Deregulation Bill
Debate between Lord Mann and Lord Clarke of Nottingham(10 years, 2 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
John Mann
As the hon. Gentleman said, he has not had time to read the Bill, which is why I itemised, for the record, every clause and schedule that removes Tory legislation. In fact, around 80% of the legislation being removed is Tory legislation. Indeed, when the Minister without Portfolio, the right hon. and learned Member for Rushcliffe (Mr Clarke), responds, he will doubtless wish to outline which bits he introduced in his various ministerial guises. Given his ministerial longevity, there will undoubtedly be several regulations that he was personally responsible for but now wishes to remove, and we on the Opposition Benches might wish to back him on that.
However, the Minister for Government Policy, a highly educated and learned gentleman, did not, when receiving his challenge on self-employment and safety, know what he was talking about. I cited, in relation to clause 1, what would happen with a self-employed mountain guide. He immediately jumped in to assist his hon. Friend the Member for Macclesfield (David Rutley), who was struggling, because he knew that I was right and that the clause represents an undoing of the self-employed mountain guide’s employment position. There is a critical flaw in the logic of the Bill. Mountain guides require insurance, and to get it they need to demonstrate that there is a health and safety profile, and that is relevant for those who employ self-employed mountain guides who take people out on ropes. By the way, I personally managed to negotiate, on behalf of the all-party group on mountaineering, exemption from the working at heights directive anomalies that affected that profession, demonstrating that the way the industry works meant it was not safe to put that application into place. I am not, therefore, on the side of unnecessary regulation, but the protection of the employment position of those self-employed people is fundamental.
A better-known example, the single biggest civil litigation case brought by a group of workers against a Government, demonstrates the issue more brutally. That common-law action brought by workers in the mining industry, for chronic obstructive pulmonary disease and Vibration White Finger, cost the Government a huge amount of money, because the people involved were employed primarily by the Government, so it was a taxpayer liability, although there were some private companies. The civil action was successful because the litigators had demonstrated that appropriate practices and procedures were not in place. If there had been proper regulation of the mining industry at the time, the cost to the health of the men forced to bring the case would have been hugely reduced, as would the financial cost to the taxpayer and other employers, which went into many billions.
That is the point of good regulation. A good health and safety procedure—for example on use of breathing equipment in a colliery or the handling of vibrating tools—would have been a mitigating factor in those processes, and a huge mitigating factor in terms of compensation. That is precisely why self-employed mountain guides require a structure within which they can get insurance and quantify it, to take them out of the provisions of the Health and Safety at Work, etc. Act 1974. What we are doing is leading to a lawyers’ paradise in which the agency that might employ people, and the individual, will be able to battle between one another over who is liable, if it can be demonstrated in court that particular procedures were not followed. A requirement of responsibility under health and safety law gives protection to that self-employed person as well as to the agency employing them.
Let me tell the House why I know that. When I ran a small business—as I did for many years—we had to deal with working at heights and a range of legislation, and I shall illustrate my point with some examples. A case was brought against us by an employee who had broken his foot. However, because of manual handling at work legislation and the fact that we had applied it, the case got nowhere. That was precisely because the legislation had created a structure with a sensible and rational procedure, which we could demonstrate and insist that the employee followed. When he did not follow that procedure, we could demonstrate that as the employer—with liability—we were not in fact liable for the accident.
It is a myth that good regulation damages small business. I lived with regulation day in, day out, and if we ask small businesses, we find that they nearly always object to two things: paperwork—that is always a nightmare—and cost. When small businesses complain—and when I did—it is about cost. If regulation costs a lot and someone is trying to make ends meet, it is difficult. However, regulations on manual handling at work, and health and safety legislation, do not involve cost other than training the work force. It is a miniscule cost. It is an absurdity when someone is handling heavy goods, as we were, not to have such regulation. Let me give a second example.
Mr Kenneth Clarke
The hon. Gentleman is making a passionate defence of the regulations under which he successfully defended a claim many years ago, but the Bill does not affect health and safety legislation as far as small employers—such as those whom he is speaking so eloquently in favour of, and such as he was—are concerned. It is an interesting illustration of the value of health and safety regulation, which I do not dispute, but what on earth has it got to do with the Government’s proposals?
