Lords Sitting of 25 March 1999

Preamble
The House met at three of the clock (Prayers having been read earlier at the Judicial Sitting by the Lord Bishop of Lincoln.): The LORD CHANCELLOR on the Woolsack.
The Earl of Devon—Sat first in Parliament after the death of his father.

Royal Assent
The Lord Chancellor (Lord Irvine of Lairg): My Lords, I have to notify the House, in accordance with the Royal Assent Act 1967, that the Queen has signified her Royal Assent to the following Acts:

Consolidated Fund Act,

City of Westminster Act.

UNHRC: Iran Resolution
Lord Avebury Lord Avebury asked Her Majesty's Government:
What issues concerning Iran they intend to raise at the United Nations Human Rights Commission.
Baroness Ramsay of Cartvale: My Lords, the European Union is again sponsoring a resolution on Iran at the UN Commission on Human Rights in Geneva, which is currently taking place until 30th April. The Government are ensuring that it will cover the EU's concerns about human rights in Iran, for example, on freedom of expression, women's rights and the situation regarding the Baha'is as well as the recent improvements under President Khatami.
Lord Avebury: My Lords, I acknowledge, as does the special rapporteur, that some progress has been made towards President Khatami's goal of a civil society based on the rule of law. However, will the Minister ensure that, apart from the matters she has mentioned, which certainly ought to go into any resolution before the commission, the resolution also deals with the recent murders of intellectuals, the need for open trials of those who have been charged as responsible for those crimes by the Ministry of Intelligence and Security, the killing of peaceful demonstrators—14 people in Sanandaj and one in Orumiyeh—in the recent demonstrations in Iranian Kurdistan, and the point the special rapporteur makes on the rights on minorities?
Baroness Ramsay of Cartvale: My Lords, yes, I mentioned only two or three of the well known, long-standing and outstanding issues with Iran. We shall be addressing the issues mentioned by the noble Lord. We were encouraged that in relation to the recent
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murders of intellectuals and dissidents, 10 officers of the Ministry of Intelligence and Security have been arrested. We shall watch the outcome of that most carefully.
Baroness Rawlings: My Lords, what progress have the Government made in halting the torture, amputations and stonings condemned by the United Nations Commission on Human Rights last April? What specific discussions on that subject has the Foreign Secretary had with his Iranian counterpart, Dr. Kharrazi, and what action do the Government intend to take at this year's Human Rights Commission to protest against human rights abuses in Iran?
Baroness Ramsay of Cartvale: My Lords, as I indicated, the European Union is drafting a resolution to put before this year's United Nations Commission on Human Rights. The noble Baroness mentioned last year's resolution. We have taken every possible opportunity in dialogue at every level with the Iranians to express our strong disapproval of the use of the death penalty and the inhumane treatment of those arrested or not that we know has been taking place in Iran.
Under President Khatami and his government, elected in May 1997, there have been small improvements and we must all do everything we can to encourage them. However, we admit that there is a long way to go.
Baroness Williams of Crosby: My Lords, I fully recognise what the Minister said about the serious failures in human rights which still continue in Iran However, does she agree with these Benches that the: recent local government elections in Iran, which brought a substantial number of women and minorities into elected positions, are an encouraging step forward and that it is in the interests of Her Majesty's Government to support the proposals of President Khatami, given that he faces strong opposition within his country to carry them out?
Baroness Ramsay of Cartvale: My Lords, I agree wholeheartedly with the noble Baroness, Lady Williams. She was right in everything she mentioned. The local elections, which took place on 26th February and brought an encouraging representation from successful candidates among women and ethnic minorities, were the first ever local elections in Iran. That is definitely a step in the right direction.
Lord Pearson of Rannoch: My Lords, the Minister twice mentioned the European Union in her answers. Can she tell the House to what extent the United Kingdom still has an independent foreign policy in this matter, if indeed it does?
Baroness Ramsay of Cartvale: My Lords, we have a completely independent foreign policy on all our bilateral relations with countries such as Iran. I am sure that the noble Lord is aware that since 1992 the EU has followed a common foreign policy towards Iran, using a combination of critical engagements and trading links

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to try to influence Iranian behaviour. Any grouping which can increase the power of influence on events such as those in Iran is surely good.
Lord Avebury: My Lords, did the noble Baroness observe that the special rapporteur noted with deep regret the increase in the bounty offered by the XV Khordad Foundation for the murder of Salman Rushdie? Does she believe that that is contrary to the spirit of the Cook/Kharrazi agreement, and should be characterised as such in the resolution of the commission?
Baroness Ramsay of Cartvale: My Lords, yes. Dr. Kharrazi made his government's position on that bounty very clear; he dissociated them from it completely and they do not support it.

The Times: Pricing Policy Inquiry
3.8 p.m.
Lord Razzall: My Lords, on behalf of my noble friend Lord McNally, and at his request, I beg leave to ask the Question standing in his name on the Order Paper.
The Question was as follows:
To ask Her Majesty's Government when they expect to receive from the Office of Fair Trading the results of the inquiry into the pricing policy of Times Newspapers.
The Minister of State, Department of Trade and Industry (Lord Simon of Highbury): My Lords, the decision to undertake an inquiry into the pricing policy of The Times newspaper was taken independently by the Director-General of Fair Trading. It is a matter for him low and when he makes his findings public. I understand that the director-general continues to make good progress with his inquiry. He will announce his decision as soon as possible.
Lord Razzall: My Lords, will the Minister accept hat my noble friend Lord McNally would regard that as a somewhat disappointing Answer? Initially his request for an inquiry was resisted on the basis that there was no case to answer. The Minister then promised a report by 28th February, and we are now told that it is progressing satisfactorily. Does he agree that that is an unsatisfactory response? Does he also agree that the issue is less about the behaviour of Times Newspapers and more about the creditability of the OFT? Does he further agree that that supports our case that newspapers need special legislation?
Lord Simon of Highbury: My Lords, in trying to reply as appropriately as I can to transferred disappointment, perhaps I may say that the response is to a complex question. On the last occasion I was at the Dispatch Box, I gave the best indication that the inquiry would be completed by February. We are now into March and I have said that the director-general will
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announce his decision as soon as possible. I believe, without any doubt, that the matter is being attended to in the appropriate way.
Lord Borrie: My Lords, has the Minister been able to consider further the suggestion that I made to him on the last occasion this question was raised; that is, whether the enhanced investigative powers of the Director-General of Fair Trading, contained within the Competition Act 1998, should be implemented as soon as possible so that they can apply to all such inquiries as the one being conducted at present?
Lord Simon of Highbury: My Lords, I thank my noble friend for that question. I am glad he returned to it. We have, indeed, followed up the point that he made. I can confirm that the enhanced investigatory powers to which he refers will be put into place—particularly in relation to the Fair Trading Act, as that is existing legislation—on 1st April 1999. That would not be applicable to this inquiry because all the data required by the director-general are in place. However, it will certainly enhance his investigatory powers as regards any future inquiry.
Lord Hooson: My Lords, the noble Lord referred to "a complex question" raised by this matter. Can he identify, for the benefit of the House, what is complex about it?
Lord Simon of Highbury: My Lords, I believe that this is the fourth time that the matter has been brought to the attention of the director-general and, effectively, no case has been found. That means that it is not a simple matter. There must be additional information and new circumstances to bring the case again. The director-general has been looking at both those matters with care. He required a great deal of information. As we stated when we last discussed the matter in the summer, he would need a great deal of extra information to ensure that the complexities were well understood.
Lord Acton: My Lords, how long has the inquiry taken and how long did the previous three inquiries take?
Lord Simon of Highbury: My Lords, this inquiry started at the beginning of last year. It has now been running for just over a year. I shall let the noble Lord know the timing of the previous inquiries. It was before my period of office so I shall need to look up the detail.

UK Military Communication Satellites: Security
3.12 p.m.
Lord Chalfont Lord Chalfont asked Her Majesty's Government:
Whether the security of the computers on board the United Kingdom's military communication satellites is adequate.
Lord Hoyle: My Lords, I can assure your Lordships that the United Kingdom's military communication

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satellites are secure. Control of the satellites is effected through secure radio links, and all associated terrestrial communications are secure and separate from any publicly accessible communications system. The security of the on-board computers is therefore ensured. Nevertheless, we keep our security arrangements under constant review to ensure that they remain effective.
Lord Chalfont: My Lords, I thank the Minister for that reassuring reply. Will he reassure the House a little further by saying that the reports—which first appeared in the British press at the end of last month, and subsequently in the international press—that the computers on board a British military satellite had been illegally accessed by what are known as "hackers" who had shifted the military satellite out of its orbit are without foundation?
Lord Hoyle: My Lords, I note the noble Lord's concern about our security. I am aware of the press reports. However, as far as we are aware there is no foundation in such reports. I can confirm that there has been no unauthorised access into the United Kingdom's military communication satellite system. That system is monitored continuously to ensure that there is no possibility of the system being attacked without our knowledge.

Immigration and Nationality Directorate: Computer System
3.14 p.m.
Lord Dholakia Lord Dholakia asked Her Majesty's Government:
When they expect the computer system in the Immigration and Nationality Department of the Home Office to work satisfactorily, and what interim arrangements are in hand to deal with the backlog and the situation of those whose immigration and asylum status is uncertain.
The Minister of State, Home Office (Lord Williams of Mostyn): My Lords, we regret the recent disruption to the Immigration and Nationality Directorate's caseworking operation during the first phase of the casework programme, a private finance initiative partnership with Siemens Business Services. The current plan is for the full computer system to be made available for testing in June and rolled out by early 2000. We have set up a joint team with Siemens Business Services to recover the previous level of service and catch up on the backlog which has developed. The applicant's status is protected where an application is made before expiry of permission to stay.
Lord Dholakia: My Lords, I thank the Minister for that reply. Does he accept that at a time when the Immigration and Asylum Bill is being debated in another place we now have a backlog of over 200, 000 cases; the files are stored in garages, which are unsafe and those files cannot be located; people queue at the Immigration and Nationality Directorate from four o'clock in the morning, and applicants are advised that
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they can apply to their embassy for new passports because theirs cannot be located? Does the Minister agree that there is an urgent need to build up applicants' confidence in the system? Would he therefore undertake to issue regular briefings to the newspapers about the progress made, explain to applicants the procedures for claiming compensation from the Government, and not to take action against those in breach of their immigration status through no fault of their own?
Lord Williams of Mostyn: My Lords, the noble Lord raises points of validity. The figures I have are not the figures he gave. They are still not good figures, by any stretch of the imagination. On 19th March, which is the most up-to-date material I have for your Lordships, there were 125, 165 cases waiting to be decided. Of those work-in-progress cases, 67, 000 were asylum cases. In the Case Allocation Unit there were almost 10, 000 asylum cases, making a total of 76, 853 asylum cases. So, it is not a good story by any means.
We give regular press briefings which I believe are of assistance. We propose to continue those regularly. As regards compensation, it has always been the practice that we consider ex gratia payments in individual cases if there is full supporting evidence to show actual and necessarily incurred additional costs. As to the third matter raised by the noble Lord, I appreciate that this is a matter of great concern. No applicant should be disadvantaged by the changes we are in the process of making.
Lord Janner of Braunstone: My Lords, does the Minister agree that the present situation is absolutely deplorable? It is of benefit to those who have no right to asylum in this country, including some villains, but it is awful for genuine, honest asylum seekers who are entitled to asylum under our law and by all the laws of decency of this honourable land. What steps will be taken to deal with the matter even more speedily? Surely, the situation should never have arisen. Now that it has, we are not dealing with it fast enough.
Lord Williams of Mostyn: My Lords, I agree that the situation should never have been allowed to arise. I have made it brutally plain that I regard it in the same way as noble Lords who have already contributed to this Question. On 15th March we set up a joint taskforce, which I outlined a moment ago, and which is to report by mid-April. This contract was let to Siemens Business Services in April 1996. We are therefore attempting to deal with an inherited situation as promptly and as fairly as we can.
The Earl of Onslow: My Lords, as the noble Lord has admitted that something ghastly has happened and as it does not matter whether the arrangement was set up by the Tory government or by the present Government, can he please say that the heads of those who made the mistake will roll?
Lord Williams of Mostyn: My Lords, it is a novel constitutional doctrine of governmental and ministerial responsibility that it does not matter whose fault it was.

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I imagine that that might be of some comfort to me in the months to come. A National Audit Office investigation has already gone into this matter with great care. Undoubtedly, mistakes were made, but I do not feel able to point to a single individual who needs his head removed in the way that the noble Earl has suggested.
I think that we both agree that the important point is that this situation should never have been allowed to develop. It is not satisfactory conduct of public administration. We are doing what we can to remedy the situation—I have been as plain as I can be about it—but it will take time, and I am sorry for that.
Lord Clinton-Davis: My Lords, is it not a fact that heads rolled massively on 2nd May 1997? Having inherited this situation, does my noble friend agree that speed is clearly of the essence and that the House will be reassured by what the Home Office is doing at present? However, is it not regrettable that it seems to be implied that the overwhelming majority of asylum seekers are bogus, but that is not true and the people who are here, awaiting the determination of their cases, are entitled to respect rather than being subject to such inferences?
Lord Williams of Mostyn: My Lords, I agree absolutely that anyone who is applying for asylum in a foreign jurisdiction is entitled to decent, civil and civilised treatment. It is taking time to put this matter right—I have given the dates. Although we hope to have the computer beginning to work properly by June of this year, it will be the early part of the year 2000 before the scheme is properly rolled out.
Lord Meston: My Lords, can the Minister say how many children are affected by this problem and whether steps are being taken to give priority to cases involving children?
Lord Williams of Mostyn: My Lords, I cannot do that, but I can give the figure for general and settlement cases: there are 15, 000 work-in-progress cases and 13, 500 in case allocation, making a total of 28, 500 general and settlement cases. I believe that that gives part of the answer which the noble Lord is seeking. If I can obtain further material on this, I shall send it immediately to the noble Lord and place a copy of my letter in the Library.
The Countess of Mar: My Lords, perhaps I may declare an interest as a lay member of the Immigration Appeal Tribunal. I have two questions for the Minister. First, was there a penalty clause in the contract with Siemens and, if so, will it be invoked? Secondly, I understand that as the new computers will not be working until early next year, there may be problems with the existing computer system and the millennium bug. Can the Minister give us some assurances on that because we seem to have lost enough cases already?
Lord Williams of Mostyn: My Lords, the computer system will be year 2000-compatible. To answer the
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first question from the noble Countess, the contract which was let in April 1996 does not include penalty clauses for late delivery or failure of the system to meet specifications. There is a provision for financial penalties if Siemens is unable to maintain satisfactory levels of service. However, in respect of the distinct question put to me by the noble Countess, there was no penalty clause for late delivery.
Baroness Ludford: My Lords, is it not a fact that the Government's promise of a fairer, firmer and faster asylum policy is in tatters, with the combination of a huge backlog of cases and the unworkable voucher system? It is a bureaucratic mess which is unfair on applicants, more expensive than it need be for taxpayers, and mean towards destitute asylum seekers. Will the Government change their mind on the Immigration and Asylum Bill which incorporates some of the worst features of the existing system?
Lord Williams of Mostyn: My Lords, the Immigration and Asylum Bill has not yet become law. The Government's policy is not in tatters. The White Paper was generally well received as a long-overdue, fundamental review of a system which is presently a shambles. We want to be firmer, fairer and faster. I believe that when that Bill passes through your Lordships' House—to general acclaim, I dare say—we shall have an asylum and immigration system which is capable of working fairly, firmly and efficiently.
Lord Mackay of Ardbrecknish: My Lords, with reference to the question asked by the noble Lord, Lord Clinton-Davis, can the Minister remind the House what percentage of applicants are found to deserve the right of asylum, what percentage are found to deserve the right of exceptional leave to remain and therefore, by subtraction, what numbers of applications are at best unfounded and at worst simply bogus?
Lord Williams of Mostyn: My Lords, I do not have those figures to hand—
Noble Lords: Oh!
Lord Williams of Mostyn: My Lords, perhaps I may continue. I have given those figures on previous occasions. I shall write again to the noble Lord so that he may have the satisfaction of making such point as has merit.
Lord Cope of Berkeley: My Lords, is it not the case that although the Minister was accurate in what he said about the penalty clause in response to the question from the noble Countess, Lady Mar, Siemens will be paid mainly by reference to the savings to the department in question, when those savings are made? As well as the computer problems to which reference has already been made, are there not also simultaneous and enormous problems arising from the decision, which incidentally was taken after the election, I believe, to move some hundreds of thousands of files to Croydon, many of which were lost on the way, which is why documents

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relating not only to asylum seekers, but to businessmen and other visitors—I refer to their passports—have been lost somewhere between Lunar House and another building in Croydon?
Lord Williams of Mostyn: My Lords, Siemens Business Services has certainly incurred higher costs as a consequence of what happened with regard to the computer programme delivery and it has received less income than would otherwise have been the case. The noble Lord is right that the problems are not limited only to asylum cases. I tried to subdivide the figures earlier to make it plain that there is no such limitation. The noble Lord is also right that about 1, 000 staff and 150, 000 files were subsequently physically relocated. In conjunction with the computer problems, I say again (for perhaps the fourth or fifth time) that that relocation caused serious problems which should never have been allowed to come about.
Lord Archer of Sandwell: My Lords, can my noble friend assure the House that asylum seekers who, through no fault of their own, are awaiting determination will not be left destitute in the meantime?
Lord Williams of Mostyn: My Lords, no applicant will be disadvantaged by the changes that we are in the process of making. I made that plain in answer to the noble Lord, Lord Dholakia. Any asylum seeker, or anyone who has a right to the assistance of the state, will continue to benefit, irrespective of the problems that I have described.
Lord Avebury: My Lords, will the Government publish a comprehensive reply to the report by the Comptroller and Auditor-General? In the meantime, have they anything to say about the recommendation that the Government should consider whether awarding such very large contracts in one lump (amounting to £77 million, I think) is a sensible policy, and whether the department had sufficient resources to manage a project of that magnitude? As so many large contracts entered into by government for the provision of computer services come unstuck—this is the latest of about five such instances—does not the noble Lord think that that recommendation should be taken particularly seriously?
Lord Williams of Mostyn: My Lords, speaking for myself and for the department, I believe that any comments, criticisms or recommendations made by the National Audit Office should be given the most careful and scrupulous attention. Indeed, the great benefit of that report was that it sought to draw out lessons for future private finance initiatives. I believe that there are lessons to be learned. It is foolish to pretend the opposite. I hope that we shall endeavour to learn those lessons.
Lord Walpole: My Lords, as a matter of clarification of the second question that my noble friend Lady Mar
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asked, is the existing system millennium-proof or not? Did the Minister indicate that the future system would be millennium-proof?
Lord Williams of Mostyn: My Lords, I said that the computer system, which is to be in existence when the millennium is upon us, is 2000 compatible.
The Earl of Sandwich: My Lords, is it the Government's intention to move more hearings for asylum seekers outside London and, if so, will that not cause many problems for legal advisers and the asylum seekers themselves? Will it not slow up the whole process?
Lord Williams of Mostyn: My Lords, it should not slow up the process. If one looks at the way it works at the moment, on some occasions the lists may be overfull in the London area, but with spare adjudication capacity outside London. If one has spare capacity and one wants speedy, efficient and fair determination, one ought to use that spare capacity.
Earl Ferrers: My Lords, may I assist the noble Lord, Lord Williams of Mostyn, by asking whether he is aware that, if my memory holds correct—and it may well not—of 100 applicants for asylum only about 17 are shown to be proper and appropriate applications and not the majority, as his noble friend Lord Clinton-Davis suggested?
Lord Williams of Mostyn: My Lords, bearing in mind the consistently cordial relationship that the noble Earl and I have, I know that he was intending to be helpful. I know that his memory is infallible and therefore he may well be right. However, I do not have the figures in front of me and it would be wrong of me to pretend that I have them.
Lord Cope of Berkeley: My Lords, in considering the National Audit Office report, should not noble Lords bear in mind that it found that the procurement was managed in a businesslike way at the start and that the contract still offers high net benefits?
Lord Williams of Mostyn: My Lords, that is what the National Audit Office said, subject to satisfactory delivery.

Local Government Bill
3.31 p.m.
Brought from the Commons; read a first time, and to be printed.

Business of the House: Debates this Day
Lord Carter: My Lords, on behalf of my noble friend the Leader of the House I beg to move the Motion standing in her name on the Order Paper. In doing so I hope that the House will find it helpful to know that the

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Speakers' List for the debate on the situation in Kosovo will remain open until 4 p.m. in the Government Whip's Office.
Moved, That Standing Order 38 (Arrangement of the Order Paper) is dispensed with so far as is necessary to enable the Motion standing in the name of the Lord Gilbert to be taken after the Third Reading of the Health Bill. —(Lord Carter.)
Lord Strathclyde: My Lords, the House will know that on Monday and Tuesday of next week we are dealing with the Second Reading of the Bill to reform your Lordships' House. Before there is a howl of protest from noble Lords opposite, this is not a ploy to delay the passage of the Bill. The date of the first day in Committee has already been fixed.
Before coming into the Chamber I checked on the number of speakers. There are now about 180 Members of your Lordships' House who wish to play a part in the debate. Furthermore, it has been announced that there is to be a Statement on Monday afternoon on a report on the Berlin summit. There is every possibility and likelihood of there being further government Statements including one on Kosovo.
It is also my understanding that the House should rise at 11 o'clock on Monday because the House sits at 11 o'clock on Tuesday morning. There is a convention that allows the staff who serve this House to have a 12-hour break between the two Sittings. In view of that fact it is unlikely that we shall be able to listen to more than 60 or 70 speakers on Monday. That means that even though we are starting the debate at about 11.30 on Tuesday, there will be between 110 and 120 speakers to be heard on Tuesday. We could be sitting into the small hours of Wednesday morning. Every extra minute that Peers speak will add another two hours to the debate.
It has also been brought to my attention that there is a very small number of speakers for the balloted debates on Wednesday. I would like to test the Government Chief Whip's mind and offer him two alternatives; either we sit again on Wednesday morning for two or three hours in order to complete the Second Reading; or the Government find an alternative time for the balloted debates when we return after Easter and devote that time to finishing the Second Reading.
I do this in a spirit of helpfulness and it is a genuine inquiry. I have been approached by many Members on my side of the House who wonder why we must sit so late on Tuesday when we can sit on Wednesday. As the House will know, many noble Lords have cleared their diaries for next week in order to deal with this particular issue. I very much hope that the Government Chief Whip can be helpful.
Lord Carter: My Lords, we seem to be having our usual weekly debate on the timetable for the House of Lords reform Bill. The usual channels appear to be in full spate on this matter. I have not had any requests from my own side on this subject. I am a little puzzled why noble Lords opposite feel the need to raise this
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issue. Like all Chief Whips, I have been doing some sums. If noble Lords speaking from the Front Bench do so at a reasonable length, and even allowing for a Statement on Monday as regards the Berlin summit, we could still rise at a not unreasonable hour on each day if the Back-Bench speakers take on average no more than seven minutes each.
Noble Lords: Oh!
Lord Carter: My Lords, that was the average time spent debating the House of Lords White Paper, and here we have a six-clause Bill. As regards Hansard it is a convention of the House, and no more than that. It has been informed that the House is likely to sit later than 11 o'clock on Monday night. We have sat into the early hours of the morning this week. It was after two o'clock and the House was able to sit again at half-past two the next day. It is a convention, but on this occasion the House will be sitting later than 11 o'clock on the first day of the Second Reading.
The two-day debate was announced at the earliest possible opportunity on the afternoon of the First Reading of the Bill. On that occasion it was also announced that the House would sit at 11 a. m. on Tuesday of next week. Thus noble Lords have known for nearly two weeks of the arrangements. A large number of noble Lords have put down their names to speak on the basis that the debate will take place on Monday and Tuesday and have planned their diaries accordingly. Many noble Lords have indicated a preference for one day over the other. Those who are compiling the Speakers' List are working to ensure that those preferences are met. Therefore, to change the arrangements now would be an inconvenience to many noble Lords who would find the day of their speech moved from Monday or Tuesday to Wednesday.
I find it a little ironic that noble Lords opposite are now asking for an additional day for this Bill in Holy Week. It seems like only yesterday that we were told by the Opposition Chief Whip and his noble friends that it was quite outrageous that a Bill of this kind should be taken at all during that week. Now they are arguing the exact opposite and that there should be more business in Holy Week rather than less.
Lord Strathclyde: My Lords, if the noble Lords is suggesting that he is willing to delay the Second Reading until after Easter, I shall be quite happy to support him.
Lord Carter: My Lords, the noble Lord can do better than that! I am merely saying that we are being asked to find another day during Holy Week when we were told only last week that it was quite out of order to have this business during that week. Now, noble Lords opposite wish to increase the time spent on this Bill by 50 per cent. during Holy Week. To put the matter in the kindest light, I find these positions rather contradictory. In addition, an amendment has been tabled to the Motion for a Second Reading. I presume that noble Lords have planned their diaries to be here on Tuesday for what is likely to be a very important vote.

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I know that we have sat late this week. That was due to an unfortunate combination of circumstances. I agree that we sat unreasonably late on Monday, but the House has risen at a progressively earlier hour each day this week and the Sittings have not been unduly burdensome. I emphasise that I have given this matter a good deal of thought and calculation. I repeat that if the House as a whole is moderate in the length of the speeches, I suggest that it will not be necessary to sit unreasonably late on Tuesday night.
On Question, Motion agreed to.

Births and Deaths Registration (Amendment) Bill [H.L.]
Lord Elis-Thomas: My Lords, I understand that no amendments have been set down to this Bill and that no noble Lord has indicated a wish to move a manuscript amendment or to speak in Committee. Therefore, unless any noble Lord objects, I beg to move that the order of commitment be discharged.
Moved, That the order of commitment be discharged. —(Lord Elis-Thomas.)
On Question, Motion agreed to.

Health Bill [H.L.]
3.40 p.m.
Read a third time.
Clause 1 [Repeal of law about fund-holding practices]:
The Parliamentary Under-Secretary of State, Department of Health (Baroness Hayman)The Parliamentary Under-Secretary of State, Department of Health (Baroness Hayman) moved Amendment No. 1:
Page 1, line 9, leave out from beginning to ("sections").
The noble Baroness said: My Lords, this large group of amendments make minor drafting and consequential amendments to the Bill. However, it is perhaps worth my spending a few moments explaining a number of them.
The changes and additions to the "Repeals" schedule (Amendments Nos. 87, 88, 92 and 93) reflect repeals made by the provisions debated and agreed at Report stage on unified budgets, the penalty charge and the repeal of the Nurses, Midwives and Health Visitors Act.
The PPRS applies to England, Wales and Scotland. Amendments Nos. 21 and 22 therefore extend the provisions in Clause 34, subsections (5) and (6) to Scotland.
Amendments Nos. 65 and 66 remove a provision in the Bill that would allow the commission to appoint its own auditors. The provisions as drafted allow for a two-tier auditing process for the commission's accounts—the first by auditors appointed by the commission and the second by the National Audit Office. These amendments remove the provision for the commission to appoint its own auditors so that the commission's accounts will be solely audited by the
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National Audit Office. This will bring the accounting and auditing arrangements for the commission into line with those for other Department of Health NDPBs. I beg to move.
On Question, amendment agreed to.
Clause 2 [Primary Care Trusts]:
Baroness Hayman Baroness Hayman moved Amendment No. 2:
Page 1, line 12, leave out from ("1977") to ("there") in line 13.
On Question, amendment agreed to.
Lord Clement-Jones Lord Clement-Jones moved Amendment No. 3:
Page 2, line 19, at end insert—
("( ) No regulations are to be made under subsection (5) unless a draft has been laid before and approved by resolution of each House of Parliament. ").
The noble Lord said: My Lords, before launching on any lengthy debate—I do not plan to do that on this amendment which has been before the House in various guises at both Committee and Report stages—and because the Procedure Committee effectively disbarred us from making comment on the passing of the Bill at the end of Third Reading, I wish to say from these Benches how much we appreciate the flexibility that the Minister has shown throughout the passage of the Bill. There were a number of instances, which I do not propose to adumbrate, where that has clearly been the case—primary care trusts, the statutory and voluntary pricing scheme to pharmaceuticals and, above all, the Clause 47 provisions regulating the professions. I should like to take this opportunity to thank the Minister for making this Bill considerably better than when it started on its course through this House.
I know the Minister and her team have tried extremely hard to fulfil all the commitments that the Minister made during the passage of the Bill through this House and it is therefore with a tinge of disappointment that I find she was unable to come back to us on Third Reading with a proposal for an equality of opportunity provision, both for primary care trusts and for the commission for health improvement. As noble Lords will know, and the Minister is only too well aware, this has strong backing—perhaps not in this precise formulation—from a wide range of sources. Noble Lords have spoken in support throughout the passage of the Bill. Also, I have before me a letter commending the provisions of this amendment to the Minister, again not in precise terms but that is the spirit in which it was written, particularly in the context of the aftermath of the Lawrence Inquiry and the fact that the Home Secretary has accepted the provisions of that inquiry.
This amendment is a further probing amendment designed to elicit from the Minister a progress report. Whether to give a specific or a general duty is not entirely clear, and that information would be extremely helpful. But it would also be useful to hear from the Minister what progress the department is making in formulating a suitable duty on primary care trusts and

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the commission for health improvement to ensure that there is a quality of access particularly to healthcare across the range of health services.
Lord Hunt of Kings Heath: My Lords, is the noble Lord speaking to Amendment No. 3 or No. 4? I rather suspect he is addressing Amendment No. 4.
Lord Clement-Jones: My Lords, I apologise to the House and am grateful to the Minister for that intervention. I do not know whether it is possible to treat this as a speech on Amendment No. 4. If your Lordships give me assent to that I shall not need to rewind the tape and we can simply re-marshal the amendments to take Amendment No. 3 after Amendment No. 4. I do not know whether the procedure of the House makes that possible. If it does, I ask your Lordships' indulgence.
Lord Renton: My Lords, perhaps I can ask the noble Lord to clarify one matter. He said that this was a probing amendment when he was speaking to Amendment No. 4. Is Amendment No. 3 also intended to be a probing amendment or an operative one?
Lord Clement-Jones: My Lords, Amendment No. 4 and its counterpart in Clause 15 are both designed to be probing amendments.
The Chairman of Committees (Lord Boston of Faversham): My Lords, intervening in the form of a Speaker of your Lordships' House, which we do not have for these purposes, perhaps I should indicate that, although the noble Lord, Lord Clement-Jones, is attempting to be helpful to your Lordships, I must call the amendments in the order in which they appear on the Marshalled List. The way in which he can continue his helpful stance, however—if I might provide a further moment of guidance—is that when Amendment No. 4 is called, he might not need to "rewind the tape".
Lord Clement-Jones: My Lords, I thank the Chairman for that helpful intervention which has got me out of a complete fix. I move therefore to Amendment No. 3, which is also designed as a probing amendment.
At both Committee and Report stages we had a discussion about consultation arrangements which would be appropriate on moving from PCGs to PCTs. The Minister said that she would carefully consider the consultation arrangements and regulations will be made setting those out. One of the problems we have had throughout Committee and Report stages is the "list" question. The noble Lord, Lord Skelmersdale, was zealous in ensuring that we did not "truck" with any lists. But the problem with that is that we cannot extensively set out on the face of the Bill those with whom it is appropriate to consult. In those circumstances, regulations are appropriate.
The Minister gave us assurances on Report, and it would be helpful to hear from her now, that she would inform us of the progress being made in terms of publishing draft regulations which would allow us, as the Bill passes through the other place, to consider
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whether they are appropriate. It is of course possible for the regulations to be approved only by affirmative resolution. I do not necessarily consider that to be appropriate. This is a way of eliciting a reply from the Minister in those circumstances. I beg to move.
Lord Skelmersdale: My Lords, for the avoidance of doubt, I should point out to the House that I am speaking very firmly to Amendment No. 3. I shall have more to say about Amendment No. 4 a little later, assuming that it is moved. The noble Lord, Lord Clement-Jones, referred to my "anathema" of lists. But of course the corollary of that is that Parliament should know whether the Government have consulted appropriate people. Indeed, the Bill talks about "appropriate people" in various places.
However, that can be done only if there is an opportunity to question the Government. It is very difficult to do so by the negative resolution procedure. So I have a great affinity with the noble Lord in his request for having the regulations under affirmative instrument as opposed to negative instrument, the reason being that it makes life very much easier for Back-Benchers. If the affirmative resolution is used and has to be debated, it is debated; whereas, if it is by negative resolution procedure, you have to notice it and then table a Prayer within 40 sitting days, which adds to the burden on Back-Benchers. Governments always love this, but it is not necessarily right for Parliament as a whole. I support the noble Lord.
Lord Renton: My Lords, as some of your Lordships may remember, I am one of those who is always anxious that we should manage to have Acts of Parliament drafted without constant reference to amplification by regulations. Here we have regulations about consultation requirements. With deep respect to the Government, especially the noble Baroness who has always done her work so splendidly for us, I wonder why we need regulations at all in order to amplify the consultation requirements. Those requirements will vary among the number of people to be consulted.
As time goes on, the nature of the consultation on somewhat technical matters will vary. It surprises me that the matter should have to be stultified at one moment by being put into regulations. If there are to be regulations, I suppose that the Houses of Parliament should be told about them and given a chance to discuss them and approve them, or otherwise. However, my doubt here is whether, in these unusual circumstances, regulations are really necessary.
Baroness Carnegy of Lour: My Lords, I may be misunderstanding this, but I do not know why the noble Lord has stated in his amendment that no regulations are to be made,
"unless a draft has been laid before and approved by resolution of each House of Parliament".
Surely it is the regulations that will be laid before Parliament, not the draft. I do not know why the word "draft" has been used in the amendment.
Baroness Hayman: My Lords, in responding to this amendment I think that we have had two different sets

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of criticisms, so to speak. As I understood him, the suggestion made by the noble Lord, Lord Renton, was that after the outline for consultation had been made clear, the arrangements for consultation would basically be a matter for the discretion of the Secretary of State. The import of the amendment is that there should actually be a level of parliamentary scrutiny higher than use of the negative resolution procedure. Indeed, that was the point endorsed by the noble Lord, Lord Skelmersdale. My own view is that it is important that there should be some element of parliamentary scrutiny of the laying of regulations about consultation requirements prior to the establishment of a PCT.
Existing provisions in the Bill provide for any regulations made by the Secretary of State to be exercisable by statutory instrument subject to negative resolution procedure. As we know, this amendment would mean that consultation regulations would be subject to affirmative resolution procedures whereby a draft has to be laid before both Houses and approved by resolution. I believe that the formulation is a draft rather than the regulations in those circumstances.
In looking at the level of parliamentary scrutiny, or considering whether any such scrutiny is appropriate for consultation regulations, we sought to follow established practice. The Delegated Powers and Deregulation Committee considered that the broad approach adopted by the department in relation to the powers in the part of the Bill dealing with primary care trusts was appropriate. The committee did not suggest in its report that the affirmative resolution procedure was a more suitable approach for these regulations. It did not raise the level of scrutiny of regulations under Section 16A(5) as an issue for the House to consider. In the context of the NHS, regulations relating to NHS trusts were and are laid before Parliament using negative resolution procedures.
Affirmative resolution procedures are considered to be necessary only in exceptional circumstances. The affirmative procedure is normally appropriate for powers affecting provision of Acts of Parliament. Such an example is Clause 52 of the Bill which deals with the regulation of health care and associated professions. It is normally appropriate for powers to impose or increase taxation or other financial burdens or to raise statutory limits on the amounts which may be borrowed by or lent or granted to public bodies. Alternatively, there are powers involving other considerations of special or exceptional importance. An example would be the powers to create new varieties of criminal offence of a serious nature.
The Government do not accept that regulations setting out the requirements for consultation are matters which fall within this category and are of such exceptional importance as to merit affirmative procedures. However, we do feel that it is appropriate to follow the precedent adopted for NHS trusts and to have some scrutiny by the negative procedure, although I obviously understand the concerns expressed by the noble Lord, Lord Skelmersdale, that the balance, therefore, goes towards the Executive rather than towards Back-Benchers. I do not believe that we are out of line with practice in this respect.
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Perhaps I may reassure the noble Lord that the consultation has taken place. We intend to consult widely with key stakeholders, including national professional and patient representative bodies on the contents of these regulations.
The noble Lord, Lord Clement-Jones, asked questions in relation to the timetable for publishing regulations setting out the requirements on consultation. We are concerned to take note of the views and comments both of this House and additionally of those in another place. Therefore, I do not believe that we can sensibly formulate a draft of these regulations at this early stage. However, I can assure the House that we do intend to bring forward draft regulations as soon as possible after the enactment of the Bill. On that basis, I hope that the noble Lord will feel able to withdraw his amendment.
Lord Clement-Jones: My Lords, I thank the Minister for that helpful reply. Indeed, it is the most extended response that she has given on this particular subject to date. However, I am somewhat disappointed that consultation will not take place while the Bill is still going through Parliament. In a sense, that seems to me to be a little like buying a pig in a poke because consultation as regards moving from PCGs to PCTs is an important part of the whole process. Nevertheless, the Minister has indicated the extent of the consultation which will take place over the regulations and that clearly will be very wide. In those circumstances, I beg leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Lord Clement-Jones Lord Clement-Jones moved Amendment No. 4:
Page 2, line 38, at end insert—
("( ) Appropriate arrangements shall be made with a view to securing that a Primary Care Trust's functions are exercised with due regard to the principle that every individual has a right to treatment according to individual need free of discrimination as to access to or the quality of service. ").
The noble Lord said: My Lords, I mistakenly had a crack at this a short while ago. I should like essentially to move the amendment formally, as I have already made my speech on it. However, in the spirit of flexibility which the Minister has displayed in other parts of the Bill, and also in the interests of drafting speed, I should like to reiterate that I very much hope that that will be mirrored in subsequent stages of the Bill. I hope that the department will bring forward some robust amendments to the Bill which will ensure equal opportunities for those who have primary care treatment at PCT level, and that it will lay down those duties for the commission for health improvement. I beg to move.
4 p.m.
Lord Renton: My Lords, the noble Lord will have the right to reply to a debate on this amendment so that he can decide whether to withdraw the amendment or to ask the opinion of the House. When he replies I wonder whether he could amplify the concept that he has in mind as to the expression,
"free of discrimination as to access".

