House Of Lords
Wednesday, 15th May 1996.
The House met at half-past two of the clock: The LORD CHANCELLOR on the Woolsack.
Prayers—Read by the Lord Bishop of Oxford.
British Buses: Ec Directive
asked Her Majesty's Government:
Whether they will invoke Article 3(b) of the Treaty of Rome ("subsidiarity") to protect the traditional London double-decker bus and the British midi- and minibuses from forthcoming European Community legislation.
My Lords, the Government are committed to the completion of the single market for the benefit of our industry. We believe that the directive is necessary. However, we do not believe that the intent of the directive should go beyond what is needed to achieve its objectives. We will continue to seek to protect the interests of our bus industry. The directive will not be retrospective and will not affect existing vehicles.
My Lords, I thank my noble friend for that Answer, which I noticed did not refer to the issue of subsidiarity. I must therefore assume that it is incapable of protecting these important British interests on this occasion. Does my noble friend not agree that, as usual, the problem is the system of qualified majority voting in the Community, which now governs agriculture, transport, culture, the environment and the single market, whereby 62 votes are needed to carry a motion and 26 to block one? Is he aware that on this occasion only Sweden and Ireland will be supporting us, which will allow us to muster all of 17 votes to protect these important British interests? How do the Government go on pretending that in these areas they can defend our interests in Brussels?
My Lords, I believe that my original Answer addressed the issue of subsidiarity. We believe that the directive is necessary and that harmonisation will be good for the industry. However, we do not believe that the directive should go too far or be too prescriptive and deal with issues such as comfort, on which we believe it unnecessary to produce total harmonisation.
As regards the noble Lord's question about qualified majority voting, we are talking about a draft of a draft directive. We are a long way away from the end of this procedure. We have already been successful in amending the proposals and I am confident that we shall continue to engender support for our views on the matter.My Lords, will the Minister give the House a further assurance in regard to the subject matter of the noble Lord's Question that the Government will resist any question of this country being compelled to get rid of its double-decker buses? Yes or no?
My Lords, when the noble Lord reads my original Answer he will see that the directive will not be retrospective and will not lead to the removal of the traditional open-platform, double-decker buses which we see on the streets of London.
With regard to future buses, we must make sure that the directive which eventually comes forward is not over-prescriptive and does not go into the kind of detail which we believe to be unnecessary. We will continue to work to ensure that that happens.My Lords, would it not be outrageous—
My Lords, is the Minister aware—
Order!
My Lords, I am well aware that this Question excites great passions. With your Lordships' permission, as the noble Lord was on his feet, perhaps we may have two questions from this side afterwards. We have time.
My Lords, I wished to ask a Question which is unlikely to excite much passion but perhaps some applause. Is the Minister aware that the noble Lord, Lord Strathclyde, today became the father of a baby girl? Yes or no?
Hear, hear!
My Lords, is the Minister further aware that if the noble Lord, Lord Pearson of Rannoch, finds that there is no sore he has an incredible temptation to create one if only to pick at it? Is it not the situation that this draft directive on the design of buses is intended to facilitate the single market and can, therefore, help to promote the export of our buses to the Continent? Is it not also the case that the United Kingdom asked for account to be taken of the special design of double-decker buses and that that has been written into the draft? It is only a draft at this stage and, of course, can be subject to further amendment to the advantage of the United Kingdom.
My Lords, I do not believe that I would be breaching the conventions of the usual channels if I were to welcome the arrival of the new daughter of my noble friend the Chief Whip. I dare say that she will be attending your Lordships' House in due course to view its proceedings.
The noble Lord, Lord Clinton-Davis, was right in saying that a considerable amount of work has been done on the directive. It has been altered to take account of the special double-decker buses which operate in the UK. British industry still has reservations about that and we intend to work hard in order to ensure that those are fully taken into account. The noble Lord was right to highlight the benefits of harmonisation, particularly to the industry, in being able to export more easily.My Lords, will my noble friend confirm that the Government will not agree to a European directive affecting the design of buses to be manufactured in this country for use in this country? Is not such an extension of the powers of the European Union utterly obnoxious and contrary to the whole principle of subsidiarity?
My Lords, of course I understand my noble friend's concerns but I have attempted to highlight the fact that considerable benefits arise from harmonisation. We believe in a single market. We believe that there are clear advantages to be gained for our manufacturers, as well as those from overseas, from being able to sell into a market in which the standards are approximately the same.
I agree with my noble friend that the directive should not be over-prescriptive and go into too much detail on matters such as comfort, width of seats and so on on which some local variance is clearly acceptable.My Lords, as a staunch member of the Conservative Party, does the noble Viscount not find it slightly strange that the Government should be in favour of allowing a group of bureaucrats who have never built a bus, who have never sold anything and who have never hired or fired anybody to impose a policy on the entire European bus industry which many bus manufacturers do not want and do not believe in?
My Lords, before this proposal becomes a directive, it will go before the Council of Ministers. Therefore, it will be for member states to decide what they feel is the appropriate level of harmonisation for the Community.
My Lords, I congratulate the noble Lord, Lord Strathclyde, and Lady Strathclyde, on the birth of their new baby. Perhaps the noble Viscount could point out to the noble Lord that the best way in which to see London and, indeed, any other city is from the top of a double-decker bus.
Is this not another instance of the European Community interfering in the nooks and crannies of British life? Will he say also what was the outcome of the meeting with Herr Bangemann on 13th May? Is it true that he said that the directive was 95 per cent. agreed and that there could be no further alteration?My Lords, I do not yet have an official record of what happened at that meeting. But the important factor is that we are a long way from final decisions on this matter. Substantial progress has been made in taking into account the interests of the British bus industry. Indeed, we have worked very closely with the industry to ensure that that happens. We shall continue to do so and we shall continue to seek to ensure that the industry's interests are protected. I agree that the draft proposals are too prescriptive and we wish to make them less so.
My Lords, does not the search for harmonisation run directly contrary to our search for competition?
My Lords, no, I do not believe that that is the case. I should have thought that a harmonised market would make it easier to compete and to have more equal competition.
Common Fisheries Policy
2.46 p.m.
asked Her Majesty's Government:
What early opportunities they can take, within the European Union, to initiate and follow up moves to achieve radical changes in the common fisheries policy.
My Lords, the key issues of reducing fishing capacity and increasing the effectiveness of technical conservation measures under the common fisheries policy will be priority concerns of the Council of Fisheries Ministers at their next meetings. In addition, if treaty changes are needed to achieve improvements—for example, in dealing with quota hoppers—the Government will seek them at the Intergovernmental Conference.
My Lords, I am grateful to my noble friend for that reply. Is he aware that leaders of a minority of fishermen's organisations are calling for the extreme course of unilateral withdrawal from the common fisheries policy and from the European Union, if that is a necessary consequence? But leaders representing most British fishermen are seeking reform of the CFP, as my right honourable friend the Prime Minister will have recognised last weekend in Aberdeen from the reasonable attitude of representatives of the Scottish Fishermen's Federation whom he met there. What are the prospects of progress at those meetings about which my noble friend told us?
My Lords, we are very keen to make progress and we have had some good conversations with the European commissioner. As the noble Lord says, we agree with many fishermen's organisations that the right way forward is through reform rather than a hurried and expensive exit.
My Lords, however lacking in influence we have been in relation to fisheries and beef, will the Minister tell his noble friend and the House what influence we should have if we were not members of the European Union?
My Lords, a great deal less than we have now.
My Lords, will my noble friend explain to the noble Lord, Lord Barnett, that we would not be affected by the common fisheries policy if we left the Union? Will he further confirm that the fishermen are in a far worse plight than those with the interests referred to in the last Question because unanimity is required in the Council to change the common fisheries policy?
My Lords, I do not think that the noble Lord should fear unanimity. After all, that is what he seems to wish to keep in many instances, whereas others wish to see more majority voting. The noble Lord should not think that we would escape from the common fisheries policy by leaving it. The rest of the Community waters would still be controlled by the common fisheries policy, and it is with that organisation that we should have to negotiate our share of those waters.
My Lords, is the noble Lord aware that Norway, which is not a member of the European Union, does very well in its fishing waters because it is not controlled by anyone? Indeed, because it is not a member of the European Union not only does it have influence but it also has a thriving economy.
My Lords, there are many good things to be said about Norway. I do not think that being outside the European Union is one of them.
My Lords, does my noble friend agree that it is likely to take a long time to reach international agreement? In view of the importance of sand eels in the food chain, will the Government take quicker action to control the fishing of sand eels in the North Sea before they are extinct?
My Lords, I am not aware that sand eels are in imminent danger of extinction. However, we have pressed for more controls and more science in the area. Moreover, to some extent, consumers seem to be ahead of us because they are persuading the major users of the oil that comes from sand eels to give up doing so, and that will have a natural effect on fisheries.
My Lords, is the Minister aware that France and Germany at their usual and regular pre-Council of Ministers meetings have already agreed among themselves and with the Commission that there will be no change in the policy? What does the noble Lord propose to do about that?
My Lords, I always work on the assumption that the noble Lord, Lord Bruce, knows more than I do. I have no access to the intimate discussions between France and Germany. I am glad that the noble Lord has, but I hope that he is wrong in what he says.
My Lords, is the Minister aware—I am sure he is because I have raised the point before—that the fisheries commissioner, Mrs. Emma Bonino, has said several times that it is perfectly possible to deal with the problem of quota hopping within the existing rules of the common fisheries policy if the Government are so minded? Do the Government agree? If so, can the noble Lord inform the House as to the action that they intend to take?
My Lords, since Mrs. Bonino first said that, we have been talking with her and her officials quite intensively. I believe that she would now say what she said in a very quiet voice, because she is beginning to agree with us that there is probably nothing to be done without a treaty change.
My Lords, is my noble friend the Minister aware that the issue of sand eels is extremely important because they are being sucked up by mass fishing? Surely that is one of the keys to the whole question.
My Lords, I am beginning to believe that the whole question of the common fisheries policy has been well trawled; indeed, there are very few new questions to answer.
My Lords, is my noble friend the Minister aware that there is a new question? With such great demands for fish nowadays, more and more people will be looking towards fish farming and that will shortly produce a completely different situation.
My Lords, at first sight that seems to be the case. But, unfortunately, one has to feed farmed fish on something and they prefer to eat other fish. Therefore, one has to catch the fish to feed the farmed fish and, from thence, one has further problems.
My Lords, can my noble friend the Minister confirm that before Britain joined the CFP we had 80 per cent. of the volume of the fish and 85 per cent. of the value and that we now only have 30 per cent. of the volume and 8 per cent. of the value? Surely if we left the common fisheries policy we would be very much better off than we are at present.
No, my Lords; I do not agree with anything just said by my noble friend. Indeed, I believe that sometimes he does not appreciate the European Union in the way that he ought to. When he stands on Rannoch Moor or in the black wood of Rannoch, I am sure that he is really grateful that they are to become Natura 2000 sites.
Water Supplies: Prepayment Devices
2.53 p.m.
asked Her Majesty's Government:
Whether they are satisfied that the practice of installing prepayment water devices does not breach the Water Industry Act 1991.
My Lords, it is a matter for the courts to interpret the law on the basis of the facts in any particular case which may come before them. I note, however, that in his press release of 22nd April, the Director-General of Water Services said that he had been,
"advised that use of these units with the agreement of customers is consistent with the Water Industry Act and with the companies' terms of appointment".
My Lords, I thank the Minister for that Answer. However, is the noble Lord aware that legal proceedings have already started? Is he further aware that many local authorities, including Birmingham, are very concerned that such prepayment devices really serve as a means to cut off the water supply? They are not water meters; they are calibrated on a different system altogether. Therefore, when the water company decides that there is not enough money in the prepayment meter, the water is cut off. Does the Minister agree that that is contrary to the Water Industry Act so far as concerns local authorities? Surely they should be notified if water is cut off from any property.
No, my Lords; I do not agree with the noble Baroness. Such devices are installed entirely at the request of a customer. Indeed, they can be taken out whenever a customer so requests. They are purely devices to enable those who have difficulty meeting the payments for water to do so in a way which suits them. This is an interesting insight into the new Labour Party's ideas for a stakeholder society; namely, that the Labour Party cannot even trust consumers to pay water bills in the way desired and that they require such decisions to be taken by local authorities.
My Lords, the Minister said that customers have the recourse of going to court if they are dissatisfied. However, would it not be far better if the regulator had reserve powers to intervene beforehand if requested to do so by the customer, who may well have his water supply cut off very quickly? Indeed, would that not only save on court costs but also on costs in general? After all, are not water companies supposed to treat customers, not themselves, as their first priority?
My Lords, I believe the noble Lord, Lord Dean, is somewhat confused on the matter. Such devices can be removed whenever requested by the individual customer. If customers do not want the facility, then they can have it removed. So far as concerns taking the water industry to court, of course I am aware that local authorities are doing so. However, the water industry regulator is not doing so because he believes that local authorities are barking up the wrong tree.
My Lords, bearing in mind the judgment of Pepper v. Hart, will the Minister advise the House whether it was the Government's intention, when putting the Water Industry Act 1991 through Parliament, to deprive consumers of a clean water supply?
No, my Lords; I do not believe so. Moreover, I do not believe that our actions and those of the water industry taken since that time provide any grounds for thinking that that was our intention; or, indeed, that that is what has happened in practice.
My Lords, is my noble friend the Minister aware that the water authorities are claiming that there are very few, if any, complaints about such metering systems? In fact, they are very popular, especially with people on small budgets because they can regulate themselves day by day.
Yes, my Lords; my noble friend is quite right. At least 90 per cent. of those who have such devices installed are very happy to pay their water bills in that way. We see no reason why they should be deprived of the ability to pay their bills in the way that they desire just because it upsets local authorities.
My Lords, what about the 10 per cent. who are not happy? Is it not the case that to remove such a meter—and indeed, to install one—is an extremely difficult and technical matter which requires a good deal of operational plumbing? Moreover, the removal of such meters requires several days' labour. If someone falls behind with the payments, it means that he will be deprived of what is, after all, a natural resource and one without which we cannot live. Therefore, is it right that the Government should encourage that method of payment when, according to the noble Lord's own figures, at least 10 per cent. of customers are unhappy with the situation?
My Lords, anyone who is unhappy enough with the system not to want to proceed with it merely has to ask for its removal. It is not a complicated matter; it is merely a valve in the main water supply system. Indeed, it is a very quick and simple exercise to remove it. Someone who is behind with his water payments, who is cut off through this mechanism and who, thereafter, has the device removed will then have his water supply restored.
My Lords, would the Minister care to undertake an experiment by having such a meter installed in his own home and then trying to get it removed just to see how long it takes?
My Lords, if there have been problems with the removal of such water devices when so requested by customers, I very much hope that that fact will be passed on to Ofwat, which I am sure will be most interested. Such devices are installed on premises on the condition that they are there at the request of customers and with their consent.
My Lords, the Minister quoted statistics from Ofwat. However, he did not give us any statistics as regards the cut-offs that local authorities are reporting. Indeed, it is reported that over 10,000 cut-offs are taking place all over the country. We are discussing a serious matter. Water has now become a very expensive commodity because water charges are based on the rateable value of the property and not the amount of water that customers are using. I completely understand why people find themselves in difficulty with the payments. Does the Minister understand that people who are unemployed and living on welfare have greater difficulty in paying all their bills, but that other services are not cut off in the same way as applies with the water boards unless such cases are taken to court?
My Lords, it comes down to the fact that these devices are on customers' premises at customers' request, or at least with their agreement. If a customer wishes to have his water metered so that he pays only for what he uses, he has that right. We appreciate the difficulties which some people have in putting the money together to pay regular bills and large bills such as water bills. That is why we welcome arrangements which allow them to pay—as these devices do—more gradually than standard water bills allow, and which are proving convenient and proving to be what these customers want.
Bosnia: Displaced Persons
3 p.m.
asked Her Majesty's Government:
What is their policy concerning freedom of movement and the right to return for displaced persons in Bosnia, and what consultations they have had with IFOR on these subjects.
My Lords, under the Bosnia Peace Agreement, the parties undertook to establish full freedom of movement throughout Bosnia and to work with UNHCR towards an early return of refugees. We expect the parties to live up to these commitments. We are in regular contact with IFOR and fully support its efforts to promote freedom of movement and to create a secure environment for UNHCR and other civilian bodies to carry out their work.
My Lords, I thank the Minister for her reply. Is not the question how the agreements are to be implemented? Will the Minister and her colleagues use her influence, which stems from our previous record on aid and our full participation in the military force, to ensure that what was agreed at Dayton is implemented?
My Lords, I assure the whole House that we are already using our influence in the way that the noble Lord, Lord Hylton, suggests, but co-ordinating the return of refugees is the responsibility of the UNHCR under the peace agreement. IFOR is authorised to support the work of UNHCR. Last week I discussed with several senior brigadiers in IFOR, and indeed with Mrs. Ogata of UNHCR, exactly how this is being carried out. I am convinced that every effort is being made not only to help ensure freedom of movement but also to provide for general security and to back up the International Police Task Force (IPTF) in monitoring law and order. It is perfectly clear that IFOR cannot by itself guarantee the safety of all refugees. That must ultimately be the responsibility of the parties and their police forces. It is they who must promote law and order and a climate of security and reconciliation for all. There is a great deal of work to be done.
My Lords, is the Minister aware that there is great concern about the flow of arms to the separate states which are signatories to the agreement? In the light of the fact that the IFOR troops will be withdrawn in due course, does that not create a situation of great instability in the area? What steps are the Government taking to ensure that this trade in arms to these new states will be limited?
My Lords, I too have heard the stories about arms flows. What must happen is that the parties themselves must, under the agreement, certainly register what they are doing. We all perceive that there could be potential instability at the end of the year. That is something that the commanders of IFOR on the ground are aware of. We must also build up the civilian desire and determination for peace. That is why we are working along with the British forces in IFOR and a number of others to try to make the place as stable and as normal as possible so that people deny the use of arms and are properly employed on jobs which will help the rebuilding and reconciliation. It is a difficult task and there are no easy answers, but it is being worked at with extreme care at the present time.
My Lords, I fully endorse what the Minister has said about the need to build up the civilian support for peace in Bosnia. The Minister will, of course, be aware that there is a December deadline for the withdrawal of IFOR. Does she agree that, given the current situation in Bosnia, it is vital that we should start planning for an effective IFOR mark 2? Will the Minister say what the Government's current position is on a successor to the implementation force?
My Lords, IFOR has at least seven months more in which to work. NATO is resolved, as I think the noble Baroness knows, to complete its current mission on time. A great deal of work is being done to increase the speed at which this is now being carried out. It was for those reasons that I spent some time in Bosnia last week. We expect the parties to take on the responsibility for their own region. Certainly the current situation on the ground and the information we receive on a daily basis both from our own IFOR commanders, and indeed from the Office of the High Representative and UNHCR, are all being put together. However, it is much too early to speculate in the way the noble Baroness would like me to do.
My Lords, can my noble friend tell the House whether preparations are going forward satisfactorily to prepare for the elections; whether a proper electoral register has been prepared; and whether displaced persons will have postal votes?
My Lords, my noble friend is absolutely right to underline the importance of the elections to come. I spent some time with OSCE in Sarajevo discussing whether the conditions will he met under Dayton and whether the elections can be held in a free and fair way. The work is going on. It is particularly difficult in those territories where the constituency falls into differing parts of Bosnia. However, we are resolved to help OSCE in whatever way we can. We have already provided funds for the running of the elections and we shall work further on that.
Business
3.7 p.m.
My Lords, after the debate on research councils and before the debate on the mentally ill, my noble friend Lady Blatch will, with the leave of the House, repeat in the form of a Statement an answer to a Private Notice Question in another place on the contaminated equipment at the Forensic Explosives Laboratory.
Business Of The House: Debates This Day
My Lords, I beg to move the Motion standing in my name on the Order Paper.
Moved, That the debates on the Motions in the names of the Lord Walton of Detchant and the Lord Thurlow set down for today shall each be limited to two-and-a-half hours.—(Viscount Cranborne.) On Question, Motion agreed to.Research Councils
3.8 p.m.
rose to call attention to the present position of the research councils, with particular reference to the present and future resources available to them and to their relationship with industry; and to move for Papers.
The noble Lord said: My Lords, in thanking the many noble Lords who will contribute to this important debate, I hope that I may say how much I—and no doubt many others—are looking forward to the maiden speech of my noble friend Lord Clancarty, whose views will, I am sure, be listened to with great attention.
There can be no doubt that in relation to science, engineering and technology in the UK, the research council system is a jewel in our crown, greatly admired in many other countries. While the reorganisation of the councils into more appropriate groupings undertaken a few years ago has won general acceptance, there are growing concerns about some of the new mechanisms and policies adopted by Government in recent years, upon several of which I shall elaborate today.
As a neurologist and researcher in neuromuscular disease, I was privileged to be involved in the work of the Medical Research Council over a 12-year period in the 1960s and 1970s, finally serving as a member of that council for four years until 1978. In many respects those were halcyon days when research projects were graded on a scale of nought to six on the basis of their scientific quality, and when most graded at 3.5 or above through a careful peer review process could be funded. I also held a long term programme grant from the MRC for neuromuscular research, a grant which was renewed twice thus extending over a 15-year period.
We now have the unfortunate state of affairs when, through restricted funding, the MRC has been compelled to reject about 70 per cent. of alpha-rated proposals for long-term strategic research. Indeed, some alpha-plus programmes have also been rejected, with grave implications for the future of medical research in the UK. And the recent precipitate decision to withdraw funding for intercalated research degrees for medical students has been another serious blow.
It is of course the case that in medicine more research funds are now being provided by the charities and the foundations—not least the Wellcome Trust—than by the MRC, and yet many original and innovative research ideas are still unable to attract any support. Some have suggested that there are too many medical research workers competing for limited funds. That suggestion is one which I must reject firmly especially when, as the report of your Lordships' Select Committee on Science and Technology on Medical Research in the NHS based upon a sub-committee inquiry which I was privileged to chair clearly demonstrated, clinical academic medicine is in serious disarray. Many senior clinical posts are vacant throughout the country; and consequently the Committee of Vice-Chancellors and Principals has invited Sir Rex Richards to undertake a major inquiry into this urgent problem.
The position is so serious that some able and highly respected research workers in clinical medicine tell me that, in despair, they are applying to the national institutes of health in the United States for support rather than to the MRC, which has been compelled to turn down some of their best alpha-rated programmes. And there is clear evidence that these problems are by no means confined to biomedical science but extend across the whole field of engineering and science. Thus, there has been a recent dispute between the particle physicists and the astronomers about the proportionate allocation of research funds between these two disciplines. No doubt several noble Lords will refer to similar problems involving other research councils.
In making this point, I appreciate that government funding is finite. Indeed, in response to a recent Question posed by the noble Lord, Lord Peyton, the Minister indicated that the MRC and the other councils must live within their means; and I accept that in the last public spending round science fared a little better than did many other sectors of public expenditure. Nevertheless, comprehensive figures recently produced by the Science Alliance have shown that between 1985 and 1993 this country has spent a decreasing percentage of its gross domestic product upon R&D and significantly less than our major competitors in Germany, France, Japan and the United States. Hence, the question must be asked whether the means now provided for the research councils are adequate at a time of increasing international competition in basic and applied science, not least from the emerging nations in the Pacific Rim.
But while financial considerations are compelling, there are other serious matters of growing concern to which I must draw your Lordships' attention. First, the transfer of the Office of Science and Technology from the Cabinet Office to the DTI—a transfer carried out with what seemed to some indecent haste—has not perhaps turned out to be as disastrous as many feared, but is nevertheless perceived in the science community as having represented a significant downgrading for British science. Despite the great interest shown in science by the President of the Board Trade and the strenuous efforts and admirable speeches of Mr. Taylor, the Minister for Science and Technology, there is a view widely expressed that without a politician of Cabinet rank fighting its corner, the science voice is less clearly heard in government than formerly. Major concerns have also been expressed over the fact that the post of Chief Scientific Adviser, held by the notable Sir Robert May, is now located within the Department of Trade and Industry rather than the Cabinet Office. It is difficult to see how a member of a spending department will be in a position effectively to advise the many other government departments concerned with science matters. Many, like myself, believe that the post should have stayed where it was.
