I beg to move, That this House doth agree with the Lords in the said amendment.

With this it will be convenient to take Lords amendments Nos. 2 to 8.

The prime mover of the Bill, my hon. Friend the Member for Newbury (Mr. McNair-Wilson), first became interested in the complaints procedure in the National Health Service during his serious illness in 1984. This morning he is in hospital as an outpatient on a dialysis machine. I am sure that we all hope that he is feeling much better already and that before too long it will be possible to find a permanent solution for his illness. Meanwhile, I have been asked to move acceptance of the amendments. I feel honoured to have the opportunity to be associated with this important Bill.

As the Bill completed all its stages in the House without amendment on 22 February, and virtually without criticism, I should explain why we are prepared to accept all eight amendments. Without the amendments, the Bill will not do what it is intended to do. It would merely perpetuate the present somewhat unsatisfactory procedure for complaints. As the law stands, the Secretary of State., under section 17 of the National Health Service Act 1977., has the power to give directions to the health authorities, and they must comply. My right hon. Friends who have served as Secretary of State for Social Services over the years have taken this duty seriously.

The result is that we have a plethora of complaints procedures, none of which is entirely effective. The procedures were listed by Lord Colwyn in another place on 17 April. It would be appropriate to read them into the record. Lord Colwyn said:

"They are: the civil law, with particular relevance to negligence, assault and defamation; the criminal law, with particular relevance to drugs legislation and certification; the General Medical Council and General Denial Council, concerned both with serious professional misconduct and fitness to practice; the ombudsman in matters other than clinical judgment; health circular No. (81)5, which deals with complaints regarding clinical judgments; HM(66)15, which is concerned with methods of dealing with complaints by patients; HM(61)112, which deals with matters concerning the hospital doctor's personal conduct, professional conduct and professional competence; HM(60)45, which is concerned with the prevention of ham to patients resulting from physical or mental disability of hospital staff.

We have also the service committee and tribunal procedure which is concerned with the general practitioner's terms of service and under which he can be fined or excluded from providing general medical service. Finally, there are the inquiries set up by the Secretary of State under Section 84 of the National Health Service Act 1977.—[0fficial Report, House of Lords, 17 April 1985; Vol. 462, c. 779.]

Recently, the Secretary of State has made use of the powers under that section in the inquiry into legionnaire's disease at Staffordshire hospital. However, my noble Friend missed out several procedures. It is amazing what one finds once one starts digging. There are also letters to the health authorities on complaints procedures of 9 December 1966 and 27 July 1970, health notice HN(78)39 of April 1978. I think that that is an exhaustive list, but I stand willing to be corrected.

The main document in use is HC81(5), issued in April 1981, which makes it clear that it is a "memorandum of guidance" and therefore has no statutory power. If the Bill has any purpose and if these amendments have any value, that gap will be closed. It is vital that we should have, for the first time, a Bill that firmly states:

"It shall be the duty of the Secretary of State to give to each health authority in England and Wales and to each Health Board in Scotland such directions … as appear to him necessary"

to achieve a proper complaints procedure.

I should like to examine the amendments in more detail. If we are to make the Bill work, we must accept all of them. Clause 1 lays a duty on a Secretary of State to exercise his existing power to give directions to health authorities so as to require the establishment and publicising of specified procedures for dealing with complaints in all NHS hospitals. The amendment extends the categories of authority to which such directions will have to be given to district health authorities in England and Wales, health boards in Scotland and special health authorities.

As previously drafted, the Bill covered only regional health authorities, and therefore applied only to England. There are no regional health authorities in Wales and Scotland, and the Bill is intended to apply in both areas. Regional health authorities in England are not the authorities directly responsible for the management of hospitals. The amendment ensures that the directions required by the Bill to be given are addressed to all authorities with hospital management responsibility. The other amendments follow from this proposed change which alters the Bill fundamentally and will make it much more effective.

Under clause 1, without the Lords amendments, there will be precious little improvement in the situation to which my hon. Friend the Member for Newbury drew attention on Second Reading. If the regional health authorities were responsible, nothing much would happen, even with the statutory obligations as laid down in the original Bill. It is worth remembering that my hon. Friend's horrendous experience—when he was treated at three different hospitals, none of which appeared to have a complaints procedure and certainly none of which informed him of one — occurred despite the plentiful supply of circulars and instructions which I outlined earlier. We must do better than that.

The key objective is to pin responsibility firmly on those bodies that run patients' services — the district health authorities. The regional health authorities are remote. In some regions, they cover thousands of square miles. They cover scores of hospitals.

I am listening carefully to my hon. Friend's argument. It was suggested in the original Bill that the matter should be looked after by regional health authorities, but it is now suggested that district health authorities should be responsible. What was in people's minds originally when they thought that this matter would be better dealt with at regional level? Will my hon. Friend tell the House why that is so, because there may be potent arguments in that direction?

I believe that the case was that the regional health authorities were regarded as the prime movers in England and Wales and that my hon. Friend the Member for Newbury had not realised that there were no such bodies in Wales. The main contact between the Secretary of State and the health service in the country at large is through the accountability reviews that he exercises during the year with regional health authorities. The Secretary of State does not normally meet the district health authorities. I believe that that is why the regional health authorities were, before the other place scrutinised the Bill, regarded as the appropriate authorities. However, in my view and that of my hon. Friend the Member for Newbury, they are not the appropriate authorities. I hope that the amendment will be accepted.

The regional health authorities may be funding certain activities — for example, regional specialties such as cardiology and kidney transplantation. However, the district health authorities carry the can for what goes on in the hospitals which they are responsible for running.

The Lords amendments to clause 1 have several other effects. They include special hospital authorities. These authorities are a legacy of the reorganisations of the NHS in 1974 and 1982. They mainly comprise certain teaching hospitals. There are eight postgraduate teaching hospital special health authorities, which were formerly run by boards of governors. They are the hospitals for sick children, the national hospitals for nervous diseases, Moorfields, the Bethlem Royal hospital and the Maudsley hospital, the national heart and chest hospitals, the Royal Marsden hospital, the Eastman dental hospital and Hammersmith hospital. There are various other special health authorities, including the Central Blood Laboratories Authority, the Health Service Supply Council, the National Health Service Training Authority, the Prescription Pricing Authority, the Rural Dispensing Committee, Rampton Hospital Review Board and the Mental Health Act Commission. Whether my hon. Friend the Member for Newbury realised that he had left all those out is a moot point, but they will now be included by these amendments.

Current DHSS guidance on complaints under HC81(5) applies to those special health authorities that provide a hospital service to NHS patients. The coverage of the Bill as amended would similarly include special health authorities that provide NHS hospital service.

Not all teaching hospitals are included in the group of special health authorities. The vast majority are run by district health authorities. I have had the privilege of being chairman of the Central Birmingham health authority which had seven teaching hospitals in the midlands, including the celebrated Queen Elizabeth hospital. The teaching hospitals in my area were not covered by special hospital authorities, although there was no technical difference between them. The postgraduate teaching at Queen Elizabeth hospital was similar to the postgraduate teaching at the hospitals to which I have referred.

It is of the utmost importance that our major teaching hospitals are not left out. When a person is acutely ill, when he has a rare condition that is difficult to diagnose or when he is an "interesting case" and liable to be discussed with students or written up as a research exercise, the gap between the patient and the NHS staff, especially doctors, frequently grows too wide. The apocryphal comment sometimes attributed to such centres of excellence is, "The operation was a great success but the patient died." I swear that that comment has been made to me in the teaching hospitals for which I was responsible. That is not good enough. It is essential that the Bill be extended to all such authorities. When the patient is in such circumstances, it is even more important that he knows how to complain, that his family know how to complain on his behalf and that others associated with his care, including his general practitioner, are able to take up the problems. It is essential that a proper complaints procedures should exist and be made available to the patient.

On Second Reading, my hon. and learned Friend the Member for Mid-Bedfordshire (Mr. Lyell) said:

"It should be a requirement of every medical school that there is at least a significant period of formal training for young doctors as to how to approach the patient." — [Official Report, 22 February 1985; Vol. 73, c. 1381.]

I completely agree. I found in the hospitals for which I was responsible that the people in a teaching hospital who benefited most from a properly conducted investigation of a complaint were the young doctors undergoing training. In the middle of all their studies — of anatomy, pharmacology, surgery, anaesthesia and the like — they are not taught well how to listen to their patients. The patient often knows best. As my hon. Friend the Member for Newbury said on Second Reading, he knew that he was allergic to penicillin. The doctors took absolutely no notice, and landed him in hospital for a further five weeks with a dangerous rash.

10.30 am

We all have constituents who have experienced similar difficulties of getting doctors, especially a young doctor, to take some notice of them and to take them seriously when they say where it hurts or what does not suit them, and how they can be better treated. If, by including special hospital authorities, we can take some small step towards avoiding those things happening, we will have done some little good.

I am following my hon. Friend's argument closely. She is right when she says that patients must be given all possible opportunities to air their complaints against hospitals. Happily, the number of complaints is not too great. Does she agree that, while we are correct to concentrate on ensuring that patients can have their grievances ventilated, we are equally right to stress from time to time that patients also have a responsibility towards the hospitals in which they are treated, and that that responsibility often includes turning up on time, on the right day and at the right place for operations and outpatient treatment? The NHS suffers from a considerable waste of time when patients do not fulfil those responsibilities. There is a social contract between the patient and the National Health Service which both sides should fulfil.

Order. We are in danger of getting back to a general debate on the Bill. We must concentrate on the Lords amendments which are before the House.

I am glad to accede to what my hon. Friend says.

The third main effect of the amendment is to extend the Bill to Wales and Scotland. I was hoping that we would see some Scottish Members here this morning. It is a pity that there is none. It was always the Bill's intention that it should cover Wales, as clause 2(3) says. However, when my hon. Friend the Member for Newbury originally tabled the Bill, it referred to regional health authorities. It happens that there are no regional health authorities in Wales. The Principality is not covered by a single RHA which answers to the DHSS.

In England, there are 192 health districts organised into 14 regions. In Wales, there are nine health districts answerable directly to my right hon. Friend the Secretary of State for Wales. There is no regional tier. Therefore, 167 hospitals in Wales — that is the figure at 31 December 1983, and I should be surprised if the DHSS does not know of a few more since then — will be covered by the Bill if the amendment is accepted. It would clearly be unsatisfactory if we did not accept the amendment. We would then have two different systems —one for the English and one for everyone else.

I take that point. There are ways in which Scottish law and administration are somewhat different from ours and there are good reasons for that. It suits the Scots, us and the Welsh. My hon. Friend has just said that there are 192 health districts in England. I am not sure how many regions there are; perhaps she can advise me. It seems to me a rather heavy job and responsibility for the Minister to have to contact each district. As he is getting in touch with them he has, to an extent, to supervise them to ensure that they are carrying out his instructions. If he makes that connection with the regions, he has a far narrower span of control which is more easily policed and effectively carried out. The regions should be allowed to do the job for which they are in place. My hon. Friend has not yet satisfied that argument.

On the first part of my hon. Friend's question, there are 14 regions in England. As to the second part, that is what my right hon. Friend the Secretary of State for Social Services is in office for. I am sure that he recognises that he has that responsibility now, but it is not a statutory responsibility. That is what the Bill will make it. He may give directions, and HC(81)5 is a memorandum of guidance. The health authorities do not have to take any notice of it at all. The Bill, as amended, will insist that the Secretary of State gives those instructions and will then insist that the various health authorities take note.

