as it requires the therapist to be gifted with human qualities such as warmth and patience but also to possess a sound understanding of the workings of the human body and to be nothing less than expert in aromatic science.
The effect of the therapy can be quite immediate as in the relief of symptoms, long term as in dealing with chronic ailments or supportive if dealing with a life-threatening illness. One of the greatest benefits which aromatherapy can claim over many other therapies is that it is the most efficient therapy in the release of stress.
Aromatherapy evolved with a small number of people who were dedicated to what they believed to he revolutionary therapy. In the past 10 years the aromatherapy movement has grown rather big. As there is a rising demand for the therapy, aromatherapy practices have multiplied. Not all of that is a good thing as many of the would-be practitioners have trained very quickly in colleges or adult education centres which employ teachers unqualified to teach the subject and who themselves have not practised. That is a state of affairs which needs to be remedied as soon as possible.
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There are at present a number of professional aromatherapy associations whose members are working very hard to define and establish the standard for the practice of aromatherapy. One such body is the International Federation of Aromatherapists. That organisation was founded 10 years ago by the pioneers of aromatherapy and has some of the most experienced practitioners in the UK in its membership. Its main aim is to play an informative role to the public and to promote and maintain standards in aromatherapy. It is a charitable organisation and, when it was founded 10 years ago, it established a network of volunteer aromatherapists and offered this free service to hospitals and hospices. Those activities made nurses aware of the existence and benefits of aromatherapy.
Currently, the Royal College of Nursing and other medical organisations are running their own training courses having extracted from the therapy what they consider suitable for the medical profession. Those courses are not designed to emphasise the psychological side of aromatherapy or a commitment to a holistic approach, as these cannot be rationalised and are time-consuming to teach and practise. That is unfortunate as it is in direct contradiction with this person-centered therapy. Many nurses have now turned to the IFA for further training in the field and it is hoped that aromatherapy will not be hijacked by the wrong parties and destroyed in the process of rationalising its deeper implications.
Most aromatherapists look forward to government regulation and sincerely hope that that will be done with the inclusion of the original practitioners' point of view.
4.56 p.m.
The Countess of Mar: My Lords, I am very conscious of the fact that, had I not received treatment from complementary medicine practitioners, I would not be well enough to be in your Lordshibs' House today. I am more than grateful to my noble friend Lord Baldwin of Bewdley for giving us the opportunity to discuss the subject. Noble Lords can hardly fail to have noticed that, for the past three-and-a-half years, I have been campaigning on behalf of those who, like me, feel that their chronic ill health is as a result of exposure to organophosphates. I should like to take this opportunity to thank noble Lords for their support and perhaps most of all for their forbearance.
As well as getting myself well, my objectives have been threefold: to gain recognition for the sufferers; to obtain treatment for them; and to prevent any more individuals suffering from the effects of exposure to those toxins. I also support those who are too ill to work in their quest for compensation.
Most practitioners of conventional medicine either do not believe or are sceptical about claims that long-term, low-level exposure to environmental toxins such as organophosphates can give rise to chronic health problems. Many of the sufferers with whom I work tell me that their GPs and consultants believe that they are psychosomatics. For those whose GPs accept the reality of their symptoms and sometimes even the cause, there is little help from allopathic medicine. Treatment is

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symptomatic, and often those who have been affected by chemicals do not respond to standard drugs as other patients do. As a result, there are at the very least several hundred individuals and their families struggling to maintain some kind of life who are ill, confused and distressed.
I first became ill in 1989 after a sheep dipping session. I went through the NHS mill of diagnostic tests, all of which drew a blank, and attempts to alleviate my symptoms (which I shall not detail here) for a period of two years. I am extremely fortunate in that my GP suggested that I try complementary medicine. At that stage we had no idea of the cause and I was never asked whether I had had any chemical exposures. In any case, I would not have made the association, as, like the majority of the population, I naively believed that licensed chemicals were safe if the recommended precautions were observed.
Again, I was fortunate in my choice of complementary therapist. After taking a complete history she came to the conclusion that I had been poisoned. She used kinesiology as part of her armoury, both to assess my condition and to decide upon treatment. I must admit that I was sceptical, but I began to feel better after taking the herbal, vitamin and mineral supplements that she recommended. Her conclusions about the effects that the poison has had upon my organs and nervous and immune systems have subsequently been confirmed by scientific means.
It was not until May 1992 that we made the association between my health problems and exposure to OPs. Sadly my therapist died in 1993. For a year I tried to find a replacement for her, mainly on recommendation, but without success. I learnt a salutary lesson; not all those who profess to have the answers do. Fortune eventually led me to Doctor Jean Monro and the Breakspear Hospital in the spring of 1995. She and her colleagues are all conventionally trained and have also been trained in environmental and nutritional medicine. Their methods of diagnosis and treatment are scientifically based. Many of their patients suffer allergies, or multiple food and chemical sensitivities—a syndrome not accepted by the establishment.
In the 15 years since the Breakspear Hospital was established, over 12,000 patients have been treated. They come from most of the European countries, Israel, Pakistan, Australia and the USA as well as from the United Kingdom. Approximately 40 per cent. of its UK patients are National Health Service extra-contractual referrals. Treatment is based upon establishing the cause of the illness and the nutritional status of the patient rather than treating the symptoms. It is apparent that most of the patients suffer gross sulphoxidation deficits. Sulphoxidation is the means by which we rid our bodies of toxins. With the aid of vitamin and mineral supplements which are known anti-oxidants, a balanced diet and vaccines licensed by the Medicines Control Agency, the patients' health status is vastly improved and most are able to resume their previous occupations and activities. I am constantly delighted by the return of my energy, strength and mental activity to levels which are almost what they were seven years ago.
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There are a number of medically qualified practitioners who specialise in environmental medicine. Many are members of the British Society for Allergy and Environmental Medicine and the British Society for Nutritional Medicine. I have already said that these fields are, for some unaccountable reason, found to be unacceptable by the medical establishment. As a farmer I find this inexplicable. My husband and I breed pedigree cattle, sheep and goats. We are conscious that the health status of our animals depends upon our ensuring that they receive a balanced diet, and because our soils lack certain trace elements which are essential for their development, for their fertility and for the uncomplicated birth of their progeny, we supplement their feed with necessary minerals. We also know that their needs change with the seasons and that, as individuals, they have varying requirements. It seems odd to me that, while the veterinary profession and most farmers as well as ourselves have this knowledge, for some reason those who treat humans do not take into account the fact that even small deficits in trace elements, vitamins or minerals can cause quite severe health problems for humans.
I have no doubt that the noble Baroness has seen the BSAEM and BSNM submissions on effective allergy practice and effective nutritional medicine but, if the noble Lord, Lord Strathclyde, will let me know if she has not received those, I shall ensure that she is sent them. The noble Baroness, Lady Cumberlege, is aware from discussions I have had with her that there are many sick people for whom orthodox medicine cannot provide a cure or respite from their symptoms. She is also aware that there is a wide disparity in the willingness of GPs and health authorities and boards to agree to provide extra—contractual referrals of these patients to facilities, such as those at the Breakspear Hospital, where there is demonstrable clinical evidence of effectiveness. Many patients who would, I am absolutely certain, benefit from its approach to the treatment of these illnesses are deterred by the cost.
May I therefore ask the noble Lord, Lord Strathclyde, whether he will ask his colleagues to give serious consideration to the long-term benefits of environmental and nutritional medicine both to the health of the population and to the costs of the National Health Service and ask also whether the Government would consider setting up a facility within the NHS for this speciality? It is accepted by both Germany and the USA, and I cannot believe that the improvement in the health of more than 12,000 patients from one hospital can be attributed to a placebo effect.
5.4 p.m.
The Earl of Clanwilliam: My Lords, I also rise to thank the noble Earl, Lord Baldwin of Bewdley, for giving us the opportunity to debate this important subject. I should also point out that I have his kind permission to mention that Lady Baldwin has recently recovered from a serious illness and that has been achieved entirely by non-conventional means. I am sure that we all wish her well. That certainly would be no part of the placebo effect. As the noble Countess, Lady Mar, has just pointed out, she is a living example

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of someone who has recovered from illness by these methods. I am sure that no one in this House would ever accuse her of 'being subject to the placebo effect.
I refer to some examples of where co-operation on this matter already exists within the NHS. I was delighted to read in the Daily Telegraph only last Friday of an interview with the Chief Medical Officer adumbrating a,
"big cultural shift in that it is absolutely essential that we involve patients on the decisions that affect them and allow them to make choices".
That is indeed a big shift, and a shift towards holistic practice. Perhaps it augers well for good results from this debate. I only hope that the CMO has the ear of the BMA.
I wish to refer to the subject of herbalism. In 1969 I became, unexpectedly, the chairman of the Society of Herbalists and since that day I have been impressed by the results achieved with patients under the auspices of the various practitioners with whom I have been associated. I have noted how their health has improved as a result of the herbal treatments they have received. I hasten to add that they have all been treated by registered practitioners.
I also wish to talk about traditional Chinese medicine which uses acupuncture, Chinese herbalism and modern medicine rolled into one. It is the regular practice in Chinese hospitals for patients to be assessed according to their perceived need for treatment by any one or by any combination of the three therapies that they practise. The words "alternative" and "complementary" are relevant to these practices and I use the word "non-conventional" with great reservations. As regards acupuncture, a recent research paper points out that in China the Government actively support research into the mechanism whereby acupuncture works, which is still obviously not clearly understood in either China or the West. That, of course, begs the question: does it work? There can be no doubt that today millions of people are being relieved of pain by means of acupuncture. I ask my noble friend whether we cannot have support for research into this mechanism.
As regards Chinese herbalism, a herbal treatment prepared by Dr. Ding Hui Luo, who is president of the Association of Traditional Chinese Medicine, is discussed in a paper written by Mary Sheehan and David Atherton, who are consultants in the Department of Dermatology at the Great Ormond Street Hospital for Sick Children. They conducted a placebo-controlled double-blind trial of a specific herbal decoction prescribed by Dr. Luo to treat severe atopic eczema. I shall not go into all the details of the trial but I would merely say that 21 severe cases were cured or substantially relieved out of 37 entrants. That is a remarkable achievement, as will be readily agreed. I am glad to report that the treatment continues to give relief to children who resist orthodox or conventional treatment. For the record, those results were published and discussed in the British Journal of Dermatology in 1992 (volume 126, pp.483–488) and in the Lancet in 1992 (volume 340; pp.13–17).
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The second instance concerns infertility treatment. I take this opportunity to congratulate the noble Lord, Lord Winston, on his maiden speech. This second instance concerns Dr. Xiao who runs the Zhai Natural Remedies Clinic in Chiswick and who is also a member of the National Fertility Association. She and Mr. D. K. Edmonds, who is the consultant obstetrician and gynaecologist at Queen Charlotte's and Chelsea Hospitals—perhaps the noble Lord, Lord Winston, knows of him—are conducting trials involving both herbalism and acupuncture on low sperm count and on unexplained fertility. Funding has been found for the herbal treatment but it remains to be found for the acupuncture trials. Surely this again is a matter which requires positive support.
Chinese medicine has a well defined history of success in clinical trials on both low sperm counts and infertility as well as in other related fields. Both Mr. Atherton and Professor Ka-Wen Ma, who is a consultant at the celebrated Wellcome Institute, have prepared papers on the subject recommending recognition of traditional Chinese medicine in the UK. It would be greatly appreciated if further talks could take place with my noble friend's officials.
I shall not go into details about traditional Chinese medicine in China, but there are 480,000 professionals in China and 70,000 have been trained in the past 30 years. There are 1,500 hospitals practising traditional Chinese medicine very successfully.
The greatest problem with all complementary medicine is credibility. That can only come with professional recognition of the practitioners. We have the very satisfactory examples of chiropractors and osteopaths, whose training and certification derive from established and approved centres of learning. That is particularly relevant to herbalists, whether British or Chinese. The UK national institute has moved forward by arranging a four-year BSc degree course at Middlesex University and is planning an entry of 40 students a year. The College of Phytotherapy at Hailsham in Sussex has a similar arrangement.
I ask that these strands of developrnent be brought together under one supervisory body to collate and disseminate the findings. There is much to be done and encouraging advances have already been made. It is imperative that the efforts should be co-ordinated.
5.11 p.m.
Lord McNair: My Lords, I add my thanks to the noble Earl, Lord Baldwin of Bewdley, for initiating this important debate. Its importance is obvious to those of your Lordships who prefer to keep healthy using complementary, alternative or holistic treatments. However, I take issue with the use of the words "complementary" and "alternative". There is a tendency to regard the march of medical and pharmaceutical technology as constituting the norm and holistic treatments as complementary. In fact, taking a broad historical and geographical perspective, the opposite is true. It is modern medicine which is complementary, or an alternative, to traditional and holistic treatment.

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We had the misfortune in this country to burn at the stake most of our traditional practitioners in the witch hunts of the 17th century. Other cultures have been less extreme and so retain a body of traditional practitioners and of treatments, many of which can play a valuable and useful role in the spectrum of treatments available today. New technology can also provide insights and breakthroughs of tremendous significance. In other words, not all holistic treatments predate modern medicine.
The word "holistic" means "to do with the whole person". The billions spent annually on pharmaceutical and other areas of medical research are aimed, one hopes, at curing bodies of illness; yet we are more than bodies. We are body, mind and spirit, and it is the interaction between all three which should be addressed in any sane and truly scientific approach to healing.
Some speakers in today's debate have their own particular interest, as we have heard. The Minister, were she able to be here—and we all wish her a speedy recovery—would not be surprised that I have chosen to speak about the part that hydrogen peroxide can and should play in maintaining the nation's health. In fact, it already plays an indescribably important part in maintaining the nation's health because every time a white blood cell destroys a bacterium or a virus it does so by engulfing it with hydrogen peroxide.
To understand why that is so and why it has such immense possibilities for human health we need to journey back in time many millions of years. At the time when viruses and bacteria evolved the earth's atmosphere contained a much lower proportion of oxygen than it does today. At present the normal percentage of oxygen is around 20, although in a polluted urban environment it can drop to as low as 11. Humans and other animals evolved much later when the proportion of oxygen had risen to its present level. A well-oxygenated body is generally a healthy body. Good fresh food and plenty of exercise in an unpolluted atmosphere definitely help, but with any condition that is caused or precipitated by an infectious organism additional oxygen in the form of hydrogen peroxide, either by ingestion or by intravenous injection, should be the first priority.
In 1993 and 1994 the noble Baroness the Minister was kind enough to invite me to tea to discuss with her and some of her advisers matters connected with hydrogen peroxide. On the second of those occasions her advisers were adamant that if the substance had the benefits that I said it had, then it must be commercially viable to carry out clinical trials. Hydrogen peroxide is produced by methods which are not only in the public domain but are the province of A-level or even GCSE chemistry. There is no prospect of a trade mark, patent or even biotechnological development in the production of hydrogen peroxide. One manufacturer has calculated that it would take 18 years to recoup the £100,000 or so that it would cost to undertake the clinical trials. It is a sad distortion of the free market philosophy which I share when mathematics become subordinated to politics. It reminds me of the attempt by the Indiana state legislature in the late 19th century to pass a law
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which made pi equal 3 rather than the 3.1412 or whatever in fact it does equal. Wiser counsel prevailed on that occasion and I sincerely hope that it will do so in the matter I am speaking about today.
I read in the Independent of Tuesday 2nd January the same quotation that was mentioned by the noble Lord, Lord Winston. I make no further comment about that now but I may be tempted to do so if the Minister, when she has recovered, tells me that it is impossible to contemplate spending £100,000 to £150,000 on research into the possible benefits of hydrogen peroxide in treatment and prevention. If I am right, those benefits would save the health service many millions of pounds a year.
Bodies are not as complex and, as a general rule, not as difficult to maintain in good health as those with a vested interest in the opposite proposition would have us believe. The impetus for restrictions on herbal medicines and food supplements comes primarily from the pharmaceutical companies. Let there be no doubt about that. I helped to head off one such move a few years ago. Others of your Lordships have more recent experience. The dire warnings about hydrogen peroxide clearly originate from the same source. No wonder, as the noble Lord, Lord Colwyn, discovered, tooth whiteners based on hydrogen peroxide are being squeezed out by European Union edict, via the cosmetics regulations in this case. I was tempted to ask the noble Lord, Lord Chesham, who answered the noble Lord, Lord Colwyn, about the 8,000 published medical papers which have appeared over the past 100 years since the benefits of hydrogen peroxide in combating and preventing disease were discovered in Germany in the second half of the 19th century. I did not ask my question on that occasion because I was as flummoxed as the noble Lord was at having his Question answered by a Minister at the Department of Trade and Industry, but I do ask it now.
What about the huge body of evidence in favour of hydrogen peroxide either ingested or given intravenously? Does the department have that information in its reference section? Has it been studied? What is the real reason for the Government's reluctance to carry out a simple clinical trial that, compared to the £1 billion wasted on ineffective treatments, will cost peanuts and could save millions? Could it be—and I choose my words carefully here—the cross-fertilisation between the pharmaceutical industry, the Department of Health and the medical profession?
There is so much evidence in favour of the benefits of hydrogen peroxide that the Government should at least have the decency to try and prove me wrong and also the thousands of people who attest to the benefits they have gained from drinking, yes drinking, hydrogen peroxide, in a sensible dilution of course. I should add that it tastes horrible, but that proves nothing. If the department is so sure that I am wrong let it prove it. If I am proven wrong I shall slink away and rue the day that I ever heard of hydrogen peroxide.

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I have been forthright in what I have said. I considered being more restrained. Then I decided that it was my duty to the thousands of people who have benefited from ingesting hydrogen peroxide and the millions who could do so to speak as plainly as I have.
5.20 p.m.
Baroness Flather: My Lords, perhaps I may begin by pointing out that I have changed places in the list of speakers with the noble Lord, Lord Menuhin, as he had a flight to catch. I therefore apologise for the changes in the list.
How I wish that I had a personal interest to declare—whether financial, because I was chairman or patron of one of the societies, or because I was a user of so-called alternative systems. I have no such interest to declare. I have never used any medical system other than the conventional system. I have tried and failed at transcendental meditation; I have not been successful at yoga; I am not a vegetarian. However, I speak in support of the different forms of treatment that we discuss today.
When we spoke about the debate, I heard whispers of words such as "cranks". All that I can say is that I am proud to be part of this group of cranks if that is so. As I come from India, I probably come from the ultimate culture of cranks because the definition would clearly apply in that way. It is interesting that in India recently we have noticed a renaissance of Ayurvedic medicine. Various kinds of Indian systems, and the Islamic system, are becoming more widely used. The so-called mainstream medical profession is taking a greater interest.
My personal view is that we are moving away from the era of post-Imperial condescension. I believe that that is happening in many other countries. One of the reasons why any unconventional or different system of medicine was looked clown upon may have been the cultural attitude towards the countries which produced the systems. Many of the systems are very old. While clearly they cannot be accepted lock, stock and barrel because we know more than was known—we ought to know more, though sometimes one wonders—we ought to consider which systems we can take on board. We have a treasure-house around the world. It is important that we keep an open mind.
Perhaps I may say how much I enjoyed the two delightful maiden speeches. I see that the noble Lord, Lord Winston, is in his place. I should like to congratulate him. That is not done out of convention because the noble Lord will know that he has been congratulated for conventional reasons. Both speeches were light of touch and full of wisdom—and shall we not enjoy their future speeches, my Lords?
I was interested in the comment of the noble Lord, Lord Winston, about the placebo effect. How are we to know that in many other instances there is not a placebo effect? The noble Lord mentioned the wonderfully interesting episode of the cough medicine. Every day our doctors say, "This medication is new. It is very good. I am sure you will benefit from it", and quite often we benefit. Perhaps the medication is new and better, but perhaps the effect is because we have been told that
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if we take it we shall benefit. The mind is a very powerful instrument. I have no problem with the placebo effect. The more we can harness the mind to heal ourselves, the better we shall be. We cannot lose. After all, conventional medicine has only drugs with their possible side effects to offer. Almost nothing can be taken as a cure that does not create some side effects. We all know that. If we can harness the power of the body and of the mind to make us better, we cannot say that that is not a good thing.
Sometimes when one talks about alternative or complementary medical systems, it seems that one is attacking the conventional medical system. That cannot be true. We are utterly dependent on conventional medicine in today's world. I would never think of attacking conventional medicine. What I would say is that we need to have an open mind. We need to consider how best an individual human's needs can be met. If the needs are there, we must look everywhere to see how to meet them.
Recently, I read an article about massaging new-born babies, and babies as they grow, before bathing. In the East, over generations, babies have been massaged. Every baby is massaged with oil before being bathed. Suddenly it is being discovered this year in The Times. When I first came to this country, no one ever talked about massages. My mother always had a massage lady. We now have aromatherapy and many different kinds of massage which certainly help. If any noble Lord has not tried them, I hope that he will immediately contact my noble friend Lord Addison for a good practitioner.
Finally, there is the danger of pulling up the drawbridge. Yes, it has been accepted that acupuncture is a useful tool, in particular for pain relief. But let us not stop there. Let us continue to search for other methods. Let us not stop at the point at which everyone agrees that some method is valuable. The practitioners of alternative medicine are the ones who are keen to pull up the drawbridge. That is not the way forward. Let us keep an open mind to ensure that we meet the needs of those whom we treat.
5.27 p.m.
Earl Kitchener: My Lords, I shall concentrate on our possible need for a particular nutrient, the element boron, and on some general points which have arisen from my inquiries into what is happening about boron.
It is agreed that boron is essential for many green plants, but the evidence that it is needed by humans, or other vertebrates, does not convince everybody. Its toxicity has been thoroughly investigated and what seems to be the most useful measure—the no observed adverse effect level—is well above any recommended intake. Its claimed beneficial effects are on bone healing and the prevention and correction of many forms of arthritis.
The Arthritis and Rheumatism Research Council and the Medical Research Council both tell me that they are reactive as opposed to proactive and that they evaluate proposals from people planning to do research rather than first forming their own opinion about what is most worth doing. A patentable, and therefore potentially

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profitable, drug naturally stands a better chance of attracting research funds than does the question of whether the recommended intake of boron should be increased from no-mention to something, or whether that of other minerals or vitamins should be altered. Both MAFF and the Department of Health are obviously concerned with the subject and there is something to be said for one or the other being given the main responsibility. This could be extended to research councils and research establishments. Some years ago, I was told by the director of one establishment, "You have whetted my appetite about boron", but later I was referred to another establishment. Specialisation would produce economies in record keeping and would protect other Ministers and establishments from the burden of answering questions from peers and others. In my limited experience, the Biotechnology and Biological Sciences Research Council has the best approach, in that an establishment connected with it is planning some work on boron.
There is a tendency to ignore anecdotal evidence, about which we have heard much today, and it is right not to do anything on a large scale, particularly if it is expensive or dangerous, unless it has been proved by thorough trials. But many important ideas have started as anecdotes. There are now so many peer-reviewed scientific journals that people may feel that it takes them all their time to keep up to date with them. The specialisation I referred to earlier would provide a place to which anecdotal evidence, whether from this country or abroad, could be sent with a good chance of being studied. A case which I have come across in another field where this would be helpful is the Hyperactive Children's Support Group. They have a certain standing, in that, I am glad to say, the Department of Health pays part of their costs. They have experience of improving behaviour by diet changes, but have difficulty in getting anything published.
It may well be that the research which the scientific establishment wants to do is not the same as that which would be most beneficial to the public and that therefore Ministers should be closely involved. The intake of boron varies widely from place to place and a link between high boron and low arthritis has been reported. A repetition of this work would be a simple and fairly cheap way of making progress. There is also anecdotal evidence that extra zinc is good for anorexia nervosa, and this would seem easy to prove or disprove.
I have had helpful correspondence and meetings with Ministers, but have come across two cases where most reputable and reasonable people met with a less than forthcoming response. I appreciate that Ministers are busy, but at least a meeting with an official would have been justified. A knowledge of the views of those outside official circles can be useful to those inside them.
The public must be protected from harmful levels of nutrients, but I hope this will be done mainly by forcing the display of analyses and warnings on the lines of those in force for tobacco, rather than by making more criminal offences. The single thing that would most conduce to us all consuming appropriate levels of each
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nutrient would be a general awareness that Ministers feel a responsibility for finding out what those levels are.
5.31 p.m.
Lord Thurlow: My Lords, it is always extraordinary in our debates on wide areas to experience the range of knowledge that your Lordships can bring to bear. I am afraid that I cannot add to it, but I have benefited from both mainstream medical treatment and also non-conventional, in particular homoeopathy.
I should like to draw your Lordships' attention to a problem for the homoeopathic profession that has arisen from a ruling of the European Court. That is the finding that the British system of specialist medical training is out of line with European law. This may sound a narrow issue, but it is closely connected to the wider issue of how homoeopathy fits into the general NHS structure. The court ruling brings to a head the unsatisfactory state of affairs for the training and appointment of homoeopathic consultants that has persisted for many years.
The structural arrangements of the royal colleges do not take suitably into account the needs of homoeopathic representation. The issue was aired in our debate five years ago. The insufficient number of homoeopathic consultants has been relieved in the meantime to some extent by ad hominem appointments. It is welcome that new appointments have been made in London, Glasgow, Liverpool and Bristol. But this kind of relief has now been ruled out by the European Court finding and the new rigidity which we have been obliged to impose, so there is now an urgent problem for homoeopathic specialists which calls for a new initiative. It appears to offer an opportunity to improve the unsatisfactory structure of the past and introduce better co-operation between the Royal College of Physicians and the Faculty of Homoeopathy.
In response to the European Court, all specialist consultants will have to acquire a new certificate. Homoeopathic specialists, who of course already have to undergo several years of general medical training to qualify, will have to undergo a long and pointless additional general medical training to qualify for the new certificate. No plans currently exist for a specific certificate issued with conditions suitable to homoeopathic specialists. They will be appointed only as sub-specialists in general medicine, with a considerably longer training period, as I mentioned. Also, general practitioners and private homoeopathic practitioners will be left in limbo.
Again, there has of course to be an advisory committee on specialist training and there are no plans for a parallel advisory committee to cover specialist homoeopathic training. The royal colleges no doubt have a great deal always on their plate, but the European Court ruling has made it urgent for something to be done to relieve the new obstacles in the way of homoeopathic specialists. The first necessary step, so far as a layman can see, is for the Royal College of Physicians to enter urgently into discussion with the Faculty of Homoeopathy. This would create a new and

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long-awaited opportunity to lay foundations for better co-operation in the selection, training and funding that may repair the structural deficiencies of the past.
There is a separate but parallel issue in the failure of the official bodies such as the GMC and the NHS Executive to promote research and development in complementary therapies. The noble Baroness, Lady Rawlings, referred to it. The MRC, for its part, sees no objection in principle but complementary medical research is not in practice getting a share of the cake. There are similar problems in some health authorities over purchase by fund-holders. Some authorities such as Cambridge and Huntingdon have refused to allow purchase of complementary medical treatment.
In conclusion, I revert to the problem caused by the European Court ruling. We hope that the Minister's recovery will be speedy and I ask her, through the noble Lord the Lord Chief Whip, to bring to the attention of the Secretary of State the problem of the court ruling and suggest that the Department of Health should make known to the Royal College of Physicians its interest in the initiation of early discussion with the Faculty of Homoeopathy.
Baroness Trumpington: My Lords, I hesitate to interrupt but we are running rather badly behind time. Perhaps I may remind noble Lords that when seven minutes comes up on the clock, we are in the eighth minute. I ask very kindly that Members who have yet to speak stop after five minutes if possible in order to allow the winders up and the Chief Whip to have sufficient time to reply to your Lordships' learned remarks.
5.40 p.m.
Baroness Sharples: My Lords, I thank the noble Earl, Lord Baldwin, for initiating today's debate.
For all the animals produced to feed our nation, the use of non-conventional treatments can involve solely nutritional supplements in unique forms, which reduces the amount of antibiotics and artificial growth promoters and reduce death rates. We benefit as the end consumer, and the farmer can also do this economically. Too much over-use of antibiotics, as we have already heard, leads to drug resistance. We are now seeing that certain bugs are resistant to all new antibiotics. Is this not a catastrophe waiting to happen?
There is a great deal of scientific evidence to prove that we can alter the progress of arthritis, both in animals and in humans, using nutritional supplementation. Imagine the lack of pain and drug side effects in those sufferers, both animals and humans, and the consequent reduction in surgical procedures. It is surely a matter of education both within the medical profession and of the general public. These treatments should not be considered non-conventional but should go hand in hand with the accepted therapies.
Such approaches are better understood in Europe. Last year. herbal drug sales (many of them prescription only) in Germany accounted for 3 billion dollars; in France 1.6 billion; in Italy 600 million: and in the UK, much below, at 300 million dollars.
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The noble Earl who introduced today's debate said that the large pharmaceutical companies were not sufficiently interested in non-conventional medicine. Why then have companies such as Boots, Johnson & Johnson. Bausch & Lomb, Degussa, Fujisawa etc. bought established phytomedical companies? They have not changed their names, and they have let those companies trade as before. Is it because this growth in the market is between 8 per cent. and 10 per cent. per annum? I suspect so. If the giant companies see the benefit of such operations, surely it is time that everyone was given the same opportunity to benefit.
5.43 p.m.
Lord Broadbridge: My Lords, I believe that complementary medicine suffers from an inferiority complex. Many complementary treatments have been used for centuries, if not millennia, and countless generations have benefited from them. It is the so—called conventional medicine that is the newcomer, using treatments "thoroughly researched" for perhaps three to five years. A large number of orthodox drugs now in widespread use have yet to pass the single generation of use mark. I do not wish to start by being pedantic, but it is really the so-called conventional medicine which is complementary, not the traditional variety. The very use of the word "conventional" gives immeasurable prestige and respectability to its products and practices, the deserving of which in many cases has yet to he proved on a long-term basis. We all remember thalidomide. So let us at the outset at least give prestige of long use to complementary medicines.
If we were in India I believe the semantics would indeed be reversed. Most people in one of the largest populations of the world rely on complementary therapies. As an example, was not a conventional preventive for malaria discovered through the observation that certain natives who did not seem to suffer from it regularly chewed the bark of the cinchona tree, which analysis showed to contain a high proportion of quinine?
The single non-conventional treatment that is generally available on the NHS is homoeopathy. Many people believe that doses of natural products, powdered leaves, seeds etc. are lacking in potency compared to conventional products. Indeed, I heard a man only recently say of homoeopathy, "You might as well eat grass". He was an educated man, too. If we pause for a moment and think of opium, marijuana, cocaine and belladonna, it is all too evident that natural products can be potent—indeed, even to the degree of being a public menace. But I say this only to satisfy those to whom degree of potency is a benchmark, for in fact homoeopathy relies on small, often minute, doses of natural products to mobilise the body's natural antibodies. By this preparation, should the main illness strike, unpleasant side effects—such as death—are avoided. Homoeopathy draws on a vast range of natural products in tiny doses to cure by mobilising agents already within the body. Because the dosages are tiny, side effects are practically unknown.

