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The Minister sought to justify the way in which the independent review is to be provided to HMRC, which would then,
I am rather suspicious of that formulation. It has an independent review getting fed into HMRC, which then has the opportunity to interfere with the “results and conclusions” before they are passed on to the Treasury, which has to lay them before Parliament. I do not understand why the review itself is not provided straight the way through the system. Why is there an opportunity for the commissioners to rephrase the findings? The Government have, for example, released the whole of the Ipsos MORI report this week but there might be occasions in future where the information is modified. That is not a helpful formula; it is not even the normal one for these kinds of things.
On whether Parliament is both Houses of Parliament, I used to think it was not necessary to separate out each House in relation to Parliament, but the Government do not always use “Parliament” to mean both Houses. For example, the Prime Minister in one of his many makeover statements announced that public appointments would be subject to confirmatory hearings by Parliament. When we pressed that further, we discovered that in this case the Government meant Parliament was only the other place. Therefore, whenever we see a reference to Parliament now, we always feel that it is necessary to clarify whether the Government mean both Houses of Parliament or simply the other place, because they have form, if you like, on using Parliament to mean both things and not necessarily being clear at the time.
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6 pm
I am grateful to the Minister for setting out that the Government intend the independent review to be independent of the Treasury and HMRC, which was what I sought to tease out in Amendment 18. I sought to avoid the kind of so-called independent review that was done, for example, of the FSA’s handling of Northern Rock. It was carried out by the FSA’s supposedly independent internal audit department, but that could not have qualified for a properly independent review. The Government have answered me in relation to Amendment 18.
Lord Newby: My Lords, I am grateful for the Government bringing forward this amendment. I supported the broadly analogous amendment put down by the noble Baroness in Committee. I am particularly pleased that the review will look to any barriers which may exist around the opening of saving gateway accounts, as the Minister knows. One of my principal concerns about this Bill is that, far from there being competition between saving gateway providers, there will not be any providers because it will not be economically viable for banks, building societies or the Post Office to do it. That provision in this amendment is helpful because it allows that potential problem to be looked at.
I have one remaining concern about the amendment, which is the suggestion that no review will take place until after seven years of Clause 6 coming into force. Seven years is a long time. If the scheme is working well, seven years may be fine. But if there are problems with the scheme in any material respect, to wait seven years before you even start looking at it seems to be too long. Although I know the Minister believes that seven years is the right period, I want to confirm the provision in the amendment. It does not say that the review will be after seven years, but that it will be within seven years. Therefore, if there were strong arguments for having a review earlier, you would still be able to do it under the legislation even though, were the Minister still to be in his post in seven years’ time, he could wait for the seven years to elapse before he did it.
Lord Morgan: My Lords, I support my noble friend’s amendment, which, in general, seems to be important and sound in substance. I also think that there are important points in the amendment tabled by the noble Baroness. I hope that we can somehow disinter her first point about financial information and advice. I do not see why that is not put specifically in the Bill. As I said earlier, the educative aspect of this Bill is a central part of it. I hope that that could somehow be embodied. I note that my noble friend says, “Well, it would happen anyway”, but I would like something a bit more specific than that.
I have two little points about the government amendment. I take it that the reference to the Ipsos MORI material means that the support will be an account in terms of not merely historical consequence but expectations. I hope that this Ipsos MORI material can be related to what appears in the report, because it shows, first, how carefully this scheme has been researched and prepared for and, secondly, it shows that socially it is potentially extremely significant in that people’s
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Finally, I sympathise very much with the noble Lord, Lord Newby, that seven years seems an extraordinary period. It is longer than the life of a Parliament even without reforming the rules on when we have elections. I hope that we can have a slightly optimistic gloss on these words from my noble friend.
