Mesothelioma Lump Sum Payments (Conditions and Amounts) (Amendment) Regulations 2014

Lord Alton of Liverpool Excerpts

Monday 17th March 2014 Grand Committee

[Lord Wigley (PC)]

My Lords, I shall certainly follow the Minister’s suggestion that we leave consideration of the new mesothelioma provisions until the next debate, which makes a lot of sense. I shall want to contribute then, if I may. Perhaps I may ask a couple of questions particularly on the regulations made under the 1979 pneumoconiosis Act. In doing so, I welcome, of course, the upratings that are taking place. They should not lose their value as time goes on.

As the Minister and others may know, I have an interest in the 1979 scheme, particularly from the point of view of slate quarrymen. The issue was not, of course, related only to slate quarrymen; it also affected those working in the kiln and cotton industries, and a number of other conditions came under the purview of that Act. Over the period since 1979 there was initially a surge of applications, which reduced in 1986 to just 95. A decade later, in 1995, this had built up to 900, and was running at a level of 1,000 to 2,000 by 2002-03. I believe that some of the cases leading to that surge arose from coal-mining pneumoconiosis, which had not been covered under the coal-mining scheme—there was originally a tripartite scheme between the NUM, the NCB and the Government, in 1975, for that purpose.

I have been trying to ascertain the breakdown of the figures since 2002-03, and would be grateful if the Minister would give some undertaking on this. My colleagues in the House of Commons have been unable to get from the House of Commons Library the breakdown with regard to industry and to the regional spread of those cases. I imagine that the information must be available in the department because it was available 10 years ago. I hope that it might be possible, by letter or some other way, for this to be disclosed. It would be interesting to see how the pattern has changed from the point of view of the sustainability of the scheme itself, which is an important factor.

The second thing I want to ask the Minister is the breakdown of the figure that he has just given us for 2012-13. He mentioned 3,500 payments and £53 million. That figure covered both the 1979 scheme and the 2008 mesothelioma scheme. Presumably there is again some breakdown between those two at the very least, and perhaps the Minister is in a position to give it today, so we can see where this is going. There will be questions about the interplay of the schemes, but I am content to leave those until the subsequent debate.

[Lord Alton of Liverpool (CB)]

My Lords, like my noble friend Lord Wigley, I will reserve my remarks about the current 2014 scheme to the later orders. However, perhaps I can ask about the earlier scheme and take the Grand Committee back to remarks that the noble Lord, Lord McKenzie, made in 2010 when he was Minister. It is good to see him in his place. He said that the,

“differential in payments puts pressure on sufferers during already extremely difficult times. For example, many feel that they need to rush through a quick claim to the department in order to maximise compensation for their families. Some are too sick to make a claim before dying and therefore their families are able to claim only the lesser amount after the claimant's death. In addition, because mesothelioma is difficult to diagnose and the disease onset is rapid, some sufferers are not diagnosed until after death”.—[Official Report, 23/3/10; col. GC 355.].

This therefore raises the question of dependency and lump sum payments which, when the noble Lord, Lord McKenzie, was Minister, he said should be the same. He commenced the process of reducing the differential and both his remarks and the action he took then are to be greatly welcomed.

Each year since 2010, Members of both Houses have asked that the differential should be reduced and each year that has been rejected, due to economic circumstances. My question to the Minister is: as the economic situation continues to improve, at what point in the recovery will there be the trigger that will lead to the Government honouring the commitment to reduce the differential and in-life lump sum payments? Until we do that, it leads to three specific anomalies. First, the dependants are paid significantly less than in-life claimants; secondly, dependants’ age is cut off at 67, compared to 77 for in-life claimants; and thirdly, the 2008 scheme dependants do not receive the 10% enhancement.

Over the next 10 years, the Government are expected to receive some £71 million, less £17 million gifted to insurers, in additional recoveries under the terms of the Mesothelioma Act 2014. Could some of those additional funds be used to reduce the differential? As I will argue later, perhaps some of those funds could also be diverted towards research because once we have established what the causes and cures are, then we will not have a need for schemes like this at all.

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[Lord Freud]

My Lords, as ever, noble Lords have asked a set of sizzling questions, which I shall do my best to address, although they are getting so technical now, because we have gone round this subject so many times, that I think that I shall end up writing quite a bit of it out, if noble Lords will excuse me for doing so.

On the question from the noble Lord, Lord Wigley, on the breakdown of the figures for the latest year, 2012-13, there is a total of 3,180 cases due to the 1979 Act. That represents the bulk of the expenditure, at £43.6 million. The 2008 scheme figures are 500 cases and £9.6 million of expenditure. I think that we have the breakdown figures that the noble Lord requested from 2002-03 onwards, but not to hand; I shall need to write with them. I did not anticipate that particular run of figures. I think that that will tie up with the recovery figures for the noble Lord, Lord McKenzie, and how they relate to the 2008 figures. I think that I will tie that up—I shall aim to do some tables.

On the split between sufferers and dependants, again, I shall use the latest year. Under the 1979 Act, of the total the bulk were the sufferers—2,900 out of the total—and 280 were the dependants. With the 2008 scheme, 450 were sufferers and 50 were dependants. That testifies to the speed with which the money gets out, given the sad mortality expectation that we were discussing. I am in no position today to move much further on making any progress in closing that gap between dependants and sufferers, but it is something that we keep under review. Clearly, we have been looking very closely at this whole area over the past year, and we will keep it under review. That is the best that I can do, speaking today.

I hope that I have covered everything, except for the HSE questions, with the awareness-raising scheme. I will write on the actual cost of what it would be to close that differential on the figures that I have just provided, which will give a baseline on what we are keeping under review. I shall also need to write on the detail of the HSE awareness-raising campaign. I feel somewhat embarrassed that I have resorted quite so much to the written word. If there is anything else at all, I shall include that in the letter. These are two important schemes. I commend the uprating of the payment scales and ask approval to implement them.

[Lord Alton of Liverpool]

When the Minister comes to write his epistles to the Members of this Grand Committee, I wonder whether he will also be good enough to come back to us about the three anomalies that I specifically raised with him.

[Lord Freud]

Yes, my Lords. As I understand the questions, they concern, first, dependants being paid less, on which I have already committed; secondly, the age between 67 and 77; and, thirdly, the 10% enhancement. I shall be pleased to deal with those as well. With that, I ask for approval to implement the regulations.

Diffuse Mesothelioma Payment Scheme Regulations 2014

Lord Alton of Liverpool Excerpts

Monday 17th March 2014 Grand Committee

[The Parliamentary Under-Secretary of State, Department for Work and Pensions (Lord Freud)]

My Lords, I thank all those who worked so closely with me while the Bill was being considered by the House. We had a series of valuable debates and I am indebted to all those who followed and studied the Mesothelioma Act with such great dedication and focus on the detail. It was a collaborative act to get this legislation on to the statute book. Noble Lords will remember that there were quite a few significant adjustments made as a direct result of those debates. I was pleased to receive those ideas and to apply them in real time. Without the efforts of everyone the Act would be in poorer shape. To the extent that I did not do everything that noble Lords asked, I apologise, but I suspect that they all know how these things work.

As Members of the Committee will know, the problem of untraced employers or insurers in mesothelioma cases has for many years left sufferers and their dependants without recourse to the compensation that should be their due. It is a huge step forward that we now have concrete provision for those people who fall foul of the insurance industry’s market failure to keep proper records. The Act finally guarantees that they will be able to access payments that will support them in a most difficult and distressing time. The Mesothelioma Act represents a huge achievement and I hope that noble Lords will share my pride in that achievement.

We are here today to debate the substance of the regulations that dictate how the scheme will be run. I will briefly outline what the regulations set out but, first, I would like to mention the recent announcement that payments have been increased from 75% to 80% of the average civil damages. On 6 March, the DWP announced that payments would move from 75% to 80% and that this was possible because scheme administration costs were now confirmed to be lower than expected. This means that we can afford to pay people more while keeping to a levy of no more than 3% of employers’ liability gross written premium. I hope that noble Lords will welcome this good news.

This announcement posed a slight problem in timing. The draft regulations had already been laid in Parliament, including a payment tariff of 75%. I give my commitment that as soon as these regulations come into force a negative instrument will be laid to amend that tariff. For the purposes of today’s debate, however, I hope we can continue as normal.

The payment tariff is a schedule of these regulations and has no material impact on the substance of the regulations, which deal with how the scheme operates. To withdraw and relay amended draft regulations at this stage would simply rule out the possibility of having the scheme operational by April of this year. I know that noble Lords are sympathetic to the need to get the scheme running as soon as possible and I hope they are assured that our debates will not be affected by the increase in payments. I will of course share with noble Lords a copy of the revised table that we intend to bring forward with the higher tariff.

I come now to the reason why we are here: the regulations. These regulations deal with the duties of the scheme administrator and with the duties of the applicant. They set out details relating to making an application, how that application will be decided on, and the right to ask for a review and a subsequent appeal. They also deal with slightly more specific issues that may arise during the scheme’s running, such as repayments in the case of misrepresentation of information in an application and imposing certain conditions on a payment—for example, requiring it to be put into a trust fund for a person who cannot manage their own financial affairs. I am sure that we will go into much more detail on the key points during our debate but, before that, I hope to clarify a couple of possible questions and mention three points.