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But above all stands the principle of homoeopathy; namely, to treat the whole person. A total audit of a presenting patient is taken by a homoeopathic doctor in consultations which average 45 minutes. By comparison, an average NHS GP consultation lasts three minutes and gives rise to elastoplast remedies—that is, prescribing specifically for the symptoms rather than investigating their root cause. This commonly leads to the patient presenting again in a little while with new and different symptoms, which are treated conventionally with more elastoplast. The patient's health frequently deteriorates and sinks into in-patient or out-patient hospitalisation. In the terms of our debate, that is terrible for the health of the nation and vastly expensive for the NHS and also for the nation's economy, since the patient's labour is largely or totally lost: a triple disbenefit. While the homoeopathic approach may be more expensive at the outset, it offers greater savings over the longer term. It is a tragedy that most of our health budgeting is short-term.
Perhaps the Minister who is to reply will indicate whether he thinks longer term views may one day be taken. Certainly the relevant move towards GP primary care and early-warning diagnosis and treatment and away from hospitalisation later is a policy on which to congratulate Her Majesty's Government—except that I think they are hopelessly optimistic about the time that this will take to implement.
No doubt the Minister is aware of a very interesting experiment in course at the Lewisham Hospital NHS Trust, where a November 1995 report presents findings of the first year of a complementary therapy out-patient service within a district general hospital, embodying a review of control trials in acupuncture, osteopathy and homoeopathy, together with details of the kind of patients referred and an assessment of the outcome of treatments. Recommendations are made for the future of the service.
The report states:
"This report is likely to be of interest to Health Authorities and policy makers, primary care and hospital providers who are considering purchasing or providing such therapies, or are reviewing how such services are currently provided. It will also be of interest to those complementary practitioners or professional bodies working with (or hoping to work with) the National Health Service".
The report makes the point that evidence suggests that non-conventional therapies are increasing in popularity with large numbers of the population seeking consultation and treatment. They believe that this is in part triggered by a more articulate public and attempts to integrate patients' views into health and decision-making. The report cites evidence for the effectiveness of non-conventional therapies for a number of conditions, in particular the homoeopathic treatment of diseases of the respiratory system, including asthma, of gastro-intestinal problems, migraine, some rheumatological disease, childhood behaviour, myalgia and skin disease. Acupuncture is said to have demonstrable benefit in pain control, asthma, arthritis, gastro-intestinal disorders, musculo-skeletal problems and gynaecological problems. Studies suggest that osteopathy and
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chiropractic are effective in back and musculo-skeletal problems. The report concludes that there is clearly a move to integrate non-conventional therapies into the NHS (particularly in primary care) with a number of hospitals and general practices employing non-conventional practitioners.
In conclusion, the centre is funded primarily on a block contract basis by Lambeth, Southwark and Lewisham Health Commission and received over 800 referrals in its first financial year, demonstrating a high demand for that service in the Lewisham area. Ninety-six per cent. of the referrals were made by general practitioners, which shows an interest in non-conventional therapies among doctors in primary care.
5.50 p.m.
Lord Harlech: My Lords, I am very grateful to my noble friend Lord Baldwin for initiating a debate on this most important and indeed vital issue. I trust that it will be the forerunner not just of a forum of discussion but of some dynamic action. I also congratulate the two maiden speakers, the noble Lords, Lord Winston and Lord Eames.
We have heard vigorous and informed discussion from noble Lords which has clearly demonstrated the interest in this field. Indeed, as we learned from the noble Lord, Lord Menuhin, in particular, medicine can come from both music and dance just as surely as from a bottle. I should rather not use the term "non-conventional medical treatment" since, in my view, it implies that the so-called modern medical system of healthcare and treatment is the only approach. In fact, as many noble Lords have pointed out, much medicine, healthcare and treatments of disease have their roots in a wealth of knowledge stretching back over centuries. Therefore, I believe that it is to mankind's detriment that we ignore the holistic or complementary approach to the nation's health. The advances in medical science can work in tandem with traditional and indeed ancient forms of care, cure and the prevention of disease for the promotion of health (to say nothing about the enormous savings to a country's Exchequer) in an enlightened understanding.
A national health system such as the one that we have in this country spends an enormous proportion of its resources in responding to ill health. Sickness is, so to speak, the response of the body to a lack of primary knowledge in looking after ourselves. Liberating the potential of mankind's vitality, the natural awareness of the self and the creativity of one's own energy and drive needs education. Education, therefore, must be one of the main keys.
Already considerable investment in research proves that dietary factors which relate to the maintenance of good health and the prevention of heart disease and cancer are still greatly ignored. We know that despite vast investment and a greater awareness of the facts through every conceivable advertising and advisory campaign directing one towards the path of good health, human nature, being what it is, regrettably finds it virtually impossible to make changes take effect,

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whether it be with regard to not smoking, eating less fat, taking more exercise or acquiring knowledge of a healthier diet or indeed the skills of obtaining and preparing healthier food.
I am sure that many noble Lords arc well aware of how, despite the rigours of a diet such as that which had to be adopted for the nation's health during the last war, statistically the nation's health improved markedly. I say with regret that, in schools, good culinary training to a great extent has now been replaced by what is called "home economics". The vital window of opportunity to teach self-help and health skills to that age group has been largely removed.
In the most recent UK Mintel survey of 1995, 75 per cent. of those questioned said that they would use complementary medicine and teaching, if they were available, on the National Health Service. Of those questioned, 35 per cent. of their own volition now use those therapies; 30 per cent. of the 35 per cent. would do so exclusively.
The perceived risk of embarking on supporting the community's health—positive health, as I prefer to call it—through a complementary approach is that it might be thought to increase the burden upon general practitioners, placing another tier upon their precious time and responsibilities. However, I believe that it would be possible to make available, by way of part of the existing budget, a separate ring-fenced provision directed only to the provision of complementary medicine and ways of getting well and staying healthy. It may be possible even to grant awards and give increased budgetary help to practices for establishing best practice in given areas of complementary medicine. One could have an overall system leading to a European, indeed international, accreditation process for complementary medical practitioners. That would give doctors security and the incentive in the early stages of referral and recommendation to offer treatments which increasingly will be recognised worldwide as a proven means of achieving a healthier, less stress-filled life.
5.56 p.m.
Lord Palmer: My Lords, I too am grateful to my noble friend Lord Baldwin for once again introducing this important subject. I was not a Member of your Lordships' House five-and-a-half years ago when the subject was last debated. Had I been a Member, certainly I should not have listened to the debate and doubt very much whether I should have read it in Hansard. But that was five-and-a-half years ago.
For most of my life, from April to October, I was crippled by hay fever and used to spend an annual sum of £50 on Triludan tablets, which in turn cost the National Health Service £71 a year. For the past four years I have taken the equivalent of a teaspoonful of white powder, which contains, among other things, Psorinum, at —18 a shot. Since then, I have taken just one Triludan tablet and that was to ease the swelling from a wasp sting, after having visited the nurse's station in another place only to find it closed because the other place was not sitting. This House was, of course, sitting. For years I have had a weak back and,
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since visiting an acupuncturist, it has improved out of all recognition. I now swear by homoeopathy and indeed acupuncture. The Government Deputy Chief Whip is joining me on my next visit, as an experiment.
When Lothian Health Board opened a new homoeopathic clinic in April 1994, within four weeks 40 per cent. of every GP practice in the Lothian area had referred a patient and every practice had done so within eight months. The demand at Glasgow Homoeopathic Hospital is increasing. It is 40 per cent. up over the past five years—40 per cent., my Lords! It now averages 220 referrals a month, 87 per cent. of which come direct from GPs.
A MORI poll in The Times of 13th November 1989 showed a doubling of the use of complementary medicine between 1986 and 1991. Consumer surveys affirm that patients are satisfied, with four out of five users claiming significant benefit or cure and 75 per cent. saying that they would use complementary medicine again. Indeed, they want it integrated into the National Health Service. A growing number of doctors want to train in complementary medicine and the Government must accept that it is a genuine postgraduate training.
I join with other noble Lords in asking for additional funding, particularly into research and development. In complementary medicine a little goes a very long way. We have recently seen the successful passage of the osteopaths and chiropractic Bills. Surely it is time to regulate other forms of complementary medicine.
It is also important that homoeopathic medicines are correctly made in accordance with the traditional homoeopathic methods because, as in other professions, there are cowboy manufacturers in abundance. The need for regulation is great, as patients are becoming increasingly confused. Perhaps even a committee could be set up to examine the whole area.
In Scotland we must all applaud the setting up of an NMAC, which has been asked by the Scottish Office how—I emphasise "how"—to integrate complementary therapies into the National Health Service. I also believe that more training establishments need to be set up to re-educate the existing workers at all levels in the National Health Service. The Glasgow Education Model is an example of what I have in mind—and here we are talking about evolution not revolution.
The interprofessional postgraduate education programmes of the academic departments of Glasgow Homoeopathic Hospital has become the most popular postgraduate medical course in the United Kingdom—orthodox or otherwise. Almost 20 per cent. of Scottish GPs have completed basic level training in homoeopathy; that is a 300 per cent. increase over the past five years. Research has shown that two years after attending a foundation course 78 per cent. of attending doctors were still integrating elements of homoeopathy into their National Health Service care. Clinical trial programmes carried out in Glasgow in, for example, asthma, suggest that a combination of orthodox and homoeopathic approaches can often enhance the care of a given patient. It is important that as complementary therapies become more popular patients do not

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experience a fragmentation of their care through an either/or mentality, placing them in positions of conflict between different therapies or therapists.
The good health of our nation is surely one of our most precious possessions. We need integrated care of a high quality with an emphasis on the art of healing; a human relationship of trust blended with skill. We deserve no less. Let us hope and pray that we get it.
6.2 p.m.
Lord Pearson of Rannoch: My Lords, I join other noble Lords in congratulating the noble Earl, Lord Baldwin, on so powerful an introduction to this debate. It is indeed timely, coming as it does so soon after our debates last year on what became the Medical (Professional Performance) Act, which confirmed that not all is healthy in the practice of conventional medicine.
There is the increasing worry, too, that conventional medicine may be reaching its limits. Bacteria, which have been around for some 7,000 million years longer than us, are adapting in a most disturbing way to the antibiotics we so routinely throw at them. The AIDS saga has shaken our arrogant assumption that we shall always be able to stay ahead of disease. Viruses and bacteria may yet hold terrible surprises in store for humanity.
It may be that my own experience of illness is unusual. But I have to declare an interest in the debate because on at least six occasions in the past six years I or a close member of my family have been cured by non-conventional medicine when conventional medicine had failed. Were it not for the conventions of your Lordships' House whereby one does not criticise a maiden speech, I would have to say to the noble Lord, Lord Winston, that I understand about the placebo effect—and I agree with it—but that it would not apply to any of those examples, so stark are they. Those experiences and millions of stories like them have had the effect of putting conventional medicine on the defensive. So it is good that so many GPs are now opening up to complementary medicine, as indeed is Harley Street itself. Let us hope that this debate today contributes to that process.
However, there is one ghost of past antagonism which has not been laid to rest, to which I should draw your Lordships' attention. This is the saga of the excellent Bristol Cancer Help Centre, which was wrongly accused, in research supported by the Imperial Cancer Research Fund, of causing its breast cancer patients to die twice as quickly and to relapse three times as often as they would have done under conventional cancer treatments. Reverse statistics would have been nearer the mark and the research was, of course, eventually proved to be complete nonsense—but only after much damaging publicity had been inflicted on the centre. I gather that the authors and sponsors of the research have now apologised, but they have not asked for it to be withdrawn. Perhaps I may therefore use this opportunity to ask my noble friend whether the Department of Health can help finally to lay that ghost to rest. I have
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ideas as to how that may be done, which, in order to save time now, I could perhaps discuss with my noble friend Lady Cumberlege when she recovers.
But there is another broader area where alternative practitioners require my noble friend's help; that is, in relation to the future regulation of their profession. Other noble Lords have referred to this. I shall deal particularly with herbal medicines, which often suffer from the problem of being both food and a medicine; an example is garlic.
I regret to say that our herbal practitioners, who have joined up with fellow practitioners in Europe to form the European Herbal Practitioners Association, are running into trouble—perhaps fatal trouble—with the European Commission in Brussels. From her Written Answer to me today I suspect that my noble friend Lady Cumberlege may not be aware of what is happening there. I should therefore inform her that Spain, France and Italy at least (all with strong cultures of conventional medicine, inspired by powerful cartels of drug companies, pharmacists and doctors) are ganging up to produce a directive which will insist that all herbs are to be treated as though they were manufactured drugs, with all the attendant licensing and testing costs.
I understand that the European Court of Justice has issued a series of rulings which suggest support for such a view, which, if enforced, will mean the death of the herbal and other alternative medicine industries. Perhaps more likely, it will drive them underground and make it impossible to police them. Can my noble friend therefore see that our representatives in Brussels are instructed to inform DG3 in the Commission and its relevant committee that the United Kingdom will not accept such a directive? I am assuming that the Cabinet decision 18 months ago to squash a similar initiative in this country will remain unaltered and that my noble friend will therefore agree that this country should for once become strongly involved in the design stage of this particular piece of Euro-nonsense.
I should confirm that our Medicines Control Agency is doing its best in Brussels for our herbal medicine practitioners, but I fear that we are once again under the shadow of a qualified majority vote which may go against us. Can my noble friend therefore look into this as a matter of urgency? There are moves afoot which may help us to escape the dread hand of Brussels, but which again, in the interests of time, I hope I may be allowed to discuss with my noble friend Lady Cumberlege when she recovers.
6.8 p.m.
Viscount Tenby: My Lords, I thank my noble friend Lord Baldwin for initiating this debate and also the noble Viscount the Leader of the House and the noble Baroness Lady Trumpington for giving us tail-enders a window of opportunity in which I promise not to get stuck.
I should like briefly to highlight the overwhelming need to start to build bridges now between the worlds of conventional and non-conventional medicine. Though no doubt some co-operation can take place—and already

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has—between the two disciplines independently, the bridges themselves can only be put in place by government.
Let me at this point declare an interest as a one-time member of the fund-raising committee of the Research Council for Complementary Medicine and as a current patron of that body. As a recent bulletin of the council confirmed,
"there appears to be growing public demand for the provision of complementary therapies within the NHS".
It goes on to point out that that produces problems in that practitioners in complementary medicine may be unfamiliar with NHS procedures and in turn their purchasers may not be conversant with what is entailed in the provision of complementary therapies.
The recent evaluation of the first year of a complementary therapy service based in the Lewisham Hospital NHS Trust provides valuable evidence of the need for conventional and non-conventional therapies to get their acts together. With 800 referrals in the first year, 96 per cent. of them from the 25 practices participating in the scheme, and with a 97 per cent. high satisfaction rate revealed in subsequent assessments, it is clear that that out-patient service is providing valuable and cost-effective skills in acupuncture, osteopathy and homoeopathy, and helping to solve some of the often long-term medical problems in that area of South London.
What is needed, however, is unrestricted exchange of information between the two disciplines, not only on what therapies may be available but also on individual case histories. NHS practitioners need to know whether the treatments are successful; whether they are cost-effective compared to conventional medicine and, above all, whether they are safe for their patients. That kind of information can only be forthcoming as a result of systematic and professional evaluation on a basis agreed to by both sides.
Although non-conventional medicine (without the benefit of a powerful and wealthy pharmaceutical industry, it must be remembered) raised a great deal of money itself—for example, over —1·5 million by the RCCM over the past 13 years—it would surely be appropriate for the Government now to make their own contribution. That is just one important aspect of what I may term the familiarisation process. But there are others and I should like to refer to two of them on which I would welcome the observations of the noble Lord the Chief Whip.
The first is a need for the establishment of university chairs and university studies. The Laing Chair at Exeter and the past Research Fellowship at Glasgow point the way forward, but although government funding for the Sheffield University project was greatly appreciated it would seem that in view of the ever increasing demands for non-conventional medical therapies the time is now ripe for the funding of further projects by government. Secondly, as the popularity of non-conventional medicine grows, and more and more referrals are being made by GPs—close on 40 per cent. of practices in England are said to offer their patients access to these therapies—it appears to be desirable that the doctors of
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the future should have at least a basic knowledge of the more popular and tested non-conventional therapies, or at least know their way around the world of non-conventional medicine.
We all know that prevention is better than cure, none more so than the Government, who continually seek to wean people away from the seeds of self-destruction implicit in their lifestyles by repeated warnings on smoking, drinking and diet. I would he tempted to add a fourth category—the overuse of drugs supplied in all good faith by many in the medical profession.
Perhaps I may respectfully suggest that non-conventional medicine, too, has an important part to play in this ceaseless battle for good health by providing not only solutions to certain medical conditions but in many instances safeguards against their recurrence. In making health care more efficacious, more cost-effective and more user-friendly we need to utilise every available resource, and the right non-conventional therapies can be important contributors to that desirable objective.
6.11 p.m.
Lord Rennell: My Lords, it is always a great privilege to speak in any debate initiated by the noble Earl, Lord Baldwin of Bewdley. I cannot think of anything more important to us all than our health. This has been a most opportune and important debate. The nice thing about it today is that on all sides of your Lordships' Chamber we seem to have agreed. So why cannot we make quicker and greater strides towards improving the health of the nation with greater use of non-conventional medicine? Is it genuine doubts about the efficacy and safety of alternative medicine, or is it money? I suspect it is money. Yet many of us feel that allowing non-conventional medicine to flourish will save millions of pounds annually. The trouble is that we are not long-sighted enough.
The National Health Service spends some £30 billion a year but alternative non-conventional services receive only —1 million. That is £100 to every £3 million spent on National Health Service conventional medicines. Lewisham hospital has produced an excellent report which many noble Lords have been sent. The hospital's total budget for non-conventional services for the year was a miserly £51,000.
More than 100 years ago inoculations were first discovered. In his play "The Doctor's Dilemma" Bernard Shaw has Sir Patrick Cullen saying:
"Ive tried these modern inoculations a bit myself. I've cured people with them; I've killed people with them; but I gave them up because I never could tell which I was going to do".
We must now move on with non-conventional medicines. The noble Earl, Lord Baldwin of Bewdley, put the case in his usual eloquent style. I shall not reiterate the many points made. My own interest in the subject is as a sportsman. I have needed for 60 years to keep fit and able; for the past 35 years, with joints beginning to creak and in need of oiling, I have used every avenue available to keep myself on the field of play whatever he sport, chess included. I have used osteopathy, chiropractors, physiotherapists, acupuncturists and homoeopaths. I have

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spent a year sleeping with my feet in the air—and so has my wife—and I have taken cold baths every day. I have taken mineral water from the Pyrenees, near to Lourdes. Surprisingly, some may say, all the remedies have worked, so I feel well qualified to support the Motion today.
One often takes alternative remedies only when conventional cures have failed to work or have not worked quickly enough. Indeed, 42.8 per cent. of people who use alternative medicine or therapy say they do so because conventional medical treatment has not worked. Complementary medicine, therefore, when it does work, where all else has failed, must be very efficacious. I am convinced that we as a nation should embrace non-conventional medical treatment wholeheartedly and now.
Reverting to my comment on chess, my family had a lovely Russian girl staying with us last summer whose father looks after the world chess champion, Karpov, keeping him fit physically and mentally. I was very pleased because the girl, Leana, was able to help me with the Alexander Technique, which is frequently used by singers, actors and, indeed, for public speaking. If I may demonstrate to your Lordships, even more benefit may come from this very important debate. If, using the technique, I stand upright and allow all the forces in the body to flow up and down in the correct position, I will completely relax myself. That will allow me to speak more slowly and with more confidence. It can also help me to sink long putts on the golf course.
I would have liked to talk about dietary education because I believe that it is upon good eating that the health of our nation depends. I prefer, however, to compliment the two maiden speakers on their truly brilliant speeches. Each one touched on a most essential element of alternative medicine and care. That is faith. One could call it the placebo effect, as the noble Lord, Lord Winston, did. One could call it confidence. Whatever religion we are, faith and belief cure all.
I endorse also the words of the noble Lord, Lord Eames, about the very fine work that the National Health Service does. I am full of admiration for the National Health Service. My wife has just been looked after absolutely brilliantly. If things do go wrong—and of course they do—it is the person—to person relationship—the pastoral care—which is so essential and which is sometimes lacking.
If it were not for the restraint of money, the use of non-conventional medicine and services would flourish, to the benefit of the great majority. It should be freely available on the National Health Service. In the longer term, with an all-embracing health education a part of the national curriculum, I believe figures would show that the country's health bill was decreasing. Would it not be wonderful to plan to be able to say, "We are the healthiest country in the world"?
6.19 p.m.
Baroness Robson of Kiddington: My Lords, it has gone back into place—I have a hip that pops out sometimes. I should very much like to consult the noble
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Lord, Lord Rennell, on this particular posture, which gives one confidence, because I could do with it just now. Like all other speakers, I am deeply grateful to the noble Earl, Lord Baldwin, for having introduced this debate. He rightly referred to the large number of therapies which now exist. I have listened to 24 speakers in this House and I have probably listened to a description of 24 different therapies for various complaints. The unanimity of the speakers in the House so far has been amazing to me, except perhaps for the noble Lord, Lord Winston. In his most amusing and brilliant speech, he was perhaps the only mild sceptic in the whole debate, but that is very healthy in a debate of this kind. Perhaps we need one or two more sceptics or we may be running away with ourselves. The noble Lord has been the only speaker who mentioned the possibility of a connection between the placebo effect and complementary medicine. That must have something to do with certain therapies which are used in this country.
The popularity of complementary medicine has been created by the general public because some things in conventional medicine have not satisfied their demands. There is disappointment with medical treatment in certain cases. A case in point with the modern generation is back trouble, where it has to be admitted that osteopathy has been on the whole more successful than the medical profession. There are many patients who cannot quite explain what their problem is, although they know that they are not well, and their doctors do not take them seriously. In such a situation, complementary therapists give their time and listen, and that is important. There is also the patients' dislike of taking drugs and the resulting side-effects of many drugs.
It is heartening that an increasing number of GPs are now prepared to refer patients to non-conventional practitioners. As many as 38 per cent. of general practitioners have received some form of additional training in non-conventional therapies. It is also interesting that in a study in 1993 it was found that, among medical students, 70 per cent. considered non-conventional medicine useful and 63 per cent. were in favour of the inclusion of such therapies in the National Health Service. The medical objection to non-conventional medicine is based on the argument that its safety and effectiveness is not based on randomised control trials. But are we so certain that all conventional medical practice is based on such trials? Much of it is based on opinion rather than on scientifically controlled trials. There is a similarity between the two.
For instance, I can remember that when I had cranial arthritis I went to a leading specialist and he said, "Well, we know what it is. I cannot explain why it is going to help you, but you take steroids and you will be all right in six months' time". I said to him, "You must tell me why I have to take this horrible stuff'. He said, "I cannot tell you why but it works". In my view that was not very scientific, but I am happy to say that the treatment did work.

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The noble Lord, Lord Broadbridge, referred to the Lewisham Hospital Trust and its report. I found it a most fascinating document. It proves the advantages of providing a service on an out-patient basis because it offers an opportunity for more knowledge to be obtained. The referral patterns in that setting can be monitored and randomised control trials can be collated. Practitioners are screened for relevant qualifications, experience, insurance and membership of professional bodies. Above all, the treatment of large numbers of patients encourages thorough assessment of outcome and treatment effectiveness.
Therefore, it is very important that we create within the hospital context packages of care. The patient may be receiving conventional treatment but would benefit from a package of treatment consisting of a mixture of both types of treatment. I believe that in time such an approach will militate against the antipathy between conventional and non-conventional medicine and that they will slowly come together and work together more happily. I believe that non-conventional medicine is very important in the way in which it may just make a patient's life happier and better. For many patients suffering from illnesses and with a very short life expectancy, there are therapies like massage and aromatherapy, which can make their last few months or years happier and more satisfying. That is something which non-conventional medicine can provide for them.
Complementary medicine is here to stay. It is a growing part of our National Health Service. I ask the Government to recognise the work of organisations such as the Research Council for Complementary Medicine, which has been mentioned by a patron of that organisation, and to harness their skills by encouraging a well-founded programme of research. Funds are needed and it is time for national funding to be allocated to research into the evidence to date and to the study of practical or potential cost benefits and effectiveness for the future. Most importantly, all practitioners of complementary therapies should be educated and trained appropriately and individual therapists should receive statutory recognition in order to ensure uniformly high standards. Above all, it is essential to safeguard the patient and to reassure him that he can safely go to a practitioner who is a recognised practitioner.
6.28 p.m.
Lord Rea: My Lords, the noble Earl, Lord Baldwin, has certainly struck a rich vein in choosing complementary medicine for this afternoon's debate. He should also be congratulated on attracting two exceptionally gifted maiden speakers who have both entertained us with their wit and knowledge. They are obviously both very highly effective communicators. I am delighted that a member of my profession should join me and give me support on these Benches after the sad loss of Lord Pitt.
I find that my first remarks are remarkably similar to those of the noble Baroness, Lady Robson. but there are perhaps one or two slants on them which are different. Many noble Lords and the noble Baroness have said that
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the great increase in the use of complementary medicine is due to the dissatisfaction of patients with orthodox and, I was going to say, science-based medicine. I take her point that some of the practice of medicine is not particularly science-based. It is said that doctors do not listen to patients long enough or carefully enough and that drug treatment is too easily prescribed, with the resultant danger of iatrogenic effects which may be worse than the initial complaint. Indeed, in many cases what for want of a better title I shall call "science-based medicine" does not provide satisfactory answers to an increasing number of symptoms, many of which have no easily demonstrable physical basis, such as migraine, irritable bowel syndrome and back pain, which was mentioned by the noble Baroness. There is a very long list.
One reason for that dissatisfaction may be that medicine has come such a long way. An impressive number of conditions can now be treated which were previously fatal or caused serious illness. Treatment can take the form of antibiotics or other drugs or reparative or replacement "spare part" surgical procedures which in the past were impossible. So expectations have been raised and it could be held that one reason for the dissatisfaction with science-based medicine is its success.
However, many of the criticisms that I have mentioned are real enough. Doctors often do not have a "whole person" approach to patients. That is not merely due to time constraints, although they are real enough in the National Health Service. It is often due to a failure of training, to the example set by the medical teachers in our medical schools and to the failure to develop a holistic attitude or approach in our medical students.
Therefore, it is tempting to ascribe, as other noble Lords have done, at least some of the success of complementary medicine to the fact that such consultations are usually longer, sometimes lasting up to an hour and to the fact that the practitioner (whatever the school of complementary medicine) can devote individual personal attention to the patient during that time. Very often any physical treatment that is given is accompanied by sympathetic listening on the part of the practitioner as patients describe their problems and relate them to their whole life situation. That sympathetic listening is often—in fact, usually—associated with gentle (but sometimes not quite so gentle) physical contact which has a healing effect in itself, quite apart from any benefit arising from the manipulation or the effect of the acupuncture needle.
I would not go so far as to say that that is entirely a placebo effect, although that plays a part. There is also very much of a healing effect. Both maiden speakers referred to that. The noble Lord, Lord Eames, said that spiritual healing and the effect of a healing approach was extremely important. I know how much better patients feel in orthodox science-based medicine when they have had a good physical examination. It is not only that they are reassured that a thorough job has been done, but I think that they get some benefit from the actual physical touch.