There are many, too, who regret the abolition of the Advisory Board for the Research Councils, so ably chaired by Sir David Phillips (now the noble Lord, Lord Phillips), who, like the noble Lord, Lord Dainton, the noble Earl, Lord Jellicoe, and the noble Lord, Lord Dahrendorf, regrets his inability to speak this afternoon. That body was able on the one hand to give cogent advice to government about science policy and, on the other, to be in regular contact with all of the research councils providing clear lines of communication and a consultative process capable of formulating policy and involving many able scientists. Without wishing to detract from the outstanding abilities of the individual concerned, I and many others believe that the replacement of that structure by a Director General of the Research Councils may have been a retrograde step. The science community is not aware of any clear mechanism through which the director general is required to take, or indeed takes, advice from the chief scientific adviser. It also seems that the crucial necessity of ongoing consultation between members and officers of the research councils on the one hand and of advising government on the other could ultimately prove to be beyond the capabilities of a single individual, however able. Such networks as exist appear to be only vaguely defined and there are grave doubts whether these form an adequate basis for informing the development of government scientific policy.
I of course recognise that one purpose of appointing the director general was to seek to increase the efficiency and effectiveness of the councils. Whether the recent vigorous slimming down process of the headquarters staffs can be accepted as achieving this aim is questionable. Indeed, I must say with great regret that the abolition of many senior posts, including the decision, taken without any consultation with members of the Medical Research Council itself, to abolish the post of its second secretary is one which provoked certain council members to react with anger amounting at times almost to fury.
Leaving aside the fact that the individual concerned, now made redundant, is a distinguished physician with an outstanding administrative record, it is almost unbelievable that on the headquarters staff of the MRC there is now no medically qualified individual with clinical experience. Surely this cannot be right. And while I commend action being taken by the Government through programmes such as Technology Foresight to try to establish much better relationships with industry to enable it to capitalise upon the results and outcomes of research, and while the programme Realising our Potential is designed to assist in so-called "blue skies" research, there is a widespread perception in the science and engineering community of real or perhaps imagined pressure to divert funding from basic to applied research, despite protestations to the contrary. Such pressure, if true, would be seriously misguided since, to take the medical model, I have often said, and could quote many illustrative examples, that today's discovery in basic laboratory science brings tomorrow's practical development in patient care. The Royal Society suggests that disproportionate pressure on OST-funded agencies or inadequate responses from other government departments may seriously reduce the benefits of Technology Foresight, distort research council programmes, and lead to a divergence between OST-funded science and that supported from other sources.
Yet another major concern relates to the intimate relationship long enjoyed between the universities on the one hand and the research councils on the other. The National Academies' Policy Advisory Group has concluded that in its present state the university system will not be able to deliver what is being required of it. With the serious problems now facing clinical academic medicine, it is impossible to see how our medical schools could possibly take the additional 500 students demanded by Government to produce the doctors that the country so badly needs.
The long hallowed principle of dual support, whereby the universities were funded to provide the infrastructure and environment in which research could be carried out and the direct research costs were then paid by the research councils or other funding agencies, was eroded for good reasons when the ABRC under the leadership of Sir David Phillips recommended a transfer of those infrastructure funds from the university funding councils to the research councils in order to protect research excellence in major university departments. Regrettably, there is now clear evidence that that vital aim has not been achieved. A recent Coopers & Lybrand report commissioned by the OST has shown, as the Royal Society and the CVCP point out, that the transfer has failed to address key issues such as long-term support for the research infrastructure of the university system. In Oxford, for example, I have been given compelling statistical information showing that the university has lost annually about £1 million and departments in medicine, for example, with outstanding research records, have suffered severe reductions in funding. One department now finds itself with a negative departmental grant of minus £40,000, when compared with the annual grant of £120,000 it once enjoyed.
As if that were not enough, the recent decision in the current year to reduce capital university funding by 31 per cent., with further reductions in coming years, has taken no account of the fact that much of that capital expenditure goes on the purchase and maintenance of equipment used in research. Bluntly, that is the unkindest cut of all, capable of destabilising totally the cherished research council/university partnership, yet further impairing the ability of British universities to employ and deploy to fullest advantage the research skills and expertise they possess. Technology Foresight and all other programmes relating to collaboration with industry depend crucially upon that expertise.
A few years ago I was privileged to chair another inquiry by a sub-committee of your Lordships' Select Committee on Science and Technology which examined international investment in UK science. It showed clearly that, for example, 40 per cent. of all US overseas investment and 42 per cent. of similar investment from Japan in science came to the UK because of the strength of the UK science base. The factors which I have outlined this afternoon plainly indicate not just that that science base is under threat but that it is in danger of crumbling. The prevailing atmosphere of short-termism will accelerate the process.
May I invite your Lordships to examine the country's record of Nobel Prizes? UK scientists figured prominently in the lists of prizewinners for many years; but within the past few years Britain has failed to attract any such award. Now we are also faced with the prospect under Prior Options Review of privatisation of many of the public sector research establishments falling under the umbrella of the research councils. No one could object if such reviews result in greater efficiency, better science, closer relationships with industry and the universities. But up to now, the results of such reviews are not wholly encouraging. Surely the Government must consult widely about the outcomes of the reviews before decisions are finally taken to alter the terms of reference, parentage or funding of the many important organisations, while giving an assurance that any transfer costs will be covered centrally and will not erode scarce research funding.
Hence, I urge Her Majesty's Government to examine the present and future of the research councils with care and to take further expert advice. Surely, communication, consultation, collaboration and efforts to achieve consensus should be the order of the day rather than confrontation and what all too often seems to be inadequately informed decision making. If it is true that the green shoots of recovery are now becoming a flourishing crop, surely the time has come to recognise that the future industrial prosperity of this nation depends upon the health and exploitation of its science base and upon a growing and predictable proportion of national resources being devoted to it. I beg to move for Papers.
3.24 p.m.
My Lords, everyone will be grateful to the noble Lord, Lord Walton, for introducing this timely debate. It is exactly three years since the White Paper Realising our Potential reformed the research councils within a new framework. It is absolutely appropriate that what the noble Lord, Lord Walton, accurately described as "the jewel in the crown" of science in this country should be regularly reviewed by this House. We have done so over many years. I used to chair a research council, the Agricultural and Food Research Council. I remember the many debates over the years where the issues which we shall discuss today were well to the fore: shortage of funding and concern that governments were directing research councils in a way that was not to the liking of all scientists and others involved.
However, when the White Paper came out in May 1993 it was almost universally welcomed. Paragraph 3.15 recorded that the research councils had performed well but that some reform was needed; so different boundaries and new research councils were formed. There was to be a new framework for the research councils, and it is important to record that paragraph 16 stated that the research councils would operate "under the direction"— I emphasise "direction"—of the Chancellor of the Duchy of Lancaster. They have now been moved to the Department of Trade and Industry. With that came the abolition of the Advisory Board for Research Councils and the appointment of a director general, which was clearly an essential new element in the framework proposed by the White Paper. I suspect that the reason the advisory board was abolished is that, although over a number of years it had operated with great distinction, it had nevertheless become something of a tradition that its advice was accepted almost without qualification by successive Ministers. I believe that the Minister at the time, Mr. Waldegrave, felt that in terms of accountability he should, if necessary, exercise ministerial accountability over the deployment of funds on the science base. For that reason, rather than perpetuate the advisory board, he moved to something which could clearly be described as closer to a process of direction under the Chancellor of the Duchy of Lancaster. The Minister could have done something more radical; and in many ways, if the perpetual issue is the funding of research councils, as the noble Lord, Lord Walton, correctly explained, what needs to be done is to bring science right into the mainframe of public interest and give it as much political clout as possible. Had that been the objective, it might have been desirable to form one research council. In other words, instead of having six research councils we would put it all together as one research council. After all, that is the United States model with the National Science Foundation. We would then have had a chief executive who would have known precisely where he stood with the Government. The slightly anomalous role of director general would not have been a problem. We could have gone even further and taken some of the departmental research out of the departments and put it into a ministry for science, with the research councils. With hindsight, I suspect that would have been a more satisfactory way of resolving, for example, the BSE problem which has clearly fallen between ministries and has lacked a co-ordinated approach from the centre, despite the best endeavours of the Chief Scientific Adviser. That would have been another, more radical proposal. A third proposal put forward by a number of people in the period of consultation before the White Paper was published was that all curiosity-driven research should be put into a separate funding council. That would have undermined the dual funding system for the universities, and many of us are grateful that it and the other radical proposals were not implemented. However, the objective would have been to try to ensure that research, the science base, received the hearing and influence in government that we all felt it deserved. Nevertheless, the White Paper was widely welcomed because it rejected the more radical options, yet it demonstrated clearly a commitment to the research council structure and a commitment to consensus. That must be emphasised because Technology Foresight and a number of other initiatives are nothing if not consensus. It represented a format for the future which we all welcomed. My predecessor as chairman of the Select Committee on Science and Technology, the noble Lord, Lord Flowers, wrote to the Minister at the time on behalf of the Select Committee. His letter states:The letter went on to give specific proposals as to how the research councils' proposed structure might be modified, some of which were taken up by government. I welcome the fact that the Government did not take a more hands-on approach, as they could have done at that time. However, there is a very fair criticism to be made of a number of ways in which government have—not "interfered"; that would be an incorrect word—influenced the science structure in an unhelpful way. That is true in one area to which the noble Lord, Lord Walton, referred; namely, continuous prior options review of public sector research establishments. Originally it was not intended to include many of the research council establishments. It has now been going on for two years. That seems an astonishingly long time to bring this degree of uncertainty to an area in which, quite frankly, research councils are quite capable, with suitable encouragement, of restructuring themselves. When I was involved with the Agricultural and Food Research Council we went through a very far-reaching restructuring programme. It was painful but necessary. It demonstrated that with the right signals from government it could and should be done. It was very much faster than the long drawn out process that is going on at the moment. The problem is not between the boundaries of research councils or even the battle as to whether the director general is exercising too much or too little influence. The real battle is how the research councils exert adequate influence when it comes to the distribution of public funds. The noble Lord, Lord Walton, was very fair. He told us at some length of all the difficulties into which the Medical Research Council, and I suspect other research councils, have fallen of not being able to fund as many research projects as they wish. I admit that in the last PES bid the Science Vote did less badly than many other sectors. I shall not put it more strongly than that. So do not let us think that the research councils were discriminated against at the expense of many other sectors. The battle is with the Treasury. It always has been and always will be. We are trying to get the Treasury and our colleagues in Parliament to understand just how important the role of the science base and the research councils will be in wealth creation and the quality of life. Instead of continually worrying about people encroaching onto their turf, the research councils should recognise the need to put together a concerted attempt to influence funding very much more directly than they have in the past. Perhaps we could persuade government not to keep meddling with the framework. Radical changes were made in 1993 and were widely welcomed. For goodness sake let us keep them. If we keep existing structures and continue, united, to make a case for further funding for the science base, perhaps we shall have more hope of success."We positively welcome the internalising of the Advisory Board for Research Councils within the Office of Science and Technology and the appointment of a director general as steps in the direction of the unified research council structure which we have long advocated".
3.32 p.m.
My Lords, I express my deep gratitude to the noble Lord, Lord Walton, for introducing this most important debate. The technological and scientific base of our nation is increasingly vital. It is important for our well-being and crucial to our place in the world. I shall confine my remarks to the activities of the Medical Research Council, the research council that I know best. I agree with so much of what was said by the noble Lord, Lord Walton, that I fear I may be repetitive; I hope that that will not be the case.
My own origins in medicine depended in very great degree on the Medical Research Council. My career as a junior research doctor was influenced greatly by the MRC. Briefly disenchanted with medicine, I toyed with the idea of giving it up and going into the arts. I must say, having looked at the press coverage yesterday, I wonder whether perhaps that would not have been such a bad decision after all! In 1971 and 1972, as a junior doctor finding medicine rather unstimulating and unchallenging, I had a completely hare-brained idea which a rather supportive chairman of department suggested ought to go to the MRC for funding. The resulting grant supported my salary and activity for two years. It came as a complete surprise to me. Largely by luck rather than intelligence, the work turned out to be extremely influential and achieved some international recognition. It led to a line of research which dominated my work for over 10 years and led me further into the area of academic medicine that I am in now. Looking back at my time as a student, my contemporaries would have roared with laughter had they seen me as a professor of medicine, particularly in a highly-rated, HEFCE institution such as the Royal Postgraduate Medical School. What is more pertinent is that I doubt very much whether there would be the slightest chance of my receiving that grant now. I was a relatively new graduate. I had never published a paper. I was working entirely with novel equipment which did not seem to work and nobody had seen before, and in a department with no track record in the field in which I was interested. I do not doubt that now, given the financial worries of the MRC and the knowledge that the great majority of alpha-rated grants—even those coming from scientists and physicians with great track records—would have a very significant effect on people like myself applying. I am sure that not only are we turning away important scientific ideas but also, more importantly, the budding young scientist whose maximum potential in some cases is lost to our economy. I do not argue against selectivity. No doubt the best science is done where there is a critical mass, the best infrastructure, collaboration, communication and, above all, contacts. Moreover, it is probably true that only the large, well-rated institutions will be able to give young scientists—after all, much good science is essentially the endeavour of youth—time to think, apparently for a good part of the time, without obviously being productive. Nevertheless, I should like to mention one or two caveats. One matter that concerns me slightly is that we have to be on our guard against an oligarchy in science which promotes its own people and its own ideas at the risk of ignoring much good in the wider educational community. That is much more likely to happen when funding is short. The MRC is a rightly applauded institution. It has produced, and continues to produce, our best medical science. That science is the envy of the world. It is probably equalled only by the National Institutes of Health (NIH) in the United States, which have far larger resources. Even though I shall go on to criticise some aspects of basic research, it is crucially important that the MRC is given a free rein in regard to such research. How could we deal with BSE if we did not understand the issue of prion disease? The MRC's mission, as set out in its charter, is:That is a most important and distinctive mission. Nevertheless, I have some slight concerns. Since the Government White Paper in 1993, Realising our Potential, the MRC invariably seemed to react by tacking onto its mission statement the aims that appear in its corporate plan. I quote from it briefly since it is relevant to its activities:"to promote and support, by any means, high-quality basic, strategic and applied research and related postgraduate training in the biomedical and other sciences with the aim of maintaining and improving human health".
That is an entirely laudable mission. But in practice how is the MRC implementing it? That is one of the problems given the resources at its disposal. Last year, £52.1 million was spent on molecules and cells; £21.3 million on the control of development, molecular genetics and the mapping and sequencing of genes; £49.4 million on infections and immunity; and £50 million on the molecular and cellular aspects of the neurosciences. But only £4.4 million was spent on health services and public health research—the very area that is now mentioned in the mission statement. These are huge basic research programmes. They are terribly important. But it is hardly surprising that some Members of the other place find little that is really relevant to British health and criticise the MRC. We as scientists, with the MRC, need to go out and sell these basic programmes. But we also need to look more at how we can interface across the board. It is perfectly true that this Government produced the research and development arm of the NHS. It is greatly to their credit that they did so. It has done exceptionally well and was a most important manoeuvre in the financing of some of the sort of research that I do, which also comes from that source. But there still seems to be too little genuine contact between the endeavours of the MRC and those of the NHS. There are too few MRC programmes of stature, such as that seen in the excellent clinical research initiative. The clinical sciences centre at the Royal Postgraduate Medical School, is an example. That is almost unique but it should not be so. Here, at least, there is a genuine interface. The MRC seems to some people to be a somewhat arcane institution. Noble Lords will be aware that the map of Africa shows countries which are composed of largely vertical and horizontal lines in many places. That is a legacy of former decisions of bureaucrats. Sometimes the MRC almost seems to work in the same way. It is to be hoped that that perception is changing but it is still as though they are taking yellow fever jabs when they should be thinking of malaria and cholera. It is a remote organisation. As the noble Lord, Lord Walton, said, far too few of the hierarchy in the MRC come from a medical background. That is most important if we are to promote the interface between the MRC and the health service. I do not believe that the head office has entirely the right skills to carry out the mission statement as it stands. There is the problem of what attracts funding. On occasions, it is difficult to find out why one's application has been turned down. I must say that the MRC is now more accountable than sometimes it was formerly. But I must also ask whether the method of peer review in camera is an entirely fair one. Why should referees of scientific projects wield such power and do it so anonymously? I wonder whether peer review might be looked at. Perhaps it might be better conducted by having the reviewers place their signatures to their opinions. That would reduce bias, increase accountability and might make for fairer application of resources. There are difficulties with that. I can imagine how many referees would object. But I believe that it would still be possible to get high quality reviewers. The trouble is that we, as successful medical academics—those of us, like myself, who have MRC grants—connive at the system. We are successful with it and we benefit from it. We too, like the people at head office, read Nature, Cell and Science, which are esoteric medical journals. But there is a tendency to forget the Lancet and the British Medical Journal. I sometimes wonder how many people at head office read the British Medical Journal. I believe that the Medical Research Council, like all the research councils, is hampered by being within the DTI. I do not feel that the relationship can be in the best interests, for example, of education, health, agriculture or, indeed, in some respects, industry. There is a case for going back to the notion of some kind of separate department for science and technology. There would be a very good case for Cabinet rank for somebody to represent it. That would need to interface most closely with other departments. But it could promote our expertise and give a higher profile to these important endeavours. It will be vitally important to our economy in world terms. Indeed, it is one of the few areas left where, provided there is adequate education, we should continue to be among the most productive nations."to advance knowledge and technology, and provide trained researchers, which meet the needs of users and beneficiaries (including the providers of health care, and the biotechnology, food, health-care, medical instrumentation, pharmaceutical and other biomedical-related industries), thereby contributing to the maintenance and improvement of human health, the economic competitiveness of the United Kingdom, and the quality of life".
3.42 p.m.
My Lords, I too am grateful to the noble Lord, Lord Walton, for instigating this debate on the research councils. Much of what I have to say is drawn from a memorandum published recently by the Save British Science Society, an organisation supported by many leading British scientists and engineers, which also has industrialists among its advisory councils. It not only expresses my own views clearly and forcefully but, I believe, the views of a great many academics working in the universities. I commend it to anyone who has a serious interest in the subject.
My first point concerns the proper role that the science base should play, the science base being the research activities in universities supported by public funds from the research councils. Its essential task is to carry out long-term basic and strategic research in science and engineering for the United Kingdom, as other noble Lords have mentioned. In so doing, it discovers new knowledge and develops new technologies. In my view, its primary objective should not be that of wealth creation. That is the business of industry. However, it should provide options for industry to select promising new or improved products and processes. I am, of course, talking about the field with which I am in contact; namely, the physical and engineering sciences. Communications at the interface are vitally important for technology transfer. Great effort on technology has gone into that area to make it more effective. Confusion in the role of the science base has crept into the thinking of the DTI as more research programmes are being funded which are narrowly industrially focused with short-term goals at the expense—because there is no new money—of broader speculative projects which have originated mainly from academics and been assessed by peer review. At this point, I emphasise that I am not against industrially oriented research being carried out by universities but only the scale and the narrowness of vision which seems to have developed. I have spent some 35 years of my career in university as a metallurgist carrying out research in the applied sciences. At the beginning of my career I was well aware of the freedom essentially to choose any research topic with SRC funding—it was SRC in those days—to the extent that research became incestuous. The last topic would breed the next one, without any reference to the needs of society or industry, which we have some obligations to serve. A degree of freedom is healthy, particularly for a young person at the start of his or her career. But I feel that it went too far. The introduction of the so-called "CASE" awards, whereby industry could top up an SERC studentship and have some say in choosing the research topic and monitoring its progress, was very healthy for science and technology in universities. Nevertheless, it was still academic research with the aim of seeking new knowledge generally. It was not specific to the industrial partner and there was the freedom ultimately to publish. For academic researchers that partnership is a wholly good thing. It brings them nearer to the needs of industry without constraining the requirement to publish and discuss the results with colleagues everywhere. It is often not understood how important are those freedoms to the health and vigour of academic research in all subjects. In particular, sometimes it is not fully appreciated by industry, whose culture is understandably more secretive, and much industrial research does not see the light of day outside the company premises. The movement towards more industrially oriented research has been continued and expanded, first by the SERC (Science and Engineering Research Council) and now by EPSRC—the inclusion and the predominance of "E" for engineering in those acronyms is no accident—and usually involves larger and more costly projects, employing more senior research staff. But the ideas would originate in partnership between industry and university. With the arrival of the Technology Foresight exercise and the projects which emanate from it, we have moved into a different world. They are tightly focused and controlled projects, clearly aimed at the perceived needs of industry, with explicit concentration on wealth creation in the short term. There are a number of causes for concern with that initiative. First, it is notoriously difficult to guess winners in the technology stakes. Secondly, because there is no new money, inevitably the more speculative longer term projects are pushed to the fence. That means that industry has fewer horses on which to place its bets and, since the later stages of industrial research and development are much more costly, mistakes in backing the wrong horse can be disastrous. I should say that the horse racing metaphor is quite appropriate to this game. Technology spotting is and always will be a gamble, no matter what high hopes and what good preparation has gone into the matter. Despite what I have said, I am not trying to deride or devalue the Foresight exercise. It needed to be carried out. It is good that industrial and academic scientists and engineers meet and thrash out what they believe to be the priorities for applied research in the United Kingdom and to publish their conclusions. However, I feel that the specific recommendations should be taken as provisional, always subject to revision by a continuing exercise and not be set in tablets of stone. It is the rigid distortion that it can give to the direction of all the science base that most worries me and others. I shall conclude by saying something briefly on the budget allotted to the research councils. It is true that it has grown in the nine-year period to 1995 by some 8 per cent. But it is a paltry amount considering what needs to be done to bring the level of university equipment and facilities up to international standards. The fact is that, according to OECD data, it would need an additional 40 per cent. of funding to bring the UK into line with the average figure for the USA, Germany, France and Italy as a percentage of GDP. It is now proposed to reduce that funding over the next three years by £56 million. That sum is not only to pay for a much enlarged university sector, but in addition the government research establishments of other departments are now encouraged to bid from the same pot, reducing the amount that they will need to spend on research themselves in the future. Again, much of the research will be of the short-term, industrially oriented type, to the detriment of longer-term basic and strategic research. There are many who believe that this could spell the end of our glorious tradition of scientific discovery, which is the real source of technological revolutions, unless drastic measures are taken to reverse the concentration on short-term and short-sighted research.3.52 p.m.
My Lords, I thank everybody for the kind welcome given to me. Also, I thank my noble friend Lord Walton for initiating this important debate.
Prior Options Reviews of the public research establishments have now been set in motion with the aims stated in the 1993 White Paper Realising our Potential. This Government's policy is to provide,What, without doubt, is most at risk is pure scientific research or perhaps, in the end, even a notion of pure scientific research. I say "notion" because I think there is some confusion about, and not enough consideration given to, what we actually mean when we talk about core science, pure science or so-called "blue skies" research. The former science Minister, David Hunt, stated last year:"only those functions which are both necessary and best carried out in the public sector".
But that oft-used phrase, "curiosity-driven research", unthinkingly belittles and somehow compartmentalises this kind of research. It may seem strange or foolhardy to those noble Lords to whom I have spoken that someone working in the arts should make their maiden speech in a science and technology debate. But, as I am perhaps hinting at already, there are certain general cultural assumptions which underlie our thinking, whichever side of the debate one is on, which I feel need to be somehow "got at" and which a broader view may help to illuminate. An artist friend said to me that at least in science there is the perception of pure scientific research against which there is a threat. In Britain in the arts, both for the general public and for most people working in the arts, there is no such notion of a perceived long-term research being carried out in the first place. I am not thinking here of art history and other retrospective disciplines. In both art and science new understandings are brought about through new movements which may themselves be part of a long-term development of thought. I make these points to suggest that we have strayed a long way from what we acknowledge traditionally as being a Renaissance-style science. The kind of science that is favoured is prescriptive; that is to say, industry requires a product. When we say it wants a return on its investment we can take the word "investment" quite literally. Industry will clothe and recharacterise the work that is carried out towards a particular end. But we could talk positively of science as a rhizomorphous activity: it proliferates; it is nomadic; it is inefficient; it seems to have no beginning or end. The chief executive of one of the public sector research establishments was quoted in the Daily Telegraph as saying:"I do not want to stop purely curiosity-driven research".
