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24 Jun 2008 : Column 1335
Lord West of Spithead: My Lords, the noble Baroness is correct. That was part of the equation in the debate. There is no full consensus in the Somali community about this. However, there is no doubt whatever about the real harm that the drug can cause. It is bought for about $1 a kilo in Kenya and is sold in this country for about £30 to £50 a kilo. It is mainly used by the men in that Somali group, most of whom have come here in the past 12 to 14 years and have tended to go to inner-city areas. It is a real problem, but it would be wrong at the moment to treat it with a criminal justice response. It is right to go about it in the way that we are, but we are continually monitoring the problem. If it should change, we will not hesitate to take action.
Lord Avebury: My Lords, what research has been commissioned by the Government since the 2005 ACMD report and the Home Office study of Somali use of khat in four major cities of the United Kingdom at about the same time? Does the noble Lord agree that if you criminalise the drug, as the noble Baroness suggested, the likely result would be to get more people into the courts and prisons without necessarily affecting the import and consumption of this product? Would the right answer be to tax khat, to supervise the establishments in which it is sold and to embark on a public education programme, particularly in the Somali and Yemeni communities?
Lord West of Spithead: My Lords, the noble Lord raises a number of points. It is absolutely right that we should treat this as a public health issue. Interestingly, there is no doubt whatever about this. This stuff is brought into the country and people should pay VAT. We have tried to engage with the mafreshi, which are the dens where, I am afraid, men will chew one or two bundles of this stuff in a session. In fact, HMRC are homing in on these places, which is a way of tackling the problem. The proper VAT and such things should be paid, but they are not being paid and those involved have not been good at engaging with us on health and safety and other things, which we need to pursue. I believe that it is still much more a public health issue than a criminal issue, but we will keep reviewing it. Occasionally, for some drugs, there is a case for criminalisation.
Lord Elystan-Morgan: My Lords, bearing in mind the complicating factors that the Minister and the noble Baroness properly referred to, will the Minister confirm that, in the event of Her Majesty’s Government being persuaded by the misuse of drugs body that there is a case for criminalisation, this can be done easily under the Misuse of Drugs Act 1971 without primary legislation? In fact, by affirmative orders in both Houses, it can be done speedily.
Lord West of Spithead: My Lords, the noble Lord is correct. That is the basis on which it would be done if we moved down that route.
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EU: Public Understanding
2.58 pm
Viscount Falkland asked Her Majesty’s Government:
In the light of the result of the Irish referendum on the Lisbon treaty, what steps they are taking to promote greater understanding of the political and social aspects of the European Union.
The Lord President of the Council (Baroness Ashton of Upholland): My Lords, the Government take their role in promoting greater understanding of the work of the European Union seriously and continue to develop and review their activities in this area. The Foreign and Commonwealth Office informs the public about the role of the European Union in various ways, including a website, publications and activities to raise awareness and debate of European Union issues, for example, in schools.
Viscount Falkland: My Lords, I thank the Leader of the House for that reply, but it does not quite address the question which I thought I had put. Is it not the case that in the three referenda that have taken place, if the question had been whether people wanted to stay in the European Union, they surely would have said yes, they would like to stay in the Union, but they have voted no on the detail? The devil seems to be in the detail. Why, in this country, has there been so much emphasis on the economic aspects of this great European experiment and hardly any attention paid to the political and social aspects? The public are getting restive and it is about time that Governments—our Government are not the only ones to blame—put their cards on the table. The public deserve to know exactly what the European Union is about.
Baroness Ashton of Upholland: My Lords, I made it clear in the Statement that the Irish Government will be bringing forward their views in October to the Council to deliberate the underlying issues in the Irish referendum. I hesitate, with good reason, to suggest that I understand better than they would what some of those issues might be, though I am sure we will speculate. It is important for this country that we make as clear as possible the benefits of being part of the European Union in all its aspects.
