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Baroness Hayman: My Lords, we believe that unified budgets that allow health authorities and individual clinicians to look across the range of services and medicines that they provide is an important way to encourage local responsibility and flexibility. As my noble friend pointed out, spending more on drugs is not necessarily the best way forward. GP practices which have decided to adopt higher rates of generic prescribing while ensuring high quality services for patients would also make savings which, under the new arrangements, could be ploughed back into their services.
However, I do not think that I suggested that everything would be available to everyone immediately. It will take time to achieve what we seek. It will take time to build up a more equitable access to high quality services for all patients, but that is what we are determined to do.
Lord Dormand of Easington: My Lords, I welcome that promising reply from the Minister. Is my noble friend aware that there was recently great satisfaction among former miners at the decision to make generous compensation, as I understand it, to those suffering from vibration white finger? However, is he aware that it is estimated that about 100,000 former miners suffer from bronchitis, emphysema and related chest diseases? Has an estimate been made of the amount of money likely to be available for the payment which he mentions? Will he confirm that compensation has been agreed? That is the interpretation I place on the Answer. Will the Minister ensure that there is rapid payment, and that we do not repeat the disgraceful delay of the past few years?
Lord Sainsbury of Turville: My Lords, as I hope I made clear, a tariff has now been agreed with the plaintiffs' solicitors' group. Therefore, that part of the process is now agreed. We still have to deal with exactly how the claims are processed. However, we hope that
As regards the total amount of compensation, the figure will be in excess of £1 billion, and it is covered in the Comprehensive Spending Review. There was no figure when we came into government; no liabilities existed. We have a figure of over £1 billion in the Comprehensive Spending Review; and the Government are committed to making certain that the liabilities are covered.
Lord McNair: My Lords, will the Minister reassure the House that coalminers who suffer from emphysema and bronchitis resulting from silicosis due to the different geological characteristics of the mines where they worked will be treated in the same way as those suffering from pneumoconiosis?
Lord Sainsbury of Turville: My Lords, the settlement announced in January 1998 solely covered chronic bronchitis and emphysema. It does not cover pneumoconiosis; and silicosis, I understand, is also not covered, being more related to pneumoconiosis than chronic bronchitis and emphysema.
Lord Lofthouse of Pontefract: My Lords, I thank the Minister for his reply. In a debate on the issue in the House on 16th November, I drew the attention of your Lordships to the fact that if every miner who had made an application had to go for an individual medical it would take years for them to receive settlement. Bearing in mind that it has been calculated that 10 miners a week die of this dreaded disease, by the time they had all had individual examinations a considerable number would have died.
Will the Minister give further consideration to my suggestion in the previous debate? Could those who have had examinations and been awarded industrial injuries benefits based on those examinations be given immediate compensation without further examination, based on a percentage award of the industrial injuries benefit? That would prevent many of those men having to wait many years, and enable them to receive compensation before they died.
Lord Sainsbury of Turville: My Lords, I agree that one of the tragedies of the situation is that people are dying while the process is going on. But we have taken considerable action. We have already paid interim payments to those people who are receiving benefits under the industrial injuries disablement benefit for chronic bronchitis and emphysema. In those cases we know that they suffer from chronic bronchitis and emphysema and have worked underground for 20 years. Therefore we can make interim payments to them.
The people not covered are those suffering from pneumoconiosis. We do not know whether they are suffering from chronic bronchitis and emphysema. We brought forward the special process of the spirometry tests so that we can make interim payments to those people.
In many cases we shall also be able to make full and final payment once we know what the lung function tests show. In those cases we shall do so. But for full compensation in many cases we shall have to await the full medical assessment process. We are doing everything to bring forward that process.
Lord Campbell of Croy: My Lords, can the Minister assure us that every protection from the health hazards which have caused so much distress and suffering in the past is now being given to miners working in the pits?
Lord Sainsbury of Turville: My Lords, I can only assure the House that the regulations are being covered. It is no longer the responsibility of the Coal Board but of the individual operators to comply with the regulations.
Lord Carter: My Lords, at a convenient moment after 3.30 p.m. my noble friend Lady Symons of Vernham Dean will, with the leave of the House, repeat a Statement being made in another place on events in Uganda. The Statement is likely to be taken between the Report stage of the Road Traffic (NHS) Charges Bill and the Report stage of the Youth Justice and Criminal Evidence Bill.
Moved, That the Commons message of yesterday be now considered and that a Select Committee of eight Lords be appointed to join with the Committee appointed by the Commons, as the Joint Committee on Financial Services and Markets, to report on the consultative document on the draft financial services and markets Bill presented by Her Majesty's Command on 21st December 1998 and any further draft of the Bill which may be laid upon the Table of both Houses by a Minister of the Crown;
That the Committee shall report by 30th April 1999; and that the Committee do meet with the Committee appointed by the Commons this day at half-past four o'clock in Committee Room 3A.--(The Chairman of Committees.)
Lord Bruce of Donington: My Lords, will the noble Lord give the House some indication of the rights that Members of this House will have to attend this committee? What rights do they have to any papers which may properly be placed in their possession?
The Chairman of Committees: My Lords, Members of your Lordships' House will have the usual rights of attendance before this committee. That is to say, in its public hearings Members of your Lordships' House will have the right to attend. On the invitation of whoever is appointed as chairman of this committee--if your Lordships accept the Motion today--your Lordships will be entitled to attend deliberative sessions, but only with permission.