Yet, in my view, truly pure research is carried out for just that reason—to discover what it was that drove the scientist down that particular path, one that is necessarily dark at the end. It is a journey of which we can say one cannot necessarily predict the route one will take—some routes will be totally new—or predict the destination, and perhaps there is no destination. A purely commissioned research takes away the freedom of the mind. Perhaps the most important problem of all is that of time, the time that is needed to develop a project. Customer-driven research means not only a specified product but also that the product needs to be on the table at a specified time. The preference for immediate results is the desire for instant gratification. A scientist needs time because so much work of importance is done in the dark, with the possibility that a result of the kind that industry would like to see may never be achieved, or perhaps not recognised at the time for what it may later become even by the scientists who are themselves working on the project. On being asked, "What use is electricity?", Faraday famously, if rationalistically, replied, "What use is a newborn baby?". But perhaps even Faraday's perspective is the wrong one. I would argue rather that the meaning of the work lies not in any potential outcome that can be bargained for with industry (and I sense that defensiveness in all the various reports and statements that emerged from the PSREs which are so rightly concerned with the effects that privatisation would, and in some cases now will, have), but in the work itself and in the relationship between the scientist and his or her work. The product, the outcome, finally is the work itself. That is the meaning of the phrase "pure science" and constitutes the essential difference between core science and commissioned research. The kind of science that is favoured is also functional. The structures and methodologies used will influence the outcome. I believe that certain forms or appearances simply cannot occur under certain conditions. In other words, if the Government want to make funding decisions based on questions of, for example, functionality or efficiency, then an overall decision has in effect already been made which is truly a cultural one. With my emphasis on pure research, I certainly do not wish to deny the use or the results of industry-financed or commissioned research. Rather, there is in a PRSE such as the British Geological Survey a fragile and subtle relationship between, on the one hand, the so-called "core programme" and, on the other, commissioned research—what the BGS calls a "synergy". To tamper with one will radically alter the character of the other. To take the broader view again, there is no Minister for the Arts but one for heritage. The Office of Science and Technology is now part of the Department of Trade and Industry. The link here is the tendency towards a purely retrospective culture: the desire to capitalise on the result before formulating the question. Finally, it may be said that the culture of a nation is defined not in what is deemed to be necessary for the life of the country in terms of its economic production but in what may be regarded as its excess. Certainly this Government regard as excessive the idea of a truly pure science. But by doing so they reject the wherewithal to solve the longstanding and wide-ranging problems it purports to address."I would be suspicious of a scientist who could not explain why the work was being done in the first place".
4 p.m.
My Lords, it is more than a privilege—it is a pleasure—for me to congratulate the noble Earl, Lord Clancarty, on his maiden speech. When I came into the House this afternoon, I looked at his entry in Dod. I had very little guidance as to what I was to expect. He is so modest that he says very little about himself. But now that he has given us a very thoughtful, interesting and surprising speech, I hope that we shall hear more from him on other topics.
I must declare an interest. I have received money from research councils for carrying out research. Indeed, I am about—I hope I am about!—to do so again. I come from the social science side and not the natural science side. The difficulty about funding research was set out by the noble Lord, Lord Kirkwood, with whose speech I very much agreed, and by the noble Earl, Lord Clancarty. The difficulty is that people who should invest in pure research have to realise that it may or may not yield fruit. If it yields fruit, it may he a very handsome fruit. The rates of return for basic research are not measured in double digits. They are very often measured in four or five digits. Basic research is very fruitful if successful. However, at the same time, one has to gamble and take a risk that what one is doing is not throwing money away but will be useful. Practical men—usually men make these decisions—want to have a preliminary assurance that the money they are giving away will not be wasted. The only way to do that is to make quite sure that the selection of people who get the money is above board and that the selection is such that we can best expect good results, although no one can ensure good results. Here I must disagree with my noble friend Lord Winston. I believe that the peer review procedure with an anonymous referee is the only guarantee I can give to the practical men that I will do the best I can and that we will all do the best we can. It is an uncertain thing to predict. No one knows the answer, but we can at best give a collective answer uninfluenced by the fear that we might meet the man in the street who has just rejected us. An objective and anonymous peer group procedure has so far been the only guarantee. Where I believe we have gone a little wrong—I echo what was said by the noble Lord, Lord Kirkwood—is that we have jumped the gun. We have said that it is not enough to have a peer group review procedure and it is not enough to trust the scientists, that we have to foreshorten this gap between basic research and the final product, that we have to have a practical test, and that research should be results-oriented and not knowledge driven. Very good arguments have been made as to why that is wrong. Perhaps I may push the argument in an area where our industry thinks it is totally useless—social sciences. Social sciences include sociology and economics. It is hard to argue that we could be useful and therefore we have to try even harder to be practical. I believe it is a mistake to pre-judge these issues. Perhaps I may give an example which is to do not so much with research but with economic study. When I was a member of the London University Senate the vice-chancellor said, "We have been told by the Secretary of State for Education that universities ought to pursue practical subjects". The person in question said that he agreed. I said, "Why did you agree? Theology is not a very practical subject. Islamic theology is even less a practical subject. But when Ayatollah Khomeini came to power we were looking around for anyone who knew something about medieval Islamic theology". It takes 10 or 15 years to produce a scholar in Islamic theology, central Asian republics or the problems in Rwanda. When problems arise one cannot then start research. By the time the research is finished, the problem is over. One has to be able to anticipate. Of course the money is limited. I know that. But because money is limited, we should not try to shape research in a certain results oriented fashion but instead have faith in the academic scientific community we have created. We could then have a review now and then to see how effective it is. I would never have predicted many of the things—good and bad—which governments have been able to do. It would have been impossible to anticipate them. The money spent on research is vital not only because it goes on useful research but because in universities there has been a climate on the teaching side, which we are not discussing this afternoon, of severe financial cuts. We are told that we should get capital grants from the PFI. That is good for the Government and it is good for the PSBR. But it is not good for the universities because they will not get the money. The money will have to be found somewhere else. That will not be good news for us. Perhaps I may put another point to the Government. The Government will say that I should know that money is scarce. I have heard all that before. I hope the Minister will not ask me how my party will pay for everything, because even if I told him, I am speaking from the Back-Benches. The Government spend an enormous amount of money on hiring consultants. They only hire consultants who are not in universities. The consultants who are not in universities cost about 10 times as much as the universities would cost and are not as good. It is surprising that universities are not used more often in giving the kind of advice they could give. That would generate revenue for them and the Government would save a good deal of money. Perhaps a few City firms would go bankrupt, but that is not always a bad thing. The Government should make more active use of the universities because the expertise is there. I can tell the Government that it would be very useful and cost efficient. I believe that we ought to discuss research not in a narrow result oriented fashion but in a broader fashion. Everything I know about the roots of growth tells me that money spent on research will be handsomely repaid and will be repaid much better than money spent on many other activities which the Government think are more practical and more useful.4.8 p.m.
My Lords, I should like to add my congratulations to the noble Earl, Lord Clancarty, on his maiden speech and hope that my fellow Cross-Bencher will take part in many more debates. Before taking a small part in this debate, I must declare an interest to the extent that I own a beef herd as part of my farming activities.
Between 1978 and 1982, I was chairman of the Agricultural Research Council, which changed its name, as the noble Earl, Lord Selborne, said, to the Agricultural and Food Research Council. At that time, there was a possibility of work being done on scrapie at Mordun and Compton being considerably reduced. Luckily for all of us, the work of this very important basic research continued. The present story of bovine spongiform encephalopathy and Creutzfeldt Jakob Disease is a good illustration of the role of a research council in supporting research on a broad front and of research institutions providing national facilities and expertise to pursue this long-term research. The AFRC support for the research on scrapie at Compton and more recently, the Biotechnology and Biological Sciences Research Council and the MRC in Edinburgh, meant that in the late 1980s they were able to initiate almost immediately a programme of BSE research at the neuropathogenesis unit and at Compton. Without this background, the lead time would have been very considerable. In addition, the NPU is well placed to collaborate with MRC's CJD surveillance unit, which is also in Edinburgh. The lessons in this for long-term basic research and the research institutes are very clear. A current worry for the research councils is that in pursuit of its privatisation policy the Government might—and I underline "might"—break the links between the research councils and their institutes, making the institutes independent and leaving them to compete on the research market. However, the real test of the DTI's intentions will be its attitude towards the councils substantial funding for basic research, mainly in the universities. Up-to-date, the DTI and the Minister for Technology have supported these activities: long may this policy continue. On a topical and worrying note: yesterday, I watched BBC television and heard the newsreader at lunchtime referring to a group of people about to take actions against the Government regarding the deaths of relatives due to CJD. The newscaster explained that CJD was,This was most inappropriate and seriously incorrect. I hope that the Minister will look into this definition, which I heard repeated on BBC 5 on my way up in the car yesterday."the human equivalent of mad cow disease".
4.12 p.m.
My Lords, I congratulate the noble Earl, Lord Clancarty, on his very thoughtful and interesting maiden speech. I do not doubt that there will be many other occasions when he will be listened to with equal interest. I also wish to thank—I call him "my noble friend" because I have known him for a very long time—Lord Walton, for introducing this Motion and for moving it in a speech which was wide-ranging and penetrating. I earnestly hope that my noble friend on the Front Bench will take that speech back to some of his colleagues, put it in front of them and leave it with them until he is sure that they have read it many times and digested it.
What bothers me—and I lack the expert knowledge of the noble Lord, Lord Walton—are the attitudes which prevail towards research today. We live in an age of change, rapid reaction, quick results, which we hope for from limited resources and, above all perhaps, instant and unceasing communication. It is not surprising that Ministers are affected by that state of affairs and as a result they develop skills in self-defence and presentation; what I fear is that they devote an excessive amount of their time, attention and energy to cosmetics rather than to fundamentals. I say that about Ministers of all parties, over many years. It is hard to imagine a climate more hostile or unfriendly to research or one which is less in tune with its needs. As I have said, I am no expert in this area but I have been chairman of a charitable trust over the past six or seven years. During that time I have learnt something of how important an assurance of continuity is and how desirable is flexibility. Without flexibility, research tends to be set on tramlines and comes up against insurmountable obstacles; with flexibility sometimes it is possible to get round them. I have found again and again that people with great skills to whom I have been able to give support have found that support doubly useful because they were not constrained too closely to follow preconceived directives. I do not mean this in an offensive way, but I do not believe that I really understand the Government's attitude to research, either what they expect from it or what they are willing to provide; neither do I quite understand what they expect from the private sector. I do not believe that private sector funding will be in a hurry to replace government funding, nor do I believe that it will be attracted easily to funding deficits. I would like briefly to refer to a Question which the noble Lord, Lord Walton, mentioned which I asked on 19th March. On that occasion my noble friend on the Front Bench very reasonably gave the unassailable answer:The questions are these: are those means sufficient for it to carry out its task; and can we possibly be content with a rejection rate of 70 per cent. of alpha-rated projects? I believe that the answers must be emphatically no. I echo what the noble Lord, Lord Walton, said on that occasion; that the 30 per cent. cut-back in capital funding for the universities must have a huge and radical repercussive effect on the research activities of our country as a whole. I would particularly like to echo, too, the words of my noble friend Lord Jellicoe. He said:"the MRC must live within its means".—[Official Report, 19/3/96; col. 1145.]
He went on to comment,"if the rejection trend persists, there is a real danger that there will be an erosion of our once dominant position in the field of basic medical research".
I do not believe that the official world is in any way aware of the depth of that disappointment, which causes me again to echo what the noble Lord, Lord Walton, said about the recent transfer of the Office of Science and Technology to the Department of Trade and Industry. I have absolutely no desire to be offensive, but I cannot restrain myself from saying that that department is a very large one. It does a great many things, and I do not believe that it does any of them very well. Research is complex, depending as it does on resources in terms of buildings and equipment and on people in terms of management, leadership and vision. All of those aspects do not run on the same plane or to the same timescale but there is a close relationship between one and the other. It is a relationship with which others tamper at their peril—or rather at our peril. Such matters may not be of much concern to those who in our day simply seemed to want to win a place for themselves rather than to plant seeds for the future. Attitudes will have to change if we are to succeed in realising our potential. Indeed, the phrase "realising our potential" is, as your Lordships will recall, the title of one of the glossy papers which are now fashionable in government circles. I hope that the time will come when research will be seen generally as a major contributor to wealth and to the quality of life in our country—not just as a sponge absorbing resources which could be more effectively dedicated to causes which would more readily win immediate and popular acclaim."how deeply disappointing [it is that] some of the brightest and youngest minds working in the field to see top-class applications rejected".—[col. 1146]
4.21 p.m.
My Lords, I too thank the noble Lord, Lord Walton, for calling attention to the present position of our research councils and for initiating this extremely interesting debate. These councils are the mainstay of research in our universities, which in turn provide the knowledge base on which modern technology and industry depend.
Until relatively recently this system operated on the Haldane principles which aimed, to quote the noble and learned Lord, Lord Hailsham—I hope that I quote him correctly—It had the confidence of the scientists and it worked very well, so well that this country led the world not only in the advancement of science but also in its practical applications. The allies' success in the Second World War owed much to the British men and women who gave us radar, polyethylene, penicillin and the jet engine. Even in the stress of war the boffins were free to develop their crazy ideas and Government Ministers and industrialists joined in the fun, and the record of success under that system was remarkable. So, what has gone wrong? In basic science, we no longer lead the tables of international awards. As the noble Lord, Lord Walton, pointed out, up to the 1960s Britain held the most Nobel prizes per head of population of any country. We expected, and often got, one or two of these each year, but the last award in this country for chemistry was made 14 years ago in 1982 and for physics in 1979. Things are not much better in applied science. We hear a lot about Nobel prizes, but the picture is not much happier when it comes to applied science. With the notable exception of pharmaceuticals, most of our industries have little to show today that compares with their great innovations of the past. How did that happen? We still have good scientists in our universities and we still have the research councils which provide, I have no doubt we shall be told, similar overall funding in real terms to that which they provided in the past. Could it be that our politicians try too hard? With the best intentions they seek wealth-creation from a chemist from the moment he opens a bottle. There is a danger that the research councils will be guided in their pursuit of government gold by short-sighted foresight committees. It has been said that if, when he discovered the electric dynamo, Faraday had been guided by a committee seeking a brighter light, he would have been advised to develop a better candle. In the late 1930s President Roosevelt set up a high-level committee of scientists and industrialists to do just what we have been trying to do—to predict what the future trends in science would be. They guessed correctly how some areas of existing technology would develop and incorrectly about others. What is more worthy of note is what they missed—and that was practically everything of importance. They missed penicillin; they missed radar; they missed the transistor; they missed rockets and satellites; they missed nylon and other synthetic fibres and plastics; they even missed nuclear power and nuclear weapons—and this was only a few years before the Second World War. I hasten to say that the British technology foresight programme has been successful in the way which I believe Mr. Waldegrave intended. I remember his telling a Select Committee of your Lordships' House that the importance of the programme would not be its conclusions but the process of catalysing a dialogue between scientists, technologists, government and industrialists. This was a laudable aim, which was achieved in part. But the later decision to shift the Office of Science and Technology to the Department of Trade and Industry, with an overarching director-general, seemed to give the wrong message about the Government's intentions for basic science and the research councils. I should like to quote a little more from the recent report on this matter from the Royal Society, to which the noble Lord, Lord Walton, referred. It states:"to separate the activity of research from the executive business of government and from economic activity".
In the end, however inadequate the funds available to the research councils may be, they must be spent wisely. I believe that that is part of the problem. The priority must be the best basic science and scientists in the universities rather than the committees' own favourite programmes. Neither should they support institutions or well-found laboratories, least of all their own, merely because they are well found, and expensive usually. There is no way in which we can afford to make 100 universities centres of excellence in modern science, and equality of funding is neither possible nor desirable. Finally, to optimise this process, the industrial laboratories must support more generously their own in-house research, as well as university research which is done mainly for their benefit. After all, they should know best how to create wealth from their own products."Technology foresight is about markets and about technologies. It is not science foresight, i.e. it does not attempt to predict how scientific knowledge will develop. Nor could it. The identification of strategically important areas of technology raises, but does not answer, questions about the science needed to underpin these areas of technology".
4.28 p.m.
My Lords, I join other noble Lords in thanking the noble Lord, Lord Walton, for providing us with the opportunity of this debate. I should declare an interest as a member of the University of Aberdeen. Perhaps I should also point out that the research council has from time to time supported my research, but has more often declined to support it.
I must also agree most strongly with the noble Lord, Lord Peyton, who drew attention to the demoralising and demotivating effect on young researchers at the beginning of their careers when they find that, after considerable effort and the submission of a good research application, that research application is rejected. Part of my job is to encourage young researchers. I am aware of the negative effect that that kind of response breeds. It takes a good deal of effort to galvanise them again. Quite understandably, many of the speeches in today's debate have drawn attention to the work of the science and technology-related research councils. As a social scientist, I should like to say a few words about the Economic and Social Research Council which in funding terms is very much the Cinderella of the research councils. Relationships between government and the social sciences have not been unproblematic, in part perhaps because social scientists sometimes have to say things that governments prefer not to hear or to learn, and in part because in areas of public policy the approach of government has been to come up with the policy and then to scurry round to find justification for it. It will be recalled that in the 1980s the situation became so bad that the then Social Science Research Council was required to change its name and became the Economic and Social Research Council. At the same time, its budget was cut in half. I believe that those days are over. I detect a change of mood. There has been a growing recognition of the contribution that the social sciences can make in seeking solutions to, and providing an understanding of, some of the major problems that confront our society. Nevertheless, the ESRC remains the Cinderella of the research councils. The social sciences account for only 5 per cent. of the science vote, despite the fact that people-related problems represent more than 5 per cent. of the factors that inhibit our country's future industrial, economic and social development. A sign of the change in mood was the article published a year ago in Nature. That is not by any means a social science publication. The article commented on the Government's Technology Foresight programme, and noted:A year on, recently in Research Fortnight—which is the insider publication for the research community—the comment was made,"… almost all of the 15 panel reports make recommendations that fall within the remit of the Economic and Social Research Council. That is not surprising. To the extent that the panels are as much concerned with the neglect of technology that already exists as with innovation in the strict sense, it is natural that they should be concerned with the improvement of the social climate for economic activity. … On the face of things, this common theme implies a bigger budget for the smallest of the Research Councils".
One could name many more to add to that list. In many cases the advances in scientific, technological and medical knowledge can be maximised only through the activities of people as individuals or as members of organisations. Much depends upon the social processes of innovation and diffusion and—perhaps most importantly—understanding of the means by which behaviour, both socially and personally, can be changed. It is evident that the ESRC and the social science community has responded positively to the Government's White Paper Realising our Potential. Following widespread consultation, the council identified nine thematic priorities which represent the big issues that will face British society over the next few decades. Without listing all of them, one can gauge the importance of them by looking at four of the main topics that have been identified: economic performance and development; the environment and sustainability; the social shaping of technology; and social integration and exclusion. I am convinced that that will address the fundamental problems and issues in determining the nature of British society. As the Minister well knows, I come from Aberdeen. About 10 years ago we lived through the "Piper Alpha" disaster. The subsequent Cullen Report graphically identified the crucial and critical role of human factors in the circumstances surrounding that disaster. I believe that we have learned a lot from Cullen, and that human and social factors are now recognised as having central importance in the whole area of safety engineering and management generally. Technological engineering structures are important, but their importance is mediated through the behaviour of individuals. That is fundamental. It is a truism that our society is changing more rapidly now than many times in the past. Often we understand little about the process of social change that goes on around us. Many changes cause individual personal despair and often a fractured society. Perhaps more than ever before we need high quality, robust and properly funded social science."It is now perfectly clear that the country's need and appetite for social science research is bigger than ever. The Council could have its budget doubled over the next five years and make every penny pay for itself over the coming decades in lower crime rates and better management of the economy to name but two".
4.37 p.m.
My Lords, I express gratitude to the noble Lord, Lord Walton, for enabling me to address your Lordships' House on a subject in which I have been engaged for so long. The noble Earl, Lord Selborne, speaks for the present. I am a voice from the past. I first made contact with the Department of Scientific and Industrial Research in 1949, nearly half a century ago. I did a stint on the advisory council and had a second term on the Science Research Council, then under the chairmanship of Sir Harry Melville. As he was about to retire, I was one of a deputation of two who went to the Minister to ask whether the noble Lord, Lord Flowers, could be the next chairman and whether he could have the status of an executive chairman. (I see the noble Lord in his place. If I misquote anything, I shall give way if he wishes to rise to correct me.) Following that, I spent a further five years on the Medical Research Council. It was there that I met the noble Lord, Lord Walton, for the first time. In addressing your Lordships this afternoon, he and I speak as old colleagues on all that we have worked on together in years gone by.
The noble Earl has referred to still more messing around as of today. I have with me all of the command papers that have been reported to Parliament on the subject of the organisation of scientific research: three, six, nine, 12, 13 and 14. There is one report to which I cannot get access for the time being. The rest of them are out of print. The reports go back to 1962, which means that since then there has been one decision every two or three years. As the noble Earl said, we are at it again. Not content with the 1993 reorganisation, here we are in 1996. We have interfered with it and sent proposals for the Department of Trade and Industry to take over. We are messing around again. It is as well to look at the received wisdom of a distinguished public servant, Sir Herman Bondi, in the introduction of a book edited by Maurice Goldsmith on science policy. Sir Herman Bondi stated:"So far I have discussed the two poles of applied research with a clearly defined objective on the one hand, and curiosity-oriented research on the other. There are large tracts of country in between. In particular, one can speak of strategic applied research; research that has in itself no direct application, but where one can make a good guess that its results will be needed so that future truly applied work can be successful. How this area should be financed, how it should be defined, and who should make the judgements, is perhaps even more difficult than in other fields.
