Roger John Liddle, having been created Baron Liddle, of Carlisle in the County of Cumbria, was introduced and took the oath, supported by Lord Rodgers of Quarry Bank and Lord Mandelson, and signed an undertaking to abide by the Code of Conduct.
John Selwyn Gummer, having been created Baron Deben, of Winston in the County of Suffolk, was introduced and took the oath, supported by Lord Chadlington and Lord Lloyd-Webber, and signed an undertaking to abide by the Code of Conduct
The Lord Speaker (Baroness Hayman): My Lords, I regret that I have to inform the House of the death of the noble Lord, Lord Quinton, on June 19th. On behalf of the House, I extend our condolences to the noble Lord's family and friends.
The Parliamentary Under-Secretary of State, Department of Health (Earl Howe): My Lords, it is for clinicians to decide on the suitability of treating a patient with photodynamic therapy-PDT. It is then for primary care trusts to consider whether to fund that treatment, taking into account the available evidence. The National Institute for Health and Clinical Excellence has issued interventional procedure guidance on photodynamic therapy for nine cancer indications, including oral cancer.
Baroness Gardner of Parkes: I thank the Minister for that reply. Does he agree with me that the most important thing, whatever the type of cancer, is early detection? Will he encourage the research that I hear is being done and which we read about in all the newspapers, which entails a very simple blood test that detects cancer at the earliest stage?
Earl Howe: My noble friend is absolutely correct. It is now generally agreed that the most important reasons for the lower survival rates in England compared with other European countries are: low public awareness of the signs and symptoms of cancer, delays in people presenting to their doctors, and patients having more advanced disease at the time of diagnosis. We are looking very carefully at how best to achieve earlier diagnosis. There are some key messages on the NHS Choices website and the national awareness and early diagnosis initiative has been under way since 2008. As for my noble friend's second question, on the blood test, the newspaper reports in recent days have been extremely exciting in terms of the potential. However, it is clear that researchers will have to demonstrate improved clinical outcomes for patients before any large-scale rollout can be applied.
Baroness Gould of Potternewton: My Lords, given the Minister's reply, does he agree that targeted screening remains the best way to prevent growth of oral cancer? Given the success of the previous Government in cutting the overall rates of cancer deaths, is he prepared to guarantee that the current investment and screening programme will continue?
Earl Howe: The noble Baroness is quite right that screening plays a very important part in the detection of cancer. However, it is not universally applicable to every cancer. In terms of oral cancer, which was the particular subject of my noble friend's Question, there are difficulties. For example, there is considerable uncertainty about how the disease progresses-its natural history-and we cannot predict which lesions will be malignant and which will not. We need clear guidelines-for dentists, for example-and we do not have those. There is also no clear evidence base for the management of malignant lesions when we find them. However, the National Screening Committee will review its position again in about three years' time and will no doubt take all the current evidence into account.
Lord Alderdice: My Lords, does my noble friend accept that when we are trying to improve treatments for cancer, we are looking for non-invasive approaches and specific and, so far as possible, less expensive approaches? Photodynamic therapy has been very useful not just for oral cancer but for skin cancers of various kinds, particularly squamous cell carcinoma. Does he accept that encouraging not just dermatologists but also general practitioners to move in this direction will mean that we can have specific, non-invasive and generally quite efficient treatment, and that that is to be encouraged by the Government?
Earl Howe: I am very grateful to my noble friend. It may help the House if I briefly explain what PDT is. It is a technique that uses laser or other light sources combined with a light-sensitive drug, which in combination
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Baroness Howarth of Breckland: My Lords, there is no doubt that, once patients are at the hospital, they are likely to get the treatment, but can the Minister assure us that GPs will be encouraged to make speedy referrals? In the cases that I know of, the difficulty has been in getting from the GP to the centre of excellence in order to get the treatment.
Earl Howe: The noble Baroness is quite right, which is why in the NHS there is such an emphasis on speed of referral when a GP first suspects that cancer may be present in a patient. This is an area to which we are very alive, and I hope that we will be able to make further announcements about it in due course.
Baroness Thornton: Does the Minister accept that new cancer treatments such as PDT have benefited both from crucial investment by the Government and from partnership with leading cancer research charities? Is he prepared to guarantee that this crucial research will continue to be funded by the Government so that more deaths from cancer can be prevented in the future?