First, noble Lords who have kindly commented on draft versions of the regulations will notice that they no longer deal with the £7,000 contribution towards legal fees. I give an assurance that successful applicants will still receive a fixed contribution of £7,000 included in their payment. Following internal legal checks, we have removed mention of the legal fees payment and will instead include these in the regulations that deal with compensation recovery.

Secondly, I wish to mention the date of commencement. Regulation 2 explains that Regulation 7(2)(c) will not come into force at the same time as the other regulations. This is simply because that regulation refers to another enactment—the third parties Act 2010, which has not yet come into force. This does not affect the rest of the regulations or the commencement of the scheme.

Finally, I should like to give a little more detail relating to the chosen scheme administrator. The commercial process to select the administrator was a topic that occupied much debate in this House last summer. I assure noble Lords that a full and open tender process was conducted—indeed, I distinctly remember giving assurances on a number of occasions that that would be the case. Gallagher Bassett won the contract because, of all the bidders, it scored highest against the published commercial criteria. Gallagher Bassett is a claims-handling company well used to delivering government contracts and it has been carrying out personal injury claims-handling on behalf of the MoD for several years. I am confident that it will deliver the high-quality service that this scheme requires, and I am delighted that, as a result of its appointment, we are able to raise scheme payments.

I hope that I have helped a little here with my introduction, and I will endeavour to answer as many questions as I can as we have this debate. Of course, where I cannot do so from the Dispatch Box, I commit to write with a full account. I commend these regulations to the Committee.

[Lord Alton of Liverpool (CB)]

My Lords, the Minister has been generous in thanking Members of the Grand Committee for the work they put in when the 2014 Bill was being considered on the Floor of the House. However, it would be churlish at this juncture if Members of the Grand Committee did not pay tribute to the Minister for the work that he did tirelessly throughout. Although we had our differences on details of the Bill, we all committed to seeing it through its stages here and in the other place because we knew that this legislation was long overdue. It sets in place a scheme that will respond compassionately to people who are given a death sentence when they learn that they have mesothelioma. It is also based on justice, and I know through the contact that I have had with the Minister that he is always keen to see that things are dealt with expeditiously. He deserves warm thanks for the personal efforts that he has made. It is not easy to get legislation through Parliament, and he has done that deftly, while also working with the insurance industry. I think that all of us are sufficiently worldly wise to know that balancing all of those things at once is no mean achievement.

The United Kingdom, as we have heard, has the highest rate of mesothelioma in the world, with a further 60,000 people in the UK predicted to die from this disease in the next 30 years—as the Minister said, more than 2,000 people annually. The need is paramount constantly to urge greater attention to how we assist victims and keep focus on the insurance industry as well as how we better fund and pool research in finding causes and cures for this lethal disease. I was struck by a reply that the Minister gave to me in response to Parliamentary Question HL3144, where he said:

“The statistical model suggests an uncertainty range of 55,000 to 65,000 deaths on that estimate. However, the true uncertainty range may be wider as longer-range predictions are reliant on assumptions about asbestos exposures that cannot currently be fully validated”.—[Official Report, 19/11/13; col. WA194.]

We can add to that the trends in many of the developing BRIC countries, which are going through many of the same experiences that we have gone through, although the figures worldwide are not collected; in answer to another Question that I tabled asking for worldwide statistics, I was told that none were available. Given our own experience as the country with the worst rate of mesothelioma in the world, we should be at the cutting edge or, to mix my metaphors, in the driving seat in insisting that there is a collaborative global approach to this horrendous problem.

The Minister will be aware that I have tabled a Private Member’s Bill, the Mesothelioma (Amendment) Bill, on research. Today gives the Minister the opportunity to say whether the Government intend to facilitate the Bill’s progress and accept the principles that underpin it. The Bill mirrors the all-party amendment defeated here on a whipped vote by a mere seven votes, which was tabled again in the House of Commons by the late Paul Goggins and the Conservative Member of Parliament, Tracey Crouch. On 7 November, the Minister in reply to a Parliamentary Question recognised the importance of research, saying:

“As you are aware there is a cross-Government commitment to support more quality research into mesothelioma. The work that the Department of Health are taking forward on this issue is designed to encourage researchers to pursue projects that will hopefully benefit sufferers of this terrible disease”.—[Official Report, 7/11/13; col. WA69.]

Can we be told today how that work is progressing? Inter alia, I commend to the Minister Early Day Motion 995, moved by Tracey Crouch in another place, which has now been signed by more than 60 Members of the House of Commons. It says:

“That this House notes with concern that mesothelioma is an invasive form of lung cancer caused primarily by prior exposure to asbestos”.

It goes on to give the kind of statistics that I have just given and ends by paying tribute to the,

“great work of the former hon. Member for Manchester, Wythenshawe and Sale East, the late Paul Goggins, to raise the profile of the need for long-term investment into mesothelioma research; and calls on the Government to facilitate the establishment of a long-term sustainable mesothelioma research scheme funded by the insurance industry”.

I would simply add to that the point that I made in the previous debate. Given that some £71 million will come into the Government’s coffers in the next 10 years, less the £17 million that will be given to insurers, surely it will be possible to use some of that money to create a pound-for-pound research fund, where we work collaboratively with the insurance industry.

On the Floor of the House, I recently asked the noble Earl, Lord Howe, about a breakthrough in mesothelioma research which has taken place in Canada. In reply, he said:

“Mesothelioma is a devastating disease, and I certainly undertake to look at the material that the noble Lord has sent me”.—[Official Report, 27/2/14; col. 1005.]

This is probably the most hopeful small breakthrough that I have seen over the years that I have been following this and I wonder, having spoken privately, very briefly, to the Minister, whether he is in a position today to tell us what follow-up has been done by the Department of Health in looking at that breakthrough and what the initial conclusions are. Will he say whether his department and the Department of Health are not only collaborating across government in the United Kingdom but working with others to try, not to duplicate work that has already been done or to reinvent the wheel, to bring together the best practice and knowledge that there is worldwide?

Perhaps I may ask about a reply that the noble Lord gave to me to Parliamentary Question 14/5095, which concerned the extensive tables he produced for the House about the occupations of people who die from mesothelioma. In that reply he said:

“The latest available analysis of citizens dying from Mesothelioma in Great Britain is based on deaths between 2002 and 2010 at ages 16-74. Only the last occupation of the deceased is routinely recorded”.

It is not the last occupation that we need but the data on all the occupations that someone has had. If we are going to get any kind of idea about tracking the causes of mesothelioma we need to know where the hot spots are with this disease.

The Minister continued:

“It is important to note that, for those Mesothelioma cases that are caused by occupational exposure, the last occupation of the deceased which is recorded on the death certificate may not reflect the source of exposure due to the long latency of the disease.—[Official Report, 11/2/14; col. WA 122.]

That begs the question of what use are the tables in those circumstances. Would it not be better to acquire data that would help us?

I was about to turn to the Questions from the noble Lord, Lord Wigley, but as he is about to intervene, perhaps he will save me doing so.

[Lord Wigley (PC)]

I am grateful to the noble Lord for giving way. Given that it is the last employment that is detailed in the Written Answer, of which I have a copy, does that not camouflage any cases that may arise from the armed services? There are indications that the premises in which many members of the armed services live have asbestos. That raises the question of the incidence and whether or not those families are notified of the dangers with which they are living.

[Lord Alton of Liverpool]

My Lords, I did not have a chance to compare notes earlier with the noble Lord, Lord Wigley. He has a copy of my parliamentary reply and I have a copy of a reply that he was given on 11 February by the Under-Secretary of State for Defence, the noble Lord, Lord Astor of Hever. After a Written Answer from the noble Lord, Lord Astor, on 4 February, the noble Lord, Lord Wigley, asked about the accommodation of families working for the Armed Forces and whether those living in accommodation that is known to contain asbestos are systematically informed of that fact and the outcome of the regular inspections undertaken of such premises. I was struck by the reply:

“However these reports are not automatically made available to occupants”.—[Official Report, 11/2/14; col. WA 122.]

What value are such reports if they are not made available to occupants?

In reply to another Question asked by the noble Lord, Lord Wigley, about the prevalence of asbestos materials in Ministry of Defence buildings and married quarters, he received a reply saying that some are known to contain asbestos and that the ministry keeps a register of all buildings which are regularly inspected. Surely anyone living in such buildings has a right to know these things.

My noble friend Lord West of Spithead said to me recently—he said that it was perfectly proper for me to repeat this remark in public—that 10 of the cohort that were at Dartmouth with him died of mesothelioma. This relates to a Question that I tabled to the Ministry of Defence. I hope that the Minister will pursue this matter, not only with the Department of Health but with the Ministry of Defence. I asked about the number of annual fatalities caused by mesothelioma involving members of the Armed Forces. I asked what data are kept on the cause of death of former servicemen and what research it planned to commission into the incidence of mesothelioma among former servicemen. I received a long reply on 11 February but the first sentence states:

“Data on the number of annual fatalities caused by mesothelioma does not identify those who were former members of the Armed Forces”.—[Official Report, 11/2/14; col. WA 124.]