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Does that mean free of discrimination as to access to a particular hospital, or form of treatment, or what?
Lord Skelmersdale: My Lords, I threatened to speak to this amendment, and so I shall. In his primary crack at this amendment, as I think he would describe it, the noble Lord, Lord Clement-Jones, referred to feeling a tinge of disappointment that nothing further had come from the Government on this extremely important matter which has run through all our debates on this Bill; namely, that,
"every individual has a right to treatment according to individual need free of discrimination as to access to or the quality of service".
To answer my noble friend Lord Renton—of course, the noble Lord, Lord Clement-Jones, will be able to answer for himself—that means the individual has a right to treatment and to access to an appropriate hospital.
That causes me to don my hat as a PMM—as I described it on Report—that is, a parliamentary moaning minnie, in that I am surprised indeed that this amendment has not been grouped with that of the noble Baroness, Lady Masham. The words that I have just read out—I shall not repeat them—refer not only to local treatment but to treatment elsewhere. We all know that there are occasions when it is necessary to have out of area treatment. I shall not discuss that because no doubt we shall debate it a little later. However, I regard this amendment as taking precedence over those of the noble Baroness. I am more than a little surprised—in fact, I am slightly miffed—that the Minister has not done what I understood her to promise to do at Report stage; namely, to put similar words in the Bill by means of an amendment.
Baroness Carnegy of Lour: My Lords, I hope I am not quite as far off the mark as I was when I intervened on the previous amendment. I apologise to the House for wasting a moment of our time. The wording of this amendment worries me because I do not see how every individual can have the right to treatment in the way that is described. For example, one hospital may have a far more up-to-date scanner than another hospital. Therefore the kind of scans that can be carried out in a particular hospital are more limited, perhaps because it has an older scanner. I speak of the situation in my own area but I am sure that scanners vary across the country.
In some hospitals one has to pay for assisted pregnancy whereas in others that is free. In some areas and in some hospitals that provision is not available. That may impinge on the amendment of the noble Baroness, Lady Masham, but I am not sure that one can ask for the right that is described in the amendment. I do not know whether the Minister intends to put something in the Bill, and if so she will probably be able to meet this problem. It is not just a matter of rationing, but different hospitals have different abilities to carry out particular treatments.
Lord Walton of Detchant: My Lords, the intention underlying this amendment is totally praiseworthy but I share the anxieties that have just been expressed by the noble Baroness, Lady Carnegy of Lour, because it seems
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to me that as the amendment is framed at the moment it would give carte blanche to any individual in any situation to be able to demand any form of treatment, however difficult and however expensive. In a National Health Service where—whatever one's good will towards the care of the individual—resources are ultimately finite, it would be dangerous to put so clear a recommendation, or in fact so clear a statute, on the face of the Bill. I am wholly in favour of the principle that individuals should have access to healthcare irrespective of age, sex, or other forms of discrimination on political, ethnic or other grounds. That is an important principle, but as it is framed I believe this amendment would be impossible to implement in a health service which has finite resources.
Baroness Masham of Ilton: My Lords, I point out that my two amendments use the term "where appropriate".
Baroness Hayman: My Lords, the brief debate we have had on these issues is an illustration of some of the difficulties in drafting appropriate legislation in this area. First, I shall deal with the point made by the noble Lord, Lord Skelmersdale, when he suggested that I had not fulfilled my promise to the House. I refer the noble Lord to the record of our debates at Report stage where I stated,
"At this stage it would be premature of me to give an absolute commitment to bring forward such an amendment because I do not yet have before me advice on whether we can properly legislate as the noble Lord would wish. However, I give the commitment that during the course of the Bill we shall return to the subject and report progress". —[Official Report, 15/3/99; col. 496.]
That is the commitment I intend to fulfil this afternoon. Therefore, I do not believe that I misled the House in suggesting that we would be able to bring forward amendments at this stage.
Lord Skelmersdale: My Lords, I would not dream of suggesting that the noble Baroness had misled the House. I merely gave my interpretation of what she said, which I must admit was from memory because I have been away for the past three days.
Baroness Hayman: My Lords, I am grateful to the noble Lord for those comments. We discussed similar points both in Committee and at Report stage when I made clear the importance the Government attach to achieving fairer access to high quality healthcare. I welcome the opportunity now to restate the Government's commitment that access to the National Health Service should be on the basis of need and need alone, with no place for discrimination on grounds of gender, age, disability or ethnicity. Although I accept the points that have been made in debate, we are not at that point yet in that we have varying levels of provision and access to services in various parts of the health service. A major part of the Government's proposals and work programme concerns reducing inequalities in access to services. However, that is an ongoing process. It is not something that can be delivered overnight in terms of an absolute diktat.

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I also stated at Report that this was one of the areas on which we had not yet managed to reach a conclusion on the best way forward in legislation, but that it was important that we came back with appropriate solutions for the NHS as a whole and not simply for primary care trusts and the commission, which are the two areas to which the amendments of the noble Lord, Lord Clement-Jones, apply. I believe that was the spirit of the comments made by the noble Lord, Lord Skelmersdale; namely, that the provision should cover out of area treatments, which will not necessarily be offered by primary care trusts, but are most likely to be offered in specialist hospitals. This is still the case. I reassure the House that we are still considering the points that have been made. However, I believe it would be wrong to lay an amendment before the House before we have made a searching examination of the issues facing the NHS both as an employer and as a provider of services. The amendment is very wide and there are varying aspects to equal opportunity issues and to planning for change where necessary. That is particularly so in the light of the Macpherson report which has posed sharp challenges to the whole range of public services. We need to explore those in a thorough way. Any legislation should flow from rather than precede such consideration. I am sure that in that context the noble Lord, Lord Clement-Jones, will welcome the fact that your Lordships' House will have an opportunity to debate the Macpherson report immediately after the Easter Recess. At that point the issues of equality of access to public services will, I am sure, be debated at some length.
I hope that the noble Lord and others who have spoken will accept my assurance that, in saying that I cannot yet offer a substantive reply, I do not intend in any way to underplay the seriousness of the issues. I would suggest that not having an instant answer reflects the importance we attach to having a coherent and comprehensive approach to issues which deserve serious and careful attention. The noble Lord, Lord Clement-Jones, referred to the spirit of the amendments. I can assure him that we embrace the spirit of the amendments. I am certain that we will return to these matters during the passage of the Bill, although, in all likelihood, in another place. On that basis, I hope that the noble Lord will feel able to withdraw his amendment.
Lord Clement-Jones: My Lords, I thank the Minister for her reply and particularly for her clear demonstration of support for the spirit of the amendment. Other noble Lords have commented on the drafting of the amendment. Having made three attempts at the drafting during the passage of the Bill, I know only too well how difficult it is to draft an appropriate amendment which reflects not only the difficulty of practical implementation but the desire to make a commitment. As noble Lords will know, the CRE has asked bodies and figureheads in various areas of public life to make a public commitment to their leadership challenge. I believe the NHS should make that commitment even though it may be difficult to do so. I recognise that it must form part of a wider examination and consideration of the whole area of public services. For that reason,
1434
when I introduced the amendment, I very much welcomed the fact that the Home Secretary had accepted the 70 or so recommendations of the Macpherson report. However, I look forward to action in the short term, not the long term.
I hope that the difficulty of the issue will not be treated as an excuse. I am sure that the Minister did not reflect that. I hope that this issue will not be treated as so difficult that it cannot be legislated for. I am sure that back in 1968 with the Race Relations Act and then with the Sex Discrimination Act, these were considered very difficult issues to draft. I am sure the drafting will be difficult but I very much hope that a formula will be found that will lay this kind of duty in the health service. In all of our debates, throughout the Committee stage and on Report, the whole question of discrimination— not only in terms of ethnicity but particularly in terms of age—came through very strongly as a matter of concern for your Lordships. I look forward optimistically to a time in the not too distant future when the Government will feel able to legislate on this matter. In the meantime, I beg leave to withdraw the amendment.
Amendment, by leave, withdrawn.
4.15 p.m.
Baroness Hayman Baroness Hayman moved Amendment No. 5:
After Clause 8, insert the following new clause—
REMUNERATION FOR PART II SERVICES
(". —(1) For sections 43A and 43B of the 1977 Act (regulations as to Part II remuneration) there is substituted—
"Remuneration for Part II services.
43A. —(1) The remuneration to be paid to persons who provide general medical services, general dental services, general ophthalmic services or pharmaceutical services under this Part of this Act shall be determined by determining authorities (and they may also determine the remuneration to be paid to persons providing those services in respect of the instruction of any person in matters relating to those services).
(2) For the purposes of this section and section 43B below determining authorities are—

(a) the Secretary of State, and

(b) so far as authorised by him to exercise the functions of determining authorities, any Health Authority or other person appointed by him in an instrument (referred to in this section and section 43B below as an instrument of appointment).

(3) An instrument of appointment—

(a) may contain requirements with which a determining authority appointed by that instrument must comply in making determinations, and

(b) may be contained in regulations.

(4) Subject to this section and section 43B below, regulations may make provision about determining remuneration under subsection (1) above and may in particular impose requirements with which determining authorities must comply in making, or in connection with, determinations (including requirements as to consultation and publication).
(5) Regulations may provide—

(a) that determinations may be made by reference to any of the following—

(i) rates or conditions of remuneration of any persons or any descriptions of persons which are fixed or determined, or to be fixed or determined, otherwise than by way of a determination under subsection (1) above,

(ii) scales, indices or other data of any description specified in the regulations,

(b) that any determination which in accordance with regulations made by virtue of paragraph (a)(ii) above falls to be made by reference to a scale or an index or to any other data may be made not only by reference to that scale or index or those data in the form current at the time of the determination but also by reference to the scale, index or data in any subsequent form attributable to amendment or revision taking effect after that time or to any other cause.

(6) Regulations may—

(a) provide that determining authorities may make determinations which have effect in relation to remuneration in respect of a period beginning on or after a date specified in the determination, which may be the date of the determination or an earlier or later date, but may be an earlier date only if, taking the determination as a whole, it is not detrimental to the persons to whose remuneration it relates,

(b) provide that any determination which does not specify such a date shall have effect in relation to remuneration in respect of a period beginning—

(i) if it is required to be published, on the date of publication,

(ii) if it is not so required, on the date on which it is made.

(7) A reference in this section or section 43B below to a determination is to a determination of remuneration under subsection (1) of this section.
Part II remuneration: supplementary.
43B. —(1) Before a determination is made by the Secretary of State which relates to all persons who provide services of, or of a category falling within, one of the descriptions of services mentioned in section 43A(1) above, he shall consult at least one of the following bodies—

(a) a body one of whose functions is to provide advice in connection with the matters to be determined,

(b) a body appearing to him to be representative of persons to whose remuneration the determination would relate.

(2) Determinations may make different provision for different cases including different provision for any particular case, class of case or area.
(3) Determinations may—

(a) be made in more than one stage,

(b) be made by more than one determining authority,

(c) be varied or revoked by subsequent determinations.

(4) A determination may be revised—

(a) to correct an error, or

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(b) where it appears to the determining authority that it was made in ignorance of or under a mistake as to a relevant fact.

(5) Determinations may, in particular, provide that the whole or any part of the remuneration—

(a) is payable only if the determining authority is satisfied as to certain conditions, or

(b) is to be applied for certain purposes or is otherwise subject to certain conditions.

(6) Subject to sections 29(4) and 35(2) above, remuneration under section 43A above may consist of payments by way of—

(a) salary,

(b) fees,

(c) allowances,

(d) reimbursement (in full or in part) of expenses incurred or expected to be incurred in connection with the provision of the services or instruction,

and may be determined from time to time.
(7) At the time a determination is made or varied, certain matters which require determining may be reserved to be decided at a later time.
(8) The matters which may be reserved include in particular—

(a) the amount of remuneration to be paid in particular cases,

(b) whether any remuneration is to be paid in particular cases.

(9) Any determination shall be made after taking into account all the matters which are considered to be relevant by the determining authority and such matters may include in particular—

(a) the amount or estimated amount of expenses (taking into account any discounts) incurred in the past or likely to be incurred in the future (whether or not by persons to whose remuneration the determination will relate) in connection with the provision of services of the description in section 43A(1) above to which the determination will relate or of any category falling within that description,

(b) the amount or estimated amount of any remuneration paid or likely to be paid to persons providing such services,

(c) the amount or estimated amount of any other payments or repayments or other benefits received or likely to be received by any such persons,

(d) the extent to which it is desirable to encourage the provision, either generally or in particular places, of the description or category of services to which the determination will relate,

(e) the desirability of promoting services which are—

(i) economic and efficient, and

(ii) of an appropriate standard.

(10) If the determination is of remuneration for a category of services falling within one of the descriptions of services mentioned in section 43A(1) above, the reference in subsection (9)(a) above to

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a category of services is a reference to the same category of services or to any other category of services falling within the same description".
(2) Sections 43A and 43B of the 1977 Act, as substituted by this section, have effect in relation to—

(a) the making of determinations on or after the commencement of this section, and

(b) the variation, revocation or revision on or after the commencement of this section of determinations whenever made,

and in this subsection "determinations" means determinations under Part II of the 1977 Act of the remuneration to be paid to persons who provide services mentioned in section 43A(1).
(3) Section 7(4) of the Health and Social Security Act 1984 and section 15(3) of the Health and Medicines Act 1988 (determinations of remuneration for services under Part II of 1977 Act deemed to be valid) have effect in relation to England and Wales as if—

(a) after "inserted by this section" in section 7(4)(b) of the 1984 Act, and

(b) after "section 7 of the Health and Social Security Act 1984" in section 15(3) of the 1988 Act,

there were inserted "and before the coming into force of section (Remuneration for Part II services) of the Health Act 1999".
(4) The reference in section 43B(6) of the 1977 Act, as substituted by this section, to section 29(4) of that Act is to be read on and after the commencement of section 10 of the National Health Service Act 1966 as a reference to that section. ").
The noble Baroness said: My Lords, in moving this amendment, I wish to speak also to Amendment No. 37, which makes similar provision for Scotland and replaces the current Sections 28A and 28B of the 1978 Act.
The purpose of these amendments, which would replace the present Sections 43A and 43B of the 1977 Act, is to make new provision for determining the remuneration of the family health service practitioners; that is, those providing general medical services, general dental services, pharmaceutical services and general ophthalmic services. The intention is, in effect, to legitimise the current practice in relation to these determinations and, in particular, to ensure that the existing basis by which health authorities are appointed as determining authorities is put on a firmer footing. This is largely a technical issue which, I am told, accounts for the length and the complexity of the amendments.
The Explanatory Notes to the Health Bill make clear in paragraph 106 the Government's intention to give primary care trusts the function of determining cash-limited payments to GPs. We see the development of primary care as an important part of a primary care trust's role. The ability to determine cash-limited payments to GPs to support general medical services is central to this. It will allow primary care trusts to make decisions about the deployment of resources to develop general practice premises and computing and to help practices with the costs of employing staff. These are key levers in improving primary care. Part of this function currently rests with health authorities.
We want to enable primary care trusts to assume the function of determining remuneration in respect of cash-limited payments to GPs through the delegation of the function in accordance with the general provisions about delegation contained in Clause 9.
Sections 43A and 43B of the 1977 Act provide a mechanism for appointment of determining authorities by the Secretary of State. In looking at how we might use this provision, it has become clear that the existing legal basis by which health authorities themselves are appointed as determining authorities is unsatisfactory. Determinations of remunerations are presently, in effect, governed by Sections 43A and 43B of the 1977 Act, but these provisions are not yet in force and, consequently, no regulations can be made under them. Meanwhile determinations are validated by Section 7(4) of the Health and Social Security Act 1984. Although this has been the position since 1984, over time this arrangement has become increasingly unsatisfactory. To ensure that the function of health authorities as determining authorities in respect of cash-limited payments to GPs and the subsequent delegation of that function by health authorities to primary care trusts is securely based, this legal deficiency now needs to be put right.
Additionally, Sections 43A and 43B also concern the remuneration of other family health service practitioners. We need therefore to take the opportunity to tidy up the legal basis for determinations of remuneration for all the family health services professions.
Much of the existing structure and present provisions will be retained. In particular, they provide for the Secretary of State to make regulations setting out requirements concerning consultation and publishing determinations. It is not intended either to extend or to reduce the current practice in terms of who is consulted or when, nor in terms of which determinations are published.
In essence, these changes are a tidying up exercise that will reflect and validate current practices. For example, the Secretary of State will continue to be required, through regulations made under these provisions, to consult the national representative bodies of each of the family health service professions before making changes to payments that affect that group. These changes are ones to the GPs' Statement of Fees and Allowances, commonly referred to as the "Red Book", or the equivalent for the other family health service practitioners. Primary care trusts' discretion in respect of cash-limited payments to GPs will be circumscribed in the same way as health authorities' discretion currently is; that is, it will be subject to the provisions set out in the GPs' Statement of Fees and Allowances. Where the Red Book dictates, for example, that health authorities must consult local medical committees, the same requirement will apply to primary care trusts.
The amendment also puts on a firm legal footing the basis for remunerating other FHS practitioners—dentists, community pharmacists and optometrists. However, primary care trusts will not be appointed as determining authorities for non-GMS Part II matters. The Bill explicitly and deliberately precludes primary care trusts having any functions in respect of these.
I acknowledge that these provisions are lengthy and technically complex, although no more so than those they replace. The reason for this is that the remuneration

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systems which they underpin are themselves complex. I hope that I have given adequate justification for the amendments we are proposing. I beg to move.
Earl Howe: My Lords, the House will be grateful to the Minister for her explanation of these amendments. I have one brief question to ask on Amendment No. 37. In the amendment, under subsection (2) of new Clause 28A, I see that the determining authorities are defined. The Secretary of State is one of the determining authorities. Since health is a devolved matter, can we take it that the role of the Secretary of State will be assumed by the First Minister for Scotland, and that therefore we may, in due course, see different fees and allowances north of the Border from those that are in operation south of the Border?
The Earl of Mar and Kellie: My Lords, I wish to ask about Amendment No. 37. Looking at subsection (5) of new Section 28A and subsection (2) of new Section 28B, I see that the Bill seems to be introducing the idea of variable remuneration being permissible to enable services to be procured in difficult localities. Is that a new principle? If it is, is it intended to secure such services in, let us say, urban areas of deprivation, or is it aimed more at remote rural areas and the three island groups? Or is the intention to unleash a complete free-for-all in remuneration within the 15 health board areas, which, I confess, I do not see as being very helpful?
Baroness Carnegy of Lour: My Lords, my noble friend Lord Howe asked a question that is extremely important to people in Scotland. If "the Secretary of State" referred to in the Scottish amendment is the Secretary of State for Scotland, or a Minister of the Scottish Parliament—I imagine it means the latter—there is no reason at all why doctors and nurses, pharmacists, dentists and so on should not gradually receive salaries that diverge considerably from those south of the Border.
If the Minister will confirm that, it will help Members in another place when they come to study the Bill to know exactly what the implications are. Taking this legislation at Westminster will not enable the Scottish Parliament to examine this arrangement at all. It may or may not suit the Scottish Parliament.
Can the Minister confirm that the two amendments are virtually identical apart from the cross-references to the legislation that they amend? I cannot find any differences, but I may not have spotted them and it would be helpful to know.
Lord Clement-Jones: My Lords, I thank the noble Baroness for attempting to clarify what is obviously the Schleswig-Holstein question for the Department of Health. To mix metaphors further, I suspect that it is a kind of Bermuda triangle for politicians to get into in the first place. A number of issues arise from the clause. Perhaps the Minister will forgive me if I re-tread some of the ground that she covered in her introduction.
We assume that the department has now obtained independent legal advice and in a sense this provision cures the issues that it was designed to cure and we shall not be faced with a re-run of this matter at a future date
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in relation to another health Bill. Further to that, will the powers in the new clause be used only to allow PCTs to deal with the cash-limited payments made to GPs for their staff, premises and computers? Will the Minister give a reassurance that when a PCT takes over any of the powers of a health authority relating to the remuneration of GPs, the PCT will be under the same duty as a health authority is currently to abide by the rules in the Red Book? For example, when the Red Book requires a health authority to consult the LMC, will a PCT also be required to consult that body? Will the Minister give examples of how a PCT might use its powers as a determining authority. Subsection (5)(a) of new Section 43B states that:
"Determinations may, in particular, provide that the whole or any part of the remuneration … is payable only if the determining authority is satisfied as to certain conditions".
What will those conditions be? Will they be decided by the Secretary of State, or locally?
Finally, will the Minister give an assurance that PCTs will not be allowed to use their status as determining authorities to allow local variations from a national contract for GP remuneration?
Lord Colwyn: My Lords, this is a long new clause. I have seen it for the first time this afternoon. Will the Minister say when this amendment was published and whether she has had a chance to receive representations from the professional bodies referred to in new Section 43A. It is the first time that I have heard about it and I do not know, for instance, what the British Dental Association feels about it.
Baroness Hayman: Yes, my Lords, the amendment is complex. It is my understanding, which perhaps I may confirm at a later point to the noble Lord, that there have been discussions with the professional bodies on this area and that they understand the reason for bringing forward these amendments. It was very much an issue of the previous arrangements being on the basis of legislation built on legislation, on powers that have never formally been brought into force, and therefore not providing a secure legal framework. There was an anxiety not to put in place an additional layer of reliance on provisions that were not themselves fundamentally secure. Therefore the opportunity has been taken to tidy up the general basis for the determination of remuneration. I am clear that that will not come as a surprise to the professional bodies concerned.
On the issue of the Scottish provisions, I understand that the amendments for Scotland, England and Wales are fundamentally the same. I also understand that this will be a devolved matter and therefore it will be possible for different decisions to be taken north and south of the Border—although, to respond to the point made by the noble Earl, Lord Mar and Kellie, the provision is certainly not intended to allow for a free-for-all, but to allow local flexibility where it is required. That might be in a variety of different circumstances. Both the rural and the

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inner-city example could have relevance. The provision is based very much on flexibilities which are already in place and are used, rather than introducing a novel concept in this area.
On the specific questions raised by the noble Lord, Lord Clement-Jones, the purpose of the amendment so far as PCTs are concerned is to allow them to take on the function of determining cash-limited payments to GPs for those purposes. It also allows PCTs to set up and make payments in respect of general medical services local development schemes. That is a new flexibility that we have recently introduced to enable health authorities to establish what are in effect local incentive schemes to improve the standard and range of services provided within GMS.
The noble Lord asked for a reassurance about consultation. When the PCT takes on the function from the health authority of making cash-limited payments to GPs under the Red Book arrangements, it will also inherit any duty to abide by the Red Book which applies to the health authority. The point of delegating that function to PCTs is not to change Red Book arrangements but to give PCTS the ability to deploy resources into general medical services in support of those services.
The noble Lord asked for examples of how PCTs might use their powers as determining authorities. It would be broadly in one of two ways: first, to deploy resources into general practice under the existing national GP contract or Red Book arrangements to support the cost of employing practice staff or to support the cost of premises development or practice computers; or to set up with GMS local development schemes with the agreement of local GPs, in the same way as health authorities now can. This might involve, for example, funding of practices to provide chronic disease management programmes not covered by the Red Book or local incentives to improve coverage of immunisation programmes.
The noble Lord, Lord Clement-Jones asked about certain conditions which would have to be fulfilled if determinations were to take place. For payments made under the Red Book, the Secretary of State will, as now, continue to set down any conditions for those payments and will define, again as now, any discretion that health authorities and PCTs may exercise.
Health authorities and PCTs will have the same degree of discretion and duties under the Red Book. For GMS local development schemes which are outside the Red Book arrangements, the Secretary of State has set the parameters for the operations of those schemes in regulations. The regulations will apply to health authorities and PCTs. Within that framework, PCTs, like health authorities, will be able to determine the conditions that will apply to local development schemes. I am happy to give the assurance that the status of PCTs as determining authorities will not allow local variations from the national contract. PCTs will be required to comply with the national contract in the same way as health authorities.
I hope that I have covered the points that were raised in the debate. I shall write to noble Lords if I have missed any points.
On Question, amendment agreed to.
4.30 p.m.
Clause 9 [Directions]:
Baroness Hayman Baroness Hayman moved Amendment No. 6:
Page 12, line 10, leave out ("16C") and insert ("16D").
The noble Baroness said: My Lords, in moving Amendment No. 6, I wish to speak also to Amendments Nos. 10, 11, 12, 63, 64, 72 to 74, 79, 82 to 85 and 91. Although it is a large group of amendments, I shall try to be brief. They bring forward provisions in relation to two issues which we discussed at Committee and Report stages: the "may or must" point, if I may characterise it as that, about publicising PCTs' audited accounts, annual reports and other documents; and a requirement on PCTs to secure appropriate professional advice.
On the first point, at Report stage I undertook to bring forward appropriate amendments on Third Reading that would have the effect of placing on PCTs an express duty to publicise the specified accounts and reports in accordance with requirements set out in regulations.
Amendments Nos. 63 and 64 meet that commitment. They require the Secretary of State to make provision in regulations requiring PCTs to publicise the relevant document. The regulations will set out what steps to publicise must be taken by the PCT. The Secretary of State, however, retains his discretion to determine in the regulations exactly what those steps should be. For example, the regulations may specify when the accounts and reports must be published and whether the list of documents that must be publicised should be extended to those other than accounts, annual reports and auditors' reports on matters of public interest. That arrangement will have the added benefit of retaining flexibility, to cater for future changes in circumstances.
On the second point, I said on Report that I intended to bring forward a government amendment so that PCTs, as well as health authorities, have a duty to make arrangements to secure appropriate professional advice. This is in response to a specific proposal during Committee from the noble Lord, Lord McColl, for which I am grateful. It also reflects a view which I think commands a good deal of support in the House—and which the Government certainly share—namely, that PCTs should secure sound professional advice from a wide range of groups in carrying out their functions.
There will, of course, need to be strong professional input into the way that PCTs are governed. But we also want PCTs to have arrangements for involving health professionals which extend beyond the "members" of the PCT. PCTs also need to engage with the broad mass of local GPs and community health service professionals, who are not PCT members. In developing local commissioning strategies and service agreements they need to involve, for example, acute sector clinicians, those engaged in NHS education research, Professions Allied to Medicine and the family health service professions. The importance of all those groups has cropped up at various points in our debates.
The amendment we have brought forward effectively mirrors the existing duty which Section 12 of the 1977 Act places on health authorities but also extends it to PCTs. When we looked at Section 12 we found that it referred

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specifically to some professions—namely, medical practitioners, nurses and midwives—but not to others. We think this distinction is unhelpful. It could be interpreted as implying that the contribution of other professions is somehow less important.
I turn to Professions Allied to Medicine, which I know has had particular concerns on this matter. A key point about our proposed provision is to ensure that groups like the PAMs are involved in shaping and delivering PCT plans. We want to remove the specific reference to doctors, nurses and midwives in the existing duty in order to reinforce the message that these are not the only groups that must be consulted. We are, in effect, putting PAMs on an equal footing with these groups in terms of PCTs' duty to secure professional advice. Perhaps I could also make clear that there must be flexibility in the precise balance of professional members at level 4 to reflect local circumstances, and in some cases it may be sensible and helpful to have PAMs on the PCT executive. I should add that PAMs could also of course be invited to take part in board discussions at level 3 on matters where they have a particularly important contribution to make.
To return to the amendment, we have opted for a duty to consult which is couched in a way which does not give special status to any professional group. But otherwise the new duty is essentially the same as that in Section 12 with the key difference that it applies to PCTs as well as health authorities. The amendment requires both these bodies to make arrangements to seek advice from healthcare professions in carrying out their functions. This is an important provision which further bolsters the role of professionals in PCTs.
The amendment inserts this new provision as Section 16C. Consequently the original Section 16C in Clause 9 has been re-numbered as Section 16D. The remaining amendments in this group are to reflect that re-numbering and to pick up on a number of references to the old Section 13 which is replaced by the new Section 16D. I beg to move.
Earl Howe: My Lords, once again, on this side of the House, we are grateful to the Minister for an extremely helpful set of amendments and for the way in which she has spoken to them. I do not believe that at the outset of her remarks she mentioned Amendment No. 73, but it is one of the key amendments in the group. For the sake of clarity, perhaps I should ask her to confirm that she was speaking to it.
Baroness Hayman: My Lords, I specified Amendments Nos. 72 to 74 which I took to include Amendment No. 73. I am glad to clarify the point.
Earl Howe: My Lords, I am grateful.
Lord Clement-Jones: My Lords, I also thank the Minister for what I agree is a helpful set of amendments. That refers particularly to resolving the "may or must" issue throughout all stages of the Bill. I thank her also for dealing with a problem which the Professions Allied to Medicine was keen to see cured. It is grateful to have its
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best, most optimistic hopes being realised in terms of the way that section has now been changed in the 1977 Act. That is extremely helpful.
The only remaining aspect on which the Minister could be even more helpful—and this is somewhat of a side wind in the context of level 4 PCTs—is that the department definitely expects the PCT executives at level 4 to involve and, in some cases, consist of Professions Allied to Medicine. That would be a positive sign to those professions that their involvement would be actively supported. In the meantime, we very much welcome the set of amendments.
Lord Skelmersdale: My Lords, I add my thanks to the noble Baroness for this comprehensive set of amendments, especially Amendment No. 73 which I am delighted to see is list-free.
On Question, amendment agreed to.
Baroness Masham of Ilton Baroness Masham of Ilton moved Amendment No. 7:
Page 12, line 24, at end insert—
("( ) The power conferred by subsection (1) shall be exercised so as to enable patients resident in an area covered by a body referred to in that subsection to be referred out of that area where appropriate for the purpose of receiving specialist hospital treatment and after-care. ").
The noble Baroness said: My Lords, I was most encouraged at Report stage by the support which your Lordships gave for my amendment on out-of-area treatment. For that reason I move Amendments Nos. 7 and 18 today. The Minister said that the fragmentation of responsibility in the past made it difficult to ensure co-ordinated planning and commissioning of specialised services. The Minister also said that the Government were giving regional offices clear responsibilities for ensuring that proper arrangements were in place and would require all health authorities, primary care groups and primary care trusts to participate in that.
Many bodies are involved. The noble Lord, Lord Walton of Detchant, said during Report stage that in some instances specialist units were uncertain as to the future flow of patients and consequently their future funding arrangements. To have these amendments written into the Bill places emphasis on the importance of out-of-area treatments. Amendment No. 7 deals with the general powers of the Secretary of State to issue directions to National Health Service bodies. The intention of the amendment is to require the Secretary of State to issue directions to achieve out-of-area treatments where appropriate.
Amendment No. 18 provides that the duty of co-operation should extend to OATs, making sure that they are covered in the Bill. Specialised medical conditions do not always fit into the flow patterns that health authorities might have arranged. Sometimes there are very difficult and complicated cases. Flow patterns might have been arranged with a hospital, such as the one at Bristol, where doctors and parents had lost confidence in the clinical results. I am pleased to hear that with a new surgeon Bristol has now improved, but that is an example of how matters can change. There should be flexibility and choice for patients, carers and doctors.
It is cost-effective in the long run to provide the correct diagnosis and treatment quickly with a fully trained medical team who have knowledge and expertise and who can solve difficult problems. Sometimes sophisticated and expensive equipment is needed for difficult diagnoses. Often it is found only in select hospitals that deal with complicated conditions. To advance in medical research and development patients need to be treated in units that have an interest in and are motivated by their conditions and, ideally, have links with universities.
We live in a fast-changing world and must not fall behind. In last Saturday's Daily Express the case of Helen Smith, aged 24, was highlighted. She had her arms and legs amputated after contracting meningitis. So far officials at Addenbrooke Hospital in Cambridge will not pay for bionic hands and lightweight artificial legs to help her walk properly. On her arms she has a stump and a claw. I gave the Minister notice that I may bring up this case. This young woman has a university degree in molecular and cellular biology and wants to return to independent living and work. She needs the expertise of an orthopaedic limb-fitting centre. Why do severely disabled people have to fight so hard for what should happen smoothly and efficiently through the NHS so that they can get on with their lives and overcome human tragedies with help and support rather than bureaucratic injustice?
The British Medical Association says that there is lack of clarity and detail in the Bill about the way in which health services will work at district and regional levels and how services commissioned by primary care trusts will fit into this process. The Bill does not make clear how the formal mechanisms for joint working will be achieved and how the existing procedures for commissioning, which are now not working adequately, can be improved. What mechanisms will be in place to achieve an overview of the planning at regional level of services commissioned by primary care trusts? What mechanisms will there be to involve hospital consultants in the decision-making process of PCTs?
Although the Bill makes provision for the functions of primary care trusts, there is no clear direction for joint working between all relevant local health and social service agencies. I believe that Amendment No. 18 will help to achieve this. Currently, some services are commissioned by a lead health authority on behalf of the other health authorities in the region. Some services are provided on a regional or supra-regional basis. What will be the effect of the Health Bill on those services? What reassurances can the Minister give that those services will be protected? This service includes many vital specialties.
The College of Health, which is a body dedicated to patient-centred care, is also concerned about these issues. On "Newsnight" on Tuesday night the need for out-of-area treatment was highlighted. It showed adolescent and young adult patients who needed vital heart treatment at Brompton Hospital. Some patients said that if they had not received the treatment with the help of GUCH (Grown-Up Children's Heart Charity)
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they would have died. Dr. June Sommerville, a world-renowned heart specialist, said that because some young people had not been transferred they had died.
I thank both the noble Baroness, Lady Hayman, and the noble Lord, Lord Hunt of Kings Heath, for their communications. Both Ministers have great knowledge of the National Health Service, but this is a new Bill. I believe that out-of-area transfers should be on the face of the Bill. I hope your Lordships will agree that this is a matter of life and death for many people. I beg to move.
4.45 p.m.
Earl Howe: My Lords, I rise to support these amendments, to which I have added my name. The Minister was kind enough to write to me earlier this week following our debates at Report stage. I am grateful for her explanation in that letter of how out-of-area treatments are to be commissioned and funded. However, I share the perception of the noble Baroness, Lady Masham, that there is still a good deal of uncertainty within the health service as to how these commissioning arrangements will work and, in particular, what mechanisms will operate at district and regional levels to enable a proper strategic view of specialisms, such as cardiac and renal services, to be taken and to ensure that the advice of the specialists themselves is taken into account. What joint working arrangements will there be between all those who have a professional interest in the planning of services?
I should like to ask the Minister about the range of specialisms that health authorities and PCTs will be expected to commission under long-term service agreements. How many specialisms typically will these agreements cover? What will happen when there is a need for a certain specialist service for which there is no agreement in place? The worry that has been expressed to me is that none of this bodes very well for patients because the decisions of regional specialist commissioning groups will be binding. Yet there will be no patient or carer involvement in those decisions, as there will be for public health and health authority managers.
Nor are there any structures in place for the views of patients and carers to be heard and acted on at regional level. Even more importantly there is no provision for an appeals mechanism against refusals to fund out of area treatments. CHCs have no rights of representation at regional level. There is no provision for patient and carer feedback into the commissioning process and the subsequent monitoring and evaluation of provision. Nor does there appear to be any mechanism for patients to find out what specialised commissioning arrangements apply to their areas.
I turn to a different aspect of the issue. I wonder why it is that when waiting lists are so long, as they are at present, limits are now being imposed on the referral of patients from overstretched hospitals to those which may have spare capacity. There is a need for greater flexibility, not less, in the way the system operates. The Government need to explain more fully how the proposed arrangements will not work in practice to the detriment of patients.

