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Lord Dholakia: My Lords, does the Minister accept that one in six people in prison on remand in custody is a very high number? It is sometimes as high as one in five. That means that of just over 72,000 people in prison, more than 12,000 are in custody, either before trial or before sentence. At the time of the goodwill season, the implication for many of the prisons that I have visited is that people must be served their Christmas dinner at about 10.30 a.m., soon after they have finished their breakfast. There is no other way of coping with such large numbers of people in prison. Does the Minister accept that less demand on custody, more use of bail, and less emphasis on imprisoning women and mentally ill offenders would alleviate the present prison crisis to a certain extent?

Lord McIntosh of Haringey: My Lords, as I think that I indicated in my supplementary answer to my noble friend Lord Corbett, the Government sympathise with many of the points expressed by the noble Lord,

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Lord Dholakia. It must be particularly unpleasant for those who have not been convicted of an offence to suffer Christmas Day in prison. However, remand in custody is used when an informed judgment has been made that there is a danger to the public if remand were to be on bail. That is a matter for the probation service and the police and can be debated when we consider the Criminal Justice Bill.

The Lord Bishop of Worcester: My Lords, does the Minister agree that the numbers on remand are extremely disturbing, given what the noble and learned Lord the Lord Chancellor said in the debate on the gracious Speech about rehabilitation being at the heart of the Government's concerns and strategy? Not only do such large numbers cause the kind of situation to which the noble Lord, Lord Dholakia, has just drawn attention, but they inhibit the Prison Service's work of education and rehabilitation for those who are given custodial sentences for a longer period. It may be comforting for the public to know that many people are being locked up on suspicion of having committed a crime—perhaps a dangerous crime—but, considering the long-term struggle against criminality, we may be doing something in this regard that militates against our long-term aims and those of the Government.

Lord McIntosh of Haringey: My Lords, the large numbers in prison have caused difficulty for rehabilitation programmes and education programmes in prison. That is not particularly a consequence of the number of remand prisoners; the significant rise in the number of prisoners causes the difficulties to which the right reverend Prelate referred. The Criminal Justice Bill provides alternatives to full-time custody and rationalises the non-custodial sentence regime by providing generic community punishments. I hope that the right reverend Prelate will take an active part in debates on that Bill.

NHS: Professional Staff Exchanges

11.21 a.m.

Lord Clement-Jones asked Her Majesty's Government:

Whether they have taken a view on the impact on the National Health Service of the proposed directive on the mutual recognition of professional qualifications.

The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath): My Lords, the aim of improving mobility is one that we fully support. Exchanges of professional staff bring mutual benefits to the NHS and other countries. However, free movement must be balanced by proper safeguards for service quality and public protection, and we shall ensure that this concern is addressed in ongoing negotiations.

Lord Clement-Jones: My Lords, I entirely accept what the Minister says as being the position of the Department of Health. However, a number of other government departments do not appear to have got the message. For example, at a recent EU competitiveness council attended by a senior DTI Minister, seven other member

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states made objections to the directive but the UK did not. Is it not time that the Government got their act together?

Lord Hunt of Kings Heath: My Lords, the noble Lord surely knows that the Government speak with one voice on these matters. There has been very constructive discussion between my department and the Department of Trade and Industry. The fact is that UK concerns about the protection of public and patient safety—I have no disagreement with the noble Lord's concerns on this issue—were discussed and raised at the council meeting to which he referred. The UK representative made substantive points in those areas. Following that, the UK Government are now consulting with the health regulator and other appropriate organisations on some of the concerns raised at that council meeting.

Lord Turnberg: My Lords, does my noble friend agree that there are considerable dangers in the draft order to get rid of the advisory committees on training? Those committees are said to be going. Although they are imperfect, they at least aim to get a minimum standard of training for specialists across Europe. Does he also agree that an effort should be made to incorporate an understanding of English among healthcare workers so that they can at least understand what patients are saying to them?

Lord Hunt of Kings Heath: My Lords, the issue of English, which is essentially concerned with EEA nationals, will be a matter for individual employers. We have made it consistently clear to NHS organisations that individual employers have every right and responsibility to check on the English of prospective applicants.

On the question about the establishment of a single committee to replace the existing advisory structure, I understand my noble friend's concern. Whatever the committee structure that is eventually agreed, it will be important to ensure that it has professional input and that the concerns of the medical profession and other health regulators are fully brought to bear.

Baroness Gardner of Parkes: My Lords—

Baroness Finlay of Llandaff: My Lords—

Noble Lords: Cross-Bench!

Baroness Finlay of Llandaff: My Lords, what transitional arrangements are being planned to ensure that professionals from accession countries in an expanded EU have adequate standards of education and training for clinical practice here, and what time-frame is involved?

Lord Hunt of Kings Heath: My Lords, the accession treaty will allow citizens from new member states full free movement rights from the day of accession, apart from those being exercised for the purposes of work. The EU position allows member states to maintain restrictions on

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workers from the new member states for up to seven years after accession. That provides enough safeguards in relation to the noble Baroness's question.

Baroness Gardner of Parkes: My Lords, what is the position of practitioners from Australia and New Zealand working in this country? I no longer have to declare an interest in this respect. If it so happens that many new people come into the National Health Service and that the Australians—the Antipodeans—look to work within other areas of the Community, will they automatically be entitled to do so or will they have to undertake additional qualifications?

Lord Hunt of Kings Heath: My Lords, as a cricket fan I have heard rather too much about Australians in the past few weeks.

The noble Baroness is right—there has been a long tradition of Australian health professionals coming to work in this country. They are very welcome indeed, and some of them stay for many years, I am happy to say. My understanding is that currently it is up to member states to recognise or not recognise applicants; under the new directive, if such people have been recognised by, for example, the UK and they practise for three years, they would be recognised in another member state.

Earl Russell: My Lords, does the Minister agree that recognition of qualifications raises the question: who confers the right to award qualifications? How is that right conferred in other countries in the EU? In particular, is there any other country in which the power to award a degree can be granted by the sole and unfettered action of the executive?

Lord Hunt of Kings Heath: My Lords, I do not have comprehensive information about the procedures in every other European country, but my understanding is that in broad principles it is the same as that in the UK; in other words, it is based on a competent body, which may be a government department or, in the case of the medical profession and in relation to medical degrees, a GMC-like body.

Baroness Masham of Ilton: My Lords, can the Minister explain how such an unsafe and unsatisfactory directive got through the European Parliament?

Lord Hunt of Kings Heath: My Lords, the European Parliament still has to consider the directive in detail. There will no doubt be an interesting debate and amendments will be passed. I am sure that much interest will be taken in it. Essentially, it originally sought to bring together and codify a number of existing directives. However, in the process of discussion, further elements were added to it. There are clearly benefits from encouraging free movement across European countries within the EEA. We should encourage that. Equally, I accept that the Government have a duty to ensure that

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the very real concerns expressed by health regulators are fully discussed and represented within Europe. We will do that.


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