Again I ask the question: why not? These are people serving in our Armed Forces who are willing to risk their lives on our behalf. Surely we owe a duty to them to ensure that, if they are in any way being placed at risk as a consequence of exposure to asbestos, everything possible is done to avert that.

--- Later in debate ---

[Lord Freud]

My Lords, I thank noble Lords for a highly informed debate and for the kind words that were addressed to me personally, which I appreciate. I thank the noble Lord, Lord McKenzie. Without the little present that he left me on my arrival, things would perhaps not have been sorted out with quite such alacrity.

A number of noble Lords asked about the timing. The noble Lord, Lord Wigley, was the first. Our intention is that applications will be accepted from April with the first payments in July. These regulations will come into force on 6 April, subject to this process. We intend to lay the negative instrument the next day, 7 April.

I shall now deal with research, on which we spent a lot of time. Noble Lords around the Room are very sympathetic to the point made by the noble Lord, Lord Alton, about improving it. That debate, which I shall not replay because it is a long and complicated situation, as noble Lords know, stimulated a substantial increase in research activity in this country on mesothelioma. I shall go through the four things that we committed to do. First, we set up a partnership to identify the priorities in research. A survey has now begun and is currently open, asking patients, families and healthcare professionals for their unanswered questions about mesothelioma treatment. The partnership will then prioritise the questions, and the end result will be a top 10 list of mesothelioma questions for researchers to answer. It is planned that that list will be ready by the end of this year, when it will be disseminated and work will begin with the National Institute for Health Research to turn the priorities into fundable research questions.

Secondly, the national institute will highlight to the research community in the spring of this year that it wants to encourage research applications in mesothelioma. Thirdly, the national institute’s research design service continues to be available to help prospective applicants to develop competitive research proposals. Finally, the National Cancer Research Institute has made excellent progress in planning a workshop for leading researchers to discuss and develop new proposals for mesothelioma studies. This event will take place on 2 May.

I know that we are not going along with the specific structures suggested by the noble Lord, Lord Alton, but I want him to feel that we are really pursuing this with energy, getting results and getting this focus within the structure of how research is managed in this country. Just because his specific proposals may not have been accepted, he should not feel that we have not taken his point thoroughly on board or that we are not grateful to him for keeping up that pressure.

[Lord Alton of Liverpool]

I urge the Minister to add a fifth point to his four other points with regard to the remarks that I made earlier about the importance of global collaboration through the World Health Organisation, also looking at best practice and innovations being promoted elsewhere in the world and the need to draw that information together. We may have the highest rate of mesothelioma in the world but many other countries face the same challenges as we do.

[Lord Freud]

That is a very powerful point from the noble Lord. I have not yet had a chance to talk to my colleagues in the Department of Health but I shall pick up that issue specifically.

On the suggestion as to where to spend the recoveries money, it is the same core point. There is a process for funding research, and it does not work to direct other moneys around in that mechanical way. The money will go into research as the right propositions come up. That is the reason why, fundamentally, we will not be able to provide support for his Private Member’s Bill. It is a difference not in aspiration but in the structures that we can accept. I know that he will be disappointed in that, but he may not be surprised.

The point that the noble Lord raised on the causes of mesothelioma and the last occupation is one that requires reflection, and I shall write to him on that particular set of points. I will also pick up the related point from the noble Lord, Lord Wigley, on the technical issue of the MoD advising tenants. On the noble Lord’s point about widening the coverage of the 2014 Bill, clearly we will continue to operate the 1979 scheme, but I have dealt in enormous detail with why we would not widen this scheme and why we are in no position to make any such commitments now.

[Lord Freud]

I have been in discussion with the insurance industry. There is currently no commitment to go ahead with its funding, but I do not think that this is the end of the story. We are still talking about various options.

[Lord Alton of Liverpool]

Before the noble Lord leaves that point, I do not want to return to the arguments that we had on the amendment that I moved in the House, but he will recall that the noble Earl, Lord Howe, in replying to those debates, made a number of substantive remarks about the important role that the industry was playing in supporting research into mesothelioma through financial contributions. If we had been aware at that time that the industry was not going to step up to the plate and provide those resources, I wonder whether some noble Lords might have voted in the way they did having been given those assurances.

I shall not press the Minister further today but I hope that he will return to the intervention from the noble Lord, Lord McKenzie, perhaps by writing to keep us informed about the progress he has made. Certainly, I know from my own meetings with the industry as recently as last week that it would much rather have a scheme where the cost is shared beyond the six companies that previously funded research. Those six companies feel that the whole burden should not just fall upon them.

[Lord Freud]

We are in danger of rerunning the debate. Clearly, we were not able to help the insurance industry to spread the burden using this mechanism, for complicated reasons which are on the record. Discussions are going on with those companies that have a sense that contributing to research is desirable and we shall see what comes out. On the question raised by the noble Lord, Lord Alton, about the extent of recoveries, over 10 years according to the impact assessment we are expecting £72.2 million.

In response to the leading and very clever question from the noble Lord, Lord Howarth—I would expect nothing less from him—we have committed to keeping the tariff under review and we will carry out a review of it after four years, once the smoothing period has finished.

Health: Neglected Tropical Diseases

Lord Alton of Liverpool Excerpts

Thursday 6th February 2014 Grand Committee

[Lord Alton of Liverpool (CB)]

My Lords, I, too, pay tribute to my noble friend Lady Hayman for her assiduous and indefatigable commitment to the elimination of neglected tropical diseases. I should mention that I am a patron emeritus of the Liverpool School for Tropical Medicine, which is one of the partners in the Global Network for neglected tropical diseases and is a leader in NTD research. I am also a patron of a project providing clean water in Turkana and a health project in Ghana.

As recently as 27 January, former Ghanaian President John Kufuor was in London to mark the anniversary of the 2012 declaration. He rightly says:

“There is no silver bullet remedy to helping a country break the cycle of poverty, but investing in the health of its population offers one of the best options for unlocking economic potential”.

Scaling up integrated NTD control and elimination strategies is considered one of the most cost-effective ways to reduce global poverty. Virtually all of the “bottom billion”, the 1.4 billion people around the world who are living on less than $1.25 a day, are afflicted with one or more of the seven most common NTDs: elephantiasis, hookworm, river blindness, roundworm, whipworm, trachoma and snail fever. NTDs disable, debilitate and perpetuate poverty and in worst-case scenarios they can kill. They cause blindness, huge swelling in appendages and limbs, severe malnutrition and anaemia—all brilliantly highlighted, I might add, in the END7 Youtube video featuring Eddie Redmayne and others.

Those afflicted include more than 500 million children. In a randomised controlled trial in Ethiopia, researchers found that consistently treating trachoma halved childhood mortality, while a study in Kenya demonstrated that deworming children leads to a 25% decrease in school absenteeism. Compare the cost of one cup of coffee at Starbucks, which can range from £1.75 to £3.50, to the fact that just 30p—or 50 cents, half a US dollar—per person per year is all that is needed to treat and protect one person against all seven NTDs. This in turn averts malnutrition, improves education outcomes, improves maternal and child health, reduces new cases of HIV and sets the stage for sustainable economic development. In Africa, the entire at-risk population could be treated for £250 million or less annually. Yet efforts to control and eliminate NTDs receive less than 2% of total global health funding, and the elimination of many of the NTDs will not be achieved without significant investment in water and sanitation interventions. Such an approach should surely be central to post-2015 objectives, and I hope that we will hear from the Minister on this.

I am particularly concerned that the 2013 report of the Sustainable Development Solutions Network, An Action Agenda for Sustainable Development, does not mention NTDs. Surely that should be rectified. I hope that the Minister will comment on that.

Many of the curses that afflict us cannot be conquered but NTDs can. These ancient diseases can and should be a thing of the past, and it is not misty romanticism or idealism to talk of a world free of NTDs for the next generation. This is achievable, and we would be failing millions, and failing our duty, not to do it. My noble friend therefore deserves our thanks for keeping this issue on the agenda, and the United Nations and development agencies should be lobbied by parliamentarians and Governments the world over to make this achievable objective a reality. I hope that the Minister will tell us that the Government are committed to doing precisely that.

Disabled People: Mobility Benefits

Lord Alton of Liverpool Excerpts

Monday 2nd December 2013 Lords Chamber

[Lord Freud]

My Lords, we are handling an extraordinarily difficult economic and financial position. As noble Lords are of course aware, we have had a decline in GDP of 7.2% from its peak in 2008-09. That is more or less the same level as what happened in the 1930s. Handling that decline has been enormously difficult and one of the most interesting things about the way we have handled it generally is that, unlike every other developed country, we have spread the inevitable difficulties across the whole economy, rather than, as elsewhere, the poor being hit far worse than the rich. That has not happened in the adjustment that we have made in this country.