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I have spent a little time on this aspect in order to show the importance of taking the healing or placebo effect into account when making claims that complementary medicine is beneficial. We need to be careful when assessing any research reports. Research projects must deal with that aspect when they are being planned. Of the briefings that I have received, I have been most impressed by that from the Research Council for Complementary Medicine, which takes a sympathetic but neutral stance,
"producing reviews and evaluation of published research data to enable health professionals to make informed choices".
This is not the forum to go into great detail about research methodology. It may be that randomised controlled trials are the gold standard. They have been valuable in assessing new methods of treatment. Perhaps they are not always appropriate or possible in complementary medicine, but I should like to hear a very good case being made out for why they are not appropriate in each case where another method is adopted. Some of the claims made for complementary medicine have been based on research that would not stand up to critical examination, although there are many other instances of excellent research.
Perhaps I may divert to refer to the report from Lewisham which has been mentioned by several noble Lords. That is an excellently written report, with 101 references and with a control group, but the control group did not receive any comparable treatment. No wonder those who received some treatment felt better. That study needs to be followed up to see whether the improvement lasts. We also need to know whether those patients need less in the way of conventional treatment as a result of having had alternative treatments.
I suggest that, if the resources of the National Health Service are to be used to fund complementary medicine, rather than being diverted to scattered single schemes which are started because of local enthusiasms, those resources would be better diverted to funding really good research, as is suggested by the Research Council for Complementary Medicine. Where local schemes have been introduced, they must be critically evaluated. I join several noble Lords in asking the Government to make a commitment to fund more research into complementary medicine. That may well save money in the long term. We on these Benches will in due course set up an office of complementary medicine to co-ordinate such research, following the example of the United States.
Complementary medicine is at present used predominantly, although not entirely, by the better-off. A small study in our practice showed that complementary medicine was three times as likely to be commonly used by those in the professional social classes as by those in manual work. Members of the higher social classes tend to have better health, but I do not think that the noble Earl, Lord Baldwin, would claim that complementary medicine was the reason for that. The health of the nation depends on much more than health services, whether they be complementary or provided by the National Health Service.
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I should like to reclaim nutrition for orthodox science-based medicine. I do not think that it is entirely the preserve of complementary medicine, just because it has been neglected in medical training. I believe that nutrition with a science base can play an important part.
To conclude, complementary medicine is popular because it often relieves unpleasant symptoms and makes people feel better, on many occasions where science-based medicine has failed. However, it does not deal with the underlying causes of disease, which include poverty, poor nutrition, poor housing and bad working conditions. Therefore, it is of only marginal importance to the health of the nation. Any introduction of complementary medicine into the National Health Service must be handled with care so that it assists rather than detracts from the main task of the National Health Service, which is to prevent and, if possible, deal effectively with the nation's burden of ill-health, which falls mainly on those in less fortunate economic circumstances.
6.38 p.m.
Lord Strathclyde: My Lords, one of the strengths of this House is its ability to deal with complex subjects, competently and concisely. I agree with the noble Baroness, Lady Robson, who marvelled at the degree of agreement that we have witnessed in the House this afternoon. We have witnessed also a wide variety of speakers, with speeches from doctors, archbishops, academics, those with great technological knowledge and expertise, and also those who just have an interest in the subject from a lay point of view. I very much welcome that mixture. I suspect that many of those who have listened to the debate have been refreshed by the experience. I know that I certainly have.
I was particularly impressed, as I think was my noble friend, Lady Flather, by the number of chairmen, presidents, patrons and members of various organisations that were represented by many of the speakers. It just goes to show how much Members of this House are appreciated by outside organisations. There is still much vigour in the House.
I know that it is somewhat unusual for the Chief Whip to wind up a debate of this type. I hope that noble Lords are not too disappointed. As the House knows, the Minister, my noble friend Lady Cumberlege, is unwell. I know that she will read Hansard with great care and interest and will want to respond by letter to points which have been made if I do not do so to her satisfaction. I congratulate the noble Earl, Lord Baldwin, on initiating today's debate, and thank all those who have contributed. I pay a particular tribute to the noble Earl on his chairing of the Parliamentary Group for Alternative and Complementary Medicine. It is equally a tribute to him that the debate has attracted two maiden speakers.
I felt for the noble Lord, Lord Winston, when he said that he did not know a great deal about complementary medicine. That was my position, but I have since learnt a great deal about it. I am wiser than I was. I welcome the noble Lord, Lord Winston, and I hope that we shall hear more of him in the future. I was also much impressed by the words by the most reverend Primate

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of All Ireland. It was not just a powerful maiden speech but a powerful speech in its own right. I am equally certain that he will play a great part in the deliberations of this House.
Many noble Lords who have spoken in support of complementary medicine have done so with great enthusiasm. It has been encouraging to hear the examples of people benefiting from the treatments that they have received. While I would agree with the many speakers who have implied that it would be arrogant to suggest that conventional medicine has the answer to every individual's medical need, it is also important to maintain a sense of perspective and to seek clarity.
"Complementary medicine" is a term used, almost carelessly, to cover a plethora of treatments and professional practices. As a consequence, there often exist tremendous differences of approach and philosophy, forms of treatment, and standards of professionalism and expertise. I therefore agree with the call for evaluation made by the noble Lord, Lord Butterfield. We need to show discernment and to exercise judgment. That does not mean closing our minds, but neither does it mean having to accept the whole package.
There are many, like the noble Lord, Lord Broadbridge, who reminded us that traditional remedies have been around for centuries. Others will tell us that making complementary medicine available on the NHS will save the country over £2 billion a year. Some traditional remedies might prove positively harmful. Where there is evidence to suggest that they are we must, in the interests of public safety, take appropriate action. The belief that complementary medicine can save the NHS money is based on little more than an assertion, whereas in fact the costs may be additional to the cost of more conventional forms of treatment.
If there is one message the Government wish to put across this afternoon, it is a call for clarity. I appreciated the comments of the noble Lord, Lord McNair. He may be aware that different views are held strongly over the terms "alternative" and "complementary". The reality is that there is no universally accepted definition. To begin at this point, therefore, why do so many insist upon using terms such as "complementary or alternative medicine" and "complementary therapies" when they can create so much confusion and division? Dentists, opticians or chiropodists, for example, are not usually referred to as "practitioners of orthodox medicine". Perhaps I may suggest therefore that we have osteopaths, homoeopaths, and aromatherapists rather thana "complementary practitioners".
Clarity is the key. Help in that area came from a perhaps unexpected quarter—the medical profession. In 1993, the BMA published a report on complementary medicine. I understand that that is a most helpful document and reflects a great deal of courage and foresight on the part of the BMA. It highlighted the need to distinguish clearly between those therapies and self-help measures which may be used as an adjunctive form of treatment, and the complete professions of osteopathy, chiropractic, homoeopathy, medical herbalism and acupuncture, which it described as the "discrete clinical disciplines".
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Your Lordships will he aware that the Government's position towards complementary medicine has been traditionally one of benevolent neutrality. We have no wish unduly to restrict its practice or the public's choice in consulting practitioners. A common theme, one raised again by the noble Earl, Lord Baldwin, has been one of urging the Government to be more benevolent and less neutral. I hope that the House recognises that since we last had this debate in 1990 a great deal has been done and we have come a long way. There have been times when government support has been very forthcoming. Perhaps the most significant example was the support given to the osteopaths and chiropractors Bills. However, to gain that support, the professions concerned have first to fulfill a number of criteria and to demonstrate that the move to statutory regulation was in the public interest. The osteopathic and chiropractic professions work hard to establish clarity—clarity in pursuing high quality patient care; establishing education, training and assessment criteria; and clarity in demonstrating that they could regulate themselves effectively. The challenge today to the individual groups and professions is to chart their own similar and independent course.
I believe positive outcomes will then follow. The NHS, for example, is making greater use of some forms of complementary medicine, such as homoeopathy, osteopathy, chiropractic and acupuncture. This, in part, is as a result of the reforms we introduced to the NHS. It is also due to some of the professions clarifying their role in helping to meet particular health needs. Because, for example, osteopathy and chiropractic have been able to demonstrate the role they can play in the treatment of back pain, they have been included in research investigating the scientific evidence into the treatment of this condition. The Department of Health has also recently invited bids from GP fundholders to participate in a small number of pilots to assess whether osteopathy and chiropractic should be added to the list of goods and services that fundholders can purchase on behalf of their patients. The Government have no desire to stifle innovation or new ideas, but our policy in relation to health care cannot be founded on those principles alone.
I agree with the sentiments expressed by the most reverend Primate of All Ireland that there is almost certainly truth in the maxim that the physician comforts while nature heals. There is, however, also a need for evidence-based health care. That brings me to the stormy waters of research. There are those who claim that complementary therapies do not lend themselves to be researched while others demand that the Government should fund more research in that area. I am sure that my noble friend Lady Rawlings and the noble Viscount, Lord Tenby, will be pleased to know that the Government are currently sponsoring some research which may help shed some light on whether the availability of, for example, homoeopathy, osteopathy and chiropractic in general practice impacts on other parts of the NHS. At present the evidence suggests that complementary medicine is often used in addition to conventional medicine. However, as I am sure noble Lords will appreciate, we cannot fund or consider funding every research proposal that happens to mention

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a complementary therapy. The Department of Health does not operate a responsive research grant scheme. It normally meets its research requirements against policy priorities on a commissioning basis, largely via competitive tendering.
But I must emphasise to my noble friend Lord Rennell that the department's R&D programme supports research into non-conventional therapies. For example, one of the !,13 priorities for research funds is the evaluation of manipulation therapies for lower back pain, supported jointly with the Medical Research Council.
The noble Viscount, Lord Tenby, and the noble Lord, Lord Rea, mentioned the Research Council for Complementary Medicine. It might be of some use to the House to know that discussions have been held between the department's R&D managers and that body about extending the opportunities for research into complementary medicine and drawing upon their expertise for considering research proposals.
As was mentioned by the noble Lord, Lord Desai, we support the call to apply the standard scientific approach of the controlled clinical trial to assess the benefits of non-western therapeutic systems.
I understand that among the majority of complementary therapy groups there has been a long-standing reluctance to grasp the research nettle. Notable exceptions to that are the chiropractic, osteopathic, acupuncture and homoeopathic professions. The research ethos must, however, be cultivated in all the therapies and professions. I appreciate that that will take time. There is also the challenge, perhaps, of finding an appropriate research paradigm, but this is not a problem that faces only complementary medicine. Quite recently my noble friend Lady Cumberlege attended a meeting at which hospital chaplains were setting themselves the challenge of finding effective outcome measurements for their own care for patients. As the most reverend Primate said—I paraphrase him—more attention must be paid to the process of healing.
Research does not have to be the large scale, multi-centred trial. As the noble Earl, Lord Baldwin, said, much can be achieved at a local level using such tools as clinical audit. We believe that certain professions within complementary medicine would benefit from access to national support for clinical audit in the same way that the Department of Health supports the clinical professions. I am pleased to be able to tell your Lordships that the department will be looking at ways in which support to the recognised and independent complementary professions might be provided.
It is of course important that anyone who practises any form of complementary medicine should do so to a high standard. I agree with my noble friend Lord Colwyn who I hope will be pleased by my call this afternoon for clarity in training, professionalism and practice among all the various groups.
The Government take very seriously the quality of health care provided by all the professions and therapies, especially the "discrete clinical disciplines". While we
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believe it is for each group to determine for itself whether or not to pursue statutory regulation, for many the establishment of a credible system of independent, voluntary self regulation might be sufficient. But even voluntary systems should contain the essential elements found in a statutory scheme.
We are strongly of the opinion that such measures should be introduced by the professions and therapy groups themselves on an individual profession-by-profession basis, and not under the cover of so-called umbrella groups. In the interest of clarity, where there are different bodies representing members of the same therapy or profession, they should consider getting together under their own single, professionally-led independent self-regulatory body.
A number of noble Lords, especially my noble friends Lord Harlech and Lady Sharples referred to nutritional therapy. Noble Lords will be aware that the Government's Health of the Nation strategy explicitly recognises that better nutrition is important for the promotion and maintenance of better health. Part of the strategy for achieving the targets for a reduction in coronary heart disease is based on diet.
The Committee on Medical Aspects of Food Policy—COMA—is reviewing the role of diet in the development of various cancers. We are also aware of the dietary regimes, such as the Gerson and Bristol diets, from which many cancer patients feel they have derived much benefit. Dietary supplements are sometimes advocated as means of improving the nutritional quality of the diet. However, while there is substantial evidence that fruit and vegetables, for example, might reduce the risk of a number of diseases, there is insufficient information to identify which components of fruit and vegetables are responsible for any protective effect.
I appreciate that my noble friend Lord Kitchener believes that boron deficiency accounts for much bone and joint disease. Boron has not been identified in independent reviews of priorities for Department of Health nutrition research.
The noble Earl, Lord Baldwin, called the Bristol Cancer Help Centre a beacon of light. Of course, that centre received great support from my noble friend Lord Pearson of Rannoch. We recognise the work of the Bristol Cancer Help Centre in developing an holistic approach to the care of people with cancer. Some forms of complementary therapies can play an important role in enhancing emotional, psychological, and physical well-being. The centre has not applied to the Department of Health for any funding. It is open to the centre to seek funding support from health authorities whose patients are receiving care from the centre.
Certainly I pay tribute to those on therapies such as the Gerson and Bristol therapies because they put so much commitment into those various nutritional therapies. Patients, families and friends often dedicate their lives to implementing an arduous and vigorous regime. In turn, that provides hope where conventional medicine has failed.
A number of other points were raised. I shall not be able to reply to all of them. But I am much encouraged, as was, I think, my noble friend Lady Flather, to see

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some of the traditional hallmarks of complementary medicine—the holistic approach, spending time with patients, individual care and even touch—being incorporated more and more into conventional medicine. Of course, that view was confirmed by the noble Lord, Lord Rea.
The noble Countess, Lady Mar, asked about the outcome of some research and whether or not my noble friend Lady Cumberlege has received it. I shall make sure that she has. If she has not, I am sure that she will write to the noble Countess.
We have heard a great deal this afternoon about the many different forms of complementary medicine. The Government appreciate that a great many people derive benefit from them. We uphold the principle that practitioners should enjoy the relative freedom to offer their services and the public's right to use them. But as popular interest grows, that must be matched by increased standards within the different professions and therapy groups in the way that I have described this afternoon.
I have thoroughly enjoyed today's debate. I am sorry that there is not more time to reply in greater detail. Again, I thank the noble Earl, Lord Baldwin, for initiating the debate. I hope, as has been the case with previous debates, it will come to represent another important milestone for complementary medicine.
6.59 p.m.
Earl Baldwin of Bewdley: My Lords, I reckon I have perhaps just a couple of minutes in which to wind up. Clearly everyone saw through the wording of my Motion. It was just that I got fed up with the old words "complementary" and "alternative", which are used so much, and so I thought I would put it in a different way this time.
We have had a wide-ranging debate from the philosophical to the very detailed. I am extremely grateful to all the participants who have given us their views and experiences this afternoon. I would like to point out that most of the things we refer to as "new" therapies—and this has been said—are in fact as old as the hills, going back to what used to be conventional long ago.
The noble Lord, Lord Rea, claims back nutrition for the mainstream. I am more than happy to give it back to him where it belongs. It has simply been by default that it has been elsewhere all this time.
I am tempted to rise to some of the more anecdotal remarks of the noble Lord, Lord Winston. I much enjoyed his speech. But I think that I will forbear there, except to say that I think it behoves any profession to listen carefully to what its clients are saying. I think we would both be interested to know why it is that more and more people seem to be doing better on the non-conventional placebo effect than on the conventional.
I was a little disappointed by some of the things said by the noble Lord the Chief Whip. But, on the other hand, I derived some encouragement from him. I shall obviously read his remarks carefully in Hansard. I am
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grateful for the encouragement on the help with audit, which was the main plank of my argument. Obviously that can be subject to further discussions.
It has been a good debate. I am most grateful for having had the opportunity to hold it this afternoon. I beg leave to withdraw the Motion.
Motion for Papers, by leave, withdrawn.

Violence in Teenage Penal Institutions
7 p.m.
Lord Henderson of Brompton Lord Henderson of Brompton rose to call attention to the report of the Howard League Commission of Inquiry into violence in penal institutions for teenagers under 18 entitled Banged Up, Beaten Up, Cutting Up; and to move for Papers.
The noble Lord said: My Lords, before I address the Motion, I should like to say that I am very pleased to welcome the noble and learned Lord, Lord Mackay of Drumadoon, to our debate. There has been some speculation as to whether or not he would speak from the Front Bench or the Back Bench. However, the matter has now been resolved. I warmly welcome him.
The report concentrates on violence in penal institutions for teenagers under the age of 18. I am glad that we do not have to deal with penal chains in this debate. The House of Commons was dealing with penal chains for women only very recently. The report reveals horrifying and totally unacceptable violence in institutions for the young—not only by bullying, but also, and particularly disturbing, self-harm and, in far too many cases, suicide or attempted suicide, however difficult the authorities seek to make it.
But the report goes much wider. It deals comprehensively with violence in society in general and particularly in the home which has led many young people to commit the unsocial and often violent crimes which result in their being given penal custody. The review was conducted against the background of the obligations which the nation owes to the UN Convention on the Rights of the Child, ratified by this country in 1991. I shall attempt to cover that wider ground.
The first matter I find disturbing is the fact that the Government do not pay due regard to the UN convention which they ratified such a short time ago. At that time the number of 10 to 16 year-olds guilty or cautioned was static or falling, as the Home Office figures for 1990–93 show. Those figures are given on page 19 of the report. That static or falling tendency has now been reversed, seemingly as a result of deliberate policy by the Government. The 1988 Green Paper Punishment, Custody and the Community, represented a real advance and seemed to have general consensus as well as reflecting government policy. I shall quote the extract from it given in the report:
"Most young offenders grow out of crime as they become more mature and responsible. They need encouragement and help to become law abiding. Even a short period of custody is quite likely to confirm them as criminals, particularly as they acquire new criminal skills from more sophisticated offenders. They see themselves labelled as criminals and behave accordingly".

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How long ago, that seems now. The Criminal Justice Act 1991 reflected the spirit. It introduced a number of community-based penalties for young people under the age of 18 and limited custody for 15 to 17 year-olds to 12 months' detention in a young offenders' institution.
All that now seems to have changed. The general understanding then among those working within the criminal justice system was that many young people committing criminal offences were vulnerable, came from chaotic family backgrounds and were in need of special care and protection. That understanding accords with research by the Policy Studies Institute for the Home Office in 1994; alas, it does not seem to be appreciated by the Government.
It is clear that the Government have been blown off course by the panic outcry against so-called "persistent young offenders" and by the killing of James Bulger in 1993. Unfortunately, that combination led to confusion between the persistent, or very persistent, and the very serious offender. I believe that that was a mistake.
I suppose it is coincidental that the Government now behave as if they would prefer not to have acceded to the United Nations Convention on the Rights of the Child in 1991 and would prefer increased and more severe forms of custody and the reduction of punishment in the community. Hence some of the provisions of the Criminal Justice and Public Order Act 1994.
I should also mention what I can only call the infamous sound-bite at the Conservative conference that "prison works". Prison certainly does not work: upwards of 70 per cent. of its inmates offend again. Prison fails to inhibit re-offending among the young as well as older prisoners. The most successful young offender institution has a reconviction rate of 70 per cent.; others are much worse. How anyone can subscribe to the boast that prison works when we have a success rate of only 30 per cent. or less is beyond my imagination.
The abandonment of the 1988 White Paper ideals has led to overcrowding. Sentencing patterns have changed. That makes things worse for constructive regimes in our prisons. Overcrowding means that prison officers do not have the time (what with locking and unlocking) to conduct prisoners to and from education and other meliorative activities. Overcrowding tends to heighten tensions in prison and makes it much more difficult for prison officers to watch out for, and prevent, routine violent behaviour such as bullying. They are much more likely to be watching out for serious trouble. Even in the most positive regimes, programmes and activities (including leisure activities) become restricted or go by the board.
I turn to another major worry; namely, the conflict of interest and duty between the Home Office and some other government departments, notably the Department of Health. The latter department, certainly when it was the DHSS, was responsible for the welfare of children. But apparently that responsibility ceases when the child becomes a criminal which can happen at the very young age of 10. Indeed, it is even lower in Scotland and
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Northern Ireland. The child is still obliged to attend education, but the national curriculum does not seem to operate in prison.
Most penal establishments try to encourage all young people to attend classes, but the quality of facilities is low. The standard of literacy among prisoners, both old and young, is low and speaks for itself. An illiterate and innumerate prison society is probably a more violent society and, in any case, its members are unlikely to be eligible for any but the lowest paid jobs on release.
If the departments for health and education had a higher status as regards young prisoners, a far higher quality of regime could be obtained. I wonder whether the Minister can comment on the quality of regimes, particularly in education, and say whether the Children Act 1989 and its regulations are followed so far as possible where the young offender is concerned.
I reiterate that far too many children from violent and chaotic backgrounds are sent to penal institutions where they meet violence. Violence tends to breed violence. If children need to be locked up, they should go, preferably—I know this is an ideal—to local authority secure accommodation where violence is much less known than in penal institutions and where children are far better attended to than in prison custody. As the report shows and strongly recommends, the children would benefit and society would benefit if that were to happen.
I wish to say a few words about training centres on the model of the glasshouse designed for defaulting soldiers. Children are not defaulting soldiers. Discipline designed for adult soldiers is not in the least appropriate for child offenders. I hope that the noble Baroness will be able to say something about the proposed "boot camps" and whether she thinks they will offer less opportunity for violence to take place than local authority secure accommodation. The same applies to all secure training centres that are planned. I believe that the culture of violence revealed by the report in existing penal institutions is something which children should not he exposed to. I very much hope to hear from the noble Baroness that steps are being taken to make things better. I beg to move for Papers.
7.11 p.m.
The Lord Advocate (Lord Mackay of Drumadoon): My Lords, I am most grateful to the noble Lord, Lord Henderson of Brompton, for affording me the opportunity of making my maiden speech on such an important and interesting topic. Perhaps before I pass to the short contribution that I seek to make to your Lordships' discussion I should begin with an apology for any confusion that may arise through the introduction of yet another Lord Mackay into your Lordships' House. I hasten to assure your Lordships that this is no part of a clan takeover. Moreover, now that there are three Lord Mackays in Her Majesty's Government your Lordships should not take that as evidence of the development of a clan within a party. My noble friend the Chief Whip has assured me that that would not be welcome.

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It is, however, a great privilege for me to make my maiden speech with my noble and learned friend the Lord Chancellor in his usual place on the Woolsack. It is over 25 years since we first worked together as lawyers in Scotland. At that time I was a solicitor; indeed our first contact occurred when I was only an apprentice solicitor. Despite my lack of seniority, I was in a position of being able to give instructions to my noble and learned friend who was at that time in practice at the Scottish Bar. I understand that those days are behind me! In the fullness of time, with not a little encouragement from my noble and learned friend, I was myself called to the Bar. It was then that certain confusion began to arise. As is the position in your Lordships' House, we were not the only Mackays around. For that reason papers sent by firms of solicitors occasionally ended up with the wrong Mackay and—possibly more surprisingly—consultations were even arranged with the wrong clan member. Those clients of mine who came face to face with the noble and learned Lord the Lord Chancellor felt honoured by the experience. I regret to say that his clients did not take the same view when they came face to face with me. Reactions of annoyance and shell-shock were common. I trust that your Lordships will not similarly discriminate between our speeches in the future.
I should explain that throughout my practice as a lawyer I have practised almost exclusively in Scotland. It is only through membership of the Criminal Injuries Compensation Board that I have had any exposure to those who have been detained in penal institutions for young people in England and Wales. Your Lordships will appreciate that on occasions such young offenders are themselves the victims of crimes of violence. They apply for criminal injuries compensation and on occasion they are held entitled to receive it. My limited experience of the situation in England and Wales does not really qualify me to comment in detail on the report which the Howard League has prepared. Rather I seek to content myself with a few observations based on my experience as a lawyer in Scotland. At different stages in my career both as counsel and as solicitor I have worked with juvenile offenders. I have both prosecuted them and defended them on charges ranging from the most trivial to the crime of murder. Of necessity I have had to visit clients in various institutions throughout the length and breadth of Scotland.
As the Howard League report helpfully reminds us, juvenile courts in Scotland were replaced in 1971 by the children's hearing system. That system deals with all but the most serious offences committed by teenagers generally under the age of 16 years. Children are referred to the children's hearing when they are deemed to be in need of compulsory measures of care. That can arise on a variety of grounds, whether they be accused of committing offences or whether indeed they have been the victim of such offences. As your Lordships will know, the children's hearing is constituted by lay members of the public who are properly trained in this important work. They work not only with the young offenders themselves but also with their parents, social workers and other professionals trying to address the whole needs of the child. As total a view of the welfare
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as possible is taken, and sometimes this can be dealt with by a non-residential supervision requirement. On other occasions some form of residence is required. Occasionally it is with another adult relative, and sometimes with foster parents, but from time to time the young people have to be kept in secure accommodation notwithstanding the fact that they arc riot yet 16 years of age.
I think it is well recognised that both within and furth of Scotland the children's hearing system is much admired but nevertheless those who pass through it do not always benefit from the approach which is adopted. The complete look at the welfare—the involvement of the parents and other professionals—does not meet with success in every instance. That seeks to illustrate the first point that I wish to make to your Lordships; namely, that it is unrealistic to expect that any one procedure for dealing with young offenders can be expected to achieve 100 per cent. success with every individual who passes through it. As any young offender passes through a system, whether it be the children's hearing system or the young offenders institution, or what have you, he or she benefits in a different way and to a different extent. One must bear that in mind when considering this important topic.
The other principal point I seek to make is to guard against a feeling of despondency. Those who work with young offenders, whether they prosecute them or defend them or whether they act as their social workers or their probation officers or they sit in court dealing with young offenders, are inclined from time to time to feel despondent about the problems these youngsters face and the serious problems they get into and, equally, about the serious problems they create for others. Indeed, reading through the Howard League report, that feeling of despondency comes across fairly forcefully in the text of the report itself. In my experience it is important to guard against such a feeling of despondency. Some young offenders learn quicker than others. Some benefit from their first experience in custody and resolve never to offend again. For others it takes longer. That is another important lesson which has to be borne in mind.
Undoubtedly the punishment element of youth custody is not confined to the loss of liberty. Bullying and occasional self-harm are major problems which require to be addressed. They are certainly being addressed in Scotland. I am sure that my noble friend Lady Blatch will explain in detail how they are being addressed south of the Border. Although these problems arise from time to time, it would be a serious mistake to imagine that every young offender who passes through an institution is faced with these difficulties. Not every inmate of a young offenders institution is either a bully or a victim of bullying. Many of them serve their sentence and get on with their lives when they come out. Certainly, my experience of working with them, both prosecuting them and defending them, is that they tend to be much more resilient than many of the very disturbing incidents which are discussed in the Howard League report suggest.