Earl Howe: The noble Baroness is quite right. This is a partnership effort, and she may know that a systematic review of PDT has been undertaken as part of the Health Technology Assessment programme, which is an element of the National Institute for Health Research. The final report on that will be published in August, but the institute has already identified that there are not enough high-quality research studies in this area. We know from experts in the field that there are at least three or four areas where further research should be prioritised.
Baroness Deech: Is the Minister aware that this month is the 50th anniversary of the invention of the laser? At that time its use in medicine could not have been foreseen. Does he therefore accept how important it is to enable universities to continue to do research in this field, in the hope that there will be future inventions, and not to cut them back in this area?
Earl Howe: The noble Baroness makes a crucial point. I am sure she will agree that neither basic research nor translational research should be neglected when we look at the research effort. Indeed, my own department is looking carefully at how the barriers to clinical research can be reduced. Therefore, she is absolutely right to focus our attention on the importance of continuing research.
The Parliamentary Under-Secretary of State, Department for Environment, Food and Rural Affairs (Lord Henley): My Lords, on 1 June a wide-ranging public consultation on dangerous dogs laws closed. This consultation received 4,250 responses, which will need to be analysed before any action relating to dangerous dogs legislation is considered.
Lord Harris of Haringey: My Lords, given the explosion in the number of attack dogs in London, with the number seized by the Metropolitan Police-I declare an interest as a member of the Metropolitan Police Authority-rising 22-fold in five years and with the Met having to budget £10.5 million for kennelling costs alone, when can we expect the Government to complete this review of the legislation? What, in the shorter term, is going to be done to expedite the processes that can often mean that dogs have to be held for many months before a final decision can be taken by the courts on their disposal?
Lord Henley: My Lords, the noble Lord is right to draw attention to the growth in such attacks and in the number of people who have to seek hospital treatment as a result of attacks by dogs. The Dangerous Dogs Act 1991 is not the only piece of legislation available to local authorities and others dealing with those matters. There is the Dogs Act 1871, the Offences Against the Person Act 1861 and the Animal Welfare Act 2006. We will certainly consider carefully the consultation started by the previous Administration and make appropriate decisions afterwards.
Earl Cathcart: Is not one of the problems of the Dangerous Dogs Act the unintended consequences of listing four types of dangerous dogs? Thousands of responsible owners have had their pets destroyed not because of how they behave but because of how they look. Surely new legislation should concentrate on irresponsible dog owners rather than on only the breed.
Lord Henley: My Lords, we will certainly look at the problems of irresponsible owners, but there are certain advantages in breed-specific legislation. The police are of the view that without the restriction that that legislation gives, particularly on pit bulls, there would be many more serious dog attacks.
Lord Soulsby of Swaffham Prior: Does the Minister agree that many of the dangerous dogs are imported from overseas, especially from Europe? They are imported into Ireland initially, and from there go to Northern Ireland and then to the mainland. If the dogs were microchipped, as they are under the Pet Travel Scheme
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Lord Henley: My Lords, compulsory microchipping was considered in the consultation. I do not think that it would necessarily solve all the problems because those who possess such dogs might not bother to get them microchipped and they would still be in breach of the law. The evidence from abroad is that where there is compulsory microchipping only 50 per cent of the dogs are microchipped.
Lord Corbett of Castle Vale: My Lords, can the Minister confirm that one of the problems facing the police in dealing with dogs which they suspect to be pit bulls is the pit-bull-type dog? It can take many months for the police to establish exactly the breed or the type of dog and at enormous cost to public funds. Some of the dogs' homes are considering refusing to take these dogs because of the time taken and the cost to the charities. Is that part of the consultation?
Lord Henley: My Lords, there have been problems with dogs being kept in kennels for rather a long time as a result of the legal processes. We will certainly want to talk to colleagues in the Ministry of Justice about whether the legal processes can be speeded up so that the dogs need not be kept in kennels for so long. We have heard from the Metropolitan Police in particular that the costs are very high and rising.
Lord Elton: My Lords, what action is available to the courts for disposal of dangerous dogs and prohibited breeds? While the owners await decisions of the court, is it the case that a number of the dogs disappear?
