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Baroness Symons of Vernham Dean: My Lords, it is concerns such as those voiced by my noble friend and my right honourable friend the Secretary of State for International Development that have led the European Union to support the target of halving the proportion of people who live in extreme poverty by the year 2015.
Baroness Symons of Vernham Dean: My Lords, we have been discussing for the past 18 months or so, at virtually every level of government, the needs of the Caribbean banana producers. As we know, the needs of those banana producers have taken something of a blow in recent weeks. I am glad to report that since we last discussed the issue in your Lordships' House the WTO agreed on 29th January that we shall have a further month of negotiations. It is an enormously important issue. There was some consensus in your Lordships' House that if the banana producing countries of the Caribbean are not allowed to continue with that legitimate trade, the temptation to diversify into some forms of illegitimate trade may become very great.
Baroness Rawlings: My Lords, I agree totally with the Minister. Given the close link between CAP reform and trade proposals for the new convention, what assessment have the Government made of the impact of such reform on the economies of the ACP states? What steps are they taking to ensure that the European Union faces the consequences of its agricultural policy for the ACPs?
Baroness Symons of Vernham Dean: My Lords, those are questions which were dealt with when drawing up the position of the European Union for the Lome discussions. They were considered before the negotiating mandate was arrived at. The negotiating mandate has now been published and the negotiations are going forward. So those points were taken into consideration in getting the European position together before the negotiations with the Lome countries began towards the end of last year.
Lord Montagu of Beaulieu: My Lords, I thank the Minister for that helpful reply. First, in view of the significance of tourism for the creation of employment, will the Government ensure that the needs and potential of tourism are fully recognised by the RDAs, and that those interests are represented on their boards? At present, they are conspicuously absent.
Secondly, how will the Government ensure that important tourist attractions and destinations are not disadvantaged when the RDA boundaries within which they are located exclude the area in which they are best marketed for tourism? I refer, for instance, to Bournemouth which would like to stay in the south and not be in the south-west.
Lord McIntosh of Haringey: My Lords, I cannot accept that tourism is not represented on regional development agency boards. Tourism is not represented on all the boards but there is representation where it is an important part of the regional economy. If there are examples where tourism should be more widely represented, I should be glad to hear of them.
It is for the regional tourist boards to determine their own regions. In Cumbria, for example, a separate tourist board would rather be linked with the north-east than with the north-west. It would be sensible for it to maintain links with both boards which might have common interests with it.
Baroness Miller of Hendon: My Lords, the Government assured this House that the boundaries of the RDAs were not to be "fixed in stone for all time". Will the Minister assure the House that the existing administrative regional boundaries will not be used as a fait accompli to prevent the boundaries for any future English development agencies being fixed by the Boundary Commission after full and proper consultation with the public?
Lord Newby: My Lords, the Minister seems to imply that the Government support the introduction of regional assemblies in the English regions outside London. If that is so, can the Minister give some indication of when we may see some progress, if only to give the democratic support which the RDAs will need in order to maximise the economic potential of the English regions?
Lord McIntosh of Haringey: My Lords, government policy has not changed since we stated in our manifesto that the prerequisites for democratic regional assemblies in England would be the wishes of the local authorities and the wishes of the people in the region. That position has not changed. The justification for regional development agencies stands on its own legs in the sense that those are business creation economic regeneration organisations designed for a country where only London is a region with GDP per head above the European average.
The Parliamentary Under-Secretary of State, Department of Health (Baroness Hayman): My Lords, I beg to move that this Bill be now read a second time. The Bill provisions make a number of important and wide-ranging changes to improve health and the treatment and care provided to patients on the National Health Service.
The origins of the Bill are the Government's White Papers in England, Scotland and Wales, published over a year ago now, to rebuild a modern and dependable National Health Service, based on the fundamental and historic principle that if you are ill or injured there will be a National Health Service there to help, and that access to it will be based on need and need alone--not on one's ability to pay, who one's GP happens to be, or where one lives.
Before I go into the detail of the Bill, it may be appropriate to record now the sorrow that I am sure is shared throughout the House at the news of the death today of the noble Baroness, Lady Robson. She made a great contribution to healthcare in this country and to debates on healthcare in this House both from the Back and Front Benches of the Liberal Democrats. I feel sure that she would have been particularly interested in the debate today with its aspects of professional
Baroness Hayman: My Lords, the White Papers on which the Bill is founded received widespread support. That is because they go with the grain of what many in the NHS had been trying to do despite the obstacles presented to co-operative working by the internal market. In our proposals now we are discarding the things that failed and building on the things that worked, such as the increasingly important role of primary care, and we have backed these proposals with the biggest cash injection the NHS has seen in 50 years.
Good early progress has been made in implementation. A great deal has already been done without the need for primary legislation. And, as we promised, we have developed our proposals through dialogue with the NHS, with users, carers, professional bodies and others. This dialogue and discussion have helped shaped the Bill now before the House.
Before running through the detail of the provisions, I should like to highlight three critically important White Paper themes which the Health Bill takes forward: first, that there has to be a new and systematic approach to improving the quality of services in the NHS; secondly, that the NHS needs to work together and in partnership with local government, with voluntary bodies and within the community--it is everyone's business to improve health and healthcare; and, thirdly, that responsibility should be devolved to local clinicians to give them a stronger role than ever before in shaping services, getting the best out of NHS resources and promoting the health of their local communities.
Your Lordships will have seen the Explanatory Notes to the Bill, and rather than replicate these, I shall aim to give some detail of the policy intentions behind the provisions. The debate today will, I suspect, focus on the provisions in Part I which will apply to both England and Wales. Later this year, broad responsibility for the NHS in Wales will transfer to the National Assembly. Devolution provides a tremendous opportunity for the NHS in Wales to be shaped so as best to meet the needs of the people of Wales.
Part II of the Bill contains provisions which will apply only to Scotland. I am pleased to see that several noble Lords with Scottish interests will be speaking later today. I am equally delighted to see that my noble friend Lord Macdonald of Tradeston is on the Front Bench and will listen, as I shall, with particular interest to their contributions.
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