There speaks a most distinguished pure scientist in the field of astronomy and particle physics and also a most distinguished public administrator of science—a good public servant—for a re-organisation once in 10 or 15 years. We are doing so once in two or three years. Surely something is very wrong with the way in which we go about business. I can say only that I thoroughly endorse everything that was said by the noble Earl, Lord Selborne. Why do we go on with these endless reappraisals? I believe that it is due in part to the influence of lay persons who misunderstand the dubious nomenclature of much of scientific effort. What does "NPB" mean? Yes, it is the National Physical Laboratory, but what is that and what does it do? Is it the same as, for instance, the Bureau of Standards in the United States? Talking of standards, what about safety standards? Does that mean safety in medicine, safety on the road or safety at work? The whole conversation is immediately off the beam. The concept of the National Physical Laboratory as involved in some kind of standard is perfectly permissible. The pound sterling has no fixed value, alas. It is one thing today and another thing tomorrow, but one cannot say that of the pound avoirdupois. It must be the same from John-o'-Groat's to Land's End and from one year's end to the next. Someone must verify it in cases where some misfeasance has taken place; for instance, someone substituting a phoney pound weight for the weight that should be in the grocer's shop. In order that the science of standardisation can enlarge, research must be undertaken. Everything that we do in life has some kind of research backing. It is no good treating research as something totally divorced from the rest of our lives. Some things are the proper activities of government. The Government have a duty to do them. I refer, for instance, to education, to the national health and to standards. Yes, standards come into it. We need to have research into standards. The standard meter used to be two scratches on two platinum studs set in an invar bar in Paris, but all that is long ago. It is now defined in terms of a wavelength of a singlet in the spectrum of the metal cadmium. That is our standard of length. So we go from lengths to areas, to volumes, to gallons, to acres, and so on. We have to have those standards and the advance of them always means research being carried out somewhere. As regards education, we cannot educate our children without teachers. We must then think of the several tiered structure—the teachers and the teachers of teachers at a higher level. There are the teachers of our teachers of our teachers and we are beginning to run into the universities and research problems. What is a university? It is a self-governing community of scholars dedicated to knowledge; to the preservation of knowledge in its libraries; to the dissemination of knowledge in its teaching functions; and to the expansion of knowledge in its research functions. That is why university research is a thing on its own. I yield to no one in my admiration for the Treasury as the only body of men in the country dedicated to the proposition that Her Majesty's Government should spend less. Everyone else wants them to spend more, provided that it is on their own pet hobby, whatever it may be. But one can have too much of a good thing, and I could not quite carry that principle of spending less to the point where I would say, "It doesn't matter what you don't spend money on provided that you don't spend it". That is going a little too far. Science has been the victim of that, and the continuing chopping and changing around with ministries is partly responsible. The Department of Scientific and Industrial Research, where I started as a member of its council, was started by Lord Haldane in World War I. It was originally a committee of the Privy Council which turned into a department under a Permanent Secretary. In my day that was Sir Ben Lockspeiser. It acquired an advisory council, of which I was a member. It tried to do far too much. It had 16 universities, 40 industrial research associations and 14 or 16 major government establishments and the council was overburdened with work. It used to delegate some of its work to its members and I was the member who had to report on the geological museum. That meant that I had to interview the keeper and lead the discussion in council and so forth. I have said quite a lot. Lord Robins, speaking from where I am standing now, often said that economic decisions are concerned with the allocation of limited means to competing ends. Why the ends compete with one another has nothing to do with economics; it is a psychological matter. Psychologically, I am sold on the side of research. If I can do anything to convince your Lordships that the noble Earl, Lord Selborne, is right and that we ought not to be mucking about yet again with the structure and responsibility of ministries towards our research councils, I shall not have spoken in vain.Thus, the overall context is daunting. How can we define a policy for R&D so that it is a real guideline for those who have to take decisions? How indeed should the decision-taking be organized? How should the whole thing be held together? Two or three comments come to mind at this point. First, reorganization of a country's arrangements for controlling R&D is common in every country with a frequency of perhaps once every ten or fifteen years. This in itself shows that nobody has found a really good solution, that every solution when tried at first produces some enthusiasm, then reveals its problems, and is replaced finally by something else".
4.48 p.m.
My Lords, in the context of this debate, for which we are grateful to the noble Lord, Lord Walton, my few words may, I feel, seem tangential. They will, however, serve to remind your Lordships that not all the research that is essential to our national well-being has a close or obvious relationship with industry: nor does it all fall within the purview of the research councils.
The British Academy, in respect of which I declare an interest as a past president, is charged by Royal Charter to promote a certain arc of disciplines that were hived off from the Royal Society about a century ago. One segment of this arc, embracing subjects now known as the social sciences, is funded from within the research council structure by Lord Sewel's Cinderella, the ESRC, in the amount of something over £60 million a year, some of which we have all heard with pleasure today proceeds in the direction of the noble Lord, Lord Desai. The other segment of this British Academy arc, the one usually referred to as the humanities, falls outside the research council structure and depends for research funding on a sum that is found within an annual grant to the Academy from the DfEE. This research sum at present amounts to about £16½ million pounds a year and it is distributed by the Academy's Humanities Research Board for the benefit of those fields among the Academy's chartered responsibilities not served by the ESRC. I see nothing wrong in principle with such a division of labour in research funding provided that two conditions are met. The first is that the separate treatment of the humanities should not be thought to connote a lower estimation of humanistic research. As the frontiers of medical and natural science research increasingly impinge on ethical concerns—to give just that one example—the relevance of even the most philosophical and least experimentally oriented of the humanities becomes more insistent and obvious. In this connection, like the noble Lord, Lord Walton, I would draw your Lordships' attention to the report published in April this year by the National Academies' Policy Advisory Group, embracing the British Academy, the Royal Society, the Royal Academy of Engineering and the Royal Colleges of Medicine. This report on our national research capability declares unequivocally that we do not in this country adequately recognise that the natural sciences need the humanities if we are to achieve public understanding of scientific developments and their consequences. The other condition governing the acceptability of a separate mechanism for funding humanistic research is that the humanities must not be treated as a poor relation. And here I have to say that, wholeheartedly as we sympathise with colleagues in the natural and medical sciences, we in the humanities face a particularly grave situation. The British Academy's funding of humanities research is aimed at sustaining the work of the 8,000 academics deemed to be "research active" in the humanities by those conducting the last Research Assessment exercise. Well, £16½ million works out at less than £300 a head in research support for these humanities scholars. And what is more—or rather, what is less—the £161½ million is to be reduced by 6 or 7 per cent. in real terms over the next three years. In short, it cannot be said that either of my conditions is being met. But, finally, let me make the obvious point that world-class research, whether in science or the humanities, depends critically on world-class information resources. Yet in all fields we are feeling the grim effects of large-scale reductions in library expenditure. Acquisitions of journals and books are being seriously reduced, not only in universities but in the national library of last resource, the British Library itself. Yet it is to the British Library that industry's research workers, as well as those in academic institutions, will increasingly be looking; not—let us hope—in vain.4.55 p.m.
My Lords, in introducing admirably this debate, the noble Lord, Lord Walton of Detchant, referred to the research councils as the "Jewel in the Crown". I agree with him of course. I cannot remember whether it was the noble Lord or my noble friend Lord Winston who also said in that regard, that our friends and competitors abroad envy us that system. I must slightly disagree about that. They did envy what we had and what we did, but I am not so certain that they still do. In fact, quite the contrary, they now see us throwing it away and they think that we are raving mad, to put the matter as simply as I can.
I am not starry-eyed. I believe that research should be useful. I have worked too often for Ministers who, when it comes to policy advice, have said to me, "What is the research basis for what we need to do?" and I have had to say, "Well, Minister, even though we have poured money into this or that, on what you are asking for, we have nothing to tell you". I have the same experience now that I have the honour to sit on this Front Bench. Far too often when I am to speak in a debate, I discover that in exactly the area in which I need good research back-up, that is the one area in which no one seems to have done any work. Therefore, it is nice if research is useful. I used to be an expert on investment decision-making in the public sector. I am horrified to discover that people now doing that work in places such as the DTI and the Treasury were not even born when I was doing that work. However, I somewhat blame myself for what has happened. I could do—and I still could if I were so inclined—a discounted cash-flow analysis on any project, and I mean any project, certainly within our area of discourse, and I can demonstrate that the pay-off to any item of research at the relevant rate of interest and bearing risk fully in mind is invariably negative; in other words, we should not do it. The outcome of that is that we would do no public sector research at all. Where then would our government be in the next generation? It is not simply that we should be an intellectual backwater but, of course, we should be poorer. When I was young, I did not have the sense to think about that at all. I would simply do the work, show it to those for whom I was working and say, "do not do it". But since then—and I am sure that it is a sign of old age—I have learnt some common sense. Therefore, in relation to economic analysis of research projects, we should be careful of what one might call the multiple reductio ad absurdum, that nothing is worth doing at all. Therefore, I hope that research will be useful and I am second to none in looking for benefits to industry and the economy. But we must not be naive about it and we must not be naïve about asking the relevant questions. I am not saying that we should not ask the questions, but it is a matter of how we look at the answers. The noble Lord, Lord Porter, guided us through that area. We cannot guarantee at all in the case of any individual item what its impact will be on industry and the economy. We do not have that kind of information, and I hate to say it but I doubt whether we shall ever have that kind of information. Therefore, I am not saying that we should not ask the question, but the real point is how we approach our inability to answer it. The noble Lord, Lord Porter, gave many examples. If one looks at fundamental research, who would even have engaged in the vulgarity of asking what would be the use of the work in the great Rutherford laboratory? Such a question would have been viewed with contempt by those great men of Cambridge and I believe that it should be viewed with similar contempt nowadays. In particular—and this is the point—no one could have predicted what would be the impact of that research in revolutionising that whole area of science. A similar point applies to my favourite subject of computers. We can all think of the marvellous work done at Bletchley in connection with Enigma during the war. That was done by brilliant people, many of whom were arts-based rather than science-based. We should never make the mistake of assuming that rational, detailed work cannot be done by arts people. Moreover, when talking about the cracking of German codes, I should also mention Alan Turing—a man tragically driven to death in a less enlightened age. Nevertheless, the fundamental work that he carried out in computers has had an enormous impact, none of which he could have predicted or, indeed, would have wanted to predict. That is the central question. It would never have occurred to him that someone might ask him, "What use is all of it?" In the end, the point is that one carries out the research which is unpredictable and much of it is a waste of time. Speaking for myself, it horrifies me when I look back at the large number of blind alleys that I have been down. However, I hope that I did one or two things which have been useful. Of course, I entirely agree with my noble friend Lord Desai that research work is a lottery and that, within it, there will essentially be one or two winners who will pay for the whole lot. I have a rather peripheral point to make, but it is one that I have been pushed into making by my noble friends Lord Winston and Lord Desai. It refers to peer review, and so on. Of course I totally agree with peer review; indeed, it is the only thing that we have. However, it is very much faute de mieux. Having been chairman of the Economics Committee of the Social Science Research Council and having been the editor of an academic journal for a great many years, I know which peers to choose—and I am not talking about your Lordships—if I want an article or a project to be rejected. I hasten to add that I do not do so. I would love to believe that natural scientists are a good deal less prejudiced than economists. However, particularly within the field of econometrics of my noble friend Lord Desai, I can unerringly get an article turned down by just consulting a particular person who has a definite view on the only method that should be used in that respect. Therefore, we should not be naïve about peer review, although it is the best that we have. I return now to the practical side. As other speakers have said—and I should simply like to underline it as chairman of the Office of Health Economics and, therefore, connected with the pharmaceutical industry—we have no better example of the benefits to our country in practical terms from our greatness in fundamental work. The reason that the pharmaceutical multinationals are in our country is to make money. I am delighted with that fact; and, indeed they are immensely successful. However, they are here not for crude practical reasons but because our departments of chemistry, and so on, are simply so outstanding. If we so much as damage them, then the multinationals will go elsewhere. That is the point that we must bear in mind. Indeed, I made a similar point in the mundane area of horticulture only the other day regarding the importance of a research base for such an elementary industry. But that industry is also competing internationally and, if we do not have a proper research base, it, too, will fail. That leads me to recognise the fact that we are in desperate competition with other nations abroad, most notably the United States. I have to say—and I hope that I will not be criticised for being unduly pessimistic—that there are too many areas in which we are no longer world-class players. People talk as if that may happen; but I can tell noble Lords that it has already happened in many areas. We are no longer big players in the big game. I hope that I am not being ultra nationalistic in saying that I deeply regret that fact. The reason behind that is one that the noble Earl, Lord Halsbury, and other speakers have made—namely, it is not just the Treasury, it is Ministers themselves. If you say, "Do this work and we will pay in the next generation", the likely response is, "I am sorry, I want to be paid next week". Indeed, I am as bad in that respect as anyone else. Someone has to say that the future, which is so blurred, does matter. We should have faith in how we prepare for it. In terms of funds, I should stress that we do have our native genius. The people of this country have not gone into some kind of genetic decline. Indeed, we will still produce very many great men and women. However, in the modern areas of research—and this is also true in pure mathematics—we now need a good deal of money to carry out certain kinds of work. Moreover, in many other areas which the Americans call "big bucks", you need such money if you want to play. It is nothing to do with politics and our governments must face that fact: either you want to be a big player in the game or you might as well get out of it. There is no intermediate phase. My time is running out but I must say a few words about universities. I am old fashioned in that respect. I cannot understand the idea of a university which is not based on research and scholarship. I cannot appreciate an academic who is not a researcher or a scholar. As academics, we may vary in our degrees of success; and, indeed, some of us run out of steam earlier than others. I should also add that some of us are better teachers, while some are not so good. But if we do not pursue scholarship in any form, we do not deserve the title of "academics" and the institutions that we work in do not deserve to be called universities. The welfare of our country—indeed, of any country—is not measured solely by GDP per capita. I know that goods and services matter. As I said, I should like the products of our research councils to have practical value. However, there are other things that matter as well as goods and services as conventionally measured. Like all noble Lords, I take great pride in being part of a nation of great scientists and great scholars, both in the arts and in the humanities. Having said that, I should like to take the opportunity to congratulate the noble Earl, Lord Clancarty, on his contribution to today's debate which was very much in that area. I, too, hope to hear from him further on that kind of subject. When speaking of national pride, I should say that I believe that the research and education policies of recent years have placed all of our national achievement over hundreds of years in peril. It may sound rather conservative, but I feel that we really must go back to earlier principles and earlier standards.5.6 p.m.
My Lords, I should like to begin by thanking the noble Lord, Lord Walton of Detchant, for tabling today's Motion on the research councils. This House has long had a Select Committee on Science and Technology and the noble Lord is a distinguished member of it, as indeed are other noble Lords who have spoken today. If I may say so—without, I hope, arousing the ire of another place—debates on this subject within your Lordships' House tend to be rather better informed than they are along the Corridor. Having said that, I should like immediately to add my congratulations to those already extended to the noble Earl, Lord Clancarty, on a maiden speech which was utterly distinguished in its clarity of thought and expression. I trust that the noble Earl will participate in our future debates not only on this subject but also on many others.
Along with a number of other speakers, I noticed that the noble Earl referred to Faraday who I fear is a little like Winston Churchill in that he gets invoked to support almost any proposition. Faraday was a distinguished scientist who carried out fundamental research, as well as what might be termed "contract research". Indeed, as my ministerial colleague Ian Taylor pointed out when speaking recently to the Royal Institution, it was his discovery of benzene that came out of the study of the decomposition of fish oil, related to the products of the London Portable Gas Company. Therefore, I have no doubt that there are different ways in which valuable research can be achieved. The 1993 White Paper, to which frequent reference has been made, was a major statement on science policy; and, indeed, was probably the first for some 30 years. It stated unambiguously that science and technology would be one of the key factors determining the country's economic future and also—and, as importantly—the quality of our lives. Further, it stated that the science and engineering base (the research and postgraduate training capability of the universities and the research council institutes) underpinned the whole science and technology structure of the country. There is no doubt that the health of that base is one of fundamental importance. Public funds are channelled into that base through two sources: first, the HE funding councils, which provide underpinning support of £900 million to the universities; and, secondly, the research councils, and some programmes administered by the Royal Society and the Royal Academy of Engineering, which provide targeted support for both postgraduate training and research amounting to about £1.3 billion. That figure was not reduced in an otherwise extremely tight PES round. As regards the Medical Research Council, its funding has increased by some 23 per cent. in real terms over the past 10 years. I understand the concern of my noble friend Lord Peyton about alpha-rated projects. It is appropriate in this context to bring into balance the figure—which, I think I am right in saying, was some £400 million—which is provided for medical research from some great medical charities within the United Kingdom. I know that some pure research is undertaken. I highlight the work that Professor Wylie is undertaking in the Department of Pathology at Edinburgh University into the subject of apoptosis. It may lead nowhere but it is possibly some of the most fundamental and exciting work that has been undertaken for a long time. I shall not ask the noble Lord, Lord Desai, to suggest a figure that his party would spend, but if the figures are added up they are considerable. The money is targeted through the research councils. That targeting largely determines the direction of the science and engineering base. The councils have key roles in supporting and developing the highest quality research teams within that base; sponsoring post-graduate students at both masters and doctoral levels; and the exploitation of ideas and encouraging interaction with users. For this reason the Government have made it clear that support for the research councils, the "science budget", was and remains a high priority. This is why on a like-for-like basis, even after correcting for the recent transfer of funds from the funding councils, it now stands some 30 per cent. above its value in 1979. Even after the transfer—which still attracts some objection—to the Department of Trade and Industry, the figure is still higher than at the time of the 1993 White Paper. As your Lordships appreciate, we now have six research councils, each with clear areas of responsibility—that is important—specific missions, and arrangements for ensuring that there is a strong user voice in their decision making processes. A further council has since been created, the Council for the Central Laboratory of the Research Councils, which provides large scale facilities and expertise. However, the emphasis on users does not mean—contrary to some lingering suspicions within the scientific community—that the Government wish to move to more short-term publicly funded research within the science and engineering base. Indeed there has been no pressure from industry to do that. If there has been a theme running through this debate in your Lordships' House which has alarmed me, it has been that this move into the DTI has in some way been prompted by the wish of those in industry to see that that fundamental research should in some way be adjusted and the money given instead to applied research. On the contrary, it is clear that what industry wants is for the science and engineering base to concentrate on its major role of training the highest quality scientists and engineers and undertaking basic and strategic research. It does not wish that research base to be applied for applied science. It is hugely difficult to spot winners. It is emerging more and more clearly that industry is saying that if there is a process of picking winners, it considers itself to be better placed to undertake that activity. We entirely agree with that view. Despite claims to the contrary, 90 per cent. of the research funded by the science budget is basic and strategic, and much of the remaining specific applied research is in the medical, agricultural or environmental areas. However, within this basic and strategic research envelope, the Government expect the research councils, and indeed the whole community, to have regard to the potential for future exploitation. To aid this process—I stress the word "aid" rather than direct—the Office of Science and Technology undertook an extensive Technology Foresight exercise to identify, as best it could, those areas of science and technology which were likely to be important over a timescale of 10 or 20 years. The findings are undoubtedly an important input, but by no means the only one, in the research councils' decision making processes. Since the publication of the 1993 White Paper, allocations of the science budget have sought some re-orientation of the research council portfolios to accord with the priorities identified in the White Paper. The key themes being developed within this re-orientation fall within three broad areas: enhancements to basic and strategic science; enhancements to people-related programmes; and improving interaction with industry and commerce. A key feature of the allocations was that the research councils should continue to support the very best responsive mode proposals. Additional funds have been provided to enhance the key disciplines of mathematics, chemistry, physics and biology whose importance was underlined in the Technology Foresight steering group report. As the noble Lord, Lord Winston, was speaking I could not help but observe that his noble friend Lord Desai shook his head vigorously as the noble Lord indicated his objections to the peer review process. I have no doubt that in the 14 or 15 reports to which the noble Earl, Lord Halsbury, referred, there would have been countless pages devoted to that process of seeking to determine what was the best basic or fundamental research to carry forward. Of course it is extremely difficult to attempt to pick winners, but I hope it is readily appreciated that it is no part of government to attempt to undertake that exercise. Whatever disagreements there may be within the scientific community, the matter must be left entirely to it to determine what areas of research should be undertaken.My Lords, I shall speak briefly as this is a time limited debate. I do not object to peer review; I object to the anonymity of peer review. That is my concern.
My Lords, I believe that even on that issue the noble friend of the noble Lord took some objection. No doubt these are matters on which there will continue to be earnest debate. I seek to underline that it is no part of my responsibility as a Minister to participate in that debate. I would far rather the issue be left to the scientific community to resolve.
I am grateful to the noble Lord, Lord Kirkwood, for his acknowledgement that progress has been made in developing productive partnerships between industry and the science base. As I pointed out, the Technology Foresight exercise is just one of the factors that is taken into account; it is not the sole determinant. In many respects people are the main output of the science base. Therefore the main emphasis is on people—new graduates, post-graduates, post-doctoral researchers and permanent academic staff. Not only must we encourage the training and development of high quality scientists and engineers within that base, but we must also ensure that their expertise and skills are used to greatest effect by ensuring that there is an effective interaction with industry, commerce and other potential users. While this debate concerns the science and engineering base, I readily understand the powerful arguments that were advanced both by the noble Lord, Lord Quirk, as regards humanistic research, and, in much the same manner, by the noble Lord, Lord Sewel, who drew on the good example of Piper Alpha, and who pointed out what important lessons needed to be learnt from the Cullen Report and how they might be taken forward with further research. Research councils have traditionally worked closely with industry and have developed a range of initiatives designed both to establish links with their users and to promote the commercial exploitation of their research. The councils have established interdisciplinary research centres affording the opportunity for collaboration with industry and business in key technologies. They are active participants in the cross-departmental LINK scheme, and they have formed companies, either on their own or jointly with others, to exploit the potential of council research. These efforts are all important in building a partnership between the science base and industry but it was recognised that there was also a need to encourage academic researchers to seek industrial funding for strategic research, and hence to improve the interchange of ideas between the science base and industry. In order to fill this requirement, in 1993 the Realising Our Potential Awards (ROPA) were established. Under this scheme, researchers in receipt of industrial support for strategic research are eligible to apply for ROPA support for research of their own choosing. ROPAs are therefore responsive mode grants independent of industrial or research council priorities. These projects enable researchers to carry out blue-sky, curiosity driven research, as my noble friend Lord Clancarty, and the noble Lord, Lord Walton, sought. The excellence of the teams is determined by industry which may determine where it is prepared to spend its money, and thereby focus on high quality research teams. However, an indication of this different form of quality assurance is that in the ROPA rounds to date a higher proportion of ROPA awards are made to departments graded 4 or 5 by the research assessment exercise than for research councils' traditional responsive mode grant awards. Aside from the undoubted scientific value of the projects themselves, this award scheme encourages the cross-fertilisation of ideas and experience which is so vital in innovative science. Indeed, it may sidestep the oligarchy in science to which the noble Lord, Lord Winston, made reference. The Technology Foresight exercise identified research priorities, some of which are being taken forward by the Technology Foresight Challenge which was announced in May last year. Perhaps more importantly, it got people talking and has established valuable networks. The research councils have been given responsibility for monitoring challenge projects and for the payment of grants to consortia which will include industrial partners. They will, therefore, be directly involved in a scheme expressly designed to encourage new collaborations between academia and industry. I believe that the one specific area of research raised was that of BSE and the alleged relationship between BSE and CJD. I have to say to my noble friend Lord Canarvon that if he heard that reference yesterday, I regret to say that it has been made frequently on other programmes. I wish that I had some ability to control the BBC in making that unwarranted relationship at this time. However, noble Lords will appreciate that that power is not given to Ministers in the DTI. However, perhaps I may say to my noble friend Lord Selborne that the Department of Health, the Ministry of Agriculture and Fisheries, the BBSRC and MRC are consulting closely on what areas of research need support as part of a directed programme. Our planned government funding for BSE-CJD research in 1996–97 already totals some £10 million and the Department of Health has recently announced an extra £4.5 million. The noble Lord, Lord Walton, had some comment to offer on the reductions in the administrative staff of a number of the research councils. Clearly we do not wish to have an undue sum of money spent on unnecessary administration. I hope that that process has not gone so far that it has affected their work. But it is worth observing that every £50,000 saved on administration represents one more fully-funded, fully-equipped postdoctoral researcher. I conclude with a few observations on the move of the OST to the DTI. In opening, the noble Lord, Lord Walton, acknowledged that some of the greater suspicions at the time of the announcement may have been allayed to some extent. I hope that that process will continue. The President of the Board of Trade is an active advocate in the Cabinet for science. The Chief Scientific Adviser is still the adviser to the Prime Minister. His role goes beyond the DTI. Furthermore, his move to the DTI has not reduced his trans-departmental role. The noble Lord will be aware that the present adviser's immediate predecessor, Sir William Stewart, indicated that he did not consider that this move would be damaging. I hope that I have now spelt out where the Government stand. My noble friend Lord Peyton seemed to feel that he did not understand the Government's position. I hope that he now understands. Very considerable sums of public money are committed to basic or strategic research. We are not in a process of trying to attack that fund and put it towards applied science for the reasons that I have indicated. I very much hope that the value of the work of the research councils is understood. There is little doubt that it is appreciated within your Lordships' House. What concerns me more is that there may not be as clear an understanding of the value of that work in the wider world. I very much hope that one of the values of a debate such as this is that there will be a greater appreciation of the worth of the research undertaken.
5.25 p.m.