John Mann
I do not find it amusing that the Government introducing the Bill have no idea what goes on in workplaces and of the effect that this change will have, so let me illustrate my point. In the kind of work that we were doing, such as setting up major concerts in huge halls, a variety of different people come in and work together. Who is responsible for ensuring that the ladders going up—perhaps 50, 60, 70 feet—are secure? If it is a self-employed person, without that requirement in law because of this change, that buck—that burden—can be shifted. One critical thing in such a situation is having an overall duty because then everyone is liable. When working in complex spaces, with people going backwards and forwards carrying huge loads of equipment, lugging it and putting it up on high, all—whether a single person, a company or a company bringing in self-employed people, as we often did—ensure that the systems and the space is properly secured because they have a responsibility without exclusion.
Mr Clarke
I am very grateful to hear it because by its very nature a deregulatory Bill gives rise to many points that can be raised in Committee.
The hon. Member for Wansbeck (Ian Lavery) raised a lot of detailed points, and said that they should be considered in Committee. He has already served on the pre-legislative scrutiny Committee. It is inevitable, when the British cover such a wide variety of things in regulation, that we sometimes have to have an item-by-item vote.
I take it from the tone of the debate today that the general direction of policy set out by the Government has fairly widespread approval. I have endured the experience of opposition, albeit briefly, in my time, and I occasionally had the burden of being sent along to a debate of this kind and trying to find something to argue about. I think that that was the problem facing the two very able Front-Bench speakers representing the Opposition today.
A strange argument broke out at one point today about whether what we were doing was totally insubstantial, worthless and of no point to the outside world, or whether it was completely horrendous and, as the Green amendment, which is no longer being pressed, says,
“ripping up vital green legislation”.
It was suggested that our blood should run cold at the idea of what we were doing to everyone from those climbing mountains to those running small businesses.
The claim was also made that the last Government had somehow achieved £3 billion of savings through their strident deregulatory measures. I am not here to debate the record of the last Government, but that is quite the most startling exposition of what they achieved that I have ever heard. I do not recommend that any Labour spokesman should try to persuade an audience of any of the small businessmen I have ever met that that was what they were doing.
The Bill represents the most determined effort of any Government I have known to pursue the deregulatory aims to which most Governments have paid lip service for the past 20 years. We were all into deregulation in the early 1990s; then the Labour Government talked about “better regulation”. I believe that this Government can claim that the substance of what we are producing greatly exceeds anything that has been done before.
Some of the figures that have been quoted about the impact of the Bill disguise the fact that it is only one part of the red tape challenge that is being led by my right hon. Friend the Minister for Government Policy. The Bill runs alongside and is part of that challenge, and it contains the elements that require primary legislation. My right hon. Friend has mentioned the 3,000 regulations that need to be repealed or improved.
The Bill has to be big enough and long enough to deal with so many detailed areas, and it will supplement and add to that to produce a deregulatory effect for businesses—particularly small businesses—as well as individual citizens, local authorities and branches of government, all of which have better things to do than to waste money on statutory duties the reason for which no one knows, or to produce reports that nobody reads or to have obligations for things that nobody is asking them to give advice on. For example, school governors have to publish advice on discipline. Our reforms will not undermine school discipline; my right hon. Friend the Secretary of State for Education has talked about the need for school discipline. Most governors do not even know they are under such an obligation, but unfortunately some do produce a statement of policy, which is not required. That regulation will now be repealed.
The key part of the Bill is the one that relates to business. I agree with my hon. Friend the Member for Stroud (Neil Carmichael) on this. I think we will need a Bill of this kind every 10 years or so. In modern times, as a result of single-issue lobby groups and newspaper campaigns, Government Departments engage in ever-more legislative and regulatory activity, sometimes for the sake of being seen to be doing something or, in the case of the lobby groups, being seen to be demanding something new. That has an adverse effect not only on the statute book and the regulatory publications but on the administration of good government and the running of any successful business. The Bill is therefore a welcome, and drastic, attempt to change the culture and go back in the direction of common sense and proper regulation that involves a true public interest and to ensure that environmental standards and the safety of workers are maintained.