Lord Myners: My Lords, I thank the noble Baroness, Lady Noakes, the noble Lord, Lord Newby, and my noble friend Lord Morgan for their most helpful and constructive contributions to the debate on this matter. I have listened closely to the points made. The noble Lord, Lord Newby, raises again a point that has been raised previously; namely, will there be sufficient account providers? I have shared with noble Lords my concern on that point as well. I have been engaged in active discussion with banks, building societies and other potential providers of saving gateway accounts. I am confident as those discussions continue that there will be a range of providers to meet the requirement of the intent behind the creation of saving gateway accounts at launch.
Questions were asked about the review period being seven years. It is important to remember that the seven years specified is the latest that this report can be published and not the earliest. If there are benefits to conducting and publishing the review earlier, the proposed new clause would provide sufficient flexibility for that to happen.
The noble Baroness, Lady Noakes, raised a number of points, one of which I can handle swiftly and, I hope, effectively; that is, the laying of reports before Parliament. “Parliament” in this context encompasses this House and the other place by virtue of the Laying of Documents Before Parliament (Interpretation) Act 1948. The noble Baroness raises important questions about eligibility for the scheme and whether the scheme is effectively targeted. It will be possible for this and other matters to be considered by the review if Treasury Ministers consider that to be appropriate. However, consideration of issues around eligibility creates a risk that the review might become a more general survey of savings, attitudes and behaviour among a wider group of people, rather than a consideration of the impact of the saving gateway on saving habits and financial inclusion among participants. The Treasury will keep eligibility for the saving gateway under review in any case, but this reinforces the view that the precise specification of the review within the framework as defined in my amendment is a matter where judgment is better made in the light of experience and observed practice.
Questions were raised as to whether my new clause would allow the Treasury to present the review in a report, whether this would be Treasury spin and whether we would see the reviewer’s own words. I assure noble Lords that that will not be the case. There will not be spin and the report will be presented in the reviewer’s own words. That is consistent with the sincerity of intent which has always been in our contemplation. This is a novel approach to tackling a significant problem around financial exclusion for the least fortunate
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The noble Baroness also raises a question around whether we should be using the word “effect” or the word “effectiveness”. I think that “effect” is what we had in mind and we would wish to leave it at that stage, but I will reflect further on the issue, as I have endeavoured to do at all times during our discussions on the Bill. I have stated again the importance that I attach to the effective post-implementation review of the saving gateway, and I believe that the proposed new clause provides for such a review, as well as being targeted on the scheme’s published objectives. It also provides a great deal of flexibility for any other relevant issue to be raised. I hope that the noble Baroness will withdraw her amendments. I beg to move.
Baroness Noakes: With respect, my Lords, it is for me to withdraw my amendment before the noble Lord moves his. I thank all noble Lords who have spoken in the debate. We are satisfied that the Government have tabled the amendment. I am sorry that he has not responded to the points that I have put before him in terms of greater specificity of what the review should cover. In my remarks, I fully accepted that paragraph (e) would allow a judgment to be made in the light of experience, as the Minister said. If that were all that were necessary it would be necessary only to put in paragraph (e) and the other matters are regarded as important. It is a pity that the Government do not believe that the matters I have raised in my Amendment 15 are as important.
I am glad also that the Government are happy for the report of whoever is commissioned to go straight through the commissioners to the Treasury and onwards to Parliament. It is not what the Act says, and it is a pity that the Government have phrased it that way. They have moved a long way and, as I said at the outset, we are grateful to the Government for tabling the amendment. It is a pity that they are not prepared to engage in improving it further, but I live in hope that there is a week before Third Reading and the Minister might wish to consider the matter further. I beg leave to withdraw the amendment.
Amendment 15 (to Amendment 14) withdrawn.
Amendments 16 to 18 not moved.