[Lord Alton of Liverpool (CB)]

My Lords, pursuing the point made by the noble Baroness about the role of Atos Healthcare, in confirming the amounts of money that are involved in this process, will the Minister confirm to the House that in the past 12 months alone, £114 million has been paid to Atos Healthcare; that, over the distance, more than £700 million has been paid to it; and that he has had to call in PricewaterhouseCoopers in order to assess its role? Will he tell us what that has cost and when the National Audit Office will now report on the tendering arrangements involving Atos Healthcare that it has decided to investigate?

[Lord Freud]

My Lords, that is a series of very specific questions, some of the answers to which are not yet in the public arena. I will have a look at which of those I can answer appropriately in that context.

Arab Spring

Lord Alton of Liverpool Excerpts

Tuesday 29th October 2013 Grand Committee

[Lord Alton of Liverpool (CB)]

My Lords, I thank the right reverend Prelate the Bishop of Wakefield for initiating this debate. I have a non-pecuniary interest as president of UK Copts. Indeed, my remarks will focus predominantly on the situation in Egypt, following on from what the noble Baroness, Lady Falkner of Margravine, has just said.

Before starting, I must say in parenthesis how much I agree with what the noble Lords, Lord Selkirk of Douglas and Lord Anderson, said about the importance of upholding Article 18 of the 1948 Universal Declaration of Human Rights. I commend to the Minister the excellent report of the All-Party Group on International Religious Freedom or Belief, of which I am an officer, entitled Article 18: An Orphaned Right, which sets out many of the arguments eloquently expressed today by the noble Lords.

Hostility and even violence against Christians is not new in Egypt, but the turmoil that followed the overthrow of President Mubarak and the subsequent removal of President Morsi has led to unprecedented violence. Just a few days ago, as the members of a community prepared to celebrate a wedding, they sorrowfully returned to their church to bury four of the guests, including two little girls: Mariam Ashraf Seha, aged eight, and Mariam Nabeel, aged 12. They were shot dead as two men with automatic weapons opened fire on guests outside the Virgin Mary Church on the west bank of the Nile. Another 17 people were wounded. The most senior cleric at Al-Azhar University, the world’s primary seat of Sunni Islamic learning, described the killings as,

“a criminal act that runs contrary to religion and morals”.

These killings come in the wake of a summer of violence. Writing about the plight of the Copts and the other ancient churches of the Middle East, Professor Diarmaid MacCulloch, Professor of the History of the Church at the University of Oxford, recently wrote:

“It is easy for them to feel abandoned and betrayed by the Christian-based cultures of the West. When will this Western silence end?”.

In November 1938, in an orgy of violence that would become known as Kristallnacht, Jewish synagogues, homes, hospitals and schools were ransacked and pillaged. The sledgehammers and petrol left more than 1,000 synagogues burnt and more than 7,000 Jewish shops and businesses in ruins. The streets were covered in shards of smashed glass from broken windows. If noble Lords compare pictures of the charred husk of the Fasanenstrasse Synagogue in Berlin, in 1938, with those of the blackened walls of Degla’s ruined Virgin Mary church, taken two months ago in Egypt, they will readily understand why August 2013 represents Egypt’s Kristallnacht. One can also compare the terror of 1938 with the fear among Copts as members of their community have been left dead and others assaulted. Their 118th Pope, Tawadros II, is now under protection, having had death threats made against him.

In 1938, the Times commented:

“No foreign propagandist bent upon blackening Germany before the world could outdo the tale of burnings and beatings, of blackguardly assaults on defenceless and innocent people, which disgraced that country yesterday”.

Reports in the Times and Sunday Times in August 2013 are in an almost identical vein, with the latter paper referring to an event in Cairo where Franciscan nuns saw the cross over their school gate torn down and replaced by an al-Qaeda flag. The school was burnt down and three nuns were frog-marched through the streets while mobs showered them with abuse. One nun was reported as saying that,

“they paraded us like prisoners of war”.

Joe Stork, deputy director for the Middle East at Human Rights Watch, reported that,

“dozens of churches are smouldering ruins, and Christians throughout the country are hiding in their homes, afraid for their very lives”.

It took the outgoing British Chief Rabbi, the noble Lord, Lord Sacks—always mindful of the events to which Kristallnacht led—to point to our indifference to the assault on the Copts, which he described as a tragedy “going almost unremarked” and as,

“the religious equivalent of ethnic cleansing”.

That is why Egypt now needs a constitution, an issue being considered as we meet, that protects minorities, women—as mentioned by the noble Baroness, Lady Falkner, a few moments ago—and secular groups. It is easy to get into denunciatory mode about the role of armies, but as Egypt saw attempts to impose a theocratic state, and the country descended into total anarchy, were those who love their country supposed to simply stand by and watch it happen? Egypt’s future can only be based on a secular constitution where human rights include the rights of women and of minorities and the rights of religion and belief—including the right not to believe—and where all those things are respected.

The 50-member committee tasked with amending the suspended 2012 constitution has, according to the Ahram news website this week, initially adopted an article 47 which stipulates “absolute freedom” of belief for Egyptian citizens and endows the state with the responsibility to ensure free practice of religion. It also adopted a transitional article that will cancel existing restrictions regulating the building of new churches. All this is very welcome, although there is pressure to restrict this to the three monotheistic beliefs, which would exclude Baha’is, for instance. I hope that that will be resisted and will be interested to hear from the Minister whether we have raised that issue directly with the Egyptian authorities.

In a climate of fear and intimidation, coupled with historic and long-standing discrimination, the significant exodus of Copts from Egypt that is now under way is entirely understandable. However, if this represents the only future for Copts it will be a tragedy for Egypt and for the Copts’ Muslim neighbours alike. An Egypt which is unable to accept difference and unwilling to promote tolerance will be an increasingly unbearable place for all of its citizens. That is why Egypt’s Kristallnacht matters so much.

Mesothelioma Bill [HL]

Lord Alton of Liverpool Excerpts

Monday 22nd July 2013 Lords Chamber

[Baroness Masham of Ilton]

My Lords, I thank the Minister for what he has done for these unfortunate people, but I very much hope that there will be an increase in research. If there is a will, I am sure that there will be a way of finding a cure.

[Lord Alton of Liverpool]

My Lords, before the Bill passes and goes on to another place, I want to add a few words to those that have been spoken. I specifically support what the noble Lord, Lord Browne of Ladyton, said earlier about the limitations and relaxations that may well occur in Amendment 5. Like him, I hope that when the Bill goes to another place it will be subject to further scrutiny.

Mesothelioma Bill [HL]

Lord Alton of Liverpool Excerpts

Wednesday 17th July 2013 Lords Chamber

Moved by

[Lord Alton of Liverpool]

2: Clause 1, page 1, line 6, at end insert “, and
“( ) fund research into mesothelioma (through the research supplement under section (Research supplement))”

[Lord Alton of Liverpool]

My Lords, in moving Amendments 2, 20, 21, 22, 23 and 24, I join other noble Lords who have expressed their thanks to the noble Lord, Lord Freud, the Minister, for doing an incredibly tough job over the last year or so. It has been very well done. I am very grateful for his remarks earlier.

The Minister said that if the Bill were delayed—none of us intended to do that—it could cause further problems in due course. Nevertheless, I just hope he accepts that that is no reason for curtailing due parliamentary process in any way. Of course, it is up to the Government to decide what to do in another place. If your Lordships decide to include amendments to the Bill here, it will not be Members of another place who precipitate the ping-pong; it will be the Government.

With those words, I refer the noble Lord to the all-party support for this group of amendments, and to the letter that was sent to him and other Members of your Lordships’ House, signed by some 22 Members. They include some of the leading authorities on medical research and the law and others with first-hand knowledge of a fatal disease that claims 2,400 lives annually and is predicted to kill a further 56,000 British citizens between 2014 and 2044. Dr Mick Peake, the clinical lead at the National Cancer Intelligence Network, is right when he says, “We must make every effort not to miss this opportunity to lead the world in this area and to finally make significant inroads into this dreadful disease for patients and their families”.

The amendments before your Lordships seek to impose a levy of no more than 1% to raise funds to support research into the causes and treatment of mesothelioma, and have the wholehearted support of the British Lung Foundation. I thank it, and especially my noble friends Lord Walton of Detchant and Lord Pannick, and the noble Lord, Lord Avebury, who are co-sponsors of the amendments, and noble Lords who spoke in Committee and who through constraints of time might be unable to do so again today.

At the conclusion of Committee, it was the Minister who encouragingly said:

“Well, my Lords, I feel like adding my name to the amendment”.

As recently as Monday, I met the Minister again—once again, I am grateful to him and his team of officials for the time and courtesy they have unfailingly given—to see whether we could find a way for him to translate that desire into a reality. I have offered to withdraw this amendment if the Government undertake to introduce their own at Third Reading, or indeed in the other place, and that offer still stands. Although I feel that the noble Lord has been a victim of the Whitehall curse, I want to put on the record that he has been deeply committed to ensuring more support for research. However, as he told us in Committee:

“I have hit a brick wall at every turn”.

It is Parliament’s job to demolish such brick walls.