The hon. Member for Newcastle upon Tyne Central (Chi Onwurah), echoed by the hon. Member for Hartlepool, got on to matters that were of concern to her. Although such things can be discussed in Committee, I have to say that an attempt was being made to make a difference of principle that was not there. For example, we had the issue of employment rights and of the tribunals dealing with claims by employees against their employer. Let me make it absolutely clear that the Bill is not remotely trying to roll back the law on unfair dismissal or to reduce the protections against discrimination in the work place.
The hon. Member for Bassetlaw (John Mann) tried to identify the party political origin of every measure in the Bill. As it happens, it was a Conservative Government who set up employment tribunals, introduced employment rights and started the whole process that we now have. The intention was to provide a sensible, accessible and low cost way of resolving disputes and awarding compensation where some breach of employment rights had taken place. Over the years, the system has become legalistic. It has become almost habitual for anybody who loses their job to bring a claim, because there is very little risk to them and a great deal of encouragement to have a go. None of that is being tackled too directly by the Bill.
Addressing the power and cost of tribunals is much overdue. The principal fundamentals of employment rights are utterly beyond dispute nowadays. For the hon. Member for Newcastle upon Tyne Central to claim that this Bill is a serious threat to the real principles underlying employment rights and achieves no important benefits shows that she has not met enough employers. When we talk to small employers about the problems of running a competitive business, most will rapidly start raising the problem and cost of claims before employment tribunals. The changes we propose could be criticised for being too modest, but they are certainly heading in the right direction. They should not invite a knee-jerk reaction from the Labour party, or anybody else, that nothing should be done to deregulate in that area and to remove unnecessary cost.
Similarly, on health and safety, absolutely nobody is suggesting, in this Bill or anywhere else, that we lower standards in this country when it comes to protecting the health and safety of the work force, or anybody else. We are not short of regulation in that area. Most of it will remain intact, but what is proposed here seems to be perfectly sensible. The biggest single change is to take away the burdens of health and safety legislation from self-employed people who are not in an occupation that can pose a threat to other people, as will be specified. It is absurd. Let us take a self-employed person, not one of those self-employed contractors in the business of the hon. Member for Bassetlaw, but someone writing a novel in his cottage in the countryside in Dorset. He is a self-employed person. Is Labour going to argue passionately in Committee that he should be subject to health and safety at work legislation, which he is at the moment? Of course he is not likely to be sued unless he throws a book at somebody in a moment of bad temper, but even that is probably not a breach of the health and safety at work legislation. He is subject to inspection. He may have to pay regard to the guidance. I have taken an extreme example of what should be a harmless occupation—if he is a reasonable novelist.
There is a range of other self-employed people who may have to take professional advice on what impact the Health and Safety at Work etc. Act 1974 has on their particular activities. We are proposing to clarify that health and safety legislation applies to those people who are engaged in activities that could pose a risk to people other than themselves. Clarity will come when we produce information—as soon as we can in the course of the Committee, as my right hon. Friend the Minister for Government Policy has said—on the specified sectors of the economy and specified occupations. A statutory burden will be lifted from a wide range of self-employed people who have been covered by it by accident.
John Mann
No self-employed novelists have had health and safety inspections or a burden that they have had to consider. Is not the problem that once we say a line will be drawn and some will be covered and some will not, that creates a grey area? The grey area creates danger and damage and risk, including for the person themselves.
Mr Clarke
I deliberately chose, as the hon. Gentleman did at the other extreme, the rather way-out example with my self-employed novelist. I have not done the research on which self-employed people have found themselves subject to inspection, the recipients of guidance they do not want or feeling obliged to take inspections. I do not know whether self-employed beekeepers or all sorts of other people fall into this area, but there is no doubt that the legislative change and the clarity proposed will put the duty and burden on those who might pose a risk to others and move it from vast numbers of other people. Our independent regulatory committee has estimated the saving for the businesses of many self-employed people.
John Mann
The right hon. and learned Gentleman gives the example of a self-employed beekeeper. A beekeeper friend of mine was nearly killed when moving a hive during rain because he was not aware of the dangers during rain. If the person moving it with him had nearly been killed, there might have been a claim against him. Does that not illustrate precisely why an overarching approach is far better than additional regulation and somebody deciding who is in and who is out?