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I share the view of the noble Baroness, Lady Masham, that these are important questions. I look forward to hearing what the Minister has to say.
Lord Walton of Detchant: My Lords, I support the amendments. I wish to take this opportunity to express my sincere thanks—other noble Lords have also expressed their thanks—for the way in which the Minister has met so many of the concerns expressed throughout the Bill's passage. I know that I speak on behalf of noble Lords on these Benches. The pharmaceutical industry and the professional regulatory authorities also feel that virtually all their concerns have been met.
I support the views expressed by the noble Baroness, Lady Masham. I do not propose to redeploy the arguments I expressed at Second Reading and Committee and Report stages about the crucial importance of out of area referrals not only for those patients suffering from rare conditions but also those who suffer from common conditions. There is clear evidence that in the treatment, for instance, of diabetes a referral to a highly specialised centre brings greatly improved outcomes in relation to patient care. One could redeploy the arguments relating to the specialised treatment of cancer, to the highly specialised specialties such as cardiac surgery, cardiology, neurology and many more.
One of the great strengths of the old NHS—if I may speak about it in that way—was that regional planning made it possible to define those hospitals in which regional services would be provided. Primary care was provided by the general practitioners. Secondary care was provided in virtually every district hospital. But the more difficult problems were referred to regional or sub-regional centres which were carefully planned. One of the unexpected and unforeseen effects of the internal market introduced by the former government was that extra-contractual referrals diminished sharply. That meant that many patients deserving of highly specialised care were not referred to those specialised centres. Not only did that have a detrimental effect on the care of many individuals, it had a devastating effect on clinical academic medicine, which often depends on such referrals for its very existence.
For that reason alone, and for many of the others expressed by the noble Baroness, I strongly support the amendments. From what the Minister said when debating the last group of amendments, I understand that hospital consultants among others will be consulted about the activities of primary care trusts. That will greatly reassure the BMA. When the noble Baroness answered some of our questions on the topic in Committee and on Report she was able to give many reassurances. But the future of specialised patient care in the NHS and the future of clinical academic medicine depend upon having effective answers to the problems posed in the amendments.
Baroness Sharp of Guildford: My Lords, I support the amendment and endorse the reservations expressed from other Benches.
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As the Minister said at Report stage, health authorities and their partners will still need to set specialised commissioning issues alongside their local priorities. We accept that the new spirit of co-operation which will pervade the National Health Service in future means that the new arrangements can or may be more coherent and purposeful. But the fact remains that health authorities and primary care trusts will still be constrained by their budgets and will be under constant pressure to buy the cheaper local services rather than to go elsewhere for more expensive services. Therefore there is the tendency to ration by postcode.
My attention was brought last weekend to a patient who urgently needed a heart bypass operation. His cardiologist reckoned that he had only a week to live if he did not have one. However, it was January and his health authority had exhausted the quota of bypass operations that it had bought from a specialist hospital outside the area, and there was no way round that. That was despite the fact that the cardiologist estimated that he had only one week to live without the operation. The specialist hospital concerned had excess capacity; namely, both its operating theatres and its specialist staff were not being used at that time.
That picks up the problem raised at Report stage by the noble Lord, Lord Winston. The noble Lord, Lord Walton, reiterated it. He spoke about unused specialist facilities and specialist staff being laid off. Yet I confess that I see little in the proposals at present to alleviate the problem. We shall still be confronted by constrained budgets and the purchaser provider provisions which are at the centre of the internal market. As my noble friend Lord Clement-Jones said at Report stage, these are the litmus test of whether the internal market continues.
It is vital for patients in this country to have access to the most appropriate and best possible care, even if it is not available within their area. We should be glad to have assurances from the Minister that I have interpreted the matter wrongly and that those facilities will be available.
Baroness Fookes: My Lords, I warmly support the amendments in the name of the noble Baroness. I prefer not to rely on some nebulous spirit of co-operation, but to have a provision written firmly on the face of the Bill. I do not believe that there ever was a golden age in the NHS when it was easy to send people out of area. As a constituency MP, I recall having the greatest difficulty under previous reforms when trying to help someone who needed that out of area support. I therefore take a rather jaundiced view as to whether the concept will work if it does not get a good shove on the face of the Bill. I am sure the Minister will give us some reassuring words about what is planned. But I should still like to see the provision on the face of the Bill. In the absence of any proposal from the Minister, I warmly support the amendments in the name of the noble Baroness.
Lord Renton: My Lords, I, too, support the amendments. I revert to Report stage, when some of us mentioned specialised services that were already available. At first I doubted whether the amendment was necessary because I wrongly assumed that those services

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would be avilable throughout the country. However, in a powerful speech, the noble Lord, Lord Winston, put me right. He mentioned that the situation varies a great deal. We know that the Government have the good intention of wanting to make the services readily available everywhere—involving travelling, of course; that cannot be avoided.
I remind your Lordships of what the noble Lord, Lord Winston, said. The noble Baroness, Lady Sharp, referred to it. He stated:
"I am convinced that if we sensibly concentrated services in certain areas to which patients could easily travel, there would be a great benefit to the patients, a benefit in terras of training and research, and a saving of money". —[Official Report, 15/3/99; col. 560.]
He then said that he strongly supported the amendments.
It is arguable that under the Bill there is power to provide these services, but there does not seem to be an obligation to do so. We know the Government want that to be done but surely it would be better to make it clear in the Bill that there is an obligation on the part of the Secretary of State and the various bodies which will be helping him in providing health care in the future. We should make it clear that there is an obligation to extend specialist services so that they are available all over the country. For that reason no harm could be done by accepting the amendments; indeed there would be a very great advantage.
5 p.m.
Lord Skelmersdale: My Lords, as I understand the position the proposed new arrangements for regional specialised commissioning centre upon an indicative list of specialised services. Health authorities will, as I understand it, only be expected to make arrangements for a limited number of specialisms each year. This is bound to continue the unfairness that has already been referred to at Report stage as treatment by postcode. For example, patients needing access— and here I declare an interest as chairman of the Stroke Association—to specialist stroke units will be able to have that if they are in the right area, otherwise not. Patients with rare diseases or complicated illnesses will find it much more difficult to have access to centres of expertise or specialist consultants.
Like my noble friend Lord Howe, I can find no provision for appeal against refusal to fund out-of-area treatments and community health councils have no rights of representation at regional level. All this leads me to conclude, like my noble friend Lady Fookes, that we need to refer to what my noble friend Lord Renton calls "this obligation" on the face of the Bill.
Lord Hunt of Kings Heath: My Lords, this has been a most important and interesting debate. I am most grateful to the noble Baroness, Lady Masham, for once again allowing us to discuss these important issues. I am very well aware of the concerns that many members of your Lordships' House have about the proper availability of specialist services within the National Health Service. It is a fact, as the noble
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Baroness, Lady Fookes, said, that there has never been a golden age. There has always been a tension between the proper provision of specialist services and the appropriate provision of local services. My own view is that the internal market added to the problems. No one should underestimate the challenge that the NHS faces in ensuring that we reach the right solutions in terms of a balance between specialist services and the services that one would expect to be provided in one's local area.
I believe that the action which the Government are taking in this area will enable us to meet many of the concerns that noble Lords have. Notwithstanding the ever present tension that I have already described, I believe that the arrangements that applied under the internal market were responsible for many of the problems that have been discussed.
It was certainly the case that fragmentation of responsibility within the internal market made it more difficult for specialised units to work together with all those who referred to their services, so as to agree how the service should develop, and how it could best be dovetailed with local services to ensure that there was a proper continuum of care that patients require. There was no mechanism for agreeing priorities for investment, so as to offer specialised centres a proper context in which to plan, to devise research programmes, and so forth. There was too much dependence on the system of "extra contractual referrals"—ECRs as they came to be known—which was designed for one-off cases, not to support the development of complex services. And for the patient and their clinician, the ECR system meant a bureaucratic obstacle, in the form of requirement to obtain "prior approval" from the health authority before referral to the specialist centre went ahead. So patients, clinicians and specialist units all had real cause for concern about the impact of these arrangements. I understand the anxiety of noble Lords to ensure that the arrangements we are putting in place will be better. I want to reassure the House on this point. There are two important strands to the action we are taking: first, that there are new, coherent arrangements to plan and commission specialised services; and secondly, new, less bureaucratic arrangements are being put in place to cover the small minority of cases where it is not possible to plan ahead.
The arrangements for specialised services commissioning recognise that these services form much too important an element of the NHS to allow their development to be left to chance, or to the goodwill of individual clinicians, units, or individual commissioning bodies or indeed to the urgings of patient groups. That is why we have charged NHS executive regional offices with ensuring there are proper, coherent arrangements in place to plan, commission and (through long-term service agreements) fund specialised services. This is essential both to ensure patients have fair and appropriate access to specialised services when they need them, and to enable the units concerned to plan ahead with confidence and, if I may say so, to provide the

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flexibility which the noble Baroness, Lady Masham, requested in what she aptly described as a "fast changing world".
As a first step, regional offices have been working with local NHS bodies to identify those collective arrangements to commission specialised services that already exist, and ensure that all health authorities and primary care groups are covered by these. There will then be a rolling programme of reviews to tackle national priorities and the priorities for attention identified in each region, and ensure that robust arrangements are in place. The result will be agreements between a group of health authorities and their primary care groups and a specialist centre, covering the service to be provided, the flow of funds, the quality standards to be expected, the intended outcomes of treatment, and other important aspects of the service. All GPs in the area covered will be free to refer patients to such a centre in line with the agreement concerned. I believe this is the best course wherever a pattern of need and referrals can be identified. But the Government also recognise that there will be a minority of cases which do not fit these arrangements, and for which provision must also be made; for example when a serious illness or injury occurs away from home, or where a patient has a rare condition and the health authority or primary care group's service agreements do not cover the specialist centre best equipped to help.
This is where the arrangements for out-of-area treatments (OATs) come in. The principle of out-of-area treatments is to make proper and non-bureaucratic provision for these unpredictable but pressing cases. Where a specialist centre can identify a pattern of receiving "one-off referrals from outside their area in circumstances such as these, the arrangement is that the funding allocation to its "main commissioner" (usually the health authority in which it is located) will be increased to reflect this pattern of referrals. The main commissioner will then add this funding to its own service agreement with the trust. This will become an agreement against which "all comers" can be treated, admitted according to clinical priority by the specialist unit.
I believe that together, the arrangements for commissioning specialised services, and for out-of-area treatments, offer a secure framework within which specialist centres will be able to make their proper contribution to the NHS. It happens that this is an area where we can proceed without primary legislation. That is the reason that it does not appear on the face of the Bill, not because we attach any less importance to specialist services than to those matters where legislation is required.
The noble Baroness, Lady Masham, referred to the case of Helen Smith. I am most grateful to her for giving me advance notice of that. The clinicians in that case have offered what they consider to be the best possible artificial limbs for her condition, which they believe will be most comfortable and at the same time provide her with the greatest flexibility. Experts at Addenbrooke's Hospital which is a regional
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disablement centre, have suggested the coverings in the bionic-electric hands which would best suit her, but she has declined them. They have also offered the possibility of referral to another NHS specialist centre, the Royal National Orthopaedic Centre at Stanmore.
The noble Baroness, Lady Masham, also referred to a story in yesterday's "Newsnight" programme about the Brompton Hospital. Like other specialist services, those services should benefit from the systematic approach for the review and commissioning of specialist services to which I have referred. I cannot give a definitive answer today in relation to the specific issue she raised, but I can say that one of the national priorities we have identified for action during 1999–2000 on specialist service commissioning is a specialist cardiac service. I hope that that will ensure that some of the issues raised will be met.
The noble Earl, Lord Howe, referred to the definition of specialist services. There is no fixed definition and as the noble Baroness, Lady Masham, suggested, there needs to be flexibility, given the fast changing circumstances with which the NHS is often faced. In a circular issued by the Department of Health, a list of potential specialist services was set out, but it highlighted the difficulty in attempting to produce something definitive. I should be happy to send the list to the noble Earl because it offers a starting point that is being worked on by every regional office.
We are asking the regions and the NHS to concentrate, first, on some selected national specialties—for example, cancer and paediatric intensive care units—and during 1999–2000, medium-secure psychiatric services, cleft lip and palate services and issues of particular priority within each region, as each region faces different circumstances and different priorities. There will then be a rolling programme for examining other services.
That is practical because these matters require careful attention. It is sensible to take them through a rolling programme. The funding of specialist services not yet covered by such an approach will be covered by service agreements.
An important question was raised about the relationship between primary care groups and trusts and clinicians. We are stressing to those concerned that long-term service agreements must be based upon dialogue between clinicians in primary and secondary care. That same approach will inform the commission of specialist services, with input from those specialist commissions, which will be critical to effective discussions.
We recognise that it is important to get these mechanisms right. Regional offices will soon be reviewing the existing collective agreements and identifying the sharing of best practice. Issues of how best to assure the proper arrangements for input from clinicians, particularly in specialist services, will be covered in that review.
In relation to the important question of user and carer input, we are stressing to the service that this must be a feature of the new arrangements. Moving

1453
to a three-to five-year time scale in relation to service agreements will allow much more opportunity for the in-depth involvement of users and carers.
I noted with a great deal of interest the point made by the noble Lord, Lord Walton, about diabetes. That is identified as a future national service framework topic.
The noble Baroness, Lady Sharp, asked about resources. I can confirm that we must work within available resources, but I believe that moving to a stronger role for primary care groups and trusts in commissioning means that the balance must be struck between specialist and local services. It will be struck sensitively and appropriately and in an atmosphere in which the clinicians closest to the patients are very much involved in making those decisions.
The noble Lord, Lord Renton, referred to the variations in service availability throughout the NHS. I believe that the impact of the specialised commissioning arrangements to which I have referred—the development of service frameworks— will help to ensure a broad pattern of provision throughout the country. Of course, when one is dealing with specialist services at a regional level, one must reflect on the different priorities which will be set in different regions.
I wish to assure noble Lords that we are taking proper and careful account of these very important debates. We plan to issue guidance soon to the NHS setting out further details on the out-of-area treatment arrangements. We will ensure that it stresses the importance of pro-active planning around the development of new services, reserving the use of out-of-area treatment for those instances where a pre-arranged service agreement is impracticable. In commissioning guidance later this Spring—and I hope that this answers the point made by the noble Earl, Lord Howe, about the preparedness and awareness of the NHS—and in the light of debates in your Lordships' House, we shall pay careful attention to the proper balance between the different forms of commissioning, local service agreements, arrangements for specialised services and for out-of-area treatments so that together they best provide for the full range of patient needs.
I believe that those arrangements, combined with a duty of partnership, the crucial importance of the health improvement programmes which we developed within each area, the monitoring role of regional offices, and the close involvement of clinicians at all levels will ensure that we deal with these important matters in the appropriate way.
Finally, I assure the House that the new provisions in the Bill—the Secretary of State's powers of direction—will extend to specialised services. I hope that the House will feel reassured by my response and that the noble Baroness will feel able to withdraw her amendment.
Baroness Masham of Ilton: My Lords, I thank the Minister for that full reply, but something he said at the end of his speech worries me a great deal; namely
1454
that different regions might do different things. I also believe that the comments of the noble Earl, Lord Howe, about the right of appeal are very important.
I thank all noble Lords who have supported me because I believe that they want the provision to appear on the face of the Bill. I know that the noble Baroness, Lady Hayman, knows in her heart that if she were sitting on the other side of the House she would be campaigning with me. I remember very well that she and I campaigned about MRSA and pressure sores, but I understand her position.
I believe that we should have a go and see what the House thinks. Therefore, I wish to divide the House.
5.19 p.m.
On Question, Whether the said amendment (No. 7) shall be agreed to?
Their Lordships divided: Contents, 113; Not-Contents, 86.

Division No. 1

CONTENTS

Ailsa, M.

Kintore, E.

Ampthill, L.

Kitchener, E.

Anelay of St. Johns, B.

Lamont of Lerwick, L.

Astor of Hever, L.

Lauderdale, E.

Attlee, E.

Leigh, L.

Berners, B.

Lindsey and Abingdon, E.

Blaker, L.

Liverpool, E.

Bledisloe, V.

Long, V.

Bridgeman, V.

Lucas of Chilworth, L.

Byford, B.

Lyell, L.

Caithness, E.

McColl of Dulwich, L.

Campbell of Alloway, L.

McConnell, L.

Carnegy of Lour, B.

Marlesford, L.

Carrington, L.

Masham of Ilton, B.

Charteris of Amisfield, L.

Mayhew of Twysden. L.

Chesham, L.

Milverton, L.

Clanwilliam, E.

Molyneaux of Killead, L.

Clark of Kempston, L.

Monson, L.

Coleridge, L.

Morris, L.

Colwyn, L.

Mountevans, L.

Cope of Berkeley, L.

Moynihan, L.

Cork and Orrery, E.

Munster, E.

Courtown, E.

Murton of Lindisfarne, L.

Craig of Radley, L.

Napier and Ettrick, L.

Craigavon, V.

Naseby, L.

Crickhowell, L.

Newall, L.

Cross, V.

Noel-Buxton, L.

Cuckney, L.

Northesk, E.

Darcy de Knayth, B. [Teller.]

O'Cathain, B.

Davidson, V.

O'Neill of Bengarve, B.

Dixon-Smith, L.

Oxfuird, V.

Donegall, M.

Palmer, L.

Eames, L.

Pearson of Rannoch, L.

Ellenborough, L.

Pender, L.

Elton, L.

Rankeillour, L.

Fookes, B.

Renton, L.

Garel-Jones, L.

Renwick, L.

Gray, L.

Roll of Ipsden, L.

Hanningfield, L.

Romney, E.

Hayhoe, L.

Rotherwick, L.

Higgins, L.

Sandwich, E.

Holderness, L.

Selborne, E.

Home, E.

Simon of Glaisdale, L.

Hooper, B.

Skelmersdale, L. [Teller.]

Howe, E.

Soulsby of Swaffham Prior, L.

Hylton-Foster, B.

Stewartby, L.

Jopling, L.

Stockton, E.

1455

Strafford, E.

Trefgarne, L.

Strange, B.

Trenchard, V.

Sudeley, L.

Tugendhat, L.

Swansea, L.

Vivian, L.

Swinfen, L.

Walpole, L.

Taylor of Warwick, L.

Walton of Detchant, L.

Tenby, V.

Weatherill, L.

Thurlow, L.

Wharton, B.

Torrington, V.

Wynford, L.

Young, B.

NOT-CONTENTS

Acton, L.

Hunt of Kings Heath, L.

Alli, L.

Irvine of Lairg, L. [Lord Chancellor.]

Amos, B.

Archer of Sandwell, L.

Janner of Braunstone, L.

Ashley of Stoke, L.

Jay of Paddington, B. [Lord Privy Seal.]

Bach, L.

Bassam of Brighton, L.

Jeger, B.

Berkeley, L.

Judd, L.

Borrie, L.

Kennet, L.

Brooke of Alverthorpe, L.

Laming, L.

Burlison, L.

Levy, L.

Carter, L. [Teller.]

Lincoln, Bp.

Castle of Blackburn, B.

Longford, E.

Christopher, L.

Lovell-Davis, L.

Clarke of Hampstead, L.

Macdonald of Tradeston, L.

Clinton-Davis, L.

McFarlane of Llandaff, B.

Cocks of Hartcliffe, L.

McIntosh of Haringey, L. [Teller.]

Crawley, B.

Mallalieu, B.

Currie of Marylebone, L.

Milner of Leeds, L.

David, B.

Molloy, L.

Davies of Oldham, L.

Monkswell, L.

Donoughue, L.

Morris of Castle Morris, L.

Dormand of Easington, L.

Morris of Manchester, L.

Emerton, B.

Nicol, B.

Farrington of Ribbleton, B.

Peston, L.

Gainsborough, E.

Ponsonby of Shulbrede, L.

Gilbert, L.

Ramsay of Cartvale, B.

Goudie, B.

Richard, L.

Gould of Potternewton, B.

Rogers of Riverside, L.

Graham of Edmonton, L.

Sainsbury of Turville, L.

Grenfell, L.

Scotland of Asthal, B.

Hacking, L.

Shore of Stepney, L.

Hanworth, V.

Simon, V.

Hardie, L.

Simon of Highbury, L.

Hardy of Wath, L.

Stoddart of Swindon, L.

Harris of Haringey, L.

Strabolgi, L.

Haskel, L.

Turner of Camden, B.

Hayman, B.

Walker of Doncaster, L.

Hilton of Eggardon, B.

Warner, L.

Hollis of Heigham, B.

Wedderburn of Charlton, L.

Howie of Troon, L.

Whitty, L.

Hoyle, L.

Williams of Elvel, L.

Hughes, L.

Williams of Mostyn, L.

Hughes of Woodside, L.

Young of Old Scone, B.

Resolved in the affirmative, and amendment agreed to accordingly.
5.28 p.m.
Baroness Hayman Baroness Hayman moved Amendments Nos. 8 to 12:
Page 12, line 28, after ("28A") insert ("41A").
Page 13, line 24, at end insert—
("( ) Subsection (3) of section 17 of the 1977 Act applies in relation to the powers to give directions conferred by sections 4, 6 and 8 of the National Health Service (Primary Care) Act 1997 (proposals for, and making, variation and termination of, pilot schemes) as it applies in relation to the powers conferred by any of the provisions mentioned in paragraphs (a) to (c) of that subsection. ").
Page 13, line 29, leave out ("16C") and insert ("16D").
Page 13, line 32, leave out ("16C") and insert ("16D").
Page 13, line 36, leave out ("16C") and insert ("16D").
The noble Baroness said: My Lords, these amendments have already been spoken to. I beg to move.
On Question, amendments agreed to.
Clause 15 [Duty of quality]:
Lord Clement-Jones Lord Clement-Jones moved Amendment No. 13:
Page 16, line 30, at end insert ("including, without prejudice to the generality of this section, general clinical care as well as medical treatment, and the promotion of health, ").
The noble Lord said: My Lords, on Report the Minister said:
"in the spirit of reading through the entrails after our previous debate, as noble Lords have done, I shall be happy, in the light of the specific points that have been raised in the debate, to check once again that nothing which has been pinpointed as essential in the contributions that noble Lords have made tonight is beyond the scope of the present definition ". —[Official Report, 15/3/99; col. 581].
We debated the definition of "healthcare" in what was then Clause 13 both on Report and in Committee. I make no apology for returning to this to ask the Minister whether she finds that definition in good or bad health after her examination of the "entrails", which I thought was a particularly apt expression to come from a Minister responsible for health.
Many issues are involved in this matter, which we have debated at some length. However, it still seems to us on these Benches that that definition is defective. I cannot see how the delivery of babies is an illness, yet the Bill purports, in terms of quality, to regulate that. Also, it is still not clear that public health promotion is covered by the definition in terms of the duty of quality. This is crucial. If noble Lords consider the Minister's assurance in Committee that local authorities cannot charge for healthcare, they will recognise that the definition of "healthcare" is absolutely pivotal when it comes to the distinction as to whether or not a means-tested charge applies or whether the service is free at the point of delivery, as in the NHS. Those distinctions will become more and more important. That is why we must get the definition of "healthcare" right. Has the Minister had time to reflect on that? It will be a very important definition in the years to come. I beg to move.
5.30 p.m.
Baroness Hayman: My Lords, I have indeed reflected further, read the "entrails" and tested the issue, as I undertook to do at various points in our earlier debates. I have checked whether or not the present definition misses anything essential. I can advise the noble Lord and the House that I remain convinced that the duty covers all that it needs to.
One example cited by the noble Lord, Lord Clement-Jones, as a service which the duty must cover—he repeated it today—was that of the treatment of pregnant women and their care immediately after childbirth. I agree it would be quite wrong if such a significant area of NHS provision were to be excluded from the duty, but in fact this example demonstrates quite well the intentional breadth of the drafting as it stands. The noble Lord is quite right to say that pregnancy is not an illness; it is a perfectly natural and, by and large, healthy state. But the NHS has an important preventive role in normal childbirth: it is on hand to help make sure that nothing goes wrong, and that avoidable harm befalls neither mother nor baby before, during or immediately after labour. This is quite clearly within the scope of the Bill's definition.

1457
The noble Lord referred to public health provision. Smoking cessation services and screening services would equally be covered by the definition and therefore by the duty of quality. Similarly, I remain of the view that the duty adequately covers nursing care—I referred on Report to the explicit reference to nursing in the part of the 1977 Act on which this definition draws. I think that what I said on Report about health promotion activity also holds true. As far as NHS trust and PCT provision is concerned, activities which promote health will also prevent illness, and vice versa.
In case your Lordships are still unconvinced, and perhaps fear that some services somehow will be "missed" by clinical governance as a consequence of the way the duty is worded, I should emphasise that clinical governance in NHS trusts and PCTs will be implemented on an organisation-wide basis. It will apply as much to trust-wide activities such as complaints, ensuring that staff are up to date with best practice, and detecting and tackling poor performance as it will to specific service areas. As a result, it is very difficult to see how any areas of clinically-related activity could in practice escape its impact.
I hope that the noble Lord will accept that my opposition to his amendment is not because of "pride of authorship", to quote what he said earlier. I share his concern that the duty should cover as full a range of provision as is practicable, but I also take the view that we should expand on the present form of words only if there are important gaps to fill. I have given this matter careful consideration and I believe that the duty as drafted is wide enough to cover the areas which the noble Lord has highlighted. In the light of that, I hope that he will feel able to withdraw his amendment.
Lord Clement-Jones: My Lords, I thank the Minister for that reply and am grateful to her for re-examining both the definition and the "entrails". The Minister's more comprehensive reply this time round and the previous absolute assurance that local authorities will not be able to charge for healthcare will be of considerable reassurance once the Bill has passed. I beg leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Clause 16 [The Commission for Health Improvement]:
Baroness Hayman Baroness Hayman moved Amendment No. 14:
Page 16, line 33, leave out from ("Improvement") to end of line.
On Question, amendment agreed to.
Clause 17 [Functions of the Commission]:
[Amendment No. 15 not moved]
Clause 19 [Restrictions on disclosure of information]:
Baroness Hayman Baroness Hayman moved Amendment No. 16:
Page 20, line 30, leave out from ("of') to end of line 31 and insert ("a serious arrestable offence, ").
The noble Baroness said: My Lords, in moving Amendment No. 16, I should like to speak also to Amendment No. 17. In previous debates, considerable concern was raised about this provision, which is Clause 19(5)(e). I have listened to mis concern, and am grateful for the comments on how we might amend the provision. As I indicated earlier, we have been reflecting on the most appropriate precedent to use to allow the commission to disclose confidential information only in connection with the investigation of a serious criminal offence. I hope these amendments will satisfy your Lordships' concerns.
The amendments have been drafted to allow disclosure of confidential information only in connection with a serious arrestable offence. Such offences would include murder, manslaughter and rape. For England and Wales, a "serious arrestable" offence is defined in accordance with Section 116 of the Police and Criminal Evidence Act 1984. That Act applies only to England and Wales, so a reference to it will not be sufficient to cover the investigation of serious arrestable offences in other parts of the UK. Therefore, we have also used the definition of "serious arrestable offence" in Article 87 of the Police and Criminal Evidence (Northern Ireland) Order 1989, to cover offences in Northern Ireland. I am informed that in Scotland there is no direct equivalent to the term "serious arrestable offence", but that the nearest equivalent term for an offence triable in Scotland would be an "offence triable on indictment". These definitions, we feel, capture those crimes which are of a sufficiently serious or grave nature to warrant the commission being allowed to disclose confidential information to the police for the purposes of an investigation.
I hope that noble Lords will feel that we are therefore meeting the concerns raised about the commission's lawful authority to disclose confidential information.
While on the general subject, perhaps I may take this opportunity to report back on the other matters; relating to confidentiality to which I undertook to pay further attention. In addition to the issue which I hope is resolved by this amendment, I undertook to look again at two further areas. They are, first, the safeguards on disclosure of information about the deceased and, secondly, safeguards regarding information which identifies an individual or enables that individual to be identified.
In these areas we have undertaken further discussion with the professions. It is important that we get this right From previous debates noble Lords will know that the question of handling information about the deceased is difficult Nevertheless, we wish to find a way forward which will properly safeguard the confidentiality of information relating to the deceased.
Noble Lords are aware that the extent to which the legal duty of confidentiality extends beyond death is unclear, and that, generally speaking, no one has a legal authority to give consent on behalf of a deceased individual for access to or disclosure of confidential information.
In the light of these significant legal uncertainties and complexities, we intend to issue guidance to the commission. We will look to further our helpful discussions with the professions on how such guidance might be drawn up; for example, how it might reflect the ethical duty of confidentiality that all health professionals have to their patients, living or dead, and how it might provide clarity on the circumstances under which information about the deceased might be disclosed where this is justified only on reasonable grounds. Any such guidance would also need to make clear the contractual duty of confidentiality that the commission's staff will have with regard to access to and disclosure of confidential information about individuals. We are considering whether there is an appropriate way of including a provision in the Bill relating to such guidance.
As regards the second point, we share the concern expressed by several Members of your Lordships' House that in some circumstances the identity of an individual may be ascertained from anonymised information where this is combined with other information.
We propose to bring forward amendments to the Bill at a later date which we hope will address these concerns. These will aim to tighten up the provisions in the Bill to protect the confidentiality of information about individuals. I hope that today I have been able to provide some clarity on our intentions in some areas relating to confidentiality and to bring forward specific amendments which deal with the seriousness of the offence for which the commission will have the authority to disclose confidential information. I beg to move.
Lord Clement-Jones: My Lords, I thank the Minister for bringing forward this amendment which conforms very closely to the suggestion I made at Report stage as regards the definition of a serious arrestable offence. I am quite sure that the medical profession will be very reassured that it now aligns the duties in the Bill very closely with its commonly accepted professional standards and duties.
On Question, amendment agreed to.
Baroness Hayman Baroness Hayman moved Amendment No. 17:
Page 20, line 45, at end insert—
('"'serious arrestable offence"—

(a) in relation to England and Wales, is to be construed in accordance with section 116 of the Police and Criminal Evidence Act 1984,

(b) in relation to Scotland, means an offence which is triable on indictment,

(c) in relation to Northern Ireland, is to be construed in accordance with Article 87 of the Police and Criminal Evidence (Northern Ireland) Order 1989. ").