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I hope that those observations from north of the Border will be of assistance to your Lordships in this very interesting debate.
7.20 p.m.
Lord Prys-Davies: My Lords, I should like to express the pleasure of the whole House at the maiden speech which has been delivered by the noble and learned Lord, Lord Mackay of Drumadoon. He spoke from the Front Bench, but his interest in the matter as a Scottish lawyer and his concern for the needs of the child are widely appreciated. I am sure that the House will draw on his experience as a successful Scottish advocate.
I am also grateful to the noble Lord, Lord Henderson, for enabling us to have this debate on this sombre report by the Howard League. The House will know that I speak this evening on a subject on which I have no great expertise. Many Members of your Lordships' House have great knowledge of the subject. Nevertheless, I speak in the debate because of my concern about the position in Wales as revealed by the report. The report devotes four separate subsections to the situation in Wales, and they too make for sombre reading.
I am bound to begin with the prisons in Cardiff and Swansea, where most Welsh juvenile defendants on remand are placed. I believe that 11 teenagers have died in those two establishments during the last 11 years. The report itself deals at some length with the circumstances surrounding the death in Cardiff Prison in 1994 of 17 year-old Joseph Stanley. An inquest was duly held, but the commissioners describe its proceedings as a farce. They have come to the conclusion that there may never be a full explanation of what happened to young Joseph.
Perhaps I may ask the noble Baroness what is the policy of the Home Office towards the sudden death of a juvenile within a place of custody, the need for a thorough investigation of the facts and the need to ensure that legal aid is available so that there can be representation of his or her family at an inquest.
On page 28 of the report we are reminded that since the suicide of 15 year-old Philip Knight in Swansea Prison in 1990 the Howard League has consistently warned of the danger to young people in Welsh prisons. It now warns that that danger has not gone away, and overcrowding must make it worse.
We are bound to ask why so many juveniles on remand are being routinely locked up in those two prisons for up to 22 hours a day with two or three in a cell, as described in the report. Why are there no education classes, no training and work facilities? Why is there that virtually complete inactivity?
The report rightly acknowledges that some improvements have been made since Judge Tumim's report in 1992. But it is also plain that conditions are still far below what could reasonably be expected. I sympathise, and I support expenditure on patching and improving old buildings in response to the pressing needs of the present. At the same time it should be
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emphasised that that is also expenditure on a structure and a system which are beyond redemption. What is required is expenditure on new secure care units in the community in the context of a long-term programme.
My second topic concerns the slow pace of reform in Wales. Since 1989, reflecting a movement in England, there have been a series of reviews of secure care facilities in Wales, followed by a substantial review in August 1991 which recommended that there should be a single all-Wales unit of 18 secure places outside prison for boys only.
It will be next summer before the 1991 recommendation will be implemented. Plainly, and understandably, it cannot solve all the problems overnight. However, with support from the departments of state—the Home Office and the Welsh Office—I believe that it has a substantial contribution to make to the development and improvement of the service for young delinquents in Wales. However, given the anxieties expressed on page 75 of the report, I ask the noble Baroness what will be the regime for that unit.
There is worrying evidence that the Welsh courts in recent years have adopted a more punitive approach to their work. One senior prison officer at Swansea summed it up:
"I've never seen such a percentage of juveniles coming in".
Further corroboration can be derived from another Welsh Office document that since October 1992 the courts in Mid Glamorgan—the area where I live—have dramatically increased the use of their powers to remand juveniles. I wonder whether the Welsh Office and the Home Office are seriously seeking an explanation for that increase and examining its implications.
The Howard League commissioners were also particularly concerned that the number of juveniles in Welsh prisons who had been through the care system was very high—it could be as high as 90 per cent. according to one witness—suggesting as it does a failure in the residential care system. I should like to know whether that linkage is being examined as recommended on page 75 of the report.
Those are my greatest concerns.
7.27 p.m.
The Lord Bishop of Chichester: My Lords, I should like to echo the thanks expressed to the noble and learned Lord, Lord Mackay, for his maiden speech. I do not know how often a maiden speech has been made from the Front Bench, and I have certainly never heard one before, but it was a great pleasure that the noble and learned Lord was able to bring to our attention experience from Scotland which might otherwise have been passed over.
Perhaps I should say, following the two previous speakers, that I speak from an English point of view. What I have to say is based on experience which may be somewhat out of date in many ways, but the report brought to my mind contacts with borstals which between 1960 and 1970 I had as a college chaplain in Oxford. My own college joined with four or five others in running camps in Wensleydale in which an equal

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number of undergraduates and borstal boys shared a common life for a week. It included a two-day hike up the dales, sleeping out, and another week inside the borstal. In the 10 camps of which I had personal knowledge I do not remember a single occasion of a borstal boy absconding. Friendships were formed which in many cases have continued. I hope I do not embarrass the noble Baroness, Lady Masham, if I say that one of my most vivid memories is of her playing ping-pong with the borstal boys, and generally winning. I use that example to illustrate one of the points that I wish to make forcefully, which is the importance of personal influence.
The value of the camps, especially in preparing the borstal boys for release, was commended by all the borstal officers and governors. I should like to testify to the high quality and caring nature of the officers who came to the camps with the boys. What is relevant to part of this report is that I remember clearly their regret at the borstal system having been taken over by the Home Office and the changed ethos which resulted from that.
Most of the colleges were linked with open borstals but my own was with the closed borstal which had been built as a prison at Everthorpe near Hull. What I read on page 24 and the following pages of the report awakened memories of Everthorpe and the sensation of being locked in there. I do not know how many Members of your Lordships' House have spent nights locked into a prison, but it is a rather terrifying experience. That brief experience of being in prison enables me to understand what is stated later in the report about the pressures which lead to suicides and attempted suicides.
Another memory from those days bears on the use of adult prisons for boys on remand. In the 1960s many boys were sent after sentence to Wormwood Scrubs while it was decided which borstal they should go to. While there, they picked up a prison mythology—the glamour (I do not think that that is too strong a word) of the more notorious and longer serving prisoners in the Scrubs who were talked about. There is great danger in putting young people with older prisoners. Therefore I agree with and strongly support the recommendations at page 67.
I recognise that since 1970 things have changed. The number of young offenders has increased. I recognise that there are always likely to be those who do not respond. The noble and learned Lord, Lord Mackay, mentioned them when he said that no system can ever be 100 per cent. effective. However, the need to treat them all as persons remains. Caring must be a central element, and that requires a large number of highly trained and caring officers. I hope also that an imaginative way of using young people of similar age as volunteers, as we did in the borstal camps, may be found. Personal contact, personal influence, is valuable and important.
The 15 to 18 year-old young offenders are as much part of our future as are other young people who are still at school, and they should be treated and cared for as such. The report, I fear, lays out facts which indicate how far we are from carrying that out at the present time.
7.33 p.m.
Baroness Faithfull: My Lords, perhaps I may join with others in thanking the noble Lord, Lord Henderson, for initiating the debate. Perhaps I may also say to the noble and learned Lord, Lord Mackay of Drumadoon, that he joins two other luminaries in this House—two other Mackays. We should not mind a few others coming down from Scotland as we greatly admire what is done with juveniles in Scotland.
I have read the report of the Howard League Commission of Inquiry. However, I hope that in addition to commenting on the report I may be forgiven in this short speech for drawing upon my personal experience, and that of my committee and staff, on the Oxford City Council Social Services, prior to that in the children's department, and even further back in the Home Office and Ministry of Health Inspectorate.
The profound belief of the Oxford department for which I worked was, first, that there should be a close working relationship between education and social services offering a preventive care work service to vulnerable families to prevent the break-up of families and to give support and a service to vulnerable children. We could wish that such a service had been given to the boys involved in the Bulger case, already referred to. If that had happened, the Bulger boy might be alive today.
Secondly, wherever possible and practicable, children found guilty of an offence and committed to care should be dealt with in the area in which they live. They should be kept in close contact with their families. To a large measure, that prevents suicides. I believe that on discharge children would join their families and have a better relationship with them. Furthermore, they could be kept in touch with local clubs, training facilities and the psychiatric services. I have to say that we had a splendid child guidance clinic to help the children and support the staff. It is an indictment or our time that a proportion of children sleeping rough are from residential establishments, not having been kept in touch with their families.
Thirdly, as the remand home (now called secure unit) was local, a sound relationship could be encouraged between the staff, the parents and the child. To this end parents could visit weekly, often at weekends. They could also attend case conferences and could be helped to understand their children and experience a sense of responsibility for them. Furthermore, the parents could help the staff to understand the problems and the background of their children. In my 18 years of service in Oxford City, only about 12 children were sent away from the city and many of them live to this day as happily married men with families within the city.
The underlying philosophy in dealing with juvenile delinquents is that it must be clearly understood by parents, children and social workers that there is a state of mind which understands that there is right and wrong. There may be extenuating circumstances leading to wrongdoing, but they cannot and must not be an excuse for committing crimes.
There is much good work being done by some local authority secure units, remand centres and youth treatment centres. However, there should be well trained

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staff, social workers, residential care staff and educationists. It is a sad reflection on our services that there has not been training for those seeking to work with children and young persons in a residential setting who have committed offences. A voluntary organisation has set up a training college for residential staff; namely, the Caldecott College. I declare an interest in the college as I am chairman of the Caldecott Community. I pay tribute to the staff of the college who have set up this new venture; and I also pay tribute to Sir Evelyn de Rothschild who is helping to make the training possible.
It is on the statute book that there should be five secure training units, each with 40 children aged 12 to 14 years at a cost of £30 million a year. That may or may not be a successful project. But I believe that it is an expensive one and I do not believe that it is the right one. Where possible the care, control and training of juvenile delinquents should be carried out in the area in which they live, mixing with the people they know and learning to make personal relationships with those with whom they have been brought up.
I cannot believe that the prison type of strategy is the right one for training our children. Many of them suffer emotional disturbance and, sadly, we have to send some children away from the area in which they live because there are very few therapeutic units that are able to help children locally. Of course, it is a very expensive area.
I recognise that the Home Office has a difficult task and I know that my noble friend Lady Blatch understands the problems. It is the wish of both the Department of Health and the Home Office to work together. I hope that we may help the children of our areas by setting up good local secure units with good trained staff working with the parents, social workers, clubs and youth training centres in the areas in which the children live. In that way I believe that we will prevent children from sleeping rough on our streets.
7.41 p.m.
The Earl of Longford: My Lords, if anyone is interested in my views on young offenders, I suppose I may recommend my book Young Offenders, published two or three years ago. However, like everyone else tonight, I am subjected to the iron discipline of the House with its seven-minute sound bites. I may have to use most of that in offering congratulations, especially to the noble Lord, Lord Henderson. There are so many reasons why he is admired in this House that I shall only add one more. It is that, as president of New Bridge, which I founded 40 years ago, he has made a tremendous success of that organisation.
All of us concerned with young offenders, young children and young people, look up to the noble Baroness, Lady Faithfull. She has gained a kind of sanctified status in the area. Perhaps that is almost embarrassing but I find it a great privilege to follow her. I also look forward to hearing my acting Leader, my noble friend Lord McIntosh, because he will make sure that the impression that the Labour Party is not so interested as it once was in penal reform is a delusion.
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I must not forget to congratulate the Minister, the noble and learned Lord, Lord Mackay, the maiden speaker. The right reverend Prelate wondered whether anyone had made a maiden speech from the Front Bench. I am sure that people have. I myself made one from the Front Bench 50 years ago. I congratulate the noble and learned Lord on his.
I have only a few minutes, so what can I say? I shall not deal with the most difficult problem, which was just touched on at the end of the speech by the noble Baroness, Lady Faithfull, and which is that some people have to be sent away. In the most severe cases, such as that of the young schoolboy who murdered the headmaster, I do not think it is enough to say, "Let the local authority provide some accommodation". The state has to take a responsibility in that case and the Department of Health has institutions of a suitable kind. I am only saying that if people are to be sent away outside the local authority area, the Department of Health and not the Home Office should be responsible.
I would rather spend these few minutes on discussing what are called "local secure units". A certain magic is beginning to be attached to their name. They are fallible, like everything else in this world. Last week I visited one which it was suggested to me might be the best. I also visited a prison which I know very well, although it is not called a prison: it is the Feltham Young Offenders Institution. I was able to make a comparison. It is worth spending a few minutes on considering the two kinds of institution.
No one can doubt that if one had a young person in whom one was interested, one would rather he went to the high-class local secure unit than any kind of penal institution. But the facts may not be in the minds of most noble Lords: they were not in mine. Orchard House, which I visited, is a fine place where 70 staff look after 28 young people, eight of them in a totally secure unit. That is 70 staff to 28 young people. I also visited Feltham, where there are two units. In each unit there are 64 young people under 18, looked after by 16 staff. So the ratio in a secure unit at the moment is 10 times as good as in prison. If we are talking about prison, we must realise that we are not talking about a level playing field.
What are the implications? I am not the devil's advocate. I have never, so far as I remember, said a good word in this House for Mr. Michael Howard's policies. However, I almost began to feel sympathetic at one point, relatively speaking, though I shall not dwell on penal reform to the extent of coming out for Howardism. The fact is that prisons are not really quite so bad as the report makes out. Its heading is Banged Up, Beaten Up, Cutting Up. I pay my tribute to the Howard League for producing it and to the secretary who is giving a new impetus to the league. However, I hope that when the Howard League produces another excellent report it will not reproduce that cover. It is a totally misleading account of life in prison. No one who goes to prisons every week as I have done this morning could assume that that is life in prison. Perhaps I may put before the Howard League. with great respect, that I hope that it will not spoil an impressive report with that kind of nonsense on the cover.

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That is by the way. Looking at the future, what do we think? I agree with the noble Baroness, Lady Faithfull, that there are a few people who should go somewhere else under the Department of Health. I do not say that there should be five units of 40 people, but at any rate some ought to go. Otherwise I am all for saying that no one under 18 should be in prison. We should transfer them to places that are much better, but that means spending money.
Let us face the implications. If we are considering giving effect to the Howard League proposals, we are talking about spending money and giving young people under 18 a much better regime than they have now. There is no way of getting round it. It is not just an ideological question; it is a question of money. I leave that thought before the House, because it did not occur to me until I went to those two places last week and saw the enormous difference. The governor of Feltham or anyone else can go there tomorrow and say: "If I had the money, of course I could do a much better job". That is one important point.
The other point expressed by the noble Baroness, Lady Faithfull, has been mentioned before in these debates. The training of staff in secure units is by no means satisfactory. It may vary greatly but it is not satisfactory. There again, we must spend much more money on training staff.
7.49 p.m.
Lord Allen of Abbeydale: My Lords, when I read this report I could not help recalling how bullying and self-harm were among those problems with which we had to cope when, a long time ago and even before the reminiscences of the right reverend Prelate, I had some direct concern with the running of prisons and borstals. The problems, indeed, are not new. But we had smaller numbers; drugs were not so prevalent; the gang culture of those days—Mods and Rockers notwithstanding—had, I think, a smaller element of violence than today; and the public was not that much concerned about prison conditions. It meant that, when resources were being handed out, prisons and borstals came a long way down the queue. But at the same time we were left to grapple with our problems in comparative obscurity and the Home Office spokesman in the Lords did not have to face debates on prisons every other fortnight or a so-called "Prisons Minister" appear on the box night after night.
It seems to me all to the good that there are now some signs, however faint, of a social conscience about the way in which those committed to custody are treated; and that it has proved possible to carry out improvements, some of them quite expensive, without affronting public opinion. But there is obviously still some considerable way to go. One trouble is that the very nature of prison life always has been a fertile breeding ground for bullying. Boredom, aggression looked on as normal behaviour, limited access to prison currency like tobacco, the reliance sometimes put by the officers on the prisoners' own pecking order, the reluctance of individuals to tell on their fellows, all add up to the creation of a state of affairs where bullying
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can too easily flourish. I could continue at length on this topic, but time is short. I shall limit. myself to four simple questions.
The first relates to official guidance. On 20th December, answering a Question about Holloway (at col. 1603), the Minister stated that the Government took the issue of bullying in all prisons very seriously and that clear guidance had been given to establishments on how to address and reduce the problem. She will have seen the suggestions in this report that, when seen from the other end, as it were, in the prisons themselves, the application of the guidance seems to be patchy and uncertain. I hope that the Minister will feel able to comment.
Secondly, does the Minister see any hope of ending altogether the practice of holding 15 and 16 year-old boys on remand in adult prisons such as Kingston upon Hull and Gloucester, as well as Swansea and Cardiff? The undesirability of keeping boys locked in their cells for much of the day and, equally, the risk of undesirable associations, speak for themselves. The Minister may agree that the educational facilities which it is possible to provide for boys of school age who are detained on remand in prison leave a good deal to be desired.
My third question links directly with the previous one. It relates to the programme for the provision of more local authority secure units. When we were discussing the 1994 Bill, I recall that we were told that there were some 270 places and that the Health Secretary was providing financial aid for a further 170—not all of them, I appreciate, for those who had been through the criminal courts. But, far from there having been an expansion since then, the total seems, so far as I can make out, to have shrunk and the provision of these units seems to be even patchier than it was. It would be most helpful to know what the prospects are. It looks as though the programme is running very late.
It is probably quite unfair, but I cannot help wondering whether there is just a hint here of divided responsibility, and whether this is the long-term consequence of the decision, which I regretted so much at the time, to move the children's department from the Home Office, where it helped to provide a human face to what is inevitably otherwise a somewhat austere department.
My fourth and last question relates to the comments in the Howard League report about the privately run Doncaster prison. Tribute is paid to some of the facilities, but it is suggested that there are no proper programmes in place to deal with bullying and self-harm. Those who visited the prison came away with feelings of concern about the ability of the inexperienced staff to provide a safe and caring regime for young people. Those comments do nothing to lessen the apprehensions that some of us have felt all along about the ability and qualifications of the staff of the new secure training centres to cope, among all the other difficulties, with the problems of bullying and self-harm. I am pretty sure that the Minister does not share these apprehensions and will no doubt say so. However, I fear that my doubts cannot be easily removed. Only time will show whether, as I hope, I am wrong.
7.55 p.m.
Viscount Mountgarret: My Lords, there is much in the report that we are debating, for which our thanks go to the noble Lord, Lord Henderson. The report is to be commended and very carefully read. However, that view has to be tempered by the continued attitude contained therein of those who wish to approach the problem of crime or thuggery committed either in prison or outside with a "soft glove", which is an offence to decent citizens and undermines the very fabric of our society.
I want to concentrate on just one word in the report—"bullying". It is described on page 33 as,
"conduct motivated by a desire to hurt … or frighten someone",
which takes several forms including actual assault or threats of violence which all too often lead to actual violence and in some cases death. It is admitted that bullies can make life unbearable for their victims. The report further admits that if bullying is allowed to flourish it creates no-go areas, not only in prison but, increasingly, outside. We have all heard of the no-go areas of Brixton and Liverpool. But now, even in my own local town of Harrogate, which was always traditionally recognised as a rather gentle spa where life goes on in a very pleasant and gentle way, there are now areas where even the police fear to tread.
It is sad, to say the least, and worrying at worst, that the Youth Treatment Service declares (page 91) that it,
"does not view it as acceptable to 'bully the bully—
It declares that,
"The normal punishment is [merely] to reduce … privileges so that the bully gets early bed, no pocket money … no access to certain parts of the unit".
That cannot be, and is not, good enough. There is nothing much left to deter from his ways the young thug who has been committed to prison. Indeed, outside prison the thug in the street has little to fear from a custodial sentence. He will think nothing of setting to work to bully, beat up, rob, maim and sometimes kill people of whatever age. The only way to counter this evil is to give the bully some of his own medicine. By that I mean a flogging.
I know that that suggestion is anathema to organisations such as the Howard League, and perhaps to some Members of this House and many Members of another place. But it is not anathema to many hundreds of thousands—in fact, I should think the majority—of citizens outside these Houses. Flogging has the purpose of making the bully aware of his own aggression and making it hurt. It is also humiliating. Not even a bully likes that.
I am well aware that Britain is associated with various conventions, and not least with the European Court of Human Rights. However, if by such association the very fabric of our life is threatened, there is every justification for withdrawing from such affiliation.
Of course, ideally we have a responsibility to try to provide the right environment, wherein thuggery has no place. It would be highly desirable to prevent it from birth. The trouble is that bullying starts in the home. I say "the trouble" because today so many mothers need to go out to work that the upbringing of the young very
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much takes second place. I do not want to be taken the wrong way. I have absolutely nothing against women playing a very active part in life. In particular, there are many areas in which women are far better qualified than men. But one cannot have it both ways. If a mother is away from home, her guidance of the family evaporates and trouble starts.
Another way in which we can lend a hand in turning young people into useful members of society is by gainfully occupying them. Perhaps some form of national service would be ideal and beneficial in many ways. At school stern punishment could well be applied without the governing authorities forever living under the threat of being sued or taken to the all-powerful Court of Human Rights.
Unless such matters are addressed in a more practical and determined way, I fear that within a comparatively short space of time citizens of this country will be driven to taking the law into their own hands—in my view, rightly so. As we know, that has been demonstrated recently by two people who were invaded by violent burglars. I find that prospect frightening. It leads inevitably to anarchy.
Parliament has a responsibility to tackle these problems in a positive and determined fashion, which excludes a pussy-footed approach to those who have no desire other than to maim, kill or injure to satisfy their sick minds. Some of that does not feature in the report.
8.2 p.m.
Baroness Farrington of Ribbleton: My Lords, I too should like to congratulate the noble Lord, Lord Henderson, on initiating this debate. I agree with the extremely interesting maiden speech made by the noble and learned Lord, Lord Mackay of Drumadoon, and in particular with his point that no system in the world will be perfect and achieve 100 per cent. success. Some very important points have been raised, in particular the questions raised by the noble Lord, Lord Allen of Abbeydale.
There are two issues of great importance raised by this report. The first is that, notwithstanding the dedicated commitment of the overwhelming majority of staff who deal with young offenders in the institutions in which they are put into custody, there is uncovered a degree of bullying, self-abuse, suicide attempts and sexual assaults among those young people which is unacceptable in a civilised society as behaviour occurring while that society is responsible for keeping them—children—in the establishment. Secondly, there is the issue of the prevention of crime and protection of people in the community from future offences that could be committed by young people.
I cannot agree with the noble Viscount, Lord Mountgarret, about the second of those issues, the prevention of further offences committed by people who have been deprived of their liberty. To a certain extent the question as to which institution by name children and very young offenders are committed is, in one sense, less important than the kind of institution to which they are committed and the regime that is possible. Many of those young people have themselves

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been the victims of violence and abuse. I cannot believe that the noble Baroness, Lady Blatch, in particular, would want to condone turning a blind eye to continued violence and abuse while they are in custody.
I have met many such young people when lecturing in a voluntary capacity to young people in prisons. Many of them indicated that they had serious problems very early in their school careers. Often they are within that group of young people who are at risk because of behavioural problems which do not necessarily stem from the school but from a variety of circumstances—the community, the school and the home. I do not feel that it is helpful always to blame the parents. Sometimes the prevailing attitudes of peer groups make it extremely difficult for parents to counter that influence.
But there is a need within the provision of care for non-statemented special needs pupils to strengthen the preventive work that is done with very young children when first problems become apparent. The report highlights the fact that by the age of 11 years many such young people are truanting. Teachers will tell anyone who talks to them that they are aware that there are young people—they can be identified—who need, above all else, time: time from responsible, trained, experienced adults who can deal with young people who have behavioural and social attitude problems.
Therefore, the thread that runs through the answer to the challenges posed by this report is how we have a society which has so many people with a high level of education who are unable to be employed while at the other end of the spectrum work remains to be done. I make the point again. From conversations with prison officers and people working with young offenders it is clear that the most valuable resource of all—human time from adults—is denied to the system on the scale that is needed.
In this category I should like to refer with great sorrow—I am glad that my noble friend Lord Longford has returned to the Chamber—to the fact that I do not believe from my limited experience that the threat of bullying and physical and sexual abuse is, as he indicated, something which never or seldom occurs in penal establishments. I apologise to my noble friend if I misunderstood him.
I believe that our penal establishments—this is of particular concern when it affects young people—are understaffed to a point at which containment, instead of an attempt to reform and change attitudes, becomes the only means open to those working in the prison system. I believe that if we wish to see a change of attitude and want to protect members of the community from offences committed in the future by those young people, then as a society we must have the courage to say, "Custodial sentences—yes; but if the person is a child or a young offender, that custodial sentence must be in an appropriate institution". We must have the courage to fight those who believe that revenge is all, in the interests of preventing future offences occurring on the scale that occurs when young people are put into a system where they are abused and taught to be more violent and more uncivilised by the time that they leave.
8.10 p.m.
The Lord Bishop of Lincoln: My Lords, along with other Members of this House, I am grateful to the noble Lord, Lord Henderson, for initiating this debate on this, as he puts it, "sombre" report. Also, I add my voice to those congratulating the noble and learned Lord, Lord Mackay of Drumadoon, on his maiden speech.
The report continues the work of the Howard League in drawing attention to the need for special care of young offenders and to the fact that prisons are, by and large, an inappropriate response to offending by young people under the age of 18. I should declare an interest as a member of the council of the Howard League. I want simply to concentrate on one issue; that is, the issue of suicide and self-harm.
Your Lordships will recall from the report that the commission found widespread self-harm throughout the prison system, even in prisons with well developed anti-bullying tactics. The figures given in the report speak for themselves. While improved recording measures may have had an impact on some of the figures, it is surely misleading to attribute the increase primarily to that factor. The focus therefore needs to be directed, as other noble Lords said, towards the effects of overcrowding, the failure of key elements in the Prison Service self-harm and suicide prevention strategy, and the increasing levels of violence and alienation affecting young prisoners.
In fairness, the Prison Service has sought to develop a more coherent strategy to reduce self-injury and suicide and of course no system can ever be foolproof if an individual is determined upon that specific course of action. But the report draws attention to the serious gap existing between policy and practice.
In April 1994 many Members of his House joined me in meeting the parents of some of the young men who had harmed themselves while in custody. To meet the families of those people was a heartbreaking experience. Many tell stories of not knowing where their children were within the system; of being unable to obtain adequate help for them; of being unable to visit them. As the noble Baroness, Lady Faithfull, reminded us, an important element which needs to be emphasised over and over again is the element of holding families together. We need to break the cycle of violence and despair. Only time and affection can do that, as we know from our own experience of everyday living. My own children—two of whom are graduates and one of whom is still an undergraduate—are still extraordinarily dependent upon me and my wife, and the same surely applies to all young people in relationship with their parents. Therefore the idea that imprisonment is a safe and simple way of protecting the public ought to be questioned, as it is in the report.
Of course some young people are committing serious and deeply anti-social offences. But to concentrate on incarcerating damaged and delinquent adolescents in large and soulless institutions, often a long way from their families, is both harmful and inhumane. We are not protecting the public when up to 90 per cent. of