Although new figures published yesterday show that the MRC has made a helpful increase in funding for mesothelioma research, the sums are still very modest and should be seen in the context of years and years of virtually no state funding. When viewed alongside the two cancers of closest mortality in the UK—myeloma and melanoma—the funds for mesothelioma still lag considerably behind. Unlike many other forms of cancer, rates of mesothelioma are still rising. The United Kingdom already has the highest mesothelioma mortality rates in the entire world, yet there is little by way of effective treatments and at present no chance of a cure.

This shocking situation was underlined by the Minister himself, who candidly told us in Committee:

“Something very odd is happening here when so little money has gone into research in this area”.

In Committee he agreed that,

“There needs to be a kick-start process to get research going”.—[Official Report, 5/6/13; col. GC250.]

That is precisely what this amendment does. It is a kick-start.

In a letter sent by his department to all Members of your Lordships’ House on Monday, the Minister reiterated his support for increased support for research, but said that, “unfortunately, the mechanism proposed is just not viable”.

With the assistance of the British Lung Foundation, I took the precaution of asking Daniel Greenberg QC to draft this amendment with me. I did so not simply because he is the editor of Craies on Legislation, Stroud’s Judicial Dictionary, Jowitt’s Dictionary of English Law, Westlaw UK Annotated Statutes and editor-in-chief of the Statute Law Review, but perhaps most importantly because he was parliamentary counsel from 1991 to 2010. Clearly, he knows a thing or two about drafting legislation, and presumably the Government would not cast doubt on the viability of the reams of legislation that he drafted for them.

The Minister will forgive me but in the nearly 35 years since I entered Parliament, I have heard the phrases “not viable” or “technically defective” as the refuge of last resort whenever we run out of good arguments. If the argument for a levy lacked viability, it would cast doubt on the whole principle that underpins this Bill, which is based on the imposition of a levy.

The Minister will recall that before Committee he was briefed to oppose the amendment on the grounds that there was no precedent for hypothecation and to raise that other old bogey of “legal obstacles”, the Human Rights Act. To answer those objections, noble Lords gave the noble Lord the precedent of Section 123 of the Gambling Act 2005, Sections 24 and 27 of the Betting, Gaming and Lotteries Act 1963, the HGV Road User Levy Act 2013, and other industry levies, including the fossil fuel levy, the levy on the pig industry to eradicate Aujeszky’s disease and the Gas Levy Act 1981. As my noble and learned friend Lady Butler-Sloss and my noble friend Lord Pannick made abundantly clear, the idea that such a levy was an infringement on the Human Rights Act is, frankly, risible. Indeed, my noble friend Lord Pannick said:

“It would be quite fanciful to suggest that there is a legal reason not to support an amendment”.—[Official Report, 5/6/13; col. GC 247.]

None of those shadow-boxing parliamentary arguments will do. They are simply not worthy of an issue that has lethal consequences for so many of our countrymen. Why has mesothelioma research had this Cinderella status? Why does it require Parliament to put it right? Why has it for so many years received little or no state funding? In Committee, the Minister provided clues. He said that mesothelioma,

“was an unfashionable area to go into and therefore the people who wanted to make their careers in research turned to other cancers. As a result, good-quality research proposals were not coming in and therefore the research council did not feel that it could supply funds. That is the reason and it has been the reason for decades”.—[Official Report, 5/6/13; col. GC 253.]

The advisers to the Minister at the DWP have written that there is no lack of necessary skills for research into asbestos-related diseases but that there are perverse incentives to tackle what are perceived as more tractable research questions or tumour types that are considered easier to study and, where possible, to build on past progress. They said that research bids that were seen as likely to fail were not being presented. Therefore, it is not a lack of capacity in the field that is the problem; as my noble friend Lord Kakkar outlined in Committee, many eminent researchers are interested in mesothelioma research. High-quality bids have been in short supply in the past decade precisely because leading academics knew that it was pointless putting time and effort into preparing a bid that was unlikely to succeed.

Dr Robert Rintoul, consultant respiratory physician at Papworth Hospital and chief investigator of the recently launched mesothelioma tissue bank, told me that if more funding is made available, big labs will suddenly get interested in mesothelioma, which will increase the quality of research grants. Dr John Maher, honorary consultant immunologist at King’s College Hospital, said, “As I write, we have a clinical-grade viral vector ready for use, an optimised and patentable manufacturing process and a recently licensed GNP manufacturing facility available to generate cell products. However, there are no realistic prospects of obtaining funds to undertake such work in mesothelioma in the near future”. There clearly is no question that further investment in mesothelioma research is urgently required.

We have heard from the Minister that this will peak in two years’ time, but listen to this stark warning from Dr Stefan Marciniak, the honorary consultant physician at Cambridge University’s Institute for Medical Research, who told me that there will be a continued increase in cases worldwide well into this century owing to the ever-increasing use of asbestos in the BRIC countries, and that carbon nanotubes share frightening similarities with asbestos-like minerals and could lead to a second wave of mesothelioma. That is why we need urgent research

I am delighted to see the Minister and his noble friend Lord Howe on the Front Bench today. The Minister will be sponsoring a reception later this month on mesothelioma research for an invited audience of some 40 people. I know that he will agree that such meetings, welcome though they are, are not enough and certainly not a substitute for statutory obligations. By themselves, such initiatives are unlikely to lead to the sea change in investment that is needed to ensure that the recent advances in mesothelioma research are sustained. If we do not seize this legislative moment, all the talk will vanish into the ether. It will be the informal approach that lacks viability, not this amendment.

As my noble friend Lord Walton of Detchant suggested in Committee, the amendment proposes that the funds be administered by a competent third party, which would have no difficulty in investing in all the different types of research that are so urgently required. We need both a statutory levy on the insurance firms and a greater effort from our public research institutions in dealing with a disease that will kill more than 2,000 people every year in the United Kingdom. It is vital that we as legislators grapple with the source of so much misery and suffering, which is the reason, after all, for the millions of pounds of compensation payments for which the Bill provides.

The amendment proposes a commendably simple approach and, crucially, has not been opposed by the insurance industry, whose representatives I met last week. No letter has been received by Members of your Lordships’ House from the industry opposing this very modest amendment.

Having listened to suggestions made in Committee by the noble Lord, Lord McKenzie, and others, we explicitly provide in the amendment for the scheme—a levy of no more than 1%—to be proportionate. The supplement reflects insurers’ market share, as the main levy contained in the Bill already does.

In the face of a vicious disease that according to the Government’s figures will claim the lives of some 56,000 more British citizens and the lethal nature of which we have known about since the Merewether report of 1930, it would be nothing short of a national scandal if we did not seize this rare legislative chance to offer those who have faced the blight of this horrific disease something better than what has gone before. I beg to move.

[Lord Walton of Detchant]

My Lords, I have been pleased to add my name to this amendment, so forcefully and ably proposed by my noble friend Lord Alton. This is an appalling and tragic disease. Although my specialty was never respiratory medicine, in the course of my professional career I saw many people suffering from mesothelioma and recognised to the full its utterly devastating effects. Indeed, one such person was a professional colleague of mine who was a consultant neurologist. One of the disease’s most unfortunate features is that, after exposure to asbestos, particularly blue asbestos, the incubation period is extraordinarily long. People sometimes do not develop the disease for many years after exposure. Indeed, I recently learnt of an 87 year-old man who had developed mesothelioma for the first time, having worked at the age of 40 as carpenter cutting up sheets of asbestos. That is one of its appalling features, and its effects are utterly distressing. It is not a localised cancer that grows in a single location where a surgeon can remove it; it is a diffuse involvement of cancerous tissue that grows over the surface of the lung, between the lung and the chest wall. It gradually begins to strangulate the lung and eventually causes respiratory failure. It is a devastating disease—I need say no more.

However, as my noble friend has said, research on this topic is extraordinarily limited. I speak as someone who had 14 years’ involvement with the Medical Research Council, ending up as a member of the council for four years. At that time, we received research grant applications from a huge number of notable doctors and scientists seeking to research particular conditions.

The MRC, as part of its policy, used to identify priority areas which it saw as requiring further research effort, but it did not identify single diseases such as mesothelioma. It talked about problems of mental health, and about problems of ageing. Even the notable Cancer Research UK campaign, which has been a massive contributor to research in cancer in the broadest sense, has not identified single-disease conditions as having a particularly high priority in its programmes.

It is interesting that the British Lung Foundation and four leading insurance firms three years ago reached an agreement under which they collectively granted £1 million a year for three years to invest predominantly in mesothelioma research. The results were impressive. New researchers from other fields who had never thought of working on mesothelioma started to take an interest. This led to the creation of Europe’s first mesothelioma tissue bank, storing biological tissue and funding work to identify the genetic architecture of the disease.

My experience as a doctor, having been involved with a huge number of different charities funding research over the years, is that the existence of charities that are established to support research on single diseases has been immensely valuable and important in attracting new scientists into the field for which they have provided funds. One has to think only of the British Heart Foundation, which has given a massive impetus to work on heart disease. Without the money which the Multiple Sclerosis Society has collected over all the years, we would never have had the same effect.