The regional health authorities will not be excluded by the proposed amendment to clause 1. The Bill will simply refer to health authorities and therefore regional health authorities, district authorities and the other health authorities can be included.

Is my hon. Friend aware that, as she said earlier, my right hon. Friend the Secretary of State, my right hon. and learned Friend the Minister for Health and myself regularly meet the chairmen of the 14 regional health authorities to discuss Health Service matters? It is not correct to say that we stop our discussions at that level on complaints or any other related issue, but through regional health authority chairmen we relate to district health authority chairmen. From time to time we meet the various district health authority chairmen in the different regions. There are more than 190 of them. On those occasions we have the opportunity to discuss issues such as Health Service complaints procedures. It is important that the impression is not given that we talk only to the regional health authority chairmen on that point.

That is right. I had the privilege of meeting my right hon. Friend the Secretary of State at such a meeting about three years ago.

My hon. Friend the Member for Northampton, North (Mr. Marlow) asked about Scotland. There is no good reason why Scotland should be excluded. There is every reason why Scotland should be part of the Bill. It was the intention of my hon. Friend the Member for Newbury on Second Reading. He is delighted to accept the Lords amendments which will extend the scope of the Bill to all parts of the United Kingdom. I understand that it is my right hon. Friend's intention to move Orders in Council that will make the Bill apply to Northern Ireland as well.

I was not saying, forgive me, that Scotland should not be included. All I was saying was that sometimes Scottish legislation is different from that of England, for good reasons. My hon. Friend is beginning to frighten me. She said that there are 14 regions and 192 health districts. She is saying that the Minister will send out his diktat—let me put it more kindly than that: his ideas and instructions — to the districts and to the regions as to how the complaints procedure should be run. That seems like a recipe for chaos, because the chairman of the regional health authority and the general manager of the district health authority will both be waving their pieces of paper from the Minister. The region will be saying to the district, "We do not like the way in which you are doing it." The district will be saying to the region, "Ah, but I have it in tablets of stone from the Minister."

My hon. Friend should study any large organisation. The one that I know best from my background is the services. She will find that the general might tell the brigadier what to do, but it is up to the brigadier how he organises his colonels. If the generals start telling the colonels what to do, there is chaos.

Far be it from me to answer for my hon. Friend the Minister, who I know wishes to intervene at some stage, but my understanding is that we will have a process of consultation after the Bill becomes law, if it receives the assent of both Houses. That will be an extensive process of consultation. The instructions that will be eventually issued by the DHSS to the health authorities in the Bill, as amended, will take into account comments that are made. I hope that they will produce something that is effective, and in view of the requirement for publicity, to which I shall come, will cope with all the problems identified by my hon. Friend the Member for Newbury and the difficulties faced by many of our constituents when they are obliged to go into hospital.

As there are no Scottish Members present, I shall deal with the matters relating to Scotland in a little more detail. Without the amendments, we should not be able to extend the Bill to the Scottish Health Service, and that would clearly be unsatisfactory. There are 15 health boards in Scotland — 12 for the mainland and three island authorities for Orkney, Shetland and the Western Isles. There are no districts. One tier, the health board, is appointed by my right hon. Friend the Secretary of State for Scotland. The health boards are directly responsible to the Secretary of State for Scotland, and they cover 365 hospitals.

I have never been in a Scottish hospital. I hope that I never have need of one. My attitude is much the same to all hospitals in Scotland, England and Wales and everywhere else. Any Scottish colleagues who read the Official Report of today's proceedings should not feel discriminated against. The National Health Service owes an enormous debt to Scottish medicine, because there is no doubt that for many years Scottish teaching hospitals have been well ahead of many of their contemporaries elsewhere. Scottish medical schools have led the nation for a long time.

My hon. Friend is treading on dangerous ground there.

I have no doubt that my hon. Friend is about to tell us that teaching hospitals in Nottingham will stand with those of the rest of the nation.

Of course.

As many of my constituents are treated there, I agree with him. However, we must recognise that under the Bill, without the amendments, Scottish hospitals would not be included. As the law stands, Scots people would not be assisted by the Bill, unless the House accepts the amendments that I have outlined. They would continue to have the benefit of only the 1977 law and the rather toothless circulars that were sent out as a result. They would continue to have a patchy service with regard to complaints, with some hospitals setting a high standard of producing leaflets telling people what to expect in hospital and how to take up matters that did not satisfy them, and some offering no advice whatsoever and continuing to act as though the patient were merely a case instead of a human being.

That is not satisfactory. By amending the Bill in this way, we shall ensure that patients in Scotland, along with those in Wales in the hospitals under the special hospital boards, as well as in England, will in future have a complaints procedure that is standard across the nation, compulsory and has statutory force. The procedure should ensure that events such as the horrific incidents described by my hon. Friend the Member for Newbury on Second Reading are investigated, put right and dealt with in a manner that can have the confidence and trust of all concerned.

England had 1,923 hospitals as at 31 December 1983. In total, therefore, 2,455 hospitals would be covered by the Bill if the amendments were accepted, 500 of them added by the amendments. Therefore, the amendments are of crucial significance to the many millions of people being treated in NHS hospitals.

An important element in the amended clause 1 would be subsection (1)(b). As amended, the clause will ensure that the Secretary of State will be obliged to require all health authorities to publicise their complaints procedure. My hon. Friend the Under-Secretary said on 22 February:

"A complaints procedure about which no one knows is of no use to anyone." — [Official Report, 22 February 1985; Vol. 73, c. 1389.]

I heartily endorse that. This is the first time that health authorities are being told that they must inform patients about some features of hospital life. It is the first time that my right hon. Friend the Secretary of State will have been obliged to lay that duty on them.

We should clarify one or two points about the amended clause. It does not give the patient the right to demand access to his files. It does not challenge hospital security on medical confidentiality. The British Medical Association had some reservations about that in the original Bill. Those matters are being fiercely debated elsewhere, not least later this morning. No doubt the Bill will add to that. However, that is not the purpose of the Bill and the subsection. It says that every health authority must tell patients in all the units for which they are responsible what to do if they are not happy with any aspect of the service that they receive. Up to now it has been said that they "should" tell the patients. Under the Bill as amended, that will be changed to "must". That is a major step forward. It will no longer be possible for the patient to be ignored. It is a most important part of the patients' charter which my hon. Friend the Member for Newbury published last September, and which attracted so many favourable comments at the time. In the circulars sent out under the previous legislation, the Secretary of State has suggested that each health authority should produce a leaflet. The appendix to HC(81)5 made some rather heavy-handed suggestions of what might be included. Paragraph 7 of the circular says:

"Information booklets should be given to hospital in-patients including, where possible at some suitable time, those admitted through accident and emergency services. These 'hospital booklets' should also be available to patients, on request, in hospital out-patient departments."

Note the word "should", not "must". We shall put in "must" as th Bill goes through both Houses and enters into law. Suggested paragraphs for use in the booklets for patients are contained in appendix 1 to memorandum HC(81)5, which reads:

"If you are seeking information when in hospital, the ward sister will generally be the person to speak to in the first instance"—

Order. The hon. Lady must relate her remarks to the amendments before the House and not go into a general discussion about the Bill.

I apologise, Mr. Deputy Speaker. I wish to point out merely that, without the amendments, the Bill would not work. It would simply reiterate and re-establish the existing rather unsatisfactory procedure.

Having been correctly called to order once before by you, Mr. Deputy Speaker, I am fearful of being out of order again. I am sure that you will correct me immediately if I stray over the bounds.

The amendments relate to procedures south and north of the border, and my hon. Friend the Member for Derbyshire, South (Mrs. Currie) is speaking to them very clearly. Does she agree that one of the issues raised in the circular to which she referred is the most important issue of monitoring, which is covered in paragraph 8? Authorities will have to introduce, both north and south of the border, systematic and effective methods of reviewing complaints. It is no good just having leaflets available. It is important to have the complaints themselves monitored and reviewed systematically.

My hon. Friend is absolutely right. Without such a monitoring system, the complaints procedure has no purpose. It will serve merely to air people's grievances and not correct the problems that led to the grievances in the first place.

My experience supports my hon. Friend in that. I was a member of the old Birmingham area health authority — a teaching authority, which has since been abolished — in the days when the circular to which my hon. Friend refers was published. We did our best to implement the circular, but, with the best will in the world, we had other priorities at the time, such as getting staff in post, particularly on the reorganisation of the Health Service. There are still hospitals in the group for which I was responsible that do not have such leaflets. It is worth emphasising the importance of ensuring that patients all over the country receive appropriate advice on how to complain. The amendment will ensure that that happens.

We had most fun at the Birmingham maternity hospital, a teaching hospital, where I had been a patient twice, in 1974 and 1977, when I had my two children. The hospital had an excellent leaflet. As a patient, I was able to make use of it. Subsequently, as chairman of the health authority responsible for the hospital. I was able to improve it, particularly by choosing better photographs. It may sound trivial to tell a pregnant girl to bring her toothbrush and some change for the telephone, but I assure the House that it felt like good advice when we woke up in the recovery room. We were grateful.

In future, as I understand it, failure to produce an appropriate leaflet will be grounds for complaint, too. I hope that the health authorities do not regard that as too much of an imposition. They should always remind themselves that they run the hospital not for the doctors, not for the convenience of the staff, not alone for the greater gains of medical research or for the reflected glory of being involved with Britain's best-loved institution, but for the patients. The patients are not a nuisance to he kept quiet—they are not a collection of statistics. That is an attitude that we must eradicate.

Amendment No. 4 is concerned with the Health Service commissioner — [Interruption.] There are eight amendments, and as the Bill had its Second Reading on the nod none of those matters was debated then. It is appropriate that we give proper consideration to them at this time. I hope that the House accepts that.

Amendment No. 4 improves clause 2 by ensuring that it extends to Scotland and thus covers the whole country. I accept that this is not the place to debate the role of the ombudsman — I do not intend to do so — but it is important that we do not hamper his work in any way. He was set up under the National Health Service Act 1977, and section 116 limits his powers in the following way:

"Except as hereafter provided, a Commissioner shall not conduct an investigation under this Part of this Act in respect of any of the following matters—

(a) any action in respect of which the person aggrieved has or had a right of appeal, reference or review to or before a tribunal constituted by or under any enactment or by virtue of Her Majesty's prerogative, or

(b) any action in respect of which the person aggrieved has or had a remedy by way of proceedings in any court of law".

That is very specific.

The ombudsman is a most important part of the overall complaints procedure. He deals with about 120 cases a year. He can take up any issue, whether it has a medical content or not. Having been on the receiving end, as a health authority chairman, I know the thoroughness and fairness of his work. He and his staff do a great service to the people and the NHS.

Without the amendment, the ombudsman would be rendered helpless, especially in Scotland. He will effectively be out of a job if he is specifically precluded from operating when any other course of action is open to the complainant, whether through legal action, a tribunal, an appeals procedure or whatever. Over time, as the health authorities obey the instructions set out in clause 1 and introduce a complaints procedure and tell people about it, the ombudsman may be unable to take up cases because the Secretary of State and the health authorities have pre-empted him.

I wonder whether my hon. Friend's constituency experience has been similar to my own. Aggrieved constituents have sought my assistance to put them in touch with the ombudsman but in practice he has been able to do very little for them. As often as not, the resolution of their worries has been outside his competence. That is why the Bill and the amendments are so important.