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young people reoffend after being in prison. We are not protecting dedicated prison staff when they are called to do a job in extraordinarily difficult circumstances without adequate support. And we are not protecting young people and helping them with their offending behaviour when we simply lock them away.
As the noble Baroness, Lady Farrington, mentioned, many of those adolescents have been in care for much of their lives. Many have been excluded from school or have excluded themselves from school for one reason or another. Very few of them have ever had a stable relationship. I remember visiting a young offenders' institution many years ago near the open prison in the west country. I remember going into the dining hall and talking to an officer, looking across at a young lad laying out a knife, fork and spoon on a table. The officer told me that he had had to teach the boy how to set out a knife, fork and spoon on a table because the boy had never had a meal in proper, ordinary, dignified circumstances. That is the level of some of the problems with which the Prison Service attempts to cope. Unemployment, alcoholism, violence in the family are the background to their childhood.
The evidence is that we still spend vast amounts of money producing increasing numbers of damaged and recidivist youngsters whose ability to cope with normal life or engage in positive relationships is reduced by the process of institutionalisation. We know that there are alternatives which can work; the evidence of the 1980s amply demonstrates that. We know, too, that experienced practitioners from both the probation and social work services can indicate positive ways forward. Can we not, for once, listen to that experience?
8.17 p.m.
Viscount Tenby: My Lords, I, too, congratulate the noble and learned Lord, Lord Mackay of Drumadoon, on his excellent maiden speech and, if I may be permitted to say so without presumption, one well up to the "Mackay" standard (as we call it in this place).
The recent report from the Howard League on conditions for teenagers in penal institutions makes—I use the word without apology—sombre reading. We must accordingly be grateful to my noble friend Lord Henderson for giving this House the opportunity of discussing it. The fact is that sentencing policies for young people are in some disarray; disposals for young people are in some disarray and nothing illustrates that point more than this disturbing report.
Unlike many noble Lords, I suspect, I have had to send men and women to prison on occasion—not, it is true young offenders, but one is depriving people of their liberty just the same and committing them to an unattractive future which, quite frankly, can only be fully comprehended by those who have visited prisons.
There are two main reasons for custodial sentences; one unnecessary and the other necessary. The unnecessary category consists of those who are going to prison because they have come to the end of the legal road and the law does not provide for any other disposal. That is regrettable and a compassionate society should
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by now have provided suitable alternatives. The other, necessary, category consists of those who have to be removed from society in order, rightly, to protect its citizens and to show society's displeasure at what has been done. That, I have no doubt whatever, we should continue to do.
There is therefore a clear need for custodial sentencing for all but the youngest serious offenders. However, I am concerned with what happens in prison to people who are there and that is why the report makes such disturbing reading. I made clear at the time that I was, as I still am, opposed to the establishment of secure training centres for a whole variety of reasons which were well aired in this House during the debate on the Criminal Justice Bill last year. I believe that the money set aside for those centres—of the order of —30 million—could much more profitably be spent on secure local authority places. Indeed, it is likely that the average weekly cost for inmates of the new STCs will not be far different from that for someone in a local authority unit.
Why is it preferable to look at secure local accommodation as an alternative to YOIs, STCs or prisons? This report tells us why. Staffing ratios may be 1:2 as opposed to 1:30, enabling constructive relationships to be developed. Security is, if anything, tighter, as it is bound to be with such a staff presence. Education for younger children—and there is a requirement for those under 15 which staffing levels in prisons and a lack of resources usually make unattainable—is a priority, and the secure local unit I visited some time ago, which is the same local secure unit visited by the noble Earl, Lord Longford—though I must say I came back with a slightly different interpretation from the one he has given today—was very impressive indeed. Bullying, so rife in adult prisons and remand wings of adult prisons, is easier to contain, again because of staffing levels and the relatively small numbers involved. In short, for me, local secure units have made their case.
The Earl of Longford: My Lords, as the noble Viscount has mentioned me, perhaps I may be allowed to intervene. Does he realise that in the unit to which he referred, which is a fine place to which I pay tribute, there have been children of 12 along with young people of 17? But there is no perfection. It is a great mistake to talk as though there is a magic in it.
Viscount Tenby: My Lords, I am obliged to the noble Earl for that intervention and I daresay that we shall continue, with the greatest deference to each other, perhaps slightly to disagree on this. I yield to no one in my admiration for the noble Earl's knowledge of prison matters. I am just a flea in comparison. However, I have stated my view and I am afraid that I shall have to stick to it.
It is true that a further 270 places in local secure accommodation will be coming on stream to add to the 254 currently available. Again, my figures differ slightly from those of my noble friend Lord Allen of Abbeydale. Perhaps the noble Baroness the Minister will be able to set us right about that. But I sense—I hope I am

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wrong—that there is very little will to regard such accommodation as a viable alternative to penal institutions so far as concerns teenagers. Of the five STCs planned, it seems likely that only two will see the light of day in the near future, and their geographical spread leaves much to be desired.
Like the noble Lord, Lord Prys-Davies, I have, as a Welshman, been very disturbed by the lack of any secure local accommodation in Wales, resulting, as the report says, in teenagers being remanded to two of the more inadequate local prisons at Swansea and Cardiff, where bullying is prevalent and conditions are sub-standard. Thankfully, secure local accommodation is coming on stream in Neath later this year, but a Welsh boy sentenced to an STC at some date in the future can, for example, expect to be no nearer to his country and his family than Campsfield House in Oxfordshire, and that is if he is lucky.
While it is true that custody, whatever the form it takes, is for the protection of society, not to try to make something of the material once it is inside so that the risk of re-offending on release is considerably reduced, is a fonn of corporate madness. We all understand that, surely, but nevertheless 88 per cent. of 14 to 16 year-olds re-offend, as do 77 per cent. of young—17 to 20 year-olds—adult males. So prison only works on the level—and admittedly it is a very important level—of the protection of the community.
Can we not be a little more adventurous and constructive and look for additional benefits from prison, like turning a boy whose life is a mess into a useful citizen? Why cannot we at least ensure, as an absolutely basic requirement, that every effort is made to educate these young people when they are inside, for that at least provides some hope for them, some hope of breaking the vicious circle, on their release? What is certain is that the conditions described in this valuable report offer little chance of future progress or success.
8.25 p.m.
Viscount Brentford: My Lords, I congratulate my noble and learned friend Lord Mackay of Drumadoon on his speech and look forward to drawing on his Scottish experience in 1he future. There are a number of ways in which English prisons can draw on the benefit of the different attitudes in Scottish prisons. Perhaps that will be able to come to pass, although I appreciate that the situations are very different.
I am glad that the name of the new clan on the Front Bench is Mackay and riot certain other names beginning with "Mac", or we might have had my noble friends bearing the name Campbell going on the warpath in your Lordships' House. I also express my gratitude to the noble Lord, Lord Henderson of Brompton, for introducing the debate, which I believe is proving valuable.
I approach the subject from the point of view of what I said in the debate on the Loyal Address. At col. 183 of Hansard on 20th November last year I made the point that 82 per cent. of our young offenders in custody being reconvicted within four years was a very unsatisfactory state of affairs, a view with which I gained the
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impression my noble friend the Minister agreed. We need to tackle this rate of recidivism with much more determination. Regretfully, I cannot find any answers to the problem. The Home Office digest, Information on the Criminal Justice System, makes the point that 68 per cent. of young offenders aged under 21 are reconvicted within two years. The report itself refers on page 67 to up to 90 per cent. being reconvicted. That is a very unsatisfactory state of affairs and I should like to see more research on the issue.
The report raises two questions. First, can action be taken to minimise the violence and force which young offenders receive both from inmates and from staff? Secondly, is detention, particularly in prison, being over-used for young offenders? Neither of those questions is easy to answer.
Reference has been made to bullying and self-harm. It is clear that there is less of both in secure accommodation than in prison. Page 76 of the report makes that clear. One main reason may well be that in secure accommodation counselling and group meetings can take place, something for which there is no opportunity in prison. That is one reason why secure accommodation is so important.
Pages 82 to 83 of the report give examples of control and restraint. There is reference to taking hold of clothing or of certain parts of the anaromy. The report states that, if it is necessary to grasp limbs, then they should be held at the knee or elbow to reduce leverage.
On both the issues of bullying and restraint the report makes clear that national policies and guidelines need to be in place and that there should be training on their implementation. I was glad and encouraged to read in a letter from my noble friend Lady Blatch last month, a copy of which she placed in the Library, that in the present financial year there is a 25 per cent. increase in the training budget for the Prison Service College. It will be able to spend £17.5 million this year on training compared with only £14 million last year. That is encouraging. We need to think of the point of view of the prison staff as well as of the point of view of the inmates, particularly young offenders. It is fair to the staff as well as the inmates that more: raining and help should be given to staff. I am encouraged. I hope that it will prove helpful in the context of the subject we are discussing.
I turn to the question of punishment. It must be purposeful. While I accept that a danger to the public requires secure detention, we need to ensure that the purpose includes creating a situation where an offender will not want to re-offend and where other people will be deterred from offending themselves. The impression I have from the report is that imprisonment further damages young people already damaged. That is a tragedy. I appreciate the problems, but we need to try to look beyond them.
There is no evidence in the report that the purpose I have outlined is being strengthened either by non-custodial punishment, by secure accommodation or by prison. The statistics on page 58 make it unequivocally clear that there is no clear improvement

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in recidivism from any of these different punishments. There are various reports by Bottoms and Maguire pointing out the difficulties and research is continuing.
I wish to emphasise again what the noble Lord, Lord Henderson of Brompton, said about the 1988 Green Paper dealing with encouragement and help for young offenders. That is still crucially important. Judge Tumim makes the same point on page 24 of the report. We need to help young offenders to rebuild inter-personal relationships. The significance of relationships was stressed by the right reverend Prelate, the Bishop of Chichester, my noble friend Lady Faithfull and others. We need to concentrate on that. We need trained staff to be able to help avoid recidivism. May we please not swing too far away from the 1988 position and keep researching the use of non-custodial sentences where appropriate.
8.32 p.m.
Baroness Masham of Ilton: My Lords, I thank my noble friend Lord Henderson of Brompton for having brought to the notice of your Lordships this report by the Howard League Commission of Inquiry. As a fellow Scot, I congratulate the noble and learned Lord, Lord Mackay of Drumadoon, on his balanced maiden speech.
As a member of a board of visitors of a borstal and then a young offender institution for many years, I know that the problems of violence among young people under 18 years of age, both inside and outside penal institutions, is a very serious and disturbing matter and one which must be addressed.
It is so ironic and tragic that a headmaster with the qualities and calibre of Mr. Lawrence should no longer be alive, because it is people like him that society needs in order to lift these damaged young people out of the paths of crime and, even more important, to stop them getting involved in the first place. Unless there are teachers and concerned people like youth leaders with the energy and leadership skills to guide young people out of their criminal environment, there will be little hope for many of them achieving a successful crime-free life.
Many people will say, "Lock them all up, put them away". But the dangerous situation is that when they come out some months or years later they may be more likely to commit even worse acts of violence and crime unless they have undergone meaningful education and rehabilitation and can see a way forward into useful employment. If, however, they find that crime is their only way of financial gain then many of them will think that it is a risk worth taking.
I believe that this report is well presented and a great deal of time and work has gone into its preparation. I do feel that it is disappointing, through no fault of the Howard League, that because two of the prisons which refused visits hold young women and teenage girls the commission felt that it was not in a position to make recommendations about the treatment of young women and teenage girls.
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The commissioners were concerned, however, after visiting Low Newton and talking to staff, about the high levels of prescription tranquillisers used and the amount of self-harm in women in that establishment. I ask the Government, because of this omission, and the fact that serious problems have been found at Holloway Prison by the Inspectorate of Prisons, to instigate an independent inquiry such as the one before us, but just for young girls and women under 18 years of age held in all penal establishments.
The number of females in custody is far fewer than for men, but the problems can be far more complicated and long lasting. If one has been at a boarding school, be it for boys or girls, there is always the risk of bullying and teasing even with young people from what might be termed privileged homes. Penal institutions having inmates with so many problems such as sexual abuse, alcohol and drug abuse, and violence and aggression often being entrenched as normal behaviour, must make bullying 100 times more likely to occur.
Vigilant, experienced staff who get to know the young people and who keep themselves alert to what is going on are the best form of prevention, as well as having a strict anti-bullying policy which is adhered to. The report worries me when it states:
"The Prison Service anti-bullying strategy is not widely implemented. Some prisons do little more than put up posters. Very few prisons are segregating bullies rather than victims. Those that do are not systematically addressing the causes of bullying behaviour".
I am sure that it would help to reduce suicides and self-harm if all bullying was stamped out. The report states:
"The prison medical facilities are a disgrace".
With a shortage of doctors now throughout the UK, I ask the Minister whether she will respond to this statement in the report and, if there is a serious problem, say how it is going to be rectified.
There seems to be a high level of stress, bereavement and family break-up among all persistent young offenders. Many of them are excluded and truant from school. Would it not be beneficial if all the under-16s did a full day's work, with homework and sports activities, and all others under the age of 18, if not in full-time education, did a full day's work and were encouraged to be useful citizens rather than being banged up in their cells for so long? The devil finds work for idle hands. I am sure that this would reduce the violence and bullying. Some of the remedial teachers I have met over the years have been committed and interested and many of the lads respond well to education in small groups.
Regional rivalries seem to be a problem. This could be a way of identifying and wanting to belong and to support each other, so as not to be an anonymous, institutionalised number. The bigger the institution the more problems there seem to be. When visiting Moorlands YOI near Doncaster I noticed that many things were thrown out of the windows, but at Wetherby YOI I hardly ever saw that happen. The buildings and surroundings seem to make a difference to the behaviour patterns. It is interesting that new buildings do not necessarily mean better behaviour and fewer problems.

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The report does stress that the key difference between prison and secure regimes is the quality of the relationships between young people and staff.
Pressure of numbers often makes a prison like a conveyor belt, with a lack of case work for the individual. The homeless young person with a criminal record and no family support is the most difficult among the many problems. The future for him must seem very bleak when shut behind bars. I wish the report success in making people think about how society can tackle the many problems encompassed in it.
I should like to end on a hopeful note. I attended the carol service at Wetherby YOI just before Christmas. It was a very happy occasion with staff, young people (the inmates) and visitors all sharing in an ecumenical service with all the churches and the Salvation Army taking part, and a choir with music from the local church. There are many people who help within the Prison Service and the chaplains as well as the staff and members of the boards of visitors all try hard to prevent the very worrying situations which are highlighted in the report. They need support to keep up morale and to run establishments which are fair and safe and able to release young people with more of a chance to succeed than fail in the community to which they return.
8.41 p.m.
Earl Russell: My Lords, I join in the congratulations to the noble and learned Lord, Lord Mackay of Drumadoon, on completing his clan's hat trick in such a distinctively Mackay style. Just in case the noble and learned Lord should be tempted to think that he might enjoy a monopoly, perhaps I may advise him that we are debating a report produced by a Kennedy, so he will have a certain amount of company.
In thanking the noble Lord, Lord Henderson of Brompton, for introducing the debate, I thank him also for bringing to our attention this really excellent report. There are very few gaps in it, but a great deal of balance and a great deal of good sense. The noble Baroness, Lady Masham of Ilton, has just drawn attention to one of its very few gaps. That gap exists because the Howard League was unable to gain access to two out of the three women's prisons which it tried to visit. I am afraid that recent events have given us some indication of what it may have been missing.
The Government are perhaps fortunate that they have me and not Mr. Gladstone speaking on this subject. His description of the manacling of prisoners was,
"the negation of God erected into a system of Government".
The Minister responsible for prisons might not like that description and perhaps she and the noble Baroness are better off since they have only me to speak from these Benches.
The other big issue on which I did not read very much was the problem to which the Lord Chief Justice called attention, the sending of mental health patients to prison. But I did start to wonder when I read that 80 per cent. of the women who had indulged in self-harm had previously been victims of sexual abuse. That is a line which leaves a great deal to the imagination.
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I got the impression from the report that the Government are following two contradictory policies. On the one hand, they believe that we should have more people in prison and longer sentences—the prison population has increased by 25 per cent. in two years. On the other hand, the Government believe that there is an imperative to cut taxes. I shall not discuss either of those policies, but I am not sure that we can have both. We are getting what the report described as,
"a bizarre and potentially dangerous lottery for a bed".
It stated that almost all of the prisons that were visited contained more people than the official limit. The noble Baroness, Lady Farrington of Ribbleton, is right about containment. Everything else more constructive is being cut back because of staffing shortages.
We on these Benches would not increase spending and taxation on everything—by no means. We think that this is one case where by rather shorter sentences and by not using custodial sentences at all in some cases expenditure could be significantly reduced. However, there is a staff shortage and the noble Baroness, Lady Masham, was right about work for idle hands. If Saatchi & Saatchi were to summarise the content of this report, there would be no difficulty in arriving at the slogan, "Prison isn't working".
The noble Lord, Lord Henderson of Brompton, touched on one leg of the Home Secretary's belief that prison works, the reconviction rate. I touch on the other, which is the Home Secretary's belief that while people are in prison they are not committing crimes. I have some sympathy here with the noble Viscount, Lord Mountgarret, although I do not think that he will expect me to believe in the efficacy of his suggested remedy. However, when somebody carves a name on a man's shoulder, that is a crime which, if committed outside prison, would carry a fairly severe prison sentence, so I am not convinced that prison reduces crime; it merely changes its location. When someone says, "I hit him because he comes from Bristol, not because he is black", I do not think that that makes it any better.
I know that the Home Office is concerned about developing an anti-bullying strategy, but I noticed from the report that in many prisons—Swansea is mentioned particularly—it is impossible to carry out that strategy for lack of staff. You really cannot make bricks without straw and if you want to do things, you have to spend the necessary money.
I was disturbed by the case of the prisoner in Doncaster who was found wearing only a towel because all his clothes had been "taxed" off hi m. I heard what the noble Lord, Lord Allen of Abbeydale, said about Doncaster and I noticed what the report said about Doncaster—that there did not appear to be very much awareness there of best practice. I think that the words "safe custody" should mean exactly what they say. We cannot rely on grassing; prison culture is too much against it. The only protection is to have enough staff to see what is going on. This is another case in which efficiency is not efficient.
Turning to the amount of self-harm, we are told that the records show an improvement. Historians are always interested in arguments that are based on the keeping of

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records, but I do not believe that the increase in suicide is a result of an improvement in record keeping—or at least I hope that it is not.
I agree with many noble Lords that adult prisons are not suitable for the young. I think that we are doing as much harm as good—and possibly a great deal more—by putting young people there. I also think that combating crime is something that needs the carrot as well as the stick. You do not need to establish only that crime does not pay; you need to establish also that it pays less than going straight. That means that we must not only make crime unattractive, but that we must make going straight attractive. We have heard a lot recently about St. George's school, which is a mile and a half away from where I live. The next-door ward, which is in the catchment area of the school, recently had 37 per cent. of its adult population on means-tested benefits. That does not really make going straight quite as attractive as it ought to be.
Going along the educational ladder is not as attractive as it used to be. It leads to poverty and debt. The noble Baroness has heard me too often on that subject for me to bore her with it any further.
Being a 16 or 17 year-old is not particularly attractive. I was talking to one in the Strand yesterday, thrown out by his parents. He said, "It is no use my trying to look for a house until I am 18". In that case, thank God, the Salvation Army had moved in and he had something to eat. But in South Glamorgan, among 16 and 17 year-olds without employment, the word "shopping" means shoplifting. Although I agree with what the Government say about individual moral responsibility, to put people into that position is to lead them into temptation. I do not believe that that is a good idea.
Finally, those people whose lives are in many ways being ruined by the lack of an adequately financed policy are the people upon whom we rely to earn the money to pay our pensions. I do not think that that is very clever.
8.50 p.m.
Lord McIntosh of Haringey: My Lords, there are specific and there are more profound reasons to be grateful for the debate. The specific reasons are the initiative of the noble Lord, Lord Henderson of Brompton, in opening the debate, the excellent, well-informed and civilised maiden speech of the noble and learned Lord, Lord Mackay, and the quality of the speeches in general as the evening has gone on. The more general and profound reason may not be so much the quality of the Howard League report upon which the debate is based as the importance of the report's findings to all of us who claim to live in a civilised society. It is up to us to be as responsible and careful as we can in seeking solutions to the problems which are graphically revealed in the report.
In the limited time available I wish to say something about the nature of the problem to which the report draws attention; to say something about present policies and their adequacy; and then to look at possible solutions to those problems.
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The first thing that has to be said about the nature of the problem—perhaps the Government should be and will be congratulating themselves upon it—is that for some years juvenile crime has been decreasing, and decreasing to a considerable extent. Throughout the 1980s, the number of young people and children given custodial sentences was also declining. Of course there is always a difficult gap between the making of political policies and the social trends to which those policies are supposed to relate. We are not discussing the issue tonight in an atmosphere of panic about juvenile crime as a whole. That is just in contradiction to the facts.
But it is true that in the past two or three years, as a result of deliberate policies introduced by the present Home Secretary and his immediate predecessor, there has been a substantial increase in the total prison population and in the prison population of young people. That can be related directly to political policies and attitudes of the Government.
I am not going to say now, or at any time, that there is no place for custodial sentences for young people. Much as I admire the Howard League report, I am unable to subscribe to those parts of its conclusions which say that we should be working towards the elimination of custodial sentences for young people. It is not realistic to deny that there are young people who the safety of the public requires should be taken away from their homes and put into some form of institution from which they cannot escape.
However, we have only to look at the evidence from the report and from many other people about the kind of people who are in custody to realise the inadequacy of the regimes to which they are subjected. The obvious example is that there are far too many prisoners of all ages, including young people, who are in custody on remand, when a high proportion of them will not receive custodial sentences in the end. One way of reducing the prison population, and overcrowding, and solving the problem of inadequate staffing, is to do something dramatic about the excessive use of remand in custody.
One has only to look also at the social and ethnic background of prisoners in custody to realise that there is something very wrong. John Gay's "The Beggar's Opera" claims that
"Since laws were made for every degree,
To check vice in others as well as me,
I wonder we ha'n't better company 'pon Tyburn tree".
We do not have better company on the modern equivalent of Tyburn tree, and it is a criticism of our society that that is the case.
Then, specifically looking at young people in custody, how many of them—how far too many of them—are disturbed young people, those who have been experimenting with drugs or are addicted to drugs, those who are mentally sick, those who are inadequate in all sorts of other ways, those who are uneducated, who have been abused, who have spent their young lives in care, who are homeless, who have broken up with their families, and who, if they are old enough, have been unemployed. The experience of everyone who knows young people in custody is that, although some of them need to be custody, they do not need the kind of regime which is available to them.

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Present policies involve two major types of institution. One is local authority secure accommodation, to which reference has been made. It is well known that we support the Department of Health initiatives to expand that accommodation, and that we wish it would go further. The second is the Prison Service. I need not repeat the criticisms which are made in the report and which have been made by many speakers, about the inadequacies of Prison Service accommodation for young people and in particular of privatised Prison Service accommodation, as evidenced by Doncaster.
A third type of institution is supposed to be the secure training centre. We went over that ground in 1994, and of course there are no secure training centres. Although the element of training proposed is to be commended, nevertheless the whole concept of secure training centres, with its emphasis on persistent young offenders, their remoteness from families because there are to be only five of them, the size and other aspects of the conditions, are all as objectionable to us now as they were when they were first proposed.
What slightly disappoints me about the report is not so much the description of conditions in custody—bullying, self abuse and so on—but the lack of analysis about what kind of regime in custody works. I am sure that my noble friends Lord Longford and Lady Farrington are right when they say that to deal with the problem for those who find themselves in custody will require considerably greater resources, particularly staffing resources.
The contrast made by my noble friend Lord Longford between the best local authority secure accommodation and Feltham, in terms of staffing, is dramatic and vivid. Nothing other than the allocation of greater resources will deal with that effectively. The result of all that custodial treatment of young people is—the noble Viscount, Lord Brentford, made a very thoughtful speech on the subject—an unacceptably high level of re-offending and recommitment.
The noble Viscount described some of the evidence which demonstrated the differences between custodial and non-custodial sentences in terms of re-offending. That is a very difficult statistical ground because, clearly, some of those who are serving non-custodial sentences are less convinced criminals than others. But nevertheless, if we are concerned with the protection of the public, it is by no means clear, despite what the tabloids say, that an increase in custodial sentences will provide greater protection for the public.
The truth of the matter is that our motives in putting away people, whether they are adults or young people, are hopelessly confused and self-contradictory. I believe that we no longer talk about vengeance. Some of us—the noble Viscount, Lord Mountgarret, among others—speak a lot about punishment. Most of us talk about deterrence and rehabilitation. Nowadays, we all talk about the protection of the public and the community.
But we must recognise that the objectives of incarceration are sometimes in conflict with each other. As many noble Lords have said, there is no easy solution. I do not believe that we shall get anywhere by
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demonising young people. We shall not get anywhere by talking about them as thugs or as somehow removing from them the humanity and the differences between them which are the characteristics of the human condition. Many of those inadequate and unfortunate young people in prison are of course also violent and have committed violent crimes. Society needs to be protected from them. But we shall not do that effectively unless we understand all the reasons that put them there as well as seeking to ameliorate the conditions in which they are held.
9.2 p.m.
The Minister of State, Home Office (Baroness Blatch): My Lords, I begin by offering the warmest possible welcome to these Benches to my noble and learned friend the Lord Advocate. He has served the legal profession in Scotland with distinction. His wisdom and experience were reflected very well in his impressive and thoughtful maiden speech. I know that the House will benefit richly from his future contributions to our proceedings and I look forward with eager anticipation to his involvement in our debates.
I welcome the opportunity that has been presented by the noble Lord, Lord Henderson of Brompton, for this far-reaching debate on issues which are at the heart of juvenile justice policy. The terms of reference of the commission give violence in penal institutions as the clear focus. However, the report, and indeed today's debate, span the breadth of issues encompassed in our arrangements for the care of teenagers who become subject to the proceedings of our criminal justice system.
The report makes a number of recommendations that teenagers under 18 should not, in the view of the Howard League, be held in prison custody. I would like to say a few words about the Government's approach to dealing with young offenders and, in particular, our views on the use of custody. I make no apologies for the fact that we believe that custody should be used for some young offenders. The public has a right to be protected from the most serious and the most persistent offenders, whatever their age. In some cases the only way to achieve that will be a custodial sentence. There is nothing in this approach which is inconsistent with our commitment to the principle in the UN Convention on the Rights of the Child that custody should only be used as a last resort. That was a point made by the noble Lord, Lord Henderson of Brompton.
Most young offenders are not of course remanded to custody or given custodial sentences. The proper use of cautioning by the police and effective community sentences have an important role to play in helping children who offend to return to a law-abiding life. Through guidance and national standards we have taken steps to help ensure that community penalties and police cautioning are used in an effective and constructive way which gains the confidence and support of all concerned.
Measures to prevent children from turning to crime are as important to police and court powers. The Government fund a wide range of crime prevention

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measures. Later this month the new ministerial group on juveniles, announced last year by my right honourable friend the Home Secretary, will meet for the first time to agree a programme of work to help strengthen measures to intervene effectively with those children who are most at risk of offending.
For those young people for whom a custodial sentence is judged to be appropriate, the main concern is not whether the institution is run by the Prison Service, a local authority or the private sector, but rather whether the regime is constructive, disciplined, secure and appropriate to the age of the young person. We recognise that it is particularly important for young people who are remanded in custody to be placed near to their home and that their needs are therefore better met in the local authority sector rather than in Prison Service accommodation, a point made so well by my noble friend Lady Faithfull. That is why we have provided funding to local authorities for a major 170-place new building programme. I understand that the majority of those places will be available by the end of 1996. The noble Lord, Lord Prys-Davies, will be interested to know that we are committed also to ending the remand of juveniles to prison custody once sufficient local authority secure accommodation is available. That is a point which matters as much to Wales as it does to England.
The Prison Service can and does provide constructive and positive regimes for sentenced young people; so too will secure training centres; so too do local authority children's homes. The report offers specific and general criticisms of the regimes in Prison Service establishments to which I shall refer in a few moments.
As regards local authority secure accommodation, which I know vexed a number of people, the responsibility for ensuring that staff in secure units are properly and adequately trained rests with the local authorities as employers. I am pleased to see that the Howard League urges local authorities to develop training and inter-agency collaboration, for that really is important too. Central government assist with a £35.5 million specific grant to local authorities through the training support programme.
The Department of Health, with the National Children's Bureau and a number of social service departments, recently secured a secure accommodation training curriculum with the aim of ensuring a consistent and thorough approach to the training of staff in the area. In addition, the Department of Health, through its training support programme, is funding the production of a specific training package to assist staff in all children's residential settings in approaches to the care and control of difficult adolescents.
There is, in particular, criticism that overcrowding has led to increasing numbers of 15 and 16 year-old remand prisoners being placed with older and more physically mature teenagers. While there has been a small increase in the juvenile population in prison, there is no overcrowding among that group. Prison Service policy is that, so far as is practicable, unconvicted male prisoners aged under 18 should be accommodated separately from unconvicted young adult males. Again,
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I know that that was a point which concerned the right reverend Prelate the Bishop of Chichester. However, governors may approve mixing and joint use of facilities in order to give young prisoners the widest possible opportunities for work, education and training.
The report deals at length with the issue of bullying. Bullying is a social problem which exists in all walks of life inside and outside prison. It is an unfortunate but inevitable fact that where young prisoners, many of whom have been convicted for violent offences, are gathered together, bullying may occur. On rare occasions bullying can have tragic consequences, as we all know. The noble Lord, Lord Henderson of Brompton, asked whether the Government were taking steps to improve matters. I can say that the Government take bullying in prison very seriously. Since 1993 the Prison Service has operated a national anti-bullying strategy and provides clear advice to establishments on how to reduce the problem. The strategy draws on many years of experience and good practice from individual prison establishments. Indeed, I have visited young offender institutions where the bullying strategies are being tackled and where they are working well. The effect of the strategy has been encouraging, especially in prisons holding young people where the Prison Service is determined to push home the message that bullying is anti-social, cowardly and will not be tolerated.
It is unfortunate therefore that the report does not recognise the hard work of staff in many young offender institutions in its conclusions on the incidence of bullying in prisons. It is suggested that the bullying strategy is a paper exercise and that it is not widely implemented. Those charges simply do not stand up. Successive reports from Her Majesty's Inspectorate of Prisons have praised the commitment and dedication of prison staff in young offender institutions who are in the front line in the fight against bullying and who make the strategies a reality.
The report states that very few prisons segregate bullies rather than their victims. That is at odds with the findings of inspectorate reports, many of which comment favourably on the work of prison staff to support victims and to segregate bullies. I see that the noble Earl wishes to intervene. I give way.
Earl Russell: My Lords, I am much obliged to the Minister. However, if she will forgive me, I do not believe that that is quite what the report says about bullying. It does not reproach the staff for not working; it says that there were insufficient staff to carry out the work. The propositions are very distinct.
Baroness Blatch: My Lords, I believe that there was room in the report for making the sort of comments I have just made about the dedication of staff where they are tackling such problems and where bullying strategies are in place, working well and showing positive results. I also made reference to the fact that the report says that prison staff do not segregate bullies. I have actually visited a young offender institution—the one at Feltham—which I know the noble Earl, Lord Longford, has also visited. There, they do segregate the bully and care for the victims.