My Lords, I am deeply grateful to all noble Lords who have contributed to what has been an excellent debate with many outstanding and powerful contributions from all sides of the House. I wish again to congratulate my noble friend Lord Clancarty upon his outstanding maiden speech in which he drew our attention to some of the important interfaces between the arts, in which he himself works, and the sciences. It is, therefore, important that I should say how much I agree with what the noble Lord, Lord Quirk, said about the crucial importance of the humanities and related disciplines, and the part that they play in the development of cultural life in the United Kingdom.
The noble Earl, Lord Selborne, from his long and distinguished experience on the Select Committee on Science and Technology, stressed the crucial importance to the research councils of a period of stability. I cannot stress that point too strongly. The noble Lord, Lord Winston, spoke about accountability by the Medical Research Council and other research councils. It is crucially important to maintain that accountability in public life. The noble Lord, Lord Kirkwood, said that the primary objective of the work of the research councils is not wealth creation. But freedom in research is a fundamental right of all research workers within the constraints of the funding and other opportunities that the research councils provide. The noble Lord, Lord Desai, and the noble Lord, Lord Winston, had a minor disagreement on peer review. However, I wholly agree that, with all its defects, it is still the fundamental principle leading to the assessment of research grant proposals and one which I would defend to the utmost. When my noble friend Lord Carnarvon spoke of his experience on the Agricultural Research Council, and the problems of BSE, I could not help thinking how much we are all disturbed by some of the recent ill-informed publicity. I speak as a member of the working party which made the original recommendations to the ARC and the Department of Health in 1989. I am most grateful to the noble Lord, Lord Peyton, for his comments and support. He is cogent in saying that in our research programmes funded by these councils, we must not look for quick results from limited resources. Flexibility in research programmes and in the application of research resources are so important. The noble Lord, Lord Porter, gave us many excellent examples of the contributions made by British research workers. He drew our attention yet again to the often neglected Haldane principle that there is separate fundamental research on the one hand and the development, deployment and use of research results in short-term development in industry on the other; and the two must be separated. He pointed out with great authority, as a most distinguished Nobel Prize winner, the importance of British science, and how sad it is that the contributions of British scientists have not been recognised for a variety of reasons in the past few years. I am grateful to my noble friend Lord Halsbury, with whom I served on the MRC, for the cogent and wise comments he made based upon his long experience of research, administration and the development of research programmes in the United Kingdom. Speaking from the Opposition Front Bench, the noble Lord, Lord Peston, said that we are in danger of damaging the research council system beyond repair. I still believe that the system is highly regarded across the world, but the whole purpose of initiating this debate is to make it clear to the Government and to all those with responsibility that the position of our research councils must be preserved at all costs. I am grateful to the Minister for his careful and thoughtful reply. I am happy that he listened carefully to the strictures of the noble Lord, Lord Peyton, and did not indulge in ministerial cosmetic obfuscation in drawing to our attention some of the principles which inform government policy in relation to research. I am glad to have the Minister's assurance that the Government give the science budget and our science and engineering base a high priority. I hope that his colleagues will take careful note of the devastating effect of the transferred funds from the higher education funding councils to the research councils based upon the OST' s Cooper & Lybrand report, which requires attention. It is damaging the university system seriously. I trust that the Minister will be able to tell us that the Government have taken action in that regard. I was glad to hear the Minister say that the Government do not regard short-termism in the exploitation of research results as being a government objective. However, that is the message which I believe must be rammed home to the scientists, engineers and technologists of the country who at the moment believe that there is pressure from the Government upon the research councils to drive research in the direction of application and not of fundamental basic research which will fertilise future exploitation. We all warmly commend the Technology Foresight and ROPA programmes. We would be happier if the Chief Scientific Adviser were still in the Cabinet Office, but I accept the Minister's reassurance that he is still able to advise other government departments. I hope he will comment later, as he did not comment on the effect of the universities' capital funding cuts. They have run into serious danger of destabilising the relationship between the universities and the research councils. Finally, I believe that the message is this. Every special interest group wishes to see additional resources, and that we wholly accept. All we ask is that, as circumstances allow and, I hope, as recovery escalates, it is crucial to the future of the country that a greater proportion of national resource be devoted to the science and engineering base. That came out in all the speeches this afternoon. I end with the four "Cs": communication, consultation, collaboration, consensus. They are issues of fundamental importance. I remember chairing a working party on communication between doctors and other healthcare professionals. One social worker speaking to a doctor said: "I can't hear what you say while what you are rings so loudly in my ears". On another occasion, a hospital administrator said: "One of my duties is to serve the interests of 200 consultants, of whom 195 owe allegiance only to God and the other five do not even accept that jurisdiction". We appreciate that communication is a crucial problem and is important. There is a powerful perception in the research and scientific communities that the communication which used to be enjoyed between the Advisory Board for Research Councils upwards to Government and downwards to the research councils is not as clear. Those lines of communication and collaboration need to be much more clearly defined than they were. I beg leave to withdraw the Motion. Motion for Papers, by leave, withdrawn.Forensic Explosives Laboratory: Contaminated Equipment
5.33 p.m.
My Lords, with the leave of the House, I shall now repeat in the form of a Statement the Answer to a Private Notice Question which was asked in another place on the use of contaminated equipment at the Forensic Explosives Laboratory, Sevenoaks. The Statement is as follows: "As I explained yesterday in response to a Question from my right honourable friend from Beckenham, on 14th March 1996 a small amount of the explosive RDX, one of the main components of Semtex, was detected in a part of a centrifuge at the Forensic Explosives Laboratory. The Forensic Explosives Laboratory is part of the Ministry of Defence, Defence Evaluation and Research Agency but provides scientific support to the police and Crown Prosecution Service in cases involving the criminal use of explosives. One of the services that it provides involves the laboratory analysis of swab samples taken to determine the presence of explosives and the type involved. This 'trace' analysis involves a range of procedures, including the use in many cases of a centrifuge.
"The contamination involved not more than 30 micrograms, or 30 millionths of a gram of RDX. It was detected in a part of a laboratory centrifuge which was probably already contaminated on its arrival at the Forensic Explosives Laboratory in 1989. By normal standards, the amount of explosive detected was tiny; nevertheless, it should not have been there. "The contamination was discovered following one of the laboratory's weekly quality assurance exercises. As soon as it was discovered, work was stopped and the centrifuge was taken out of operational action. The Forensic Explosives Laboratory then instigated an immediate investigation into the source of the contamination and any implications there might be for casework samples. "As I told the House yesterday, all the information from this preliminary investigation was laid before the Government in a formal report. A copy of that report was placed in the Library yesterday. "There is a small theoretical possibility that casework samples showing RDX traces may have been affected by the centrifuge contamination. Regular quality assurance tests are undertaken by the laboratory. In addition, every time the laboratory examines a casework sample it also tests a control. Neither of these checks at any stage indicated RDX traces at a level which would suggest that casework samples are likely to have been contaminated. "But further investigations are required to determine precisely how the incident occurred and what the implications are for the criminal cases involving RDX in which evidence was submitted by the Forensic Explosives Laboratory. That is why my right honourable friend the Secretary of State for Defence and I agreed that an independent review should be established to look into these matters. As I explained to the House yesterday, the terms of reference of this review will be: to report on the general likelihood of contamination being spread from the centrifuge to samples in the laboratory; to examine Forensic Explosives Laboratory papers on all cases in which RDX traces were found and a criminal conviction resulted and assess the likelihood of contamination; and to examine the laboratory procedures in the trace laboratory and make recommendations. "As the House knows, I have invited Professor Brian Caddy to undertake this review. Professor Caddy is Professor of Forensic Science at Strathclyde University and is a renowned expert in the field of trace explosives. He was involved in the appeal cases of the Birmingham Six on behalf of the appellants and advised the Maguire family for the May inquiry. "Professor Caddy will report to me in the first instance, but the results and recommendations of his review will be made public and I will, of course, bring his findings to the House. In advance of that, as soon as a definitive list has been established and agreed with Professor Caddy, the representatives of those whose cases involved an RDX trace and resulted in a conviction will be notified. As I indicated yesterday, on present information it is thought about a dozen cases could be involved. "I will consider in the light of Professor Caddy's report whether particular cases should be referred to the Court of Appeal. If any case is referred to the Court of Appeal, it will then be for the court to weigh the evidence and decide how to proceed. "From the information presently available to me, it would appear that the risk of contamination is small, but in a matter of this importance and sensitivity I am determined to act only on the basis of the most rigorous and independent scientific assessments. As I have already said, I will keep the House fully informed of the outcome of Professor Caddy's review and the measures which flow from it. It would be quite wrong to leap to assumptions about any case until we have the clear scientific evidence on which to base proper decisions. "I hope that the House will recognise that in the regrettable circumstances of this incident the Government have taken every proper measure to deal with the consequences." My Lords, that concludes the Statement.5.40 p.m.
My Lords, I am grateful to the Minister for repeating the Home Secretary's Statement made in another place. However, it seems unfortunate that this information was first given in the form of a response to a Written Question and also that, as I understand it, briefing to the press began before that Written Question appeared in the House.
The Statement is disturbing since it affects the convictions of a number of terrorists. Quite clearly, it would have been courteous to make it verbally to both Houses of Parliament in the first instance. It is tragic that the sustained efforts of many police officers, lawyers and witnesses that have secured the convictions of a number of terrorists may have been placed in jeopardy. It would also be tragic were it to be found that innocent people had been convicted and served prison sentences. In either case, public confidence will have been shaken and the morale of police investigators severely damaged. Three years ago I was a member of the Select Committee chaired by the noble Lord, Lord Dainton, which examined the working of the Forensic Science Service. As part of that investigation we visited the explosives laboratory at Halstead, although technically that was outside the remit of our investigation. On the whole, we were reassured by what we found in the Forensic Science Service. However, we were concerned about, in particular, the poor communication that existed between lawyers and scientists, who quite clearly spoke different languages, and also between scientists and politicians and the Home Office. This House contains many distinguished scientists. As the Minister said in a previous debate, it is often better informed than is the other place. Therefore, one of the important recommendations made in the report of the Select Committee was that a forensic science advisory board should be established to advise the Home Secretary on matters relating to forensic science. It is very much to be regretted that such a board has not been set up. It could have advised the Home Secretary on basic good housekeeping practices, which would presumably have included regular checks on all the equipment involved in testing for traces of explosives. It is extremely difficult to understand how a second-hand centrifuge that has been at Halstead since 1989 was not thoroughly cleaned and tested on arrival and why it has not been thoroughly checked since then. Another of our concerns was the difficulty for the defence of obtaining independent forensic evidence. One of our recommendations was that the Metropolitan Police laboratory should remain separate from the rest of the Forensic Science Service so that to some extent there would be some sort of "Chinese wall" between different parts of the Forensic Science Service, and the defence would be able to obtain independent evidence and would be able to have traces of Semtex and so on checked for. We welcome the appointment of Professor Caddy to examine these matters, and have every confidence in his ability to pursue them with great rigour and to report to the Home Secretary appropriately. It is very important that he should report within a limited timescale. There may well be innocent people in prison; or, on the other hand, the confidence of police officers who investigate terrorist outrages will be undermined if the investigation is excessively prolonged. I would welcome some indication from the Minister as to the timescale in which she expects Professor Caddy to report, so that public anxiety can be allayed and confidence in the criminal justice system can be restored.My Lords, like the noble Baroness, Lady Hilton, I thank the Minister for repeating the Statement. Like the noble Baroness, also, I find it almost incomprehensible that Ministers were not frank with the House yesterday rather than being dragged down here as a result of a Private Notice Question in the House of Commons. That is simply no way to treat a matter of this degree of seriousness.
Apparently the press was informed some time between 3.15 and 3.30 yesterday afternoon—at about the time when a Statement should have been made in both Houses. That demonstrates a remarkable lack of judgment in dealing with a matter of critical importance to the system of criminal justice in this country. Is the Minister aware that the revelations that have now been made inflict further damage on our criminal justice system? Certainly I welcome the independent inquiry under Professor Caddy, a man of immense reputation. But how could such a situation arise, as it has on this occasion, after so many well publicised miscarriages of justice relating to forensic science evidence in the past? That is the point that I find the most difficult to understand. Like the noble Baroness, Lady Hilton, I find it surprising that after the failures of the past which led to the appointment of the Royal Commission under the noble Viscount, Lord Runciman, the Government ignored the recommendation of that commission, of the Science and Technology Committee of this House and of the Royal Society for Chemistry that a forensic science advisory committee should be set up which would report to the Home Secretary on the performance and efficiency of the forensic science laboratories. Once again, the Government have demonstrated their indifference to independent, expert advice. Are they now prepared to admit, after this deeply regrettable error, that they have erred and that they will now appoint the committee that the Royal Commission recommended? Is the Minister aware that the only people who are celebrating today are the IRA? Does she appreciate the sense of incomprehension among the general public that such a situation has been allowed to arise and, to take up a point made by the noble Baroness, Lady Hilton, the indignation among many operational police officers, who may face the prospect of seeing their dedicated work in the investigation of serious crime swept aside because of this disgraceful episode of incompetence?My Lords, I thank the noble Baroness. While recording her reservations for the purposes of this debate, she nevertheless made very measured and constructive comments. I should like to take up some of those points. I am afraid that I cannot say the same for the noble Lord, Lord Hams of Greenwich. The noble Lord has made the mistake of presuming incompetence before Professor Caddy has even undertaken his work. We should not in this House prejudge the outcome of the investigation of this eminent scientist.
As soon as the contamination was discovered in the explosive trace laboratory, work was stopped, the centrifuge was taken out of action and the Forensic Explosives Laboratory then instigated an immediate investigation into the source of the contamination and the implications there might be for casework samples. The report was formally submitted to the Home Office on 25th April. My right honourable friend the Home Secretary lost absolutely no time in doing what anybody in his position would have done; namely, to make sure that there was a proper investigation, that that investigation should leave no stone unturned, that it should report fully and that the results of that report should be made public in both Houses. The press was not briefed before the House was informed. It was not briefed between 3.15 and 3.30 yesterday. It was after the House received written notice that the press was given an opportunity to ask any questions it wished to ask, and it was given answers to those questions. But there was no discourtesy to either House. The report was laid before both Houses and was placed in the Library of both Houses. There was no oral statement for very good reasons. The full facts and the action being taken were set out in the Written Answer. As I said, the laboratory report on the incident was placed in the Library. Until we have Professor Caddy's report, there is absolutely no profit in speculating or second-guessing what may or may not have happened. It is better to have the considered view of a scientist. It is important that, when the review is completed, the House should be informed of its findings. The Home Secretary will make sure that that is the case. A point was made about the recommendation that there should be an overseeing, overarching body. It is important to report for the purposes of this debate that there is a United Kingdom forensic science liaison group. The group came together to draft the code of practice that is in place. The noble Baroness referred to being impressed by the way in which the code of practice is working in the laboratories. Indeed, the head of that laboratory was a member of the liaison group which drew up the code of practice. Secondly, there is the United Kingdom National Measurement Accreditation Scheme (known to many as NaMAS). It acts as an external auditor. It visits and revisits the laboratories on a six-monthly basis. It tests the systems and puts the laboratory through a fairly rigorous exercise before offering accreditation to those laboratories. That is a form of external audit which is very important and is, one might say, a monitor of standards. The British Standards Institute also has a role. So there is still some question mark over quite what the nature of any overarching body would be. I was asked by the noble Baroness about the time-scale within which Professor Caddy is likely to report. He intends to come to the Home Office tomorrow to talk about how he will set about the work. As to how long he will take, we hope that he will do it as speedily as possible. But it must be a full and thorough review. It will take as long as he needs to take. The noble Lord, Lord Harris of Greenwich, referred again to the role of the Commission and the Forensic Science Advisory Council's recommendation to provide external over-sight. I have referred to that a little, but perhaps I may make one more comment on it. The existence of such a council would not have prevented an error of that kind. One can never totally rule out errors of that kind. External over-sight of the main public sector bodies in forensic science is already provided by NaMAS and, of course, by the British Standards Institute. The Government's interim response to the Royal Commission, published in February 1994, explained that the Government were looking very carefully at the proposal for an advisory council but would need to take account of a number of reviews under way at the time. Those are now concluded. The Government will publish its final response to the report in due course, setting out their views and bringing together various legislative and other steps that have been taken or are intended to give effect to the Royal Commission's recommendations. It must also be said that it is just possible that Professor Caddy himself will have something to say on the matter. We look forward to hearing anything that he may have to say. The noble Lord, Lord Harris of Greenwich, said that the revelations inflict further damage on the system. It goes without saying that this is a serious situation. It is bound of its very nature to dent confidence. But it would have dented confidence even more to have delayed putting an investigation in place and making sure that it would be carried out by an eminent scientist, one in whom I believe we all have confidence. That I believe will do more to restore public confidence. But there is no doubt that public confidence is an issue and I believe that Professor Caddy's work will go a long way to make sure that it is restored.5.52 p.m.
My Lords, will my noble friend accept that many on this side of the House are grateful for the Statement and the fact that an independent inquiry is to be set up, not least as a way of giving reassurance to police, lawyers and others who have been involved in those cases and who must feel, as has been pointed out, that their work might have been undermined? Does she agree that many noble Lords who have listened to the Statement and have read the newspapers would not, as she herself suggested, accept that, had there been some kind of overarching body, it could possibly have found out that a piece of machinery was not working properly any more than my right honourable friend the Home Secretary or any Government Minister could have found it out? After all, it is not their job to test those kind of things. Were they involved in that kind of detail, they would not be able to do the many things that they should be doing. Will she accept that it is very important that the inquiry that takes place should address its questions to the people who are responsible?
My Lords, I am grateful to my noble friend for those remarks. Some of the things that we have read have been quite extraordinary. We should not be surprised at what we have read about this incident. We have come to expect hysterical responses. But there have been some very irresponsible parliamentary responses from members of the Opposition, in particular members of the Liberal Democratic Party, about this matter.
My right honourable friend has done what he should have done. An incident has been revealed to him. He has set in place an investigation. He has appointed an eminent scientist to oversee it. He will not rest until he knows what has happened and he accounts to Parliament precisely for what has happened, indicating the steps that should be taken and what should be learnt from it.My Lords, perhaps I may commend the appointment of Professor Caddy not only because of his eminence scientifically but because he was involved in some of the earlier appeal cases against miscarriages of justice with which I was associated. Nevertheless, I agree with the noble Lord, Lord Harris, that in the Home Office there is sometimes no way out. One has to face Parliament. It is better to do it earlier than later because, given the propensity to exaggerate, that sometimes makes the situation a good deal worse.
Perhaps I may put one question. What is the significance of the date 1989? Does it mean that any cases before that date have to be resurrected because of what may be discovered? Is it a firm date or is it the date when the machine came into use?My Lords, the noble Lord speaks from experience, having been in the hot seat at the Home Office. He will know that the primary duty of the Home Secretary in such a situation is to see that answers are sought and that information flows freely back to Parliament, to which any Home Secretary would be accountable. I am grateful to him for those remarks.
The year 1989 is significant because the piece of equipment which has been seen to be contaminated was brought into use in 1989 in that particular laboratory. My understanding is that it was on the site at Halstead but being used by another department. As it was moved as a piece of equipment from one department into this particular laboratory, it cannot be guaranteed that it was not contaminated on entry.My Lord, I hesitate to say thank you to the Minister for repeating the Statement. The whole business calls into question three different areas, if I may so put it.
The first is the way in which this Government treat Parliament. I think that is very significant. I heard yesterday on the grapevine that the press had been briefed yesterday afternoon. This morning I saw reports in the newspapers. Also this morning I read in yesterday's Hansard (it was delivered today) the Written Answer which effectively gave the information. My understanding is that it was information that was available only today rather than yesterday. It may be that the procedures and paperwork relating to the other place are rather different from those in this Chamber, but in terms of the Government informing this House, effectively we received the information a day late. So there is a question mark about the—I would put it as contempt in which this Government hold Parliament. The second problem is the calling into question of the scientific basis of a very delicate area of our criminal justice system. It has been said before that it is amazing that such a situation should develop, given the previous difficulties and miscarriages of justice that came about as a result of precisely scientific efforts in this particular area. So the scientific basis for the forensic science part of the criminal justice system is being brought into question. The third problem is that it calls into question the very basis of our whole scientific community. Bearing in mind that we are currently dealing with a major scientific bombshell in the shape of BSE, the calling into question of the ability of our scientific community to operate satisfactorily that this situation has raised is very unfortunate. It is very unfortunate that this whole situation appears to stem from the Government's inability to appreciate the seriousness of matters with which they are faced.My Lords, I find that statement utterly preposterous.
Hear, hear!
My Lords, I do not believe that I have heard such a preposterous statement in this House for a long time. The noble Lord extrapolates from an incident in a laboratory that we call into question the whole of the criminal justice system and the whole of the scientific basis of this country. The noble Lord should think again about what he said.
In relation to the argument that we have treated Parliament with contempt, I can say that as soon as was possible my right honourable friend put before both Houses a full written Statement. He could say no more because what the House is interested in is what happened, how it happened, what lessons can be learnt and where we go from here. That can be answered only when we have seen the work of Professor Caddy. That is why an oral Question yesterday would not have furthered the Statement put before the House. I have already made clear that there was no briefing of the press before the Statement was put before both Houses. I hope therefore that the noble Lord will think again. We have a fine criminal justice system, a fine forensic science service and a very fine scientific body of work going on in this country. I do not believe that this one incident calls all of that into question.The Mentally Ill: Care In The Community
6.1 p.m.
rose to call attention to the situation of the mentally ill under the care in the community programme, especially those requiring 24-hour nursed residential care; and to move for Papers.
The noble Lord said: My Lords, I framed this Motion to give an opportunity to take stock. The community care scheme has now been in effective operation for three years. The Griffiths Report was published in 1988; implementation was postponed from 1991 to 1993 and a new edifice has been or is being built. As with all large edifices, it could not be completed overnight. The building had to be occupied before it was fully finished and the work of completion and improvement is still going on. I hope that the Minister will regard any critical contributions this afternoon as intended to be constructive. Care of the mentally ill is not a party issue.
We gratefully acknowledge the fundamental transfer of emphasis from segregation in the vast old institutions to a network of services designed to integrate patients into their local communities, as far as possible linked to families and friends, for which the Government are responsible. But, as Sir Roy Griffiths indicated, there are inevitably problems and frictions where responsibility is divided. The Government must retain responsibility for health treatment as such; but local authorities are best qualified to provide most of the supporting services—accommodation and so forth. And many local authorities, as has been so vividly illustrated in some of the reports published in the past two years, had little or no familiarity with the needs of the mentally ill until five years ago.
A thick fog of ignorance and inertia of both councillors and officials had to be penetrated and replaced with enthusiastic interest and commitment. There is a limit to the extent that, after devolution of responsibility, departments can intervene beyond guidance, encouragement and funding. Much progress has been made on which the Government and local authorities deserve congratulation. But, as Ministers would be the first to acknowledge, much remains to be done before community care becomes a reality throughout the whole country, especially for the seriously ill.
I hope that, after three years, it is timely to take stock. The Motion does not embrace the whole constituency of community care. The Motion of the noble Lord, Lord Carter, in 1992 covered the whole field—the needs of the aged, the disabled and the handicapped, as well as the mentally ill. It is the latter alone with whom we are concerned today.
A vast number of sufferers, estimated at some 250,000 (and to those one must add the carers who bear such burdens and have such pain) form a huge segment of society. Most noble Lords have had some personal experience of the immense burden that this scourge inflicts. It is reassuring that some 25 per cent. of sufferers eventually, after a first attack, recover. But most relapse frequently and I understand that between 10 and 15 per cent. are permanently and gravely ill.
In the past year many different facets of the problem have been discussed in our debates on legislation and in Questions. Latterly, the main concern has inevitably been about homicides. Sensationalised by the media, they have given the public an entirely false impression of the prevalence of violence among schizophrenics. I am advised that aggression and violence are not symptoms of the illness as such. But negative coverage has increased the prejudice and anxieties of the public about relations with the mentally ill and that of course has been reflected in resistance to the opening of facilities in residential areas and generally tends to add to the difficulties of carers and professionals. The mentally ill need sympathy and inclusion in social life.