Lord Henley: My Lords, I am not aware that any have disappeared from kennels while waiting for the court's decision. If my noble friend has any evidence of that, we would be grateful if he would pass it on to us. The Dangerous Dogs Act deals not only with specific breeds but, under Section 3, allows action against a dog of any type or breed if it is deemed to be behaving dangerously.
Lord Henley: My Lords, as regards timing, I do not think that I can help the noble Baroness much more than by saying that we will do that as soon as is possible-we have all said that before-but we will certainly publish the results of our consultation when we make the appropriate decisions about how we should respond to it.
Lord Addington: My Lords, has the noble Lord considered that resources and the number of people trained to deal with the Act might be one of the most important factors in whether this or any other piece of legislation works?
Lord Henley: My Lords, Defra offers guidance to police forces, and all police forces have to have a designated dog legislation officer who knows what the law is and how it can be used to best effect. We certainly assist in providing training for those dog legislation officers, so that local authorities can enforce the law in the most appropriate manner.
To ask Her Majesty's Government whether they intend to exercise the power conferred by section 58(4)(a) of the Courts and Legal Services Act 1990 to reduce the maximum success fee chargeable under a conditional fee agreement in defamation proceedings.
The Minister of State, Ministry of Justice (Lord McNally): The Government are currently considering the recommendations from Lord Justice Jackson's report, Review of Civil Litigation Costs, published in January 2010.The Government's analysis of Sir Rupert's recommendations, once completed, will determine the next steps on the success fee in defamation proceedings.
Lord Lester of Herne Hill: My Lords, first, I pay tribute to the noble Lord, Lord Bach, and the right honourable Jack Straw, who began to focus on the abuses created by conditional fee agreements with 100 per cent success fees. I urge the Minister and his colleagues not to wait for consideration of the vast Jackson report before taking urgent action to deal with what I think is a scandal, where some fellow members of my profession charge inordinate fees through the conditional fee agreement so that the costs far outweigh any damages that NGOs, individuals or the press may have to pay. That is a very urgent matter.
Lord McNally: My Lords, we recognise the sense of urgency, but also the complexity of the issue. As my noble friend will know, the proposals made by the previous Government ran into trouble at the other end of the building. We are looking at the Jackson report and we will treat the matter with the urgency that my noble friend said that it deserves.
Lord Bach: My Lords, the Minister knows that on 25 March last, this House agreed the statutory instrument that would have given effect to the intention of his noble friend Lord Lester. Will he please use his undoubted
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Lord McNally:I can give assurances that we will treat the matter with all due seriousness. Whether we will follow the same path as the previous Administration is more questionable. As the noble Lord will know, Lord Justice Jackson has made a different recommendation about how to deal with this problem. We will weigh up what he has argued in his report and consider the debate in this House and other views on what the previous Administration was proposing to do.
Lord Pannick: My Lords, can the Minister confirm that a very large proportion of success fees are paid in defamation cases brought by claimants who are sufficiently wealthy themselves to pay a proper professional fee for their action? Therefore, success fees make no contribution whatsoever to proper access to justice. In asking that question, I declare an interest as I act for Mirror Group Newspapers, which is bringing proceedings in the European Court of Human Rights relating to success fees in the case of Naomi Campbell and her privacy complaint.
Lord McNally: Having spent some years treading the line between public relations clients and what I could say in the House, I am always very envious of how my learned friends manage to tread that line so well. This defamation area produces great scandals, and I think that the balance of Lord Justice Jackson's report will point us in the direction of urgent action. I pay tribute to the noble Lord, Lord Lester, who has made available to my department his not inconsiderable research and preparation for a Defamation Bill, which will, I hope, enable us to move forward very quickly on this. I do not think I will say any more about the Mirror Group case.
Lord Bates: Can the Minister confirm whether this change in success fees would apply to cases heard in the High Court? If so, is he aware of a ruling in the High Court this morning that the decision of the previous Government to impose unitary authorities on Norwich and Exeter was unlawful? Given that this is a victory for common sense, will he ensure that there is no maximum in the success fee available to counsel?
Lord McNally: I thank the noble Lord for bringing me up to date on that saga. I think there should be a limit on success fees or, as the noble Lord, Lord Pannick, suggested, that the success fee should be borne by the successful claimant.
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