Clause 27 : Orders and regulations
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Lord Myners: My Lords, this amendment increases the parliamentary scrutiny of the use of the regulation-making powers provided by the Bill. As noble Lords may know, most of the Bill’s delegated powers will be subject to the affirmative procedure on their first use and the negative procedure on subsequent uses. That will allow appropriate parliamentary scrutiny of the scheme’s details that will be introduced, but also the flexibility to make minor or technical changes to the scheme. As the Bill stands there are four exceptions, where every use of a power will be subject to the affirmative procedure. These are the three delegated powers that relate to eligibility for the saving gateway and the power for regulations to set the match rate. The delegated powers relate to central features of the saving gateway and so it is right that any changes should be subject to full parliamentary scrutiny.
The noble Baroness, Lady Noakes, proposed in Grand Committee that several further powers should also be subject to the affirmative procedure. My noble friend Lord Davies and I agreed to consider the points carefully. As a result, the amendment would make a further three regulation-making powers subject to the affirmative procedure on each use, rather than just on their first use. They are the powers to set the monthly deposit limit, set the maturity period that we discussed earlier and finally to set the number of accounts that people can hold, either at the same time or in their lifetime.
Having considered the matter closely, I agree with the noble Baroness that changes in these areas could affect the cost of the saving gateway relatively significantly and that the affirmative procedure is appropriate. I hope that noble Lords will welcome the increased parliamentary scrutiny of the Bill’s powers. I beg to move.
Baroness Noakes: My Lords, the Minister said that I tabled amendments in Grand Committee to achieve the same effect as the amendment before the House today. I am grateful to him for taking on board the points that I made. I merely remark that this is a most agreeable way to conclude Report stage.
Coroners and Justice Bill
Bill Main Page
Copy of the Bill
Explanatory Notes
Amendments
7th Report from the Delegated Powers Committee
8th Report from the Joint Committee on Human Rights
Committee (2nd Day)
6.15 pm
Clause 7 : Whether jury required
Baroness Murphy: I rise to speak for the first time on the Bill. I was unable to be present at Second Reading, but I want to express my thanks to my noble friend Lord Patel for his generosity in incorporating my main points in his Second Reading speech.
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I turn to this group of amendments, in which I have two with slightly different implications. We come to address the rules that deal with when a coroner must call a jury. The amendments would ensure that all deaths in custody in state detention, including deaths of those detained under the Mental Health Act and those held under the Immigration Acts, were automatically investigated at an inquest held before a jury, including those where death is presumed to be of natural clauses.
I should declare at the outset an interest in this point as a psychiatrist and a former Mental Health Act commissioner who spent far too many months of my life on various inquiries into homicides, untoward incidents and quality-of-care examinations in special hospitals’ regional secure units and local psychiatric units.
It seems that the new legislation weakens the current position in some respects, where some inquests following deaths in custody are held before a jury, although not all in the case of detained patients. The jury is at the coroner’s discretion but is held where the death occurred,
- “in circumstances the continuation or possible recurrence of which is prejudicial to the health or safety of the public or any section of the public”,
a phrase that has encouraged a coroner to call a jury where there is a suspicion of contributory neglect. It is, however, still common for a coroner to decide not to call a jury in the case of the death of a detained patient.
It is worth reminding ourselves at this point that juries are convened in only about 4 per cent of coroners’ inquests and the amendments would not extend that percentage much. The new provision states that inquests into deaths occurring in detention and custody will take place only before juries where the death was violent or unnatural, where the cause of death is unknown, where a member of the police is involved and where the death was due to a notifiable accident, poisoning or disease, or otherwise where the senior coroner believes that there is sufficient reason for doing so. It is therefore possible that significant numbers of deaths that would previously have been investigated before a jury will not automatically receive the same scrutiny.
On the face of it, the provision seems sensible. It means that apparent deaths of natural causes of aged people with terminal illness or those who are otherwise expected to die within a short time will not be dealt with in this way. I hope to convince noble Lords that that should not be the case and that there are good reasons for having a jury when people are in closed, locked institutions.
