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Lord Molloy: My Lords, will my noble friend consider the possibility of her department getting in touch with the appropriate department of the Royal British Legion which recognises that this issue concerns ex-servicemen and women who have been badly wounded serving their nation? Noble Lords laugh. I must tell the party opposite that I do not find this a humorous matter. Will my noble friend give the issue the serious consideration that it justly deserves?

Baroness Jay of Paddington: My Lords, I am grateful to my noble friend for drawing attention to this particular group who have a special interest in the matter. I assure him that the Department of Health will consult as widely as it normally does on this and other difficult issues.

Lord Lester of Herne Hill: My Lords, does the Minister agree that there is one awkward area of ambiguity, namely, the meaning of "suffering" or "distress" as distinct from pain? Does she further agree that the Walton Committee on medical ethics recommended that doctors should be able to relieve severe distress as well as pain but that there is no lawful authority establishing that that is what doctors can do using the principle of double effect? Is that not a serious gap in our understanding of the law?

Baroness Jay of Paddington: My Lords, having been a member of the committee chaired by the noble Lord, Lord Walton, I remember our long consideration of that issue. Perhaps I may draw the noble Lord's attention to the judgment made in the case of Dr. Cox,

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who was charged with manslaughter in relation to a case of this kind. The judge, summing up the evidence, said:

    "If a doctor genuinely believes that a certain course is beneficial to his patient, either therapeutically or analgesically, then even though he recognises that that course carries with it a risk to life, he is fully entitled, nonetheless to pursue it".

Lord St. John of Fawsley: My Lords, perhaps I may congratulate the Minister on her brilliant encapsulation of the law on this difficult subject. Does she agree that there is guidance for the medical profession in the wise words of the late Lord Horder? He said that the good doctor is able to distinguish between prolonging life and prolonging the act of dying.

Baroness Jay of Paddington: My Lords, I am grateful for the noble Lord's kind words. That thought is expressed exactly in the whole consideration of the double effect, described by the noble Lord, which is considered to be relevant to the practice of medicine in this field.

Lord Jenkins of Putney: My Lords, is my noble friend aware that there is a case for clarifying the law, having regard to the movement of public opinion on the matter? Will she look into the subject again, with the idea of making it possible for a doctor to act in accordance with the patient's desire and the doctor's own judgment of what is right without the doctor risking the possibility of being charged with murder?

Baroness Jay of Paddington: My Lords, perhaps my noble friend will forgive me for saying that I believe that I dealt with that point in the question about the law relating to advance directives. The problem involves those who may be mentally incapable at the time when the necessary decisions are taken. I know that my noble and learned friend the Lord Chancellor is looking at the report of the Law Commission which raises difficult additional problems about the law.

Baroness Cumberlege: My Lords, does the noble Baroness agree that some of the greatest skills and best expertise on pain control for dying people is exercised by Macmillan and terminal care nurses? If so, will she honour our commitment to introduce nurse prescribing nationwide next year, especially when evaluations of the pilot scheme show it to be popular with patients, good for nurses, efficacious and cost effective?

Baroness Jay of Paddington: My Lords, I believe that that is slightly wide of the Question on the Order Paper. However, I am delighted to respond. I spoke at the national rally of the Macmillan nurses last week and I am glad to say that I was well received by them. They seem to feel that the present Government are fulfilling their responsibilities for that important movement.

Nurse prescribing, as the noble Baroness will know, was referred to a national piloting scheme in April. We shall take a decision when the results are known.

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3.22 p.m.

Lord Campbell of Alloway asked Her Majesty's Government:

    Whether they will act against industrial action which subjects everyday life and business activity to significant disruption and where there is a manifest disproportion between the purpose of the strike and its consequences to the community.

The Minister of State, Department of Trade and Industry (Lord Clinton-Davis): My Lords, the Government see no justification for adding to the existing controls on industrial action.

Lord Campbell of Alloway: My Lords, does the Minister recall that at the time when ACAS was unable to resolve a series of disputes in London Underground, his right honourable friend the Prime Minister appeared to favour mandatory arbitration to seek to resolve that dispute?

Without going into the merits of any industrial dispute, I wish to ask the Minister whether in such disputes as the ones affecting Connex and BA there should be an effective regime which proscribes and contains disproportionate industrial action where there is no alternative provision.

Lord Clinton-Davis: My Lords, this Government do not believe that further legislation is required. Of course we would support recourse to any avenue to resolve disputes. Arbitration is one. Whether mandatory arbitration would be the appropriate way of dealing with the matter, I am not sure.

The important point is that it is surely for the parties to find the right way to go about the resolution of disputes; arbitration may be one of the courses.

Lord Evans of Parkside: My Lords, will my noble friend acknowledge that when an employer arbitrarily worsens the pay and conditions of his employees and then, following a legal ballot, threatens to sack or sue any of his employees who participate in industrial action, the employer is at least as guilty as the trade union in subjecting everyday life and business activities to significant disruption?

Lord Clinton-Davis: My Lords, in expressing his concern about the matter, my noble friend is inviting me to comment about a current dispute--which I decline to do. I do not believe that my intervention from this Dispatch Box in relation to that dispute can do other than exacerbate the position. All I can say is that I hope that the avenue of conciliation through ACAS will be properly explored by both sides.

Lord Rochester: My Lords, will the Minister go a little further than he did in his Answer to the noble Lord, Lord Campbell? Will he positively encourage employers

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and trade unions to reach voluntary no-strike agreements, committing themselves to arbitration if no common ground can be found?

Lord Clinton-Davis: My Lords, that is an option for trade unions and employers to consider. However, we need to tackle the whole issue in a rather more fundamental way. How do we ensure that there is a greater sense of partnership in industry, with one side respecting the other more than is the case at present? What I decline to do is to condemn people when they are in the course of negotiations, as our predecessors frequently tended to do. The butt of their criticism was always the trade union movement.

Baroness Turner of Camden: My Lords, does the Minister agree that in a democratic society the right of employees to withdraw labour after appropriate procedures have been followed--such as balloting--should be safeguarded? Any negotiating agreements which are entered into should have as their objective the requirement to adhere to that right.

Lord Campbell of Alloway: My Lords, will the House--

Lord Clinton-Davis: My Lords, the noble Lord, Lord Campbell, is being a little precipitous since my noble friend is entitled to a response. Not only is she right, but in addition, we have obligations under our arrangements with and our membership of the International Labour Organisation to observe fundamental rights at work. That is one of them.

Lord Fraser of Carmyllie: My Lords, I wish to save the noble Lord's breath by saying that of course we recognise, following on the mandate secured on 1st May this year, that the Government are entitled not to follow the wise course proposed, to which my noble friend drew attention in his Question. Clearly, the BA strike is extremely serious and it has potentially global consequences for the United Kingdom. Can the Minister tell us, from what is contained within the Labour Party manifesto, whether that dispute is more or less likely to be satisfactorily resolved?

Lord Clinton-Davis: My Lords, I find that question strange coming from the noble and learned Lord. I very much doubt whether he, standing at this Dispatch Box, would have entered the terrain which he invites me to enter. First, the so-called "wise course" on which he commented has been significantly rejected in the mandate given to this Government.

Secondly, as concerns the BA dispute, I repeat that what we need now is for both parties, in a bona fide way, to look at the possibilities of conciliation. ACAS is ready, willing and able to assist in that direction. Let us hope that the conciliation procedure will be properly explored by both sides at this stage.

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