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House of Lords

Tuesday, 10th October 2000.

The House met at half-past two of the clock: The LORD CHANCELLOR on the Woolsack.

Prayers--Read by the Lord Bishop of Hereford.

The Lord Chancellor: Leave of Absence

The Lord Chancellor (Lord Irvine of Lairg): My Lords, before the commencement of business, I take the opportunity to inform the House that I am to undertake an official visit to the United States of America from Thursday 12th October to Wednesday 18th October, when the House will sit. In the course of that visit I shall be delivering a lecture at the University of Boston and delivering the James Madison Memorial Lecture at the University of New York. Accordingly, I trust the House will grant me leave of absence.

North Staffordshire NHS Trust

Lord Walton of Detchant asked Her Majesty's Government:

    Whether they support the findings and conclusions of the Griffiths report of 8th May reviewing the research framework in the North Staffordshire National Health Service Trust in the light of the criticisms set out in the paper by Sir Iain Chalmers and Dr Edmund Hey, published in the British Medical Journal on 22nd September.

The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath): My Lords, the Government accepted all the recommendations made in the Griffiths report, which mainly concern improving research governance and guidance. The criticisms made in the article by Sir Iain Chalmers and Dr Hey relate to only one aspect of the review and do not invalidate the recommendations.

Lord Walton of Detchant: My Lords, I thank the Minister for that reply. In the light of the damning criticism of certain aspects of the Griffiths report set out in this paper published by two distinguished physicians, will the Government now withdraw that part of the report which contains those criticisms and apologise to the doctors, nurses and members of the local research ethics committee in North Staffordshire, whose reputations have been tarnished so unjustly by the inquiry? Also, will the Government ensure that all further inquiries into alleged research misconduct are conducted under guidelines that are at least as fair, robust and equitable as those used by the Medical Research Council?

Lord Hunt of Kings Heath: My Lords, Sir Iain Chalmers and Dr Hey were asked by the Medical

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Defence Union to review the papers leading up to the Griffiths report, and an article duly appeared in the British Medical Journal. In the same journal a response to some of those points was written by Dr Griffiths, who chaired the review panel. I want to make it clear that the terms of reference of the review arose from concerns expressed by parents in the early 1990s about some aspects of the conduct of research in North Staffordshire. The core recommendations of the Griffiths review relate to suggestions and recommendations in relation to the improvement of research governance throughout the National Health Service. The Government believe that those recommendations are sound and intend to implement them.

Lord Clement-Jones: My Lords, I am surprised to hear that the Minister believes that the recommendations of the Griffiths report are sound in view of the considerable criticisms made by Chalmers and Hey in their paper. I am sure that the noble Lord is aware that, particularly in the Birmingham area as he will have seen from the Birmingham press, this is a fraught subject, with paediatricians believing that they are under threat and being witch-hunted, and parents also having extremely strong views, believing that paediatricians are labelling them with Munchausen's syndrome by proxy. This is a difficult area for us all to understand. Will the Minister consider undertaking a new inquiry into the research carried out at the North Staffordshire Trust? Also, in view of the fact that there are other inquiries hanging over the trust and other paediatricians involved, will he ensure that fair and proper procedures are carried out for those inquiries as well?

Lord Hunt of Kings Heath: My Lords, I do not believe that a further inquiry should be carried out into the Griffiths review. However, the department has received representations in relation to that review which we are now considering. Let me make it clear that the noble Lord is right when he refers to the controversial nature of many of the issues which have arisen. It is true that a number of the doctors involved are the subject of investigations by the North Staffordshire Trust and one of the doctors is currently subject to complaints being considered by the General Medical Council. However, the core recommendations arising from the Griffiths review relate to guidance on research governance within the National Health Service. It is on those recommendations that we have taken action.

Lord Turnberg: My Lords, will the Minister agree that the Griffiths report appears to have given rise to a number of injustices, despite the Minister's comments about the value of some elements of it, not least of those being the apparent denial of human rights to the doctors being criticised in that they were not allowed to see the report before it was produced in order to be able to answer some of the criticisms?

Lord Hunt of Kings Heath: My Lords, I have no reason to believe that the review was not conducted appropriately. My understanding is that each person

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interviewed was able to explore the issues that were raised. They were provided with a transcript which they agreed for accuracy. All the transcripts were then considered by the panel to decide who needed to be interviewed further. Further interviews with the panel took place, with witnesses again being provided with a transcript of their evidence for them to agree. I have said that we received representations and will be considering them. I repeat, the core recommendations, which relate to research governance, I believe to be sound.

Lord Winston: My Lords, I sit on these Benches because I believe in a fair society. I also believe there are so many flaws in the Griffiths report that it must be reviewed by the Government. It is clear that there are numerous factually incorrect statements and that throws into disrepute the whole probity of the NHS governance framework for research. Will the Minister consider the matter in a more carefully phrased answer?

Lord Hunt of Kings Heath: My Lords, I have said that we have received representations and will consider them carefully. I have also said that we believe the core recommendations to be sound. Professor Griffiths responded to a number of the points made in the same edition of the British Medical Journal.

As regards inquiries, reports and reviews, a number of different methods are undertaken within the NHS. I do not believe that the review was out of order or kilter with others which have taken place, or are taking place, within the NHS.

Lord Campbell of Alloway: My Lords, I have listened to a plethora of words but I want to ask the Minister a simple question. Is he prepared to consider giving the apology sought by the noble Lord, Lord Walton of Detchant, or is he not? Can I have a straight answer to a straight question?

Lord Hunt of Kings Heath: My Lords, I always think that "yes", "no" answers are best avoided. Perhaps I may repeat that we have received representations about the conduct of the inquiry and we shall consider them. I stand by my earlier statement that the substantive recommendations made by Professor Griffiths are sound and that we intend to act upon them.

Earl Howe: My Lords, the Minister said that the Griffiths panel expressed the view that research governance in the North Staffordshire Hospital Trust did not match best practice. In the light of that finding, has the guidance on research governance in the NHS been changed and if so in what way?

Lord Hunt of Kings Heath: My Lords, yes. The panel stated that as far as it could tell the governance system in the early 1990s was broadly in line with the then departmental guidance but would not be considered best practice now. The Department of Health has

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produced a consultative document on research governance and that is being considered by its recipients. We shall be providing definitive guidance in due course.

Classroom Disruption: Pupil Exclusion

2.45 p.m.

Baroness Young asked Her Majesty's Government:

    Whether they are satisfied that teachers have sufficient powers to deal with disruptive children in the classroom.

The Minister of State, Department for Education and Employment (Baroness Blackstone): My Lords, the School Standards and Framework Act 1998 already gives head teachers the powers they need to maintain discipline in their schools and to exclude violent or very disruptive pupils. The Act carries forward provisions on discipline and exclusion introduced in earlier legislation by the previous government.

We have recently issued new guidance for exclusion appeal panels to indicate that the head teacher's decision to exclude should not be overridden in a range of circumstances, including where there is violence or the threat of violence.

Baroness Young: My Lords, I thank the Minister for that Answer. Is she aware of the serious situation which exists in the teaching profession? I understand that because of the teacher shortage at least two schools are working a four-day week. Is she not worried that among the many reasons for concern is the plight of teachers who have been subjected to violent pupils: when their cases are considered everything appears to be weighted against teachers trying to do a responsible job and in favour of disruptive children? Does not that situation need a great deal of consideration and action?

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