Some of the difficulties of dealing with complaints and of getting people to complain correctly and adequately to the right person at the right time were dealt with in the debate in another place. My hon. Friend raises a most important point. Part of the problem is a matter of attitudes. It is surely possible to advise people of the complaints procedure before they go to hospital for planned surgery or treatment. They should receive a leaflet in advance including advice on what to do if they are unhappy or have questions to ask. That advice should cover not just the patient, but his family, his general practitioner, his other medical advisers, and so on. If the patient has that information before he goes to the hospital he is likely to ask the appropriate questions at the right time and the people treating him are more likely to regard him as a human being whose fears and anxieties have to be allayed, not ignored. We must make that point very firmly today.

As for the powers of the ombudsman, it is worth reflecting that more than 5 million outpatients and, I believe, more than 600,000 inpatients are treated every year. Under the guidance of the Ministers concerned, record numbers of patients are being treated, but there are only about 9,000 written complaints per year which have to be investigated, and the ombudsman deals with only 120.

Order. The hon. Lady said that she did not intend to talk about the ombudsman's duties. She must deal with the amendments.

On a point of order, Mr. Deputy Speaker. If the ombudsman is prevented from fulfilling the purpose for which he exists and from meeting the needs of complainants, the question whether the situation is best dealt with by the Minister issuing instructions to regional health authorities or directly to district health authorities would seem to be germane to the debate. To that extent—

Order. That is an interesting question, but it is not one for me. It is for the Chair to decide whether a matter is in or out of order.

With regard to amendment No. 4, the law is a little hazy. It is not clear whether the ombudsman would be ruled out of court by the Bill as it stands, but we do not intend to find out the hard way. The clause is especially defective in relation to Scotland. In this context, we are pleased to note and to support their Lordships' amendments, which will ensure that the ombudsman's work in Scotland will continue on exactly the same basis as in the rest of the United Kingdom and that the benefits to which my hon. Friends have referred will be assured.

In my view, the Lords amendments greatly improve the Bill's effectiveness and are to be welcomed. Under the existing legislation it was possible for my hon. Friend the Member for Newbury to visit three different hospitals without being given any information about complaints procedures and to be a patient for months on end without realising that the Secretary of State had written to all health authorities years earlier advising them to set up a complaints procedure and to tell everyone about it. Indeed, other patients turned to him as a Member of Parliament to take up complaints on their behalf. In other words, the powers that be were able totally to ignore the myriad circulars sent out and the advice of the Secretary of State to the effect that they should have a complaints procedure. I am sure that my hon. Friend the Member for Newbury was surprised to read all those circulars and no doubt that was the basis of his determination to make the procedures statutory and mandatory so that no hospital could make the excuse that it did not have time and had not bothered to establish the necessary procedures.

This little Bill, with these important amendments, will be a step forward in patient care. My hon. Friend the Member for Newbury has asked me to thank all the staff at the DHSS for their assistance at all stages of the Bill. I also thank them for their very effective briefing to me in recent days. My hon. Friend has also asked me to thank all hon. Members who have assisted in the passage of the Bill in both this and the other House, especially the Under-Secretary of State, my hon. Friend the Member for Oxford, West and Abingdon (Mr. Patten) who must be singled out for special praise as he has taken a close personal interest in the Bill.

Finally, I am sure that the whole House will join me in thanking my hon. Friend the Member for Newbury for bringing forward the Bill. We congratulate him on his success in the ballot and we recognise the courage and dignity with which he presented his case and with which he continues to combat his illness. We wish him good health and we hope that he will never have occasion to set in train the procedures that he has established in the Bill.

The Bill is very welcome, but it is important that it should be coherent and that the amendments should be properly considered. As my hon. Friend the Member for Derbyshire, South (Mrs. Currie) has said, it is important to include Scotland and Wales—and potentially Northern Ireland as well—so that the whole United Kingdom can benefit from this boon.

At present, the Minister has power to issue instructions but is not required to do so. In the light of my experience of real constituency problems in this area, I am anxious that the Minister should give the instructions to the right people. The House is frequently concerned with human rights issues, but what happens in the Health Service is not just a question of human rights — sometimes it is a matter of life or death. Those who survive the sad death of a loved one are rightly deeply concerned about the circumstances. Sometimes, they fear that something which should have been done was not done or that the concerns of the bereaved have not been properly considered. A constituent whose mother died in a hospital outside the area sought an investigation into the circumstances in the belief that the right treatment had not been given. That may well have been so. The doctors do a tremendous job, but to err is human and mistakes happen. We must consider how complaints of that kind are best investigated in the light of the real burdens of sadness and distress that many of our constituents face.

Where do we go from here? Do we, as the Bill suggests, require the Minister to send to every one of the 192 district health authorities in England an elegantly phrased edict — knowing my hon. Friend the Under-Secretary of State, it will be both elegant and eloquent —as to how they should proceed?

11 am

In Northampton, but not in my constituency, a young girl was recently misdiagnosed and, sadly, died of appendicitis. There was a great deal of publicity and anxiety about the case, and people feel that questions have not been answered.

Is my hon. Friend the Minister required, in regard to the complaints procedure, to pass his instructions to district health authorities or to regional health authorities? If he gives instructions to DHAs, that means that he is responsible for ensuring that they are carried out. If he gives his instructions to RHAs, he has a proper responsibility to ensure that they are carrying out his instructions, but there are 14 of them. Some of us have been in the Army, industry and management and have heard about something called the span of control. The ideal span or number under a chief is eight. I am aware that my hon. Friend is beyond the realms of normal human beings. He is a gifted and gracious man and I am sure that he could cope more than adequately with a span of control of 14. Nevertheless, I wonder whether, in his heart of hearts—for, despite his great skills, my hon. Friend is a modest man — he feels that he could administer and supervise 192 DHAs.

I am naturally loth to intervene in this agreeable flood of compliments, and I hope that my hon. Friend will not feel that my intervention should cut him off from continuing in that vein. Does my hon. Friend agree, however, that there are great difficulties in Health Ministers involving themselves in detailed management, including management of complaints procedures, in 192 DHAs? Does he further agree that it is therefore important that we should issue general instructions to all health authorities, as my hon. Friend the Member for Derbyshire, South (Mrs. Currie) said, in so doing trying not to intervene unnecessarily beyond the span of control in the running of those 192 DHAs, or that we should approach the task through our regular contacts with the 14 RHAs?

I am beginning to be reassured. Perhaps I might bore the House with my experiences in uniform. When I was in the Army, we had things called Defence Council instructions and Army Council instructions, which were sent throughout the service to every unit, however small, The War Office, as it then was, and the chiefs of staff were not directly responsible for or in control of each unit. I should be worried if I thought that my hon. Friend had to manage the 192 DHAs directly.

It is instinctive for a professional body to look after its own. Disasters are bound to occur in the Health Service, and when they do there is a closing of ranks. There is little controversy about that. If prime responsibility for dealing with the complaints procedure rests within the DHA, responsibility will lie precisely where the ranks will close. It could be advantageous for responsibility to be vested in the higher tier. With responsibility in the lower tier, internal politics and knowledge of individuals—

I am a bit worried about what my hon. Friend is saying. Is he entirely ignoring the introduction of the new management structure, the appointment of the general manager, Mr. Victor Poge, general managers for RHAs and for DHAs and the appointment of managers at units of management level? Does my hon. Friend agree that that provides a line of management which will enable complaints procedures to be dealt with managerially and outwith any closing of ranks, which my hon. Friend suspects might happen?

My hon. Friend says that I suspect it might happen. I am not suspecting anything in a nasty way; I am reflecting on human nature and how things happen in organisations and institutions. The new management structure is a tremendous step forward. Like him, I believe that it will be massively helpful for the Health Service as, at last, there will be somebody at each level with whom the buck will stop.

We have a police complaints procedure, and one of the criticisms of it is that it is in-house. The police are involved with people's civil liberties. The Health Service—

Order. Will the hon. Gentleman tell me to which amendment he is addressing himself? I see no reference to these details in the amendments.

The thrust of the amendments is the inclusion of all health authorities as opposed to just regional health authorities. I am seeking justification for my hon. Friend sending his instructions to each hearth authority rather than, as the Bill originally provided, to RHAs.

Order. The hon. Gentleman must address himself to that argument. I have not heard it deployed yet.

There is anxiety that the police complaints procedure is in-house. I am saying that we should be more careful in the Health Service because we are dealing with matters of life and death. As we are having a complaints procedure, we must ensure that it operates at the proper level. I feel instinctively that the main responsibility could quite properly lie with the RHA, although I accept that, as with Army Council instructions and Defence Council instructions, it is right for my hon. Friend to send his eloquent, elegant and well-written instructions to every health authority in the realm.

I am sure that my hon. Friend will have a good reply to that question. What is the best method for ensuring that my hon. Friend's instructions are carried through?

Ultimate responsibility lies with my right hon. Friends the Secretaries of State for Social Services, for Wales and for Scotland. Responsibility for the complaints procedure therefore devolves downwards through the health authority network and management structure in the three different countries. I do not see that my hon. Friend has a point to make, because the line of responsibility goes up to the three Secretaries of State involved.

I respect my hon. Friend's point, and I am sure that later he will provide further details that will satisfy even my mind.

In the NHS my hon. Friend has a management structure, just as ICI, BP, Shell, and Guest, Keen and Nettlefold have a management structure. If, as a supplier or receiver of goods, one had a commercial complaint against any of those firms and wrote to the chairman or managing director, there would be a tendency within the firm concerned to close ranks. That is why we have consumer protection legislation. Splendid though the general managers in the Health Service are, if complaints are made relating to their area, are they the best people to operate the complaints procedure, or would it be better done at a higher level? That is the question that I leave with my hon. Friend.

In case the crowded Benches in the House this morning should give the public at large the wrong impression, I should like to make a brief contribution in support of the Bill in general and the amendments in particular.

In the 17-line explanation of the purpose of the Bill there are 19 words that we are considering this morning to which the amendments are specifically addressed. Those words are:

"to establish and publicise, as respects each of the hospitals they are responsible for managing, a procedure for dealing with complaints made by, or on behalf of, patients at such hospitals."

Given that that is the kernel of the Bill, I do not think that anyone could reasonably suggest that the amendments do anything but emphasise and underscore those objectives. It is right and proper that we should have one law in the United Kingdom to deal with a hospital complaints procedure. Many of us — even after two years in this House—still cannot come to terms with the fact that we do everything three times — first for England and Wales, then for Scotland and then for Northern Ireland. The public must also be puzzled that we have to multiply our legislation in that way. If the Bill simplifies the procedure, I am sure that that is all for the good.

I do not think that the analogy of generals bypassing their brigadiers and talking to their colonels, in the manner suggested by my hon. Friend the Member for Northampton, North (Mr. Marlow) is fair. Indeed, if that is how they operate, I can understand why the management structure of the services was in such a mess in the first world war. I think that the point that my hon. Friend was trying to make was that perhaps our worthy colleagues in the DHSS should talk only to the regions and not to the districts.

There are only 14 regional health authorities. My authority is Trent. They are vast organisations. The public might think it more appropriate that the Minister should write direct to the district councils, which are nearer to the grass roots and much more in contact with local people and local Members of Parliament. The Trent region stretches from Sheffield in the north to Leicester, or even further south. Those vast regional authorities employ thousands of staff.