On Question, amendment agreed to.
Clause 22 [Co-operation between NHS bodies]:
Baroness Masham of Ilton Baroness Masham of Ilton moved Amendment No. 18:
Page 22, line 4, at end insert—
("(2) The duty in subsection (1) applies in particular to co-operation in enabling patients resident in an area covered by a body referred to in that subsection to be referred out of that area where appropriate for the purpose of receiving specialist hospital treatment and after-care. ").
The noble Baroness said: My Lords, this amendment covers the same principle as that in Amendment No. 7, which has been agreed to. The amendment has been spoken to and I hope that it will be agreed. I beg to move.
On Question, amendment agreed to.
Clause 34 [Controls: supplementary]:
Baroness Hayman Baroness Hayman moved Amendments Nos. 19 to 22:
Page 30, line 37, leave out (" 29(2)(a), (7) and") and insert (" 29(6) to").
Page 31, line 10, leave out ("and") and insert— ("(4A)").
Page 31, line 15, after ("Act") insert ("and section 49 of, and Schedule 10 to, the 1978 Act").
Page 31, line 22, at end insert ("or, as the case may be, the 1978 Act").
On Question, amendments agreed to.
5.45 p.m.
Clause 36 [Disqualification etc. of Part II practitioners]:
Lord Hunt of Kings Heath Lord Hunt of Kings Heath moved Amendment No. 23:
Page 37, line 40, leave out from ("to") to ("when") in line 41 and insert ("disqualify, or conditionally disqualify, him").
The noble Lord said: My Lords, in moving Amendment No. 23, I shall also speak to Amendments Nos. 24 to 34, Amendments Nos. 75 and 76 and Amendment No. 86 regarding the NHS tribunal in England and Wales and Amendments Nos. 38 to 61, 80, 81 and 90 which affect the provisions for the NHS tribunal in Scotland.
It may be easier if I speak first to the amendments for Part I of the Bill for England and Wales. These amendments attempt to clarify the provisions in Clause 36 of the Bill governing the NHS tribunal in England and Wales. There are also minor consequential amendments to Schedule 4 and Schedule 5.
The NHS tribunal is the ultimate disciplinary body for family health service practitioners. Clause 36 provides new powers for the tribunal to disqualify practitioners who commit fraud against the NHS. Noble Lords will know from previous debates that the tribunal currently only investigates cases where it is alleged that the continued inclusion of a practitioner on a health authority's list for that service would be prejudicial to the efficiency of that service. It is a small minority of practitioners who commit fraud against the NHS, but it is a minority which needs to be tackled.
The majority of the amendments introduce minor textual changes such as the introduction of the terms "local disqualification" and "national disqualification" which attempt to make the clause clearer for the reader. In particular I draw the attention of the House to Amendments Nos. 33 and 34 which, in the main, make drafting changes to clarify the action that the tribunal may take on review of a fraud case. As your Lordships will be aware, Clause 36 introduces several new sections into the 1977 Act. In order to aid understanding, Amendment No. 34 also introduces two new provisions into one of these new sections, the new Section 47, so that fewer provisions will need to be read in conjunction with the others. These are, first, that the tribunal shall not impose any disqualification on review where it would be unjust to do so and, secondly, to clarify when a determination on review would have effect.
As regards Amendments Nos. 38 to 61, 80, 81 and 90 affecting the NHS tribunal in Scotland, the Scottish tribunal is essentially similar to the tribunal for England and Wales. It draws its powers from the 1978 Act to which Clause 50 and these amendments seek to make changes. Noble Lords will recall that I introduced a number of amendments at Report stage which added some important new provisions to those already in the Bill. At that time I informed your Lordships' House that my noble friend Lord Macdonald of Tradeston was looking to bring forward similar amendments to those I had brought forward at that stage.
I shall not go over all the same ground that I covered rather extensively on Report. However, I shall briefly mention that they cover a range of areas including allowing the NHS tribunal in Scotland to disqualify bodies corporate which commit fraud from providing ophthalmic and pharmaceutical services in the family health services. There is an amendment to the definition of fraudulent conduct to provide a clearer

1461
definition against which the NHS tribunal would test the conduct of practitioners. It will ensure that decisions of the tribunals in England and Wales and Northern Ireland are applied similarly to Scotland. These amendments for the Scottish tribunal also incorporate equivalent amendments to those I am speaking to for England and Wales today.
As regards England and Wales, these amendments do not change the fundamental purpose or impact of the existing tribunal provisions in the Bill, but they are needed for clarity and to ensure that the NHS tribunal can work as intended. These provisions are part of our comprehensive strategy for countering fraud in the National Health Service. I beg to move.
Baroness Carnegy of Lour: My Lords, it is difficult to follow what has happened to the Bill as a result of these amendments. I am grateful to the noble Lord, Lord Macdonald, who wrote to me saying that he has asked the Scottish Office officials to compile an updated consolidated version of provisions in the Bill resulting from these amendments. That is a great help.
I hope the Government have taken on board the fact that things have been difficult for us and to require a consolidated version in order to understand the Bill is obviously not good enough. I hope that both the Government and the future Ministers of the Scottish Parliament will read the tea leaves here and try and prepare legislation which is easier for Members of both Houses to understand. I am grateful for this and I am sure that Members in another place will be grateful also because they will have the benefit of it before they look at the changes. They will be able to see whether the tribunals in Scotland seem to them to be adequately provided for.
The Earl of Mar and Kellie: My Lords, I suspect I should know this, but will the Minister clarify for me whether the NHS tribunal is a UK-wide body or whether there is a separate NHS tribunal in Scotland? I believe he said that there was, but that was not my understanding.
Lord Hunt of Kings Heath: My Lords, it is my understanding that they are separate tribunals but I shall be happy to send further details of the composition and make-up to the noble Earl if he wishes.
Perhaps I may say to the noble Baroness, Lady Carnegy, that I took careful note of the comments on these matters made by noble Lords during Report stage, particularly those of the noble Lord, Lord Renton. I have ensured that those comments were brought to the attention of the appropriate people.
On Question, amendment agreed to.
Lord Hunt of Kings Heath Lord Hunt of Kings Heath moved Amendments Nos. 24 to 34:
Page 37, line 43, leave out ("exercise that power") and insert ("disqualify, or conditionally disqualify, him").
Page 37, line 46, leave out ("exercise that power") and insert ("disqualify, or conditionally disqualify, him").
Page 38, line 12, after ("shall") insert ("make a local disqualification, that is").
Page 38, line 14, after ("may") insert ("also make a national disqualification, that is").
Page 38, line 17, leave out from ('Tribunal") to ("they") in line 18 and insert ("make a national disqualification").
Page 38, line 31, leave out ("power to disqualify") and insert ("functions of making Disqualifications").
Page 38, line 32, leave out ("includes power to make") and insert ("include making").
Page 38, line 37, leave out ("under") and insert ("by virtue of").
Page 39, line 7, leave out ("under") and insert ("by virtue of").
Page 39, leave out lines 25 to 35 and insert—
("and, on a review of a fraud case, may make any further disqualification or conditional disqualification which they consider appropriate. ").
Page 40, leave out lines 10 to 17 and insert—
("and, on a review of a fraud case, may make any further disqualification or conditional disqualification which they consider appropriate.
( ) If, on a review under this section of a fraud case—

(a) there is a national disqualification which the Tribunal do not remove or make conditional,

(b) there is a national disqualification which is conditional and which the Tribunal make unconditional, or

(c) the Tribunal make a national disqualification,

they may also make a declaration of unfitness.
( ) The Tribunal shall not under this section—

(a) in the case of a conditional disqualification, make it unconditional or vary the conditions.

(b) make any further disqualification or conditional disqualification, or

(c) make a declaration of unfitness,

if they are of the opinion that it would be unjust to do so.
( ) A determination of the Tribunal under this section shall have effect—

(a) if no appeal is brought against it, at the end of the period for bringing an appeal,

(b) if an appeal is brought against it, when the appeal process is exhausted. ").

The noble Lord said: My Lords, with the leave of the House I shall move Amendments Nos. 24 to 34 en bloc. I beg to move.
On Question, amendments agreed to.
Clause 39 [Repeal of law about fund-holding practices]:
Lord Hunt of Kings Heath Lord Hunt of Kings Heath moved Amendment No. 35:
Page 41, line 26, leave out from ("1978") to ("sections") in line 27.
On Question, amendment agreed to.
Clause 45 [Expenditure of Health Boards and other bodies]:
Lord Hunt of Kings Heath Lord Hunt of Kings Heath moved Amendment No. 36:
Page 43, line 28, leave out ("(d)") and insert ("(e)").
On Question, amendment agreed to.
Lord Hunt of Kings Heath Lord Hunt of Kings Heath moved Amendment No. 37:
After Clause 49, insert the following new clause—
REMUNERATION FOR PART II SERVICES: SCOTLAND
(". —(1) For sections 28A and 28B of the 1978 Act (regulations as to remuneration) there is substituted—
"Remuneration for Part II services.
28A. —(1) The remuneration to be paid to persons who provide general medical services, general dental services, general ophthalmic services or pharmaceutical services under this Part of this Act shall be determined by determining authorities (and they may also determine the remuneration to be paid to persons providing those services in respect of the instruction of any person in matters relating to those services).
(2) For the purposes of this section and section 28B, determining authorities are—

(a) the Secretary of State; and

(b) so far as authorised by him to exercise the functions of determining authorities, any Health Board or other person appointed by him in an instrument (referred to in this section and section 28B as an instrument of appointment).

(3) An instrument of appointment—

(a) may contain requirements with which a determining authority appointed by that instrument must comply in making determinations; and

(b) may be contained in regulations.

(4) Subject to this section and section 28B, regulations may make provision about determining remuneration under subsection (1) and may in particular impose requirements with which determining authorities must comply in making, or in connection with, determinations (including requirements as to consultation and publication).
(5) Regulations may provide—

(a) that determinations may be made by reference to any of the following—

(i) rates or conditions of remuneration of any persons or any descriptions of persons which are fixed or determined, or to be fixed or determined, otherwise than by way of a determination under subsection (1);

(ii) scales, indices or other data of any description specified in the regulations;

(b) that any determination which in accordance with regulations made by virtue of paragraph (a)(ii) falls to be made by reference to a scale or an index or to any other data may be made not only by reference to that scale or index or those data in the form current at the time of the determination but also by reference to the scale, index or data in any subsequent form attributable to amendment or revision taking effect after that time or to any other cause.

(6) Regulations may—

(a) provide that determining authorities may make determinations which have effect in relation to remuneration in respect of a period beginning on or after a date specified in the determination, which may be the date of the determination or an earlier or later date, but may be an earlier date only if, taking the determination as a whole, it is not detrimental to the persons to whose remuneration it relates;

(b) provide that any such determination which does not specify such a date shall have effect in relation to remuneration in respect of a period beginning—

(i) if it is required to be published, on the date of publication;

(ii) if it is not so required, on the date on which it is made.

(7) A reference in this section or section 28B to a determination is a reference to a determination of remuneration under subsection (1) of this section.
Part II remuneration: supplementary.
28B. —(1) Before a determination is made by the Secretary of State which relates to all persons who provide services of, or of a category falling within, one of the descriptions of services mentioned in section 28A(1), he shall consult at least one of the following bodies—

(a) a body one of whose functions is to provide advice in connection with the matters to be determined; or

1464

(b) a body appearing to him to be representative of persons to whose remuneration the determination would relate.

(2) Determinations may make different provision for different cases including different provision for any particular case, class of case or area.
(3) Determinations may—

(a) be made in more than one stage;

(b) be made by more than one determining authority;

(c) be varied or revoked by subsequent determinations.

(4) A determination may be revised—

(a) to correct an error, or

(b) where it appears to the determining authority that it was made in ignorance of or under a mistake as to a relevant fact.

(5) Determinations may, in particular, provide that the whole or any part of the remuneration—

(a) is payable only if the determining authority is satisfied as to certain conditions; or

(b) is to be applied for certain purposes or is otherwise subject to certain conditions.

(6) Subject to sections 19(3) and 25(3), remuneration under section 28A may consist of payments by way of—

(a) salary;

(b) fees;

(c) allowances;

(d) reimbursement (in full or in part) of expenses incurred or expected to be incurred in connection with the provision of the services or instruction,

and may be determined from time to time.
(7) At the time a determination is made or varied, certain matters which require determining may be reserved to be decided at a later date.
(8) The matters which may be reserved include in particular—

(a) the amount of remuneration to be paid in particular cases;

(b) whether any remuneration is to be paid in particular cases.

(9) Any determination shall be made after taking into account all the matters which are considered to be relevant by the determining authority and such matters may include in particular—

(a) the amount or estimated amount of expenses (taking into account any discounts) incurred in the past or likely to be incurred in the future (whether or not by persons to whose remuneration the determination will relate) in connection with the provision of services of the description in section 28A(1) to which the determination will relate or of any category falling within that description;

(b) the amount or estimated amount of any remuneration paid or likely to be paid to persons providing such services;

(c) the amount or estimated amount of any other payments or repayments or other benefits received or likely to be received by any such persons;

1465

(d) the extent to which it is desirable to encourage the provision, either generally or in particular places, of the description or category of services to which the determination will relate;

(e) the desirability of promoting services which are—

(i) economic and efficient; and

(ii) of an appropriate standard.

(10) If the determination is of remuneration for a category of services falling within one of the descriptions of services mentioned in section 28A(1), the reference in subsection (9)(a) to a category of services is a reference to the same category of services or to any other category of services falling within the same description."
(2) Sections 28A and 28B of the 1978 Act as substituted by this section have effect in relation to—

(a) the making of determinations on or after the commencement of this section; and

(b) the variation, revocation or revision on or after the commencement of this section of determinations whenever made,

and in this subsection "determinations" means determinations under Part II of the 1978 Act of the remuneration to be paid to persons who provide services mentioned in section 28A(1).
(3) Section 7(4) of the Health and Social Security Act 1984 and section 15(3) of the Health and Medicines Act 1988 (determinations of remuneration for services under Part II of the 1978 Act deemed to be valid) have effect in relation to Scotland as if—

(a) after "inserted by this section" in section 7(4)(b) of the 1984 Act; and

(b) after "section 7 of the Health and Social Security Act 1984" in section 15(3) of the 1988 Act,

there were inserted "and before the coming into force of section (Remuneration for Part II services: Scotland) of the Health Act 1999".
(4) The reference in section 28B(6) of the 1978 Act (as substituted by this section) to section 19(3) of that Act is to be read on and after the commencement of section 10 of the National Health Service Act 1966 as a reference to that section. ").
On Question, amendment agreed to.
Clause 50 [Disqualification of Part II practitioners]:
Lord Hunt of Kings Heath Lord Hunt of Kings Heath moved Amendments Nos. 38 to 61:
Page 49, line 1, leave out from ("receive") to end of line 9 and insert ("from a Health Board representations that—

(a) a person who is included in any list meets either of the conditions for disqualification, or

(b) a person who has applied to be included in any list meets the second condition for disqualification, ").

Page 49, line 11, leave out ("representations within subsection (2)(a)") and insert ("such representations").
Page 49, line 16, leave out from beginning to ("a") in line 21 and insert—
("(b) where the representations are that the second condition for disqualification is met and regulations prescribe the time within which such representations are to be made, within that time.
(4A) Subsectioas (4B) to (5C) apply for the purposes of this group of sections.
(4B) The first condition for disqualification is that the continued inclusion of the person concerned in the list would be prejudicial to the efficiency of the services which those included in the list undertake to provide.
(4C) The second condition for disqualification is that the person concerned—
1466

(a) has (whether on his own or together with another) by an act or omission caused, or risked causing, detriment to any health scheme by securing or trying to secure for himself or another any financial or other benefit; and

(b) knew that he or (as the case may be) the other was not entitled to the benefit.

(5)").
Page 49, line 32, at end insert —
("(5A) "Health scheme" means—

(a) any of the health services under section 1(1) or any corresponding enactment extending to England and Wales or Northern Ireland; and

(b) any prescribed scheme;

and regulations may prescribe any scheme for the purposes of this subsection which appears to the Secretary of State to be a health or medical scheme paid for out of public funds.
(5B) Detriment to a health scheme includes detriment to any patient of, or person working in, that scheme or any person liable to pay charges for services provided under that scheme.
(5C) Cases in which representations are made that the first condition for disqualification is met are referred to below as efficiency cases; and cases in which representations are made that the second condition for disqualification is met are referred to below as fraud cases. ").
Page 49, line 35, after ("sections") insert ("and Schedule 8").
Page 49, line 37, leave out from beginning to end of line 28 on page 50 and insert—
("The NHS Tribunal: supplementary.
29A. —(1) Where an ophthalmic optician is a body corporate, the body corporate is to be treated for the purposes of this group of sections as meeting the second condition for disqualification if any director meets that condition (whether or not he first met that condition when he was a director).
(2) Where a body corporate Games on a retail pharmacy business, the body corporate is to be treated for the purposes of this group of sections as meeting the second condition for disqualification if any one of the body of persons controlling the body corporate meets that condition (whether or not he first met that condition when he was one of them).
(3) A person who is included in any list ("the practitioner") is to be treated for the purposes of this group of sections as meeting the second condition for disqualification if—

(a) another person, because of an act or omission of his occurring in the course of providing any services mentioned in section 29(5) on the practitioner's behalf, meets that condition; and

(b) the practitioner failed to take all such steps as were reasonable to prevent acts or omissions within section 29(4C)(a) occurring in the course of the provision of those services on his behalf.

(4) The Tribunal is not requited to inquire into a fraud case if they have previously inquired into representations in respect of the person concerned and the same acts or omissions.
(5) In a fraud case, regulations may make provision (including provision modifying the effect of this Part) for the purpose of securing that the person subject to the inquiry is not added to any list until proceedings in that case are finally concluded.
(6) For the purposes of this group of sections, in a fraud or efficiency case proceedings are finally concluded—

(a) if the Tribunal determine not to disqualify or conditionally disqualify him when they make that determination;

(b) if they determine to disqualify or conditionally disqualify him and no appeal is brought against the determination, at the end of the period for bringing an appeal;

1467

(c) if they determine to disqualify or conditionally disqualify him and an appeal is brought against the determination, when the appeal process is exhausted.

(7) An inquiry under section 29 is not affected by the person subject to the inquiry withdrawing from, withdrawing any application to be included in or being removed from the list to which the case relates.
Powers of NHS Tribunal.
29B. —(1) Subsection (2) applies where the Tribunal are of the opinion—

(a) on inquiring into an efficiency case, that the person meets the first condition for disqualification;

(b) on inquiring into a fraud case, that the person meets the second condition for disqualification.

(2) The Tribunal—

(a) shall make a local disqualification, that is disqualify him for inclusion in the list to which the case relates; and

(b) may also make a national disqualification, that is disqualify him for inclusion in all lists within the same paragraph of section 29(5) as that list. ").

Page 50, line 29, leave out from ('Tribunal") to ("they") in line 30 and insert ("make a national disqualification").
Page 50, line 32, leave out ("in question") and insert ("to which the lists in question relate").
Page 50, line 37, leave out from ("section") to end of line 44 and insert ("shall have effect when the case is finally concluded. ").
Page 50, line 45, leave out from ("disqualified") to end of line and insert ("for").
Page 51, line 1, leave out from ("The") to ("that") in line 2 and insert ("functions of making disqualifications under section 29B include making a conditional disqualification, ").
Page 51, line 3, leave out ("they") and insert ("the Tribunal").
Page 51, line 7, leave out ("under") and insert ("by virtue of").
Page 51, line 11, leave out from ("any") to end of line 12 and insert ("acts or omissions within section 29(4C)(a), ").
Page 51, line 13, at end insert—
("(2A) Conditions so imposed shall have effect when proceedings in the case are finally concluded.
(2B) Section 29B(5) applies to a conditional disqualification as it applies to a disqualification. ").
Page 51, line 14, leave out ("in writing").
Page 51, line 17, leave out ("or").
Page 51, line 20, leave out ("under") and insert ("by virtue of").
Page 51, line 21, leave out from ("References") to ("do") in line 22 and insert ("in any enactment to a disqualification by the Tribunal").
Page 51, line 27, leave out ("(whether or not conditional)") and insert (", conditional disqualification").
Page 51, line 28, after ("disqualified") insert ("or conditionally disqualified").
Page 51, leave out lines 37 to 45 and insert—
("and, on a review of a fraud case, may make any further disqualification or conditional disqualification which they consider appropriate").
Page 51, leave out lines 46 and 47 and insert—
("(3) If any Health Board request a review of a conditional disqualification on the ground that—

(a) there has been a change in the circumstances by reference to which the conditions were imposed;

(b) the person concerned has failed to comply with the conditions; or

1468

(c) in a fraud case, the person concerned has since the Tribunal imposed the conditions (or made the disqualification conditional) again satisfied the second condition for disqualification,

the Tribunal shall review the conditional disqualification.
(3A) In the case of a person who is providing services in England and Wales or Northern Ireland, the reference in subsection (3) to a Health Board includes any corresponding authority under the provisions in force in England and Wales or Northern Ireland corresponding to this Part. ").
Page 52, leave out lines 5 to 12 and insert—
("and, on a review of a fraud case, may make any further disqualification or conditional disqualification which they consider appropriate.
( ) If, on a review under this section of a fraud case—

(a) there is a national disqualification which the Tribunal do not remove or make conditional;

(b) there is a national disqualification which is conditional and which the Tribunal make unconditional; or

(c) the Tribunal make a national disqualification,

they may also make a declaration of unfitness.
( )The Tribunal shall not under this section—

(a)in the case of a conditional disqualification, make it unconditional or vary the conditions; or

(b) make any further disqualification or conditional disqualification;

(c) make a declaration of unfitness,

if they are of the opinion that it would be unjust to do so.
( ) A determination by the Tribunal under this section shall have effect—

(a) if no appeal is brought against it, at the end of the period for bringing an appeal;

(b) if an appeal is brought against it, when the appeal process is exhausted. ").

The noble Lord said: My Lords, with the leave of the House I shall move Amendments Nos. 38 to 61 en bloc. I beg to move.
On Question, amendments agreed to.
Clause 55 [Interpretation]:
Lord Hunt of Kings Heath Lord Hunt of Kings Heath moved Amendment No. 62:
Page 56, line 23, at end insert—
(""the 1978 Act" means the National Health Service (Scotland) Act 1978, ").
On Question, amendment agreed to.
Schedule 1 [Primary Care Trusts]:
Lord Hunt of Kings Heath Lord Hunt of Kings Heath moved Amendments Nos. 63 and 64:
Page 61, line 32, leave out from beginning to ("to") in line 33 and insert ("Provision must be made by regulations requiring Primary Care Trusts").
Page 61, line 39, at end insert—
("by taking such steps as may be specified in the regulations. ").
The noble Lord said: My Lords, with the leave of the House I shall move Amendments Nos. 63 and 64 en bloc. I beg to move.
On Question, amendments agreed to.
Schedule 2 [The Commission for Health Improvement]:
Lord Hunt of Kings Heath Lord Hunt of Kings Heath moved Amendments Nos. 65 and 66:
Page 67, line 1, leave out sub-paragraph (3).
Page 67, line 3, leave out (", together with copies of the auditors' report, ").
The noble Lord said: My Lords, with the leave of the House I shall move Amendments Nos. 65 and 66 en bloc.
On Question, amendments agreed to.
Schedule 3 [Regulation of health care and associated professions]:
Baroness Hayman Baroness Hayman moved Amendment No. 67:
Page 69, leave out lines 26 and 27 and insert—
("(b) invite representations to be made to him about the draft by persons appearing to him appropriate to represent the profession to be regulated, persons appearing to him appropriate to represent those provided with services by the profession and any other persons appearing to him appropriate to consult about the draft. ").
The noble Baroness said: My Lords, this is another issue with which we dealt at both Committee and Report stages. I am pleased to be able to bring forward an amendment which I hope meets the wishes of the House.
We discussed at previous stages the need, in bringing forward an order on professional self-regulation, for proper consultation before the order-making power is used. As I explained, it has always been our intention that consultation on any proposals to use the order-making power should be wide. The views of a number of interests will need to be taken into account, including the professions, the NHS, patients, service users and the wider public. This amendment reflects that intention by broadening the Secretary of State's duty to consult about the draft. At this late stage in our deliberations I would not wish to create a precedent by involving the imposition of a list of those to be consulted on the face of the Bill. We have discussed at length the dangers of that. But we want to make quite clear that the Secretary of State's consultation must not just be with the profession affected by the proposed order.
We have all agreed that the primary purpose of professional self-regulation is the protection of the public and it is right that the responsibility towards consultation with the public, patients and carers should be on the face of the Bill. The Secretary of State will want to consult representatives of the interests of patients and other service users, as well as other interested parties such as the Scottish Parliament and the Welsh and Northern Ireland Assemblies.
Although this amendment varies in drafting terms from those tabled by the noble Baroness, Lady Wilcox, who I know had to go abroad and is therefore not able to be in your Lordships' House today, I hope noble Lords will agree that this amendment meets the objectives she had in mind when arguing on previous amendments before the House. I beg to move.
Lord Morris of Manchester: My Lords, I intervene only briefly. This is an important amendment that I welcome. It provides an opportunity to emphasise again today how essential it is for Ministers to ensure that the profession to be regulated is fully and meaningfully consulted. The amendment also enables those of us who have debated Schedule 3 with her to thank my noble friend, both for her stamina and her abiding readiness to listen.
1470
The Committee and Report stages of the Bill led to positive developments that include commitments from the Government on the protection of title, on continuing the role of the Privy Council in relation to the professions, and on additional safeguards covering future use of order-making powers. There was some progress also in relation to protecting professional self-regulation.
I hope very much that in the spirit of this amendment the Government will go on listening to the professions, especially where demonstrably their principal concern is for high professional standards and protecting the public interest. As the Minister knows, I speak as President of the Society of Chiropodists and Podiatrists and I spelt out their concerns. But the more I speak to representatives of other professions, the clearer it becomes that our concerns are very widely shared.
My noble friend told your Lordships' House that she was sure that her objectives would soon be shown to be the same as those of the society. She also made it clear that she would welcome further dialogue with us and the society looks forward very much to a further meeting with her. Meanwhile, I hope her amendment will be quickly approved.
Baroness McFarlane of Llandaff: My Lords I, too, add my thanks to those of my noble friend Lord Walton of Detchant and the noble Lord, Lord Morris of Manchester, for the great care that the Minister has shown in meeting our concerns about professional self-regulation and building in so many safeguards for both the public and the professions. I know that the Royal College of Nursing and the UKCC are now happy with the Bill and this schedule as it stands printed. I am delighted to support this amendment.
Lord Clement-Jones: My Lords, I rise briefly to add my thanks to the Minister for her flexibility in the course of the passage of the Bill in this particular respect, and to make one short point on behalf of some of the professions allied to medicine.
The Minister made it clear throughout the course of the Bill what the process of consultation going forward now is in terms of the new council. Many of those professions have been reassured by the safeguards now in place. But then: is still some concern about the elements that will be brought within a uni-professional majority and the noble Lord, Lord Morris, expressed some of those concerns on behalf of the Society of Chiropodists and Podiatrists. Others, such as the physiotherapists, have similar concerns, and are concerned about whether it is possible—they believe it is not—to split the fitness to practise aspects between different types of case. That seemed to be the implication of some of the responses by the Minister at Report stage.
Clearly these consultations will be carried forward, but I urge the Minister, in the course of those consultations, to be aware that a number of the professions wish to see education, training and fitness to practise all brought within that uni-professional majority.
6 p.m.
Baroness Hayman: My Lords, I am most grateful to noble Lords for the generosity of their response. I believe that we have actually improved the Bill as regards Schedule 3 and that we have managed to meet the legitimate concerns of the professions that there

1471
should be sufficient safeguards in the future. I was personally pleased that we were also able with that amendment to put clearly on the face of the Bill the interests of the users of health services. I believe that the right balance has been struck in that respect.
I have suggested to the House that it would be inappropriate to talk about the detailed content of proposals upon which we will be consulting at a future date in terms of this Bill. The Bill allows us to have those debates and I fully take on board those points made by my noble friend Lord Morris and the noble Lord, Lord Clement-Jones. I understand the concerns regarding the need to have very detailed consultation to ensure that we get it right in terms of improving professional self-regulation for all the professions, but obviously the professions allied to medicine have particular concerns in this respect. I look forward to conducting those debates with the hope and expectation that we will be able to effect change thanks to the provisions of this Bill.
On Question, amendment agreed to.
Baroness Hayman Baroness Hayman moved Amendments Nos. 68 to 71:
Page 70, line 11, leave out ("references") and insert ("the reference").
Page 70, line 12, leave out ("include") and insert ("includes").
Page 70, line 12, leave out ("references") and insert ("the reference").
Page 70, line 13, leave out ("include") and insert ("includes").
On Question, amendments agreed to.
Schedule 4 [Amendments of enactments]:
Baroness Hayman Baroness Hayman moved Amendments Nos. 72 to 84:
Page 71, line 8, at end insert—
(". In section 12 (supplementary provisions for sections 8 and 11), subsection (1) is omitted. ").
Page 71, line 15, at end insert—
(". After section 16B (exercise of functions by Primary Care Trusts) there is inserted—
"Advice for Health Authorities and Primary Care Trusts.
16C. —(1) Every Health Authority shall make arrangements with a view to securing that they receive advice appropriate for enabling them effectively to exercise the functions exercisable by them from persons with professional expertise relating to the physical or mental health of individuals.
(2) This section applies to Primary Care Trusts as it applies to Health Authorities. "").
Page 72, line 6, at end insert—
(". In section 28C(4) (personal medical or dental services), for "13" there is substituted "16D". ").
Page 73, line 39, leave out from ('Tribunal") to ("they") in line 40 and insert ("make a national disqualification, ").
Page 73, line 48, leave out from ("substituted") to ("and") in line 49 and insert (""national disqualification"").
Page 75, line 42, at end insert—
("( ) In subsection (4), after "to make such" there is inserted "transitional, saving". ").
Page 76, line 5, leave out ("in") and insert ("by").
Page 76, line 27, leave out ("16C(1)") and insert ("16D(1)").
Page 77, line 37, at end insert—
1472
(". In section 19A(3)(b) (medical lists), for the words from first "disqualified" to "29" there is substituted "disqualified for inclusion in the list by, or by virtue of a direction of, the NHS Tribunal".
.Section 31 (disqualification provisions in England and Wales or Northern Ireland) is renumbered as subsection (1) of that section and—

(a) in paragraph (a), for the words from "services" to "29(1)" there is substituted "any of the services mentioned in one of the paragraphs of section 29(5)";

(b) in paragraph (b), at the beginning, there is inserted "in relation to the services in question" and for the words from "a list" to the end there is substituted "any list and (if also the subject of such a declaration under those provisions corresponding to a declaration of unfitness) be treated as if a declaration of unfitness had been made in respect of him";

(c) after that subsection there is inserted—

"(2) Where under the conditional disqualification provisions in England and Wales or Northern Ireland—

(a) any conditions are imposed in relation to the provision by any person of any of the services mentioned in section 29(5); or

(b) any conditions so imposed are varied,

the Secretary of State may, by a notice in writing given to each Health Board and to the person in question, impose those conditions in relation to the provision by that person of those services under this Part.
(3) A notice under subsection (2) may make such modifications of the conditions as the Secretary of State considers necessary for them to have the like effect in relation to Scotland as they have in relation to England and Wales or (as the case may be) Northern Ireland, but only if the Secretary of State has previously given the person concerned written notice of the proposed modifications and an opportunity (in accordance with such requirements, if any, as may be prescribed) to make representations about them.
(4) Conditions imposed by a notice under subsection (2) shall cease to have effect if the Secretary of State withdraws the notice by giving written notice to the person concerned.
(5) In this section, "the conditional disqualification provisions in England and Wales or Northern Ireland" means any provisions in force in England and Wales or Northern Ireland corresponding to sections 29C and (so far as relating to conditional disqualifications) 30. "
. Section 32 (regulations as to sections 29 to 31) is renumbered as subsection (1) of that section and—

(a) in paragraph (c) after "disqualification" in both places where it occurs there is inserted "or condition";

(b) after that subsection there is inserted—

"(2) Regulations under subsection (l)(a) above may in particular provide that, where (apart from the regulations) it would be the duty of the Tribunal to inquire into both an efficiency case and a fraud case in respect of the same person, they may inquire into one case before inquiring into the other and, after proceedings in the first case are finally disposed of, may if they think it appropriate adjourn the other case indefinitely. "
. In section 32A (applications for interim suspension)—
(a) after subsection (1) there is inserted—
"(1A) A Health Board may, if they have requested a review of a conditional disqualification on the ground mentioned in section 30(3)(b) or (c), at any time before the review is concluded apply to the Tribunal for a direction to be made under subsection (2) in relation to the person to whom the review relates. ";
(b) in subsection (2), for the words from "it" to "patients" there is substituted "either of the conditions for doing so is satisfied" and after "in question" there is inserted "or the case to which the review in question";
(c) after that subsection there is inserted—
"(2A) The conditions for giving such a direction are—

(a) that it is necessary to do so in order to protect persons who are, or may be, provided with services under this Part to which the case in question, or the case to which the review in question, relates;

(b) in, or in the case of a review relating to, a fraud case, that unless they do so there is a significant risk that—

(i) an act or omission within section 29(4C)(a) will occur; or

(ii) the investigation of the case or the review will be prejudiced";

(d) in subsection (3)(c), for the words from "under" to "engaged in" there is substituted "of unfitness in relation to";
(e) in subsection (4), after "case" there is inserted "or review";
(f) subsection (5) is omitted;
(g) in subsection (6)(a), "prepared under this Part of this Act" is omitted.
In section 32B (continuation of suspension pending appeal)—
(a) for subsection (1) and the preceding sidenote there is substituted—
"Suspension pending appeal.
32B. —(1) Where, on disposing of a case under section 29B, the Tribunal make a national disqualification, they may, if they consider that either of the conditions mentioned in section 32A(2A) is satisfied, direct that section 32A(3) shall apply or, if a direction has been given under section 32A(2), shall continue to apply to him as respects services of the kind to which the disqualification relates. ";

(b) in subsection (2), in paragraph (a), for "direction under section 29(2)(b)" there is substituted "national disqualification" and, in paragraph (b), for "that direction" there is substituted "the disqualification";

(c) in subsection (3), for the words from "direction" to "section 29(3)(c)" there is substituted "disqualification which is not coupled with a declaration of unfitness";

(d) subsection (4) is omitted.

. In section 32D (suspension provisions in England and Wales or Northern Ireland), for "29(1)" there is substituted "29(5)". ").
Page 78, line 43, at end insert—
(". In Schedule 8 (the Tribunal), in paragraph 8—

(a) in sub-paragraph (2)(a), for "section 29" there is substituted "sections 29 to 29C";

(b) in sub-paragraph (2)(b), after "disqualification" there is inserted "conditional disqualification or declaration of unfitness";

(c) in sub-paragraph (2)(d), for the words from "the application" to the end there is substituted "section 32A(3) may be made to apply or continue to apply". ").

Page 80, line 25, leave out (""16C"") and insert (""16D"").
Page 83, line 7, after ("Act)") insert—
("(a) in subsection (1), for "13" there is substituted "16D" and").
Page 83, line 8, at end insert—
("(b) in subsection (2)(b), for "13" there is substituted "16D". ").
On Question, amendments agreed to.
Schedule 5 [Repeals]:
Baroness Hayman Baroness Hayman moved Amendments Nos. 85 to 93:
Page 83, line 22, column 3, at end insert— ("Section 12(1). ")
Page 83, line 27, column 3, at end insert—

"In section 49A, subsection (5) and, in subsection (6)(a), "prepared under this Part of this Act". Section 49B(4). ")

Page 83, line 35, column 3, after ("section 97, ") insert ("subsection (2), ").
Page 83, line 40, column 3, at end insert—

("In section 122(2), "as a simple contract debt". ")

Page 84, line 5, column 3, leave out ("(2)(j)") and insert ("(2)(d) and (j)").
Page 84, line 8, column 3, at end insert—

("In section 32A, subsection (5) and, in subsection (6)(a), "prepared under this Part of this Act".

In section 32B, subsection (4). ").

Page 85, line 11, column 3, after ("paragraphs") insert ("3(a), ").
Page 85, line 15, at end insert—

(" 1997 c. 24.

The Nurses, Midwives and Health Visitors Act 1997.