Mr Clarke
I admire the eclecticism of the hon. Gentleman. I knew that I could not engage with him on mountain climbing but I underestimated his knowledge of bees and beekeepers. I shall take considered advice on the application to beekeeping and I have no doubt that the matter will be raised in Committee if the position of beekeepers becomes a point of real contention when the list is published. The point that I am trying to make is that I think that the vast majority of self-employed people—I shall not name another esoteric profession—need not be covered by legislation, subject to the Health and Safety Executive, inspection and so on, or to take professional advice. We are rationalising and making sense of one area whereas otherwise our commitment to the health and safety at work of employees and the health and safety of the public remains undiminished.
Another measure that all Opposition Members tried to make a mainstream political point about is the growth duty we are putting on non-economic regulators. I am not a climate change denier; the Government are in favour of environmental protection, and the conservation of our habitat and essential national heritage is a perfectly important objective of the Government. It is completely over the top to describe the changes in the Bill as sometimes threatening all that. We are saying that the various non-economic regulators should have regard to the desirability of the growth of the economy while carrying out their other duties. That was described as a mad dash for casino growth and likened to our casting away of regulation on bankers, which we did not do—it was the previous Government who did that. I would have agreed with the hon. Member for Bassetlaw had he cited that example, as it was a good example of the importance of regulation and the pathetic inadequacy of the Financial Services Authority when the then Chancellor gave it that responsibility. In this case, all that we are doing is saying that while it remains liable to follow its existing guidance—it has been pointed out that it is supposed to regulate only where necessary and proportionate—it is supposed to have regard to the impact on individual businesses, and it should have regard to the growth of the nation. Serious conservation in a highly developed, advanced economy like ours and the protection of our natural environment have to take account of the fact that at the same time, we hope to be a growing economy and a powerful, modern, industrial nation. It is a question of balance, judgment and common sense between the Government’s economic interests and our desire to conserve what is best in our heritage. Describing the Bill as an attack on that is absurd.
That shows why the previous Government’s record was pathetic on deregulation and reducing the burdens on business. They constantly gave in to pressures that drove them in the other direction, and it requires a Government with clarity of purpose to get hold of the subject and make a detailed attempt to reduce unnecessary burdens, bureaucracy and paperwork. The printing of useless documents and general obstructions to growth and efficiency need to be removed if that is to be a success.
I welcome the fact that some things received universal approval. My hon. Friend the Member for Stroud (Neil Carmichael) discussed what we are doing on apprenticeships, and no one gainsaid him on that. Those are important measures that will strengthen skills training in industry and help to improve young people’s prospects of employment. The measures on yarn received widespread support from those in the House who do knitwork. The measures on rights of way achieved remarkably unanimous acceptance—this is an impossibly controversial area, but the stakeholders’ group has reached agreement. The Government’s proposals have been advanced, and I am glad that they have been accepted.
There was talk of the European Union. We are going to try to secure the application of the same principles there, and Barroso has begun a deregulatory drive, which faces the same difficulty in Europe that it has always faced in Britain, because most of the regulations are supported by some lobby or other. The European regulations are the result of the single market. To stay in the single market required a mass of regulations. When the then Government pressed for the single market to be created, the British Commissioner whom we appointed—Arthur Cockfield, I think—came up with thousands of amendments, which were required in a single market if it was to have common regulation, as we heard, of consumer rights, safety standards, consumer protection, environmental protection and so on.
Our example should be followed in the rest of Europe, and it will help us to guide other member states to adopt the same approach. I believe that for all European countries, but it is Britain that particularly concerns me. If we are to regain our competitive position in the wider market and return to normality as one of the stronger economies in the modern world, deregulation and reducing burdens on business is part of that.
As my hon. Friends the Members for Macclesfield (David Rutley) and for Witham (Priti Patel) said, we are not saying that this is the sole answer for our economy or for small business. It is merely a contribution to a Government policy that is wholly taken up with the plan for long-term economic growth, giving particular priority to small and medium-sized enterprises in this country as never before. We are reviewing the range of advice that the Government give to small businesses and the range of financial support available to them. We have reduced the tax burden on small employers, particularly for young employees. UK Trade & Investment is concentrating on small and medium-sized businesses that want to get into export markets. We are putting a great trade effort as a Government into supporting them. We are reforming UK export finance to make sure that it is available to those small exporters.