My hon. Friend is pressing me, as I have been pressed hard by my hon. Friend the Member for Northampton, North (Mr. Marlow), on the question of devolved responsibility. Will my hon. Friend accept from me that it is our intention, should the Bill become law, that while all health authorities will be given identical instructions, we regard our relationship as being initially with regional health authorities on the general conduct of business, of which the complaints procedure is but one part, and thence onwards to the district authorities, as laid down by law?

I accept my hon. Friend's point without reservation. I am sure that the Bill will be accepted in its present form. I welcome and support it.

In the unavoidable absence of my hon. Friend the Member for Holborn and St. Pancras (Mr. Dobson), I confirm that the Opposition welcome the Bill as a step in the right direction.

Congratulations are due to the promoter, the hon. Member for Newbury (Mr. McNair-Wilson), who is not very well and cannot be here today, and to the hon. Member for Derbyshire, South (Mrs. Currie). We must not only congratulate the hon. Lady but you, too, Mr. Deputy Speaker, for your forbearance during a speech lasting 40 minutes in which Scotland was referred to only half a dozen times, when every amendment relates to Scotland. I am not sure who deserves most congratulations—you for your forbearance, Mr. Deputy Speaker, or the hon. Lady for getting away with it.

The hon. Lady also deserves congratulations for striking fear into the heart of the hon. Member for Northampton, North (Mr. Marlow). That is not an easy thing to do. Perhaps it is a forerunner of what may happen when we deal later with the Sexual Offences Bill.

The Hospital Complaints Procedure Bill is a step in the right direction and we commend its extension to Scotland. We do not need to have separate legislation for each part of the United Kingdom; that is neither necessary nor desirable. The fundamental argument is that there is a need for a proper complaints procedure in the NHS, and that it should extend to all parts of the United Kingdom.

It is regrettable that there is still no proper democratic system for running the NHS, and that matter needs to be examined carefully. From time to time I receive complaints which can be taken up with the area health authority or the regional health authority and I do not always receive satisfaction, despite the good intentions of those involved. In many cases there is no proper way in which to follow up complaints. I know that from time to time the Minister receives letters of complaint about the procedure and he must appreciate that it is not effective.

I should like to see the involvement of local councillors who are directly elected. I commend the efforts of Councillor Hugh Thompson in my own area. He has started the first advice surgeries for people with complaints about treatment in the NHS. They are held on a regular basis so that people have someone to whom they can air their grievances.

I shall be writing to the Minister in due course on another matter which does not fall under the legislation before the House. There are plans in Hammersmith, which is a special health authority area, to close seven wards for the month of August. I have already received several complaints from people who will not be able to enter hospital and will suffer extra pain because of the month's delay. The reason for closing the wards is simply to save £100,000. That is the nature of the problem, yet a few moments ago the Minister intervened to say how much the Government were spending on the NHS. The public recognise that there is a real undermining of the NHS taking place and a deterioration in the services provided.

The Bill is a small but important step towards a proper complaints procedure, and will put firmly on the statute book a recognition of the principle that some form of national complaints procedure is required. But sooner or later the House will have to examine in more detail the administration and control of the NHS on behalf of the people who make use of the services. We should also consider whether it should be separate from local government.

Our interesting short debate has been notable for the fact that the affairs of Scotland and Wales have been debated without many hon. Members from those countries being present to consider the amendments.

I join the hon. Member for Hammersmith (Mr. Soley) in paying tribute to my hon. Friend the Member for Newbury (Mr. McNair-Wilson). I described him during Tuesday's debate on the NHS as our valiant hon. Friend —and valiant he is. I know that he wished to be here today, but is unable to be present because he is having hospital treatment. He certainly intends no discourtesy to the House by his absence. He has an adequate and elegant substitute in my hon. Friend the Member for Derbyshire, South (Mrs. Currie).

The amendments have been fully examined. Most involve the extension of the Bill to other parts of the United Kingdom, though there are also important issues involving the Health Service Commissioners.

Clause 1 lays a duty on the Secretary of State to exercise his existing power to give directions to health authorities requiring the establishment and publicising of specified procedures for dealing with complaints in all NHS hospitals. Lords amendment No. 1 extends the list of authorities to which such directions will have to be given to district health authorities in England and Wales, health boards in Scotland and special health authorities wherever they are located. That provision greatly exercised the mind of my hon. Friend the Member for Northampton, North.

My hon. Friend the Member for Derbyshire, South went into the amendments in detail and I complimented her on her speech, which I followed with great care. We are sometimes a little too free with our compliments in the House, just as we are sometimes a little too free with our abuse of each other. When I read what I had said about the hon. Member for Oldham, West (Mr. Meacher) at the end of Tuesday's NHS debate, I was a little ashamed of myself. I referred to his possible future as a Front-Bench spokesman and used the words of a well-known first world war song to express my regrets that the hon. Gentleman might not be on the Opposition Front Bench in the future. Perhaps I went a little far and, therefore, perhaps I have been a little restrained in my compliments to my hon. Friend the Member for Derbyshire, South.

As drafted, the Bill covered only regional health authorities and therefore applied only to England. There are no regional health authorities in Scotland or Wales and it is now intended that the Bill should apply in both those countries. My hon. Friend the Member for Nottingham, South (Mr. Brandon-Bravo) complained about our legislative diversity, but the countries that make up the United Kingdom express that diversity in their organisation of the NHS and in other ways, and we have to make appropriate legislative provision for them. However, I understand why my hon. Friend feels that the process takes up much of our time.

Regional health authorities in England are not directly responsible for the management of hospitals. Lords amendment No. 1 will ensure that the directions to be given are addressed to all authorities that have hospital management responsibilities. I made that point two or three times during interventions in the speech of my hon. Friend the Member for Northampton, North. I am grateful to him for having given way because we had a useful debate about the responsibilities of the various health authorities.

Lords amendment No. 1 extends the Bill to Wales and Scotland, but not to Northern Ireland. In an enjoyable and all too brief speech, my hon. Friend the Member for Nottingham, South told us his views on legislative diversity and said that he always liked to see one law for the United Kingdom. For two and a half years I was Under-Secretary of State for Northern Ireland and I was often here at two o'clock or three o'clock in the morning debating Northern Ireland issues. I know that if the right hon. Member for South Down (Mr. Powell) were here today, he would give a "Hear, hear" to the sentiments of my hon. Friend the Member for Nottingham, South.

The amendments are technical, but they are important to Wales and Scotland. They are designed to ensure that the Bill can have its intended effect, and the Government support them wholeheartedly. For my right hon. Friend the Secretary of State to be able to make directions which will bite on the relevant authorities, the Bill must specify the authorities correctly. As originally drafted, it did not do so.

Clause 1 refers only to regional health authorities. As has been pointed out time and again in the debate, those authorities exist only in England. There is no regional tier of management alone in Scotland and Wales. Moreover, as my hon. Friend the Member for Northampton, North mentioned in his powerful speech, regional health authorities in England do not directly run hospitals. That is the job of district health authorities and of special health authorities to which my hon. Friend the Member for Derbyshire, South referred at length, though I should have liked her to develop her comments on special health authorities, because they are neglected bodies. I fear that all too often the public do not appreciate the relationship between district, special and regional health authorities, particularly in London.

In Wales, district health authorities are the relevant authorities, while in Scotland the health boards run hospitals. The amendment would include those authorities in the Bill. In addition, to the extent that regional authorities are responsible for elements of the management of hospitals, the Bill will bite on them. My hon. Friend the Member for Northampton, North referred to that. I see that he has moved to the Opposition Front Bench; I hope that that is only a temporary aberration.

The Bill was originally intended to apply only to England and Wales, but the Government and my right hon. Friend the Secretary of State for Scotland, who has had to give his assent. have agreed that it should apply north of the border as well. My hon. Friend the Member for Newbury has said that he wishes the Bill to be extended as widely as possible and the Government support that objective. There has been no dissenting voice from England, Scotland or Wales during the debate.

Lords amendment No. 2, which is also a technical amendment, will include a necessary reference to the legislation governing health boards in Scotland. It will permit equivalent Scottish legislation to be applied in the issuing of directions to health boards north of the border. I commend the amendment.

11.30 am

It is important briefly to consider amendment No. 3, which provides for references to health boards in Scotland to be included in the Bill. It is consequent upon the previous two amendments and ensures that the Scottish health boards are referred to in the Bill where necessary. The Government support the amendment. The issue was of great concern to my hon. Friend the Member for Northampton, North, who, I am relieved to see, is now crossing the Floor, back to his rightful place below the Gangway on the Conservative side of the Chamber. I was worried to see him on the Labour Front Bench consulting the hon. Member for Hammersmith.

Amendment No. 4 is interesting and ensures that the Health Service Commissioners are not precluded from carrying out investigations, under part V of the National Health Service Act 1977, into cases that have been investigated under any procedures laid down in the directions to be made by the Secretary of State in pursuance of the duty conferred on him by the measure. Those directions should not in any way interfere with the work or the jurisdiction of the Health Service Commissioners. The amendment makes equivalent provision for Scotland, which the Government wholehear-tedly support.

The offices of the Health Service Commissioners, which will be affected by the amendment, provide an important avenue for an independent review of complaints. Certain criteria must be met before the Commissioners can investigate, but they are not onerous and are intended to ensure that justice is done to both the complainant and those complained against. Although my hon. Friend the Member for Derbyshire, South made that point, I am sure that the House regrets that she did not speak at greater length on it. The Bill is not intended to restrict the Commissioners' powers, and it is important that that is widely recognised.

A strict interpretation of the legislation governing the Commissioners' activities may well have caused problems. Therefore, section 116 of the National Health Service Act 1977 prevents any investigation of an action where the complainant has a right of appeal, reference or review by a tribunal constituted under any enactment. If the section were not specifically exempted, it might bite on the procedures to be laid down as a result of the Bill. That is not the intention of the Bill and, therefore, clear provision is made to allow the Commissioners to investigate complaints and to exempt the Commissioners' investigations both north and south of the Border.

Amendments Nos. 5 and 6 are technical amendments to ensure that the interpretations of the provisions applying to Scotland are included. Just as there are different legislative provisions north and south of the Border, so Scotland and England are at times divided by legal language. If my hon. and learned Friend the Member for Perth and Kinross (Mr. Fairbairn) were present, he would say, "Hear, hear," to that, and stress that it was desirable. The amendments ensure that the Bill will be understood on both sides of the Border, and include necessary references to Scottish law. The Government support them.

Amendment No. 7 refers to clause 2(3) and deals with the extent of the Bill. It deletes references in the Bill which exclude Scotland. The amendments that we have so far discussed render redundant the exemption of Scotland from the Bill, and this amendment brings Scotland fully within the Bill's scope.

Amendment No. 8 deals with the long title, which it is important to get right. At present it refers only to regional health authorities, and the amendment provides for the inclusion of references to district and special health authorities in England and Wales, and health boards in Scotland. As drafted, the long title reflects the previously limited scope of the Bill, but thanks to the advocacy of my hon. Friend the Member for Derbyshire, South we have extended that scope. The amendment ensures that the long title accurately reflects the amended Bill's contents, and parallels the wording that has been agreed for clause 1(1) in its references to health authorities in England and Wales and health boards in Scotland. We support the amendment.

I hope that the House will approve the amendment and that the Bill will pass into law. My hon. Friend the Member for Newbury, ably and strongly supported by my hon. Friend the Member for Derbyshire, South, has advanced the rights of patients to have complaints against hospitals thoroughly investigated within and by the NHS. The Government wholeheartedly welcome the spirit in which the Bill was introduced in February, and hope that the measure will eventually pass into law.