The whole Act. ")

Page 85, line 19, at end insert—
("The repeal of section 97(2) of the 1977 Act has effect for the financial year 1999–2000 and subsequent financial years. ").
On Question, amendments agreed to.
In the Title
Earl Howe Earl Howe moved Amendment No. 94:
Line 4, after ("functions;") insert ("make provision in relation to monitoring and improving the quality of health care in independent hospitals;").
The noble Earl said: My Lords, this amendment is consequential upon the one agreed by your Lordships on Report which gives the Secretary of State a power to extend by order the duty of quality in Clause 13 and part or all of the remit of the commission for health improvement on to independent hospitals. It is technical amendment. I beg to move.
Lord Clement-Jones: My Lords, I rise briefly to express my support for the amendment which clearly is consequential. However, on consideration of it, I hope that the Government will not attempt to reverse the amendment made in another place. This is a very important aspect of the Bill for many of us. We believe that the standard of quality should apply right across healthcare in this country and not just in the NHS.
Baroness Hayman: My Lords, the noble Earl rightly said that this was a technical amendment which is consequential upon the amendment that we made on Report. We debated the issue of substance at that point and I do not intend to reopen that debate now. Erskine May makes it absolutely clear that debate on an amendment of the Title should be limited to the question of whether the alteration is necessary to bring the Title into conformity with the Bill. I am happy to accept the amendment on that basis.
On Question, amendment agreed to.
An amendment (privilege) made.
Baroness Hayman: My Lords, I beg to move that this Bill do now pass.
Earl Howe: My Lords, despite the general admonition from your Lordships' Procedure Committee, I hope that I may be permitted a very brief moment in which to draw together a few concluding thoughts. This has been a fascinating and rewarding Bill to debate. That has been due in part to the contributions of noble Lords from all sides of the House which have enabled us to achieve what I hoped on Second Reading we would achieve; namely, to correct the Bill's more glaring shortcomings. However, there was one indispensable ingredient in that process without which those corrective measures would have been well nigh unobtainable; that is, the contribution of the Minister.
In one of our recent exchanges the noble Baroness remarked that it "takes two to tango". It is her consistently receptive and constructive approach to our debates which I believe merits recognition and for which from these Benches I should like to thank her. If one disregards for a moment the amendments which have been agreed to against the Government's recommendation, I trust that the noble Baroness will agree that what we now have, especially in relation to pharmaceutical pricing and professional self-regulation, is a distinctly better Bill than the one initially set before us.
Lord Clement-Jones: My Lords, in the spirit of the admonitions of the Procedure Committee, I should just like to associate myself with the noble Earl's comments.
Baroness Hayman: My Lords, it would be churlish of me not to respond with a few words of thanks to both the noble Lord and the noble Earl, although I shall maintain the basis of having our debates as list-free zones and shall not, therefore, mention everyone who ought to be thanked in terms of our proceedings. However, I should say that the officials who have supported me so well have also been most helpful as regards the assistance that they have offered to all sides of the House. I believe that that has enabled some of the improvements that we have managed to make to the Bill, and I agree with the noble Earl in that respect. I believe that we have managed to achieve that because of the spirit in which these debates have been conducted, although, after some of our late nights, I am not sure whether I have had my dancing shoes on.
We have had very constructive debates. Even on those issues where amendments have been passed against the advice of the Government, it really has been an issue of the manner of implementation of shared objectives rather than any deep divide as to what those objectives were. I believe that the Bill will help us to improve the NHS and the service that it gives to patients in this country. I am extremely grateful to all noble Lords who have contributed to our debates and who have helped to make the Bill's passage through your Lordships' House very productive.
On Question, Bill passed, and sent to the Commons.

Kosovo
6.7 p.m.
The Minister of State, Ministry of Defence (Lord Gilbert)The Minister of State, Ministry of Defence (Lord Gilbert) rose to move, That this House takes note of the situation in Kosovo.
The noble Lord said: My Lords, I thought that the best way in which I could be helpful to noble Lords this afternoon was to give as detailed as possible a review of the military position as is available to us in the Ministry of Defence at this time. I am well aware of the many discussions that have taken place about how we got to the position in which we regrettably all find ourselves. I do not think it profitable for me as a defence Minister to tread that ground again, although I shall be happy to try to respond to any points made by your Lordships in that respect.
As noble Lords may have observed, I normally find it less than congenial to read from a text, but on this occasion I shall crave your Lordships' indulgence in that a good deal of what I am going to say will be written out in a brief which is in front of me. However, I assure the House that it comes with very considerable authority because the overwhelming proportion of it relates to remarks that were made earlier today by the Chief of the Defence Staff at a press conference which he and my boss the Secretary of State for Defence held this morning. I have only edited the text very slightly to make it sound sensible in your Lordships' House.
As your Lordships will be well aware, in NATO we have a formidable array of military capability at our disposal to achieve the objectives that we have set ourselves. I mentioned these more than once yesterday when answering questions on the Statement that had been delivered in another place. Noble Lords will probably be aware that 13 NATO allies are directly involved in the provision of military assets and that other allies are making contributions in other ways. With all the force at my command I should like to emphasise that this is not an Anglo/American affair; indeed, the whole of NATO is engaged.
The action that we have found ourselves forced to take has the solid political backing of all the Allies. We have more than 300 NATO aircraft ready for operations, of which more than 200 are attack aircraft, and among this number are eight Royal Air Force GR-7 Harriers. NATO can also count on British and American Naval assets equipped with cruise missiles, including our submarine "HMS Splendid", the first of Her Majesty's submarines to be equipped with cruise missiles, and the first one, incidentally, to have fired them.
Last night these forces began military operations against a number of targets in Yugoslavia, as your Lordships will be aware. The offensive action, which involved sea and air-launched cruise missiles, as well as manned aircraft from the United States, the United Kingdom, France, Canada and Spain, was supported by a number of other Allied air forces flying essential fighter cover, air refuelling and defence suppression missions. No fewer than 13 NATO air forces were involved. I am glad to be able to tell your Lordships

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that whatever rumours you may have heard, all NATO aircraft returned safely after their missions had been completed.
The first targets, which were mainly facilities associated with the Yugoslav air defence system, were hit just after seven p.m. Zulu. Assets used included air-launched cruise missiles, fired by United States B-52 aircraft, which had taken off from Royal Air Force Fairford in Gloucestershire earlier in the day, and Tomahawk land attack missiles fired by US Navy ships and, for the first time, by "HMS Splendid". Follow-on attacks were conducted by manned tactical aircraft, including Royal Air Force Harrier GR-7s, based in southern Italy using Paveway 2 laser guided bombs. Other targets included facilities associated with military units which were directly involved in the violence within Kosovo.
"HMS Splendid" fired its Tomahawk missiles against a key military radar facility located near Pristina airfield in Kosovo. This facility, comprising two highly capable air defence radars and an associated control building, was capable of providing extensive data to Yugoslav air defence forces, to their fighter aircraft, surface-to-air missile units and their anti-aircraft artillery. The control centre was also capable of correlating data from a number of subordinate radars and distributing this throughout the national air defence network for use by other units and to help build up the national air picture. Clearly, such a capability posed a serious threat to NATO manned aircraft and it was vital, therefore, that it was put out of action.
Just over an hour after the first cruise missiles impacted on their targets, six Royal Air Force Harriers were tasked to attack an ammunition storage facility just a few miles to the east of the Tomahawk target. Four of the aircraft were armed with two Paveway 2, 10001b laser guided bombs—the type used extensively and with considerable success during Operation Desert Fox— while the other two Harriers acted as escort. The bombers were tasked against explosive and ammunition storage buildings within a Yugoslav military ammunition storage facility which was known to support the Ministry of the Interior Police, who have been at the forefront of repressive actions against the Kosovar Albanian population. As I am sure your Lordships will appreciate, this type of facility contributes significantly to the repressive capability of the Serbian security forces.
It is still too soon to speak with any confidence of the results of the attacks by the British aircraft. I can tell the House, however, that "HMS Splendid" successfully launched its Tomahawk land attack missiles. We do not yet have any detailed imagery of the targets, and it will probably take some time for NATO to conduct a full battle damage assessment exercise. The Harriers formed the third wave of a very concentrated attack on that target. Because of explosions, fire and smoke caused by the first two waves, our Harriers had difficulty seeing and maintaining lock on their targets. Bombs from our first aircraft lost lock once they were in flight and fell short of the target on open ground. As a result, the following three Harriers aborted their attack and returned to base with their weapons. This restraint and
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discipline underlines our determination to avoid collateral damage and civilian casualties. I am sure your Lordships will agree that this speaks well of the training and espirit de corps of our air crews.
I understand that the Supreme Allied Commander Europe (SACEUR) is satisfied overall with the results achieved so far although he recognises there is still much to be done. We are, of course, very relieved that all NATO aircraft have returned safely. In addition to the ground attack operations that I have just described there were some air encounters between NATO and Yugoslav aircraft last night. Some reports that are still unconfirmed suggest that up to four Yugoslav military aircraft were shot down. As I say, the reports are still not confirmed, but they indicate that three were modern MiG 29s and one was a MiG 21. Last night's action was, of course, only the opening salvo, the first step towards NATO achieving its military objectives. Our forces are likely to be in action again, alongside our allies, and we are ready to continue these efforts for some time to come.
I wish to say a few words about force protection. We have, as your Lordships know, some 4, 500 British troops in Macedonia. Some were sent there originally to be ready to extract our peace monitors in an emergency. The majority, however, were sent there to be ready to take part in a NATO led implementation force should the Rambouillet peace accords be signed by both sides. All of these forces, and those of other allies, are now under the operational control of General Sir Mike Jackson, the British commander of NATO's Rapid Reaction Corps. Under SACEUR, General Jackson has put in place contingency plans to respond to any attack upon NATO forces in Macedonia. He has confirmed this morning that his planning is complete. Similar contingency arrangements have been made for NATO forces elsewhere in the region. Any attack on our forces would meet with a swift and severe response. There should be no misunderstanding about that in Belgrade nor in the minds of any junior Serb commanders.
Before I came to your Lordships' House this afternoon I asked for a detailed update on activities by Serb forces on the ground today. I regret to have to tell your Lordships that so far I have no definitive information available to give to your Lordships. There are various unconfirmed reports that Serb activity has slackened. However, there are other reports that their attacks are still continuing on certain villages. I shall no doubt report again to your Lordships' House as to the progress of military activities in Kosovo and over Serbia in the next few days, but I hope that I shall not have to come to your Lordships' House too often. I am sure your Lordships will agree with me that we must all hope that it will not be necessary for defence Ministers to stand at this Dispatch Box, or that in another place, too frequently, and that peace is rapidly restored to this unhappy part of the world. My Lords, I beg to move.
Moved, That this House takes note of the situation in Kosovo. —(Lord Gilbert.)
6.20 p.m.
Lord Moynihan: My Lords, I am deeply grateful to the Minister for his comprehensive speech, a view which I am sure is shared throughout your Lordships' House. I hope that the Minister will accept that, while my noble friend Lord Burnham will respond to matters relating to defence policy, my objective this evening is to focus on the critical political, foreign policy and diplomatic issues under consideration.
Yesterday, on one of the gravest and most sombre days faced by NATO in its history, the hour came for the alliance to carry out its much-threatened air strikes against Serbia. Provided they are part of a coherent strategy with clearly defined and achievable goals from these Benches we have always offered our full support for NATO air strikes against Serbia should all channels of diplomacy be exhausted, should talks prove fruitless and should force prove to be the only language of negotiation that President Milosevic is prepared to understand. It has long been our position that once diplomacy has been backed by the threat of the use of force, that threat must be a credible one. We fully appreciate the onerous and difficult decision which the Government made in authorising military action last night. In the light of the repeated threats and ultimata of the past months, we firmly believe that, having put NATO's credibility on the line, there was no alternative.
However, today is not the time for criticism of past dithering, disunity and indecision. I wish to place on record once again our support for the Government on the action they have taken. We may have had disagreements on the road which the Government have taken up until now; we may have questions about the Government's future strategy; but no government takes lightly the decision to risk me lives of our young servicemen and servicewomen. The Opposition associate themselves with the words of the Minister, as does the whole House, in paying tribute to the courage and professionalism of the British and allied forces which took part in the co-ordinated NATO air strike yesterday; namely, the crews of HMS "Splendid", the four RAF Harrier jets and the two aircraft which flew supporting missions. There is no doubt in your Lordships' House that they will continue to serve Britain with equal distinction during this operation. Our thoughts are also with the families of those servicemen and servicewomen and the combination of pride and anxiety that they will surely feel throughout this operation.
The action carried out by NATO last night was unprecedented. Never before in NATO's history have attacks such as these been carried out against a sovereign country. This was the biggest aerial bombardment in Europe since the Second World War. As a result, there are doubts and concerns in this House and in another place which, given the magnitude of the occasion, deserve to be listened to with respect. From these Benches I have often said in your Lordships' House that I believe that the alternative to this action—namely, to ignore the human cost of the crisis in Kosovo; a crisis which has worsened month by month, week by week, and now day by day—would not be
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justified. We have a moral imperative to respond to suffering, repression, massacre and misery on the very back doorstep of Europe.
Since fighting broke out in Kosovo last year more than 2, 000 people have been killed and hundreds of thousands have left their homes, fleeing the forces of ethnic violence, aggression and atrocity. Our television screens have shown the desperation of those trying to leave Kosovo—by bus and on foot—families fleeing for their lives while their homes, their villages and their lives are in flames. Relief agencies, which have carried out their work tirelessly under impossible conditions, estimate that at least 25, 000 ethnic Albanians have fled since Saturday alone. The United Nations Food Agency says that it needs emergency supplies for more than 10, 000 refugees in Macedonia. That is why NATO acted, and, consistent with the requirements of a just war, that action must ensure that the suffering which is an inevitable consequence of the use of force is less than the suffering which such military action prevents.
I do not doubt that the Government have clear, unequivocal answers to the questions I intend to raise. I should be grateful if this evening the Minister could clarify some of the issues which have been raised in recent days, both in this House and in the media—although I wish to emphasise to the Minister at this stage that I am not expecting, nor would it be appropriate, for me or this House to receive detailed answers to all the questions I pose.
Given that the Secretary of State for Defence has said that air strikes will continue until President Milosevic ceases his savage repression in Kosovo, can the Minister give an assurance that NATO has clear criteria by which it would judge the success of its action, without identifying those criteria? Will the Minister also give an assurance that when this action is over the House will receive a report on those criteria and the extent to which they have been met?
The Deputy Prime Minister has said that NATO will,
"continue to hit hard until its military objectives are achieved". —[Official Report, Commons, 24/3/99; col. 484.]
Can the Minister state clearly for the record what are the objectives—both political and military—of the NATO action? Are they to degrade President Milosevic's military capability so that he is no longer able to continue his brutal policy of waging war against his own people in Kosovo? Are they to compel compliance with the will of the international community and to secure a peace settlement, given that President Milosevic was threatened with such air strikes in the event of his refusal to sign the Rambouillet peace agreement? It has been clear to observers that in recent days the principal objective has moved from the latter—that is, compelling compliance with the will of the international community—to the former; namely, degrading President Milosevic's military capability.
In the event that NATO action is forced to continue until Serbia is no longer able to repress the Kosovo Albanians, what strategy do NATO and the Government have to persuade President Milosevic to return to the negotiating table?

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To what extent do the Government believe that air strikes alone will be able to achieve sufficient damage to Serbia's military capability? To take the most recent parallel to this crisis, does the Minister accept that, while damaging Iraq's military capability, air strikes in Iraq have failed to degrade it in its entirety? Does the Minister further accept that, given the formidable Yugoslav air defence system, this objective in Serbia presents considerably more of a challenge than in the case of Iraq?
The whole House has listened carefully to General Sir Michael Rose, who commanded the UN protection force in Bosnia, who cautioned that it may also take the deployment of ground troops to stop President Milosevic's assault. Do the Government accept that if President Milosevic is confident that no ground troops will be deployed that will significantly affect his position and could, at worst, strengthen the view that he may attempt to sit out the horrors of the air strikes? On that critical point, can the Minister clarify the role of the troops currently stationed in Macedonia? Does he agree that it would be a very different proposition from that which was originally intended for those forces to fight their way into Kosovo to impose a peace that has not been made and to enforce a ceasefire which has not been agreed? There is a world of difference between keeping the peace in a permissive environment and making the peace in a non-permissive environment. In the light of Sir Michael Rose's assessment, can the Minister confirm that ground troops will not enter Kosovo until there is a political settlement?
Given that the Secretary of State for Defence has said that any attack on the NATO peacekeeping forces would result in an "immediate and considerable response", is the Minister satisfied that there is sufficient protection in place to deter Serbian reprisals against the NATO peacekeeping force in Macedonia.
The mood in Pristina last night was reported as one of panic, fear, tension and menace. I believe the House will benefit from reports of today's events on the ground in Kosovo and the actions of the Serb forces there. Today the Yugoslav news agency, Tanjug, stated that Belgrade has declared a "state of war" against NATO. In the light of this defiant act, can the Minister confirm that NATO has a coherent strategy for action in the event of continued non-compliance by Serbia following NATO air strikes? There is a suggestion that the Serbs may use the military tactic of "hugging" the enemy by positioning tanks in Albanian villages. Without giving any details, will the Minister confirm that NATO has a strategy to address this eventuality?
It is right for Parliament to make an assessment of the widely reported fears of the Kosovars that, far from securing both an end to the Serbs' brutal repression and an agreement to a peaceful settlement, a vindictive Serbia will seek to exact revenge from the Albanian population and worsen the plight of those still in Kosovo.
In the light of President Milosevic's address to the Serbian people yesterday, in which he said the freedom of Serbia was at stake and pledged to defend the country in the event of attack, what assessment have the
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Government made of fears that, by appealing to ultra-nationalist tendencies long prevalent in Serbia, the present NATO campaign may serve to strengthen President Milosevic rather than to weaken him; and that, far from defusing the powder keg in Kosovo, it will serve not only to inflame it but also to ignite a conflagration across the Balkans, in Macedonia, Albania and Bosnia? I am sure that the Government have strong views capable of contradicting that theory. I look forward to hearing them.
It cannot be denied that there is dispute within the international community and the UN in particular over the legal authority for NATO's action. I am sure the Minister will agree that it would be of great assistance to the House if the Government could explain with the utmost clarity why they believe that NATO's action is lawful. Will the Minister therefore assist the House by setting out the legal basis for NATO's action?
Is it the Government's view that the relevant resolutions of the Security Council, Resolutions 1198, 1199 and 1205, provide sufficient legal basis for the NATO action? Or is it the case that there: exists in international law the general right to intervene to prevent a humanitarian catastrophe, in line with Article VII of the UN Charter? Or does the Minister believe that this action creates an entirely new precedent in international law?
While there is rightly an obligation incumbent on us to intervene to prevent humanitarian disasters, that is something which to date has been honoured more in the breach than in the observance.
In the Security Council, China has joined Russia in condemning what both call "an illegal military action", and both countries have expressed concern that as a result of the air strikes the region will be plunged into greater turmoil. I assume that an assessment has been made both of short-term and the longer-term consequences of these deep divisions on our relations with China and Russia.
Given the evidence of Russia's anger at the bombing—for example, the cancellation of Prime Minister Primakov's visit to the United States, the recall of Russia's chief military representative at NATO and the ending of all co-operation with the alliance—can the Minister say on what basis the Leader of the House told this House just two days ago that,
"we should not be too alarmed by the Russian reaction … At this stage, we should be optimistic about their collaboration, If not their welcome, in relation to what may need to happen next". —[Official Report, 23/3/99; col. 1177.]
According to this morning's reports, Russia's most recent welcome of what has in fact happened next is a "series of extreme measures" prepared in response to NATO's military action, but which have yet to be implemented. Does the Minister now accept the importance of Russia's role in the peace process? Indeed, many noble Lords would like to have seen its greater involvement in the peacekeeping force on the ground. I look forward to learning the effects that such action could have, both in terms of positive Russian assistance to the Serbs, and in terms of damaging NATO-Russian relations.

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The noble Baroness the Leader of the House also referred to the important role played by the Russians in the Rambouillet negotiations. Will the Minister say whether there were any indications during those negotiations that the Serbs would look more favourably on an OSCE-led, rather than a NATO-led, implementation force to alleviate the appalling humanitarian disaster?
In conclusion, the provisions of the Rambouillet agreement were an important step on the road to securing a just and lasting settlement in Kosovo. We applaud the Kosovo Albanians for their willingness to compromise and to accept the agreement on the table in the interests of securing peace for their people.
The hope is shared throughout this House that President Milosevic will see sense, will end the suffering and the slaughter of his people by his people, and will return to the negotiating table. In the circumstances prevailing after Rambouillet, the Government had no choice but to agree to the use of force in an attempt to achieve that outcome. From these Benches, Her Majesty's Opposition support the Government in that decision and we fervently hope that it succeeds.
6.34 p.m.
Baroness Williams of Crosby: My Lords, there has probably been no graver moment in the past 20 years in terms of the possible repercussions of the actions now taken. I very much appreciate the remark of the noble Lord, Lord Gilbert, that no government would put at risk its own servicemen and women unless they believed the cause to be a substantial and important one. But what is presently happening in Serbia may have repercussions that we cannot imagine—on NATO, on Europe, on our relations with Russia and China, on the United Nations, and far beyond. It is therefore necessary for us to hear the counsel of the wisest among us. In that context, I know that many noble Lords will feel as I do that we shall gravely miss the wisdom of Lord Gillmore of Thamesfield and the controversial but often exciting and imaginative contributions of Lord Beloff. We all look forward to the speech of the noble Lord, Lord Carrington. The noble Lord has had more to do with many aspects of the frightening development associated with the break-up of the former republic of Yugoslavia than any of the rest of us.
For me, and I am sure for many other noble Lords, the moral issues involved in this particular set of decisions are acutely painful and difficult. We on these Benches have made clear that we support the Government in what they have done. But we do so with considerable concern about what may be the wider repercussions, and we have expressed our concern about the lack of a clear political goal.
We could not have stood aside. The systematic massacre of civilians—telephone taps indicate that some orders for massacres, including that at Racak, can be directly traced back to the administration in Belgrade— the systematic destruction of villages, the fleeing of thousands upon thousands of refugees, and the gradual
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destruction of the whole of the countryside of Kosovo are events that we saw previously in Bosnia. Many of us were profoundly ashamed that we did not intervene until so late in the day in that part of the former Yugoslavia. I do not believe that we could have stood aside again and watched this situation unfold before our eyes.
That, of course, is the case for what the Government have done. All of us recognise, too, that there is a paradox in the Government's action in that delays—I acquit Her Majesty's Government of responsibility for those delays—have already allowed the government of Belgrade to destroy a substantial part of the morale and strength of the Kosovar Albanians. Very great humanitarian tragedies are taking place in that province. They are happening even before the bombing has been concluded.
There is of course an argument—this question was raised by the noble Lord, Lord Moynihan—about the legal basis for what is happening. We can point to United Nations Security Council Resolutions 1199 and 1203. We can point to the Geneva Convention, which is clearly being broken by the government in Belgrade. But many of us feel troubled by the fact that the action does not have United Nations support and agreement behind it. It is very important, indeed incumbent on the Government, as soon as possible to try to achieve the support of the United Nations for the actions we take. Most of us strongly believe that the United Nations continues to be indispensable to the gradual creation of a world of international and moral law.
That said, I nonetheless believe that what we are seeing unfold before our eyes is a gradual attempt to establish a minimal level of human rights, of moral behaviour and of recognition that civilians need to be protected, which is gradually extending beyond the areas of the United States, the European Union and various other states that are members of the Council of Europe. The tragedy of the former republic of Yugoslavia is that it has always been outside the civilised circle. It is vital to bring that country back into the mainstream of European life as soon as we possibly can.
However, I believe that one of the dangers of our present debates—and I do not need to point to the arguments being conducted in the media—is that Kosovo is being treated as an isolated situation. I take noble Lords' minds back to 1991, to the occasion when the same kind of events unfolded in Croatia, when the city of Dubrovnik was shelled by the Yugoslav navy, with no intervention until it was virtually destroyed. A month later the city of Vukovar was burnt to the ground and no one intervened. Then the Belgrade government argued that the cease-fire had been breached and had its allies walk out of the negotiations.
That was Croatia. Not so long afterwards the same pattern was seen in Bosnia and Herzegovina: arousing nationalist sentiment, arguing that there had to be some military action and then the presentation of President Milosevic as the mediator, the outside force that would create a peaceful settlement. Kosovo looks like a re-run of exactly the same story. Again and

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again, Mr Milosevic is at the centre of the scene, the person offering himself for international solutions to the problems which he himself has created.
Today, we hear the extraordinarily courageous commitment of the prime minister of Montenegro, a part of the former republic of Yugoslavia, denouncing Milosevic's provocation of the intervention. It is an act of extraordinary courage which tells us that we must not talk about Yugoslavia and Serbia as if we were talking about a united country bent upon the destruction of Kosovo. Indeed, we are talking about a country deeply divided, a brave and courageous country, many of whose fellow citizens are putting their own lives at risk by arguing against and opposing the actions of Mr Milosevic. I believe that were we not to stand up in Kosovo, we would see the same story unfold in Montenegro, where the prime minister has already been denounced as a separatist by Mr Seselj, the leader of the smaller party in the Yugoslav coalition, in Vojvodina, where the leader Mr Nenad Canak, has been similarly denounced, and even in Sandzak, where we hear pleas by the Moslem population that they are constantly being hounded and harassed by the forces of the government of Belgrade.
It is crucial to put that on the line because I believe we are dealing with a far more complex situation than our media suggest when they present simply the goodies and the baddies and do not give us the depth that we need to understand the situation in all its subtleties.
I therefore wish to ask the Minister three questions. The first is: what steps are Her Majesty's Government taking to bring home to those parts of the former republic of Yugoslavia that are themselves deeply uneasy with Mr Milosevic's rule that we in the United Kingdom and the whole contact group recognise and appreciate the position in which they find themselves? We wish them nothing but good. I believe that we have neglected the propaganda side of the whole exercise and should be trying to reach at least some of the people and politicians of the former republic of Yugoslavia.
Secondly, I ask what steps Her Majesty's Government and the contact group intend to take with regard to the terrifying vulnerability of what are now estimated, as the noble Lord, Lord Moynihan, mentioned and more recently the United Nations High Commissioner for Refugees confirmed, to be some 250, 000 refugees. Sixty thousand in the past week alone, according to the most recent figure, are now desperately vulnerable because they are not being permitted to enter Macedonia and they would take their lives in their hands if they tried to enter Albania. They are sitting there, simply waiting for the possibility of the Serb army revenging itself upon them.
What steps are Her Majesty's Government taking to ensure that those refugees are protected, so far as we are able to protect them, possibly by opening the borders and providing some support for them until such time as they may return? Otherwise, they will have to flee out of their country and dissipate themselves across the whole continent of Europe.
I apologise to the noble Lord for my last question, because I have reiterated it on many occasions in this House. We cannot hope to bring about a peaceful
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settlement in Kosovo unless we are prepared to be at least even-handed. That means we must take, or be willing to take, some action—should there be a peaceful settlement—to deal with the situation at the Albanian border which has become the source of a huge trade in drugs, arms and people. That, I believe, is an offer we need to make in order to persuade the Yugoslav Government of our own good intentions.
Finally, I have not a question but a point. There is one last chance of bringing about a reasonably rapid resolution of this difficult situation. That immediate chance, in my view, rests with Mr Primakov, the prime minister of Russia. Russia has been extremely cautious in what it has said, despite the perhaps more emotional outbursts of President Yeltsin. Mr Primakov has shown an extraordinary degree of sense and moderation. He is a historic ally of Yugoslavia. It is time to recognise his request that the contact group meet again. In that event it should seriously consider inviting Mr Primakov to carry a mission to Belgrade to see whether he at least can bring Mr Milosevic round to common sense and to realise the extreme damage he will do to his own country if he pursues his present course.
6.46 p.m.
The Lord Bishop of Oxford: My Lords, I am grateful to the Minister for his detailed statement about last night's military action. Like other noble Lords, I am conscious of the awesome responsibility of the Government at this time in initiating the most serious military action in Europe since the Second World War.
I do not think it is the role of a churchman to pronounce, from the safety of this country, about the Tightness or wrongness of a particular war, but I hope that your Lordships will not think it out of place if I draw on the long tradition of Christian thinking on the subject, in order to ask the Minister some questions. Those of us who had to watch the suffering of the Kosovar people over the past year have asked time and time again what can be done about it. We can have no doubt at all that we have a just cause here; namely, the protection of innocent people from further terror. Furthermore, it seems quite clear that everything that could have been done in the way of resolving this dispute by peaceful means was tried and tried again and eventually was found to have no further mileage.
In addition to those two questions, the long tradition of Christian thinking on the subject asks questions about legitimate authority. It is one of the hopeful developments since the Second World War that we now take it for granted, we assume, that any military action in the world today which is justified in some sense needs United Nations authorisation. As the noble Lord, Lord Moynihan, and the noble Baroness, Lady Williams, have already said, it is important to hear from the Minister under what resolution of the United Nations he believes this military action is legitimated.
There are, of course, further questions when we come to the next criterion of this long tradition of just war thinking. It is the difficult question of weighing evils and trying to make a judgment that more evil will not be unleashed by military action than would ensue if the

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situation remained as it is. The corollary of that, integrally bound up with it, is the criterion that there must be a reasonable chance of success.
What counts as success at the moment? I have no doubt at all that due to the courage, skill and training of our forces the military objectives will be achieved. But what is the relationship between those military objectives and that political goal which we all know is so desirable? There are very, very great worries which have already been so eloquently expressed that the risks of this military action are high. If noble Lords do not mind my being personal, as one who supported recent military action in the Gulf and the bombing of Iraq and argued for three years that military intervention in Bosnia was required before we intervened, I believe that the risks of the present military endeavour are higher than any of those other actions that we have undertaken. It is important to have a greater understanding of the relationship between that military objective which I am sure will be achieved and the political goal that is absolutely essential. We know that there has been a series of very sombre military analyses in the newspapers in recent days.
I return to the point with which I began: the awesome responsibility of the Government at this time and their courageous decision to protect the innocent people in Kosovo. It is the Government alone who know all the facts. They have had to weigh the risks very carefully, and it is their responsibility. The prayers of all people of good will are with our forces and with our political leaders that there will be a just and speedy outcome of this conflict.
6.51 p.m.
Lord Craig of Radley: My Lords, I thank the noble Lord the Minister for introducing this debate and for his review of the current position. We can be thankful that last night's operations have gone as well as they have. It is a great credit to all those involved—the commanders, planners, logisticians, groundcrew and, above all, aircrew—who have collectively demonstrated once again what a major air operation is about and how professionally it can be executed. It has been executed not only by the tight co-ordination of several hundred aircraft sorties, with 100 or more cruise missiles, but in a way that ensures that there is a low level of risk from enemy forces.
We should not underestimate this achievement. The Serb air defences are not to be dismissed lightly. They have a strong potential to inflict severe damage on NATO's attacking forces. That they did not do so last night is probably due to the enormously effective technologies now available to modern air forces to suppress enemy air defences. It has coined its own mnemonic: SEAD (suppression of enemy air defences). No offensive air operation against well-found air defences can expect to succeed without strong SEAD support. I am sure that in last night's operation we can thank the US-co-ordinated SEAD capability mightily for the survival of all the NATO aircraft that took part. What we do not yet know is whether the Serbs were trying their damnedest and signally failed to achieve any
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success or whether they were husbanding their forces for subsequent nights when the weight of attack, especially from cruise missiles, might not be as great.
It is fashionable, and in some ways dismissive of the value of airpower, to hear repeated so often the mantra that one cannot impose one's will on the enemy without the use of forces on the ground. Certainly, if the military objective is to occupy and defeat the enemy's forces and to take hold of his territory there can be no argument about the requirement for in-place effective ground force. However, as I have indicated, there is more to it than that. The military objective must be considered.
In Serbia and Kosovo the military objective is not (or so far has not been stated to be) to occupy territory or to defeat the enemy forces in the large; it is to degrade their capability to continue to inflict major suffering on civilians in Kosovo. Whether that will be achieved, or how long it will take to achieve it from the air alone, is the 64, 000-dollar question. But I do not believe that it is right to imply that the use of air power will somehow be ineffective almost as a sideshow; far from it. More and more it is proving to be an essential tool in the Government's hands and one which so far has allowed them to proceed with little or no loss of life. Let us thank Lady Luck for that.
But the use of air power must be related to the military and strategic objective. That was why I asked the noble Baroness the Leader of the House when noble Lords were questioning the Statement on Kosovo on Tuesday whether Her Majesty's Government could give the House some assurance of their confidence that the operation on which we are now embarked would achieve the stated objective. Although the noble Baroness was not able to say more than that it was the intention of HMG that the,
"objectives should be attempted to be achieved in the way we have described in the Statement as being theoretically possible", — [Official Report, 23/3/99; col. 1181]
I am sure that the House will accept that it would be immoral to commit our forces and those of our NATO allies to an operation in which lives are in grave danger unless there is a strong expectation of success. We can only wait to see whether that careful judgment is borne out by events. I for one feel that it is incumbent on all of us now to express confidence in that judgment so that those we ask to undertake operations and to put their lives at risk know that we are behind the judgment that has been made.
When the shooting dies down, then will be the time to reconsider the whole sequence of events that has led to this very serious and worrying event. I take comfort from the fact that there is such a strong unanimity of view throughout NATO countries. That is a strong bolster to our forces' morale and feelings—and those of their families—about the rightness and justice of what is taking place. I say that without in any way detracting from a feeling of sadness that the bulwark of NATO, which has been such a strong and dominant player in the defence of our freedoms as a defensive alliance, has on its 50th anniversary had to resort to what I fear legally may be termed aggression against a sovereign state, no matter how morally overriding is the suffering in Kosovo or, in the words of the right reverend Prelate,

