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Lord Ashley of Stoke: My Lords, does my noble friend agree that one person in 25 carries the cystic fibrosis gene and that screening could save a great deal of suffering? Can she give a commitment to the House that screening will be available for everyone who wants it regardless of the attitude of their health authority?

Baroness Jay of Paddington: My Lords, my noble friend rightly draws attention to the enormous scientific advances which have led to doctors and scientists being able to identify the gene for cystic fibrosis. That in itself has made an enormous difference. The National Health Service's health technology assessment programme is at the moment conducting a systematic review of the process of screening for cystic fibrosis, both ante-natally and after a child is born. We are expecting the report of that health technology assessment exercise shortly. It will then go to the national screening committee which, as the House will be aware, judges the priorities for national screening programmes. I am sure that cystic fibrosis will be high on its agenda.

Earl Howe: My Lords, in opposition, the Labour Party accepted the case for free prescriptions for adults with cystic fibrosis. Will the Minister confirm that in the review of prescription charges there is a presumption in favour of such an exemption in the mind of the Government?

Baroness Jay of Paddington: My Lords, I am tempted to repeat the answers given by my noble friend Lord McIntosh of Haringey in relation to the Budget Statement. I am sure that the noble Earl does not expect me to pre-empt the findings of the comprehensive spending review which, as he is aware, within the Department of Health concerns prescription charges particularly. The noble Earl will also remember that the review in the Department of Health is being conducted in the context of the manifesto commitment that if you are ill or injured there will be a National Health Service there to help you and access to it will be based on need, and need alone.

Baroness Pitkeathley: My Lords, does my noble friend agree that it seems unfair that where a family with a member suffering from the condition takes home that family member rather than having him or her nursed in hospital, the family may have to pay for equipment such

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as nebulisers and feeding equipment which, had the patient remained in hospital, would have been provided free?

Baroness Jay of Paddington: My Lords, I am aware of this problem but, as I understand it--my noble friend may be in a better position to know through her work with the Carers National Association--if a nebuliser is prescribed by a hospital consultant, the family to whom it is prescribed may use it at home.

Lord Chalfont: My Lords, is the Minister aware that cystic fibrosis is one of the diseases which is likely to be most susceptible to treatment by gene therapy? Are the Government and their advisers examining possible future developments in that regard?

Baroness Jay of Paddington: My Lords, as I said in reply to a previous question, we are aware of the work that has been done to identify the gene for cystic fibrosis. That has made the potential for the screening programmes, which I mentioned in reply to my noble friend Lord Ashley, far more realistic. Clearly, work on gene therapy which could, for example, involve pre-embryo implantation work would be of great scientific interest. It would also have ethical considerations which I am sure that many people would want to discuss.

Lord Winston: My Lords, I am sure that my noble friend is aware that one of the strategies for dealing with cystic fibrosis in families which are affected and have a child who is already seriously ill is to screen embryos and to replace those which are free of the genetic defect. One problem faced by such families is that they can sometimes get treatment on the National Health Service, but sometimes they cannot and they have to pay for it themselves. As it is a cost-effective treatment, would my noble friend be prepared to give a cautious and favourable response, as she did to the noble Lord, Lord McNally?

Baroness Jay of Paddington: My Lords, as I said in reply to the noble Lord, Lord McNally, we would very much hope that specialist conditions, such as cystic fibrosis, would be susceptible to the national clinical frameworks. The priority with which those clinical frameworks are established will depend on many issues relating to resources and, frankly, the other conditions which are in the queue with regard to the establishment of that system.

Lord McNally: My Lords, as we have a moment to spare, I wonder whether the Minister would like to send her congratulations to the Welch brothers, my neighbours in St. Albans, who last Saturday organised a very successful sale of their toys as part of the "Blue Peter" appeal for cystic fibrosis, which has been one of the most successful "Blue Peter" appeals. The Minister's congratulations to "Blue Peter" and to the thousands of children who are participating in the appeal would be most welcome.

Baroness Jay of Paddington: My Lords, I am only too happy to underwrite the noble Lord's

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congratulations on the fund- raising appeal. I only hope, however, that that will not lead to another noble Lord rising to his feet to suggest either that I should congratulate his local fund-raising appeal or, following my noble friend Lord Winston, that that is the way to fund basic research in the health service.

Business

3.4 p.m.

Lord Carter: My Lords, at a convenient moment after 3.30 p.m. today, my noble friend Lady Jay of Paddington will, with the leave of the House, repeat a Statement that is to be made in another place on the future of London health services.

I should like to take this opportunity to remind the House that the Companion indicates that discussion on a Statement should be confined to,


    "brief comments and questions for clarification".
There is a mandatory limit of 20 minutes from the end of the Minister's initial reply to the Opposition spokesmen.

Crime and Disorder Bill [H.L.]

3.5 p.m.

The Parliamentary Under-Secretary of State, Home Office (Lord Williams of Mostyn): My Lords, I beg to move that the House do now resolve itself into Committee on this Bill.

Moved, That the House do now resolve itself into Committee.--(Lord Williams of Mostyn.)

On Question, Motion agreed to.

House in Committee accordingly.

[The CHAIRMAN OF COMMITTEES in the Chair.]

Clause 1 [Anti-social behaviour orders]:

Lord Williams of Mostyn moved Amendment No. 1:


Page 1, line 13, after ("acted") insert (", since the commencement date,").

The noble Lord said: In moving Amendment No. 1, I should like to speak also to Amendments Nos. 25 and 318. These amendments, as can be readily seen from their terms, are intended to ensure that the act in respect of which an anti-social behaviour order is sought takes place after the commencement of the clause but that where there has been behaviour before commencement which may help to explain why the act has caused, or is likely to cause, harassment, this is admissible as supporting evidence. It was formerly disallowed under Schedule 8, which specifically prevented any evidence being adjudged of any anti-social acts committed by the defendant prior to the commencement of the clause.

We considered carefully before putting forward these changes. Plainly, it is essential that the act which forms the reason for the order takes place after commencement to avoid the taint of the orders being retrospective. However, it may well be the case in practice that such an act is merely one of a series of anti-social actions and

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that there is a background of continued harassment--perhaps even from extraneous noise and things of that sort--and perhaps failed mediation and persuasion which the court could usefully take into account in considering the application for an order.

We considered that the restriction placed by Schedule 8 was too limiting upon the court's discretion and should therefore be removed. The three amendments together achieve that aim. The first makes it clear in the body of Clause 1 that the action which causes the application for an order must occur after commencement. The second defines commencement specifically as the commencement date of Clause 1. The third removes the limitation on supporting evidence in Schedule 8. Overall, they bring the provisions into line with the sex offender orders in Clause 2 and should therefore result in a more effective introduction to the order. I beg to move.

Lord Henley: I thank the Minister for moving Amendment No. 1 and for speaking also to Amendments Nos. 25 and 318. I do not intend to speak at any length on this amendment because we shall be taking some time over Clause 1 in due course in considering my amendments, those tabled by my noble friends and those from other noble Lords. At this stage I rise merely to thank the noble Lord, Lord Williams, for writing to me and, I take it, to others in considerable detail about the government amendments. I have read what he said in his letter of the 29th about the three amendments to Clause 1 and I am satisfied.

On Question, amendment agreed to.


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