I beg to move, That this House does agree with the Lords in the said amendment.

With this, it will be convenient to take Lords amendment No. 2, in page 1, line 11, at end insert Will she, in explaining this group of amendments, say whether amendment No. 2 applies to subsection (1)(a) and (b) or only to (b)?

I was alluding only to what I believe are established facts. I meant no other inference.

Before dealing with points that hon. Members may wish to raise, I will outline the purpose of the Lords amendments, which I accept, and then deal with any queries arising out of them. Although the Lords amendments substantially change the original clause about kerb crawling, they still contain two points which were important to me from the outset.

First, there is a specific offence applying to those who use motor vehicles, as widely defined, for the soliciting of women for the purpose of prostitution. This is such a nuisance in certain areas of some big cities that it is important that that point should be at the heart of the Bill in clause 1.

Secondly, the principle—again, a principle to which I attach great importance—is maintained that, where a woman has a single approach made to her by a kerb crawler and is thereby upset and annoyed, she has redress under the clause.

The other place, however, attached two safeguards, which are alternative safeguards, and I hope that they will allay the misgivings that were expressed by hon. Members on both sides of the House when the clause was presented in its original form.

The first is that one will have to show that the man was soliciting for the purposes of prostitution, which, in my view, is a severe test in any case. In addition, the word "persistently" is included—either one woman or more than one woman—and that deals effectively with the point made by those who felt that an innocent man—perhaps asking the way, which seems to be the classic example that we are given—might be accused, tried and perhaps convicted unjustly. I appreciate why, in forming a new criminal clause, hon. Members were seeking to safeguard the innocent. The element of persistence does so.

The second alternative test or safeguard reads:

"in such manner or in such circumstances as to be likely to cause annoyance to the woman … or nuisance to other persons in the neighbourhood."

Again, that deals effectively with the bitter grievances of residents who find that their ordinary lives are disrupted by kerb crawling by numbers of different men coming into the area. I hope that it will give much needed relief to areas such as Bedford hill, parts of Tooting, Southampton, parts of my constituency of Plymouth, Drake and other areas of the country. They have looked for redress for long enough. I hope that they will find it in the way in which the clause is now formulated.

Also of interest to the House—this also applies to the question of additional safeguards—is the addition that has been made in the other place about the Crown prosecution service. When we discussed the measure before it went to the other place, I pointed out that the independent prosecution service would afford an additional safeguard against over-zealous police prosecuting a man who might be innocent. I did not think that that was a great risk, but I accept that others thought otherwise.

The result of that matter being dealt with as part of this group of amendments is that the new service, which will be independent of the police, will have to be in operation before that part of clause 1 can be effective. I understand that it might come into operation at different places at different times, but the Minister will be able to give more authoritative information about that than I, a Back-Bencher, can do. This will provide a final and effective test and safeguard against any wrongful accusations or trials in court.

I will not delay the House by dealing with one amendment which is consequential on another.

Two amendments standing in the name of my hon. Friend the Member for Northampton, North have been included in this group. His amendments would toughen up the clause to such an extent that it would be almost impossible to bring any prosecution with any chance of success. To that extent they are unacceptable, but I will explain in more detail why that is the case.

My hon. Friend's first amendment suggests that in place of "nuisance" the term "serious nuisance" should be in the Bill. I gather that over the years there has been a clear understanding in the courts of what "nuisance" means and that it is not to be taken lightly. To import the additional adjective "serious" would, in my view, restrict the operation of the clause to such an extent as to make it unworkable. For that reason, I could not accept it, although I understand the reason for my hon. Friend wishing to introduce it.

I have explained why the annoyance or nuisance test is useful and why it meets the wishes of residents and women in particular areas who are subjct to the nuisance. To remove it would weaken the Bill unacceptably. Therefore, I must advise the House not to accept the two amendments standing in my hon. Friend's name.

The new package, to which their Lordships gave considerable time and effort, represents a reasonable compromise between those, like myself, who were anxious to see that an effective clause was in place to deal with the nuisance of kerb crawling and the objections of those who felt that innocent men might inadvertently be caught up in a new criminal offence.

My hon. Friend has eloquently set out the position. She will recall that I asked her whether amendment No. 2 covered both paragraphs (a) and (b) of subsection (1).

The plain answer to my hon. Friend's question is yes, it does.

I think that I have covered adequately the various points of importance in their Lordships' amendments. I warmly commend them to the House.

First of all, can I draw attention to the remarks of Lord Wigoder in another place? The Bill has gone through the other place, and we are all desperately trying to rewrite the whole of it. The point that I am making is that we have received from their Lordships—I make no complaint about this—a Bill that has been substantially changed. What we are here to debate is whether the changes are the right changes and whether or not they produce the right Bill.

Can I congratulate my hon. Friend the Member for Plymouth, Drake (Miss Fookes) on bringing this measure to the House and, despite alarms, scares and ups and downs, getting it to this stage? I think that we all agree that in some parts of the country there is a very severe nuisance caused and areas of considerable blight as a result of the habit of kerb crawling that has grown up. I wonder whether it would be appropriate to stress this by referring to some remarks made in Committee by my hon. Friend the Member for Birmingham, Edgbaston (Dame J. Knight). My hon. Friend drew attention to what it is like to live in a red light district. She went on to say that she was pleased to say that she had never had the misfortune to do so herself. However, it appears that she has received many complaints from constituents. She said:

"When kerb crawlers have created a red light district it is as if a blight were over the whole area. I cite the example of a woman who was waiting outside her daughter's school to bring her home. She was accosted by two prostitutes who told her, in the foulest language imaginable, to get off their patch … That happens constantly in that sort of area. A young girl was called over to a car by a man who was kerb crawling. The driver exposed himself, which frightened the child and she ran away." —[Official Report, Standing Committee C, 27 February 1985, c. 72.]

These are the sort of things that happen in these areas. I have no doubt that in such areas other forms of crime thrive as well. If my hon. Friend's Bill will rid our country of this blight, I think that we should all be grateful to her.

There are areas where prostitution takes place. There is an element in Northampton but not so much in the area of the town that I represent. I do not think that it has reached the level that was described by my hon. Friend the Member for Edgbaston in Committee. I think that in those circumstances — the police will probably agree — the police have sufficient and adequate powers to deal with the problem. When the problem has reached the proportion that makes it a nuisance, under the existing law, they have managed to deal with that nuisance. However, there are other areas and those other areas do need, perhaps, the protection of the law; they do not need the protection of morals. I do not think that our constituents are asking us here to take a moral view. They are asking us to prevent abuse and nuisance. They are asking us to do it in such a way that we are not in danger of introducing injustices.

I know that the hon. Member for Hammersmith (Mr. Soley), who is on the Opposition Front Bench, is quite rightly concerned about police powers. I know that he will be looking at the Bill as it is likely to be amended and as it has been amended by their Lordships to ensure that any additional powers that are given to the police are necessary powers.

12.15 pm

This is an ambitious area for a Private Member's Bill. It is not an area that is completely devoid of controversy. Where we have an area that is not devoid of controversy, we must be very careful, obviously, how we proceed, particularly when a Private Member's measure is involved.

One thing that has obviously concerned me and my hon. Friend the Member for Derbyshire, West (Mr. Parris) is the possibility of injustice taking place. In this particular area, it is not just a matter of somebody going to court and being found guilty when they are innocent. Of course, that is bad enough but that is not the injustice that we are basically concerned with. In this particularly sensitive area one is concerned about the possibility that an innocent man may be picked up, may be charged, may be brought to court and then found to be innocent. The fine that might have been involved would be as nothing compared with the effect of that charge, innocent though he be, on his reputation. It could have a catastrophic effect on a man's marriage. It could have a catastrophic effect on a man's family life.

I am listening with great interest to the hon. Gentleman but he must relate his remarks to one of the amendments that is before the House. I invite the hon. Gentleman to do so.

The amendment that I am referring to, Mr. Deputy Speaker, is Lords amendment No. 2, which introduces the concept of nuisance or annoyance. I seek leave to speak also to my amendments, which are (a) and (f). What we have in amendment No. 2 is that a man will commit an offence if from a motor vehicle or whatever he

"persistently or … in such manner or in such circumstances as to be likely to cause annoyance to the woman (or any of the women) solicited, or nuisance to other persons in the neighbourhood."

We had a long debate in the Chamber—I think that a similar debate took place in Committee — about the inclusion of the word "persistently". My hon. Friend the Under-Secretary of State felt that to include the word "persistently" would be to weaken the Bill and to make it to that extent inoperable. However, he did agree that the problem had been debated in their Lordships' House. We are, of course, very grateful to them for that. Their Lordships have a great deal of expertise on this subject. There are many Law Lords and lawyers in another place who have been involved in the courts and know the problems that come from the courts. Their Lordships decided in Committee that "persistently" should be imported into the Bill.

The Bill then had problems, so further amendments had to be introduced. My hon. Friend the Member for Drake has said that the amendment that suits the purposes of the Bill is No. 2. We now not only have "persistently"—it is not "persistently and" but "persistently or". The "or" is

"in such circumstances as to be likely to cause annoyance to the woman (or any of the women) solicited, or nuisance to any other persons in the neighbourhood."

I am concerned to hear from my hon. Friend the Minister precisely what is meant by that clause. I am particularly concerned about the safeguard

"subject to section 5(5A)".

I am sure that when my hon. Friend the Minister catches your eye, Mr. Deputy Speaker he will have quite a lot to say about that.

The amendment reads:

"in such manner or in such circumstances as to be likely to cause annoyance to the woman (or any of the women)".

I hope that my hon. Friend will be able to tell the House why we have to include the words "to be likely" and why it cannot just be left

"in such manner or in such circumstances as … to cause annoyance".

In other words, why cannot we have a provision that makes it an offence actually to cause annoyance?

What is likely to cause annoyance to one individual is quite different from that which is likely to cause annoyance to another individual. Some people are happy-go-lucky, carefree and relaxed. Some people are a little nervous, a little concerned and a little agitated. By their nature, they are more likely to feel an annoyance than others. What construction would the courts normally put on this? Do they expect a reasonable person in a reasonable state of mind to be reasonably annoyed? Some people, even with the best will in the world, are fairly fractious.

Amendment No. 2 states:

"or nuisance to other persons in the neighbourhood."

What is "nuisance"? My hon. Friend the Member for Drake told us that it was a well-known concept in the courts, but I am not a lawyer. How grave does a matter have to be for it to be a "nuisance"? If a dog fouls a pavement outside the gate of one's house, is that a nuisance? If someone drives a car slowly up the street in which one lives, is that a nuisance? If a man parks his car in one's drive and spends 15 minutes chatting up five prostitutes and making leery remarks, and the reactions between the man and the prostitutes are offensive to people in the neighbourhood, that is obviously a nuisance. If many people are bobbing around a district looking for prostitutes, jamming the streets, making noises and blowing petrol fumes around the place, that is a nuisance. Where does one draw the line?

I have tabled an amendment which refers to a "serious" nuisance, because I can understand that concept. A serious nuisance causes distress and inconvenience and is a factor that creates a blight in an area. I await the comments of my hon. Friend the Under-Secretary of State with interest.

The Bill has been massively and properly amended by the other place. It is a sensitive issue. If the legislation has been wrongly drafted, the lives and reputations of innocent people could be blighted. The Bill is necessary, and I look forward to hearing the explanations of my hon. Friend the Under-Secretary of State.