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however just the cause. I hope that the Government can reassure us that there is no possibility of any of our servicemen being at risk from being brought before an international court on a charge of having been involved in a crime under international law.
While on the subject of legality, perhaps the Minister can clarify the following points. Has war been declared? Are we at war with Serbia? Are our servicemen and women, especially those who have been taking part in the operations over Serbia, deemed to be on active service? What is the position if, regrettably, one or more of our aircrew is shot down and taken prisoner? Will he be treated as a prisoner of war? Does the Geneva Convention apply? Is the Red Cross standing by to carry out its responsibilities in the event of any of our service personnel being captured? Anything that the Minister can tell us now, or later if that is necessary, about these matters would be helpful. Whatever be the position, can he reassure us that those who are taking part have been made aware of the situation as it might affect them?
Finally, I think that this latest operation and, indeed, a number of previous operations embarked on by Her Majesty's Government in recent months and years, have demonstrated the immense value and importance of having an effective and modern air arm in our mix of forces. The requirement to upgrade our air superiority capability with the Eurofighter, and to enhance the performance of existing aircraft will not diminish in the years ahead.
The Government's fullhearted commitment to those programmes is self-evidently important. But there is another key point. There must be sufficient well trained, motivated and committed personnel to service, support and operate this equipment. Without them there is no air power to use in our modern diplomacy and foreign policy. We are still losing too many well trained and valuable people. It is beholden on the Government to recognise that.
The treatment of our personnel, their pay, their conditions of service and their accommodation are, if possible, even more important today to the success of our national policies and our position in the world and in the Security Council than ever in the past 50 years. Let the Government reflect on that in the moments of quietness between these crises, and not neglect anything that needs to be done. We need to retain as well as to recruit the best to support our Government's policies.
7.1 p.m.
Lord Carrington: My Lords, I join with other noble Lords in thanking the noble Lord, Lord Gilbert, for the statement, and in saying that we knew well that British forces would behave as they did last night, and will continue to do so.
After numerous threats, all unheeded, all ignored, over a period of time it would have been difficult for NATO to do nothing after the break up of the Rambouillet talks. It would have been a derided organisation. I accept that. But I have to say that I do not know where or how it will end, or what the Government will do if bombing does not achieve their aim. I have the gravest misgivings about the course on which we are set.
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I believe that the policy which has led to us being where we are now is both mistaken and ill-conceived. I say at once that President Milosevic is in the first instance to blame for what has happened. He decided to revoke the autonomy that the Kosovars had enjoyed under Tito. He also refused, even more foolishly, to negotiate with Mr. Rugova, who was then the leader of the Kosovar Albanians—a very moderate man, and a man who would have been quite prepared at that time to settle for a return to autonomy. Now of course he has been pushed into an infinitely more extreme position.
What worries me is that I do not think that we have learned the lessons of the two wars: the Serbo-Croat war, and the Bosnian war. Those two wars showed what a mistake it is to intervene, in particular militarily, to keep a peace which does not exist and in a situation where we do not wholeheartedly support one side or the other; that is, supporting with all the means at our disposal which means not just aircraft but troops on the ground, with a full attack on their positions. If we do as we did in Bosnia, the likelihood is that we shall increase the timescale of the immense suffering of the civilian population. Intervention can even make things worse.
The final solution which will happen in Bosnia will not be dissimilar from that which would have occurred anyway if we had not been concerned with it. In the meantime, tens of thousands of people have been killed and hundreds of thousands of people have been ethnically cleansed. Unless we are prepared to settle things once and for all with all the force at our disposal, and to take sides about who is right or wrong, then we shall fail. Here I agree with the noble Baroness, Lady Williams, although I do not think that the position is quite as clear cut as she makes out in the Balkan Wars. I do not think President Milosevic was the only person to blame. President Tudjman and President Izetbegovic have a great deal to do with what happened.
If we intervene, we must decide on whose side we are. But in this particular case both sides had a case. The Serbs believe, and rightly, that Kosovo is part of Serbia, and has been for generations. Moreover, it is the birthplace of Serb nationalism. It would be very foolish to underestimate the resolution which the Serbs will show to maintain their possession of Kosovo. Equally, the Kosovar Albanians have a case. Not only have they seen their autonomy removed, but they have lost a great many of their civic and human rights. Due to the intransigence of the Serbs, they have been pushed into an armed revolt.
In addition, we all know that an independent Kosovo is not acceptable to the international community. Consequently we are faced with the problem: who do we support? Quite rightly, we sought to broker an agreement between the two sides. All credit is due to those who tried to achieve an agreement. Quite rightly, we sent as much humanitarian aid as we could.
So far so good, my Lords. But where I believe it went wrong was to threaten Serbia with bombs and cruise missiles if they did not agree. The Serbs were threatened with that long before the Kosovar Albanians agreed to the proposals. No one ever suggested bombing the Kosovar Albanians. The objective, I suppose, is to bring

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Milosevic back to the negotiating table and to impose the kind of settlement that was agreed at Rambouillet. But the Serbs have wholeheartedly already rejected that, and it clearly does not satisfy the Albanians who want their independence.
We also know that if bombing does not succeed, no NATO country, least of all the Americans, will be prepared to put ground forces in to fight against the Serbs in an all-out war. President Milosevic knows that perfectly well. Do we then go on bombing and bombing? If not, what do we do after that? No one has told us; certainly the Government have not told us.
As other noble Lords have asked, are we really on good legal grounds for what we are doing? Are we not setting a rather dangerous precedent? It is also true to say that if we argue that we are doing it for humanitarian reasons, the removal of the monitor force has caused more immediate suffering to the Kosovar Albanians than anything else in the past few months.
I believe too that international opposition—not just from the Russians and the Chinese—will grow against what NATO has done and I fear that opinion in the NATO countries, if civilian casualties grow, will be increasingly hostile to what we have done. I am sorry to be so pessimistic but I think it right to say these things.
The die is cast. We are now on this course. I do not know where it will end, and I have a horrible feeling that the Government do not know either.
7.10 p.m.
Lord Eames: My Lords, it is indeed a daunting experience to find one's name on a list of speakers following someone of the stature of the noble Lord, Lord Carrington, on a subject such as this. None of us in the House this evening can possibly underestimate the gravity of the situation as has been vividly illustrated by previous speakers, a situation which not only confronts NATO and the people of the Balkans but—dare I suggest?—contains the ingredients for the most grave consequences for the whole of Europe. If we listened carefully to the noble Lord, Lord Carrington, Baroness Williams and others, we would have no doubt about that point.
What has been said already this evening in this House clearly indicates the gravity of this moment. The arguments for and against the military action undertaken by NATO will continue for a long time and, as the right reverend Prelate, the Bishop of Oxford, has reminded us, there is a sense in this country, and I think among most of our allies that what we have attempted to do, rightly or wrongly, has been motivated by that sense of the just war. Tragically, the real judgment on what has happened will be made by history and that judgment, as the noble Lord, Lord Carrington, has just reminded us, will have the benefit of hindsight to which you and I are not privy at this moment.
Justification for what NATO has done in the last 48 hours or so is couched in the name of international humanitarian intervention. That is a very interesting phrase. My chief concern this evening in your Lordships' House is to suggest that there is another
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factor in this situation which requires international humanitarian intervention. It is factor which we can all so easily forget, given the tensions of this grave moment for our country.
Above all else, above all the military considerations and behind the smoke-screen of the bombs and missiles that we have been seeing on our television screens, this is a human tragedy. A recent estimate, as we have been reminded, speaks of one quarter of a million civilians who have been displaced, and 65, 000 within the last month. Even as we debate at this moment in this House that figure is rising: people burned from their homes, people shot, TV pictures of little children crying on tractors and trailers, and elderly people dying in the attempt to escape.
What we are seeing is the greatest mass movement of refugees in the Balkans since the last war. Do I need to remind your Lordships' House of the historical significance of conflicts which, over the years and generations, have in fact begun in the Balkans? Anyone who knows that region and knows it intimately will agree with me that the picture of the misery of ordinary people caught up is nothing less than a cauldron of fear.
We all pray for an end to this tragedy and I have to say that I share some of the misgivings expressed by the noble Lord, Lord Carrington, when he spoke so movingly just now and attempted to answer the question: where is it leading? I believe that we would be failing not only the people of this nation but our colleagues in NATO if we did not recognise first of all the desperate need for a solution to this tragedy. Whether it comes from the results of the last 48 hours or not remains to be seen. At this moment—and I choose my words carefully—far away from the conference table and far away from the corridors of NATO, the United Nations in New York, European power bases, and even far away from your Lordships' House, there is a mass movement of human misery taking place. That misery will remain long after any solution emerges. The longer the conflict lasts, the greater will be the need to solve that problem. The longer a solution is delayed, the greater those figures will magnify.
We cannot and we must not forget the human side of this issue. I have seen at first hand in my life what refugees and displaced persons have to contend with. I will not bore your Lordships' House with a description of it save to say that it has to be experienced to be understood. It is for that reason that I speak in this debate from a deep personal conviction that we must not lose sight of the human element.
I appeal to the House and in particular to Her Majesty's Government, while paying tribute to the Minister for his very clear statement which has benefited us all this evening, that allied now to any decisions over the military aspect, instead of waiting for an end to what we can only refer to as "the war", every effort is made now to address the massive refugee problem. I recognise the difficulties involved and those who deal with problems of this nature will immediately say that it is bland to raise it at this moment. It is not bland. It is a moral, clear duty.

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I urge Her Majesty's Government to take the lead among the European nations and among the partners of NATO in supporting, indeed (dare I suggest) initiating, humanitarian relief on a massive scale. I do not believe it is overstating the situation at this moment to say that whatever the moral questions raised by the current bombing, unless we address and are seen to address the moral issues of the human misery of the refugees and of the war, we will stand condemned not just by the world but by history. I humbly submit this evening that it is not just on military action that we will be judged by future generations.
Lord Kennet: My Lords, what a lot of good and important speeches we are having. I want to begin by inviting the House to go back to 1648 which was the end of the Thirty Years War in Germany. I believe that it was the worst war Europe has ever known, in terms of the proportion of the population at risk which was killed in the war and as a direct result of it.
In that year, by the Treaty of Westphalia, the Germans invented the principle of cuius regio eius religio: that is to say that each of the little principalities of which Germany was then made up should choose its own religion, Protestant or Catholic, and that at their own speed, unharassed and in peace, people should be allowed to move house if they wished to the nearest region which had the religion that they believed in. It is in point of fact the greatest invention towards civilisation that the German people ever made.
In the Yugoslav war (we are in a war: they have declared war on us, incidentally; the Federation of Yugoslavia has declared war on NATO collectively though we have not declared war on them) we have to recognise that among other things there is an element of religion. The internecine Yugoslav War is a religious war. It has had three movements: first, the Serbo-Croat War between Catholic and Orthodox; secondly, the Bosnian War between Orthodox and Moslem; and now, the war we are talking about, between Orthodox and Moslem again.
At the end of the day, we are all thrashing around looking for a political aim. At the end of the day, I offer as a political aim the establishment of the principle cuius regio eius religio in Yugoslavia. It will take some exposition to get it home to people and to governments around the world, but it might be worth a shot. The Balkans have been politically held apart from that possibility, which has been exploited to the general peace and good will by all the other countries of Europe, first because of the Turkish dominion, then because of the Austrian dominion and most recently because of the communist dominion. Each of these has prevented the natural development and movement of peoples. It has prevented change. They are in a condition anterior to that of religious and political liberty which the rest of us enjoy. Naturally, steam blows out around the edges.
If we look around the world and see how things lie, all NATO countries, even Denmark, are included in this force. That is a remarkable achievement of military diplomacy. Outside, we see Russia, the absence of which is deeply troubling and can teach us a lot. It is a European country if ever there were one. We also see
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China, which in general terms has expressed a position against force and against interference in the internal affairs of another sovereign state. It accuses us of circumventing the United Nations. That is the Chinese position, as one would expect. It is easy for the Chinese to say that because they are a long way away, but it is still the position of international law.
I wish to turn to a few detailed questions. They may be a little too detailed on the diplomatic side. If my noble friend Lord Gilbert feels that he has enough to put up with on the military side, they can remain on the record until later. What did Mrs. Allbright promise to the Kosovars when she got them to sign when the Serbs would not? We know that she promised something. She spoke separately with the Kosovars in Rambouillet and never spoke with the Serbs at all. I understand that they were proximity negotiations where little was done around the table; the teams were in separate rooms. Did she promise the amalgamation of the Kosovo Liberation Army into the political and military life of Kosovo after the end of the war, with direct military funding from the US and with a State Department official working full time to organise all that? At any rate, so said the armed forces minister of Albania yesterday. The Kosovo Liberation Army has also received a State Department invitation to visit political and military circles in the United States—and that in the middle of the war.
Moreover—I am filling in some gaps because not everyone knows—it is alleged by the Bavarian interior minister that £40, 000-worth of illegal drugs money was raised at one meeting in Bavaria, a meeting of Kosovar exiles and others, and sent to the Kosovo Liberation Army. It was said that the total amount of illegal drugs money that has gone to them is between £300, 000 and £400, 000.
Returning to negotiations, President Milutinovic of Serbia has said that the only option open to his country was to accept foreign troops or be bombed. Is that right? He was told that he could have 28, 000 soldiers governing Kosovo, and if he would not have them he would be bombed. So what difference did that utterance from the United States make to the Serbian reaction to the Rambouillet proposals?
They saw the proposals from Rambouillet, taken along with that choice, as violating their sovereignty and constitution. Moreover, it was not the Contact Group which made it, because by the time it was made the Russians were not there.
I wish to conclude by quoting the words of Secretary General Solana of NATO in the Spring 1999 issue of the NATO Review. He wrote:
"Our view is that Russia's constructive engagement with NATO is fundamental to the new security order … The year ahead promises even greater consultation and co-operation activity. The Kosovo crisis has proven the value of this new relationship".
How much trouble was it to the NATO governments to turn round that judgment and stand it on its head, to make war in spite of it and, for the first time in 10 years, to drive Russia into outright opposition to NATO and all it stands for?
I ask the question which all noble Lords who have spoken have asked. What is our objective? Politically, we should remember the great possibility to which all

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human freedom in Europe has been due, and in the Americas, too; the possibility for people to move to a place where a government they can stand is in occupation, without interference. On the military side, I do not know—what is our military aim? Is it bombing, bombing, bombing as the noble Lord, Lord Carrington, asked? Obviously not, so what is it?
7.28 p.m.
Lord Sandberg: My Lords, we are all grateful to the noble Lord, Lord Gilbert, for initiating this necessary debate. I wish that I could say that I had a solution which no one else had thought of and that this is how we should be proceeding, but I am in the same position as most other noble Lords; that is, I am unhappy about what is happening, but not clear about the alternatives.
We are worried about casualties, as we should be. They will come in due course and we should be under no illusion about that. We wonder whether we can send many aircraft thousands of feet above a country and bomb it into submission. It is unlikely. We did not do so in Iraq, which has gone off the front page, but we continue to bomb Iraq every day. We have not seen much of a solution. Of course, Iraq is a different kettle of fish from Serbia, but one must consider the similarities.
The problem is that we see no alternative. Nobody would disagree that more talks would be good, but as yet talks have brought no progress.
As my noble friend Lady Williams said, we have to hark back and remember what happened in Bosnia—where we did nothing—and in Croatia. There comes a time when one has to take note of human misery and try, to the best of one's ability—perhaps not very good ability—to do something about it. I believe that we really could not just stand there and do nothing.
I return to the subject of the bombing alone because the thought of putting troops on the land, and the appalling casualties that would undoubtedly occur, is more than we can bear. Only last week I was in Washington. The talk of body bags, a rather emotive phrase, was paramount in the American newspapers. Who can blame people for that?
We have to press on as far as we can but we must also answer the question, "What on earth do we do when we have pressed on and nothing much has happened?" I do not agree with all newspaper reports; if one does, one is very naïve. However, it was uncomfortable to read an article in the Washington Post yesterday. Somebody asked President Clinton, "What happens if the bombing does not succeed?" The report goes on to say that the president looked rather puzzled and turned to one of his aides for an answer. The answer came back, "You go on bombing".
Obviously, that is not something with which we can live forever. We do not know the solution, but I believe that all of us would like to hear from the Minister what the long-term thoughts are. Of course, the bombing campaign has only just started. We have not yet given it a chance to succeed. Perhaps it will—we all hope that
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it will—and that it will bring Milosevic back to the negotiating table. I am sure that we have a long-term strategy. I believe we are all anxious to hear what it is.
We are in an unhappy position. The Serbs are a proud people. We cannot forget what Yugoslavia went through during the war when they fought long and hard against the Nazis and tied down many divisions of German troops which would have been used against us on the Western front. I do not believe, therefore, that we can expect a quick and dramatic surrender by the Serbs. I wish I was wrong.
That brings us back, full circle, to where we started, with the question, "What is the long-term solution?" There must be further talks. We must ensure that further talks with Milosevic—if we can bring him back to the table—must not just be with Mr. Holbrooke; there must be a raft of people who should talk to him. Obviously, we must bring the Russians in, whether Mr. Primakov or his chosen man. They are close to the Serbs and are likely to have much more influence on them than we are likely to have.
This is probably a difficult situation for Mr. Primakov. He makes remarks and his boss, President Yeltsin, makes unhelpful ones. We must try to bring them in. I hope that the Government are making approaches to the Russians in this regard. I do not expect answers at this time but I hope that such approaches are being made. I believe that they will be the people who can help us to resolve this most unfortunate situation.
7.33 p.m.
Lord Stoddart of Swindon: My Lords, this has been a serious and sober debate to which there have been many wise contributions, none wiser than that of the noble Lord, Lord Carrington. He put the whole question into a very reasonable perspective. We must bear in mind that he did so from his wide, detailed and close experience of the whole problem of Yugoslavia. I hope that the Government will heed his wise words.
The Kosovo operation is a momentous departure in policy. Our Armed Forces are not defending the realm, nor any specific British interest, nor any sovereign state which has made a request for assistance. In the Gulf War, Kuwait and Saudi Arabia were under attack from an outside body. They requested assistance and received it. The fact that we have not yet ended that war should be borne in mind. So, there has been no request for any military assistance from anywhere.
Furthermore, as we have already heard, the armed intervention in Yugoslavia does not have the backing of the United Nations. I believe it was entirely wrong that we should have embarked upon that operation without even apparently consulting the Secretary General of the United Nations. That was a snub which I believe is unforgivable. I think that he felt that very hard. As has been pointed out, the repercussions could be dire. They were adequately pointed out by the noble Lord, Lord Moynihan, and the noble Baroness, Lady Williams.
This evening, I speak to dissociate myself from what happened last night and from what, unfortunately I believe is to come. I never thought I would see the day when a Labour Government—albeit a "New" Labour

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Government—took part in unleashing a massive bombardment on a small country of 10 million people who, as we have just heard, have endured centuries of oppression and who helped to defeat the Nazis in the last war.
It is particularly odious that the Luftwaffe took part in the bombing given that it last blitzkrieged Belgrade over 50 years ago. Far from undermining President Milosevic's position, I believe that that will strengthen it. It is most unfortunate that we allowed the German Luftwaffe to be involved. It is sad to see the mightiest armed force in history, representing over 600 million people, unleashing such a bombardment on a small country of 10 million people. We are told that it is to protect the Kosovar people. Quite frankly, I do not see how it will protect them. It may put them in more danger.
However, there are two sides to this issue. Kosovo has been recognised as part of Yugoslavia. The KLA, by Western parlance, is a terrorist organisation. Its members, too, have committed atrocities; but, that seems to have been forgotten. They have been attempting to undermine the status quo in Yugoslavia, which has existed over a long period of time. They have been trying to do so by armed struggle. The Serbs, quite naturally, have reacted accordingly—unfortunately, viciously on occasions. Everybody regrets that. Diplomacy, intentionally or otherwise, has encouraged the KLA to believe that NATO would eventually come in on its side. The bombing will be seen as confirmation of that. Again, I believe that that is most unfortunate. It really is difficult to see what the end game is. Is NATO prepared to pulverise Serbia to dust to get it to submit to what it sees as unjustifiable demands? How many casualties is NATO prepared to countenance?
What of the Kosovars? If the Serb army entrenches itself in built-up areas of Kosovo, what then? What are we to do to clear it out? We cannot do it by bombing; otherwise we hurt the very people we want to defend and to help. Suppose the Serbs continue to defy NATO; how long will it be before ground troops are sent in—and at what cost in terms of our servicemen's lives? There are rumours flying around that ground troops will be sent in sooner rather than later. I should like my noble friend to comment on that and to say whether those rumours have any substance. How long will the troops remain if they are sent in? Will it be for one year, five years, 10 years, or 20 years? Have we thought about this? How many casualties are we prepared to sustain and what is the cost of this operation to British taxpayers?
Again, one has to ask: why Serbia or Yugoslavia? There was no armed intervention in Chechnya, Tibet, Somalia, Rwanda or in other areas, including Turkey, which oppresses the Kurds, and which is, of course, a member of NATO. Why is Serbia or Yugoslavia being treated in this way?
Just exactly what is the objective of western policy? Is it simply to get more autonomy for Kosovo, to get independence for Kosovo and eventually incorporation into Albania, or is it part of a game plan to incorporate
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Yugoslavia as a whole into the western European bloc? We do not know. I should like to know. I should like to be told, but I fear that I shall not be told this evening.
It must be a great anxiety that Britain has been drawn into this deadly venture from which it seems; that there is no quick or easy exit, as the United States found in Vietnam and as the Soviets found in Afghanistan, after the loss of hundreds of thousands of lives.
Finally, there is not the near-unanimity of consent of purpose in this country for this armed assault on a small nation which is entitled to defend its territorial integrity, just like any other nation. We should immediately get back to the negotiating table, but this time on the basis of a real discussion, on equal ground, and not based on the threat of massive air bombardment if one side does not give in and allow an army of occupation on its soil. That is what we need. Let us not forget Churchill's dictum,
"jaw-jaw is always better than … war-war".
7.42 p.m.
The Earl of Lauderdale: My Lords, I was greatly heartened to hear the noble Lord, Lord Stoddart of Swindon, expressing his disgust—I think that that is the word—for the use of Luftwaffe pilots and crews in this so-called "Allied" attack on a sovereign state which stood by us during World War II and suffered greatly on our behalf.
I was also much heartened to hear the warning from my noble friend Lord Carrington, who speaks with unrivalled experience as a former Foreign Secretary, of the dangers of the course on which we are now embarked. I tried to make some notes as he spoke, but I cannot read my own writing at any time and my notes probably would not add much anyway. He was perfectly right in saying that a clear objective is lacking in this operation unless it is somehow to show that we are the bullies who can get away with murder.
I find myself at this moment almost as embarrassed and unhappy about the policy that the Government are pursuing, and to which our Opposition's leadership is consenting, as I was when British forces left the Suez Canal zone in the mid-1950s, the consequence of which has been our utter impotence to influence Middle Eastern affairs.
I was greatly more encouraged by the attitude of the noble Baroness, Lady Williams of Crosby, who showed considerable understanding of the internal politics of Yugoslavia and in particular of the significance of Montenegro in the whole picture.
We have heard the term "moral imperative" used. Indeed, I heard my noble friend Lord Moynihan use it from our Front Bench this afternoon. The term "moral imperative" is absolute rubbish here because the confusion of sentimentality with morality is probably one of the greatest errors of the age in which we live. Sentimentality is odd basis for deciding major international actions.
I have a special reason for participating in this debate. For many years, I was the Balkans correspondent of The Times and I used to visit South Serbia, as it was then

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called, quite frequently. I have been in and out of that country for 60 years. I am probably the only noble Lord who can understand Serbian, although I do not speak it very well. In fact, I speak it badly.
The background to this situation is seldom understood. Most of the so-called "Albanians" in Kosovo are not indigenous. They have infiltrated more or less as illegal immigrants over the past generation, having been encouraged to do so by the Tito regime in an attempt to spread Communism among the Serbs, whose individualism was totally resistant to it.
In that sense, perhaps I may ask your Lordships how we would feel if, over a generation, we found that Dutch, Belgians or French were gradually taking charge of events in Kent, Sussex and Hampshire, buying up farms and shops and gradually establishing themselves there. We would not welcome that—and the Serbs do not welcome it in their country either, but that is what they have seen in Kosovo over the past generation. We are not talking about indigenous Yugoslav citizens who are being bullied by their fellows but about illicit infiltrators who have finally forced their hosts to run out of patience.
I do not have any special love for the Albanians, but I do know that when the Albanian Crown Prince Leka was in London a few years ago, he was openly proclaiming the ambition to lead his country to a greater Albania, incorporating Kosovo.
We are told that the Kosovars have been offered autonomy, but that is not acceptable to the Serbs—and I shall tell your Lordships why. We have discovered in our own country that the Scottish Parliament has unleashed talk about Scottish separatism which was unheard of five years ago. In the eyes of the Serbs, "autonomy" spells eventual separation. That is one reason why the autonomy which their constitution awarded Kosovo some years ago was withdrawn. There was a fear that separatism was afoot.
I speak with the greatest reluctance. I say again that I have the same sense of nausea about the confusion of sentimentality with morality that we have heard tonight as I felt at the time of the British withdrawal from Suez in the mid-1950s, some 40 years ago. At that time I refused my party Whip and became an open Suez rebel. I am not proposing to become a Kosovo rebel now, but I am seeking as well as I can in my dotage to warn the Government, and our own Front Bench, to be cautious about all this. It is not as easy as it looks; we have heard from an expert on aerial warfare that it is by no means clear that bombs can do the job. We have been warned by the noble Lord, Lord Carrington, that we have embarked on an enterprise which has no obvious end. We do not know where it is going to lead. I am very sad indeed. If there was any way of toning down or altering the Motion before us tonight I would try to do so, but I have not had time to find out, whether, procedurally, that could be done.
"Taking note" is a timid, mild and half-hearted way of responding to an international crisis of great severity and difficulty affecting an area which is of historic importance to the Serbs. Perhaps I may say something
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which neither of the Bishops mentioned. When I spoke about the French, Dutch and Belgians occupying perhaps Kent, Sussex and Hampshire, I meant including Canterbury. I remind your Lordships that Pec in the Kosovo area of south Serbia is their Canterbury. To lose that is to lose their national shrine.
Noble Lords who do not know that part of the world as I do and who have had the exposure to it that I have had, cannot begin to understand the sentiment that has been aroused. It does not surprise me at all that the Serbs, who are not great negotiators in the familiar Mediterranean sense, would rather stand their ground. They would rather be killed than give way. They are unlikely to be moved by sentimentality, let alone talk about morality. They have their history, their values, their ancient monuments and traditions. They will fight and die for them, and I say God bless them.
7.52 p.m.
Lord McNair: My Lords, I also thank the Minister for the way in which he introduced this debate. I recognise the heavy responsibility that lies on him and the Government. I shall not detain the House for long. There is one element of this conflict to which I believe attention should be given.
We have seen and read about the intense brutality which has been a part of this conflict for the past 10 years. We have been appalled by the ferocity and unbelievable cruelty which has characterised it. It is true that prior to this decade different cultural, religious and ethnic communities had been living in peaceful proximity for many years. It is also true, in contrast, that previous episodes of inter-community fighting have been bitter and very violent.
I am raising this issue following a discussion I had with the noble Baroness the Leader of the House after the Statement on Kosovo made the day before yesterday. I hope I am not taking her name in vain, but she expressed an interest in what I said then and what I am saying now. I believe that she invited me to mention this when we next discussed the situation.
I believe that we should focus at least some of our attention on the psychological warfare elements to which my noble friend Lady Williams has already referred. There are two main phases to this. First, there was the spreading of hateful propaganda to incite a population to want to make war by making them regard other communities as inferior, a threat or probably both.
Secondly, in conjunction with a continuation of the first phase, there are measures to strengthen the resolve of the fighting troops. It will be some time before we have details of these measures in respect of the fighting in Kosovo, but we do know that in Bosnia, exhortation which, presumably accompanies every briefing to soldiers in a combat zone, was strengthened by supplying the Serbian soldiers with psychoactive drugs to increase their ferocity and determination. I suggest that the intense brutality and unbelievable cruelty to which I referred earlier was heightened by the use of these drugs.
The decision whether to involve ground troops in the conflict will be a political as well as a military one. I suggest that in preparing themselves for such a decision,

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or in preparing NATO ground troops for such an eventuality, the Government should review available literature.
I have no idea what psychoactive chemicals were used in Bosnia by the Serb military leaders, but it is common knowledge that some psychoactive drugs can give people who have taken them immense, almost superhuman, strength and an inability to feel pain. In that respect at least the Serbian soldiers were also the unwitting victims of a horrible experiment, as reports I have with me make clear. In addition to white pills, liquid drugs and injection equipment were found on dead and captured Serbian soldiers.
In returning to the first phase of this psychological warfare, the hate propaganda, we should remember how Radovan Karadzic, the successor to Jovan Raskovic, as leader of the nationalist Serbs in Bosnia—and, like Raskovic, a psychiatrist—used the mass media to generate fear and hatred among the Serbian people. Raskovic wrote a book to this end called This Mad Country which was a mixture of Mein Kampf and Freudian nonsense. It chillingly propagandised the supposed inferiority of the Moslem population. I hope that besides all the other considerations that the Government have in this matter, they will take account of these two psychological warfare aspects of the Balkan conflict.
7.56 p.m.
The Earl of Sandwich: My Lords, one of the ironies of the war in Kosovo is that there had been some dramatic improvements in the conditions of the Albanian people there in the past few years. That was due in part to the presence of international humanitarian agencies. I shall quote only one example. Infant mortality was the highest in Europe five years ago. It has been halved thanks to an immunisation campaign. There have been many other successes in health and education. UNICEF and the other agencies involved fear that all these gains may now be thrown away.
There are about 16 non-governmental organisations active in Kosovo including some names which are well known to us, such as Oxfam, Save the Children, UNICEF, the International Committee of the Red Cross, and the Red Crescent. Some have provided welfare such as supplementary foods and material aid and others like Oxfam are focusing on long-term priorities such as clean water and sanitation, often in very dangerous and difficult terrain. It is a formidable task. The noble Lord, Lord Eames, described the extent of the human need. I have seen a figure of 180, 000 internally displaced persons. The noble Baroness, Lady Williams, rightly says that the figure has increased to 250, 000 of whom two-thirds are children and most of the rest women.
The courage of aid workers needs little explanation because in a sense they are the counterparts of any humanitarian crisis. They have to be there because, however much we endorse the actions of NATO, it is simultaneously our policy to serve the victims on the ground, the ordinary people and the refugees.
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Some NGOs have already suffered direct hits themselves. For instance, the ICRC medical team struck a landmine last September and lost a doctor. Earlier last year three ethnic Albanian workers of the Mother Teresa Association died at the hands of the Serbian police.
My purpose in the debate is to ask some questions of the Minister. In a war which, as a matter of policy, does not involve ground forces—in other words, a war of punitive air strikes—are we not exposing our aid workers considerably more than would be the case in other emergencies and conflicts around the world? What consultations, if any, are taking place between NATO and the non-governmental organisations on the position of these personnel? Is there any contingency plan to protect NGOs, perhaps via the ground forces in Macedonia? We all saw on television last night the worried looks of the NGO staff in Pristina as they contemplated the prospect of joining the refugees they had gone to help.
I hope that the Government do not regard the situation of the NGOs as an optional extra in a modern war of this kind. Their contribution continues to be of vital importance during a crisis of this magnitude.
8 p.m.
Lord Ponsonby of Shulbrede: My Lords, I, too, begin by thanking my noble friend for his introduction to today's debate. To make my position clear at the outset, I believe it is right for the Government to feel that they cannot stand aside. It is right also that NATO should demonstrate that it is serious about the principles and values on which it is based.
Today's debate is really a convolution of three debates which have been running now for many months. The first concerns the action and capabilities of British troops and how they are performing. That is very much the way in which my noble friend presented his speech when he was talking about last night's action. Perhaps he could say a few more words about the position of British troops, both in Bosnia and Macedonia, and how they may be protecting themselves.
The second debate that has been running over the past few months concerns the institutional relationships, to which a number of noble Lords referred, between NATO, the UN and the OSCE. The Washington Summit is to take place shortly where we will be looking at European defence. Institutions will be built on the experiences through which we are going at the moment. I hope that those experiences will lead us to the conclusion that we need to strengthen Europe's capabilities for acting on small-scale types of task—so called "Petersberg" tasks—to prevent us from getting into these extreme situations in the future. The noble Earl, Lord Sandwich, referred to the huge efforts made by NGOs over the past months and how it is ironic that they averted the crisis over the winter period only to arrive at where we are today.
The third convolution of the three debates is the moral argument; the rightness of this cause as opposed to other causes; the necessity to take sides and at the same time to try to maintain a balance. It would be useful if the Minister could say something about the Government's

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support for the President of Montenegro in some of the brave things he has been saying over the past day or two. I welcome also the fairly subtle change in wording as regards the Government's view on the status of Kosovo in the future. They are not repeating the same mantra that Kosovo will never receive independence. I welcome that change.
I wish to make just one point and to develop the point made by the noble Baroness, Lady Williams. It concerns the importance of the Russian Prime Minister Primakov. It is easy to be negative about Russia; I have done it myself and have sat through many debates where the point was made that the only thing that unites Russian politicians is their opposition to the expansion of NATO. It is easy to talk about how its economy is in tatters and it is easy to say that it is weak and being ignored. At best Russia is seen as a dangerous ally.
But it is extremely important to be far more positive than that. I hope that we will soon be in contact with the Russian Government and when we are, we will need to be positive about what is happening in Russia. I would point out that we are seeing the very beginning of a recovery in the Russian economy. There was a terrible crash on 17th August, but I believe I am right in saying that in the first three months of this year the Russian stock exchange performed better than any other stock exchange in the world. So that indicates a very small start towards recovery there.
It is also right to point out that the Russian people are becoming more influential in the world than ever before as they join western companies and work in all parts of the world. While the Russian Government may be losing influence, in my view the Russian people are not. My third point is that Russia remains a hugely dominant regional force and must be used as such.
The one message that I really want to give the Front Bench tonight is that if and when our Prime Minister talks to Prime Minister Primakov, he must be positive about Russia's contribution; about its overwhelmingly important role in trying to move this desperately difficult situation forward. In doing that he must point to its successes over the past few years.
8.5 p.m.
Lord Wallace of Saltaire: My Lords, this has been a short and sober debate. No doubt we shall have others. The Minister correctly said that at this stage we must limit ourselves primarily to the military operations and to their immediate implications, though it is also correct that we always have to ask what are the long-term objectives and where do we think we may be going? Can the Government assure us that there are sufficiently clear objectives?
There have been a number of calls in this debate for us to make our objectives entirely clear. I say with some sympathy for the Minister and Her Majesty's Government that at this stage, in these extremely complicated circumstances, it is not possible to have entirely clear objectives. There are a number of things we do not know. We know that Mr. Milosevic is in a shaky position in Serbia. He has been forced to dismiss
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his director of intelligence and deputy-commander of his army within the past 10 days. We know that there is considerable resistance within Yugoslavia to the call-up, and we are thus facing a conscript army unwillingly going to war.
A number of people questioned the possibility of fighting the Serbs in Yugoslavia, unless we have overwhelming military force. I remind your Lordships that we faced in the Falklands an unwillingly conscripted Argentinian force and the difference between unwillingly conscripted people fighting for something about which they are not entirely convinced, and those who are fighting for clear objectives and who are well trained, is not something that can be ignored in calculating the level of force needed on both sides.
Clearly air power has to be proportionately applied for proportionate purposes; air power in itself is not enough. I welcomed the speech of the noble and gallant Lord, Lord Craig, emphasising that this is part of what is being done, but it cannot in itself do everything. From these Benches we have said throughout the Yugoslav crisis, since 1991, that forces on the ground have to be part of the package. There were those within my own party who said that we ought to have put forces into Bosnia at an earlier stage, when it was clear that Yugoslavia itself was breaking up, because a proportionate use of force then would have prevented worse now.
I remind Members of the House that there are already 1 million refugees from the former Yugoslavia now scattered throughout the European Union. We have seen an extra 250, 000 created within Macedonia and it is estimated that 100, 000 more lost their homes within the past month, before the bombing started. That seems to justify the action that Her Majesty's Government have just taken, which was the essence of the speech of the right reverend Prelate the Bishop of Oxford, with which I entirely agree.
If air power is not enough, then clearly we have to think about the long-term implications. Again, people from my party have said throughout that this is likely to be the beginnings of a long-term commitment; that we are likely to have to put forces in on the ground at one stage, we hope by agreement, raising major questions about military overstretch, about whether or not the SDR's cutting down of reserves was sustainable, about how we may manage with our allies to sustain a military presence in Bosnia and in Kosovo, and perhaps also, as my noble friend Lady Williams said, in northern Albania over an extended period.
Perhaps I may remind those who have spoken in favour of hesitation in this debate that the alternatives are not particularly easy either. What we have seen is clearly the beginning of ethnic cleansing within Kosovo. There are those who suggest that what Mr. Milosevic has really been attempting to do is perhaps to divide Kosovo into north and south, as Bosnia was divided, so as to hang on to a northern Kosovo in which Serbs would become the dominant party and from which Kosovars would be driven, leaving them with the remnants of an already destroyed southern Kosovo.

