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Lord Blackwell: My Lords, does the Minister accept that experience suggests that waiting time objectives are more likely to be met by freeing up doctors and local managers through programmes such as the Government's foundation hospital programme, rather than through centralised initiatives, and by freeing up patients to take their treatment elsewhere? What do the Government expect the rate of development of the use of non-NHS facilities by NHS patients in the next year to be?
Baroness Andrews: My Lords, I agree with the noble Lord that it is not simply a question of delivery through the hospitals and through centralised systems. One of the reasons why we are so pleased to see GPs develop special interests is that it means that we are taking a whole-system approach. We attach priority to getting people treated and out of pain, and we are considering various ways of doing that. I cannot, however, put timescales or figures on it, in the way that the noble Lord suggested.
Baroness Trumpington: My Lords, is the Minister aware that what the noble Lord, Lord Marsh, said about people being refused treatment because they were too young is true? I speak as somebody who has two false knees. If somebody has that operation at the age of 60, it is possible that the replacements will wear out. Going through such an operation again is something to be avoided.
Baroness Andrews: My Lords, because of the devolution of power and the shift in the balance of power, primary care trusts have greater responsibility to work with GPs, including specialist GPs, and to inform and support patient choice. That means that the whole system works more effectively together.
The Parliamentary Under-Secretary of State, Department for Environment, Food and Rural Affairs (Lord Whitty): My Lords, I feel that I should apologise to the House and to my noble friend Lady Andrews for preventing her achieving a grand slam today.
We are not convinced of the need for a waterways regulator. British Waterways and other navigation authorities are already subject to the law against anti-competitive practice. However, I know that British Waterways is discussing with the Inland Waterways Association the procedure for dealing with appeals against decisions on mooring and on other charges. I think that that should be fully explored.
Lord Corbett of Castle Vale: My Lords, I thank my noble friend for that response. But does he acknowledge that canal boat owners question the independence of an ombudsman appointed and paid for by British Waterways and that users of marinas and river berths have nowhere to go when faced with rises in charges of up to 300 per cent in a single year? Will the Minister tell the Inland Waterways Association and the National Association of Boat Owners, which see the need for an independent regulator, where they should go to seek redress, when complaint now can, and does, lead to the loss of moorings?
Lord Whitty: My Lords, as regards British Waterways, the largest operators, the Inland Waterways Association has some complaints about British Waterways because it has moved away from a national matrix of affixing charges to a more locally developed one which is, in effect, making it more commercial. However, the Inland Waterways Association is not in favour of a regulator. It is discussing a more effective appeals system with British Waterways. It is important to note that by and large these charges are fixed only once every five years and that the average increase of British Waterways's mooring charges last year was only 6 per cent.
Lord Livsey of Talgarth: My Lords, does the Minister agree that mooring charges should be levied at a sustainable rate to all who enjoy boating? Certainly, they should be affordable. The appointment of a regulator would help to achieve that good objective.
Lord Whitty: My Lords, I agree with the first part of the noble Lord's question. Because there is a demand on certain moorings and the facilities for some of those moorings have been improved, it is reasonable that the
The noble Lord said: In substance, Amendment No. 1 is reflected by subsection (2) of Amendment No. 8. Amendment No. 8 would leave out Clause 1 and set up a new regime. If Amendment No. 8 were to commend itself, all amendments tabled to Clause 1 would fail. There is a conflict of conception, which I hope may be resolved in favour of this and other amendments. There is no pre-emption and, indeed, notice has been given of the intention to move that Clause 1 do not stand part.
Against that background, the amendment would remove what is a grave sexual assault, hitherto not understood or defined as rape, from the redefinition of rape proposed by Clause 1(1)(a). The Oxford Latin dictionary renders rapio as ravishment, rape of the Sabines, and fellatio as a sexual perversion which, according to in-house medical advice of the highest order, carries the dire risk of infection from both old and new-age diseases.
Without consent, or if enforced, it is a serious sexual assault which should constitute a specific offence, but it is not rape as ordinarily understood or defined, nor is it readily intelligible as such to any jury. Albeit that the structure of the Bill affords an opportunity to set up the specific offence, such is not the concern of this amendment. That opportunity will be considered on Amendment No. 11.
The main distinction between the specific offence and rape is the risk of pregnancy andwithout becoming emotional or too detailedeverything that that entails; all the consequences of that risk. On Second Reading, noble Lords who have had the conduct of rape cases and who have had to directoh dear, we are doing it again. This is the third time that the noble Baroness has intervened when I am trying to address the House.
Lord Campbell of Alloway: I am so sorry to have to do that. I was trying to make quite a serious point. On Second Reading, noble Lords who have had the conduct of these rape cases and have had to direct juries in them spoke about the unacceptable effects of proposed redefinition. No doubt they will speak again today. Your Lordships may wish to take due account of the practical experience of such noble Lords, including the noble and learned Lord, Lord Lloyd of Berwick, whose hallmark of approval for this amendment is acknowledged with gratitude, and even more gratitude that he is in his place.
The Government want to change the law. What is the justification? As yet, none has been adduced. There is concern about the conviction rate in the consent cases of rape as now and hitherto defined. But that bears no kinship with this proposed redefinition. Is this some form of placebo? If not, what is the justification? As yet, there is no justification. I have read the report of Second Reading more than twice. There is none. Let us hear what it is today.
There is little else to be said. In the end, it is a lay questionnot a legal questionas to what your Lordships feel is a due and fair way of administering justice. It is a matter of perspective. The perspective of the noble Baroness, Lady Mallalieu, recorded in her Second Reading speech, may commend itself to your Lordships as it did on that occasion. She said that rape is the more serious offence and that,