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Segregation of the bully and support for the victim are central pillars of the current anti-bullying policy. Prison Service research into the issue has shown that in a great many prisons holding young people facilities are available and are used to isolate the bullies and challenge their behaviour. That sends out the right message to the bully and ensures that the message is being heard.
However, we cannot afford to be complacent. The Prison Service business plan for 1995–96 makes a commitment that all establishments will implement a firm anti-bullying strategy within the financial year. A new unit based at Prison Service headquarters has been set up to look at ways of controlling violent behaviour which includes bullying. The unit liaises with prisons to provide guidance and practical help in meeting that obligation. I repeat: the Prison Service is absolutely determined to challenge the bully and to ensure that prison is a safe place in which young people can serve out their sentence and concentrate on building their futures.
The Prison Service recognises that young offenders, especially those on remand, may be vulnerable to suicide or self-harm. The causes of suicide and self-harm are complex and there are no simple solutions. The population received into custody is particularly vulnerable and, as we know, suicide has increased among young males in the community at large over the past 10 years. The statistics and examples highlighted in reports—such as the Howard League report—focus exclusively upon the negative and instances of failure. Sadly, the enormous amount of staff dedication to working with young offenders and the success stories go largely unreported.
The current strategy of providing care for the suicidal was introduced in April 1994. Its principles are based on sound research and it has received both interest and acclaim from other organisations faced with similar problems. The strategy emphasises the responsibility of all staff in identifying and providing support for those who are judged to be at risk. It is designed to achieve a shift from viewing suicide as a purely medical problem. Each establishment has a multi-disciplinary team whose job is to oversee and monitor local implementation. Prisoners may be cared for within the residential unit or within the health care centre. Support may be provided by staff, fellow prisoners trained as listeners, or by visiting Samaritans. Many establishments are able to provide a "care suite" where people can be housed and kept under observation during periods of crisis. The strategy is also underpinned by an intensive staff training programme.
For the future we will continue to seek improvements in the procedures already in place to ensure that young people are appropriately provided for by the criminal justice system. In particular the introduction of the secure training order for the hard core of 12 to 14 year-old criminals will provide a new alternative. I emphasise that I am referring to the hard core of persistent 12 to 14 year-old criminals. Such offenders will be sent to new secure training centres which will provide positive regimes offering high standards of care, education and training.
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This is a timed debate and it will not be possible for me to address all the individual points which have been made, but I wish to highlight just a few. I refer first to the context and perspective of the debate. It is important to record that 11 per cent. of ma;e offenders aged 14 and under 18 and 2.8 per cent. of female offenders sentenced for indictable offences were sentenced to custody. That means that 89 per cent. of males were not sentenced to custody and 97.2 per cent of females were not sentenced to custody. The debate has centred around a perception that too many of our young people are going into custody. Almost all of thern are not sent into custody. The number of males aged 14 to 17 sentenced to custody has fallen from 12,500 in 1984 to 4,200 in 1994. That is totally at odds with what the noble Lord, Lord Henderson of Brompton, said. The juvenile 15 to 17 year-old sentenced population at the end of October was 1,073.
The noble Lord, Lord Henderson of Brompton, referred to the important matter of welfare. The Children and Young Persons Act of 1933 sets out the need to take account of the welfare of children. The Home Office and the Department of Health are working closely together to see that that is honoured. The noble Lord, Lord Henderson, also asked about the official policy on regimes in young offender institutions. One of the Prison Service's goals is to provide positive regimes which help prisoners to tackle their offending behaviour and allow them as full and responsible a life as possible. The Prison Service therefore requires young prisoners to participate in a rigorous, demanding and constructive regime which is focused on education and constructive activity designed to help them to lead law-abiding lives after release.
The noble Lord also referred to high intensity training centres. I suppose that in common parlance they are referred to as "boot camps". The noble Lord asked how they would affect new offenders. They will not have any impact upon the young people we arc talking about tonight. The new high intensity training regime is being implemented for persistent offenders in the 18 to 21 year-old age group. The noble Lord, Lord Prys-Davies, asked about the increase i n remands. There is no single explanation. There are a number of factors, of course, including demographic changes, but decisions about the use of remands to prison custody in individual cases are a matter for the courts. The noble Lord also mentioned secure accommodation in Wales. The new 18-place secure unit in Wales will be subject to inspection by the social services inspectorate, like all secure units. I can give that assurance.
The noble Lord, Lord Prys-Davies, also mentioned both the institutions in Wales at Swansea and Cardiff. Managers at both institutions are acutely aware of the need to provide a service for the young people held in custody. While this is not always easy within the context of busy local prisons, as the noble Lord knows, there are clear action plans in place and no lack of urgency to implement them. The juveniles are to be moved to newly refurbished accommodation next year and there will also be new reception and induction programmes and new education facilities. I believe that the noble Viscount, Lord Tenby, is also interested in that matter.

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The noble Lord, Lord Prys-Davies, asked what we were doing about suicide and self-harm. He was joined by many noble Lords in the course of the debate. A new strategy for caring for suicidal prisoners was introduced in April 1994. Initiatives include listener schemes in which selected inmates are trained to support those going through a crisis; intensive training for staff; and the designation of a suicide awareness team in each establishment. Every death in custody is a serious matter and is investigated thoroughly, and indeed should be. However, I believe that I am right in saying to the noble Lord that legal aid is not available for inquests in such circumstances. Nor, I believe, is it available for any inquests in England.
The noble Lord, Lord Allen of Abbeydale, in a thoughtful speech, referred to the changing culture and nature of the times now compared with some years ago. I should like to add some of the factors that I personally believe are a feature of the debate we are having about young people. I believe that there is less family cohesiveness. There are too many young people with no structure in their lives. Too many young people have no proper framework within which to grow up and develop. I believe also that there is too much unspent energy, or that where energy is spent it is spent in the wrong way. There are too many young people for whom no ground rules operate other than the rules of the street. There is no anchor in their lives. Fearlessness is another factor. Young people are absolutely unafraid. They are not afraid of their parents, teachers, policemen, probation officers or social workers. I do not mean oppressive fearlessness, but there is almost a minor form of anarchy. We all have a responsibility to address these problems, starting with the first and greatest influence on any child—the parent and the home.
It is against that background that those who deal with young people who offend have to work with them. I believe that great efforts are made within institutions and within the Home Office and the probation service to meet the challenge of returning young people to a more law-abiding way of life.
The report is very subjective about the prison at Doncaster and certainly lacks a great deal of objectivity. I refute absolutely the assertion that Doncaster is not able to provide a safe and caring regime for young people. It has made solid progress since it opened. The particular needs of juveniles are recognised. They are housed in two identified units with extra resources. The management is well aware of the propensity among young people to bully, to threaten and to commit acts of violence against each other. Those issues are treated seriously and a clear anti-bullying policy is in place with robust procedures for dealing with bullying behaviour. A probation officer has been appointed. A full-time anti-bullying co-ordinator has also been appointed. A working party—Safety in Doncaster—is addressing broader issues concerning development of more controlled regimes and perceptions of safety in the prison environment. The level of proven assaults continues to decrease.
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Doncaster further demonstrates a particular concern for caring for the suicidal through the use of a designated full-time suicide prevention co-ordinator. A meeting is held every morning of the week at which a team of people consider those at risk, reviewing all prisoners identified as being at risk. The model used is wholly consistent with public sector prison service strategy and builds effectively upon it.
The reference by the noble Earl, Lord Russell, to the phrase "going shopping" in relation to 16 and 17 year-olds in Glamorgan is, I believe, an insult to the young people of Glamorgan. It is a fact that a small minority of young people is responsible for crime. For example, 0.3 per cent. of males born in 1973 who had made six or more court appearances before the age of 17 accounted for 21 per cent. of all appearances in court of their age group.
I am defeated by time. I welcome the debate because it has provided an opportunity to focus on the complex issues involved in providing for young people who become involved with the criminal justice system. As we have seen, there are many concerns to take into account in attempting to strike the right balance in the provision of appropriate care for each of the agencies responsible for young people in custody. They are well aware of the burden of that responsibility. I can assure your Lordships that the needs of young prisoners are at the forefront of the minds of all those charged with the responsibility, and that goes for those of us who work in a ministerial capacity at the Home Office.
9.25 p.m.
Lord Henderson of Brompton: My Lords, it has been a most constructive debate. I thank and congratulate all noble Lords who have taken part, in particular the noble Baroness who replied in such a temperate way which I found attractive and reassuring.
I say only one thing about the debate: it has had a geographical spread as well as another kind of spread. The geographical spread started with the noble and learned Lord and continued with the noble Lord, Lord Prys-Davies. I believe that the only part of our country not represented today is Northern Ireland.
It has been a worthwhile debate. I beg leave to withdraw the Motion.
Motion for Papers, by leave, withdrawn.

Restaurants (Service and Cover Charges) Bill [H.L.]
9.26 p.m.
The Earl of Bradford: My Lords, I beg to move that the Bill be now read a second time.
I should make my personal interests clear, as president of the Master Chefs of Great Britain, chairman of the Westminster Considerate Restaurateurs Association, committee member of the Restaurateurs Association of Great Britain, Chairman of Weston Park Enterprises, and owner of Porters Restaurant. By inclination and by nature I am a committed believer in

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deregulation and the more directives that appear from Brussels to handicap our restaurant trade unnecessarily, the more I feel that way.
However, the Bill is deregulatory as it will clear away a morass of unworkable codes of practice and government directives to create a positive level playing field on which all restaurateurs can play the game by a clear set of rules. Surely that is better than baffling our customers with rather ambiguous and conflicting practices as we do at present.
The fact is that there is already regulation over misleading prices under the Consumer Protection Act 1987 and the Code of Conduct for Traders on Price Indications which followed a year later. The Department of Trade and Industry appeared to realise that both the Act and the code of practice were not working or being complied with, as it set up a working group in 1992 to study the best way forward. It sat on the recommendations until 1993 and then completely ignored the working group's call for regulation, instead proposing a reformed code of practice. Sadly, it has even failed to deliver that.
All I seek to do with the Bill is to simplify and clarify the mess and confusion that both business and consumers face from the present perplexing mixture of regulation, codes of practice and industry traditions.
Over 16 years ago I tried to introduce a voluntary code to the industry entitled the Newport Code. Its main stated aim was to remove hidden extras from menu pricing and bills. The only achievement was that the Government changed the law regarding not including VAT in menu prices inside the restaurant. One day shortly afterwards I went to my own restaurant to be offered a cocktail entitled, rather grandly, the Newport Codebreaker. This contained a mixture of dark rum, light rum, vodka, advocaat, coconut cream, orange juice, a dash of nutmeg, a pinch of cinnamon and ice. On inquiring as to why on earth it was called the Newport Codebreaker, the manager cheekily told me that it was the cocktail with all the hidden extras in!
Sadly, many serious problems arise when the restaurateur wilfully causes confusion for the customers by using pricing policies that are at best unclear and at worst a deliberate attempt to delude the customer into thinking that a meal will cost him less than it does. This particularly affects tourists as they are totally perplexed by the contrasting policies which are completely the opposite to the situations that they find in their home country. They then leave Britain with a feeling of great dissatisfaction.
In 1992, recognising that the continued muddle over different pricing practices within the trade was persisting, I tried to introduce a restaurant customers charter with the support of the British Hospitality Association, the Restaurateurs Association of Great Britain and the British Tourist Authority. Regrettably, this totally failed to make any significant impact, though it contained sound principles. The same is true of the voluntary code instituted by Her Majesty's Government in 1988, which recommended all-inclusive pricing. Yet again it was almost completely ignored.
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In Europe, fortunately, the situation is entirely the opposite. France changed the law a few years ago to make all-inclusive pricing compulsory. This does not mean that you cannot leave a small tip to reward excellent service, but it is not the expected norm. After all, no one can force the public not to tip as it is a voluntary act. Across the rest of Europe, all-inclusive pricing is now standard procedure with the strange exception of Greece, but apparently tipping is not normal there either.
In many ways I agree with those who state that it should not be necessary to legislate over these matters and that the industry should put its own house in order. Unfortunately, time after time it fails to achieve that. There is no way for even the best intentioned industry body to enforce a set of rules or code of practice. Members just ignore that which they disagree with or resign from the organisation.
Is it not time, therefore, that we followed the lead of continental countries and introduced by statute a few standard practices here? The first requirement of the Bill is that prices should be quoted on a fully inclusive basis and that this should be made clear to the customer by means of a simple statement printed at the bottom of the menu and the bill saying that: "Our prices are fully inclusive and our staff do not expect a tip or gratuity". This would ensure that for the first time in this country pricing in all restaurants, instead of just the few, will be fair, honest and open.
I am certainly not expecting—and some have expressed concern about this—that waiting staff will be worse off as a result; rather that they will be properly and more straightforwardly rewarded for the job that they do. At the moment they have to rely on either the strange legalised begging ritual of tipping or on the vagaries of variable seasonal business to produce a reasonable service charge tronc making their wages up to a proper level. The change should increase the public's professional respect for their specialist skills and, in particular, should ensure that they will be decently remunerated with a proper wage commensurate with their ability, in a similar fashion to all other restaurant staff. After all, you do not march into the kitchen when you order a meal and wave a £10 note under the head chef's nose to guarantee that you get good food. Why should you then have to bribe the waiting staff to bring it to the table?
In no other retail business actually selling goods—and obviously I do not include taxis and hairdressers under that heading—does the present situation occur. You do not pay a charge of £1.50 to walk through the doors of an electrical goods shop. You do not then find that the price of a microwave has increased because various parts have been left out, like vegetables in a restaurant all too often. You certainly do not tip the sales assistant when you are paying for the goods.
It follows very simply that if prices charged in restaurants are fully inclusive then there cannot be any reason not to fill in the credit card slip in its entirety. This is a most appalling abuse at present. Only the other day my wife had dinner in a Chinese restaurant in Pimlico Road where they presented her with a bill at the

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end of the meal that had an unspecified service charge—actually 124 per cent.—added to the total. She presented her credit card. They returned it without the bill and tendered the credit card slip with only the top line filled in. She had to ask for a copy of the bill to check whether or not service had been added before completing the transaction. It was a blatant attempt to try to fool her into leaving a tip on top of the service charge.
Then we come to this strange creature—the cover charge or couvert. Some restaurateurs try to justify that by saying that it pays for the laundry, others that it is for bread, butter, olives. In reality, they could just add it into the charge for every main course and stop trying to mislead the customer into thinking that a meal may cost less than it actually does.
The final requirement is that a restaurant must produce a legible and readily comprehensible bill so that the customer can easily ascertain what he is being charged for. In some restaurants at the moment it would require the use of a calculator along with further careful perusal of both the menu and the wine list to work out some of the indecipherable bills with which you are presented.
This Bill could have gone even further and removed the vegetable charge abuse that so often occurs; namely, when you are persuaded to order three vegetables with your main course and end up with an extra £6 or more, having been charged for a full portion of each. All main courses should be served accompanied, as happens in most other countries. It is yet another way of disguising the final cost of the meal to the customer.
The Bill has the full support of the British Tourist Authority, the Consumers Association, the National Consumer Council, Caterer & Hotelkeeper, The Good Food Guide, Egon Ronay Guides, the Harden Guide to London Restaurants, Sharrow Bay Hotel, the Four Seasons Hotel Group, Albert Roux, Nico Ladenis, and many others in the industry. They regard it as being progressive and in the best interests of business and the customer; they certainly do not consider it as regulatory or even controversial.
Those in the catering trade who argue against it by trying to insist that freedom of choice is important demonstrate how right and important it is, because they all adopt different practices themselves, thus illustrating perfectly the lack of any consensus among them and the confusion that is then caused to the customer.
Other opponents have made conflicting and rather simplistic claims: that it will drive up prices, reduce competition, or make it difficult for a customer to complain by withholding a tip if the service has not been good.
The answer as to whether the Bill will increase prices is yes and no. Yes, in the case of those rare establishments that do not levy service or other charges and where tipping is at the discretion of the diner; but for the vast majority of establishments, no. The price paid by the customer will remain the same; the only difference will be that he or she will know at the outset
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what the total bill will be and will not be surprised by an additional £1.50 for this or £2.50 for that, plus a hefty service charge.
The second criticism I find particularly strange. Surely fair competition between restaurants will increase if the customer more easily understands what he is to be charged in each individual establishment and is not seduced by strangely ambiguous pricing policies on the menu displayed outside a restaurant into going inside and then being stung by many hidden extras.
Lastly, you can undoubtedly withhold payment for substandard service, exactly as you can for poor food or drink by making a deduction from the bill.
The recent Which? report from the Consumers Association showed that an overwhelming 85 per cent. of the public wanted the price on the menu to be the price seen on the bill; and 73 per cent. wanted cover charges to be scrapped. Obviously, most people are thoroughly fed up with the present situation and we should not disregard their wishes.
Her Majesty's Government should support this Bill, as it is entirely consistent with their declared policy of promoting free choice, fair competition and value for money. I urge them to heed the pleas of many of the most respected in the profession, and particularly the clear call from the public as well as from the many supporters in this House. I should be delighted to discuss the whole Bill with the Minister and make any changes that he sees fit, so long as the substance is not lost.
I realise that there is an absolute necessity for considerable consultation to examine the finer detail and even certain legal problems with the wording. That will inevitably lead to consequent amendments. But let us please attempt to start moving our catering industry practices into the modern age by removing these abuses of the customer and the tax system. In that way we shall make eating out a much happier and more straightforward business, and ensure that the respect and reward earned by being a member of the waiting profession is a vastly better one.
Lastly, I am delighted that two noble Lords will make their maiden speeches tonight on this subject: my noble friend Lord Phillimore and the noble Viscount, Lord Thurso. I am sure that they will add considerable weighty argument and experience to our debate. Altogether, I feel that we have appropriately a fine vintage selection of speakers tonight. I look forward to their contributions with keen anticipation. I beg to move.
Moved, That the Bill be now read a second time.—(The Earl of Bradford.)
9.40 p.m.
Viscount Thurso: My Lords, I believe that I should begin by declaring several interests. I am a director of the Savoy Hotel Plc., the chairman of Lochdhu Hotels Limited in Caithness and managing director of Champneys, the health resort. I am also a former chairman of the Clubs Panel of the British Hospitality Association and currently chairman of the Master Innholders. According to my mother, my father once spoke in your Lordships' House during a blackout. The

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Chamber was lit by candles and the microphones were not working. He, with his customary skill and ability, surmounted those difficulties. I am only too delighted tonight to have both light and sound. I only hope that when I sit down your Lordships will feel the same way.
I am most grateful to the noble Earl, Lord Bradford, for this opportunity to speak for the first time in your Lordships' House on an issue which has been the subject of hot debate in the industry in which I have spent my whole working life. I am only sorry that on this occasion, while I am in sympathy with the objectives with which this Bill seeks to deal, I cannot support the noble Earl, since I believe that primary legislation is not the appropriate method for dealing with these matters.
My entire working life has been in the hospitality industry, having gone straight to management training with the Savoy Company after leaving school. During those early years, I worked in every department in the hotels and for much of that time was the recipient of service charge and tips. In the light of that experience, I should like to make one general observation. I have often heard the assertion that receiving tips or service is demeaning to the recipient. But I have never in fact heard it from anyone in the industry who benefited from that income. In my case and the case of colleagues with whom I worked at that time, we were only too delighted to be able to increase our remuneration by our own honest endeavour and skill. I do not recall feeling demeaned. I do recall the joy of receiving a tip for a service well performed.
I have been extremely lucky in my life in the hotel industry. By great good fortune I was appointed the general manager of the Savoy's hotel in Paris at an early age. At that time, it was customary for the majority of hotels and restaurants in France to levy a service charge, which was then governed by, I believe, the Loi Goddard. I am aware that the law in France has now changed, but at that time that law set out the rules governing all aspects of service charges. If my memory serves me correctly, it was a requirement that, where a service charge was levied, it had to be paid to the staff. In this country, so far as I am aware, there are circumstances in which a service charge can be levied but not given to the staff. I have heard of establishments which indicate a service charge but do not distribute it, it being kept by the proprietor. I believe that to be wholly misleading, since customers are perfectly entitled to believe that there is no requirement to leave any form of gratuity, whereas in fact the staff will receive nothing. I would certainly support any action to deal with that iniquity.
On my return from France I had the further good fortune to become the founding general manager of Cliveden. I decided at that time and in that particular property that a service charge was inappropriate. I hoped that guests who were happy with the service we provided would chose to leave whatever gratuity they felt appropriate. But at the same time I wanted to make it clear to them that there was no pressure from either the management or the staff. We therefore ended up with a long-winded statement on the bottom of our menus which indicated that service was "neither
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included nor anticipated", which we later amended when it was pointed out to us by a client that he thought we meant that service charge was neither included nor anticipated. Gratuities thus were left: entirely to the discretion of the guests.
At that time I also came across the practice of leaving credit card slips open, a practice which I personally dislike intensely. I made it a disciplinary offence for any member of staff to leave a credit card slip open. The only complaint I ever received was from a gentleman who complained that he was unable to add a gratuity to his bill, which proves something that all hoteliers know: you cannot look after all of the people all of the time.
Until recently I ran a small company which owned three hotels and a major golf club. One of the hotels was in America where there is no service charge, or there was no service charge in that establishment. But everybody was well aware that one tipped for everything. I was interested to discover that the wages paid to waiting staff in Florida were generally lower than comparable wages paid in this country, even though there was a statutory minimum wage. However, overall it seems that the waiting staff earned more than their counterparts in this country because of the tips that they received.
I have always been struck by the friendly and efficient service which the majority of establishments give in the United States. I believe that there is a direct correlation between the quality of the service and the financial interest which the servers have in rendering good service. However, that system only works if the customers are prepared to partake in tipping, and it seems to me that in this country generally customers are less likely to tip.
Until October of last year I was chairman of the club's panel of the British Hospitality Association. The BHA takes the view, which I endorse, that it is inappropriate to deal with this matter by primary legislation; rather, it would prefer to see an extension to the Price Marking (Food and Drink on Premises) Order 1979. I am also currently chairman of the Master Innholders, an association of some 80 hoteliers who have received the accolade of Master Innholder. At a recent meeting of its executive committee I asked those members present for their views. They were unanimous in opposing legislation as the correct method of dealing with this matter.
I apologise for taking up so much of your Lordships' time in relating my career. However, hope that my experience may be helpful in this debate. While I fully accept that consumers would benefit from an abolition of service charge in the short term, I am equally convinced that employees would lose.
A well-run service charge system permits the restaurateur or hotelier to have a degree of flexibility in his labour cost, which is usually the highest cost element in his operation. At the same time, it allows the employee to share both the gain of the good times and the pain of the bad times. That of course can also be achieved by a bonus or commission system. However, current taxation law is such that if the proprietor

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indicates that the service charge is voluntary, then the taxation treatment is more beneficial than if it is compulsory or inclusive.
I suggest therefore that an amendment to taxation legislation to allow all service charges, whether voluntary or compulsory, to benefit from the same tax treatment, coupled with compulsion for restaurateurs to pay staff any amount of service which they have indicated is included in the bill, would allow restaurateurs to obtain the benefit of the current service charge system while allowing existing legislation to be used for strengthening the rules governing the display of service charges. Most importantly, it would allow restaurateurs to display prices as inclusive of a specified percentage of service without any negative impact for him or his staff in taxation terms.
I dislike the practice of cover charges intensely and none of the businesses with which I am involved in an executive capacity employs them. However, I believe that cover charges have largely died out and I doubt the necessity of requiring their abolition by legislation.
This is an important issue in our industry. However, at a time when restaurateurs and hoteliers are facing an increasing barrage of regulation, I urge that the Bill is an unnecessary curtailment of their commercial freedom.
9.48 p.m.
Viscount Montgomery of Alamein: My Lords, it is my privilege on behalf of the whole House to congratulate the noble Viscount on his splendid maiden speech, and I do so unreservedly. He comes from a distinguished Scottish Liberal family who have served both his party and the nation over many generations. But today he chose to speak on a subject of which he has great knowledge. He cogently outlined his career in the restaurant industry, and that is precisely what we have found to be of great value. He is uniquely qualified to speak with authority on the subject, and indeed he did so. I hope that we shall hear him frequently in the future.
My noble friend Lord Bradford, who is a successful restaurateur and also speaks with knowledge, has explained the objectives of the Bill very clearly. I believe that it would be widely welcomed by consumers but, sadly, as my noble friend has explained, it has not been accepted universally by the industry. Before we go much further it is important to distinguish, as both previous speakers have done, between cover charges, which include table money, cutlery, table cloths, and so on, which practice of charging has been widely discontinued and of which very little exists, and the service charge—tipping—on which I propose to concentrate now as it is clearly the more controversial element and is causing quite a lot of complication.
In doing so I must declare an interest in that I am a former honorary president of the Restaurateurs Association of Great Britain. My noble friend is a member of its committee. Unfortunately, as he pointed out, the industry is not entirely of one voice; nor is the British Hospitality Association, as was mentioned by the noble Viscount, Lord Thurso. To a certain extent that is understandable, because no restaurant wishes to take a
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lead and put itself at a disadvantage to its competitors. However, if the matter of no tipping was made mandatory, it would be taken out of restaurants' hands and would be more acceptable since it would be universal. In other words, there would be one rule for all. As my noble friend has pointed out, the code of practice which the industry attempted to recommend and which was endorsed by the Department of Trade and Industry has not been 100 per cent. successful.
The other interest I have to declare in this matter is that I have recently been appointed honorary president of the Academy of Food and Wine Service, a position to which I succeeded when my noble friend Lord Montagu retired. It is an extremely worthy organisation with the most admirable aims—to improve appreciation of food and wine by developing the knowledge, service and social skills of restaurant staff. In other words, it is a training organisation which aims to achieve nationally recognised levels of professional competence in restaurant services. Its objective is to promote the image of restaurant service as a profession equal in all respects to other craft/skill occupations. That is a most excellent and worthwhile objective as it will inculcate the idea of waiting and service as a career. In that sense, it deserves very full support from Her Majesty's Government.
As noble Lords can imagine, the Academy supports the objectives of the Bill since, if restaurant charges are all inclusive, the staff will have a proper salary structure and thus a longer term stability than might otherwise be the case. I should have thought that that would appeal to all parts of the House. Indeed, it is the situation in both France and Italy, where legislation has been applied to this matter. I therefore support the Bill wholeheartedly and hope that it makes further progress.
I shall be interested to hear what my noble and learned friend on the Front Bench has to say, because I am extremely doubtful that the Bill can make its way onto the statute book unless the Government are prepared to support it properly or at least to take it seriously, which I hope they will do, and give the matter further consideration for the future. I support my noble friend and hope that the House will give the Bill a Second Reading.
9.54 p.m.
Lord McConnell: My Lords, I wish to join in the congratulations to the noble Viscount, Lord Thurso, on a very interesting and informative maiden speech. I hope that we shall often hear from him in future. The only interest that I might declare in this subject is as a customer who has nothing whatever to do with the restaurant business. I strongly believe, as has already been said, that staff in restaurants should get proper wages and that they should not have to rely on tips to augment them. They are respectable people and, although the noble Viscount may disagree with me, I personally feel that it is degrading to have to slip money to some other man who is just as good as I am and who is there as a waiter. I believe that he is entitled to a career and to be regarded with respect in that and get his wages in the proper way.