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I have students from the region. I was talking to two Serbian students last week before they went back to Belgrade. I have to say that both of them are women. I was also talking to a Bulgarian student of mine. It was a deeply depressing experience with two Serbs and a Bulgarian sitting round a House of Lords' tea table discussing the future of the region. There is a great deal of opposition within Serbia to the current position of the government. As my noble friend Lord McNair said, we are aware that the Serbian Government have been attempting to use propaganda to inflame ethnic hatreds.
I reinforce what my noble friend Lady Williams said about the importance of maintaining as actively as we can our efforts to inform and influence opinion within the Federal Republic of Yugoslavia. There has to be an alternative to Mr. Milosevic and, when there is an alternative to him, we will do our best to help. As I spend some of my time advising Serbians on what they should do until Mr. Milosevic goes, perhaps I may add that part of what the European Union needs to do is to help prepare those who will have to reconstruct Yugoslavia after a change of regime.
We have heard a certain amount about dreams of a greater Albania from the noble Earl, Lord Lauderdale, who seems to support dreams of a greater Serbia and not of the various alternatives. Those of us who know a little about the history of south-eastern Europe can recall that there were dreams of a greater Bulgaria, dreams of a greater Romania, dreams of a greater Greece, of a greater Serbia and, indeed, of a greater Albania all to be built out of the ruins of the Ottoman Empire that led to the three Balkan Wars of the first 10 years of this century, with their ethnic cleansing and massacres on all sides. The governments currently attempting to cope with what is happening in south-eastern Europe are conscious that that is only two generations away and that the potential for a return to that kind of ethnic cleansing is there, way beyond the boundaries of former Yugoslavia. That is why we have to take this responsibility on board.
I should tell the noble Lord, Lord Stoddart, that I do not believe that there is an alternative in the long run other than to extend across this region of Europe the peace, prosperity and order which we have established inside the European Union over the past 50 years and which we are in the process of extending across the states which are currently applicants for the European Union. That is one of the many reasons why I support the EU. I regret the speeches of the noble Lord, Lord Stoddart, and the noble Earl, Lord Lauderdale, with, I have to say, their anti-German undertones. I find it odd to argue that it was right to go into Suez, but it is wrong to go in to suppress Serbian air defences now.
In looking at a long-term commitment, we have to recognise that there may well be casualties, both British and others. I was in Germany for three days last week. I heard Oschka Fischer talking about the situation. I did not meet great German imperialism; indeed, we all met deep unease among members of all parties at a conference that I was attending about the commitment of German troops. As part of building a more peaceful European region, it is now time, 50 years after the war, for the Germans to take their share of the common
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defence. After all, that is what Her Majesty's Government are calling for in the initiative which they have taken with my party's active support. I give way to the noble Lord.
Lord Stoddart of Swindon: My Lords, when I made the remarks about the Luftwaffe, what I said was in no way anti-German. I said that psychologically it was a bad move because it would strengthen the hand of Mr. Milosevic. Therefore, my remarks were not anti-German; nor, for that matter, were they anti-anyone else.
Lord Wallace of Saltaire: My Lords, I accept the noble Lord's explanation. Indeed, I accept his comment in that light. I believe that we must put this into a different context, while recognising that there are many historical echoes in what everyone does in the region. However, we must also recognise what the alternatives are if we do not act. The potential destabilisation of the European Union due to another 2 million or 3 million refugees is not something which we should contemplate with entire ease. So our political goal must be to extend peace and prosperity across the region and to recognise that that is a shared enterprise in which Britain must do its duty.
We have been concerned as a country with the Balkans ever since the Ottoman Empire began to crumble. An early leader of my party, William Gladstone, was himself much concerned with the emergence, first, of Greece and then of Bulgaria from the Ottoman Empire. On one occasion he said, "We are part of the community of Europe and we must do our duty as such". I believe that that is what we have to do.
8.17 p.m.
Lord Burnham: My Lords, I am to some extent an amateur historian—a bad amateur historian. I shall not, like the noble Lord, Lord Kennet, go back to the Thirty Years' War. I would draw your Lordships' attention to the words of the short story writer Saki who, writing at the time of the Balkan War in about 1912, said:
"The Balkans create more history than they can consume locally".
In that respect, the events of July 1914 are very much in mind at this time. I remind your Lordships that the murder of the Austrian Crown Prince in Sarajevo on 28th June 1914 was followed by ultimata to the Serbians from Austria. They, in their turn, were followed by the expression of Russian support for Serbia, of German backing for Austria/Hungary and, in due course, the involvement of France and Britain in the whole panoply of horror of the Great War.
At this time we should not forget the disasters of 85 years ago. We go into the current conflict in the knowledge that there is a real danger that it may escalate now as it did then. President Yeltsin has already indicated his support for Serbia and opposition to the NATO action. In the light of the history of the relationship between Russia and Serbia, this is scarcely surprising: the bear does not change his spots. Nor should we forget the moral support that the British and the French gave at that time to "gallant little Serbia" and

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the appreciation of the strength and determination of its opposition to the might of the dual alliance. Again, during the Second World War we looked with admiration on the struggles of the Yugoslav peoples, even if all of them did not fight on the same side.
Today we must remember and appreciate that what NATO has entered upon will not be easy, possibly in the sense that the Gulf War against Iraq was easy. We are facing a warlike and determined people, who to a large extent have an absolute loyalty to their leader, Mr. Milosevic.
I apologise to the House for the absence of my noble friend Lord Moynihan who had an unbreakable engagement and has had to leave, having spoken at the beginning of the debate. As the debate was laid on at short notice I hope that the Minister will ignore the convention that he cannot be expected to reply to anyone who has left the House. I hope that these are special circumstances. In a way his absence is symbolic because the situation in Kosovo divides nicely into two sections: the diplomatic and the military. My noble friend spoke on the diplomatic side; I shall concentrate on the military side.
In another place the Government spokesmen were the Foreign Secretary at the beginning of the discussion and the Secretary of State for Defence at the end. I am sure the House joins me in being immensely grateful to the noble Lord, Lord Gilbert, for the detailed explanation of what happened last night and the way in which the air strike was conducted. I am only sorry that he does not have a Foreign Office hat that he can wear to give some explanation of what led up to these military events which he described so well.
I apologise to the noble Lord for the fact that last night I described him—as I thought—as being somewhat gung ho. He quite rightly objected to that. I am surprised today to find that the people who are gung ho seem to be the Liberal Front Bench. There is an air of sadness and sorrow among your Lordships. There is general support for the actions of the Government, but there is sadness and sorrow at the situation in which we find ourselves. In the circumstances I found it most interesting to listen to my noble friend Lord Lauderdale who, with his Serbian connections, gave very much the other side of the story, which is not something we hear often.
In the debate on the Statement last night the Minister—here I do take issue with him—intimated that the Serbians have a conscript army whose morale may not hold up under heavy bombardment, and that Mr. Milosevic is unaware of the depth of air power he faces. I am unable to accept either of those suggestions. As I have made clear, the Serbians have always been a determined people and Milosevic must surely know what he is facing. The noble and gallant Lord, Lord Craig, mentioned the anti-aircraft defences which the Serbians have.
Last night the noble Lord also pointed out that we were not talking in terms solely of a British force, not that I needed reminding of that. But even with our allies, experience has shown time and time again that air power
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is not enough and that we shall have to go in on the ground. It is fair to suggest that bearing in mind the nature of the country it is not unreasonable that the Serbs will be able to resist an army many times greater than anything NATO can put into the field. During the war the Germans had six divisions in Yugoslavia, including one SS, as well as a considerable number of Italians. If ground troops are now to be sent in, I do not think the numbers we can produce will have the success we determine, not even with the Germans, although they have experience of the country.
The British history of overcoming primitive peoples—if we may so describe the Serbians—on their own terrain is not good. The most obvious example is the lack of success of the British Army from India in the Afghan wars. Those operations were carried out in circumstances where the British forces did not have the limitations in numbers that we see today. The SDR was clear that only a limited number of operations could be carried out at one time. Even critics of the SDR did not expect the statement would come home to roost so soon. Are the Government confident that they can maintain and supply operations in Kosovo and Bosnia for the years that it may well take? Are there aircraft and anti-aircraft weapons to defend troops on the ground in Macedonia currently out of the range of aircraft flying from the supply fields in Italy? Do we have the numbers to sustain operations for a lengthy period of time without placing an intolerable strain on troops on the ground? The logistics of sustaining operations in all these fields at the same time would seem to be beyond the capabilities of all the NATO forces, let alone those of Britain as an isolated force. We certainly do not have, between us, the 150, 000 troops which would seem to be necessary.
None of this would be happening without US involvement. It is not only the air power but communications and intelligence which are so important. Without the United States, Europe does not have the means to act, and not all Europe has the will. It will take years and billions of pounds to build the capability, and that cannot start without a radical change of policy, which we cannot see as being imminent. I hope that the Government have thought all of this through. I have been reminded—this was mentioned, in other terms, by my noble friend Lord Carrington—of the three rules governing involvement in a civil war, as generated by the historian Michael Howard: first, don't do it; secondly, choose which side you are on; thirdly, see that that side wins. I am not certain that we have done all three.
This morning on the wireless I heard mentioned—it was mentioned too by the right reverend Prelate the Bishop of Oxford—that the action has many of the attributes of a Christian, just war. He may well be right; namely, that the Government have done their job by coming to a decision to interfere as they have. However, that is by no means as certain as some people make out.
We have made the decision, and we on these Benches give the Government our entire support. Nevertheless we may express concern with regard to the consequences of that decision. Whether Milosevic gives way or not, what do we do next? If he does not give

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way, how do we stop our attacks and where do we stop them? The Prime Minister has ruled out the use of ground troops, but for all the reasons which have been given this would not seem to be realistic. If the bombing does not work—and there is a strong possibility that it will not—what will we do? Escalate? Or merely walk away? And when we have walked away, what happens then? How can the whole matter be sorted out without putting our troops on the ground? Sadly, it is difficult, if not impossible, to find a qualified commentator saying that the matter can be concluded without the use of land forces.
We need therefore to call on the Government for assurances that any troops in or near Kosovo will be adequately equipped and protected and also that, having embarked on military action—wisely or unwisely, as events will show—they are prepared to carry through with it as far as necessary. We also need reassurances that this is a reasoned and considered course of action in which the Government are supported by all their professional advisers, the chiefs of staff. I believe I heard the noble Lord, Lord Gilbert, give those assurances, but I would be grateful for repetition of them, as I am sure would your Lordships.
On these assumptions the Government have the considered support of the Official Opposition in this unwelcome but apparently inevitable course of action. All sides of the House and of the country have the fullest confidence in the expertise, the courage and the determination of our Armed Forces. We must hope that they are not too hardly pressed.
8.30 p.m.
Lord Gilbert: My Lords, this has been another sombre debate. I am grateful to all noble Lords who have participated in it. I think it would be helpful if I were to start on at least one encouraging note. With regard to the position of refugees in Kosovo, I understand that the border with Macedonia has been reopened and that the refugees who seek to escape in that direction are now able to do so. That is one of the few cheerful things I have to say to the House tonight.
I have been struck by the number of times noble Lords have asked questions about the legal basis for our operation in Kosovo and in Serbia. I can do no better than to quote what I said to the House only yesterday evening:
"We are perfectly confident that we have a good legal basis for our action". —[Official Report, 24/3/99; col. 1396.]
The relevant Security Council resolutions are 1199 and 1203. We are confident—this is the view not only of Her Majesty's Government but is one that is shared by all the other 18 members of NATO—and we are justified because of the accepted principle that force may be used in extreme circumstances to avert a humanitarian catastrophe.
I was asked whether the Security Council had been kept informed and there was a suggestion that Mr. Kofi Annan had been snubbed. That is not the case. The Security Council has been kept fully informed throughout and, as your Lordships will know, there was overwhelming support in the Security Council debate on
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24th March, though Russia, China and Namibia did not agree with the propositions that the rest of the Security Council were supporting. Mr. Kofi Annan said that, diplomacy having failed, there are times when the use of force is legitimate in pursuit of peace.
Many noble Lords have raised the question of the involvement of Her Majesty's Government and our NATO allies with the Russian authorities. I can tell your Lordships that we have been in close contact with both Prime Minister Primakov and Foreign Minister Ivanov. We know that the Russians are as exasperated with President Milosevic as we are. We understand the Russian objection to the air strikes but my understanding is that the Russian authorities are totally appalled by Mr. Milosevic's actions in Kosovo. The Russian negotiator, Mr. Mayorsky, played an important part in negotiating the Rambouillet accords. We hope that Russia will play a positive role in persuading Milosevic to desist from the pattern of atrocities that his forces are currently undertaking.
I was asked a specific question by the noble and gallant Lord, Lord Craig, about the position of our forces if they were taken prisoner and whether or not the provisions of the Geneva Convention would apply. The position is that it does not need a declaration of war, though Mr. Milosevic says he has declared war, whatever that may mean, on NATO, as distinct from any individual country. It is necessary only that hostilities exist for the Geneva Convention to apply and any members of the Armed Forces of either side can and should expect the full protection of the Geneva Convention in the circumstances that exist at the moment in Kosovo and Serbia. I am quite sure that the Red Cross will be present and doing what it can. It is fully entitled under the terms of the Geneva Convention to be present in Serbia and Kosovo at this time if it thinks it fit to be there.
I turn to another point made by the noble and gallant Lord, Lord Craig. I happen to be a strong believer in the force of air power. It is of course for the noble and gallant Lord to speak for himself but I thought I heard several of your Lordships misquote the noble and gallant Lord. I understood him to say that there have been enormous advances in the quality of air power in recent years. That has certainly been my experience. It is of a totally different degree from the nature of air power when I was last at the Ministry of Defence. The growth in the technological capability of air power to suppress enemy air defences, the growth in the precision of the weapons that our aircraft carry and the range of those weapons is remarkable. That we can fire cruise missiles from a submarine at periscope depth in the Adriatic to hit with a degree of accuracy which is unbelievable, guided by a GPS system, without any of our sailors being put at risk is a demonstration of air power of a kind that was not available only a very few years ago.
Many noble Lords, including the noble Lord, Lord Burnham, referred to the need for us to intervene with land forces. It is not in any way a part of the objectives of this Government to occupy Kosovo, to occupy Serbia or to subjugate the Serbs. That point was made to me last night. The objectives are absolutely clear. They are to disrupt the present Serbian activities with respect to

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what the Serbs are doing in Kosovo and to curb for the future President Milosevic's capability to engage in such activity.
The noble Lord, Lord Carrington, to whose expertise I of course bow, asked many questions: when will it end; how will it end? I cannot answer those questions. I am sure the noble Lord realises that. No one can answer those questions for the simple reason that we do not know how Mr. Milosevic will behave. I suspect that in two weeks' time Mr. Milosevic may behave in a very different way from the way he is behaving now or may behave in two days' time. Unfortunately, we must continue to engage in the air activities in which we are engaged in order to achieve our objectives.
The noble Lord made one point with which I feel I have to take issue. He said:
"The removal of the observers"—
I hope I am quoting him correctly—
"has caused more damage than anything else in recent months to the poor people of Kosovo".
But the observers have been gone for only 24 hours. I do not see how the noble Lord can come to that conclusion. It is unfortunate that we do not have observers on the ground at the moment—
Lord Carrington: My Lords, as a result of the observers going, the Serbian army moved in.
Lord Gilbert: My Lords, I am not sure that the noble Lord is reading the same newspapers and the same reports. The Serbian army has been there for some time. The Serbian security police have been there for some time. Their tanks have been destroying Serbian villages for weeks. That is why we are there. The noble Lord may say that the fact that there will be no observers there in future may diminish our ability to restrain the Serbs. That is a perfectly tenable point of view. But to say, as he did, that their removal has caused more damage than anything else in recent months is an argument that defeats me.
My noble friend Lord Kennet asked me what Mrs. Albright promised the Kosovars. I have no idea what was said. My noble friend asked what was our objective. I stated it yesterday, I have stated it again today, and I shall repeat it time after time. Our military objective is to disrupt what is presently going on in Kosovo and to curb President Milosevic's capabilities to continue with that kind of activity in the future.
The noble Lord, Lord Sandberg, said that casualties will come. The noble Lord may be right. I very much hope that he is not. It is magnificent that we have had none so far. The noble Lord pointed out that the aerial activity has only just begun. The main objective of air attacks in the immediate future is to degrade the air defence capabilities of the Serbian government so that in future our forces may fly more safely over their territory.
It is a very precise and guided set of targets that I see every morning down in the bowels of the Ministry of Defence. I take issue with those who talk in the terms used by my noble friend Lord Stoddart, who referred to "pulverising Serbia to dust". We are not pulverising
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Serbia to dust. The talk about bombing Serbia, as though we were trying to produce another Dresden in Belgrade or another Coventry in another town, is absolute fiction. We are addressing a very small number of precise military targets, in exactly the same way as we were doing in Iraq, where Saddam Hussein has been unable to provide any demonstration of mass casualties as a result of the Desert Fox campaign and subsequent activities. My noble friend spoke of our "unleashing a massive bombardment on a small country". He uses such evocative language that I must take issue with him. It is simply not the case. Had my noble friend been listening to my introductory remarks he would realise that we sent out four Harriers last night. Three of them returned with their bomb loads intact because they were not sure that they could hit their targets. That is not "pulverising Serbia".
The Earl of Lauderdale: My Lords, I thank the Minister for giving way. Perhaps he can clear up one matter. We understand that among the targets attacked last night were the defences and the town of Novi Sad. I hear that the town of Novi Sad itself was damaged. Does the Minister know whether or not that is the case?
Lord Gilbert: My Lords, as I have already said, it is impossible for me to give a detailed bomb damage assessment so I am afraid that I cannot answer the noble Earl's question. If I find that there is any information when I return to the Ministry of Defence I shall be happy to write to the noble Earl on that point.
We are dealing with a brutal dictator who, as the noble Lord, Lord McNair, said, has engaged in unacceptable ferocity and cruelty. As the noble Lord, Lord Wallace, said, we must play our part and accept our duty and responsibility for being part of Europe, even though it may appear to some noble Lords that there is no direct British connection.
I am grateful for many of the remarks of the noble Lord, Lord Burnham. However, the noble Lord said that we must go into Kosovo. We have no intention of fighting our way into Kosovo. I shall repeat that as many times as necessary. Neither we nor any of our NATO allies have the intention of fighting our way in on the ground. We are sending our troops in only by agreement when the circumstances arise.
The noble Lord asked whether we could defend our troops in Macedonia. Perhaps I did not have the noble Lord's full attention when I addressed the House earlier today. I said that General Jackson had told us that he had plans in place which he was satisfied would meet the case if necessary, were his troops to be attacked by ground troops under the control of the Serbian authorities in Kosovo. Of course there will be a strain on our troops on the ground. Of course there will be logistical problems. But I give the noble Lord the reassurance that the Chiefs of Staff, and particularly the Chief of the Defence Staff, believe that we have the situation under control.
Lord Burnham: My Lords, I thank the Minister for giving way. Perhaps I may remind him that we sent troops

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into Northern Ireland to defend the Catholic population and within months they were shooting our troops in the back.
Lord Gilbert: My Lords, that is one of the reasons why we are not sending troops into Kosovo.
As I said, our objectives are clear. Our objective is not to occupy, not to subjugate. We do not know what is going to happen. We do not know how Mr. Milosevic will behave. And we shall be judged by whether or not we succeed in disrupting his activities and curbing his abilities. We may fail. I do not believe that we shall. I have the greatest confidence in the skill and capabilities and the assets at the disposal of our forces and those of our allies who are engaged in these very dangerous activities. I do not propose to contemplate the possibility of failure. I am sure that everyone in this House joins me in saying God speed to those of our forces who are engaged in these extremely dangerous operations. I hope for their sake, and for the sake of the people of Kosovo and Serbia that they are successful.
On Question, Motion agreed to.

European Parliamentary Elections (Gibraltar) Bill [H.L.]
8.47 p.m.
Lord Bethell: My Lords, I beg to move that this Bill be now read a second time.
This is the third time in the past year that I have raised the question of the voting rights of Gibraltar citizens in the European Parliament. I make no apology for returning to this question now. Twice, your Lordships rejected amendments to the European Parliamentary Elections Bill which called on the Government to facilitate the voting rights of Gibraltarians for the Strasbourg Parliament. But there has been a serious development since that happened, inasmuch as a case brought by a Gibraltar citizen before the European Court of Human Rights has been approved by that court, and by a resounding majority of 15 votes to two, one of the two minority voters being the British judge.
The people of Gibraltar are deeply concerned about the question of voting rights in the European Parliament. In June last year I presented a petition to your Lordships signed by no less than 90 per cent. of the voting population of Gibraltar. I urged the House to see to it that Gibraltarians were able to vote in the elections that will take place on 10th June this year.
The 17, 000 voters of that small territory have many duties and obligations which are brought upon them by the European institutions, including the European Parliament. Of course they want to have an input into who their representatives in Strasbourg and Brussels should be. They want someone who represents them, to whom they have access and to whom they can present individual matters.
Miss Denise Matthews, the applicant to the Strasbourg court, points out that according to Article 3 of the First Protocol of the European Convention on
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Human Rights, Gibraltarians have the right to a free vote over the choice of the legislature. The last time we discussed this in your Lordships' House, the Government argued that the European Parliament was not a legislature. However, the 15 judges in Strasbourg took a different view. I wish to quote what I believe is a rather devastating comment made by the Minister, the noble Lord, Lord Williams, on 24th June 1998, in his summing up speech:
"One speaker asked whether the present situation is in breach of the European Human Rights Convention. My advice is. quite clear and unambiguous: it is not". —[Official Report, 24/6/98; col. 301.]
Seldom, I suggest, has a Minister been guided by such erroneous advice. I accept that the advice was clear and unambiguous and I absolve the Minister of blame for having accepted the advice that came from his department or probably from another department. But the advice was mistaken, according to a substantial majority of the judges in the Strasbourg court.
Therefore, I believe that this puts the Government in a position where they must act, they must not just express sympathy, good will or intentions. They must act and must take measures that will enable the question to be resolved. We have lost a lot of time. If action had been taken in June 1998, we would be further along the path. But let us take action now.
The Minister also said last June that he had clear and unambiguous advice on another point: that voting rights could not be given to the people of Gibraltar because of the 1976 Act on voting rights agreed by the governments. I hope that the Government will not be too influenced by that "clear and unambiguous advice" that comes, I have no doubt, from the Foreign Office legal department, on the question of the 1976 Act. I pray that the Government will not put a supposition by the Foreign Office legal department above a clear and resounding decision taken by the Court of Human Rights. Surely, the Government should do something concrete, not just something sympathetic or nice, to ensure that the question is sorted out.
The Bill that I put before your Lordships would allow Gibraltarians on the electoral roll of Gibraltar to vote in the elections in June this year, if it is passed in time and if the House of Assembly in Gibraltar approves it. It would put the 17, 000 voters on the London regional list. Here, I must declare an interest in that I am a candidate on the London regional list. However, I hope that my interest will not be seen as being excessive, as there are 17, 000 voters in Gibraltar and 5 million voters on the London regional list. So the Gibraltar element would only be one-third of 1 per cent. of that list, if the Bill is passed.
I should also declare an interest in that I have a few times in the past 20 years visited Gibraltar at the expense of the Gibraltar Government. This is a point to which I have returned on many occasions and if the Minister has it in mind to say that the question should have been addressed seriously by the Conservative Government over the years, I can only say that I agree with him entirely. It has been hanging around for about a quarter of a century. I therefore ask the Minister to

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think carefully about the point and the invidious position in which he finds himself as a result of the poor advice he received from the Civil Service.
I do not expect the noble Lord, Lord Williams, to oppose this Second Reading; it is unlikely that he will. But it is possible, if I have correctly read the words of the Foreign and Commonwealth Secretary, that he will say that there is no time for it to be properly dealt with in another place. It would be a tragedy, if it were left so that the present position prevailed. I believe that the Government are honour bound, because of their mistakes in the past, to take into account the human rights of the people of Gibraltar and to ensure that they have a vote on 10th June.
As to the attitude of Spain, there are indications that the Spanish Government would not object to it. The Spanish Ambassador in London spoke to that effect a few days ago. I do not believe that the Government of Spain—any government of Spain—bearing in mind the recent history of Spain and the vivid memories that Spain has of violations of human rights, would find it in their hearts to deny the franchise to the 17, 000 people of Gibraltar. Spain will not fly in the face of the European Court of Human Rights. The Spanish have more respect for it than certain other countries.
I therefore hope that the Minister will go beyond sympathy. He said in June last year that he was unable even to sugar the pill. I hope that this time he will not only sugar the pill but provide an effective medicine that will cure the disease that has arisen as a result of the decision. I beg to move.
Moved, That the Bill be now read a second time. — [Lord Bethell].
8.57 p.m.
Lord Hardy of Wath: My Lords, the House is obliged to the noble Lord, Lord Bethell. Whether his Bill meets the requirements of legal niceties I am not qualified to say, but I believe that its principle is good. I maintain the view that Gibraltar should not be the only part of the EU which lacks representation. I said so in a debate in the House last year, so I need not detain the House long this evening.
There may be many in Spain who do not like the decision of the court to which the noble Lord referred, just as there are many in Spain who might be quite happy to see political exclusion continue or to see the nuisance, the churlish behaviour and delays at the frontier continue. There are those in Spain who would deny history. Yet it has some relevance.
Gibraltar became part of the state of Spain in 1462 and ceased to be part of Spain politically in 1713–251 years. It has been linked with Britain for a considerably longer period than that. But even if Spanish interests dismissed that historical fact, they can surely not expect to take Gibraltar into Spain against the overwhelming wishes of the people of Gibraltar. It may not be fashionable to suggest that the Spanish Government could more clearly recognise the contribution which Gibraltar made during the Second World War, when a large part of the population of Gibraltar were removed
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in order that it could properly concentrate on its role as a fortress for the eastern Mediterranean and a watchtower for the maritime approaches to Europe.
These matters are still of some significance. But, more than that, Spain should recognise that there is virtue and value in consistency. I have a number of friends involved in political activity in Spain. I have marvelled at the lack of consistency that sometimes they display. For example, Spain became part of the Council of Europe in the late 1970s. From that time no country or parliamentary delegation was more enthusiastic about encouraging, promoting and recognising democracy than my Spanish friends. I made this point last year and so will not labour it. No one did more to ensure that Liechtenstein, Andorra and San Marino were recognised as independent sovereign states, even though I can remember reminding the Spanish spokesman that they were roughly the size of Gibraltar. But they recognised it was right that even the smallest states in Europe should enjoy full democratic recognition and character. I believe that it is our responsibility in Britain to ensure that the democratic deficit that clearly exists is resolved at the earliest possible time.
9.1 p.m.
Baroness Hooper: My Lords, it is always very satisfactory to be proved right. Those of us who supported my noble friend Lord Bethell in his proposed amendment to the European Parliamentary Elections Bill last year are certainly vindicated by the judgment in Matthews v. United Kingdom. I place on record my congratulations to Miss Matthews on her perseverance and single-mindedness in bringing the action as well as its successful outcome. It is also fortunate that this victory, focused on one small area as it is, took place before the death of General Sir William Jackson, former Governor of Gibraltar and doughty champion of Gibraltar's right to determine its own future and play its part in the European Union. He must have been very pleased by this result.
But my noble friend Lord Bethell is another whose perseverance must be admired. I am very pleased to be able to support the Second Reading of this Bill which has the merit of being both short and simple. My noble friend raised a number of important points as did the noble Lord, Lord Hardy of Wath. No doubt we shall hear useful contributions from other noble Lords. My questions concentrate on timing and the practical issue of the appropriate constituency base that must be considered with great speed. What is the Government's estimate of the time required to put the necessary arrangements in place? Should the new arrangements not be in place by June, what will the Government do to comply with the ruling of the court given that almost a year ago (June of last year) this issue was raised in your Lordships' House? Had action been taken then it might have been possible to make the necessary arrangements in time.
My final question relates to the constituency base. I do not see how Gibraltar can form a separate constituency in any sense given its size; nor do I believe it appropriate that the whole of the Gibraltar electorate should be attached to one mainland British Euro

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constituency. However, I am very taken by the suggestion of my noble friend Lord Bethell that it should be attached to the constituency for which he is to be a candidate. Nevertheless, I believe that it would be more appropriate to find a way in which Gibraltarians can choose where their votes should be attached and that that should be in any part of the United Kingdom.
We have been over this ground on a number of occasions. Therefore, I shall not elaborate further. I pose one final and more general question. I ask the Minister whether in these days of political correctness his right honourable friend the Foreign Secretary intends to make an apology to the people of Gibraltar for getting it wrong.
9.4 p.m.
The Earl of Carlisle: My Lords, I support this Bill to provide for electors in Gibraltar to vote in elections to the European Parliament. I thank and congratulate the noble Lord, Lord Bethell, for his courage, skill and persistence in this matter. We are all in his debt, not least the electors of Gibraltar, and also Her Majesty's Government who are ultimately responsible for their security and therefore their democratic way of life, which they both relish and cherish. So do we.
This is a liberal measure concerned with democracy. It is a fundamental principle in a liberal democracy, especially in Britain, that every person over the age of 18 years is entitled to vote in local, parliamentary and European parliamentary elections. Since we joined the European Union, British citizens with British passports—the electors of Gibraltar—have been denied a very basic right: the right to vote in European parliamentary elections. They are and feel themselves to be, culturally, economically, socially, politically and legally—as do citizens of the United Kingdom and the Kingdom of Spain—a part of Europe. The noble Lord, Lord Bethell, has already quoted the remark of the noble Lord, Lord Williams of Mostyn, on 24th June. I shall not repeat that. But the last three words that he used—"It is not"—give food for thought and "words for eating". Since then the European Court of Human Rights, on 18th February of this year, has ruled by an overwhelming majority that Her Majesty's Government have been in breach of the law. I am sure that the noble Lord, Lord Williams of Mostyn—a highly respected lawyer and Minister in this House—will agree that this is a very serious matter.
How should we get round, or over, the problem? First, we should support the Bill. Secondly, the noble Baroness, Lady Symons of Vernham Dean, (who is not in her place today) informed your Lordships on 25th February that to comply with the judgment of the European Court of Human Rights through domestic legislation would put us in breach of the 1976 Act. On whose advice does the noble Baroness base that statement? Was it based on the opinion of those lawyers whose advice has already been shown to be unsound? Perhaps the Minister will inform us.
If we do not have the power unilaterally to extend the European parliamentary franchise to Gibraltar, then I, like other noble Lords and in particular the noble
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Baroness, Lady Hooper, seek answers to these questions. First, have the Government consulted their European Union partners? When did the process start; and what, if any, are the outcomes of the consultations? Secondly, will legislation be introduced through the European Union institutions in time for Gibraltar to vote in the June election?
As a Member of the constructive Opposition, perhaps I may offer a suggestion. Will the Government incorporate the electorate of Gibraltar into a United Kingdom Euro-parliamentary constituency? Could they do so as speedily as possible, because we do not want to be in breach of the European Court of Human Rights again if the Gibraltarians cannot vote in two-and-a-half months' time.
We, the taxpayer, have already had to foot the bill for the previous court case at Strasbourg. We do not want to do so again. This is a sorry story. The people of Gibraltar have demonstrated again and again their loyalty to the Crown and to democracy. One of them has had to take us to court. The court ruled in the plaintiffs favour. It ruled against Her Majesty's Government. Since 1973 injury has been inflicted upon Gibraltarians by successive British governments. We now have the opportunity to rectify that injustice by supporting the Bill before us. Let us do precisely that. We do not want to add insult to injury.
9.9 p.m.
Lord Chesham: My Lords, I thank my noble friend Lord Bethell for introducing the Bill and give it my full support.
I appreciate that the Government have taken steps to discuss the situation with our European partners and I congratulate them on that. It is the right thing to do. However, as I understand it, there are at least two conflicting legal opinions. I am sure the Minister will agree that the way to sort out two conflicting legal opinions is usually in court and not just to say, "We know that the opinion we have is right" when that has proved to be wrong.
The Government have had the benefit of a judgment by the European Court of Human Rights which was not available to the previous government. Any argument that we are simply going down the same track as the previous government is negated by the position of the European Court of Human Rights. I hope that the same old argument that we have heard so often in the past will not be trotted out again.
I believe that we should immediately legislate to incorporate the UK electorate in Gibraltar into a mainland British euroconstituency. I have no particular feeling about which constituency. If any other country wishes to challenge that legislation, let it do so in a British court which can be in the locus of the European Court of Human Rights. Time is of the essence. The European elections are due in June. I believe that that proposal would be the swiftest and most correct way to right the proven wrongs perpetrated on the citizens of Gibraltar.
I ask three simple questions of the Minister. Do the Government expect the failure to amend the Act in time for the June election to lead to another legal challenge

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in the European Court of Human Rights? Have discussions on amending the Act taken place between Her Majesty's Government and Spain; and what are the outcomes of those discussions? Has any advice been received by Her Majesty's Government that amending the Act would be in breach of the Treaty of Utrecht?
9.11 p.m.
Lord McNally: My Lords, in opening the debate, the noble Lord, Lord Bethell, indicated a number of interests. Those of us who have heard the noble Lord over the years know that, as a dog with a bone, he takes up the causes he adopts with terrier-like tenacity. I do not think that anyone doubts the reasoning underlying his pursuit of this subject.
There is no doubt that the citizens of Gibraltar should have the right to vote in European elections. What is in doubt is whether they should have the right to vote via a British constituency as is suggested by the Bill. I am not a lawyer, but I would be eager to know from the Minister, or perhaps from Lord Bethell, whether the judgment of the European Court of Human Rights is simply a recognition of the right to vote in European elections without providing the solution, or whether it is specifically pointing in the direction that this Bill does, because the weight that we give to that judgment is important.
I realise that, in speaking from this Front Bench, I am to a certain extent walking on egg shells. Noble Lords have heard the passion of my colleague and noble friend Lord Carlisle on this matter. I understand that colleagues in another place would be eager to support the Bill if it went there. We need clarification about whether the 1976 Act would necessitate unanimity. It is still a matter of some doubt, as a number of Peers have pointed out, as to whether or not it would need a court case in Britain to clarify the position; I do not know.
What I do know is that this is not an issue which can be divorced from the long-term future and interest of Gibraltar. That future must be on the basis of close and harmonious relations with Spain. For us at this point to spatchcock this legislation on to our domestic European Elections Bill I cannot believe would be seen by Spain as anything other than highly provocative. I do not think this Bill will resolve the right of Gibraltarians to vote in European elections. In some ways it is a cruel hoax on the people of Gibraltar to believe that it would.
There is a situation that has been identified here which successive governments have left on the back burner for too long. I do not object to the noble Lord, Lord Bethell, using this device to keep the pressure on as regards this issue. In the meantime, as my noble friend Baroness Williams suggested, the European Committee of this House may take a closer look at Gibraltar and may even make it the subject of a special study. It is time for the Government to put this issue very much on the front burner in terms of discussions with our colleagues in Europe. It is an injustice. It is one that has festered far too long. We certainly do not oppose the Bill this evening. Nor do I suggest that it has all the solutions to the problem with which the absence of a vote for the people of Gibraltar leaves us.
9.18 p.m.
Lord Cope of Berkeley: My Lords, the last time that this matter was discussed (which has already been referred to), the noble Lord, Lord Williams of Mostyn, expressed fulsome sympathy with the people of Gibraltar although he said that legally his hands were tied. He said he would love to help—I am paraphrasing—but he could not. In the jargon popular at the moment he "shared their pain" over this matter, but could do nothing.
Tonight I have to confess to your Lordships that I cannot avoid having some sympathy for the Minister, because the position has changed totally. Now the Minister is being told by the Court of Human Rights that he must help. That was the decision by an overwhelming majority, as has already been said.
When I was first a Minister I used to find that civil servants sometimes came and said, "We are very sorry, Minister. We know you want to do this"—whatever it was—"but legally you can't. You will be taken to court. You must realise, Minister, that judges now take judicial review very seriously. There is no way you can do it. It is legally impossible. Our legal advice is unequivocal".
However, over time I observed two things, which no doubt the Minister, as an experienced lawyer, observed for himself long ago. The first is that in every court case up and down the land approximately half the lawyers are proved wrong every day. The second is that often legal advice changes over time, as we have seen recently. Someone else's lawyer puts forward a new point, a new argument or a different part of the law which argues the opposite way. Court cases which are begun with great confidence on the basis of the best available advice turn out to hinge on issues or points of law which emerge during the course of the argument. In other words, all legal advice is fallible.
The law of unintended consequences states that the unexpected effects of legislation are often the most important. The law of unexpected arguments in court cases is just as powerful.
However, another argument frequently addressed to Ministers, particularly those from the Foreign and Commonwealth Office, is, "You understand, Minister, that it is very important that we do not upset this foreign country because we need its help on some other matter". It is not always right, of course; every negotiation is different, even in the European Union, which is in a constant state of negotiation. However, in this particular case, I do not believe that Spain would ignore the decision of the Court of Human Rights. I believe that it would and should accept it and allow us to give the citizens of Gibraltar the right to vote as suggested in my noble friend's Bill.
Here I disagree to some extent with the noble Lord, Lord McNally. His noble friend, the noble Earl, Lord Carlisle, took a different view, but, after all, they are Liberal Democrats so we can forgive them. I believe that on the wider issue of Gibraltar, Spain has consistently gone about the matter the wrong way. I believe that if Spain wished to take over Gibraltar once again it should have been wooing its people and being nice and kind to them in order to draw them into Spain.