The first debate in Standing Committee was on my amendment No. 2 which would have inserted after the word "prostitution"

"in a manner likely to cause nuisance or offence."

The amendment was fully debated in Standing Committee, but I was not able to persuade hon. Members that it was a sensible improvement.

The next debate was on whether the element of persistence should be imported into the Bill. My hon. and learned Friend the Member for Folkestone and Hythe (Mr.

Howard) and I argued that it should be. We were unable to persuade the Standing Committee that that was the right change to make.

The House of Commons agreed to let the other place take another look at the matter, and it has done so. Their Lordships have imported into the Bill both the element of persistence and the element of likelihood to cause nuisance or offence. It would be churlish of me to say that that does not represent precisely the improvement that I wanted.

My hon. Friend the Member for Northampton, North (Mr. Marlow) is a little unhappy about the element of likelihood to cause nuisance or offence. I understand his fears, but we proposed the importation into the Bill of the element of persistence not because there was an inherent viciousness in persistence which could not attach to a single act but because a person, by being persistent, was more likely to cause nuisance or offence. If the element of persistence is included, there is less likelihood of an innocent person being prosecuted.

If it has to be shown that a person is causing nuisance or offence, that reduces the possibility of an innocent man being prosecuted. In that case, we must clearly define just what it is about persistence that we seek to proscribe. We seek to proscribe the offensive potential of persistence. Although I understand the point put by my hon. Friend the Member for Northampton, North, I do not object, for those reasons, to the importation of a likelihood to cause nuisance or offence or to the importation of the element of persistence.

One tries to be careful in this place, and I do not think that I ever said that I was against the importation of a nuisance or annoyance. I was concerned about how this provision was made. The matter should be properly debated and given the safeguards of new section 5(5A). This is a matter on which I need significant reassurance from my hon. Friend the Under-Secretary of State. Although my hon. and learned Friend the Member for Folkestone and Hythe (Mr. Howard) and some of my other colleagues are in the Chamber, many of our colleagues are not. It is up to us on their behalf to take an interest in what is happening.

My hon. Friend is right. We need reassurance on that point. If my hon. Friend's amendment (b) had been selected, I would have supported him, if necessary in the Division Lobby.

We might seek some reassurance on the likely prosecuting policy of the new prosecution service. I understand that there have been discussions as to the type of advice that might be given. I shall be interested to hear what my hon. Friend the Under-Secretary of State says on this matter. He might well offer my hon. Friend the Member for Northampton, North and me the reassurance that we seek.

I would not go as far as Lord Denning did in the other place on Third Reading when, referring to the Crown prosecutor, he said:

"He will not prosecute an innocent man, or anything of that kind." — Official Report, Houe of Lords, 3 July 1985; Vol. 465, c. 1281.]

His contribution to the evolution of English jurisprudence has been immense — and I do not doubt that it will continue — but I think that he goes further than even the most radical of us would wish to go. I would not assume that, because the new Crown prosecutor prosecutes, the man involved is to be taken as guilty. I hope that the House does not assume that either.

We were unhappy about a number of aspects of the Bill in Committee, on Report and on Third Reading. We let the matter go to the other place for another consideration. Their Lordships have in large measure made the changes that my hon. Friend the Member for Northampton, North, my hon. and learned Friend the Member for Folkestone and Hythe and I sought. It is right to acknowledge that the Bill has been greatly improved in the other place, that these amendments are right and that, taken all in all, with these amendments the Bill will be a useful addition to the statute book.

The hon. Member for Derbyshire, West (Mr. Parris) got into considerable trouble in Committee and elsewhere for pushing hard on the door that he has just said has opened a little. I was involved in putting forward amendments that referred to "nuisance". The hon. Gentleman got into a great deal of trouble while I did not — I suspect because I am a member of the official Opposition while he is a member of the unofficial opposition. This supports the old theory that one's opponents are in front and one's enemies are behind. We had the unedifying sight of the Conservative party attacking its own members for not sticking to the party line.

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In fairness, the hon. Member for Derbyshire, West has pursued the issue determinedly and in a principled way. I stick by my initial position that I put on the Floor of the House and in Committee — that we are trying to reach the right balance between protecting the rights of individuals and minimising the risk of wrongful conviction with the rights of people in some parts of the country who suffer from men driving or walking around their areas trying to find women whom they think to be prostitutes. Those areas tend to have many prostitutes. It was recognised that that was a problem.

I still take the view, as I did when we began to discuss the Bill, that we are attempting to deal with a complex problem by dealing with only a small part of it. As I have said on a number of occasions, the problem is not one of prostitutes per se. All hon. Members know that it is not and never has been an offence to be a prostitute. It is an offence to solicit for prostitution in a public place.

We need a much more detailed programme to enable prostitutes to meet their clients without causing a public nuisance. That is the core of the problem that we still have not resolved. At the same time, I recognise, as Members on both sides of the House do, that there has been a problem in some limited parts of the United Kingdom.

One of my anxieties, which is shared by a number of my hon. Friends and one or two Conservative Members, including the hon. Member for Derbyshire, West, is that we are legislating for England and Wales as a whole on a problem that affects parts of the country only. That is always a danger that we should avoid if possible. I made suggestions in Committee and on the Floor of the House as to how we should deal with the matter, but it is not appropriate for me to go over that ground again.

The House of Lords has, to some extent, come to our rescue. We were struggling to find a form of words which introduced the concept of nuisance to people who lived in the areas that we were discussing. I put it to the Minister that I thought it possible to find a form of words which would enable residents who felt that there was a nuisance to give evidence to a court or, alternatively, some form of drafting which would enable that nuisance to be made explicit in the Bill. The House of Lords has managed to do that.

In doing so, the House of Lords has introduced the concept of persistence. The Opposition have mixed views on the issue of persistence. There is a feeling that a person should not have to commit an act more than once for it to be an offence. If something is an offence, it is an offence on the first occasion. The act should not have to be committed two, three, four or more times to prove that it is an offence. That has always been an argument against persistence.

We have the problem because "persistence" was introduced in the concept of prostitution in the first instance. It is always instructive to bear in mind that that was done with good intentions, as so often in this place — to protect women, it was thought, from wrongful conviction. The idea was that a woman should be warned at least three times by the police before she could be charged with being a prostitute. That has resulted in women being taken before the courts and described as common prostitutes. To be described in court as a common prostitute, it was accepted that one had already been warned three times about one's behaviour. We are now introducing the concept of a "common kerb crawler". That is the problem that arises from using the word "persistent". It shows the difficulty of legislating on this matter coherently and consistently.

I believe that the Lords amendment improves the Bill, for many of the reasons given by the hon. Member for Derbyshire, West. I am still not happy with it, for all the reasons that I have given previously, but I accept that it may be the only way we have of dealing with the problem in the parts of the country that have been mentioned.

I look forward to hearing the Minister — if I may have his attention for a moment while I refer to him. There is anxiety about whether the Bill will be used wrongfully. Perhaps the Minister will give the House a commitment that the figures showing the number of people arrested, charged and convicted will be made available to the House so that we can see how the Act works over a period.

I understand that the Minister is also prepared to give a commitment to the House about the guidance given to the prosecution service. With the Lords amendments and those commitments from the Minister, I do not wish to delay the Bill's passage.

May I first say how grateful I am for the helpful way that hon. Members have addressed the task of considering the Lords amendments. I shall try to respond as fully and cogently as I can to the points that have been raised, because it is important that those matters are considered with care. As we all acknowledge, the House should never take lightly the creation of a new criminal offence. Given the careful consideration in both Houses, no one can say that it has been taken in anything other than a most careful way.

Before getting down to some of the details, I think that it would be churlish not to pay the warmest of tributes to my hon. Friend the Member for Plymouth, Drake (Miss Fookes) for the skill and determination with which she has taken the Bill through the House—

And a bit of luck.

I was going to come to that.

My hon. Friend the Member for Drake has also kept in touch with the Bill's progress in the other place, where it was piloted through by a distinguished predecessor, Lady Vickers, who for many years was a most distinguished representative of the city of Plymouth, as my hon. Friend is now. I welcome the hon. Member for Bow and Poplar (Mr. Mikardo) to his place because he has played a constructive role in the discussions. As he said, my hon. Friend also required a bit of luck, but a bit of luck in a good cause is something that we can all welcome. In the end, I suspect that one of the principal reasons why hon. Members wanted the Bill to go through was not simply that it addressed a serious problem in a serious way, but the respect and regard that they have for my hon. Friend and their wish that she should be gratified in her legitimate desire to change the law in this sensitive area.

When the Bill was conceived, it was designed to create three different offences. That followed careful examination by the Criminal Law Revision Committee of the present state of the law on sexual offences, particularly in relation to the harassment of women in public places. The committee took seven years to consider those matters. We recognise the difficulties that faced the committee in making judgments that are not just legal — I remember the point made by the hon. Member for Bow and Poplar on that. It is not just a lawyers' paradise. We are making social judgments, too. It was in recognition of that that the Policy Advisory Committee on Sexual Offences was established, which consisted of people from social services and education, probation officers, psychiatrists, and so on, who were intended to broaden the ambit of the discussion and ensure that the legal discussion did not just fasten on the narrow lawyers' interest, but took account of the wider social implications.

I recognise the matter that the hon. Member for Hammersmith (Mr. Soley) has been at pains to point out throughout the Bill — that, while the Criminal Law Revision Committee is considering the whole of the law on sexual offences, the Bill deals with only a narrow part of it. I understand why he and my hon. Friend the Member for Derbyshire, West (Mr. Parris) have said on several occasions that it would have been better if the Bill had dealt across the board with the criminal law on sexual offences, particularly the vexed question of the extent to which prostitution may be permitted in today's society. In an ideal world, I feel sure that that is what we wanted to do. However, so difficult is the consideration of the law on prostitution that it has not even been possible yet for the Criminal Law Revision Committee to conclude its deliberations on that matter.

The difficult decision that my hon. Friend the Member for Drake had to take, and with which we in the Home Office assisted her, was whether the problem of kerb crawling and some of the associated difficulties had reached such a peak that it could not be left on the shelf to await the receipt of further advice. The inevitable difficulty, particularly in a congested Department such as the Home Office, is finding a place in the legislative programme for a major and full-scale reform.

I felt that there was an element of urgency about the matter, which was impressed on me by the hon. Member for Tooting (Mr. Cox), who is not here but who has taken a great deal of interest in the matter as the hon. Member representing the Bedford hill area. In an Adjournment debate in February last year the hon. Gentleman raised the problem of kerb crawling in his and other areas in very strong terms. He said that, having banged on the door of just about every Minister at the Home Office, he believed that action could no longer be delayed. On that basis—rightly, as I am sure the House agrees — I asked the Criminal Law Revision Committee if it could bring forward its consideration of the kerb crawling aspect of the law on prostitution so that its report would be available in the summer of 1984. If any hon. Member was then minded to bring in a Bill on the subject, as my hon. Friend the Member for Drake subsequently was, the House would be able to pass a law on the matter far more quickly than would otherwise have been possible. I am very glad that the Criminal Law Revision Committee was able to do that and that its advice was set out in such straightforward terms.

My hon. Friend the Member for Drake then had to decide whether to follow the advice of the Criminal Law Revision Committee or whether to take a different approach to the problem. She was persuaded — like the Criminal Law Revision Committee and, I believe, the whole House — that the time had come to address the problem of kerb crawling and that one could no longer take the attitude taken in the 1957 report that the problem had not yet become so serious and commonplace as to justify making kerb crawling a criminal offence. The balance of convenience has plainly changed and the Criminal Law Revision Committee was right to recommend a change in the law.

