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Lord McIntosh of Haringey: My Lords, will the Minister agree that, whatever may be the technical merits of identity cards, public confidence in the ability of this Government to introduce them fairly and to maintain confidentiality will be reduced by the proposed privatisation of the police national computer? Will she give an undertaking that, if such cards are to be introduced by the Government, they will not subsequently be privatised?
Baroness Blatch: My Lords, I will give no such guarantee in advance of the consultation exercise. I do not believe that there is a read-across. All aspects of introducing a card will be taken into account in the Green Paper. For the purposes of this debate, it will be a very green paper, because particular options will not be preferred by the Government in advance of the document. Perhaps I may correct what I said in an earlier reply. I referred to "travel document" when I meant to say driving licence.
Lord Wyatt of Weeford: My Lords, does the Minister realise that, despite what her noble and learned friend Lord Hailsham (who was Hogg) said, not many illegal immigrants will have either a plastic card to get into this House or a driving licence? Is not the whole point that we
Baroness Blatch: My Lords, all those very colourful points made by my noble friend will be part of the consultation exercise. Perhaps I may also make a very important point. The noble Lord mentioned illegal immigrants several times in his remarks. Some identity card options might just help the prevention or detection of illegal immigrant offenders. But such a control would be in addition to existing controls. There is no intention whatever that identity cards should replace our current system of primarily ensuring the security of our frontiers.
The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege): My Lords, on 23rd February the Government issued guidance on NHS responsibilities for meeting continuing health care needs.
Lord Ashley of Stoke: My Lords, does the noble Baroness agree that if such standards were established by the Government, clinical teams throughout the country would have to decide solely on the basis of medical need whether a person should be in hospital, as they should do? But will she confirm that the Government refuse to establish those standards because they know that some trusts are poorer than others, so the Government allow variations in health care not on the basis of medical need but because of cash? Is not that situation entirely wrong?
Baroness Cumberlege: No, my Lords, that is not the case. Take the case of a person who has had a stroke. The result may be that that person can live a normal life but will have a limp. On the other hand, a person who has had a stroke may be so paralysed that he will have to have long-term care. It must be left to local clinicians to make the decision as to what care is required in conjunction with both the patient and the family.
Baroness Jay of Paddington: My Lords, is the Minister aware that many patients and their families were reassured by some of the guidance suggesting that there would be a right of appeal under the new system? For example, if someone felt that he might be pushed out of an NHS bed and into means-tested social care, he would have a right of appeal. But how can that appeal system possibly work fairly if there are no national criteria?
Baroness Gardner of Parkes: My Lords, is it not a fact that in the past many acute hospital beds were occupied by people with long-term and unimproving conditions that were not suitable for continuing hospitalisation over a long period? Was that not one of the reasons why changes were made?
Baroness Cumberlege: Yes, my Lords. We believe that the National Health Service has a responsibility for continuing care. But it must be based on health needs. Where social care is required, we believe that it is the responsibility of the social services.
Baroness Fisher of Rednal: My Lords, in her reply the noble Baroness did not draw the attention of the House to the cutbacks in local authorities' funding, which means that they cannot pick up the jobs that health care is giving them. Does she agree that the real problem is that, although local authorities may want to do the job, they cannot do so unless the necessary cash is given to them?
Baroness Cumberlege: My Lords, there is a total increase in social services funding for 1995-96 from £6.3 billion to £6.9 billion. Funding for community care services will increase from £4.6 billion to £5.1 billion. Funding for local authorities' new community care responsibilities will increase from £1.3 billion to £1.8 billion. I have a table giving those figures which I shall be pleased to put in the Library if it will help your Lordships.
Lord Ashley of Stoke: My Lords, the noble Baroness is always fair. However, I am very surprised at her Answer. Why does she think that the British Medical Association's spokesman in effect has said that it is the end of the free National Health Service? Does she believe that he was talking nonsense on behalf of his colleagues? Has she read the abundant evidence which shows that clinical teams throughout the country are being guided by the lack of cash allocated to them by the Government? Does that not mean that people needing hospital care are not receiving it, not because of the doctors but because of the Government's allocation of funds?
Baroness Cumberlege: My Lords, the guidance reinforces NHS responsibilities. I am not sure whether the noble Lord has had an opportunity to read it in detail. It makes clear that health authorities must arrange and fund within their resources a full range of services to meet continuing health care needs. But it goes on to say that it depends on the complexity and the nature and intensity of those needs. I feel that the BMA also misunderstood the guidance.
The noble Lord said: My Lords, I do not wish this to be a politically partisan debate. I have at least two substantial reasons for that. The first is the appalling effect which excessive attention to party politics has had, under different governments and over several decades, on Britain's ability to deploy an effective and consistent European policy. The second is that in my view there is an urgent need to revive the cross-party pro-European alliance which provided the Heath Government with its 1971 majority for taking us into Europe and which overwhelmingly won the 1975 referendum, despite indications six or nine months beforehand that public opinion was just about as unfavourable as it looks today. That same cross-party alliance, in a brief revival in your Lordships' House, secured a massive majority for the Maastricht ratification nearly two years ago.
However, there is no denying that the superficial mood in the country has become much less favourable than it was at the time of those several past events. But, as Sir Edward Heath himself pointed out in last week's debate in the other placea debate which I found singularly instructive in a number of ways, to which I shall referif year after year a government do practically nothing to counter the drip, drip, drip of denigratory news about Brussels and everything to do with the Community and if they allow that to be almost the only European diet of the British people, enthusiastically magnified by a press
It is also undeniably the fact that 20 years of vacillation have reduced British influence in Europe to its lowest point since we joined in 1973. That political history was encapsulated by Mr. Blair, again in that instructive debate, when he said that he would prefer to be leading a party which had been anti-European and is now pro-European than leading a party which was pro-European and is now becoming anti-European. That fair, if damaging, summary was not very flattering to either party but tells us a lot about what has bedevilled British policy towards Europe. I do not want to be self-righteous about this
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