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It should not have closed the border and so forth, which appears to be Spain's policy most of the time. In the end, it is for the people of Gibraltar to decide what they want and the actions of Spain have tended to make them decide more firmly to stay with the United Kingdom. That is a matter for the Spanish Government rather than for the Minister.
As my noble friend Lord Chesham pointed out most directly, the situation surrounding the Bill has changed. The law of unexpected arguments, from the point of view of the. lawyers advising the Minister, has worked through in this case from the Human Rights Act. The law of unintended consequences has also worked through from the Human Rights Act. I welcome that and the Bill.
However, the issue of timing has entered the debate. It is obvious that if, last June, the Minister had taken the line that he seems to be obliged to take today, Gibraltarians would certainly have had the vote in the European elections this June. Now we must wait to see whether that is so. In doing so, I hope that the Minister will bear in mind that justice delayed is justice denied.
I therefore support the Bill's Second Reading. I congratulate my noble friend Lord Bethell on his persistence in this matter against all governments over a long period of time.
9.25 p.m.
Lord Williams of Mostyn: My Lords, I too congratulate the noble Lord, Lord Bethell, on his diligence in championing the cause of Gibraltar for many years, particularly in this context. I believe it is right that I set out the Government's position as clearly as I can.
As a number of noble Lords have indicated, and, in particular, the noble Baroness, Lady Hooper, pointed out, we discussed these issues at some length during the passage of what is now the European Parliamentary Elections Act. I can fairly say that I recognised the fact that the inability of the people of Gibraltar to vote was a matter of legitimate concern. I also said that the legal advice that the Government received was that this was not a situation that could be simply remedied through domestic legislation.
My understanding of the present judgment of the European Court of Human Rights is that that aspect of the legal advice is upheld. In other words, the European Court of Human Rights accepted that the interpretation of the legal position by the United Kingdom Government was correct in that it accepted that we could not unilaterally extend the franchise. There are two distinct questions here, the first of which is whether or not the refusal of the right to vote was in breach of the European Convention. The noble Lord, Lord Bethell, is quite right in saying that the Court found against the United Kingdom on that. However, it did not find against the United Kingdom on the second important question of whether we could act unilaterally, which is the point touched on by the noble Lord, Lord McNally.
I do not think that it is right to attack those who give advice to Ministers. Sometimes advice is right. I believe that the quality of the legal advice one gets is of a high
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standard. It was, perhaps, generally surprising to most lawyers that the court reached the conclusion it did. Be that as it may, I entirely agree with your Lordships that we have to deal with the present position.
The noble Baroness asked me to secure an apology from the Foreign Secretary. I knew, as I uttered them, that I should not have used the words, ''clear and unambiguous" as the noble Lord, Lord Bethell, reminded me. Of course, I regret the fact that the legal advice we were given turned out to be not upheld; in other words it was wrong.
I said at that time that it would not be profitable to try to amend the annexe to the 1976 Act. This is the key text which confined the franchise to the United Kingdom since there seemed little prospect at that time in those circumstances of securing the unanimous agreement of other member states. Quite plainly, the position has changed. It would be idle to say differently. There was the ruling in the case of Mathews v. UK. My noble friend Lady Symons said, virtually immediately in this House, that the Government accept that ruling and are looking to take immediate action to remedy the situation.
We have not been idle. On 4th March, we announced our intention to bring about an amendment of the 1976 text. On 16th March our permanent representative at the European Union, Sir Stephen Wall, tabled an amendment to the annexe to the 1976 Act. That amendment, if brought about, will widen the annexe to include Gibraltar and, in so doing, will allow the people of Gibraltar to vote in European Parliamentary elections.
The amendment is short and of the simplest. It adds to Annexe 2 the words, "and Gibraltar". Perhaps it would be helpful if I read out what Annexe 2 would read if the amendment was carried:
"The UK will apply the provisions of this Act only in respect of the United Kingdom".
The words to be added will be, "and Gibraltar". That is the amendment that was tabled on 16th March.
We will be lobbying hard to get all member states to accept this amendment. It is most likely to be considered as part of the wider negotiations on common principles for the election of MEPs which are currently underway.
Once the amended Act has been agreed and ratified by all the other member states, it will be possible to amend our own domestic legislation to extend the franchise to include Gibraltarians. I must emphasise that there is no point in the UK Parliament enacting domestic legislation until we have secured the agreement of all the other member states to the amendment to the 1976 Act. For that reason alone, the Government regard the Bill as premature.
I know that the noble Lord, Lord Bethell, has tried to overcome that problem by introducing into his Bill the provision that the Bill will not come into effect except by an order made by the Secretary of State; and the Secretary of State is not to make such an order unless
"requested by the appropriate representative authority of Gibraltar. "
I do not know what that phrase is intended to mean because it is not defined in the Bill. I think that it would need to be so defined.

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There is another question. If the people of Gibraltar are to participate in United Kingdom elections, we will need to be certain that their electoral procedures are compatible with ours. We will have to ensure that the same rules governing issues such as electoral registration, voting arrangements and absent votes apply to everyone eligible to vote in our European parliamentary elections.
The noble Lord, Lord Bethell, is right that we would need further United Kingdom primary legislation—the noble Lord knows more about the domestic law of Gibraltar than I do—and that in all probability legislation in Gibraltar would also be needed. I agree. That is the present situation.
I was asked a number of specific questions which I shall attempt to answer. The noble Lord, Lord Chesham, asked me whether a failure to amend the Act would lead to another challenge. I simply do not know whether another challenge would be mounted. We shall be in a position to assert that we have taken concrete steps to put the matter right by tabling our amendment on 16th March.
We have not yet had responses from fellow member states. That is hardly surprising as the time that has elapsed between 16th March and today, 25th March, is so short. I do not know how they will react. However, it is extremely unlikely that the situation will be resolved in advance of the elections this June. We have not received any advice with regard to the question from the noble Lord, Lord Chesham, about whether extending the franchise to Gibraltar would affect the Treaty of Utrecht.
Perhaps I may continue with a further exposition of the Government's position. I do not believe that this Bill will do the work that the noble Lord, Lord Bethell, wishes it to do. However, I reiterate that we are committed as a government to giving effect to the ECHR ruling at the earliest possible date. I have to say—because I think it unkind not to do so—that I think that it is extremely unlikely that things will move fast enough to allow the Gibraltarians to exercise their vote in June.
I believe that we have taken on board our obligations pursuant to the judgment of the European Court. That judgment was given only this February. We announced our intention to seek the amendment early the following month—that is, this month—and we tabled our amendment on 16th March. So I do not think that it can be suggested that there has been any criticizable delay.
I believe that I have answered the questions put to me. I reiterate our support for the principle of what the noble Lord, Lord Bethell, has suggested. However, I do not believe that this Bill will do that work. Many details remain to be resolved, not least the question of where Gibraltarian voters would vote. Would they need postal votes or absent votes? What would be the registration procedure? I do not think that any of those points will be sorted out in time for the June elections.
9.34 p.m.
Lord Bethell: My Lords, I am grateful to all those who have spoken in this debate and to the Minister, who has been more positive on this point today than on previous occasions. He has accepted in the most gracious fashion that erroneous advice was given. I am sure that that will be noted with appreciation by the people of Gibraltar, 90 per cent. of whom asked your Lordships to give them the vote in the June 1999 elections.
I hope that some progress can be made before 10th June. I am glad that the Minister speaks in terms of that being unlikely or very unlikely whereas the Foreign and Commonwealth Secretary was more negative. He said straight out that it was impossible. So we are making some progress towards bringing about the conclusion that I believe we all accept must be reached sooner rather than later.
This debate will be observed most carefully by the Gibraltarians. They will be pleased that at last something is happening, but disappointed at the rather negative idea that this measure may not take effect in time for 10th June. However, I trust, that the principle having been conceded, the measure will eventually find its place on to the statute book.
On Question, Bill read a second time, and committed to a Committee of the Whole House.

Police Vehicles
9.36 p.m.
Lord Campbell of Croy Lord Campbell of Croy rose to ask Her Majesty's Government whether they will give advice to police authorities on the circumstances in which police vehicles may exceed speed limits, ignore traffic lights and in other ways disregard the regulations governing traffic on public roads.
The noble Lord said: My Lords, I hope that the noble Lord, Lord Hoyle, who I am glad to note is to reply to the debate, can inform the House about the present situation and any review of guidance to police that may be in train. The police have to achieve a difficult balance to respond urgently to emergencies and also to create the minimum of danger and inconvenience for the general public in doing so.
I am raising an aspect of relations between the police and the public and not just the motoring public. My aim has been to help improve those relations. A recent incident some four weeks ago brought the subject to the headlines. A well-known television presenter, Sheena McDonald, was, as a pedestrian, hit by a police car with its blue lights flashing and siren wailing. She had to be placed in intensive care in hospital. I hope she is making a good recovery.
I shall not comment on cases in which investigations and proceedings are continuing. I shall refer only to indisputable facts reported in the press—the accidents, deaths, and injuries. These are some of the recent ones. The Times of 3rd February reported a court in Newcastle being told that a police car on the wrong side of the road travelling at 70 miles an hour had killed a pedestrian.

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The Daily Telegraph of 22nd February reported a case of two police officers seriously ill in hospital after crashing in east London when answering an emergency call. In November, on the outskirts of Aberdeen, two pedestrians (a married couple) were killed by a police car answering a call to investigate a suspected robbery in a video shop. Last Christmas Eve a 10 year-old boy was severely injured in South Shields by a police car that crashed into a fence and lamp-post before mounting the pavement. Noble Lords will know of other incidents.
The Times has also provided some general statistics from Home Office sources presumably referring to England and Wales only recording that between 1991 and 1995 nearly 100 people were killed and about 1, 400 injured in accidents involving police vehicles.
I am not launching a campaign against the police. Far from it. In six days' time I am to initiate a debate on car crime, having been successful in the ballot, and I shall then, as in the past, be examining ways in which the police should be assisted and supported. I am a member of the European Secure Vehicle Alliance whose membership includes police forces. We work together at meetings and in correspondence.
My interest and concern in the roles of police cars were aroused during the four years when I was Secretary of State for Scotland and answerable to Parliament for the police forces in Scotland as Minister for Home Affairs. As Secretary of State I made an official visit to the Scottish police college at Tulliallan. I was glad to be briefed there on driver training, which I count as very important. I insisted, though, that exercises in speeding at 120 or more miles per hour should only be carried out on the adjacent public roads when the essential training of drivers required it, in the interests of the public. Of course, in certain situations the police have to reach high speeds; for example, in a chase. And we encourage them, if they are pursuing known murderers, terrorists or drugs gangs. However, speed can be a killer and should be resorted to with care.
Another organisation with which I am associated is the Parliamentary Advisory Council on Transport and Safety. Six weeks ago it held a conference solely on the subject of speed and its connection with crashes and severity of injuries. The opening speech at that conference was made by the noble Lord, Lord Whitty. So I hope that I need not dwell now on the dangers of speeding and the need to restrict it to special circumstances.
My concern was heightened when, by chance, about four years ago I saw a police car accident near here and reported it, realising that I might be the only independent witness. I should explain that I have to visit hospitals as a patient to be inspected at least every six weeks as a result of being severely wounded in the war, and when I am in London it is St. Thomas' Hospital I visit, now the parliamentary hospital. In the Lambeth Palace Road near here, I saw a police car being driven at speed on the wrong side and at a blind curve have a head-on collision with a car whose driver could not have avoided the crash, though both managed to slow down. When I returned to the Houses of Parliament I reported what I had seen to the Metropolitan Police who then
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acted, I thought, admirably. They thanked me because they had received no other observer's report and kept me informed about the case, to my surprise, for months. Finally, they informed me that there had been an appropriate reprimand or equivalent given to the policeman in the car. In that connection, I wonder whether the noble Lord, Lord Hoyle, can confirm a recent report that the Metropolitan Police are starting to fit black box recorders, like those used in aircraft, in their cars to help trace the course of those cars.
I have been pursuing my own research and inquiries into other incidents. It seems that a large proportion of emergency calls are false alarms or are found to be trivial or unnecessary. We have to ask whether a reasonable balance is being maintained between a quick response on the one hand, and the danger and inconvenience to the public on the other. Of course, the police have to respond quickly; they are not to know until later whether or not an emergency call was a false alarm.
At this point I must comment on the report of the Audit Commission for England and Wales published last January on police performance indicators. The commission produced league tables comparing the records of various police forces on two counts. The first was the average time before a police car responds to an emergency call. The second was the average time to reach the incident. The first is an excellent competitive measure—that is, the time between a call and the car moving off—a test of readiness at all hours. The second is, in my opinion, unfortunate in promoting competition of a different sort. The time taken for a police car to reach an incident depends on several factors beyond its control; for example, whether it is in a city or urban area, whether it is during the rush hour or in fog or bad weather. Pressure to drive fast through red traffic lights on the wrong side of the road in order to compete and record times that look good invites accidents.
I thoroughly approve of the Audit Commission's general principle of obtaining value for money, but on the subject of emergency calls I believe that the test should be limited to how quickly the police car moves off after receipt of the call.
I have so far been speaking of accidents and casualties. But there is also the inconvenience, the aggravation and the minor damage often experienced by the public, whether motorists, cyclists or pedestrians, when, for example, a police car suddenly decides to start up its siren and dash through red lights as traffic observing the green light is already crossing its path. Any damage may be minor—small dents to bumpers or panels caused by sudden braking and involuntary shunting. But the repairs needed deprive the owners of their cars for a day or two, or longer.
My understanding is that if a police car hits something or someone, the police accept some responsibility. If, however, it does not hit anything, the police practice is not to accept any responsibility nor to contact witnesses who have come forward to volunteer accounts of what they saw of the police car's passage. The trail of minor mayhem that a police car may leave

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in its wake, especially at the crossings and corners on its path, which may extend for several miles, is not, apparently, their concern,
I entirely understand that attitude. The bills that the police would face could be enormous. There are specialist solicitors who will advise their clients in those situations how to claim for such things as whiplash, stress, nightmares and other alleged conditions. The police may avoid such claims, but the insurance companies will have to cope with them to the detriment of the public as insurance premiums increase. I speak as one who was the non-executive chairman of an insurance company before I reached its retiring age. I am aware of the escalating quantity of claims in this area. I am informed that police forces are now insuring only against claims above £50, 000. Nonetheless, I hope that they are covering fully injuries to their own personnel.
A recent development that may reduce the turmoil among the traffic affected by a speeding police car is a new kind of siren called the "Localizer". It apparently indicates the direction from which the police car is coming. Noble Lords will immediately see the advantage of this if they have experienced the sudden, deafening start of a siren nearby. It is impossible to tell whether the police are coming from behind or from either side at a crossroads. Drivers try to react helpfully, but perhaps do so in the wrong direction or bump into each other.
The West Yorkshire Police who are carrying out trials with the new siren have so far reported favourably. Where other traffic is concerned, their figures are these. There has been a 15 per cent. reduction in what are described as "panic" manoeuvres, and a 20 per cent. increase in signalled manoeuvres, while the police car has experienced an 8 per cent. reduction in lane changes. That is the way that the success of the experiment so far has been described. I suggest that this directional siren should be an improvement. The noble Lord, Lord Hoyle, may care to comment in that respect.
I know that the law allows police vehicles to ignore speed limits and other regulations if the purpose of their mission would otherwise be harmed or frustrated. But how is that decided, often at very short notice, and by whom? The police are not above the law. We wish them well in their endeavours to curb crime and help with emergencies. But who polices the police?
Is a decision to start on a dangerous run through traffic at speed delegated to a sergeant or constable in the car, or must he get permission over the radio? I presume that most forces delegate instant decisions to the policemen in the car, but if so they should nonetheless be operating within clear guidance and according to directives carefully prepared by their superiors. Can the noble Lord confirm and tell the House that reviews are taking place, with government supervision, to spread best practice and to standardise procedures where this is relevant?
The police are performing a difficult function in this area. Ultimate responsibility at higher levels is divided and not clear. Chief constables have duties concerning
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their particular forces. Police authorities are now a mixture of councillors, magistrates and others. The presiding Ministers are the Home Secretary and the Scottish Secretary in their respective territories, with the exception that the Home Secretary of course is also directly responsible for the Metropolitan Police.
It is our job as parliamentarians, I suggest, to protect the interests of the public—and that is my aim this evening—to improve safety for individuals on our roads and pavements, whether on wheels or on foot, and also to reduce the disarray and tribulations that a speeding police vehicle can leave in its wake.
9.51 p.m.
Viscount Simon: My Lords, I am delighted that the noble Lord, Lord Campbell of Croy, has tabled this Unstarred Question. It gives us the chance to debate matters which are of concern to many people today. I may inadvertently even answer some of the questions that the noble Lord has raised.
It is quite common for people to complain about the press conducting witch hunts unnecessarily, but on this occasion I am pleased that the Daily Mail has decided to highlight certain aspects of police driving. Before proceeding any further I should perhaps declare that I am a civilian holder of the police Class 1 driving certificate, a former examiner of advanced motorists in Australia, and a civilian who regularly goes on traffic patrol with the police and is learning many other aspects of their difficult job.
Legislation exists which gives drivers of emergency vehicles exemption from certain aspects of the Road Traffic Acts when attending an emergency call. It allows drivers of such vehicles to be exempted from compliance with speed limits, and traffic signs etc., but places an obligation on the driver to drive with due regard to the safety of other road users, including pedestrians, at all times. And, to answer one specific part of the noble Lord's question, it should be pointed out that traffic signs, such as red lights and stop signs, are treated as give way signs and individuals should only exercise legal driving exemptions when they have received the appropriate driver training. Should an emergency vehicle, travelling in these circumstances, cause, or be involved in, a crash, then the driver of the emergency vehicle is liable to prosecution. If an emergency vehicle is not on an emergency call and the driver fails to comply with the Road Traffic Acts, that driver is liable to prosecution.
Regarding the fitting of black boxes, these were tried out some time ago. As the noble Lord, Lord Campbell of Croy, has indicated, they are being fitted again to about 500 vehicles. I think that they will certainly be useful.
It should not be forgotten that emergency vehicles attending an emergency have been summoned by somebody who believes that urgent intervention is necessary; nor should it be forgotten that the police attend more emergency calls than the other two emergency services. But it would be unhelpful to divorce police vehicles from other emergency vehicles which have permitted exemptions and whose vehicles have completely different handling characteristics.

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The ambulance service must meet certain standards—called Orcon standards—set by the Department of Health and those standards exist for urban and rural areas. The fire service has slightly more complicated response times imposed upon it depending on the number of pumps to be deployed, whether the call originates within a city, town or is rural.
Operational control of each police force rests with the chief officer and instructions cannot be issued by the Home Office or a police authority which in any way remove that operational autonomy. The level of response and time of attendance is determined by questioning the caller about the nature of the emergency and a graded response has frequently been adopted to cope with demand which sometimes outstrips available resources. I have been with a crew in London responding to a call for assistance some 10 miles away when no other vehicle was able to attend. This took place after dark but with numerous other vehicles on the road. The driver went rapidly between points A and B and was only slightly hindered by a youth stopping on a pedestrian crossing and giving us a "V" sign before continuing to amble across. It transpired that someone, who was completely blotto, had been bowled over by a van—fortunately without injury—and I assisted the officers in their examination of the vehicle involved and the cause of the crash. But, in this instance, all the crew knew was that someone had been run over and that, despite being far away, no other vehicle was available. Therefore speed was of the essence. I can only say from personal knowledge that traffic officers do not exceed speed limits unnecessarily nor speed inappropriately.
There have been other times when a crew has been called to an incident but, after a short time, has had its attendance cancelled, leaving anybody observing the marked deceleration and extinguishing of lights and noise somewhat bemused.
Ambulance crews know roughly what they are going to; fire crews usually know what they are going to: but the poor police officer sometimes knows what he is attending, but not always, and therefore the response time can be critical. I was amused to read in the Mail on Sunday last weekend that the police rushed to the aid of a terrified woman who told them, presumably when they arrived, that she had seen a gigantic, poisonous tropical spider. It turned out to be a large ball of wool.
Police officers receive a very high standard of driver training at various police driving schools throughout the country. The Metropolitan Police adopt these standards, with trained divisional officers either assessing and authorising the basic driving qualification for panda cars or, as at present, courses at the police driving school at Hendon for those who drive emergency response cars and vans. It has been said that a Hendon-trained advanced driver is one of the best in the world, and other countries have not only adopted its training methods, but send some of their officers to be trained there.
The system of car control has evolved since the driving school was first opened in the 1930s. As a direct result of being trained, I have to say that the last insurance claim I made was about 40 years ago. Unfortunately, like other areas of modern life and the
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demands placed upon it, fewer but sufficient funds are being allocated in different ways and are being better targeted towards those who need the driving skills.
The newspaper suggests that driving should be independently monitored. There might be some benefit in that suggestion—I am not in a position to judge—but it should be stressed that police driving is not linked to normal civilian driving. Advanced training reduces the chance of accident and the skills reached reflect the competence to drive urgently in an unusual scenario. The ACPO Police Pursuit Driver Training Report of September 1998 makes many recommendations, including accreditation of driver training, competency-based assessments and standardisation of instructor training. I would hope that this important ACPO report is adopted by every force. Having said that, it should be noted that in some forces basic drivers are not authorised to respond to emergency calls.
A recent report by Her Majesty's Inspectorate makes the recommendation that although traffic policing has been ignored for some years it should become a core police activity. I hope this recommendation will be implemented.
While legislation and service instructions already exist in respect of compliance with the Road Traffic Acts, no call is so urgent as to warrant the involvement of an emergency service vehicle in a crash, which will only delay the attendance of help to the person or incident. Drivers of emergency vehicles have the ultimate discretion to discontinue a fast response or pursuit if the safety of others is compromised in any way.
Sometimes we hear of someone being killed in a crash involving a police vehicle engaged in a pursuit. Thankfully, such incidents are rare. The newspapers always seem to make as much as possible out of such a tragedy, usually slating the police, whereas in reality if the driver of the pursued vehicle had stopped when ordered so to do, the death would not have occurred. There can be no excuse for not stopping when so ordered.
I wrote down what someone said in April 1997 in Greater Manchester, when her son, and others, had been killed following a pursuit. She said, "There are five mums who have all lost sons because of this. We have come here to try to work out what happened. The police should not have been chasing them". I feel sure that, if she has come to terms with her awful loss by now, she will agree that everyone should stop their vehicle when ordered to do so by a police officer. Sympathy goes to the family and friends of anyone killed in a crash following a pursuit, but that does not hide the fact that, had that person stopped when told to do so, the fatality would not have occurred.
Noble Lords may be interested to learn that within the Metropolitan Police (I do not know about other forces) a system exists of awarding points for mishaps and more serious incidents. Similar to the civilian points system on licences, one to 12 points may be given depending on the severity of the wrongdoing. At a certain stage the officer is recalled for assessment and possible retraining.

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I am led to believe that an officer receives one point for damaging a wheel after hitting a kerb. So the system demands a high standard even of standard class drivers.
Finally, it might be worth reminding your Lordships that a police vehicle called to an incident may well be making a loud noise and flashing blue lights. But that is necessary to warn other road users and pedestrians of its approach. While some people may regard that as an intrusion on their senses, those people would not expect anything else if they had caused the emergency and were awaiting the attendance of the police. The use of noise and lights only applies when necessary.
10.1 p.m.
Lord Cope of Berkeley: My Lords, we are more or less agreed on the principles of this subject. We all want the police to arrive quickly when we need them, particularly at serious incidents, when crime or danger can be avoided by the police being present. The same applies to the other emergency services. But at the same time we want them to drive safely for the sake of others, and indeed for their own sake. Policemen have been hurt in accidents in the course of high speed manoeuvres en route to incidents as have other people, as my noble friend Lord Campbell of Croy pointed out. Certainly, our sympathy goes out to everyone who is hurt in this way, and particularly to those who who have been close to people who have been killed.
Speed on the roads is dangerous in any circumstances. That is why we have speed limits. But speed is sometimes necessary for the police and the other emergency services. That is why I welcome this Unstarred Question requesting fuller consideration of the matter and guidance for the police. I do not mind whether it comes from the Home Office or from ACPO; it should come from whichever is most appropriate.
I hope that those who prepare any new guidance will think the matter through. I hope they will consider whether it might be possible in these days of fast, elaborate and more accurate communications to give more information about the cause of a call and to distinguish between a real emergency, when police on the ground a minute or two earlier can make a real difference, and other incidents where an extra minute or two makes little or no difference. In these days of better communications that might be possible. False alarms are a matter about which the police can do little at the time. But not all genuine 999 calls justify risking lives. It is much worse for someone who is maimed by a police car in those circumstances or for someone who loses a relative or friend, if it turns out that the call was made for some relatively trivial incident where a policeman arriving a minute or two later would have made no practical difference to the situation.
I do not pretend it is an easy matter to sort out but, as the noble Lord suggested, it needs careful consideration, particularly because the other two emergency services sometimes have more information about the incident they are trying to attend.
Obviously, the best training that can be provided is important and highly desirable. However, I should not wish to limit high speed response to a selected group of
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policemen who were specially trained, while those not specially trained were not allowed to respond to an incident. It is not desirable.
While the matter is being examined, I reinforce what my noble friend said about sirens. It is an important question and I find it difficult to tell from which direction some of the modern whistling, wailing sounds come. It makes it more difficult to keep out of the way or take appropriate action in a car or vehicle. In urban situations the sound reverberates from the buildings and as the vehicle moves, the sound appears to come from different directions, and it reverberates differently. Careful thought should be given to the problem and if new types of sound would be of benefit, they should be adopted as soon as convenient. When crashes occur, they are not necessarily all the fault of the police drivers. It may be that others react in an unpredictable way, not least because they misunderstand where the sound is coming from.
Altogether, the debate has been valuable in drawing attention to the matter and I thank my noble friend for providing the opportunity for your Lordships' House to consider it.
10.6 p.m.
Lord Hoyle: My Lords, like other noble Lords who have spoken, I am grateful to the noble Lord, Lord Campbell of Croy, for raising the issue. It is right that when Parliament passes laws we should pay particular attention to anyone granted exemption from them. The police driver has been granted some exemptions from road traffic law, but they are limited and specific.
Before I discuss those matters in more detail, I wish to deal with some of the points raised here tonight, particularly those made by the noble Lord, Lord Campbell. My noble friend Lord Simon was supportive of the police and made many of the points that I shall make, so I shall reinforce what he said. I believe that the noble Lord, Lord Cope, also was supportive of the police, as were all those who spoke tonight.
First, as the noble Lord, Lord Campbell of Croy, said, we cannot discuss particular cases but we all hope that Sheena McDonald is making a speedy and complete recovery. We extend our sympathy to the families of those who have lost their lives after being involved in crashes with police vehicles, as well as other vehicles.
It is interesting to look at the statistics. Most of the fatalities occurred in three police activities: 20 per cent. were routine patrol cases; 23 per cent. arose from responses to emergency calls, which we have been discussing; and 45 per cent. were pursuit-follow situations. It is also interesting that in 73 per cent. of the cases the vehicles were travelling at below the local speed limit when the accident occurred.
I was also asked about driver training. The media have made a number of comments about that. As has been explained by my noble friend Lord Simon, driver training is very rigorous. Drivers are trained to a very high level of expertise. Like my noble friend, I hope that the ACPO police pursuit driver training document issued in September 1998, which made a number of

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recommendations, including night training for drivers— because that is when many pursuits take place—will be accepted by many police forces.
Reference was made to black boxes being fitted to vehicles by the Metropolitan Police. It is true that those boxes are being fitted. If any vehicle were involved in an accident the black box would be able to provide independent evidence of speed. Other police forces will be watching with great interest to see just how effective that is.
Various aspects of police vehicles were referred to, including police sirens. White noise sirens have been developed by the University of Leeds. The noble Lord, Lord Campbell of Croy, referred to this. The noble Lord, Lord Cope of Berkeley, said that if there was a better type of siren it would be a great advantage because very often one did not know from which direction the police car was coming. The white noise Localizer siren operates on a broader sound frequency and enables people to determine not only the presence of the emergency vehicle but, more importantly, the direction from which it is coming. I believe that that is a great advantage. The noble Lord, Lord Campbell of Croy, accurately summed up the results of the experiment in West Yorkshire. The new siren has resulted in a 15 per cent. reduction in the incidence of panic manoeuvres, a 20 per cent. increase in signalled manoeuvres and an 8 per cent. reduction in lane changes.
Work is also being done to improve the visibility of police vehicles. It has been suggested that motorway police vehicles in particular should be of standard design and that they should have blue and yellow side markings. I am pleased to say that already 22 forces in England and Wales have adopted that. In addition, pulsing headlamps have been designed which show more white light to other road users. That is another safety device that will become available. All of those measures, taken together, I believe will help to improve road safety, which is what we are about.
Perhaps I may deal with the response time to emergency calls, which was raised by the noble Lord, Lord Campbell of Croy. He said that there should not be any competition in relation to that. I am sure that we all agree with that, but if people make emergency calls they want the police to arrive as quickly as possible.
Lord Campbell of Croy: My Lords, the Minister may have misunderstood my point. I said that competition as to the shortest time to leave in the car was admirable. That could be a matter of 10 or 20 seconds. I was referring to a league table to show the time between leaving for and arriving at incidents. That might be 15 or 20 minutes. I described many variables. That was the kind of competition of which I disapproved.
Lord Hoyle: My Lords, I think that I understood the point made. However, when the public call the police they want to see them arrive as soon as possible, taking safety into consideration. That is why the police seek to meet the 15 or 20 minute period depending on whether it is an urban or rural area. That is important. It does not involve a league table. It is a key objective of the
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police service. While it will not feature as a ministerial priority, it remains an important area of police activity. My noble friend Lord Simon pointed out that when a person calls the police, he wants to see them arrive as quickly as possible.
Having dealt with the many issues raised, perhaps I may refer to the point on exemption from road traffic law. In the case of speed limits, Section 87 of the Road Traffic Regulation Act 1984 provides that,
"No statutory provision imposing a speed limit on motor vehicles shall apply to any vehicle on any occasion when it is being used for fire brigade, ambulance or police purposes, if the observance of that provision would be likely to hinder the use of the vehicle for the purpose for which it is being used".
In other words if the vehicle is needed, it can breach the speed limit. The section effectively provides that not only must the vehicle be being used for police purposes but that those purposes would be hindered on the particular occasions by complying with the speed limit.
The provisions are clearly seen as applying to vehicles involved in pursuits and emergency responses. It should be noted that it gives the police no exemption from anything other than the breach of the speed limit which would otherwise constitute an offence.
The police must be very careful at traffic lights. The limited police exemption is set out in the Traffic Sign Regulations and General Directions 1994. Those provide that when a vehicle is being used for fire brigade, ambulance or police purposes, and the observance of the prohibition conveyed by the red signal would be likely to hinder the use of that vehicle for the purpose for which it was being used, then that restriction should not apply.
However, the restriction is more limited because the regulation goes on to state that in those circumstances the vehicle may go through the red light but should not proceed beyond the stop line in a manner or at a time likely to endanger any person or cause the driver of any vehicle proceeding correctly with the lights to change its speed or course in order to avoid an accident. In other words, it simply gives the driver the right accorded to any driver in the case of a give-way sign. It is up to the driver to proceed with care, bearing all that in mind. The police vehicle has to comply with the regulations in that way. There are similar exemptions and provisions which apply not only to red lights but to pelican crossings and to various light and horn regulations so as to permit the police vehicle to use special lights. However, strict compliance with other road traffic regulations is always required.
I hope that it will be appreciated from what I have said that police officers do not have carte blanche to ignore speed limits or red traffic lights. The exemptions which have been granted to them are very specific, limited and are enshrined in law. If as a result of exercising those exemptions any accident occurs, the police driver is every bit as liable for the consequences as any other motorist using the road. The courts will have to make their own decision where proceedings are brought in the light of particular circumstances.
The law in relation to these matters is very clear. Guidance on these exemptions has been issued and we expect strict compliance with them. However, I shall

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ensure that all the points that have been made tonight— and they have been made in a very constructive manner—will be considered and, if necessary, I am sure that the attention of the relevant authorities will be drawn to them.
Lord Campbell of Croy: My Lords, because in this kind of debate I do not have the right to wind up, I
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should like to take this opportunity to thank the noble Lord for having answered concisely most of the questions which have been put during the debate and particularly the matter of exemptions and the law that applied with the regulations in 1994. I am sure that what he has said will be read very carefully by the large number of people who are concerned with this subject.
House adjourned at twenty minutes past ten o'clock.