The question which aroused controversy both here and in another place was how the law should be changed to strike the difficult balance between providing the relief from this problem that women in many areas undoubtedly need and taking account of the difficulties which arise in sensitive matters of this nature as we have done on previous occasions by introducing the concept of persistence into other statutes relating to sexual behaviour in recognition of the fact that the risk of a miscarriage of justice, which may arise under any criminal statute, is perhaps a greater risk in this area of the law.

My hon. Friend the Member for Drake elected to follow the advice of the Criminal Law Revision Committee and to create three offences. The first deals clearly and unequivocally with the problem of kerb crawling and makes it clear that if a man solicits a woman from a motor vehicle for the purpose of prostitution an offence is committed. That obviates the need to rely on the rusty old blunderbuss of the Justices of the Peace Act 1361 which, apart from many other drawbacks, can result only in binding over. The intention is not to jam the courts with kerb crawlers but to send out a clear message that kerb crawling is a criminal offence and thus to deter many people who might have indulged in the practice while it remained hedged about with equivocation.

It was recognised that in the case of offences occurring in the street but unrelated to kerb crawling by motor vehicles a requirement of persistence was appropriate, as is already the case in the parallel provisions relating to homosexual soliciting. The fact that persistence is required in the case of people on foot but not in the case of those soliciting from motor vehicles has struck some hon. Members on both sides of this House and in another place as rather odd and there has been legitimate and persistent debate on that aspect at every stage of the Bill. I make no complaint about that, and I know that others will make no complaint about the fact that I have a very firm view on the matter to which I still hold.

The revision committee then considered the more difficult problem of whether solicitation of women in a manner likely to cause fear, irrespective of whether it was related to prostitution in a street environment, should be an offence. It recommended that it should, and my hon. Friend the Member for Drake took up the matter. That was far and away the most difficult proposition among many difficulties in the Bill. It has been recognised generally here and in another place that, although the advice of the revision committee is worth while, we were not wholly persuaded that it would be appropriate to broaden the scope of the Bill to include cinemas and other places where, perhaps, the case for change is not so clear-cut.

Because of the extraordinary happenings on those two Fridays a couple of months ago when the Bill died and was revived, we did not take out clause 3. It was taken out in another place and we shall have an opportunity to give that our blessing later.

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I am glad that there was discussion of clause 4—the increase in penalties — in another place because the matter has not been subject to amendments, although some have been proposed. It is a grave and potentially dangerous anomaly that the penalty for indecent assault, which can be committed by a serious sex offender, is only two years. The courts have drawn attention to the fact that such a sentence is wholly inappropriate and that it could be in everybody's interests, including the offender, to confine an offender and to increase the penalty to 10 years.

The increase in the penalty for attempted rape from seven years to life imprisonment would, but for a proviso in the Criminal Attempts Act 1981, already be in place. That Act rightly took the view that, because the intention is always to commit the full offence, to be guilty of attempt, the intention must be more serious than the act. As the hon. Member for Bow and Poplar, who is nodding assent, knows, somebody can be convicted of murder if he intends to cause serious bodily harm but he cannot be convicted of attempted murder unless he intends to kill. On advice from the revision committee, the House took the view, in 1981, that the penalty for an attempt should always be the same as the penalty for the completed offence on the basis that that left the courts with proper discretion to sentence.

Attempted rape was left out of the 1981 Act because the revision committee was considering the merits of that offence. It was thought right to leave the matter as it was so that it could be taken up in a full-scale review of sexual offences, to which the hon. Member for Hammersmith looks forward. Time has passed and the pond has perhaps got a little murkier. It is not appropriate to leave this gap any longer. A dangerous sex maniac might not succeed in carrying out the full act of rape, but he might have such a history of offending that, having committed the rape, he would have been sentenced to life imprisonment.

As the Minister who deals with life sentence matters, I know that some of the most difficult cases on which to make a decision about release are not the homicide cases but the non-homicide cases in which people, when at liberty, have been driven to acts of ever-increasingly serious sexual misbehaviour. Without going into the matter in too much detail, it is surely an anomaly that in dealing with distinctions of millimetres on the question of when attempted rape becomes rape, the courts should have their hands tied. Therefore, I am sure that the changes that have been made will be widely welcomed.

We are principally concerned with clauses 1 and 2. I have made clear my view that to import any consideration of persistence or of nuisance and annoyance would weaken the impact of the Bill. My views were accepted in this House but not in the other place, although I was glad to see that that most distinguished of common lawyers, Lord Denning, took the opportunity in the debate — as obviously one hoped that he and others like him would — to make clear his view that that was the right approach.

The process of legislation, particularly on private Members' Bills, involves each of us giving the best advice that we can to the House, but if others choose to disagree and their view prevails, it is then up to us all to make the best that we can of the new arrangements, and certainly not to stand in the way of the Bill proceeding because it does not represent what one would personally regard as the best arrangement.

Their Lordships, having taken their decision about persistence, then made certain amendments which enabled the Bill to be a workable Bill. Therefore, I am not grudging in my acceptance of it or in my recommendation that we should accept it. I am warm in my feelings towards the Bill, although I would have been positively steaming about it if I had had my way entirely. But that is life.

In the debate in the other place the issue of persistence was considered. Several peers took part in the debate, some with legal qualifications, others without. However, we do not want our debates to become blighted with apartheid in the sense of Members having or not having legal qualifications. After the debate, by a majority of 33 to 26, the decision was taken to insert the word "persistently."

After that there were deliberations in the other place and also outside. I was glad that my hon. Friend the Member for Drake played some part in those deliberations. We tried to see whether, the decision having been taken that the element of persistence was needed, there was a case for introducing a parallel offence which, in a very specific case, would not require the element of persistence. We wanted to ensure that the Bill would be workable and deal with the central problem that had been troubling all of us so much.

There are two competing problems with which we are concerned. The first is the blight upon an area where prostitutes operate openly in the streets and where there is kerb crawling by potential clients. The prostitutes are happy about that but, obviously, not the rest of the community. Several hon. Members, particularly my hon. Friends the Members for Derbyshire, West and Northampton, North (Mr. Marlow), have had the quite legitimate concern that one single act could be misinterpreted by an over-zealous policeman. Inevitably, the prostitute herself would not be available to give evidence, being happy about the transaction, and it would be wrong to blight someone's prospects, career and future family life — matters to which my hon. Friend the Member for Northampton, North has referred eloquently today and on other occasions — on the basis of one equivocal incident. For that reason, it was felt necessary to have the clear safeguard that such an incident should have to happen twice.

However, having agreed with that view, their Lordships recognised in their intensive discussions that that would not deal with the other major problem that has caused us so much concern and led many people to want to change the law, which is the situation where the woman who is the object of the solicitation is not a prostitute, but an ordinary woman — one's sister or wife, or someone else's daughter — going home or to visit a friend and not dressed in a way that could be described as extravagant or sexually provocative.

Polls in Bedford hill and many other parts of the country showed that such women were regularly being propositioned, and their pleas for redress are every bit as intense as those of people who are embarrassed by the fact that their home street has become a haunt of known prostitutes.

If such a woman had been the subject of an unwarranted approach, probably in abusive and insulting terms, it would be wrong to require the same thing to happen to someone else before there were any means of redress. The recognition of that fact has united us. We have all been troubled about that matter, however we may differ about the ways of building in safeguards. I know that that aspect worries my hon. Friend the Member for Northampton, North, and my hon. Friend the Member for Derbyshire, West put it well in Committee when he said:

"I can see that to embarrass a woman gravely or to inconvenience her seriously may be enough of a crime to warrant prosecution. Many women, particularly those who live in London and in the areas where the problem exists, are inured to such solicitation and are probably no longer put in fear by it, simply because it happens so often, but that does not mean that it does not offend or inconvenience them, or that those who solicit should not be prosecuted." — [Official Report, Standing Committee C, 20 February 1985; c. 7.]

There was common ground in their Lordships' consideration of finding a way whereby innocent women — our wives, sisters or mothers; the hon. Member for Barking (Ms. Richardson) showed how catholic is the taste of some of these gentlemen when she recounted a personal experience of a kerb crawler—can be protected.

Equally, their Lordships wanted to be sure that vexatious and improper prosecutions would not arise. That is why the concept of nuisance and annoyance was exhumed, as so many parts of the Bill have been exhumed from time to time, and inserted in parallel with the concept of persistence, so that if nuisance is caused to persons in the neighbourhood or annoyance is caused to the woman, there is no reason why a criminal penalty should not ensue. That is the proposal which their Lordships ask us to accept.

There need to be safeguards. The fact that the words "nuisance" and "annoyance" have been inserted makes it virtually inevitable that there will have to be evidence from either the woman who was the victim of the solicitation or a local resident who clearly saw and heard what was going on. The safeguard is built in by the need to establish nuisance or annoyance and not merely the fact that the act of solicitation took place.

I appreciate that, as many hon. Members and noble Lords have said, perhaps we should take advantage of the recent creation, with all-party support, of an independent prosecution system to ensure that, even more than anyone could claim today, there is an objectivity in the decision to take a case to court, given all the implications that follow from that and about which my hon. Friend the Member for Northampton, North spoke so eloquently. There is a case for providing that only in the most exceptional circumstances should a case under the nuisance or annoyance provisions proceed without a non-police witness being available.

As my noble Friend Lord Glenarthur pointed out, the Director of Public Prosecutions is ready, if the House thinks it appropriate, to give guidance to Crown prosecutors about the operation of this part of clause 1. The guidance would be along the lines that where the charge alleges annoyance to the woman solicited or nuisance to other persons in the neighbourhood, it should, save in exceptional circumstances, be supported by the evidence of someone other than a police officer, and, wherever possible, by that of the woman herself. I hope that my hon. Friend the Member for Northampton, North sees that as a step forward. It binds in to the point that I made clear to the hon. Member for Hammersmith when we last considered the Bill — that we shall monitor the number of cases that are put to the independent prosecution service as being worthy of prosecution, the number it decides to prosecute, and the number that result in conviction. Those three sensitive figures will show whether the Act is being properly applied.

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I agree with my hon. Friend the Member for Northampton, North that we should not put innocent transactions, such as asking directions, in jeopardy. We have had to strike a balance between wanting to protect women and wanting to protect men from unreasonable prosecutions. After all our efforts, I believe that we have struck that balance, and obviously I hope that hon. Members agree.

Before I deal with some of the detailed points raised by my hon. Friend the Member for Northampton, North, I wish to pay warm tribute, not merely to those in this Chamber who have helped to ensure the passage of the Bill, especially my hon. Friend the Member for Derbyshire, West who, having recognised how much progress has been made, spoke warmly in support of the proposition today, but to those in the other place who have played a leading role in ensuring, at some difficulty to the procedures of the other place, that the Bill was debated two nights running this week so that it could return to this House in time.

Lord Denning gave the wise advice that one would expect from the foremost common lawyer of the century. There was considerable assistance from the Opposition Front Bench, especially Lord Mishcon, who was ably assisted by Lord Elystan-Morgan, who was the most reluctant to accept the arrangements, but in the end was willing to do so. I am grateful to him for that, as I am to Lord Houghton, for whom I have a particularly high regard because of our joint work on animal welfare and experimentation—issues with which my hon. Friend the Member for Drake is also intimately concerned. He was undoubtedly unhappy about some elements of the Bill, but he determined that sufficient had been done to change it to his satisfaction. I salute him for a typically courageous and principled approach to the matter, which has been echoed by my hon. Friends the Members for Derbyshire, West and for Northampton, North. Lord Harris, a former Minister of State, Home Office, Lord Wigoder, a distinguished practitioner in criminal law, and, last but not least, Lord Monson all took part in intensive discussions and helped to bring the Bill through to this stage.