This Bill is far from being the entirety of what we are doing to turn Britain into a competitive nation again. It does not cover everything we are doing for the small businesses that provide much of the employment nowadays if one gets one’s economy moving again, but it makes a very important contribution. We actually have a Government who are anti-regulation, anti-bureaucracy and anti-pointless cost. I commend the Bill to the House as a very useful contribution to our efforts.
Amendment, by leave, withdrawn.
Question put and agreed to.
Bill accordingly read a Second time.
Deregulation Bill (Programme)
Motion made, and Question put forthwith (Standing Order No. 83A(7)),
That the following provisions shall apply to the Deregulation Bill:
Committal
(1) That the Bill shall be committed to a Public Bill Committee.
Proceedings in Public Bill Committee
(2) Proceedings in the Public Bill Committee shall (so far as not previously concluded) be brought to a conclusion on Tuesday 25 March 2014.
(3) The Public Bill Committee shall have leave to sit twice on the first day on which it meets.
Consideration and Third Reading
(4) Proceedings on Consideration shall (so far as not previously concluded) be brought to a conclusion one hour before the moment of interruption on the day on which those proceedings are commenced.
(5) Proceedings on Third Reading shall (so far as not previously concluded) be brought to a conclusion at the moment of interruption on that day.
(6) Standing Order No. 83B (Programming committees) shall not apply to proceedings on Consideration and Third Reading.
Other proceedings
(7) Any other proceedings on the Bill (including any proceedings on consideration of Lords Amendments or on any further messages from the Lords) may be programmed.—(Gavin Barwell.)
Question agreed to.
Deregulation Bill (Money)
Queen’s recommendation signified.
Motion made, and Question put forthwith (Standing Order No. 52(1)(a)),
That, for the purposes of any Act resulting from the Deregulation Bill, it is expedient to authorise:
(1) the payment out of money provided by Parliament of any increase attributable to the Act in the sums payable under any other Act out of money so provided; and
(2) the payment of sums into the Consolidated Fund.—(Gavin Barwell.)
Question agreed to.
Deregulation Bill (Carry-Over)
Motion made, and Question put forthwith (Standing Order No. 80A(1)(a)),
That if, at the conclusion of this Session of Parliament, proceedings on the Deregulation Bill have not been completed, they shall be resumed in the next Session. —(Gavin Barwell.)
Question agreed to.
Oral Answers to Questions
Debate between Lord Mann and Lord Clarke of Nottingham(13 years, 3 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
John Mann (Bassetlaw) (Lab)
T1. If he will make a statement on his departmental responsibilities.
The Lord Chancellor and Secretary of State for Justice (Mr Kenneth Clarke)
To begin with a topical statement, I must tell the House that approximately 40 prisoners were involved in a serious disturbance at Ford prison between 31 December 2010 and 1 January 2011, which resulted in parts of the establishment being set on fire. Staff withdrew from the prison’s B wing for their own safety and specially trained prison staff were deployed to regain control of the prison and assist the fire service in its efforts to extinguish the fires.
Last night, there was disorder at Littlehey prison which, I am glad to say, was brought under control quite quickly. To the credit of those staff involved, no staff or prisoners sustained serious injury.
The Prison Service manages some of the most dangerous people in society and we normally have 30 such incidents every year. I pay tribute to the prison staff and the fire service for the skill with which they handle these matters on behalf of us all.
John Mann
In a statement to the House, the Under-Secretary of State for Justice, the hon. Member for Huntingdon (Mr Djanogly) said that Worksop county court would be transferring to Worksop magistrates court, and he confirmed that in answer to my question. In fact, the opposite has happened. Is he the kind of Minister who is in control of his Department and is his word his authority when he speaks to this House, or is he the monkey to his civil servants’ organ grinder?
Rehabilitation and Sentencing
Debate between Lord Mann and Lord Clarke of Nottingham(13 years, 4 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Clarke
I agree with my hon. Friend entirely. We should give those who have the backbone to go straight, with help, a chance to do so because that will protect the public. Those who do not, and who commit crime again, will be punished again. It is just hopeless to suggest that giving extra emphasis to reforming criminals who want to be reformed is somehow weakening in the context of law and order; it is not. It would improve the protection of the public if we did it, and, as my hon. Friend says, it is a perfectly sensible way for a civilised state to behave.