My anxieties arise from a current case, which I will mention, and from working as a psychiatrist in the past in mental health units remote from district general hospitals—indeed, all special hospitals and regional secure units, and many psychiatric units are remote—where I and many other psychiatrists experienced difficulties in getting adequate physical healthcare for our patients. I have had experience of sitting on inquiries and also of the reports made voluntarily to the recently defunct Mental Health Act Commission of the deaths
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A current case I want to mention is that of Mrs Sandra Allen, a 61 year-old woman who was detained in a north London psychiatric hospital under Section 3 of the Mental Health Act for a recurrence of her manic depressive illness. She died of natural causes—a heart attack—in 2006. The inquest was held without a jury. The coroner ruled that she died of natural causes which were unavoidable, but her children are challenging the verdict because they believe that their mother’s death could have been avoided with better care. They claim that she was neglected.
The circumstances were as follows: Mrs Allen, who was 61, died from a heart attack after choking on a sandwich which she had been left to eat unattended. She had no dentures and a long history of choking, possibly as a result of medication she was taking. The staff were inexperienced in dealing with the situation; they were unable to clear her airways and did not know how to operate the oxygen canister which was provided on the ward. She was still choking when the ambulance arrived; it waited several minutes outside the unit because the security guard was asleep and the ward was locked. The ambulance staff simply did not get in to help her in time. Her family has argued that the coroner was wrong to reject its request for an inquiry before a jury, since it felt that much of the psychiatric and physical care she received was unacceptable and contributed to her untimely death.
I can remember another very similar case: a patient of mine needed urgent coronary angioplasty; he was difficult to manage but I believe he could have been cared for on a normal hospital ward with psychiatric advice. The cardiac surgeon procrastinated under circumstances in which any other patient would have been treated as a matter of urgency. The patient died of a heart attack within a couple of weeks. Again, the finding was of natural causes.
When I was a practising psychiatrist, I often had great difficulty getting adequate specialist consultant advice for patients. Mental health nursing staff were often inexperienced in dealing with physical conditions and reluctant to refer patients to a district general hospital because of the stigma and fear that the patients generate, sometimes with the best of intentions.
Matters have improved considerably, I believe, in special hospitals and regional secure units, but it seems to me to remain crucial that relatives of detained patients who die in state custody, even when it appears to be a completely natural and expected death, should be exposed to a manner of inquiry which gives the public the greatest confidence. I have often been struck by the distress, anxiety and suspicion that relatives have when what is apparently a natural death has not been fully exposed to scrutiny. If the sister of David Bennett—sometimes called Rocky Bennett—had not articulated very clearly before a jury the circumstances of his death in a regional secure unit, I doubt whether the conditions there would have been fully exposed.
Reports of the recently defunct Mental Health Act Commission have exposed the difficulties in obtaining adequate care in many units. There are approximately
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There is a race and culture dimension to the problem. Black patients currently make up 30 per cent of patients detained in high-security psychiatric hospitals, 40 per cent of those in medium-secure settings. The black population is at much higher risk of diabetes, stroke and cardiovascular disease, and at an earlier age. They therefore have difficult responses sometimes to some of the drugs that are given in psychiatric units. It is crucial, of course, that they have good access to care but that we do not misinterpret deaths of detained patients from natural causes as due to poor care if they have had the best care and advice. Services must not only be doing their best but be seen to be doing their best.
The Disability Rights Commission report, Equal Treatment: Closing the Gap, highlighted the profound differences in smoking-related disease and increased mortality of those with learning disabilities and serious mental health problems, an unpredicted doubling of the rate of bowel cancer in people with schizophrenia and the very poor access to healthcare by people with serious mental illnesses and learning disabilities. We need to pick up when care goes wrong in closed units if we are to improve awareness and support families who want to understand what happened to their relatives.
Finally, it is worth commenting on the sharp decline in the numbers of deaths of detained patients in psychiatric hospitals, probably not because of better care but simply because the age profile has changed dramatically, and older, long-term patients are now cared for in care homes and nursing homes. This means that the number of patients for whom an inquest with a jury would be required would be relatively small.
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