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It has been said that in many other retail trades there is not such a thing as tipping. If one goes into an outfitter's shop one may try on various garments. One may be given advice by the assistant, but one is not charged for what might be quite a lengthy service. He gets his wages and he is happy to serve the customer. He may possibly earn some commission, but there is nothing extra charged to the customer. Why should it be any different in a restaurant? I cannot fathom that.
It has been said—and I have heard it many times before—that not all service charges are handed over to the staff. There are cases in which a service charge is levied—very often a large amount, between 10 per cent. and 15 per cent.—and the restaurateur puts it into his own pocket. I believe that to imply that the payment is for the staff and then to pocket it is very near to the criminal offence of obtaining money by false pretences. It should be made a specific offence.
I know that there has been a recent High Court decision that in certain circumstances gratuities which are not in cash become the property of the restaurateur. I am told that that case will be the subject of an appeal. But it should be made clear in law and not left to interpretation of what is rather ambiguous legislation at the moment. It is essential that we have proper legislation. Voluntary codes are of no use at all because decent people in the trade will follow them and the cowboys will take no notice. Therefore the legislation has to be something that applies to everyone and which can be enforced.
I was very glad to see mentioned in the proposed legislation credit card slips and the space which is left at the end. I have come across that as, probably, have most noble Lords. I write in "nil" against the addition and give something in cash to the waiter because I know right well that some are going to put in a figure underneath the sum and then a subsequent total for a higher amount. That is very sharp practice, to put it mildly, and it may be a little more than that.
I agree that we should be brought into line with the rest of Europe, which, with the possible exception of Greece, as has been mentioned, has, I am led to believe, proper legislation. Our near neighbours certainly have legislation which we could well benefit from examining to see to what extent we can copy it.
I notice that the Bill does not apply to Northern Ireland. That is probably inevitable because it seeks to amend Sections 21 and 25 of the 1987 Act, and those two sections are contained in Part III, which does not apply to Northern Ireland although Parts II, IV and V do apply there. It is very much a hotchpotch of legislation. I do not see why one part of the United Kingdom should be treated any differently from the rest. It may be that an Order in Council will be produced if the Bill becomes law, but I deprecate that method of legislation. I deprecate introducing an order which cannot be amended and which has to be accepted in total or rejected altogether. It negatives the function of this House as a revising Chamber if something is presented to us and we are told, "You cannot revise it. You cannot do anything about it. Take it or leave it".
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I support the Bill and hope that it will eventually become law. It is a good first step. It may be necessary to have other pieces of legislation along these lines, particularly with regard to the enforcement of wages for catering staff, but I have great pleasure now in supporting the Bill.
10.2 p.m.
Lord Phillimore: My Lords, I welcome this opportunity of making my first speech in the House in support of this Bill. My interest in supporting the proposed legislation lies in being a restaurant customer who detests being "badgered, bothered and bewildered" by the variety of practices adopted by restaurateurs in relation to cover and service charges and the presentation of the costs of a meal.
Every customer is entitled to be made welcome and comfortable in a restaurant. That includes not only the provision of pleasant and attentive service and good food, but also a clear presentation of the likely cost of the meal. No one likes to query the position about cover and service charges at the end of a meal when wishing to leave. I am sure that, like many restaurant customers, I am too interested in the food for the health of my body or wallet, and so I concentrate on the choice of dishes rather than on scouring the menu card for details of cover and service charges, and thus leave myself open to a price shock at the end of a meal. The usual practice, whereby the menu card is efficiently whisked away after the initial choices are made, often never to be seen again since a separate dessert menu is sometimes presented which does not refer again to cover or service charges, serves only to compound the confusion.
Some of the practices that I have experienced, which I understand that the Bill seeks to eradicate, are, I am sure, well known to your Lordships and have been referred to already, but they bear brief repetition. I refer to the lack of clarity as to whether there is a cover charge; to the lack of clarity as to whether there is a separate and additional service charge; to the so-called "optional" service charge which is often filled in before the presentation of the bill to the customer, thus eliminating or at least strongly discouraging any choice by the customer; and to the blank space that is left on the credit card voucher for the insertion of a gratuity which is presented to the customer whose memory has faded about the details of the menu card as to service charges, perhaps from having wined and dined too well.
Those practices cause much confusion and can be misleading not only for those who live in this country but also for those who visit this country for tourism or business. It is vitally important for the reputation and economy of this country to make all visitors feel as welcome and as well treated as possible. This legislation will lead to uniformity of practice to the great advantage of the customer, who will know the likely price of a meal on studying and comparing menus displayed outside a restaurant as well as when he sits down inside a restaurant.
Legislation in this form is necessary because the restaurant profession is not seen to have adopted a uniform code of practice on these matters; and the

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present legislation is inadequate in that the definition of "misleading price indications" under the Consumer Protection Act 1987 is not wide enough to outlaw these practices. So I commend the legislation to your Lordships.
10.5 p.m.
Lord Rathcavan: My Lords, it is my privilege on behalf of the House to congratulate the noble Lord, Lord Phillimore, on his maiden speech. I share with him the distinction, wisdom and good taste of having chosen a French wife, but I also share with him a keen interest in the restaurant business. I was most interested to hear his comments on the Bill, delivered in a style which was a tribute to his training in the Middle Temple. I am sure we all greatly look forward to hearing his future contributions.
I have to declare an interest as now a director of the Berkeley Hotel, which owns restaurants. I have been involved closely in the restaurant business over the past 15 years as a non-executive director and at one time as a proprietor of a restaurant business. Up to a point, I strongly support the aims of the Bill to remove the great confusion which exists among restaurant customers, particularly foreign visitors, and to prohibit the levying of hidden and unexpected charges.
The cover charge habit, as many noble Lords have pointed out, is indefensible. It is rapidly going out of fashion, and I hope that most noble Lords will support its prohibition. As any good restaurateur knows, the cost of the cover should be absorbed into the normal overheads. Secondly, the habit of adding on what amounts to a compulsory service charge, often as high as 15 per cent., is immoral when it becomes a charge which is not distributed to the staff but is taken by the company or the restaurant owner as a contribution to his own overheads. That is all too frequently the case.
I find equally indefensible a service charge which is said to be distributed to the staff but is in fact taken by the company or restaurant owner and paid to the staff as part of their weekly wages.
That is as far as I would go in supporting the Bill: prohibiting the unfair, the unclear and immoral service charges which go to the proprietor and not to the staff; and banning the cover charge and stopping the confidence trick of not fully completing credit card slips when given to the customer for signature. However, I do not agree that genuine and optional tipping or gratuities for good service should be actively discouraged, as the Bill proposes.
Reward for good service is a part of the restaurant business. When it is properly organised it acts as a great incentive in so many ways to the efficiency of a restaurant. That is recognised by our tax system also. I am grateful to the noble Viscount, Lord Thurso, for having brought such expertise on the subject in his excellent contribution. Where a gratuity is genuinely optional, and where it is distributed directly to the staff, as he said, by an agreed or even elected and truly independent representative of the staff, known as the troncmaster, that charge is not subject to VAT or liable
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to national insurance contributions. Together those savings amount to over 3 per cent. on the total bill or 25 per cent. of the gratuity given.
I checked this week with the VAT office of Customs and Excise and with the Contributions Agency of the DSS. Both confirmed that there is no reason to change the special treatment in the regulations for tips and gratuities. Restaurants which operate that fiscally efficient system save over 3 per cent. in tax costs. If the Bill goes through in its present form and staff are remunerated only by the employer and not partly through a troncmaster, those costs will be passed on to the consumer.
I assure your Lordships that staff who are partly paid by and through the independent troncmaster greatly prefer that system, as the noble Viscount, Lord Thurso, confirmed was the case when he worked in the industry. They see their weekly wage reflecting the level of business and the reward for good service. It means a fluctuating weekly wage but it is a mighty incentive towards higher standards of service and greater efficiency. Some restaurant owners even ask their troncmasters to bear a percentage of the costs which arise from breakages and pilfering. It is extraordinary what effect that has on the level of breakages and pilfering. I hope that when the Bill is discussed in Committee, your Lordships will take into account that point and will allow the troncmaster system to continue.
Most restaurateurs would like to see a level playing field where bills are legible and readily comprehensible; where prices are as net and as inclusive as possible; where there is no more confusion about spurious service charges which do not get properly distributed to the staff; and where there is a real incentive to compete on the same pitch with good fresh food and good value for money.
I thank the noble Earl, Lord Bradford, for bringing the Bill before the House. It seems to prohibit some of the worst practices now used in the industry. But I do not believe that it should discourage genuine gratuities and tipping. I hope that I have been able to explain to your Lordships the important role played by that most respected man in the restaurant staff—the troncmaster.
10.12 p.m.
The Earl of Lindsey and Abingdon: My Lords, I begin by congratulating both the noble Viscount, Lord Thurso, and my noble friend Lord Phillimore on their excellent Maiden speeches and their contributions to the debate.
Some 40 years or more ago, I was considering making the hotel and catering business my career. I undertook a course in hotel management and bookkeeping which required one also to have some practical experience. I applied for a job and was accepted as a junior or commis waiter at a well-known London hotel. Although I lasted for less than six months in the job, the experience was most interesting and worth while. I believe that it has contributed to my being able to understand more clearly the views of the restaurant owner and the waiter as well as those of the customer.

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The hotel for which I worked had an extremely good and well-regulated system governing additional charges. There was no service charge as such. That was left to the discretion of the customer. The restaurant was divided into what were known as stations, which covered about six to eight tables each. Each station had one head waiter, one chef waiter and two commis waiters. Only the head waiter of each station was allowed to accept a tip or gratuity. That was then put into a pot known as a tronc. At the end of each week's takings, the amount was distributed on a percentage basis to the four waiters who worked on the station.
I assure your Lordships that that was an extremely welcome bonus, small as it was in my case, because basic pay was extremely low considering the long and unsociable working hours. There was no such thing as trade union protection or a guaranteed minimum wage.
After I decided to pursue another career, I experienced a very different situation. As an interest, I invested a small amount in a restaurant near to where I then lived in London. The establishment did not impose a service charge and a waiter who received a tip was allowed to keep it. However, the management imposed a cover charge which, if converted into today's money, would amount to about £2 per customer. I wondered what that was for because the place provided no table cloths or napkins; indeed, there was not even a carpet to clean. The floor was of stone and covered in sawdust and the walls were hidden by prints and watercolours.
I find it most annoying—and I am sure that many of your Lordships will agree with me—when eating out at some of these restaurants, when what should have been an enjoyable meal ends up with confusion over the bill. With a menu stating "cover charge and service included" there is a gap for the gratuity when the bill arrives. That amounts to a double service charge. If you pay by cheque or credit card, there is no knowing if the so-called "gratuity" goes to the waiter who has served you or into the coffers of the management. I must say that I am inclined to leave that amount blank and hand a cash donation to the waiter concerned if the service has warranted it. I am also fully aware that there are tax implications to be considered in the Bill.
In conclusion, I welcome the Bill to "prohibit the levying" of service and cover charges other than those stated. I wish my noble friend Lord Bradford every success in getting the Bill through its remaining stages and on to the statute book.
10.17 p.m.
Lord Montagu of Beaulieu: My Lords, I hope that my career in the tourist industry over the past 45 years and its inevitable connections with the catering industry is well enough known for me not to bore your Lordships' House with a long list of my appointments past, present and in the future.
I believe that the noble Earl, Lord Bradford, is to be congratulated on raising this issue, even if the Bill fails to become enacted. I certainly support the Bill, but as Ihe details have been so well rehearsed, there will he no good in repeating them tonight. However, I should like
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to submit to your Lordships' House my view that, if passed, the Bill would have a very radical and beneficial result, not only on our restaurants, cafeis and hotels but also on Great Britain's ability to continue to compete successfully in the tourist industry. The facts arc simple: tourism is our most important overseas earner and one of our biggest employers, but it was not always so.
Before the war our food was unexceptional; there were very few good hotels and restaurants and there was no expertise or skill to command respect or indeed to attract people to these shores. Over the past 50 years those concerned with the tourist industry have done a magnificent job in making Britain one of the world's great tourist attractions for millions of overseas visitors, as well as our own people who take holidays in this country. Our food is no longer a deterrent, and the same can be said for British wine. The industry has been transformed by better training, dedicated chefs and restaurateurs. It is now not only respected and admired, but also emulated. Indeed, we have seen roast beef featured on French menus, which is a great compliment.
The only regular criticism is the confusion on prices and costs which has been described. The uncertainty about the total bill and how to deal with gratuities deters many people from eating in restaurants, and that applies particularly to the lower income bracket and young people who are not experienced in restaurants. So what do they do? They go instead to fast-food establishments because there is no VAT and no service charge on hamburgers and hot dogs.
France had a similar problem and it successfully solved it by legislation of this sort. Therefore I hope that the Bill will succeed. It is to my mind necessary that any extra charges are not imposed, but what is equally important is that they are seen not to be there. Managers of restaurants can present themselves with transparent honesty as long as they say what is being sold and for how much. That is sadly lacking today. The result of the code of practice is that the good guys obey it but the bad guys do not and therefore the good guys suffer.
Great patronage will result from increased respect and confidence. Of course the staff must be rewarded but I believe that it is for the management to determine how best that should be done. It is not the responsibility of the customer. Some noble Lords tonight have the impression—I hope that the noble Earl, Lord Bradford, will correct this—that the Bill seeks to abolish gratuities. In my opinion, that is certainly not the case. I believe that the noble Earl, Lord Bradford, will confirm that when he replies to the debate. Individuals must of course always retain the right to reward good service. I hope that this Bill will succeed, as I believe that it will make an important contribution to customers' satisfaction and consumers' interests.
10.21 p.m.
Lord Monson: My Lords, as well as congratulating the two maiden speakers on their excellent and interesting maiden speeches I also wish to congratulate the noble Earl, Lord Bradford, on his initiative in devising and bringing forward this Bill. The all too frequent abuse of service charges is something which

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has concerned me for a long time. Indeed, I first raised this matter in your Lordships' House when the party to which the noble Earl belongs was seated on the opposite side of the Chamber, which takes us back 17 years or more.
However, unlike the noble Earl, my particular concern has been not so much for the customers, most of whom—although I concede not all of them—are astute enough to look after themselves, but rather for the employees. I know from several sources—not least from younger members of my family and their friends who in the past have worked in restaurants during long vacations—that all too often service charges which the customer fondly imagines are destined for the pockets of the waiter or waitress go instead into the coffers of the owners or managers, in whole or in part. Here I entirely endorse what the noble Viscount, Lord Thurso, and the noble Lord, Lord Rathcavan, have said on this matter.
I have often mulled over the idea of introducing a Private Member's Bill myself which would make it obligatory for service charges to go entirely to employees, but I have always been stymied by the all too likely prospect of unscrupulous owners or managers redesignating themselves as employees and thereby creaming off the greater part of the money raised by the service charge. The noble Earl may have come to the same conclusion; at any rate, his solution is the bold, even ruthless, one of outlawing both service charges and cover charges altogether. I use the words "bold" and "ruthless" for two reasons. Even in North America where tipping, and substantial tipping at that—15 per cent. is normally expected—is an absolute social, even if it is not a legal, obligation, service charges are now normally levied if the party is larger than six or eight. This applies not only in areas frequented by British and other European tourists but throughout the greater part of North America.
Moving back to the eastern hemisphere, we find that—unless legislation has changed since I was last in France—the cover charge is still alive and cooking (that is a Freudian slip; I meant to say alive and kicking) on the European continent. If one orders one of the prix fixe menus in France, as one normally does if one has any sense as they are such good value, one will not pay such a charge as such menus are genuinely all inclusive. It is a very different matter if you order à la carte. In that case you are almost invariably charged a couvert, not unreasonably. I am the first person to defend the practice, under certain circumstances.
Restaurateurs are normally terrified of someone monopolising a potentially profitable table on a busy day and ordering perhaps only one course and a glass of tap water. Contrary to popular supposition, it is possible to get a glass of tap water in France despite the restaurateurs' protestations. It would obviously be disastrous for their profits if the practice were to become too widespread. Therefore, I believe that in certain limited circumstances a cover charge on an à la carte menu rather than a table d'hôte one, can be justified.
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Provided the customer is kept fully informed, which is not the case at present, and provided there is no ambiguity and no cheating of customers or staff, I believe that restaurants should be allowed a choice. There are many reasons for that. In view of the late hour I shall mention only two.
An isolated restaurant with intermittent trade may only be able to survive if its part-time staff, who may be students, are paid on what is effectively a piecework basis, as happens in Canada and the United States. Secondly, many customers, surprising though it may seem, feel uncomfortable not tipping and would prefer the basic price not to include service so that they can tip either on an ad hoc basis or, having had the calculations made for them, by means of a service charge. Remember that in France, even though prices may be all inclusive, it is usually stated that service of 10 per cent., 12 per cent. or 15 per cent. is compris so that people are aware that there is a charge, which, if the restaurant is properly run, presumably goes to the staff.
To sum up, I agree with the noble Viscount, Lord Thurso, that Clause 1 of the Bill is over-prescriptive, as is the last half of new subsection (1A)(c) in the otherwise excellent Clause 2. However, the latter can be amended in Committee. Should it come to a vote I shall certainly vote for the Second Reading of the Bill as the status quo is most definitely not satisfactory.
Viscount Montgomery of Alamein: My Lords, before the noble Lord sits down, perhaps I may correct him on one matter of fact. Generally speaking, there is no cover charge in France. However, there is frequently a minimum charge. The minimum charge is usually sufficient to cater for the person who comes in and orders one course and a glass of tap water to which the noble Lord referred. Therefore, it is a minimum charge rather than a cover charge. There is no cover charge.
Lord Monson: My Lords, I am grateful to the noble Viscount for pointing that out. It is a long time since I have eaten à la carte in France. I go there as often as possible, but I usually eat the prix fixe menu because it is so much better value. However, that gives me an opportunity to say that, if one sees the words "minimum charge" on a menu, it is extremely off-putting. I would prefer to have a cover charge because there is something very down-market about seeing "Minimum charge £5" on a menu. I would prefer not to see that, but it is entirely a question of personal taste.
10.28 p.m.
Lord Cadman: My Lords, in rising to speak in support of the Bill I hope to be brief in view of the hour. The only interest that I can declare is that of a consumer, albeit one who still pays his dues to the British Hospitality Association. Also, my wife and I were the operators of a restaurant business for some eight years until fairly recently.
During our incumbency of that business we sought selectively and voluntarily to ask our customers for a contribution towards service. Our motivation was to ensure that our staff were adequately rewarded for the extra effort involved in dealing with large groups and at

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Christmas time, when invariably their expectations in that regard were rarely met. We had few problems with this policy and in general everyone was happy. It has been suggested that the Bill seeks to abolish tipping. I can see no case for this. Tipping is a personal matter and no business should rely on the custom of tipping, in the restaurant or any other trade, to fund their staff's remuneration.
The public seem to have accepted that a service charge is something that they must pay if they want to eat out. Otherwise, what restaurant would be able to get away with imposing it? That is the whole point underlying this practice. It has been suggested that restaurant staff wages will suffer, or that somehow restaurants will pay more in VAT and national insurance contributions as a result of the Bill. That will only occur if the restaurant finds itself able to incorporate any charges it might make into its menu prices thereby increasing them, or by reducing staff wages to compensate for its inability so to do.
It goes without saying that unless the restaurant has a captive audience its prices have to reflect market forces and I can assure noble Lords that there is a great deal of competition out there, notwithstanding the fickle nature of restaurant customers in general.
Making a cover charge is, I feel, less of a problem. At least it is normally nominal and is generally accepted as being for bread and consumables not charged for on the menu. Again, I have to say that these days those who make a cover charge feel that they can get away with it. I should be careful here because cover charges are made in your Lordships' House. Perhaps it is a tradition, but it may be one which has become inappropriate.
Providing uncompleted credit card vouchers for signature is, of course, an open invitation to the customer for a gratuity and no customer ought to feel obliged to accede. I know of one charge card company which actually encourages this practice, although I have to say that I feel it encourages fraud. In our business we had some instances of customers signing the voucher and neglecting to fill in the total. After all, if a customer wishes to add something to the bill in this way he can always ask the waiter to bring another voucher for him to complete and destroy the original.
As things are at present there is total confusion with customers not knowing their rights, or whether any contribution they make goes where they think it ought. Some restaurants make charges of varying amounts; others do not. Some charge groups; some impose a charge above a certain amount spent; some are optional; some are not. It is total confusion, and perhaps some regulation is now necessary. I welcome the Bill and should like to thank and congratulate my noble friend for the way in which he introduced it. I wish the Bill a fair passage.
10.32 p.m.
Viscount Mountgarret: My Lords, I begin by congratulating the noble Viscount, Lord Thurso, on an excellent maiden speech by one who is obviously at the top of the tree in his profession, as is the noble Lord,
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Lord Rathcavan. The words they have imparted arc worthy of great consideration by my noble friends, most of whom have spoken in favour of the Bill. They are two people who are very knowledgeable in their field. In fact, the noble Viscount is even cleverer than the remainder of us. I think I am right in saying that as regards the two restaurants of the Savoy, in the Grill Room there is a cover charge, service charge, and so on, and in the River Room it is all inclusive. So there is a hedging of bets. If you wish to have the benefits of the one as opposed to the other, "you pays your money and takes your choice".
I must declare an interest in that I am involved with my stepson who has just started a very humble sandwich bar. I hope that one day he might go the route of others to the top of the profession. Like me, he is very opposed to the Bill and I shall tell the House the reasons.
I believe that the sentiments expressed about the unnecessary addition of cover charges, that it is not fair to add in service charges and so on, cloud the issue. The noble Lord, Lord Rathcavan, said that he does not like them. I do not like them. To my mind, a £16 steak is £16 and there should not be any cover charge, nor should there be an automatic service charge. But that does not mean that we need to regulate the matter. Parliament is not there for that; there are trade associations which are more than capable of putting their own house in order. Just because my noble friend Lord Bradford says that it has not been done is no justification for Parliament to legislate. If one takes it to absurdity, are we to have every mortal thing regulated?
I may be treading on tricky ground here because I do not know the facts too well. However, let us take the Jockey Club which runs racing. An enormous amount of freedom is given to the Jockey Club to make the rules and run racing and it is autonomous. If all the rules and the organisation were to be regulated by Parliament, it would completely destroy freedom of life and freedom of choice. It would he most unfortunate.
I must apologise to my noble friend. Having been in the position of proposing a Private Member's Bill which noble Lords kindly allowed me to introduce, like my noble friend Lord Montgomery I know what it is like to have perhaps not the wholehearted support of one's colleagues and friends. At the end of the day, we Back Benchers must stick together because united we stand, divided we fall. However, one cannot support something with which one disagrees fundamentally.
Let us take the wording of the Bill. I am no parliamentary draftsman, but line 10 of Clause 1 states that any restaurant or premises offering similar services "is misleading as to price" if it indicates a separate charge for service of food and drink and a separate cover charge. But that is not misleading, it is very clear. I should like to see on the menu that a cover or service charge is made if the restaurant wishes to make it. It is up to the customers to decide whether they accept it. If they do not like the way the restaurant runs its business they can stay away and go elsewhere. Therefore, to have the clause as drafted is a contradiction in terms. It is not misleading; it is clear and indicative.