Lord Forsyth of Drumlean: My Lords, are not the Government getting into a ridiculous position where they appear to be denying the British people a referendum, but wanting the Irish to have two referendums? If money and resources are to be spent on education, should that education not be directed at a European elite—rather than the European people who have to pay for it—who need to learn the lessons from the feelings which have been legitimately expressed in a proper democratic event?
Baroness Ashton of Upholland: My Lords, I do not believe that the Government have said anything about whether the Irish should have a second referendum. I have made it clear that the Irish Government will
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Lord Davies of Coity: My Lords, can my noble friend consider the Question that has been asked about promoting greater understanding of the political and social aspects of the European Union? Can confirm that 19 states have already confirmed that they understand the political and social aspects of the European Union? Is it not the case that the Irish have to learn that and it is not our job to provide it?
Baroness Ashton of Upholland: My Lords, my noble friend is correct that 19 states have been through the parliamentary process and/or have ratified the treaty as it stands. We will await what happens in the other nations. I disagree with my noble friend in the tone in which he describes what should happen in Ireland. It is very important that the Irish have time to reflect on what happened in the referendum and come forward with proposals.
Lord Pearson of Rannoch: My Lords, would the noble Baroness agree—
Lord Mackay of Clashfern: My Lords, why is it only the Irish who have to consider the situation before October?
Baroness Ashton of Upholland: My Lords, all nation states have to consider very carefully. At the Council meeting it was important to reflect on the consequences of what has happened with the Irish referendum, but also, as I think I indicated in the Statement, to further consider all the work that needs to continue as we work together on some of the major issues that face us all.
Lord Wallace of Saltaire: My Lords, does the Minister accept that one of the great failures in almost all member states of the European Union over the past 10 years and more has been a failure of political leader to explain to their publics and to each other’s public the advantages and the costs of membership and what the major priorities of European co-operation should be? Can we ask Her Majesty’s Government to invest a real effort in promoting a public debate at all levels from schools to other capital cities on what we see as the priorities of the European Union?
Baroness Ashton of Upholland: My Lords, the public debate is very important. When I was an education Minister some of the work, which has been continued since then, was to make sure that young people in education establishments in particular had the opportunity
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Lord Kilclooney: My Lords, since the Irish understood that there would be a president of the European Union, a European diplomatic service and a European foreign minister and that they might get sucked into a European security system, is it not insulting to suggest that they did not understand the treaty?
Baroness Ashton of Upholland: My Lords, I would not suggest anything of the kind, although the noble Lord described a European diplomatic service, which is not what the treaty says; it says an External Action Service.
Baroness Ashton of Upholland: My Lords, it was significant in the debates on the subject in your Lordships' House that we made the distinction clear between the concerns that noble Lords rightly had that that service would take over the diplomatic services of this country or any other, and what was actually proposed. It is important that people of all nations get the chance to understand precisely that.
Lord Stoddart of Swindon: My Lords, would it not be in the interests of democracy if, instead of trying to persuade the Irish to change their minds and giving them special conditions, the European Council recommended to all the countries of the European Union that they hold referendums?
Baroness Ashton of Upholland: My Lords, again, I have been here before; there is a sense of déjà vu. As we have already indicated, it is for each sovereign nation state to determine the appropriate process. That is what has been done, and that is how it should be.
Lord Inglewood: My Lords, would the Government be prepared to take an initiative in the Council of Ministers to try to lead the other member states into creating a European Union that is slightly less complicated? Surely much of the difficulty that all of us face dealing with European matters is the Byzantine complexity that has arisen over the last 50 or so years.
Baroness Ashton of Upholland: That is precisely what the treaty would have done, my Lords.
Lord Howell of Guildford: My Lords, one body that seems to have reached a greater understanding of the European Union is the judicial panel advising the Government of Sweden. It has ruled that the Lisbon
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Baroness Ashton of Upholland: My Lords, I hope that the noble Lord is not accusing us of telling untruths. In our debates, he and I discussed many times whether we would bring in opinion from other countries. For every opinion that he can bring from one state, I can bring another.