An important new recent development has been the improvement of drugs on which treatment largely depends. I am told that clozapine and risperdal apparently have much enhanced efficacy and have far fewer harmful side effects. But they are extremely expensive. There is evidence that fundholders responsible for budgets are resorting to rationing of the new drugs to save money. That is a problem that needs to be addressed. If the new drugs clear up the symptoms, they will save money on future treatment and be cost effective, as has apparently proved to be the case in Germany. Is this a matter that the Royal College of Psychiatrists can clarify?
The Government have taken many helpful new initiatives in the past three years. The most important recently has been the decision to provide additional nursed residential accommodation for 5,000 seriously ill patients. There have, as we well know, been repeated reassurances that the closure of old hospitals was being matched by modern replacements, but many of us have felt that in the real world this has often not been experienced. We welcome the new decision but a number of questions arise. Are the new units going to be of the required high standard? There is a graded scale of the degree of supervision, nursing, security, recreation, employment opportunities and so on that residential homes and hospitals require. It is above all important that they should not be too large. I believe the optimum for therapy is said to be 10 to 12 beds with ample sitting rooms and private gardens—all very expensive in terms of both staff and buildings. What is the timetable to be?
At present, closures are, I understand, continuing to proceed apace at the rate of some 4,000 to 5,000 beds a year. How long then will it be before the new nursed residential units are open? Surely there should be a moratorium on closures in any area in which there will not be replacement beds with nursing and medical services. I, for my part, have never been able to understand why the Government have been so inflexible on accelerating closures. Questions in both Houses of Parliament have signally failed ever to get a clear explanation. I must say that the absence of replies suggests to the uninitiated that the programme is dictated by prejudice against the old institutions.
All of us who have visited the old hospitals to see patients in them have initially been horrified by their awful appearance. That seems to dominate the perception of their quality—a quite different thing. I shared the initial reaction but I revised it. In spite of the forbidding old buildings and the isolation from the community which we deplore, these hospitals have provided, in the absence of suitable alternatives, good care, excellent treatment with all the skills available on the spot, companionship, decent food and a sense of protection. They can indeed come to be regarded as a home from home. No doubt there are difficulties in adjusting timetables but patients' care should not be subordinated to bureaucratic inertia.
The excellent reports on the successive homicides have vividly illustrated the dangers of discharge when there are no adequate services to take their place. But there is heavy pressure to discharge too early, especially in London and the big cities. Again, patients requiring beds and treatment are turned away because there is no room. I have illustrations of this which I shall not quote as I have not time.
A related problem of accommodation is the quality of the private sector homes. Some of your Lordships will have seen a rather sensational "Panorama" programme—not the first sensational programme by "Panorama". I do not necessarily suppose that this is a fair representation of what goes on generally in the private sector, but it indicates that there are cowboys about exploiting the taxpayers' readiness to fund residential accommodation and disregarding the responsibilities that go with the provision. The Audit Commission in 1994 found that no district surveyed had an adequate range of community services. There is a great problem of co-ordination. This is a problem that all concerned have to continue to address.
We much look forward to the maiden speeches of two contributors tonight. We shall be greatly interested in what they have to tell us. My Lords, I beg to move for Papers.
6.17 p.m.
My Lords, may I express an interest in the care and nursing of the sick? As a nurse I followed in the footsteps of my mother, Vera Tyrwhitt. She inherited the Berners Title but she did not take her seat. She trained as a nurse at Guy's Hospital in the 1920s, and died only four years ago at the age of 90. I trained in general nursing at the Radcliffe Infirmary, Oxford, just as penicillin was first being used on the wards. I think the skills at administering injections of antibiotics left much to be desired from the patient's point of view. I well remember one of my patients escaping through a window one night as the four-hourly dose-time approached. We just managed to prevent him from disappearing down the Woodstock Road.
What a huge change there has been in the various treatments and codes of practice in the nursing profession, not only since my mother's day but also from my day. It is quite staggering. Doubtless many changes came about due to the experiences and expediencies of the war. There has been vast funding and investment in research and in training for new disciplines to serve different concepts of treatment. There are special codes of practice for transplants, scans and high technology in every field of medicine—and certainly no more just bed rest. Since my days of nursing many more skills are needed by nurses, so Project 2000 was devised to provide facilities to study for these new skills up to graduate standard. Many jobs previously done by junior doctors are now done by these nurses. Those who have the love of nursing in their blood but do not want university qualifications are happy to back up these skilled graduate nurses and they join the profession as health care assistants. A vast array of these people are needed not only in the hospitals but also for the delivery of the various packages put together for care in the community. This much-valued policy is for looking after people in their own homes where they are in familiar surroundings and can keep to their own routines as much as possible. This promotes the patient's own ability to stay the course with a little—or in some cases a lot—of help from nurses and friends. I am sure that this is also applicable to the mentally ill in a great many cases. Memories and hearsay of those large institutions where people with every kind of mental illness were housed, often for life, in the first place, were necessary then. There was less effective treatment to control or cure their conditions. This is a thing of the past. There are, of course, some people for whom secure accommodation is very necessary, like those who are known to be dangerous either to others or to themselves. Places for these patients do exist, as they do for the 24-hour nursing care for Alzheimer's patients and the demented. I live near a very new unit for the acute mentally ill, built and run by the East Gloucestershire Health Trust. It also has a special assessment centre that sorts out, by careful tests, what would be the best on-going arrangements and treatments for people who are sent to it by hospitals and the general practitioners. In the same complex is an excellent, recently extended long-term care unit and convalescent hospital where my mother helped out for a while when they first moved to Cheltenham in the 1960s. There are other places in Gloucestershire where help and support can be found, such as mental health resources centres. There are four of these fully staffed and working in conjunction with general practitioners and social services where people with mental problems can find understanding and sympathy together with professional help and advice. I have a friend who works at an organic garden project in the Stroud valley that takes many young men and women with learning difficulties who come there from local hostels and homes. This project gives them, among other things, an interest—or fosters one that they already have—for growing things, looking after domestic animals and for the countryside. Bee-keeping and art are also practised there. They have a shop which they stock from the garden where they can learn to handle money. They do have little problems now and again—like someone pulling up the week's supply of lettuces in a fit of pique at having to weed them—but this sort of enterprise in the community gives to an otherwise pointless and empty life something worthwhile to do and look forward to. It develops useful skills and involves them with people in everyday life. So we are looking with hope and optimism to the future, but as we live in an imperfect world we do not see perfection yet. We must be vigilant and not complacent. The old instincts of cruelty and mistreatments, brought about by man's imperfections, must be watched for and condemned. I have spoken of these huge changes during the past century, but what has not changed is the dedication and compassion of men and women who continue to nurse and care for us.6.24 p.m.
My Lords, I am very grateful indeed to the noble Lord, Lord Thurlow, for initiating this debate on such a crucially important subject. I congratulate the noble Baroness, Lady Berners, on her excellent contribution to the debate. I assure her that the Radcliffe Infirmary is still an excellent hospital. It is very good that the noble Baroness will be able to bring her long practical experience to debates in this House. We look forward to hearing her again.
In the early 1960s as part of my training for Ordination I had the good fortune to work, under trained supervision, in a large mental hospital. Many of the patients had been there 10, 20, 30 or more years. They had become institutionalised. Against that background, the concept of care in the community is to be most warmly encouraged and welcomed. In 1955, there were more than 150,000 people in mental hospitals; now there are about 50,000. Because of changing attitudes to mental illness, increased levels of care and the advent of better drugs, many people are now living in the community who once would have been hospitalised and institutionalised. It is good that they are in the community and not outside it. It is good that as a society we recognise the need for care towards them by the community in which they live. That said, it is crucial to recognise that we will continue to need psychiatric beds for people who are acutely ill. There are people who are a danger to themselves and to others. They need to be protected both from themselves and from those who might take advantage of them. The public needs to be protected from them. But there is at the moment an acute shortage of psychiatric beds. Recently people who have needed admission to a psychiatric unit in Oxford have had to travel as far as Stafford. Conversely, there have been occasions when people who have lived as far away as Greenwich have had to come to Oxford for the nearest vacant hospital bed in a psychiatric unit. When we consider how much those who are mentally ill need the support of their family and friends, such distances are quite unacceptable. Most of these acutely ill people will eventually recover enough to return to the community. When they do they will continue to need, for their own sake and for the sake of others, skilled care. They may also need for a period to be in special accommodation offering supervision as well as care. It is vital that the resources to offer that care are in place, that there are clear lines of responsibility and accountability for offering it and close co-operation between the different agencies involved. Alas, we know through a number of highly publicised cases recently that that has not always been the case. Jayne Zito, whose husband was murdered by Christopher Clunis, Sandra Sullivan and Wendy Robinson, both of whom lost their daughters, and Jane Newby, grandmother of Jonathan Newby who was murdered, are just some of those who have come together in the Zito Trust to try to ensure that these tragedies that they have experienced personally do not happen again. Even more recently, however, we have had the case of Darren Carr, a psychopath who was discharged from hospital and who ended up burning a mother and her two children to death. In the words of the Buchanan inquiry into an earlier case, discharging a person time after time is simply,Two other aspects of these tragedies should not be overlooked. The publicity can engender a fear of mentally ill people which is totally unwarranted, as the noble Lord, Lord Thurlow, quite rightly emphasised. Furthermore, they call into question and undermine the whole concept of care in the community. In fact, it is unlikely that the number of murders committed by mentally ill people now is any greater than it was at times in the past; but, understandably, the publicity which such cases are given underlines the need for better provision. I emphasise again as strongly as I can that care in the community is a thoroughly worthwhile concept and it must be made to work. It wants people to be in the community, taking responsibility for their lives so far as they can. But for it to work the ideals behind it must be met. Those goals and standards are well set out in the community care plan for Oxfordshire, just to take one example where these words are written. First, there must be a systematic assessment of health and social care needs; secondly, nomination of a key worker to co-ordinate the package of care offered to the client; thirdly, a written care plan; fourthly, regular review of need; fifthly, inter-agency and inter-professional collaboration and care planning; sixthly, consultation with users and carers; and, seventhly, effective co-ordination of packages of care to support individuals in the county. It adds that care management is to be fully integrated into the care programme so that people will have only one key worker, and full joint paperwork is planned. The question is whether those excellent standards are being met and whether there are the resources available to meet them. Mental illness is not a marginal problem in our society. To take just one example, Oxfordshire has a population of 372,300 people aged between 18 and 65; 1,514 of those are expected to suffer from a functional psychosis, which means admittance to hospital, at least on some occasions. The total number of people suffering from mental problems of one kind or another is 55,890. That means that one in seven of the population is likely to be affected at one time or another. Among that large number of people there is one particular group to whom I should like to draw attention. I refer to the mentally ill among the homeless. A very high percentage of homeless people suffer from mental illness of one kind or another. Furthermore, an extraordinarily high percentage of people who are discharged from psychiatric units have nowhere to live; they are homeless. What more can be done to help that particularly vulnerable group of people? The Health Advisory Service report, People Who Are Homeless, pointed out that 60 per cent. of homeless people do not know where to seek help on health matters. They view health as a low priority, fear discrimination if they try to register with GPs and move frequently. Making mental health services accessible to the homeless, a high percentage of whom need them, is a continuing problem. The wording of the Motion refers especially to people requiring 24-hour nursed residential care—that is, those who need long-term close supervision as well as care for up to 10 years. I find, both locally and from organisations like MIND, that there is a great deal of uncertainty about what this actually involves. It is not clear whether some of the people living in the 24-hour nursing residential places will be detained under the Mental Health Act 1983, nor how 24-hour nursed care will differ from hospital provision. There is also the further question of how this provision for 24-hour nursing care fits into the philosophy of care in the community which aims to prepare the residents for returning to live in the community and which therefore helps them to develop life skills. I know that many people will be looking to the Minister for further clarification on a number of points, as well as the assurance that such 24-hour nursed care for people with severe and enduring mental illness will not run counter to the care in the community programme. I am also somewhat sceptical about whether the policy is financially feasible. Small homes for between eight and 20 people—ideally for 12 people—are being planned. On the Government's own estimate, there is a need for something like 5,000 places of that kind, which means more than 400 such homes. The cost of building them—let alone running them—will be very high. One wonders whether there is the political will to overcome those difficulties. I only hope that those difficulties will not detract from other priorities. As I have already mentioned, there is a need for more beds in already established psychiatric units. When someone is taken acutely ill with a psychotic illness, that person needs prompt admission to a hospital in the locality and skilled medical attention. The great blessing today is that the majority of people afflicted in that way can, with prompt skilled attention, recover and return to their own home. But they may very well need continued care along the lines of the admirable guidelines to which I referred earlier. Then there are those, a large number of whom (although no danger to themselves and others, except through neglect) need continuing support, perhaps through a hostel or warden-assisted accommodation. They too need the benefits of community care. It may be that if there are more beds in psychiatric units, and if community care achieves the standards it has set for itself, the need for 24-hour nursed residential care will be less than is predicted. I hope so—for none of us can relish the thought of people being in a new form of asylum for up to 10 years. Such homes, offering 24-hour nursed residential care, may prove a valuable component of the total spectrum of care in the community, but fewer such homes will be needed if there are adequate beds in psychiatric units and if the other components of care in the community are in place and working properly. The ideal on which care in the community is based is thoroughly good. The directives which have been sent out recently, together with the care plans which have been drawn up by many authorities and the recommendations arising from inquiries into recent tragedies, have highlighted the practical steps that are necessary to ensure that skilled and professional care is, indeed, offered. But resources are needed for that. If severely mentally ill people are to receive the supervision and skilled medical care that they need and if all those suffering from mental health problems are to receive the help that they need, there must be enough skilled, trained personnel to do the task, as well as enough appropriate accommodation."an offence waiting to happen".
6.35 p.m.
My Lords, it is a privilege to take part in a debate initiated by the noble Lord, Lord Thurlow. I cannot help reflecting on the fact that the replies from the three Front Benches are to be made by three noble Baronesses and that we have just heard from another noble Baroness making her maiden speech. The wisdom of women is thus strongly represented. When one thinks that this House resisted the membership of women for 40 years after their arrival in the Commons—even then only four were allowed in—one realises that we are very lucky to live in this age and not earlier.
I must take this opportunity to congratulate the noble Baroness, Lady Berners, on her maiden speech. I always feel humbled when I hear a former nurse speaking in this House. The noble Baroness, Lady Cox, usually sits close to the place occupied by the noble Baroness, and the noble Baroness, Lady Cumberlege, is to reply on behalf of the Government. If one goes round like I do, poking my nose into all sorts of awkward situations, one realises how very much easier it is to do that than to work in a hospital, to see the job through and to do that job for, say, 24 hours a day. I salute the noble Baroness and all nurses. When I heard the right reverend Prelate the Bishop of Oxford deliver his expert address, my mind went back to my time in Oxford when I was a councillor for Cowley. I had already become interested in prisoners. When one young man, an arsonist, was convicted he was sometimes sent to prison and sometimes to Littlemoor Hospital. From that moment onwards—that happened over 50 years ago—I realised the extraordinary and delicate line that has to be drawn between illness and crime. I rise tonight to put one simple question, of which I have given notice, to the noble Baroness, Lady Cumberlege, who is probably better qualified to speak on these matters than any health spokesman in my time in this House. I hope that that compliment will soften her heart and ensure the right kind of response from her. I know that it would if the noble Baroness were in total command of the situation, but she is part of a government team. Some time ago— during the war in fact—Mr. Duff Cooper, then Minister of Information, told the public that if they heard any defeatist talk they were to go up to the person in question and ask, "Are you a paid or unpaid agent of Hitler?" In the past I have been inclined to say that I was neither a paid nor an unpaid agent of the Matthew Trust. Now that I have had the great honour of becoming its president, I suppose that it is appropriate to say that I am an unpaid agent of the Matthew Trust. However, I do not rise tonight only to speak on behalf of the Matthew Trust. The Matthew Trust was begun—and has always been inspired by—Mr. Peter Thompson, a remarkable man. He left Broadmoor with nothing in the world except the discredit which in those days came from being in Broadmoor. He has built up the Matthew Trust to its present great performance. I speak today not only of the Matthew Trust, which is a medium-size organisation, and the work it has done for ex-mental patients, but many smaller organisations. Peter Thompson of the Matthew Trust has taken the initiative in starting a federation of smaller mental health organisations. Preliminary meetings have already taken place, and they are on the way to formation. The only reason I rise tonight is to ask the Government whether they are ready to recognise and encourage in the most appropriate fashion this new federation. I refer to a leading member of a small organisation called Consumer Forum. He was at Eton. That counts in his favour in my mind; but I hope that it does not count against him in anyone else's mind. That old Etonian found things difficult for a time but, like Peter Thompson, he rose above it all. Currently, he and a colleague see 50 ex-mental patients per day. That is just one example of the work of these smaller organisations. Already 160 of them are interested in the federation. I am told that there are at least as many who are waiting to be asked to join. I put to the noble Baroness the simple question: are the Government ready to back the federation of smaller mental health organisations not only by word but by deed?
6.42 p.m.
My Lords, it is a great honour to be able to speak in your Lordships' House, particularly on a subject of such great importance and one so close to my heart. I do so for the first time with great diffidence. In a mental illness survey in 1994 95 per cent. of the general population agreed with the statement that,
I fully agree. Anyone who has grappled with the issue of how best to care for someone who is seriously mentally ill—in particular, whether or not to commit that person to full-time care outside the home—knows what a complex matter it is. My first experience of this issue arose at a relatively early age when I was asked to commit my late father. On a rather lighter note, some years ago I visited two cousins who were both in the same institution. I asked the guard whether I could have two passes to see them at the same time. He said that I could not and I had to see one, exit and then return. By the time I exited a different guard was on duty. He asked whether I had just been in and I said yes. He asked whom I had come to see and I told him. Then he asked whether I was a relative, to which I said yes. He looked at me and said, "Sir, have you ever been with us?" I count myself extremely fortunate to be living in an era when changes in attitudes towards mental health and advances in medicine have combined to produce a more hopeful picture for sufferers and their companions. I speak from my experience of having seen the quality of life of those close to me improve dramatically following treatment, and my experience in business where incapacitated employees have returned to productive work. On the negative side, the dramatic effect of costs in this area was made clear to me several years ago in the United States where I was running a business. In that year the healthcare costs of that business formed the expense category with the largest growth (approximately 40 per cent.). The largest growth segment in that category was the mental healthcare cost for employees and their families. We believed that one of the best ways to recoup the expense was to provide treatment to restore worker productivity. It is hoped that for sufferers of serious mental illness the days of being consigned to the "bin" are over. Recently, I was told by a well respected professional in the healthcare field that 95 per cent. of cases relegated to care in asylums 30 years ago could now be treated and those people could hope to lead productive lives in society outside hospitals. That is good news. The shift from old hospitals to the new programme of integration into the community is both welcome and warranted. Not only is that possible due to advances in treatment, but it holds the promise of lower expenditure. Recent experience in the United States indicates that long-term hospitalisation is approximately four times as expensive as home group living, and that living in a productive community can further reduce costs. I hope that we can also have that experience here. A major issue today is: what is the quality of the care that is being provided in the community? I suggest that during the transition from the old system to the new several areas deserve greater focus. The first is the creation of supportive communities. The care programme approach adopted in 1990 had as its aim,"we have a responsibility to provide the best possible care for people with mental illness".
I respectfully suggest that there may be an error in logic, in that a key assumption is that a "community" exists. The truth is that for many patients who are released into the community a network of family members, neighbours, religious organisations and others with the wherewithal to support these people does not exist. If it does exist, it exists only in a limited form. People who try to avoid poverty and isolation are often placed in situations that are characterised by these traits. This dynamic is further exacerbated by the greater prevalence of serious mental illness—schizophrenia—among those from lower socio-economic classes. We must focus on how best to create supportive communities—some of which already exist as a result of private sector initiatives—and perhaps to assist them with funding. We must continue to create an environment where the mentally ill members of the community feel at home and are supported and encouraged to become productive members of society. Unless we do that, many will continue to wish that they were back in the hospitals where they felt safer. This requires more than the purchase of professional health services and the provision of financial support. It asks that we ensure that an appropriate living community exists for those for whom we have taken responsibility. Recently, I visited the headquarters of Fountain House in New York. It is a club house which provides healing and hope for men and women who are recovering from mental illness. All individuals are members and build on their strengths and capabilities to move from isolation and dependence to self-reliance and productivity. Members work together. They work in transitional employment, and the club provides housing. The atmosphere is happy. Fountain House has produced very impressive results in returning people to normal life and reducing the rate of relapse. There are some 300 Fountain House clubs worldwide, and I am pleased to say that 14 are open in this country. Local authorities have helped to fund these wonderful facilities and are interested in their non-medical approach. They have no throughput requirements. Membership is for life. The ideal is to return the members to independence and to be there for them if they wish to come back. We need more of these types of support mechanisms. I believe that the second area of focus is the inventory of beds. The rate at which the old hospitals are discharging patients as a result of closures exceeds the rate at which the new communities can absorb them. As the mechanics of housing and caring for the severely mentally ill who are in transition, relapsing, moving and so forth are being fine-tuned, we have a situation in which our resources are being misallocated. People who are being relocated are occupying acute care beds and those who need them are not being accommodated. It would seem that one way to improve that situation would be to slow or even to reverse the rate of closing and discharge pending the community's readiness. I suggest that the third area of focus is dealing with the hard cases; those needing incarceration. As recent events have demonstrated, there are some mentally ill patients who should not be released into the community because of the dangers they create for themselves or for others. We must continually review the status of such individuals and accept that there is a group for whom the best place is a contained environment. We must also develop and implement strict guidelines as regards those who must be institutionalised for the long term. We should strive to create communities for them under the most humane conditions possible but we must recognise that this group may need to live in an insulated community. Finally, I suggest that a full accounting of the effects of changing from the old system to the new would be very useful. It would allow us to follow the pound saved by closing the old hospital through to its expenditure in the community under the new system. We will then be able better to ascertain the financial ramifications of the changes made and improve our prospective decisions. One characteristic of mental health is said to be flexible thinking. We may need just that as we evaluate and perhaps change existing policy. In that regard, I am hopeful that this debate will assist in improving the quality of life of the seriously mentally ill."to provide a network of care in the community for people with severe mental illness, which would minimise the risk that they would lose contact with services".
6.52 p.m.
My Lords, it is indeed a privilege for me to congratulate the noble Lord, Lord Gerard, on an outstanding maiden speech. It was delivered so well with such humour and did not upset anyone, including my noble friend the Minister, so far as I could tell. It could not have been a better maiden speech. I notice that his address is in New York. I hope that we shall see a great deal of him in this House and that he will frequently come over from the States, if that is where he is to continue to live, and give us the benefit of his very wise remarks.