In my research field of neuromuscular disease, had it not been for the work of the Muscular Dystrophy Campaign there is little doubt that we would not have reached the stage that we now have, where research on exon skipping has led to the introduction of a drug for the treatment of the most severe form of the disease. Those are massive developments, but they came about because funds had been raised by individual charities and groups specifically for research in that disease.

As my noble friend said, until this recent initiative by the British Lung Foundation, the funding for research on mesothelioma had been miniscule. Unfortunately, the funding by the BLF and others has now run out. The sole purpose of the amendment is to persuade the Government to accept that a tiny percentage of the levy which they already lay on insurance companies for the support of patients with this condition and their families should be specifically devoted to research. That could make a massive contribution to the future of patients with mesothelioma and to the development of an effective treatment in the foreseeable future.

The Government cannot protest on the grounds of hypothecation, because the levy under Clause 13 is already hypothecated. They cannot just say that people working on mesothelioma can apply to the Medical Research Council. Of course they can, but the crucial point about the levy is that it would provide funds that will attract scientists to work on that highly intractable problem. The fact that it is intractable is not an excuse. It deserves more attention, it deserves funding, and this group of amendments is one way to make certain that that funding will be made available and that scientists will be attracted to work in this field.

--- Later in debate ---

[Earl Howe]

A very great deal of the research conducted in this country is funded by different sources. It is funded by the Government, charities, universities, and industry. Nothing in the arrangements that I have outlined precludes a joint arrangement for funding mesothelioma research, which is why I welcomed the indication that the noble Lord, Lord McKenzie, gave about the ABI and the possibility of augmenting whatever funds are forthcoming from the MRC or the NIHR. That is an important point to make. I think I have said enough. The ball is in the noble Lord’s court.

[Lord Alton of Liverpool]

My Lords, I am always grateful to the noble Earl and I know that the House will appreciate what he has said about the four steps that he intends to take. I think he would agree, though, that there is nothing incompatible in taking those very welcome steps and supporting the spirit of this amendment. I made it clear when I spoke at Second Reading, in Committee and again today that if the Government—during the many discussions that the noble Lord, Lord Freud, and I have had about this—had been willing to accept the principle and come forward with their own amendment, I would have been happy to withdraw my own. The principle that I have been trying to underline is the need for a statutory requirement to step up to the plate to deal with this killer disease, which we all agree will take any number of lives—an estimated 56,000 before the disease completes its first wave. We heard in the quotations I presented to the House earlier today that there is a possibility that, in the BRIC countries and with new forms of asbestos being used worldwide, it will not be 56,000 who die, but many more.

The noble Earl has suggested that if such a levy were imposed, it would be swallowed up into Treasury funds and there would be no guarantee that it would then be used for its intended purpose. I do not think that any of us really believe that that would be possible. If Parliament has legislated that a levy of up to 1% should be imposed—that is all; it is a levy inside a levy and what this entire Bill is about—there is no reason why that money should not then be used for this specific purpose. The noble Lord has already said that this should be a priority area.

The noble Earl has said that there should be competitive research proposals; very good research proposals have been put forward but, unfortunately, have not gained traction because the funding has not been available for them. It has been a Catch-22 situation. It was also said that it would be unethical to support second-rate work. Nobody in your Lordships’ House would suggest otherwise—of course we accept that there should be no second-rate work and, through the Medical Research Council and specified outside bodies, an evaluation would be made of the quality of that work and of the proposals that have been put forward.

The noble Earl said that around £2 million will now be made available, and that is welcome. However, the House should just bear in mind, for example, the £22 million being made available this year for bowel cancer, the £41 million for breast cancer, the £11.5 million for lung cancer and the £32 million for leukaemia. Those comparisons show the position in which mesothelioma still appears in this terrible league table.

The noble Earl also said, quite rightly—and the noble Lord, Lord Howarth, touched on this, too—that we should protect the purity of the system, but my noble friend Lord Kerr of Kinlochard dealt admirably with that argument and I can add nothing more to what he said. No one wishes to pollute the process but the Bill before the House is about one specific disease, and that is why this amendment is before your Lordships. It is not that we are being asked to set a precedent for any number of other things. Mesothelioma has a unique characteristic. The reason that the noble Lord has been able to negotiate with the ABI and the industry is that, for instance, smoking cigarettes cannot lead to mesothelioma. This disease is specific and that is why the industry has accepted its responsibilities in this regard. Therefore, it is different from other diseases, and that is why we were able not only to have this Bill but to exclude from it even other asbestos-related diseases, which cannot be said to be specific, as mesothelioma is. I think that that is a perfectly good reason for attaching to the Bill an amendment that deals specifically with this disease.

I am extremely grateful to everyone who has participated in this debate. I am sure that we listened with great care to my noble friend Lord Walton of Detchant, who said that this could make a massive contribution and that it could pave the way for a cure. The noble Lord, Lord Selsdon, was right when he asked why it was not done a long time ago. As long ago as 1965, the Sunday Times reported on work that had been done by the London School of Hygiene and Tropical Medicine. In cities such as Belfast, Liverpool, Glasgow and other epicentres of the disease, it had identified the nature of mesothelioma, as well as its very long hibernation period, alluded to by the right reverend Prelate the Bishop of Norwich, before it had its terrible impact.

I doubt that there are many of your Lordships who have not come across people who have contracted this disease and died within the two years—that is all it takes—from the time that it is diagnosed until death. The right reverend Prelate referred to the late Bishop of Peterborough. When we dealt with the LASPO legislation last year, the noble Lord, Lord McNally, told a deeply moving story at the Dispatch Box about his sister, who had died as a result of washing the dungarees and overalls of her husband, who had worked in the industry. This is something that can affect us all and we need to do something about it urgently.

The noble Lord, Lord Pannick, said that it might be claimed that the amendment is not viable. That has not been said in the debate today, yet it was said in the letter that was distributed on Monday. The amendment deliberately mimics Clause 13 of the Bill so that it does nothing that the Bill itself is not doing. It cannot possibly be challenged under the Human Rights Act, but perhaps we could be challenged under that Act by victims of mesothelioma if we fail to do enough or take the opportunity to provide for proper research to deal with this disease.

The noble Lord, Lord Wigley, said that the mechanisms that we have at the moment are not generating the research but he said that this vehicle is at hand. There is no reason at all why this should delay the legislation. As I told your Lordships in my opening remarks, I met with the ABI. The industry had expressed no opposition; indeed, it has been generous in providing what funds there have been in the past towards dealing with this disease. Therefore, there is already a precedent here. I am certain that if the Government were to say that they would make available matching money, even more funds would be made available by the industry. The noble Lord, Lord Howarth, touched on that point, and rightly so. Yes, there is a moral obligation. Because of the privileges issue, it would not be appropriate to include that here, but there is no reason why it could not be attended to in another place and there is no reason at all why this should become a matter for ping-pong.

The mortality rate for most cancers is falling while it continues to rise for mesothelioma. There are humane and altruistic reasons for supporting funding for mesothelioma research, but for the Government and the insurance industry there are straightforward financial considerations, too. It would be impossible to eradicate all asbestos from our homes, schools, hospitals, factories and offices.

The Bill represents a genuine desire to act justly to those who have been afflicted with mesothelioma, which is why I have supported the noble Lord, Lord Freud, throughout in placing the Bill before the House. However, the one certain way to prevent deaths from mesothelioma will be to find a cure. That will not happen without adequate resources and that in turn requires political will. That is why I thank all those who have spoken today in the debate and who have supported the amendment. I would like to test the will of the House.

[Earl Howe]

Before the noble Lord finally decides what to do with his amendment, may I just explain why the Government have not brought forward their own amendment, which was one of his criticisms? We do not believe that a legislative route is necessary. We believe—as the noble Lord, Lord Empey, indicated—that we can do this in other ways. We can give the process exactly the kind of kick-start that was referred to in the debate much more effectively than can this amendment. Funders for research build areas for research by bringing researchers and clinicians together, not by throwing money at a problem, which is, I am afraid, what this amendment would do.

[Lord Alton of Liverpool]

My Lords, this is not about throwing money at problems. That is certainly something that I have always eschewed throughout the whole of my time in politics. You have to demonstrate the case and there is a case here. If 56,000 of our countrymen are going to die of this disease over the next 30 years or so, we have to find adequate resources to tackle mesothelioma. That is not being done by this Bill. We have a rare opportunity to do something about it.

[Lord Walton of Detchant]

Before my noble friend sits down and eventually decides what action he proposes to take, I wish to ask him whether he feels that the important developments referred to by the noble Earl, Lord Howe, relating to forthcoming meetings between the Medical Research Council, the NIHR and other organisations, might not—at the moment—be a useful way forward?

[Lord Alton of Liverpool]

I am grateful to my noble friend and yes, of course I am delighted that those meetings are going to happen. The noble Earl was kind enough to say that perhaps the debates that have been precipitated on this issue in Committee, at Second Reading and again today have helped to bring that about. However, the moment will pass and all of us who sit in this House know that once the legislative vehicle has moved on, the opportunity to make something happen disappears into the ether. That is why I intend to press this to a vote and to test the will of your Lordships’ House.