Health and Social Care Bill
3.06 pm
The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): My Lords, I beg to move that the Bill be now further considered on Report.
Moved accordingly, and, on Question, Motion agreed to.
Clause 41 [Standards set by Secretary of State]:
Lord Campbell-Savours moved Amendment No. 30:
“( ) The Secretary of State shall make provision for the adoption of minimum standards of frequency for the inspection of the premises of social care providers.”
The noble Lord said: My Lords, the amendment allows us to raise once again a concern from Committee; namely, resources available to the Care Quality Commission to deal with the inspections necessary for care facilities. It deals with the frequency of inspection. I place on record my total opposition to the recently introduced inspection regime, which I regard as Treasury-driven. It is opposed by many Members of the other House, including some on my side, particularly those who are aware of how it is working. It is also opposed by the unions, charities for the elderly, the Relatives & Residents Association and many of the inspectors involved.
I quote Unison because it is closely connected with the inspection regimes:
“We are particularly worried about recent changes to social care inspection methodology and the reduction in frequency of inspections from annual or twice-yearly inspections to periodic reviews which could be carried out for some providers only every 3 years. In a recent survey of members working in CSCI conducted jointly by our unions, 76% of respondents said they believe this new reduced inspection methodology does not provide a robust assessment of risk to service users, and 81% believe that more frequent inspections are necessary. Our members are telling us that associated cutbacks have meant that inspectors no longer have time to follow up on problems and have far fewer opportunities to meet and listen to service users. We would question whether reducing the ‘burden’ of regulation is appropriate when it affects some of the most vulnerable people utilising health and social care services. This is even more critical at a time when the Government is encouraging a wider variety of providers to enter into the market”.
I pay tribute to the many inspectors who, sometimes in very difficult circumstances, carry out the very sensitive work of inspection. It is a very difficult task, where too often one can stand accused of being far
24 Jun 2008 : Column 1340
One person interviewed by Mr Manell said:
- “know that due to the workforce reduction, everyone is under pressure to get the work done and meet targets. So if the home is made adequate inspectors have the time to undertake their planned schedule of inspections”.
The same inspector went on to say, in relation to a particular inspection:
“I completed my report and sent it to my manager as required by the CSCI. My manager came back to me and suggested changes to the report. These were to change all the poor ratings to adequate. And the reason? ‘The care provider is a good provider, they can turn this problem around quickly. So make the overall rating adequate and we can keep them on our side and work with them.’ For me the issue was, the care is poor, and if it is poor we need to say it is. However, the pressure that I was under was huge. So against my own judgement, I made the rating adequate”.
“I think my main concerns are that the homes aren’t inspected as frequently as they were before. We rely a lot on information given to us by the providers of a service to say how good that service is. When we actually go out to visit the homes they are completely different to what the proprietors have told us in their feedback to us. So, it may mean that we are not inspecting a home as frequently as we should do because of the information we are receiving about it or the lack of information we are receiving about it”.
I was on the Public Accounts Committee throughout the 1980s and remember that sometimes National Audit Office reports that came before our committee at their earliest stage were prompted by whistleblowers; and also, that whistleblowers sometimes have a bad track record. I have no doubt that there are people in the care sector who make reports of malpractice for all sorts of reasons. Perhaps they were subject to a disciplinary procedure, are discontented in their place of work or have been in arguments with management. I recognise that that can be the case with some people who act as whistleblowers to draw the public’s attention to deficiencies in the places where they work. However, that cannot account for all reports in this case.
“Providers are pleased to be left alone, some don’t even want to complete their own self-assessment”.
“The home was poor throughout and needed enforcement action to be taken but the Regulation Manager did not want this to happen—too many poor homes this year”.
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“So that there is less conflict with home owner and to make our regional figures look better, i.e. less poor services—statistics then show false improvement of standards”.
I repeat: there may be whistleblowers out there who have a grievance; however, I cannot believe that all these reports come from such people. There must be something wrong in the system, and I am sure that, with the right resources, all these matters could be dealt with.
3.15 pm
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