My hon. Friend the Member for Northampton, North has properly asked telling questions about what exactly the Bill means. I want to deal with his important and valuable points. He reminded us that clause 1 will read as follows:

"A man commits an offence if he solicits a woman (or different women) for the purpose of prostitution (a) from a motor vehicle while it is in a street or public place; or

(b) in a street or public place while in the immediate vicinity of a motor vehicle that he has just got out of or off, persistently or, subject to section 5(5A) below, in such a manner or in such circumstances as to be likely to cause annoyance to the woman (or any of the women) solicited, or nuisance to other persons in the neighbourhood."

The first point that we must make about that is that it creates two alternative ways of bringing the offence. The second point that should be emphasised is that, to show that what we say about the role of the independent prosecution service is not just window dressing — I strongly commend this point to my hon. Friend the Member for Northampton, North because it goes a long way to meeting his points about the innocent not suffering — clause 5(5A) states that this part of section 1 should not come into force until the independent prosecution service is operating in the area. Therefore, I have entered into a meaningful commitment today. There is no risk of the law being enforced for about 12 months in some cases, and possibly longer in others, by arrangements that are not in accordance with the new framework that we have established. That shows the good faith that we have been anxious to establish.

My hon. Friend the Member for Northampton, North asked me about nuisance. One reason why their Lordships were attracted to the proposition which, in its final form, emerged from discussions in which the lead was taken by Lord Denning and by First Parliamentary Counsel, was that we should distinguish between what must be proved in relation to the woman solicited and the neighbourhood, because their interests are different. For the woman, we wanted an offence of annoyance, and I shall come to my hon. Friend's pertinent questions about how that should be tested in a moment. As for the neighbourhood, we are talking about nuisance, not annoyance, because nuisance to a place is the commonly understood, familiar tool in the courts. It is much better to cleave to words which lawyers are accustomed to using in other contexts than to use new words.

My hon. Friend posed several carefully thought-out questions, and I do not believe that it is ducking the questions to say that it is impossible with this, as with any other issue of fact, to give a conclusive answer. Such issues of fact must be determined by the courts, which will consider the background to the alleged offence, basing their consideration on the way in which they approach nuisance in many other contexts. The word "nuisance" is found in civil and criminal law. Nuisance is a question of fact, and the court will investigate all the circumstances of the case: when it happened; the manner in which it happened; the effect of what happened; and whether all the circumstances lead to the conclusion — this is the key point — that the nuisance was material and substantial.

The damage — this is the reinforcement which my hon. Friend seeks — must not be merely sentimental, speculative, trifling, temporary, fleeting or evanescent. I have not dug that list of words out of "Roget's Thesaurus", they have come from cases in which the courts have said, based on the way in which they have dealt with the concept of nuisance, that it must be none of those things. The framework exists for a common-sense recognition of what nuisance is.

We come to the equally difficult point of the objectivity of the complaint. My hon. Friend is troubled by the possibility of a woman being excessively worried by what would be regarded by others as perfectly normal approaches, and that that woman could wreak havoc with the career of a man who simply drove up to her and asked, "What is the way to the public house?" The woman could say that she had been approached in a way that gave her the right to complain under the offences contained in the Bill.

The key to this is the use of the words "likely to", which I know trouble my hon. Friend. I believe that the words "likely to" will ensure that a properly objective test is applied. We do not want a definition of nuisance or annoyance that varies with the length of the individual's foot. We want the courts to be able to say, "Would a person of reasonable firmness, placed in a similar position, be caused annoyance?" In other words, was it likely, and would a reasonable person in the offender's position know, that such an approach was likely to cause annoyance?

The amendment says:

"likely to cause annoyance to the woman".

Does that imply a woman of reasonable firmness or the actual woman involved in the incident?

That is a perceptive question. I believe that it means likely to cause annoyance to women. It does not mean that the court would take into account the particular circumstances of the woman, unless those circumstances were obvious. If the incident involved a woman with a white stick, the court would be entitled to take account of the fact that it is more likely that some words would cause annoyance to a disabled person, who in any event would be disoriented by any approach, than to a woman in full possession of her faculties.

I believe — and, what is more important, some of the distinguished people who have been mentioned as being involved in this believe — that an objective test is being established. It is proper and helpful for my hon. Friend the Member for Northampton, North to ascertain this. I agree that if the House were not satisfied that this was an objective test, it would be entitled to be sceptical, but there is an intention that there should be an objective test, and I think that that intention has been properly carried into effect with the wording.

Does my hon. Friend's argument work the other way? Suppose that a woman was not offended or annoyed, perhaps because she was a policewoman, although in plain clothes. If the solicitation was such that, had she been anyone other than a policewoman inured to this kind of thing, she would have been annoyed or offended, would the solicitation be likely to annoy or offend her?

That would follow, but the element that is different, and that we have added by way of a safeguard, is that no longer are words of solicitation for the purpose of prostitution enough in themselves. They have also to be of a kind likely to cause annoyance. In other words, they have to go quite far.

A purely innocent member of the public might find that any words of solicitation were likely to cause annoyance, so the differences in some cases may not be great. However, it is important, because it gives a firm basis to the contention that lies at the heart of this matter — that there should, wherever possible — and only in exceptional circumstances not — be available a person who is not a police officer to give evidence. If these people are so offended that they look to us for redress, they have to be prepared to play a part in getting redress. They cannot slough off that responsibility on to others. We have achieved that, and changed the position.

I hope that what I have said satisfies my hon. Friend the Member for Northampton, North. I am happy to give way to him if I can be of any assistance to him on any other points.

I am grateful to my hon. Friend for his patience, his careful exposition of the position, and the way that he has taken account of the points that I have made. I feel that the safeguards that he has suggested stand a good chance of achieving what both he and I are seeking to do. I congratulate him on what he has done.

That is a most handsome remark for my hon. Friend to make. I am extremely grateful. It has been no hardship to deal with these points because they are essential to our consideration of the Bill. It is right that these matters should be properly looked into. I have always been concerned to see that everyone recognises that in the end — I had to learn this lesson as much as anybody else — the process of getting the Bill right is one of give and take. All of us will come with different views, and we shall not get everything we want.

My hon. Friend has made it clear that he is anxious only to test whether the Bill meets the worries that he legitimately has. I am glad that he thinks that I have satisfied him, and I thank him for his useful contribution, now purged of any suggestion that it was based on malevolence towards the Bill's future. I thank him for the interest that he has shown on previous occasions. The Bill strikes a balance that all new criminal legislation would do well to achieve—a balance between effective controls of activities which the criminal law should address and effective safeguards for those whose activities should not be drawn within its scope.

1.15 pm

The message which I hope we are able to send out this morning is that the buying and selling of the services of a prostitute must not take place in and around the homes of ordinary people who wish to go about their daily lives without the nuisance and offence that is caused on an intolerable scale in many inner-city areas.

The message also goes out in the Bill that serious sexual offences will be adequately punished as a result of the increases in the maximum penalties which clause 3 effects. I consider both signals to be important and worth while.

I am sure that it was inadvertent, but given that the Minister is sending out a message, he might wish to reconsider the phrase he used about the buying and selling of the services of a prostitute "in and around" homes. The Bill does not apply within the home. He may wish to clarify that.

The hon. Gentleman is right. We are dealing with the public manifestation of the problem. I am grateful to him for following my remarks with care enough to correct me when I am incorrect.

We have managed to build in the safeguards that the House wanted, while doing what my hon. Friend the Member for Drake and I consider to be absolutely paramount — sending out the message that kerb crawling is an offence. The fact that the Bill covers one approach to a woman who is caused nuisance and annoyance — and which is shown by objective analysis to have been an offence — means that people cannot go kerb crawling thinking that they can have one bite of the cherry and that, so long as they get that right, there will be no problem.

We have been greatly assisted by the other place in our consideration of these matters. I commend to the House the amendments that their Lordships have suggested.

I beg to move, That this House doth agree with the Lords in the said amendment.

The purpose of the amendment is simplicity itself. It seeks to delete clause 3, the essential substance of which reads:

"A man commits an offence if he solicits a woman for sexual purposes in a manner likely to cause her fear."

Their Lordships have been good enough to honour an undertaking given by me, in consultation with the Minister, to this House before their Lordships considered the Bill. It was felt that the clause could give rise to serious concerns and that perhaps it went too wide in what is essentially, I still think, a useful proceeding to ensure that a woman has redress when she is put in fear by approaches from a man for sexual purposes of whatever kind. We recognised that that was a worry and it was understood that we would not press it. This amendment achieves that, and I am grateful to their Lordships for making it.

There have been numerous excitements with the Bill, both here and in the other place. It may date me to refer to a splendid little wireless programme in the days of my childhood entitled "Dick Barton, Special Agent." From 6.45 pm to 7 pm this hero had the most exciting adventures. Sure enough, at half a minute to 7 o'clock he would be within an inch of losing his life. That happened every night. I felt like that myself when I had several narrow shaves with the Bill. Indeed, there were several this week.

When I say that I am grateful for the assistance that I have received, I am not reciting those words without feeling. I am intensely grateful for the assistance that I have received from my hon. Friend the Under-Secretary of State and others who have been helpful to me from the very beginning of the Bill's passage. Those others will know who they are. I am grateful also to those who were willing to sponsor the Bill. It is quite an undertaking for a private Member to carry forward such a measure, bearing in mind that it seeks to create more than one new criminal offence.

I am grateful, of course, to those who served as members of the Committee. I thank especially Lady Vickers, who had such a distinguished career in this place. Lady Vickers' part in the Bill's passage through both Houses involved her in a great deal of work and some anxiety. I am grateful to those of their Lordships who gave a great deal of their attention — many of them have great experience of criminal matters and matters of life generally — to the Bill.

I am happy that the Bill retains the essential features which it was my intention to embody in law from the beginning. I hope that the Bill will be satisfactory to the hard-pressed residents of red light areas who have suffered for many years from the increasing menace of kerb crawling.

During the Bill's passage through Parliament I have been impressed by the number of letters that I have received and by the meetings that I have had with residents' associations, especially those from Wandsworth. I learned a great deal in the course of the proceedings and it is with the greatest pleasure that I commend the amendment to the House.

I hasten to say to my hon. Friend the Member for Plymouth, Drake (Miss Fookes) that I am not rising a la Dick Barton because I think that the amendment requires another 68 minutes of debate. I rise purely to say, as one whose activities might have implied some disagreement with some of her proposals earlier in the proceedings, how grateful the whole House is to her and how grateful the country will be that she has tackled this problem in the way that she has, and that she has brought forward a measure which I think the House now believes will deal with this problem, this blight, which affects many of our inner-city areas.

Although my hon. Friend might have been concerned about some of the points that my hon. Friend the Member for Derbyshire, West (Mr. Parris) and I were making, we were concerned purely to see that there was no danger, in a new criminal law, that innocent people could be brought before the courts and their reputations and lives blighted accordingly. I feel that we have now reached a stage when my hon. Friend's requirements have been met and the innocent are no longer in danger. I would like finally to say that I congratulate my hon. Friend on her courage and persistence and on getting it right.