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Clause 2 is misleading. It is designed to discourage reward and thanks by a customer for service or whatever it is by saying on the menu that staff do not expect a gratuity, end of story. Many customers would feel, "The staff don't expect it, I'd better not give it". Noble Lords know as well as I do that no two people think alike and a customer at the next table may wish to give a tip or gratuity.
I wonder if anyone remembers how the late Nubar Gulbenkian would arrive at the Ritz Hotel in his taxi, turning, as he put it, on a sixpence, would sit down at his table and would produce the equivalent of a £20 note. Putting it on the table, he would say to the waiter: "It's yours if I'm satisfied. It's mine if I'm not".
My noble friend Lord Bradford mentioned going to a restaurant and bribing the chef. It really does not matter a hoot. You either bribe the chef beforehand, or bribe the waiter and the chef afterwards. The fact is that if a customer tips the waiter, or whoever, he will enjoy better service next time than the man who does not. Therefore it is quite wrong to try to encourage customers not to give a tip by having those words in the Bill.
My noble friend Lord Montagu said that it is the responsibility of management to reward, and not the customer. I disagree. It is not the responsibility of management to reward, except in so far as it is entirely right, proper and desirable that the staff are properly rewarded in the level of salaries they receive. But that is not up to the customer; it is up to management. The knowledge that the restaurant trade is badly paid is irrelevant in the context of whether the customer should tip or whether there should be a service charge. Basic pay is basic pay, and it is an area where there could, and should, be improvement, hopefully with the encouragement of the associations.
Last year I was in the United States and Canada, which I am sure many noble Lords know far better than I. I found that the service received in every restaurant, across the whole of the United States, was excellent because the waiters rely on tips. It was known that the prices did not include tips, and therefore the staff gave a better service. On the other hand, if a service charge is added, they can sit back if they feel so inclined and do nothing. That is the advantage of tipping.
My noble friend Lord Bradford, like me, does not like regulation. He stated that. Yet here he is trying to regulate. He said that the association had failed to get its act together and therefore legislation was necessary. That is a non sequitur. He said that his wife had an unfortunate experience in a restaurant. I suggest that perhaps she will not go to the restaurant again. He listed the organisations that support the Bill, such as the Four Seasons. But do they support the principles? I do not believe they do. I know the Four Seasons quite well, and I seem to recall that it certainly had a cover charge and a service charge added.
The Earl of Bradford: No, it does not.
Viscount Mountgarret: I may stand corrected, and if so I apologise.
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The sentiments of this Bill are right, but the practicalities contained within it are wrong. I hope that it will not be given a Second Reading. I will take guidance from my noble and learned friend Lord Fraser as to how we proceed from here.
10.44 p.m.
Lord Mountevans: My Lords, as always, I declare an interest. We still have to do these things, until we put them on paper at the end of the month.
We are all grateful to my noble friend Lord Bradford for introducing this Bill seeking to abolish compulsory service and cover charges and thus simplify the consumer's menu-based concept of what he or she is getting. I believe that he seeks to abolish compulsory service charges while seeking to preserve gratuities and tipping which are discretionary.
I am also grateful to the two maiden speakers. The noble Viscount, Lord Thurso, put the supplier case, while my noble friend Lord Phillimore put the case for the consumer. Both want fair play, but their approaches, as a supplier and a consumer, were inevitably different.
The noble Viscount suggested that tipping should be discretionary and I go absolutely and totally along with him. My noble friend stressed the importance of tourism, and indeed uniformity of practice, which I believe is the most important matter. I found myself agreeing with both of them on a number of points. Of course, tipping—gratuity—should be an option. But service charge, cover charge or, as we call it in this House, "table money", should not, I feel, be compulsory.
So where do we go? Do we seek better enforcement or do we seek compulsory regulation? The argument has gone sometimes this way and sometimes the other. There is a whole wad of legislation which could be prayed in aid: the Price Marketing (Food and Drink on Premises) Order; the Price Indications (Method of Payment) Regulations of 1987 in so far as they refer to credit cards; or the Consumer Protection Act 1987 and its references to misleading information on the price to be charged for goods. They should all be taken into consideration and perhaps in an ideal world they would be. Certainly they are all relevant.
I say that in an ideal world they should be taken into consideration, but sadly this is not an ideal world. That, I think, is what provoked my noble friend Lord Bradford to bring forward his Bill. And because it is not an ideal world, one has to go for something stronger. Even if it is only a matter of giving the issue an airing in this House and giving the Bill a Second Reading, putting it on the record, I believe that, deep down, one has to support my noble friend.
Tourism has been mentioned. Again, I declare an interest. Foreign tourists spend some £2.2 billion in this country. Indeed, 22 per cent. of their total spend is spent on eating out. The British Tourist Authority and my old colleagues there make a major point of marketing the variety not only of British food but also of what one might call foreign cooking. London is the food capital of the world. We lack a Lithuanian restaurant, but

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otherwise there is just about every nationality that one can seriously think of providing food either in the capital or in the provinces. We make a point of encouraging restaurants to provide quality and value for money. But it is difficult to do that if there are different interpretations of what one might call existing subsidiary legislation.
Foreign tourists are, of course, "Johnny foreigner". But we must remember that our restaurants make far more money—I am sure that my noble friend Lord Bradford when he winds up the debate will confirm the fact—from the British tourists. We are all quite often tourists in our own country. So it is quite interesting to see an English Tourist Board survey published only last month which reveals that 55 per cent. of those interviewed were not totally au fait (if I may use a foreign phrase) with the concept of service charge, whether it was compulsory or whether it was discretionary, while 35 per cent. did not understand what services were provided by cover charges or, as the noble Lord who will respond might say, "table money".
Given that ignorance, interpretations or misconceptions, and given European practices, which have been mentioned by several people, we are out of line on this matter. Certainly my experience in France and Sweden has been different. In France, one tosses into the pot the centimes that are left; in Sweden, one tosses in what Swedes call the lösöre—the small sums. I know that the noble Lord, Lord Peston, eats in a rather higher standard of restaurant than I do and he can defend his position when he rises to speak. Certainly in Sweden, if one has a bill for the equivalent of £59.35, one throws the 65p. into the pot. That is all one has to do.
Good service is taken for granted. It is not something that one has to add on—unless of course the service is brilliant. If it is really good, then of course one rewards it. I do not like the hidden extras—the cover charges, the service charges and the others that have cropped up, let alone the incomplete credit slip. I must support my noble friend Lord Bradford. As I said, he has given this matter an airing. I am not sure that his Bill has any great chance of succeeding, but I certainly hope that it will receive a Second Reading tonight. As a consumer, I would certainly support that.
10.50 p.m.
The Viscount of Fallkland: My Lords, I came into this debate with an open mind and I leave it with an open mind, I hope, but much better informed. The contributions of the two maiden speakers were quite remarkable—one from a customer's point of view and the other from a supplier with a great deal of experience. My noble friend Lord Thurso again shows the expertise that comes into your Lordship's House even through the hereditary peerage. I hope that that will be picked up in particular by the popular press. We look forward to hearing both maiden speakers contribute again in this House in the near future.
My feeling as a reluctant diner-out is as a creature of habit. I tend to stick to a restaurant which I like and where everything seems to go according to what I think
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is right in terms of food and service. One restaurant to which I am extremely loyal is connected with the noble Lord, Lord Rathcavan. I believe he founded it and most noble Lords will be aware of the restaurant to which I refer. One of the rewards for both the providers of good food and those who serve it is that customers return to the restaurant. That is a reward in itself.
Tipping is an extraordinary concept. I do not believe that anybody in your Lordships' House has not said at some time, "How much shall I leave?" We have all developed our own mental arithmetic for working the sums out quickly, especially those who frequent betting shops as well who become extremely quick at mental arithmetic.
I cannot see any great benefit in the complications or the "morass", as the noble Earl, Lord Bradford, described it. He is to be congratulated on explaining his position so well and so clearly. I am three-quarters of the way with him. But it seems to me that restaurants and the serving of. food implies that one will receive one's food served in the best way possible. It is difficult therefore to calculate whether or not a tip has been earned.
For example, there is no difficulty in a restaurant in deciding that one wants to tip the lady who looks after one's coat or hat. If that service is done grumpily and she squashes one's hat or tears one's scarf, one will only leave her a fraction of what is laid out as a heavy hint in the saucer on the shelf. However, if she has done something like look after one's motor cycle helmet, which is often done for me, one may leave a little more. The same is true of the man who parks one's car. One may want to reward the man or woman who goes out in the rain to park one's car. One may even feel that the waiter has done something exceptional if he goes out to one's car to retrieve a wallet left there. But, I have just returned from Italy where, as noble Lords explained, the procedures are governed by law. In that country one receives a bill at the end which one knew perfectly well one was going to receive, and one just leaves small change or perhaps something more substantial if something exceptional happened by way of service. And that is the ideal situation.
Having researched the whole complex problem a little, I find that the situation is not so simple. It washing explained to me by a lady who had been a hairdresser and a waitress—not normally my source of briefing, but on this occasion extremely useful—that in restaurants which generally have a lower turnover and where the price paid per customer is relatively low, the customers and staff are usually young people, who tend to go out on Fridays and Saturdays. At that time, therefore, it is difficult to obtain staff because they also want free weekends. So to those who come in on Fridays and Saturdays tipping is an important part of their agreement to serve the establishment.
Having heard the informed contributions in your Lordships' debate, it seems to me that that could well be corrected by a minimum charge. I see no problem with a minimum charge. I do not agree with the contention of the noble Lord, Lord Monson, that a

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minimum charge is somewhat infra dig, or whatever phrase he used, rather more than a cover charge. It seems to me that a cover charge is less acceptable.
Fundamentally, the British are rather frightened of waiters. On the rare and distasteful occasions when one sees someone being rude to a waiter that person is invariably drunk, which means that he has whipped up some Dutch courage. About 10 years ago I had the great fortune at a dinner to sit next to the distinguished architect, Sir Basil Spence. It was a very charming evening. He said to me early on, "Please speak up because I am rather deaf. It is one of the afflictions of old age. There is only one compensation for reaching old age. You're no longer afraid of waiters". That has always stuck in my mind. There is a kind of fear of waiters among diners and a great deal of uncertainty, which would in a way be dealt with by the noble Earl's Bill.
After today's debate I tend to lean towards the feeling that legislation is the only answer. Certainly cover charges and the other things, which are on the way out as I understand it, are unsatisfactory. What I really do object to is to see on a bill the note that a 12.5 per cent. or 15 per cent. service charge has been included at the customer's discretion. That is an unfair thing to do because the drunk may well say, "I'm not going to pay your charge", but the sober, well-behaved diner may think, "It's frightfully embarrassing. I don't particularly like this restaurant anyway. I'll pay it and I just will not come again". But that is an unsatisfactory of dealing with a business.
It has been an excellent debate and the evening is drawing to a close. I would just say to the noble Earl that if his Bill gets nowhere this time he should follow the example of other noble Lords on other matters and present it again; and if, again, he is unlucky or meets with no co-operation he should put the Bill to a Select Committee of the House. That is what we did on the Dangerous Dogs (Amendment) Bill and I have great optimism about that piece of legislation. This is an excellent subject to be dealt with by a Select Committee of this House if all else fails. I am quite sure that an enormous amount of helpful information would come out of such a procedure on which even better judgments could be based.
10.58 p.m.
Lord Peston: My Lords, I, too, must start by making a sort of declaration of interest. I am chairman of your Lordships' Refreshment Sub-Committee. The House has the equivalent of a cover charge and service is levied in some parts. I have to tell noble Lords that the staff are happy with that and, indeed, all they ever tell me about is the number of noble Lords who do not feel that they want to tip. I shall not regale the House with some of the delicate problems I have had to deal with in that regard. My daughter is a chef of some distinction and I have many friends in the restaurant industry, from those who own restaurants at one end to those who do the washing up at the other. Rather like the noble Lord, Lord Phillimore, I have probably spent more time and
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money in restaurants than is good for me. Perhaps I may also say at this point how much I welcomed his maiden speech and that of the noble Viscount, Lord Thurso, who both spoke from experience and knowledge.
Although, as always, we shall grant the noble Earl the courtesy of giving his Bill a Second Reading, because we always do, I am bound to say that, unlike most, but not every, noble Lord, I am totally opposed to it and would not be in favour of it entering the statute book. Therefore, I shall be as blunt as I can. The Bill seems to be based on a misunderstanding of consumer protection on the one hand and on the economics of the restaurant industry on the other. I am aware of the views, inter alia, of the British Tourist Authority, the English Tourist Board, the Consumers' Association and the National Consumer Council. It is my judgment that they are mistaken, too.
I am especially sad about this because my point of departure tonight is what it always is; namely, to follow Adam Smith's dictum that the criterion to be applied in judging any industry's performance is consumer satisfaction. What the Bill seeks to do is to limit what restaurants can do by service charges, cover charges and the like. I shall return to the special question of leaving the credit card slip open and deal with it in a few minutes. It will be illegal to do those various things, as I understand it, that the restaurants currently do.
Why would it be right to bring the law into this? The answer, in so far as any rational argument has been put forward at all, appears to be that that is what consumers want. Before examining that, perhaps I may reflect on what happens in a sample of restaurants that I go to—the matter has already been referred to—and which I particularly like. I shall mention four of them. The restaurant in the Capital Hotel has a very expensive prix fixe and an à la carte menu. It is a superb restaurant and states clearly that there are no cover charges and no service charges of any kind to be added. That is what one pays. At Alistair Little's there is only a prix fixe and again no cover charge, and service is left to the customer. At The Ivy there is à large a la carte, a cover charge, and service is stated not be included. At Shepherd's, to which many of us go across the road, there is a prix fixe with some dishes costing extra, no cover charge and service is added. So we have a full range of what happens.
In the last three cases, since it is clear before the customer enters the restaurant what the position is, I cannot see that those restaurants are doing anything wrong at all. I have to emphasise that the noble Earl is simply in error in what he is attempting to do. Perhaps I may add that, when he reads Hansard tomorrow, I believe he will also note that he has been verging on the defamatory in his remarks on his fellows in the restaurant business, and I was not happy with that.
In particular I must emphasise—and this lies at the heart of where the noble Earl is mistaken, and the point has already been made—the restaurant business is highly competitive. Some people, as a result of both culinary and managerial skills, together with good luck, earn a lot of money: many others do not. The successes of the former attract new entrants, but most do not

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succeed or survive for very long. It is always a source of great sadness to me that many a good restaurant that I have favoured has gone out of business.
My point is that. in this highly competitive environment it is certainly in the interest of the restaurant to give the customer what he or she wants, especially something so simple and straightforward as a cover charge or a service charge. If consumers want it, one will get customers by printing on the menu in large letters for all to see, "Menu £25, no further charge required or accepted". My view is that if it does not suit The Ivy, for example, to do that, it is up to them to decide and to risk losing their clientele, but that is hardly likely. It is for them to decide that and not for us as legislators.
That takes me to the crux of the matter, which is information. A good example is provided by the best of guides, The Good Food Guide, published by the Consumers' Association. In our present area of discourse it does exactly what is required and what is most helpful. It gives a clear indication of the restaurant's price range, its position as regards service and cover charges. It tells one about the dreadful practice of leaving credit or direct debit slips open when service has already been levied. In other words, it does exactly the job that ought to be done.
That takes me to the Price Marketing (Food and Drink on Premises) Order 1979, which has been referred to. I do not believe that that has been superseded by Part III of the Consumer Protection Act 1987, but I do believe that Sections 20(1) and 26 of that Act are important supplements to the earlier order, together with the Code of Practice for Traders on Price Indications published by the Minister's department in November 1988.
My own view is that it is transparency that is required and that the existing legislation, if enforced, protects the consumer while not interfering unnecessarily in the way in which restaurants conduct their businesses. I believe that the noble Viscount, Lord Mountgarret, made that point earlier.
In that connection, it has been alleged that, although restaurants disclose fully all prices before the customer enters the eating area, which is what they are required to do under the price display order, their actual menus are different. My experience does not bear that out at all. The menus that I am given in the places to which I go are precisely what was in the window before I stepped into the restaurant.
At this point, I must mention another matter which is important but which the noble Earl's Bill ignores. Section 5 of the price marking order requires the display of wine prices. Most restaurants, including the Savoy, do not meet that obligation although it is a legal requirement. The trading standards departments with which I have been in contact—for example, the excellent department in North Yorkshire—do not seem to enforce that requirement rigorously. I believe that not infrequently when the restaurant bill is larger than one expects, the reason is the obvious one: you have ordered more and better wine than you had intended. I believe that consumers must bear the consequences of their own actions in this regard as long
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as they have not been misled. However, I would welcome the Minister's comments on the enforcement of Section 5, the wine section, of the price marking order.
Perhaps I may now turn to the problem of open credit card slips. I agree with all noblte Lords that that is an outrage. I am told by my legal advisers, however, that restaurants which levy a service charge and then leave open the credit card slip are almost certainly committing criminal deception. The noble Lord, Lord McConnell, who is versed in such matters alluded to that. If restaurants are committing criminal deception, we may not need new legislation; we merely need to enforce the criminal law and someone should bring a test case, perhaps backed by the Consumers' Association or the NCC. However, I may be naive on this matter and perhaps we need a straightforward ban on that unattractive practice. Again, since the Minister has all the legal expertise that I lack, I should welcome his guidance and advice on the point.
I have two points to make about tips and pay. First, as other noble Lords have said, it is the role of management to ensure good quality service first by recruiting good quality staff and then by paying them appropriately. Secondly—this is my only political point—the way to deal with low pay (which arises from excessive bargaining power on the part of the employer relative to the employee) is to introduce a statutory minimum wage. A restaurant which cannot survive except by paying very low wages to its staff deserves to go out of business. Of course, I appreciate that there is occasionally malpractice. The case of Burger King, owned by Grand Metropolitan, appalled all of us. It was an abuse of managerial power, but I have not heard that any managers have been fired. Cases of malpractice are not unique, but abolishing tipping has nothing to do with that kind of malpractice.
As we are on the subject of occasional malpractice, I should add that I was shocked by the television programme late last year which showed clear-cut cases of violence against junior staff being perpetrated by senior staff in some restaurants. Again, does the Minister know of any impending prosecutions by the police in relation to those instances of criminal or common assault? It is a very serious matter.
To conclude, all of this depends on the view that one takes of the consumer on the one hand and competition on the other. The state has a role to ensure transparency—full information—and to prevent the exercise of undue market power, but it is not the role of the state to impose uniformity on this sector or, for that matter, any other. I, for one, believe that the consumer can be trusted. That is not to say that all restaurant experiences are satisfactory. I believe that the noble Earl referred to his wife having such an experience and I could bore your Lordships with many tales of how I have been poorly treated in one restaurant or another.
Even though a restaurateur is subject to great competition, I am always puzzled as to why he sometimes goes out of his way to annoy his

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customers. When that happens, my answer is simple—again, the noble Viscount, Lord Mountgarret, made the point—I just do not go back. I am under no obligation to go to any particular restaurant, or any restaurants at all. I write off the bad experiences. I go further and tell my friends accordingly. Consumers generally can and should do the same. Therefore, although as a matter of courtesy we give the Bill a Second Reading, I hope that that will be the last we see of it.
11.10 p.m.
The Minister of State, Department of Trade and Industry (Lord Fraser of Carmyllie): My Lords, I have listened to the debate with great interest. My noble friend Lord Bradford has been an admirably persistent campaigner for all-inclusive pricing in restaurants over a long period. I begin by congratulating him on his tenacity. It has been all too clear during the debate that some of the points he made struck a chord with many noble Lords, not least my noble friend Lord Montgomery and the noble Lord, Lord McConnell.
First, perhaps I may congratulate the noble Viscount, Lord Thurso, on his excellent maiden speech. He revealed great experience of the industry and made a number of usefully perceptive points. At the same time, while opposing the principle of the Bill, he skilfully eschewed a tone of controversy which might otherwise have been unacceptable in a maiden speech.
Perhaps I might similarly congratulate my noble friend Lord Phillimore. In some respects, while his speech was equally excellent, he had an easier task because he supported the principle of the Bill. He admirably expressed that irritation which we have all experienced of being subjected to an ill-defined pressure to leave a tip when the service has not warranted a penny of appreciation, although we have been uncertain whether a charge appearing ultimately on the bill is one which was declared openly some hours previously when the meal was first ordered. As he put it, for a variety of reasons recollection of what was on that menu might have become somewhat dimmed. It Was a useful pair of maiden contributions, and I congratulate them both.
As your Lordships will be aware, the Government have acknowledged on a number of previous occasions, as I do now, that the variation of practice in how restaurants and similar establishments choose to set their prices can, in the absence of clear indications, at times be confusing. But that is not in itself a reason to put in place further regulation in the form of primary legislation.
To prohibit service and cover charges, as is proposed, would restrict restaurateurs' freedom to run their business in the way they believe will best enable them to maximise their custom and provide their clientele with an effective service. I believe, as the noble Lord, Lord Peston, said, from the consumer's point of view that competitive forces would soon see off those businesses with, if I may put it this way, too greedy an appetite for profit.
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I enjoyed the speech of my noble friend Lord Lindsey, but wish that he would reveal to us just how long it was the restaurant in which he invested his hard earned money survived, given the quality that was offered. My main concern is what would be the impact of obligatory all-inclusive pricing on the general level of meal prices.
My noble friend Lord Bradford may have noticed an article in today's Evening Standard which takes up the point of pricing. It has the apposite headline, "Just tip the taxman". That is a point upon which the noble Lord, Lord Cadman, dwelt. I fear that it would necessarily follow that if the Bill were to be implemented, VAT on a service charge included within a single total would, as a matter of law, be required. Inevitably, that would sooner or later be passed on to the consumer.
That is not the only matter. There is also the question of transparency. Whereas now service and cover charges must be clearly stated if they apply, my noble friend's proposals—this may not be what he intends—would have them hidden in one single overall figure. It would thus become more rather than less daunting for consumers to withhold a percentage of the bill if they considered that they had received poor service. Even if in law—and that is an interesting question—they were entitled to withhold a service element having regard to the poor quality of the service received, what would he the percentage to be withheld? Is it to be 8 per cent., 10 per cent., 12.5 per cent., 15 per cent. or in smarter restaurants 25 per cent.? Unless that too were specified, I do not know how the matter would be handled.
What matters, of course, as for any other commodity or service, is that consumers are not misled over what they must pay and can therefore make an informed choice on where to place their custom. General and specific legislation to achieve those objectives is already in place.
An order which requires menu prices to be displayed at restaurant entrances and any compulsory additional charges also to be displayed at least as prominently as the menu prices has been in effect since 1979. Additionally, Part III of the Consumer Protection Act 1987 makes it an offence to give consumers a false or misleading indication as to the price at which virtually any goods or services are available. That Act also empowers the Secretary of State to make regulations on how price indications may be given. The fact is therefore that consumers already have to be made fully aware of what they will have to pay for their meal before they enter the restaurant and place their order.
There is no legislation governing optional charges, but a code of practice approved by the Secretary of State for Trade and Industry under Part III of the 1987 Act recommends that such charges should not be included in bills presented to customers. While a breach of this code is not in itself an offence, a departure from its recommendations may be used to support the prosecution of a false or misleading price indication under the Act.
The Government have twice in recent years reviewed the case for specific regulation on service charges. In February 1993, my noble friend Lady Denton of

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Wakefield announced that she was not convinced that further legislation would make an effective contribution to solving the problems that can arise over payment for service. She was responding to a report on the issue by a working group of relevant interests from the Monitoring Committee on Misleading Price Indications which the Government had appointed in 1989 to review the operation of Part III of the Consumer Protection Act. My noble friend's view was that it was better to rely on consumer common sense and to encourage best practice within the trade.
My noble friend Lord Strathclyde took the same view when a subsequent proposal to abolish service charges was made in another place in February 1994. I too share those views, while noting again that the power to regulate is already available for use under the 1987 Act should sufficient evidence emerge to justify further controls.
My noble friend Lord Bradford has drawn attention to the survey by the Consumers' Association reported in a recent edition of Which? magazine. This suggested a high level of confusion among people who eat out about what cover charges are for and about their rights to refuse to pay for service. A high proportion of those interviewed were reported to favour abolishing cover charges and either including service charges in meal prices or not allowing an extra charge to be added for service. I do not believe that those findings can be dismissed immediately. But given the confusion that exists as to whether service charges can or cannot be objected to, I wonder whether there is not a greater ambiguity in those findings than is claimed for them. Certainly the fact is that:, despite regular airing over the past three or four years of the issue, the apparent concern revealed in Which? has not been reflected in evidence of consumer dissatisfaction reaching the DTI and particularly pointing to the solution offered by my noble friend. Therefore, while I do not set aside what has been indicated as a matter of concern, I remain to be persuaded that the proposal advanced does indeed meet the not very well expressed concerns that the general public may have.
I should tell the noble Lord, Lord Peston, that, as he implied, the 1979 order does require. wine prices to be indicated. I do not have the knowledge of the same fine restaurants that the noble Lord frequents to know how well that is followed through, but the law is certainly sufficiently clearly stated.
Perhaps I may also deal with the matter of the open credit card. It is really quite difficult to give a simple answer in that respect. If the matter is simply left open—that is, effectively, leaving the customer in exactly the same position—where a service charge has been imposed and he wishes to give a further charge, that is entirely a matter for him. However, if the waiter, when asked whether a service charge has been included, denies it, or if he should actually add in a figure after the credit slip has been signed, it would seem to me that it is not difficult to envisage a number of offences at common law arising.
I shall now turn to the proposals put forward by my noble friend for amending Part III of the Consumer Protection Act 1987. By defining as misleading for the
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purposes of the Act price indications which indicate a separate service or cover charge, Clause 1 of the Bill would, in effect, prohibit such indications. The Long Title of the Bill confirms that that is the intention.
The purpose of Part III of the Act is to achieve transparency in price indications across all goods and services. It would surely be contrary to That aim—which would seem to be desirable—to prohibit a type of price indication which explicitly advises a consumer whether or not, as the case may be, a service or cover charge is included. That would seem to me to be perfectly clear and not at all misleading. So I would be concerned that the effect of Clause 1 would be to reduce transparency and clarity. I believe that that was exactly the point that my noble friend Lord Mountgarret made in his speech.
A second point of importance is that the clause would change the scope of Part III of the Act to introduce provisions which relate to a specific sector. That would be undesirable, in that it might cast doubt on the continued general application of Part III of the Act to all price indications.
I referred earlier to the power which Parliament gave to the Secretary of State under the 1987 Act to make regulations relating to the circumstances and manner in which price indications are given. If my noble friend's Bill were to proceed, it would override that discretion. Although the Secretary of State has not seen it as necessary to use that power in respect of service charges, were he to do so, he would be under a statutory obligation first to consult the Director-General of Fair Trading and other parties. The proposal would circumvent that requirement.
These are fundamental objections and not simple technical details that could readily be resolved. However, other aspects of the Bill also give rise to concern about how much attention has been given to its drafting and the consequences that it would have. For example, in Clause 1, it is not clear whether,
"a separate charge for the service of food or drink",
would include the entire provision of the food or drink or simply the service actually at the table. In the latter case, the way would still be clear to make a separate charge for the preparation. Similarly it is not clear whether it would be possible to charge for entertainment.
If your Lordships have an objection to sloppy waiters, I am sure I shall unite noble Lords when I say how much I detest singing waiters. If one were entitled to impose a charge for a singing waiter, a dancing waiter or, as I have once been exposed to—horror of horrors—a roller skating waiter, it would seem to me that the valid concern that my noble friend has would in large measure be sidestepped.
Clause 2 of the Bill also contains what I consider to be a number of other defects, but given the time of night it might be acceptable if I were not to spell those out, but I consider they are real ones. The principal objection that I have is the way it is drafted. If there were to be a breach of the code of practice referred to under this provision, the clause of itself would not provide for an offence and accordingly the legal certainty which one would presume was intended would not be achieved.

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This has been a useful debate. It has spelled out a number of concerns that are undoubtedly felt across the community and a wide range of views have been clearly and usefully expressed. However, for the reasons that I have spelled out, not least the problems that I see about transparency and the deprivation of choice that would be imposed—while I would hope, as the noble Lord, Lord Peston, said, that the normal courtesy of your Lordships' House would be extended to this Bill in relation to a Second Reading—I have to say that it is not a Bill that I can wholly recommend to your Lordships.
11.26 p.m.
The Earl of Bradford: My Lords, I realise that we have arrived at a rather late hour so I shall try to keep my comments reasonably brief. The purpose of this Bill is essentially to simplify the situation and to avoid confusion. I shall explain a little about tipping. Originally this was a reward for excellence. It has now become the norm. I think it should return to being a reward for excellence. The service charge should be done away with; it is an anomaly.
Various noble Lords have mentioned the situation in America—the land of great and free tipping. Now the service charge is creeping in there. Surely that is the thin end of the wedge. Does that not indicate the right way forward for us to take here? As regards cover charges going out of existence, that is not happening. At lunchtime only today my wife went to a restaurant where a £2.50 per head cover charge was imposed. If a service charge is added to that, too, it can represent a considerable extra charge. I personally cannot see why that should not be absorbed into the cost of other dishes on the menu. It seems a ridiculous anomaly in this day and age.
Also we should recognise that in the main we tend to be rather more sophisticated as regards the matter we are discussing. I would love to be the guest of the noble Lord, Lord Peston, at any of the restaurants he mentioned tonight. However, that is very much the top end of the market where the clientele tend to be rather more sophisticated and understand in advance what they are going to be charged. We must remember the visitor to London, both foreign and British, as was mentioned by my noble friend Lord Mountevans. Those visitors look to advertisements, which seldom give any good guide as to prices in the restaurant, and then they look at the menu outside the restaurant. I certainly experienced quite recently what my noble friend Lord Mountgarret referred to as the cowboy phenomenon. Appropriately, that was in a steakhouse. There the restaurant had managed to cover up the indication of the cover charge and the service charge with the menu of the day. That was not only on one menu board outside the restaurant but on all three. One did not realise until one was inside the restaurant.
Lord Peston: My Lords, is the noble Earl aware that that is illegal? It may be done, but it is illegal.
The Earl of Bradford: My Lords, I fully accept that it is illegal, but unfortunately all too often it happens.
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Tourists are not as sophisticated as we are and they are totally confused by different practices in different restaurants, as has been demonstrated in our discussion tonight.
Extremes exist all round the world. In Japan there is no tipping at all. Australia does not have a tradition of tipping, while in America the position is the complete opposite. In Europe we have moved to a position where service charges are no longer normal, and tipping—not normally only a few centimes left on the table but one hopes a few francs (and I am not sure what the currency is in Sweden)—is used to express appreciation of a wonderful meal brilliantly executed and very good service. I should like to see us return to a position where tipping is not the expected norm for the ordinary but appreciation of the exceptional.
There seems to have been some slight confusion with regard to credit card slips. I referred particularly to the fact that if charges were all-inclusive there would be no necessity to leave a credit card slip open. I abhor the practice whereby a service charge is made by a restaurant and the credit card slip is left open. Equally, where no gratuity has been charged to the customer and it is left to the customer's discretion as to whether he wishes to leave a tip at the end of the meal, I believe that it is acceptable to leave the credit card slip open, as long as the customer fully understands where he stands.
I find it very sad that a committee of the catering industry on which I sit which for some years has declared itself to be in favour of an all-inclusive pricing policy should recently have changed that policy and now considers that restaurants should be free to do whatever they want so long as that is made clear to the customer. How long does the customer have fully to understand what he will be charged? How many people study the fine print? Across Europe the catering industry has simplified its practices. The customers have shown themselves to be in favour of that.
I should like to end by congratulating the two maiden speakers. They expressed rather different views. The noble Viscount, Lord Thurso, gave us the benefit of his experience working at the upper end of the trade. My noble friend Lord Phillimore gave us the customer's view and referred to what was reflected in the recent Which? survey, to which we should all pay attention.
I conclude by asking the House to give the Bill a Second Reading and to allow a Committee of the Whole House to consider the positive points which it contains. I realise that changes will have to be made. While I accept some of the criticisms of the drafting, perhaps I may say that the Clerk of Public Bills was extremely helpful in putting my points into draft form. Equally, I accept criticism for anything that I may have got wrong. I realise that drafting requires expertise that I do not have. Perhaps we can put some of those points into better order on a future occasion. I ask the House to give the Bill a Second Reading.
On Question, Bill read a second time, and committed to a Committee of the Whole House.
House adjourned at twenty-six minutes before midnight.