I thank the noble Lord—I nearly said my noble friend but I should not—Lord Thurlow, for initiating the debate. It is some time since we had a similar debate. I also thank him for laying emphasis on the 24-hour nursed residential care. He is so right in considering that this is a suitable time to take stock of community care. It is the right moment and I believe that the programme is getting underway at last. The debate gives me the opportunity to thank in particular my honourable friend Mr. John Bowis, the Minister responsible for mental health, my noble friend Lady Cumberlege and their Secretary of State for the financial help that they have given to the Isle of Wight health authority during the past few months. I wish to thank John Bowis for his most thoughtful reply to a letter that I wrote to him last March about some of the outstanding problems that I saw in providing care both in and out of the community in the years to come. The financial help and part of the correspondence relate to the subject of this debate. The Minister provided assistance to the Isle of Wight to recover stability in its health funding, which was badly out of control, and has awarded £305,000 from the Mental Health Challenge Fund, which his Secretary of State initiated last December. We on the island are indeed grateful to all concerned in the Department of Health for their assistance on those two issues. One of the points that I made more than once in my March letter to John Bowis was the fact that, when determining help needed by the mentally ill, there was initially, a requirement to assess that help without consideration of its possible cost. That gives at least one true picture of what really is wanted. Of course, the question of what can be afforded must always be faced, but I suggested that that should be done only after seeing the true picture. The Minister in reply stated that that did indeed happen. But I must confess that in the past 13 years that I have been concerned with this subject it has never been obvious to me that it has. It is nice to think that at least the Government believe they are doing that, and long may it continue. As your Lordships will know, during the past 35 years, since Enoch Powell first started shutting down mental hospital beds, people on the ground, such as members of the National Schizophrenia Fellowship, have been saying to successive governments, "Please don't do that too quickly". The noble Lord, Lord Gerard, said just the same thing and, as far as I could tell, was saying that it was as applicable to the United States as it was to us. It is interesting to note that that should be the view. My impression during the past 13 years, since I was first introduced to the NSF, has been that governments, health regions and districts reporting to them were so keen on the civil liberties of sufferers and on saving money that they never waited to find out what was really needed before reducing beds. However, in the case of the Isle of Wight the exercise of assessing needs initially without regard to resources has been done as a preliminary to applying for the award to which I have referred. During the course of 1995 a project worker undertook a detailed survey of the needs of 360 island residents with serious mental illness. Perhaps I should say in passing that that number is approximately what one would expect from a community of 125,000 at a particular moment. As has been said by other noble Lords, there are probably more such cases in a lifetime but at a particular moment that is probably just about the right number. The project worker discovered that, in the opinion of the key workers looking after the clients, as they described them, about 250 people were appropriately placed. Roughly half of the remaining 110 people needed more intensive care and those tended to be in the more independent accommodation. The other half of the 110 needed less intensive care and those tended to be in the more secure accommodation. From that survey, the Isle of Wight Health Commission deduced that it needed, first, the provision of a 24-hour crisis intervention service; secondly, an increase in the provision of 24-hour staffed accommodation; thirdly, an increase in the provision of crisis beds; fourthly, more facilities for clients supported in housing association accommodation; fifthly, fewer inappropriate admissions to acute in-patient beds; and, sixthly, fewer mainland placements, that being achieved by the increase in the 24-hour staffed accommodation. I should explain to your Lordships that when we talk about mainland accommodation we refer to people who have to be taken across the water from the Isle of Wight because we do not have the necessary secure accommodation for them. That is one of the aims that we are hoping to achieve. The award from the Mental Health Challenge Fund will enable the health authority to achieve those aims. Until now, many people felt that more beds were needed until community care was developed fully. For the Isle of Wight, it seems that it is more the case that we need an increase in secure beds and the 24-hour crisis intervention service and more care in hostels rather than hospitals. If the number of beds are added together, there is the right number but you cannot get the right people into them. That is what needs to be adjusted. We are on the way there and much more quickly than I had expected. I hope that poor old England will catch up later. In conclusion, I am told that there is growing concern that general practitioners are beginning to press that some of the money allocated for the severely mentally ill, who are out of GPs' hands, should be diverted to the care of people in mental distress for whom the GPs care. I suggest that that needs to be watched because we must not lose what has been won for the severely mentally ill. There also seems to be a national shortage of psychiatrists and specialised support staff. I should be extremely grateful if, in her reply to the debate, the Minister could comment on those two points. I hope that she received my letter asking her to do so. I hope that she will give some idea of how the Government are tackling those problems. Thanks to what I have been able to recount to your Lordships this evening, I am able to conclude this speech in a much more hopeful manner for the future than I have in many other debates during the past 13 years in which I have been involved. I believe that we are reaching a point at which many of the facilities for which we have been crying out are coming into existence. I hope that there is no hold-up in developing that further. Perhaps the best solution to the whole problem would be to divert all the National Lottery money to looking after the mentally ill.7.2 p.m.
My Lords, I thank my noble friend Lord Thurlow for giving us the opportunity to discuss this vital subject. I congratulate also the two maiden speakers. Some of my remarks will give examples of deficiency in the service but others will demonstrate positive aspects of excellent projects which have been established by dedicated people providing a much improved service.
I served on the Yorkshire Regional Health Authority when discussions were taking place about closing many of the long-stay hospitals for the mentally ill. My voice was one of several which said that that would not be a cheap option. I warned that it was wrong to close beds until acceptable improved facilities were put in place. I said then and still say today that severely mentally ill people are the most difficult and unpredictable group to be dealt with. If they fall between health, social services, the voluntary sector, the prison service, the police and the probation service, which many seem to do, they themselves and society at large may be put at risk. There needs to be co-operation and communication among all the agencies, with adequate training about mental illness. Family members or friends who may be helping with individuals who have a mental illness need to be listened to and not fobbed off by the professionals, who so often seem to think that they know best. They often do not know what goes on behind closed doors in people's homes. I visited Brixton Prison with the all-party Penal Affairs Group. There, we saw a ward which was filled with 100 per cent. of prisoners suffering from schizophrenia. When those people are released back into the community, it is vital that satisfactory aftercare facilities are in place for them. I should like to quote from a report commissioned by the Department of Health on 24-hour nursed care. The report states:How will the Government ensure that health authorities provide for that need? What will happen if they turn to the Government and say that they do not have the money to pay for the nursing staff who provide such a service? Will ring-fenced money be given for that specific 24-hour care? People who misuse drugs and alcohol are much more likely to be violent than those with a major mental disorder. But alcohol and drug misuse increase the risks for patients with a major mental illness. However, emerging findings of a strong association between violent behaviour and times at which the symptoms of severe mental illness are active rather than in remission have major implications for future healthcare policies. That was stated in Volume 312 of the BMJ on 13th April 1996. On 21st April, I received a letter about a hostel for discharged psychiatric patients in Southwark. The letter states:"There is accumulating evidence of a need for residential nursing care for a relatively small group of so-called new long-stay clients".
I ask the Minister who monitors those hostels and who cares what happens. I should like to pay tribute to Bill Kilgallon, who served with me on the Yorkshire Regional Health Authority. He has been a past Lord Mayor of Leeds and chairman of the city council housing committee. His brainchild has been St. Ann's Centre for the Homeless, which includes people with mental illness who otherwise would have been in hospital or on the streets. They have a flat to live in and support services are available. Another splendid project is the recently opened unit for severe sufferers of Alzheimer's disease at the Hospital of St. John of God at Scorton in North Yorkshire. That is an independent hospital. The unit caters for people who can no longer live at home and who need 24-hour nursing care. The patients have extremely comfortable accommodation with a garden. It was full before it was officially opened. It has nursing home status. Throughout the country there are some excellent facilities for mentally ill sufferers with caring staff. There are also some deplorable ones, with people doing the job just for the money. There should always be a minimum standard. AIDS dementia, also known as HIV encephalopathy, HIV-associated dementia and HIV brain impairment are most distressing conditions. They affect between 10 and 15 per cent. of the known HIV population. The incidence of AIDS dementia doubled in 1993–94 compared with cases studied in 1991 to 1994. Patients with that diagnosis require higher levels of supervised care, often for 24 hours. The only residential facility dedicated to that group of people is a four-bedded unit in Hammersmith. Therefore, care managers are in the difficult position of arranging a costly 24-hour package of care for individuals in order to maintain them safely in the community. Care packages are often extremely time-consuming to prepare for the managers. I shall give your Lordships an example. A man of 38, a former academic lecturer, with severe AIDS dementia has been discharged to his one-bedroom flat, unable to care for himself in any sense. He cannot prepare himself a meal or walk safely on the road. He was recently conned out of a large amount of money by unscrupulous workmen. He smokes constantly, without paying attention to where he holds his cigarette and is, therefore, a health hazard. In the flat above him lives a family with young children. He needs 24-hour care. His mother, while willing to help, is herself elderly and frail and is frightened of him at times when he gets aggressive. She is unable to restrain him if he wants to go out in the middle of the night or to lift him if he falls. He has a number of different agency staff sent in to care for him but he is aggressive with those whom he does not know and sometimes refuses to let them in. As many of them have no particular training in how to deal with such clients, they cannot always manage to gain admittance. He has moments of insight. In one such moment he recently wrote a short note saying:"The occupants are woken about 6 am. and given a meagre breakfast and then sent out for the rest of the morning until their midday meal at 11.30 am. which lasts for half-an-hour. After this they are discharged again into the streets to wander about until their last meal at 5.30 p.m. and sent to bed at 6 p.m. They do not have any of the amenities of present day life, such as television and so on. They can be seen wandering about Vauxhall Park performing ridiculous tasks, such as imagining they are collecting litter, and so on. They are sent out of the hostel regardless of the weather. Their clothes or some of them are in a poor condition. I send you this account in the hope that your Ladyship may be able to alter these conditions which probably prevail in other such institutions".
Care managers based at St. Mary's Hospital, Paddington, are currently trying to arrange for the community care of 30 AIDS patients with dementia in the community. I hope that the Minister will help, through her department, to promote services for this very unfortunate patient group with dementia. The needs are more training and facilities with 24-hour care, combining psychiatrically trained staff and psychological input familiar with AIDS dementia, including professional and informal carers; an increased emphasis on early assessment and diagnosis so that adequate planning can occur before a crisis breaks out; and joint funding between health and local authorities for community care and hospice-type provision. There is a recently formed HIV brain impairment forum which should help to centralise research and planning. There seem to be so many pressing needs for the many different mentally ill groups."I am not myself now. Apologies for the inconvenience caused".
7.13 p.m.
My Lords, I am most grateful to the noble Lord, Lord Thurlow, for introducing this most important debate with such a very fine speech. I must declare an interest in that I am a patron of MIND's Golden Jubilee Appeal. In its 1994 report entitled, Finding a Place: A Review of Mental Health Services for Adults, the Audit Commission stressed that two thirds of expenditure on mental health services is still tied up in hospitals and hence is unavailable for care in the community.
At paragraph 27 of the report, the Audit Commission graphically portrayed the current vicious circle: most funds are tied up in providing hospital beds; thus there is no spare capacity to develop community services; thus people are unsupported in community and so are admitted to hospital; and thus hospital beds are full. The Audit Commission called on all authorities to plan on how to break out of that circle. An important scheme towards which their thinking ought to be directed is MIND's model of a 24-hour crisis service. After consulting its own network of local groups and people who use its services, MIND points to the need for community-based crisis services. Their role would be to respond rapidly to people having mental crises; to offer support until their acute problems are resolved; and to link people to longer term care and support when that is wanted. A crisis service ought to be available around the clock and would consist of a variety of features. A crisis telephone helpline specialising in mental health problems needs to be developed and given wide publicity. People in mental distress could turn to the telephone for immediate assistance. The helpers would listen to the problems, give an outside view and advise on how to get further assistance, if necessary. Southampton's MIND runs a most successful crisis point which combines such a telephone line with a "Drop in" on Friday and Saturday nights from 10 p.m. to 8.30 a.m. A crisis counselling service would be a non-medical service providing immediate short term help to people in mental distress. That service would give the advice and aid necessary to assist people to cope; for example, the Leeds crisis service provides counselling on a seven-day basis, from 10 a.m. to 10.30 p.m., with the possibility of an overnight stay. Crisis houses would be non-medical, safe houses which would give people a sense of security, enabling them to get away from their problems and—it is to be hoped—get through their severe distress. Those houses might be set up for particular needs; for example, women-only houses for women who have been sexually abused. Wokingham and District MIND runs a most successful crisis house along those lines. The core service for people in acute distress would be home treatment. A range of mental health specialists would staff the service: social workers, housing workers, community psychiatric nurses, psychiatrists and community support workers. That team would treat people at home whenever possible, with a 24 hour on-call cover. The team would have a sensible case load enabling frequent contact with the patients. The West Birmingham home treatment service offers an excellent example. The team provides acute, intensive medical health care at home on a 24-hour, seven-days-a-week, basis. Home treatment is most effective when there is 24-hour cover. That can be achieved by enabling patients to telephone a team member at any time of day or night. After the introduction of such an on-call system in Sparkbrook, Birmingham, the proportion of users who could be treated entirely at home rose from 41 per cent. to 65 per cent. If, for some reason, it is undesirable for the person in severe distress to stay at home, the team would require alternative accommodation. Bassetlaw health district uses an unstaffed flat with a telephone link to an acute ward for both crisis and rehabilitation purposes. As some noble Lords have already said, for those people who cannot be supported by those services, highly staffed acute residential accommodation will continue to be essential. Some will be hospital based, and some medium secure or high secure for those who pose a risk. However, some acute units need not be in a typical district general complex. For example, the Grange in Newcastle is an acute unit in a large house with nine residential places and capacity for 13 patients to attend by day. National standards for such a 24-hour crisis service would be essential. Community Care at the moment is a lottery depending on where people live. As the noble Lord, Lord Mottistone, has told us, the Isle of Wight is doing rather well in that part of the lottery. The Government should set national standards which would insist on a minimum level in each health authority area. In setting the standards, the Government might do well to look at some examples of existing home treatment services. In the first two years of the West Birmingham home treatment services, only 15 per cent. of the people seen needed to be admitted to hospital, while in south London the Daily Living Programme, which gives home care to people facing emergency admission to hospital, reduced their time spent in hospital by no less than 80 per cent. All the examples I have cited show that every different feature of MIND's model of a 24-hour crisis service is eminently practical. On 19th February the chief executive of the National Health Service wrote to all district health authorities and mental health trusts about the planned patients' charter and mental health services. In the letter he declared:This is a fine expression of government intent, but what is needed is money. As the Royal College of Nursing aptly states in its briefing:"Over time, direct 24 hour access to services should become the standard for people with serious mental illness everywhere".
MIND estimates that something like £300 million of new money is required to provide nationwide crisis care in the community for people with serious mental health problems. That is a large sum of money, but then this is a huge problem affecting many people, as the noble Lord, Lord Thurlow, and the right reverend Prelate described so well. The question is: when will 24-hour crisis services in the community really happen on a nationwide and satisfactory basis? They will not happen until the Government provide that £300 million. They will not happen until the crisis services are actually set up and are running. It is for the Government to lead the way out of the vicious circle by providing that £300 million."Health authorities and boards should be given money which must be spent on the double running costs of developing a full range of community services whilst phasing out hospital services. Bridging money over a two to three year period is essential if trusts are to develop realistic alternatives to hospital admission".
7.22 p.m.
My Lords, I am very pleased to support my noble friend Lord Thurlow on the very important subject of his debate. Many mentally ill people can be treated by their GPs; they never see a psychiatrist and never go into a psychiatric hospital. The remainder, however, need to be referred to a psychiatrist and need to be admitted to hospital. Recovery, a return home and to work is a possibility for some of the first group. The remainder probably need long-term treatment and care.
The Government's initiative for 24-hour nursed residential care for 5,000 is welcomed by the National Schizophrenia Fellowship among others. The acceptance of patients awaiting discharge for accommodation funded by social services departments can apparently take up to three months, and no wonder as it can entail over 100 pages of forms and reports. Can the Minister say whether this is so and whether they are all really necessary? The waiting can apparently lead to the blockage of acute beds, which can be exacerbated by the lack of highly staffed residential care and leads to problems with admissions, and possibly too speedy discharge for some to free spaces. Mencap confirmed—when I asked it—that those with learning disabilities can suffer from mental illness as well. This can create problems in diagnosing their special needs, and it is important not to lose track of the need for special skills in dealing with people who have both conditions: the dual diagnosis. Perhaps the services for learning disabilities and mental health services should work together. This is often done where there are psychiatric hospitals in the vicinity, but not so much where they are more scattered and away from services. This would help to ensure that people get the best of both worlds and not the worst of both, or risk falling between the two services. Perhaps the Minister could look at this problem, please? The brain changes in people as they age who suffer from Down's syndrome are known about, but much less is known about people with Down's syndrome who suffer from dementia, which I understand is by no means the same thing. It is important that the minority who suffer from mental disability and mental illness are catered for and not disregarded as difficult, because they may not be able to speak to help others to help them. There are some who may not use words much and some who may not use words at all, thus it may be difficult to assess their needs and their condition. The Royal College of Nursing feels that, although there is a series of policy initiatives such as the care programme, approach management for supervised discharge and a mental health charter, this cannot be fully implemented without further investment in specialist nursing services. This really means an increase in the numbers of community psychiatric nurses. The Government have this year accepted a review of mental health services and outlined a package of measures. The Government have also accepted the results of a report on the need for 24-hour nursed care, commissioned by the Department of Health, which found accumulating evidence of a need for residential care for a relatively small group of people who need long-term care who suffer from severe and enduring mental illness. It is to be welcomed that the Government have accepted that there is a need for this kind of care, and may we hope that they will be able to increase the number of community psychiatric nurses to help with these new measures, and so help to relieve the pressure on the nurses already working in the community? May I ask the Minister if she has seen the article in the Psychiatric Bulletin of May 1996 by Dr. Tony Whitehead of Brighton General Hospital in which he describes his acquaintanceship over many years with psychiatric hospitals? He says that,Let me hope that those I have just mentioned will see their hopes fulfilled in the future of care in the community. There is some concern felt that even small residential care places are not necessarily places of freedom but could become institutionalised if they are based too far from services. As a result they can suffer from discrimination and stigma. As my noble friend Lord Thurlow said in opening this debate, although the old hospitals were isolated, they supplied nursing, feeding and above all companionship. Although we all welcome the new small residential homes, no beds in the old hospitals, which should provide the highest quality of care, must be closed until care is in place in the community or meets or exceeds those standards of care. There needs to be proper management training and more trained psychiatric nurses working in the community, and I wish the future of care in the community success."Most psychiatrists have spent their lives battling against institutionalism and over the years have created, with the help and enthusiasm of nurses and other professionals within the psychiatric service, inpatient regimes that discouraged institutionalism and encouraged the establishment of care in the community".
7.28 p.m.
My Lords, I rise to speak because I have been asked by a number of your Lordships why on earth I am not speaking in a debate on community care. The reason is quite straightforward, as I am sure your Lordships recognise. I am the chairman of Mencap, which deals with people with a learning disability or mental handicap. That is a different problem from those facing people with a mental illness. A learning disability is lifelong; it is something with which one is generally born and from which one does not recover until death, as it were. But, on the other hand, mental illness can occur to any of us present in your Lordships' House or those outside. But, thank goodness, it is possible to cure it in many cases. However, that is not the case with learning disability.
Reference was made by my noble friend Lady Kinloss to the fact that people with a learning disability can also suffer from mental illness. That is true. On the other hand, in the Department of Health's series entitled The Health of the Nation, a booklet entitled A strategy for people with learning disabilities has a useful section on the mental health problems of people with learning disabilities and how to deal with those problems. Without wishing to add to confusion between mental illness and learning disability—it is a confusion that is always put forward by the media; we see glaring headlines which confuse mental illness, mental handicap and learning disability time after time—I wish to make it clear that people with a learning disability can suffer from mental illness as well. Therefore, our mental health strategy must cater sensitively and appropriately for that minority of people with learning disabilities who also have mental health problems. We have too often failed them in the past; and now we have the opportunity to do better in the future.7.30 p.m.
My Lords, I, too, wish to thank the noble Lord, Lord Thurlow, for introducing the debate today, in particular as he has chosen to concentrate on one aspect of community care. I feel privileged to have listened to two maiden speeches on a subject close to my heart. It has demonstrated that the two new Members of this House will be able to contribute enormously to future discussions in this Chamber. We look forward to hearing them.
The care in the community programme has come under considerable criticism as failing to provide an adequate safety net for those with mental health needs. The right reverend Prelate the Bishop of Oxford gave us some outstanding examples of where the community care programme has failed. But we have been privileged also to listen to the noble Lord, Lord Acton, and the noble Lord, Lord Gerard, who were able to tell us about the wonderful achievements of voluntary organisations from which I believe that we can learn a great deal. However, everyone, even the Minister, has to admit that the community care programme has not yet achieved all that we had hoped. Both the Royal College of Psychiatrists and the Royal College of Nursing are concerned that most health authorities still have to spend too much of their resources on in-patient beds because of the high demands for those beds. In London, for instance, one-third of in-patients on admission units—those beds intended for short stay—have been there for more than three months and some for as long as six months. Health authorities in some other parts of the country are having to spend millions of pounds admitting people to distant hospitals as extra contractual referrals. That not only involves costs but misery for the patient who is removed far from his own community. The Royal College of Psychiatrists is concerned that despite a continued fall in bed numbers, there are more people aged 15 to 44 in psychiatric hospitals than there were 10 years ago. The increase in hospital episodes is most pronounced in young men, who account for over 40 per cent. more episodes than they did a decade ago. Very few hospital beds have been replaced by other residential provision in the community and there is now only one-third of the residential places (hospital or community) that were available 40 years ago. The tragedy is that, despite the great reduction in the number of hospital beds, they still account for about 75 per cent. of expenditure on National Health Service psychiatric services. This is largely due to the increase in unit costs of caring for a disturbed group of patients concentrated in psychiatric beds, and chief executives express little hope that further closures will make a substantial contribution to the funding of community services in the future. Many of these units report that, because they are permanently occupied 100 per cent., they have to discharge people prematurely to make way for new admissions. As a result of these problems, disturbed people in the community are not receiving the care that they are entitled to expect. In inner London, mental health teams found that 46 per cent. of council tenants, for example, received no day-to-day support and 40 per cent. suffered social isolation. With the best of intentions, social workers and NHS support provide only a few hours of contact each week to many patients in need. Despite a series of policy initiatives—such as the care programme approach, arrangements for supervised discharge and a mental health charter—it is clear that mental health needs in the community will not be met without further investment. I believe that three things are required. First, there needs to be additional support for general practitioners, whose workload has increased as a result of the care in the community initiative. Secondly, policies for mentally ill people cannot be implemented without adequate numbers of appropriately trained community psychiatric nurses. Yet there is currently a shortage crisis in mental health nursing. For example, GPs find it difficult when calling on community psychiatric nurses for help with their patients. Those nurses are unable to take on a patient for perhaps as long as three, four or five weeks. That is too long for such patients to have to wait. Only one in five people diagnosed as suffering from schizophrenia currently has access to a community psychiatric nurse. The Royal College of Nursing estimates that the number of community psychiatric nurses needs to be doubled to around 10,000 in the United Kingdom. We also need an increase in the social services which provide the back-up in the community for people who are able to live on their own in the community. As has been said, the Secretary of State for Health has accepted the results of a report on the need for 24-hour nursed care for a number of patients who are not in need of full hospital care but who nevertheless need 24-hour supervision. We welcome that initiative, but the resource implications must be addressed. That is the greatest hurdle. According to the health authorities, we cannot save the money on the psychiatric hospitals. Therefore, the Government must consider the resource implications. We welcome the introduction of 24-hour nursed care establishments because they must inevitably create a better atmosphere for the patient than being in an institution. The National Health Service executive has itself estimated that some 5,000 people may need access to this accommodation. It has been estimated that £300 million will be needed to provide the accommodation, as well as a further increase in the number of psychiatric nurses. Perhaps I may say to the noble Lord, Lord Acton, that the sum of £300 million seems to be needed in more than one field relating to this problem. Will the Minister also tell the House how medical cover is to be provided for residential homes? I have heard concern expressed by general practitioners who feel that it may fall to them to be responsible for medical cover, especially increased night cover, thus adding to their workloads. One problem on which we and the health service providers should concentrate is the need for better communication between hospitals, the community psychiatric nursing services, social workers and general practitioners. Too often, general practitioners who carry much of the burden are not informed before a patient is discharged back into the community. I was talking to a general practitioner in Wales who was called in by the local psychiatric consultant to assist in the committal of one of his patients. Six weeks later, the patient turned up in his surgery, having been discharged. The GP had not been informed of her discharge, which was quite unforgivable. I believe that all those problems can be overcome. Communication difficulties can be overcome with good will. But in order to do so, the service as a whole needs to feel that it is financially supported by the Government. I hope that the Government will do their best.
7.41 p.m.