John Mann (Bassetlaw) (Lab)
Bassetlaw has the largest drug treatment programme in the country by far. We have reduced crime further by locking up repeat offenders. The Secretary of State is trying to get rid of the courts, he is getting rid of 300 front-line police officers, and now he is conducting this social experiment. Can my community, which is totally against this idea, please have an exemption? We could then compare and contrast the results to find out what works best.
Mr Clarke
One day I will convert the hon. Gentleman. With great respect, I think that he has been a great leader in his community in tackling the problem of drugs in Bassetlaw, and it is partly down to his efforts that it has been tackled in that part of Nottinghamshire much more forcefully than ever before. We are going to send repeat offenders to prison; no one is going to stop punishing people who keep offending. It is not a key part of the legal system in north Nottinghamshire that we should keep redundant courts, although we are still consulting on the two courts in his constituency. The foresight that he has shown on the problems of drugs will not be frustrated by our attempts to improve yet further the drug rehabilitation programmes that young people get in his constituency. This is not all about money, and that has not actually been the way he has approached this issue in the past few years either.
Oral Answers to Questions
Debate between Lord Mann and Lord Clarke of Nottingham(13 years, 5 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
John Mann (Bassetlaw) (Lab)
1. How many prisoners who have completed their tariff remain in prison for the purpose of public protection.
The Lord Chancellor and Secretary of State for Justice (Mr Kenneth Clarke)
On 17 November 2010, 14,680 prisoners were serving an indeterminate sentence of imprisonment for public protection, or a life sentence in prisons or secure hospitals. Of those, 6,320 are held beyond their tariff expiry date, excluding offenders who have been recalled to custody following release.
John Mann
Those prisoners have been held in prison for good reasons and on good judgment. Does the Secretary of State intend, as is rumoured throughout prisons, to reduce the number of such offenders in prison? If so, how many sex offenders and violent criminals will be released back into our communities?
Mr Clarke
That rumour is probably on the hon. Gentleman’s website where I have seen that he is telling his constituents that I will release robbers, burglars, drug dealers and so on. Perhaps he will wait for the sentencing review, and stop living in a fantasy world. The indeterminate prison sentence has never worked as intended. The intention was that it would apply to a few hundred dangerous people who were not serving life sentences. The number is piling up, and more than 6,000 have gone beyond their tariff, but they will not simply be released. We will re-address the subject, and we will not release all the people he keeps telling his constituents we will release.
Oral Answers to Questions
Debate between Lord Mann and Lord Clarke of Nottingham(13 years, 6 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Clarke
I was compelled by my hon. Friend’s first question and I had not thought that there was more to come. As he said, we must move away from the overuse of drugs and methadone maintenance, and aim at detoxification and returning people to a condition in which they might stay out of prison. Methadone maintenance is sometimes necessary when dealing with people who are seriously addicted when they enter prison. If people are serving a very short-term sentence, there is not much more we can do than maintain them on methadone.
However, the Ministry of Justice is looking, with my right hon. Friend the Health Secretary, to see what can be done in the context of his health reforms to deal more constructively with the huge problem of drugs offenders and crime. As I said, more than half the people whom we admit to prison are believed to have a serious drug problem when they arrive, and some who enter drug-free become addicted while there.
John Mann (Bassetlaw) (Lab)
Some of us believe that decisions on drug treatment, including in prison, should be taken by doctors, not by politicians. Which Government agency will take the lead on drug treatment in prison under this Government?
Mr Clarke
I know that the hon. Gentleman takes a close interest in drug treatment in his constituency, where he has an excellent record on the subject. Responsibility for such treatment in prisons has been transferred to the NHS. I agree with his proposition that clinical judgments must lie at the heart of any drug treatment programme, but it is necessary for Departments to collaborate. My right hon. Friend the Secretary of State for Health and I hope to produce a combined framework on treatment in prison and treatment for convicted drug users in alternative residential accommodation. That might include the transfer of prisoners in suitable cases to community-based mental health care. All those things must be tried, because the current situation is quite appalling. However, in the end, treatment of an individual must be a clinical decision. It is certainly not a decision for politicians.