--- Later in debate ---

[Lord Stoneham of Droxford]

My Lords, I will comment on a number of issues to which these amendments give rise—and they are very sensitive issues. Any start date is arbitrary, and there will always be people who are caught by a start date, so whether it is 2010 or 2012, there will inevitably be feelings of unfairness. However, the earlier the start date, whatever the cost—perhaps the Minister will clarify the cost, but we were told it was £119 million, and if it is 70% of that it will come to £80 million—agreeing to that concession would cause a 25% increase in the cost of this scheme. Where is the money going to come from? Will it come from a new negotiation, or from reduced benefits and compensation for those who will receive money from the scheme? That question has to be answered by the movers of the amendment.

On the issue of coverage, there are obviously concerns about the self-employed and people from the same household, but are we saying that we are going to complicate this legislation and hold it up while we have an argument about public liability insurance versus employee insurance? That would be a recipe for severe delay. The great advantage of this legislation is that we have kept it simple and we have an agreement. It is a balancing act to get to that agreement and to get the legislation through so that it benefits the people who were in employment. Once this settles down, we could consider coming back to this—I hope the Minister will do so at some stage—and look again at how we might cover the self-employed and people from the same household, but if we start that discussion now we will be here until 2015 or 2016 before we have legislation to benefit the families for whom it is intended.

[Lord Alton of Liverpool]

My Lords, I will speak briefly to these amendments, in particular to support what the noble Lord, Lord McKenzie, argued in Committee and what these amendments call for today. We had a long debate on 5 June, in which I spoke at some length. The point I made then, which partly answers what the noble Lord, Lord Stoneham, has just said about the arbitrariness of dates, was that the original consultation period is surely the point from which this scheme should kick in, not the date of July 25 last year, the last day of the Session, when a welcome announcement was made that there would be a Bill along these lines and a scheme of this kind.

The consultation date of February 2010 is, for me, a seminal date. For those affected it represented a promise waiting to be fulfilled. The eligibility date should be at the commencement of the consultation. After all, the Association of British Insurers began the discussions at that time. It can hardly have woken up on 25 July last year, shocked at having failed to make contingency plans or reserves. Therefore, applying the date of February 2010 is the right and fair way to go about this. It is the date that people anticipated and expected. In law, as well, it is far more consistent. After all, there will be people who were diagnosed with mesothelioma during that period and it is important that they are accepted as part of this scheme.

I know that the Minister will not be in a position to share the legal advice that he has been given within the department, but we might well leave ourselves open to claims because of the consultation document that was issued and the clear indication that this scheme would probably begin from as long ago as February 2010, rather than 25 July last year. For those reasons alone, I am happy to support the noble Lord, Lord McKenzie.

Mesothelioma Bill [HL]: Impact

Lord Alton of Liverpool Excerpts

Tuesday 25th June 2013 Lords Chamber

[Lord Freud]

Let me make it absolutely clear that we have been acting as the agents of the sufferers in our discussions with the insurance industry. The idea that there is some kind of cosy relationship between government and the insurance industry is absolutely not true. It has been a really tough business to get a deal through. I talk regularly to victims’ groups and lawyers. I get their support and as we develop the next stage, which is a practical process, I will be getting their views and having them very much in mind.

[Lord Alton of Liverpool]

Will the Minister confirm that with people dying of mesothelioma at a rate of 2,000 a year the Government have predicted a further 56,000 deaths over the next 30 years? Will he tell the House the total level of compensation that will have to be paid out during that period to meet those claims? Will he contrast that with the not a penny piece that is currently being spent on research into finding cures for mesothelioma? In that context, will he give further consideration to the letter sent to him by more than 20 Members of your Lordships’ House from all sides of the House asking for public and insurance industry money to be used in order to do more to find a cure for this terrible disease that will take a further 56,000 lives in the next 30 years?

[Lord Freud]

My Lords, that is precisely the point. This is a terrible disease. It is about to peak in the next couple of years. That is why I have been in such a hurry to provide a scheme for those who cannot get compensation. I cannot do the sums in my head, but the payments are clearly in the many hundreds of millions. We have had much discussion about the lack of research in this area compared with other cancers. It is something that I and my noble friend Lord Howe are concerned about. We are going to try to launch that. There are two aspects: whether the Medical Research Council will find it valuable to do the research, and the insurance industry, which has been providing the only substantial source of funding until now in this terrible area.

Social Security (Disability Living Allowance, Attendance Allowance and Carer’s Allowance) (Amendment) Regulations 2013

Lord Alton of Liverpool Excerpts

Monday 24th June 2013 Lords Chamber

Moved by

[Lord Alton of Liverpool]

That this House regrets that the Social Security (Disability Living Allowance, Attendance Allowance and Carer’s Allowance) (Amendment) Regulations 2013, laid before the House on 4 March, will result in the loss of Motability provision for many disabled people; and that this House considers that transitional arrangements should be put in place urgently. (SI 2013/389)

[Lord Alton of Liverpool]

My Lords, the House will be aware that this Motion of Regret refers to the Social Security (Disability Living Allowance, Attendance Allowance and Carer’s Allowance) (Amendment) Regulations 2013. My three particular concerns, referred to in earlier debates, relate to: first, the way in which the changes in regulations will impact on the support which disabled people need to ensure mobility; secondly, the role of Atos Healthcare in assessing those who will be reassessed for PIP as a consequence of the changes; and, thirdly, the 20/50 metre criteria used for enhanced personal independence payment.

On the latter question, I begin at least with a welcome for the Government’s decision to consult, over the summer, on the 20/50 metre criteria for enhanced PIP. I hope that the Minister will be able to assure the House that this will be a genuine consultation and not simply a paper exercise, going through the motions, to avoid judicial review. In a Written Answer on 13 February, the Minister said:

“Once PIP legislation is in place, any consequence of a failure to meet the entitlement conditions for the enhanced mobility component would not result in a judicial review as long as the legislation was applied fairly to the claimant. We have robust dispute resolution procedures in place to ensure that this is the case”.—[Official Report, 13/2/13; col. WA 157.]

Presumably, the new consultation is a recognition that the earlier announcement was not based on fairness. If this really is to be a genuine consultation this time, and the new regulations applied fairly to each claimant, the Government will need to assure us that they will publish the responses to their consultation and explain the reason for their eventual decision. Will the Minister outline the procedure that will be followed? Until the consultation has been undertaken, how will current claims be assessed? Which rules will apply? What will happen to those claimants if the consultation determines that the rules have to be changed?

There are two other two issues which I want to explore: the impact on disabled people’s mobility and the role of Atos Healthcare. On February 25 last, with the support of my noble friend Lady Grey-Thompson, who has been unable to join us this evening because of pressing family commitments but who wishes to be associated with these remarks, I moved an amendment in Committee to the Welfare Benefits Up-rating Bill. My amendment was a plea to the Government to think about providing a transitional arrangement—perhaps at least a two or three-year period of grace—for those who already have vehicles and who risk losing them. Prior to that amendment, on 17 January, 24 January and 13 February, and in a series of Written Questions, I pressed the Government about the impact of their proposals on disabled people.

Subsequently, on 30 April, the Minister for Disabled People and Member of Parliament for Wirral West, Esther McVey, met my noble friend Lady Grey-Thompson and me, along with Jane Young, who has done a great deal of work in ensuring that this issue does not slip from sight. The Minister told us that the DWP would be announcing its own transitional arrangements this month. Can the Minister tell us what has happened to them? Since our meeting, Ms Young has been told that the department’s transitional arrangements would be reworked into joint transitional arrangements with Motability. Can the Minister can tell us whether that is so? How will that assist those who use their higher-rate mobility component on an alternative means of independent mobility other than the Motability scheme? I hope the Minister will be able to tell us.

During those discussions we made the point, which I reiterate tonight, that this is not a trivial issue. According to the noble Lord, Lord Sterling, who does such admirable work chairing Motability, there are 620,000 Motability vehicles on the road, which he says is probably the largest fleet of such vehicles in the world. That figure simply refers to Motability vehicles, not to the significantly larger number of people who rely on other forms of transport to ensure a degree of independent living. The Government have been unable to tell us, throughout these debates, how many people will have their vehicles sequestrated or repatriated and how many people who currently receive help with transport will lose access to that help. My noble and learned friend Lord Hardie has also been attempting to extract information about the numbers of people. Members of your Lordships’ House will have seen his recent Written Questions about this. I suspect that obtaining that information has been rather like drawing teeth.

I for one do not believe that Parliament has any business enacting government policies without knowing what the full effect will be of their proposals. For Parliament to be asked to walk blindfolded into decisions will undoubtedly result in some Motability users having their specially adapted vehicles repossessed. That is simply unconscionable and deeply irresponsible.

Although I am appreciative of the time that Esther McVey spent with my noble friend and me, I freely admit that I am still no wiser about the number of people who will lose their vehicles or be affected by these changes. The detail of the Government’s proposals is still inadequate; we simply do not know. The inadequate consultations match that. The transitional arrangements which are to be put in place by both Government and Motability are simply in the ether. We do not know what they are. It is for that reason that I tabled this Motion of Regret this evening and to ensure that the noble Lord, Lord Freud, who has spent a lot time on these questions, has the opportunity to come to your Lordships’ House to explain in more detail and answer some of these questions.