My Lords, I wish to thank the noble Lord, Lord Thurlow, warmly for introducing the debate. He has given the House an opportunity to discuss again an issue which has become of serious concern to noble Lords on all sides of the House. As he said in his introduction, we have discussed many facets of the problem over the past year, but I do not believe we can do so too often. I am grateful to him for giving us the chance.
I wish too to congratulate the noble Baroness, Lady Berners, and the noble Lord, Lord Gerard, on their maiden speeches. I look forward to hearing them again, as I am sure we shall return to this vexed question on many occasions. They will both be able to add to the great authority on the subject which is available in your Lordships' House. Tonight it is worth while and useful once again to restate that there is general agreement that community care for the mentally ill is a policy to which we all aspire. Everyone subscribes to the community care policy, at least in theory. In practice, the acute problem which faces everyone who is concerned about it is that community care for the mentally ill is failing. There are growing numbers of mentally ill people in the country and their care is causing great anxiety to the professional and informal carers who try to look after them; anxiety to ordinary citizens who are sometimes disturbed and also threatened by the presence of seriously mentally ill people in their midst; and above all, anxiety to the patients themselves, in whom care in the community often leads to a feeling of isolation and helplessness. Today, sadly, it can be common to see mentally ill people aimlessly wandering the streets, apparently without proper support and treatment. As has been described by several speakers in the debate, their present plight is a direct result of the failure to develop adequate community care services to substitute for the old-fashioned long-stay residential institutions—the asylums. Too many psychiatric beds in hospitals have been closed too quickly. That is something to which several noble Lords referred tonight. The noble Lord, Lord Thurlow, described the Government's attitude as "inflexible". Suffice it to say that nearly half the beds in hospitals have been cut since 1980 and the patients who occupied them have been discharged, largely to fend for themselves. As your Lordships have heard, in February the Government announced the review of the mental health services provided by local health authorities and a package of proposals for improving care. Many of the questions and points which have been raised today are the same as those which were raised when the proposals were announced three months ago. I am particularly glad that the noble Lord, Lord Thurlow, drew special attention to the document on 24-hour nursed care which was published as part of the so-called "Spectrum of Care" introduced on 20th February. The document on 24-hour nursed care addresses absolutely head on the issue of residential care, of beds for psychiatric patients. It seeks to find ways of filling the gap which has been left by the too rapid closure of psychiatric beds. The real situation is that there are just not enough appropriate beds for patients when they need them. The right reverend Prelate the Bishop of Oxford gave us vivid examples of the difficulties which arise in different instances. After all, not all mentally ill people can be cared for at all times in a community setting, however good that community setting may be. Indeed, the very nature of episodic mental illness may mean that there will always be demands on acute beds. So sanctuary of some kind is vital—not least, it has to be said, for the relatives of those suffering from episodes of acute mental illness. Access to that sanctuary is being denied in part because acute beds are being blocked due to a shortage of appropriate community facilities for mentally ill people. The noble Lord, Lord Acton, referred to the Audit Commission's report, Finding a Place. To quote again from it, it mentions one research study which found that up to two-thirds of admissions could have been avoided had better community support been available. In those circumstances it is common sense to welcome the ideas behind the proposals for 24-hour nursed care. But like other noble Lords who have spoken, I wonder how they will ever be implemented. The record on radical community care programmes is not encouraging. I remind the House of the care programme approach which was supposed to form the basis of all community care for mentally ill patients and would probably be the framework within which 24-hour nursed care would be operated. That had still not been fully implemented when the new proposals were introduced in February, although it was intended to be in place five years ago, in 1991. When the Minister introduced the new proposals in your Lordships' House on 20th February, the Statement said that the care programme approach would be universal by 1st April this year. I hope that when she replies tonight, the Minister will be able to tell us that that has happened. I also remind the House that the Government's own review of the mental health service which was published in February noted that two-thirds of all health authorities did not expect to be able, even with additional help, to offer comprehensive services by the end of this year, as had been intended. In the North Thames region, no health authorities at all are expected to be able to deliver their programmes. Incidentally, I should mention that I spoke this morning to the chief executive of one of the health authorities in the North Thames region. Although the document on 24-hour nursed care gives special emphasis to the lead role required by purchasing authorities, the chief executive—certainly not someone who is lax or lazy—had not even seen the report. The question of resources has been raised at different points around the House. I join the right reverend Prelate in describing my attitude to it as "sceptical". The new expenditure on 24-hour nursed care is reckoned to be about £275 million, with capital costs at over £1 million for each unit which will be provided; and revenue costs which would be anything from £35,000 to £50,000 per place in one of the new units. When the package of proposals was introduced in February, we were told that there would be £95 million additional money to contribute to the new programmes. We raised doubts at that time about whether it would be new money. Helpfully, the National Association of Health Authorities and Trusts in its March briefing broke down the £95 million in a way which did not suggest that we were getting new and amazing largesse from the Government. The briefing document said that, of the £95 million package, £53 million had been previously earmarked by health authorities; £10 million would come from the Government's new Mental Health Challenge Fund, with a matching £10 million contribution from health authorities; and £20 million from the mental illness specific grant, with a matching £2 million from local authorities. In that context, the figures suggested by several noble Lords this evening, including at the top end, as it were, the figure quoted by the noble Lord, Lord Acton, of £300 million, are very wide of the mark. I hope that we shall not be told by the Minister in replying that this is an opportunity for the Private Finance Initiative. The House will have a chance, of which I hope we shall all take full advantage, to debate the Private Finance Initiative in the National Health Service next week. I certainly do not want to go into that troubled history in detail tonight. However, it would be particularly unfortunate if an important initiative such as 24-hour nursed care were to be at the mercy of the Private Finance Initiative. My briefing from the financial experts suggests that, already, consultancy fees and management time have been estimated by NHS trust chief executives at around £200,000 per scheme, and that in the mental health field no firm agreement has been made on any provision of any substantial kind. I believe there is concern and interest now in the possibility of perhaps explicitly exempting mental health schemes from the PFI. It would be a very welcome suggestion if that were so. In the meantime, while the arcane financial and institutional debates continue, many people with mental illness struggling to survive in the community will continue to be in need. The 5,000 or so patients with severe enduring mental illness are in special need of course. In the past few months we have seen yet more tragic examples of violent incidents involving mentally ill people released into the community. We know that these people are exceptions and that the severely mentally ill are more likely to harm themselves than anyone else. Nevertheless, high profile cases such as that of Jason Mitchell—reported on in March by Sir Louis Blom-Cooper—who murdered three people while living in a hostel undermine public confidence in community care programmes. An earlier report on the Christopher Clunis case is quoted in the document on 24-hour residential care. It states:We can all agree with that. But if we are realistic, we must surely also be sceptical that health authorities will be able to provide 24-hour nursed care to alleviate the problem, at least in the short term. There are other practical solutions. I urge the Government to halt further psychiatric bed closures until appropriate community services have been developed; to take action to address the staff shortages referred to by several noble Lords, particularly the problem of community psychiatric nurses; and, particularly important, to implement immediately the care programme approach—a priority in all parts of the country and in every health authority. Once again, I thank the noble Lord, Lord Thurlow, for introducing this timely debate. I hope that the Minister will be able to give him a positive response and that she will be able to respond positively to my proposals when she replies."If the needs of that small group [the severely and enduringly mentally ill] are not met, care in the community will be discredited and … perceived as a policy which has failed. We do not think that as a society we can afford to let this happen … and we have no wish to return to the days of locked, impersonal, dehumanising and undignified institutional care".
7.53 p.m.
My Lords, in thanking the noble Lord, Lord Thurlow, for securing this debate, not only do I congratulate him because I know of the fierce pressures on parliamentary time, but I would like to make three points. First, it is gratifying to have a debate led by a noble Lord who has such a depth of knowledge and insight into this very difficult and sensitive subject. Secondly, it has attracted two excellent and interesting maiden speeches. I hope that we shall hear more from these two particular maidens on this and other subjects.
I should like to say how pleased I am that the noble Baroness, Lady Berners, did not follow in her mother's footsteps and has taken her place in this House. Her experience as a nurse will inform and enlighten our debates. Clearly, she is one to keep her knowledge up to date. The noble Lord, Lord Gerard, is also extremely knowledgeable. I am grateful to him for his perceptive speech, his transatlantic experience, and his welcome for community care. Thirdly, I am pleased that this should be a Cross-Bench debate, not only neutral as the noble Lord, Lord Thurlow pointed out in terms of party politics, but on a subject which I believe is getting a higher profile and, for a variety of reasons, some positive, some less so. I believe it is time that this Cinderella service leaves the hearth, and, if not quite reaching the ball, at least comes into the limelight and receives the recognition due. The Government have made mental illness a priority for the NHS and have awarded considerable resources to back their medium-term strategy, a "Spectrum of Care". Listening to the contributions made in this House, and knowing of the personal commitment of Ministers, not least my right honourable friend the Secretary of State for Health, I believe that that recognition is now with us. As noble Lords are aware, mental health problems are common. At any time, around one in seven adults has a significant mental health problem. As the noble Lord, Lord Thurlow, said, these problems cause real distress, not only to the individuals themselves but to their families. It is vital that we identify these problems early and provide effective treatment. That may involve drug treatment or psychotherapy, or both, and is usually provided through the primary care team. But, as the noble Baroness, Lady Jay, said, the focus of this afternoon's debate is not on the generality of mental illness but on those who need more constant care. I start by asking your Lordships to consider a young man, Paul Weston, who 25 years ago was diagnosed as having acute schizophrenia and considered to be a danger not only to himself but to others. He was admitted to a 1,000-bed hospital, 30 miles and over an hour's journey from his family home. He lived in a dormitory of 30 patients, where the only privacy was a curtain round his bed. He wore ill-fitting, secondhand trousers and shared a bathroom with 15 other patients. He was able to walk in the grounds of the hospital, although there was little else to occupy his time besides short shifts packing ballpoint pens into plastic packs, earning just enough money to buy cigarettes. In summer he would be in bed before dark, complying with a hospital regime which took little account of the needs of individuals but was more concerned with systems necessary to run a large institution. Over the years, Paul became passive and dependent, and had no contact with his family or friends from home. Paul is a fictitious character, but one which those who have experience of this service will recognise. But what if Paul Weston's mental health problems had been identified this year? Through the Care Programme Approach, he would have been assessed, either at home or in a local hospital, by the specialist mental health team who would have arranged the care that he needed. That would include a home to live in, people to talk to, something to do, whether it be a job, work around the house or social activities, and an adequate income—together with the help needed to organise and sustain his unremarkable lifestyle. He would also receive effective treatment, including drug treatment and psychotherapy. His progress would be monitored and a specialist team involving his family would reach a view about how to continue to support him. One option would be intensive support at home; another would be 24-hour nursed care. It is our intention to provide a "Spectrum of Care", for we know that different individuals have differing needs. Twenty-four hour nursed care is one component. It is intended for the small number of people with severe and enduring mental illness who, like the Paul Weston of 25 years ago, require a high level of support, often over a long period of time, in a safe, non-institutional setting. Without 24-hour nursed care these patients have often stayed for too long in an acute hospital where it is impossible to provide the range of facilities and the rehabilitation that they need. Twenty-four hour nursed care offers greater intensity of care than can be provided at home and, by facilitating discharge from hospital, ensures that acute beds are available for those patients who need short-term intensive treatment. The noble Lord, Lord Thurlow, raised the issue of the timetable for building 24-hour beds, or at least creating them. We have not given a timetable on the establishment of 24-hour nursed beds; but we are encouraging their provision as part of the local "Spectrum of Care". Indeed, some are already in existence. I refer noble Lords to the very good, independent report that we commissioned on 24-hour nursed care which sets out some of the examples and the aims of this particular policy. We intend partly to finance that through bids via the Mental Health Challenge Fund money. We know that some authorities are using that and some are finding resources from other sources. The noble Lord also questioned the quality of private sector homes. That is important because we foresee that some of those 24-hour nursed beds will be provided by the independent and private sectors. I understand his anxiety and that of the noble Baroness, Lady Masham, that all homes for mentally ill people should be adequate. Of course, we try to achieve that, not only through regulation but through regular inspection. Indeed, we know of many cases now in which social services have taken action when deficiencies have been brought to their notice. Perhaps I could look into the instance raised by the noble Baroness, Lady Masham, and come back to her in due course. Should Paul Weston be identified by the team as at risk of harming himself or others, he will be included today on the supervision register, which is another component in the spectrum of care. The register will ensure that, as a particularly vulnerable patient, he will continue to receive the care that he so badly needs. Details of the circumstances in which he would be at greatest risk will be included on that register, so that his key worker can make sure that preventive action is taken should any of those risks occur. If Paul Weston had been detained in hospital under the Mental Health Act and was considered to present a substantial risk of serious harm to himself or others unless his aftercare were supervised, he would now be eligible for supervised discharge—a third component. That new power, introduced on 1st April, would mean that if he failed to agree with the agreed care plan, it would lead to an immediate review of his care and, if necessary, readmission to hospital. But that may not be needed. An adjustment to his care plan may be sufficient. More often, it will involve the local authorities. As the noble Lord, Lord Thurlow, said, it requires local authorities and health authorities to work together. We have been encouraging that, not only through local workshops and study days but also with our guidance booklet, Building Bridges, which sets out good practice on inter-agency working and has been welcomed by both services. I am aware that what I have described is the ideal. It is what the Government, through the NHS and social services, wish to deliver. But we recognise that the spectrum of care providing services designed to meet individual needs in the most suitable environment requires targeted resources. Specialist mental health services must focus on those with severe mental illness, and that is being achieved through the care programme approach supplemented by the supervision register and supervised discharge when those measures are appropriate. The right reverend Prelate the Bishop of Oxford, the noble Lord, Lord Gerard, and the noble Baroness, Lady Masham, raised the issue of cost, particularly in relation to 24-hour nursed beds. Again, I draw attention to the document commissioned by the NHS Executive. With regard to resources it states that more work is needed to cost 24-hour nursed care compared with other forms of care for this client group. Nonetheless, it is clear that the cost per resident, though high, does not compare unfavourably with the cost for current alternative provision for this client group. More importantly, in our view, it represents much more cost-effective provision when the wider benefits to the mental healthcare system as a whole are considered. We currently spend £2.35 billion on NHS hospital and community mental health services. A review of mental health purchasing carried out in the autumn indicated that health authorities planned additional investment in mental health services in the present financial year. Your Lordships will recall that on 20th February in this House I repeated the Statement made by my right honourable friend the Secretary of State for Health announcing several new initiatives. Those included a new Mental Health Challenge Fund, an additional £10 million matched by health authorities pound for pound which has been allocated to a range of developments, including an expansion of 24-hour care, strengthening of community mental health teams and provision of a crisis service for people with acute mental health problems. At the same time we announced that the mental illness specific grant allocated to local authorities would be extended into its fifth year and increased by £11 million to a total of £58.3 million. That grant has already supported 1,200 projects, helping over 100,000 people since it was introduced in 1991. The noble Lord, Lord Thurlow, referred to violent patients, as did the noble Baroness, Lady Berners. We understand the concern about violent behaviour. However, there is no evidence to suggest that homicides by mentally ill people are on the increase. Convictions for homicide under Section 2 of the Homicide Act 1957—which provides the best available indicator of the number of homicides committed by mentally ill people—are no higher now than they were 20 years ago, though the total number of homicide convictions has increased substantially. It should be remembered that severely mentally ill people are far more likely to harm themselves than to harm others. Before addressing the points raised by the right reverend Prelate, I should like to mention my sincere bereavement. Due to a decision made by the BBC, we shall in future be deprived of the right reverend Prelate's "Thought for the Day". I am truly saddened by that. However, this afternoon we have not been denied his thoughts on mental health, some of them from first-hand experience. I am delighted by his warm welcome for community care, although I understand his view that it needs to be made to work. The right reverend Prelate particularly addressed the issue of homeless mentally ill people. They are a group which has concerned the Government for a considerable time. Your Lordships will know that in 1990 we launched the Homeless Mentally Ill Initiative in response to those concerns, particularly about people sleeping rough in London. That scheme aims to introduce mentally ill people to mainstream services by encouraging them into temporary accommodation, where they can receive appropriate care and assistance before moving on into the community. The initiative funds five multi-disciplinary community psychiatric Outreach teams and nearly 150 temporary hostel places. We have spent over £20 million on the initiative so far and this year a further £2 million has been top sliced from the mental illness specific grant to extend the initiative into other areas because we know from our experience that this scheme has brought real dividends to that vulnerable group. The noble Earl, Lord Longford, sought to soften my heart. He does not have to try too hard. Apart from his charm, the noble Earl has the respect of this House for a long and very distinguished career in politics, having held an array of offices of state. Latterly we know of his determination and commitment to improve the care particularly of those involved in both health services and the penal system. Perhaps I may say that I found his book Prisoner or Patient very enlightening. The noble Earl particularly mentioned the Matthew Trust and also a new body that is being set up to represent a number of small aftercare bodies in the field of mental aftercare. I learned of that only recently. In fact the noble Earl courteously told me about it yesterday. I understand that that body has not yet been fully established. But, along with other voluntary organisations, such as the Mental After Care Association, which we already support through the Section 64 scheme, we should want to keep a close eye on it as it develops. I am sure that the noble Earl will keep me in touch with its progress. I should like to thank my noble friend Lord Mottistone for his generous remarks to both my honourable friend and colleague John Bowis and myself. We have listened to my noble friend over time both with regard to issues concerning the particular needs of the Isle of Wight and to his reservations concerning the speed of moves toward community care. I know that the organisation for which he has been a champion—the National Schizophrenia Fellowship—has campaigned for some time now for a 24-hour nursing service, albeit it names it differently. It has also campaigned for greater powers to ensure that those suffering from schizophrenia are not neglected and fail to take their medication. That is an issue which we have addressed through supervision orders. But tonight my noble friend particularly wished to mention the responsibilities of GPs as did the noble Baroness, Lady Robson. We accept that there are tensions between the need to focus services on severely mentally ill people while helping primary mental healthcare teams to cope with their patients who have more minor forms of mental illness. In February this year we announced a two-year project to allow fundholders to purchase not only community mental health service and out-patient care, but also to purchase in-patient care. The 27 fundholders taking part in the pilot scheme will be contributing to agreed strategies for local services and will aim to strengthen their links between community mental health teams and primary healthcare teams in order to offer better support to their patients in the community and to prevent unnecessary admissions. We will therefore be monitoring the initiative carefully. The noble Baroness, Lady Robson, also wanted to discuss the issue of medical cover for 24-hour nursed care and was concerned that that would again fall onto GPs. We expect either local authorities or the relevant professions to forewarn the GP that a patient is about to be discharged from hospital as part of the care plan to be drawn up before the patient leaves hospital. Again, that is something we shall be monitoring closely. My noble friend Lord Mottistone also wanted to draw attention to the shortage of psychiatrists. He is right to do so. We are addressing that issue and recently announced an increase of 114 specialist registrars in general psychiatry, forensic psychiatry and old-age psychiatry. In addition, a joint working party from the Department of Health and the Royal College of Psychiatrists is looking at workforce issues. The noble Lords, Lord Gerard and Lord Thurlow, expressed concern about hospital closures and discharges. I can assure your Lordships that permission is not granted for the closure of long-stay hospitals unless adequate provision is available in the community. In addition, we issued guidance about the discharge of patients into the community to balance both their own needs and that of the community. Of course, the care programme approach should ensure that. The noble Lord, Lord Acton, and the noble Baroness, Lady Robson, expressed the view that too much money is still tied up in hospitals. As the number of patients in long-stay institutions decreases, so the unit costs of those remaining increase, which was a point made by the noble Baroness. Those patients remaining are likely to be more severely mentally ill than those initially discharged into the community. We are encouraging health authorities to develop comprehensive reprovision strategies covering services and resources. Again, with the undertakings we have given about non-closures, I am told that there are facilities available. We believe that is the way forward. The noble Baroness, Lady Masham, urged us to listen to carers. In our consultation document, Mental Health Services: The Patients Charter, we set out a number of rights and expectations which both users and carers should expect in the delivery of care and treatment. We look forward to the results of those consultations. I am grateful to the noble Lord, Lord Acton, for outlining existing services which support families when they and their mentally ill relatives are at crisis point. He is right that we need a spectrum of care, a variety of services, especially those based in the community, to deal with crises. He may be encouraged to know that through the Challenge Fund 12 new crisis services have already been set up. A number of other issues were raised. I shall pick them out in Hansard and write to noble Lords. But perhaps I may mention one or two points raised by the noble Lady, Lady Kinloss, who was concerned about the matter of psychiatric nurses. Again, that is an issue that we have addressed. Indeed, in the current year we increased the training numbers by 17 per cent. But the growth in the number of community psychiatric nurses has been considerable. Clearly, however, there is an increasing demand and it is something with which we have to keep pace. The noble Lady also raised the issue of people with a mental illness and a learning disability. There are various views concerning that, as outlined by the noble Lord, Lord Rix. I do not want to enter that debate tonight, except to say, as the noble Lord said, that we are sending out guidance in terms of a booklet. Perhaps it is an issue that we shall come back to on another day. On the question of form filling, I can assure the noble Lady that we are in the midst of an efficiency scrutiny and are examining what forms are unnecessary. Although I understand that the role of the Opposition is to oppose, it is a pity that the noble Baroness, Lady Jay, did not acknowledge the huge strides that have been made. All districts now have the care programme approach in place and only a few have not applied it to all their patients in contact with specialist psychiatric services. The NHS Executive is pursuing those authorities which have not met the target date of April 1996. I understand that they will have achieved full implementation by the end of June this year. As the noble Lord, Lord Thurlow, stated, the Griffiths proposals have only recently been introduced. I am sure the majority of your Lordships will agree that the care which can be provided for Paul Weston in 1996 is far better than that available 25 years ago. We owe it to Paul Weston and to everyone else with severe mental illness to ensure that care of that quality is available for every person with a severe mental illness. Real progress has been made and the policy to establish a spectrum of comprehensive services is not in doubt. The prize will be to enable those with severe mental illness to live among us, supported by the care which they need, leading safe and fulfilling lives and contributing to the community to which they and all of us belong.8.16 p.m.
My Lords, I thank all those who have contributed this evening from their considerable personal experience. In this House we enjoy the advantage of being able to draw upon great knowledge and experience in so many fields, and that certainly applies to the field of mental illness.
I hope that the Minister will feel that the contributions were made with a constructive intent. It has been a constructive debate. As I suggested at the start and as the Minister emphasised, the edifice proposed by Griffiths is still young; it is still being built and it would be entirely unrealistic to have expected a perfected building to be available yet. However, it has been encouraging this evening to hear of the remarkable strides that have been made in achieving the reality of community care to a much greater extent. That does not mean to say, as your Lordships have not been slow to point out, that there are not serious continuing gaps, and at present it is difficult to envisage how they will be filled without new initiatives. One gap in particular that was mentioned in relation to the problems of local authorities points to the need for some kind of new training blitz to help councillors in local authorities to understand some of the problems better, as well as the medical and legal framework. Like others, I too congratulate our two maiden speakers. Though the noble Baroness, Lady Berners, had to leave, it is a great advantage to have another nurse in our ranks, especially, as your Lordships emphasised, with the critical situation that exists in the supply of CPNs. I was interested by some of the new ideas that arose in the course of the debate. I was not surprised to learn a lot. The noble Lord, Lord Gerard, told us of the interesting Fountain House project which is being extended throughout the country. That seems to provide a wonderful instance of how ordinary members of the community can help to back up the professionals and others in this field. My main impression of the debate is on the whole in line with that of the noble Lord, Lord Mottistone, that the trend has been encouraging and is encouraging. Much remains to be done but we must be grateful to all concerned for the progress made. I beg leave to withdraw the Motion. Motion for Papers, by leave, withdrawn.Disabled Persons And Carers (Short-Term Breaks) Bill Hl
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 Rix.) On Question, Motion agreed to. House adjourned at twenty-one minutes past eight o'clock.