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Baroness Scotland of Asthal: My Lords, I agree with the noble Earl that it is very important that the probation service is properly resourced. It has a very important role to play. Since 1997, spending on prisons has increased in real terms by 30 per cent and spending on probation by 46 per cent. However, there has been a significant increase in sentence severity despite those changes. So we are making a real commitment to resource the probation service to enable it to do the job which it is more than fitted to do.
Lord Acton: My Lords, can my noble friend say whether the decline in women prisoners in England and Wales by 160 for the year ended 14 January was due to an increase in community sentences? Will the Government encourage the greater use of community sentences for women in future?
Baroness Scotland of Asthal: My Lords, I very much agree with my noble friend on the need to look at increasing the use of non-custodial sentences for women where appropriate. We do of course welcome the reduction. It is difficult to ascribe such changes in the figures to one particular factor. It would appear that the decrease in the number of female prisoners for the year ending in January is largely the result of the decrease in the remand population. However, there was also a 6 per cent reduction in the size of the shorter sentence prison population and there are indications of a welcome increase in the number of women being given community sentences during the 12 months to September 2004. So I very much welcome the import of my noble friend's question.
Lord Dholakia: My Lords, will the Minister confirm that recent research studies indicate that curfew orders have not been effective and that people who receive custodial sentences reoffend within two years? Does she consider that the resources given to the probation service are inadequate, in the sense that in some parts of London the probation service is almost at breaking point? Does she therefore consider that to improve non-custodial alternatives it is necessary to put much more resource into the probation service?
Baroness Scotland of Asthal: My Lords, as I have already made clear, the Government have already made
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a significant increase—a 46 per cent increase—in spending on probation. We absolutely accept that those resources are needed, and they are now being put in place. The number of new probation officers has grown significantly and the Government will continue to meet that commitment. Curfew orders must be seen against the whole panoply of orders that join together to give us effective sentences and they have an effective part to play in proper control and sentencing.
Lord Ackner: My Lords, do the Government accept that the reduction in the discretion of the judge to imprison or not and the imposition on the judiciary of minimum sentences tends to add to the population in prison?
Baroness Scotland of Asthal: My Lords, I do not accept the fundamental precept on which the question is based. As I said to the noble and learned Lord during the passage of the Criminal Justice Act 2003 and other Acts, the discretion of the judge remains. Of course there is a clear framework and standards, but it remains within his remit for the judge in any given case to come to a decision about how to do justice in that case, as it properly should. The noble and learned Lord will know that minimum sentences have been used very sparingly and, we would say, proportionately.
The Lord Bishop of Worcester: My Lords, is it the Minister's view, as it is the view of most people engaged in prison reform work, that it is almost always—if not always—the case that far more can be accomplished to rehabilitate an offender by the use of a community service order over a long period than by custody over a short period, which simply produces disruption and instability in the Prison Service and prevents it doing the work that it is best equipped to do?
Baroness Scotland of Asthal: My Lords, we have clearly set out our view that community sentences should be used for non-dangerous, non-violent offenders where that would be most effective. I hope that noble Lords will remember that the menu of orders presented in the Criminal Justice Act 2003 takes us from conditional cautioning, before a person is brought to court, right the way through to custody minus, which comprises all those things that fall short of imprisonment. We think that we now have the appropriate menu from which the judge can choose both to punish and, we hope, to enhance rehabilitation and reduce the level of recidivism.
Baroness Howe of Idlicote: My Lords, given the shortage of placements for community service orders, although one applauds the way in which they are being rolled out, to what extent is the voluntary sector being used? Could we make greater use of the voluntary sector for that purpose?
Baroness Scotland of Asthal: My Lords, as the noble Baroness will know, we are working through the local criminal justice boards creatively to consider
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local opportunities, including volunteering, to see what sort of things we can encourage community service offenders to do in the community that are visible and will clearly demonstrate that they are paying back to the community in the proper way. We are vigorously pursuing that.
NHS Case Management: US Evercare Model
2.53 p.m.
Baroness Neuberger asked Her Majesty's Government:
Whether they agree with the advice of the King's Fund that a further evaluation of the cost-effectiveness of the United States Evercare model for reducing emergency hospital admissions should be undertaken before this model is introduced in England and Wales.
The Parliamentary Under-Secretary of State, Department of Health (Lord Warner): No, my Lords, because we already have in progress an independent evaluation of the Evercare model by the National Primary Care Research and Development Centre. Its interim report provides evidence that care based on case management principles will improve the lives of those with more complex needs arising from long-term conditions. The NHS and social care model published on 5 January recommends that healthcare providers in England adopt those principles to improve the care and support offered to their local population. That model draws on experience from overseas, including Evercare, and the NHS, without advocating any particular scheme, and will be supported by the 3,000 new community matrons the Government are funding.
Baroness Neuberger: My Lords, I thank the Minister for his reply, but, having read the National Primary Care Research and Development Centre report on the Evercare model, it seems to me and many others who have reported on it that it is not the green light for which Ministers were hoping. Will the Government now invest in a much more robust evaluation further to what is being done at present in Manchester to consider different approaches to case management, beyond what Evercare is doing and, meanwhile, stop recruiting the 3,000 community matrons who they want to take that forward until the evidence is far clearer?
Lord Warner: No, my Lords. As I tried to make clear, an interim evaluation is available. We will be receiving Manchester's final report in 2006. Sometimes, I think that there is no pleasing the Liberal Democrats. When we published the NHS and social care model on 5 January, we were chastised by the Liberal Democrat Front Bench for not moving fast enough. Now the Liberal Democrats seem to want us to go slower.
Baroness Murphy: My Lords, does the Minister agree that case management is a tough and difficult job
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to do well, the complexity and difficulty of which is often underestimated, and that the successful overseas pilots in Australia and, extensively, in the United States have all required significant financial levers, bringing together specialist care, primary care and social services? When will the Government produce schemes within the NHS and social services here that mirror those successful schemes with financial incentives?
Lord Warner: My Lords, we have done a number of things. We published the NHS and social care model for long-term conditions on 5 January. That distils the wisdom from a number of schemes, both overseas and here. There have been very good schemes in this country—those at Castlefields and Whipps Cross come to mind—of which I am sure that the noble Baroness is well aware. I accept that schemes need to be carefully planned and co-ordinated between health and social care, with GPs and with an enhanced nurses' role.
Earl Howe: My Lords, the Minister mentioned community matrons. Can he reassure me that community matrons will have sufficient authority and resources at their disposal to make a real difference to how care is delivered outside the hospital setting?
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