On 17 January I asked:

“Can the Minister confirm the Government's own prediction, made earlier this month, that 27% fewer working-age people will be eligible for the Motability scheme once PIP is fully rolled out? Disability organisations say that the new proposal means that 42% fewer disabled people of working age will be eligible—an average of 200 people in every constituency”.—[Official Report, 17/1/13; col. 818.]

I received no reply on that day but on 13 February the Minister told us:

“Yes, my Lords, there is some churn”.— [Official Report, 13/2/13; col. 742.]

He also said:

“My Lords, we know how many people will get the higher mobility component, a figure that will clearly be fewer under PIP than under DLA. I have provided those figures but, just for the record, the figure of roughly 1 million people on the DLA component in a steady state will reduce to roughly 600,000”.—[Official Report, 13/2/13; col. 741.]

How does that translate into repossessed vehicles and into the loss of Motability support?

Let us be clear. One third of disabled people live in poverty. Some claimants will lose as much as £150 per month if they fail to meet the newly tightened criteria, an annual loss of around £1,800. Their situation will be unbelievably bleak. On the other side of the coin, Oxford Economics estimates that the mobility provided for disabled people contributes to our nation’s economy by the equivalent of £1.3 billion every year, as I pointed out in an earlier debate after being referred to the document by the noble Baroness, Lady Hollis.

The Disability Benefits Consortium, which represents more than 50 disability rights groups, reminds us that it is not just about the positive contribution made by disabled people. Motability vehicles are,

“their means of independence and participation, the lifeline that enables them to get to work, to GP appointments, to the shops or to take their kids to school”.

We simply do not know what is going to happen to people, some of whom have had very expensive adaptations to their vehicles, and who will be left without an adequate method of getting around. We especially do not know what the effect will be on people living in places where public transport is not easily available or accessible. As my noble friend Lady Grey-Thompson told the House in February:

“The short timescale between notifying someone of their car being removed and it being taken away could make life extremely difficult. Without some further protection, it could lead to chaos for many disabled people”.

She continued:

“At the briefing that was held on the PIP regulations on 22 January 2013 with the Minister, the noble Lord, Lord Freud, and the Minister in another place, Esther McVey, it was my understanding that the timescale for someone having to return their car if they were no longer eligible for PIP could be relatively short, perhaps just a matter of a few weeks”.—[Official Report, 25/2/13; col. 937.]

Can we now have further clarity on the timescale? I should be grateful if the Minister would remind the House how much public money is provided to Motability each year and tell us what discussions the Government have had with Motability about transitional arrangements and a package of support.

--- Later in debate ---

[Lord Freud]

My Lords, I do not think we have time to debate what heavily adapted comprises. However, the figure for cars heavily adapted for a disabled person is 2%. Clearly, we all personalise cars to some extent. I can let the noble Baroness have some more information on that to the extent that I have it, but that is the figure that I have. I confirm that the noble Lord, Lord Sterling, is looking carefully at how Motability can help to mitigate the impact for those who may be affected by the move to PIP.

[Lord Alton of Liverpool]

Before the Minister leaves that point, will he tell us a little bit more about what he is doing to create joint transitional arrangements, if that is what they are to be, with Motability, and when they will published? When will opportunities occur for people to be consulted and to respond to the consultation?

[Lord Freud]

My Lords, we are working with Motability currently on what the arrangements might be. I have no information at this stage on where we are with those discussions between the department and Motability, but clearly we are in discussions. I am not informed as to when I can update the House on that matter.

On the judicial review, as noble Lords have seen, there is a consultation on the 20 metre/50 metre issue. I can assure my noble friend Lady Thomas that this is a genuine consultation which we are entering with an open mind and we will be looking to hear the views of individuals and organisations. Once that consultation is closed, we will publish our response, including how we intend to act.

The noble Lord, Lord Alton, referred to changes to Atos’s supply chain since the tendering stage of the PIP. I assure noble Lords that the department’s decision to award the contract was not based on the mention of any particular organisation in the bids to deliver the PIP. It is usual for there to be changes between contract award and delivery. Indeed, we expect Atos’s use of supply chain sites to rise and fall in line with referral numbers. The department made a change to the reassessment timetable after Atos submitted its tender, which means that there will be significantly fewer assessments in 2013-14 than it had originally planned. However, it is important to note that Atos has kept the department informed about changes and we are confident that Atos and its partners are able to deliver successfully.

The noble Lord asked about the £391 million that the Government are said to have given Atos over three years. I do not have that information to hand but I will write to him on that matter.

[Lord Alton of Liverpool]

I am grateful to the noble Lord. He will recall that I also asked him specifically whether the 60 minutes’ travelling distance which Atos had said would be the maximum that people would have to travel to an assessment centre will be maintained or whether it will now be extended to 90 minutes, as has been alleged. Will the total number of assessment centres be reduced from the number I cited earlier to just a handful?

[Lord Freud]

I remind noble Lords that Atos tendered for four of the contract areas and received two, so it is not surprising that the 22 sites it was looking at have been reduced, given that it has a smaller number of contract areas. My information is that the 22 figure has gone down to 14. I will add to my letter any information I have on travel times estimates.

In summary, this issue is about balance and fairness—fairness to those who have a Motability vehicle and to the substantial majority of mobility component recipients who do not. However, this is fairness tempered with appropriate mechanisms to ensure that the impact on existing and future users of the scheme is minimised. Specific transitional arrangements are in place for those directly impacted when the measure was introduced and there will remain appropriate and generous provisions in the future. I commend the hospital in-patient arrangements to the House and trust that they have reassured the noble Lord, Lord Alton, and that as a consequence he will not press the Motion.

[Lord Alton of Liverpool]

My Lords, as always, I am grateful to the Minister for the way in which he answered the questions that were put to him, although I think he would be the first to agree that a number of questions raised during the debate remain unanswered. However, he will also understand that, although the measures may be narrow, parliamentarians have to take their chances. If they can find a hook on which to hang their coat, they are obliged to do so. That is surely part of our role as scrutineers. Your Lordships will be glad to know that I do not intend to drag this out although there is no time limit. Even though this is a dinner hour debate, we could have gone on for much longer. I think those taking part in the following debate will recognise that we have been pretty disciplined in the way that we have gone about this.

The issues that we have covered range from the disproportionalilty in the way that these changes will affect rural areas and poorer areas and concerns about the statistics that have still not been shared with us. We do not know the number of people who will be impacted by these changes and the cost of the vehicles, which was a point made by the noble Baroness, Lady Wilkins. Will it cost between £8,000 and £12,000 for someone to purchase one of these vehicles—a vehicle that had been made available to them previously by an Act of Parliament? It was an Act of Parliament that laid down the criteria under which people qualified. Surely we are guilty of behaving without due concern for the effect of the changes that we have put in place.

I repeat what I said in our deliberations earlier this year. It is our duty to understand the impact of the decisions we make. The Minister has just said that we cannot reliably estimate the impact; we do not know. That is not a good position for us to be in. Decisions will affect the mobility and independence of people with disabilities. The noble Baroness, Lady Hollis, put it very well when she said that you turn a person from being independent to being dependent when you take such decisions.

Just as we found a way of encouraging the Minister to come to the House this evening, I know that I and other Members of your Lordships’ House will look for other ways of holding the Government to account to ensure that we mitigate the worst effects of these changes. On the basis of the reply that has now been given, I beg leave to withdraw the Motion.

Motion withdrawn.

Homeless People: Night Shelters

Lord Alton of Liverpool Excerpts

Tuesday 11th June 2013 Lords Chamber

Asked by

[Lord Alton of Liverpool]

To ask Her Majesty’s Government what provision they are making for homeless people left without access to night shelter provision following the Anglesey judgment on housing benefit and the funding of night shelters.

[The Parliamentary Under-Secretary of State, Department for Work and Pensions (Lord Freud)]

My Lords, local authorities are best placed to make local provision for homeless people and have been allocated £470 million from 2011-12 until 2014-15 to prevent homelessness and tackle rough sleeping.

[Lord Alton of Liverpool]

My Lords, if there were no material changes in the Government’s regulations concerning night shelters, why are homeless people who were in shelters now on the streets? In the light of the Anglesey judgment is there not an urgent need for the Minister to issue new guidance to close a revolving door which has sent vulnerable people, many of whose lives were, in any event, in freefall, back on to the streets, sleeping rough on park benches or in shop doorways or seeking hospital beds, and which in Salford precipitated the closure of Narrowgate, the only night shelter serving Manchester and Salford, which has, in the past, helped more than 2,000 people? To protect the homeless, do we not need to rapidly hammer out a humane and just solution, with new guidelines issued to local authorities and to charities working with the homeless?

[Lord Freud]

My Lords, clearly homelessness is a priority of this Government and we are putting a lot of resource into prevention. The most important area in which we are doing that is the No Second Night Out policy, which is proving very successful and is being run out across the country this year. This is an isolated example of how particular shelters are funded.