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Grand Committee
Arrangement of Business
(Baroness Stedman-Scott) (Con)
Good afternoon. If there is a Division in the House, the Committee will adjourn for 10 minutes.
Enterprise and Regulatory Reform Act 2013 (Consequential Amendments) (Bankruptcy) and the Small Business, Enterprise and Employment Act 2015 (Consequential Amendments) Regulations 2016
Motion to Consider
That the Grand Committee do consider the Enterprise and Regulatory Reform Act 2013 (Consequential Amendments) (Bankruptcy) and the Small Business, Enterprise and Employment Act 2015 (Consequential Amendments) Regulations 2016.
The Parliamentary Under-Secretary of State, Department for Business, Innovation and Skills and Department for Culture, Media and Sport
(Baroness Neville-Rolfe) (Con)
My Lords, these regulations make necessary changes to primary and secondary legislation as a result of introducing a new process for how a person applies for bankruptcy and changes made to the requirements for reporting on the conduct of directors of insolvent companies.
Currently, when an individual wishes to take the option of making themselves bankrupt, they must complete a paper petition and present it to their local court. From 6 April this year, if we are content with the regulations today, instead of going to court, individuals will be able to apply online via the central government website GOV.UK. We recognise that applying for bankruptcy is a big step and one which should be contemplated only when no other options are appropriate, but the new digital process offers significant advantages. It will be easier and cheaper to access than the current court-based system, and will remove the stigma that some individuals associate with going to court.
Applications for bankruptcy by individuals in financial difficulty will be determined by the Adjudicator—a new post within the Insolvency Service. Once the order has been made, the case will transfer to the Official Receiver in the same way as it does now for administration and, if appropriate, investigation. The process for creditors wishing to make individuals bankrupt will not change, as the courts have an important role where there may be disagreement between parties about amounts owed.
Some people have expressed concern that the new system does not provide for remission of the application fee, which the courts were able to do, or an alternative to online application. Administration costs around fee remissions are disproportionate and any reduction in fees for some applicants would result in higher fees for others. The new system does provide that the application fee—£130, which is a reduction on the old fee of £180 —can be paid in instalments, which will help those on low incomes. People who do not have access to a computer are able to use those in local libraries or can get help from a friend or relative, or a debt advice organisation such as Citizens Advice.
Taking the courts out of the bankruptcy process will deliver cost savings in the form of reduced staff, administration and court time. The impact assessment for these measures was published in 2012 and estimated that the savings would be between £8.1 million and £16.6 million a year, depending on the number of debtor petitions. In fact, the number of people petitioning for their own bankruptcy has steadily declined since 2012, and, based on the figures for 2015, it is now likely that savings will be in the region of £6.3 million rather than the £8.1 million that I mentioned. The benefit to business is not material; the main savings we are seeing are in administration and court costs.
The second matter dealt with in these regulations is the issue of reporting on a director's conduct. When a company goes into insolvency, the officeholder appointed as liquidator or administrator is required to report to the Secretary of State on the conduct of its directors. Reports that indicate misconduct on the part of a director are investigated by the Insolvency Service and may lead to disqualification proceedings. Currently, officeholders must submit their report within six months of the insolvency. From 6 April that period will be shortened to three months as part of a package of measures in the Small Business, Enterprise and Employment Act 2015 that strengthen the director disqualification regime.
In addition, we are introducing a new process for how officeholders complete and submit their report. In common with the new bankruptcy process, we are replacing the current paper-based forms with a digital system that allows officeholders to complete and submit their report electronically and upload new information as soon as it comes to their attention. If for any reason the online system becomes unable to receive information for more than a week, the Insolvency Service will be required to provide an alternative means for officeholders to submit their reports.
In both cases, therefore, we are adjusting to the digital age.
Removing forms and moving to an online reporting system means that the changes being introduced are deregulatory measures, delivering a net benefit to insolvency practitioners of £3.4 million a year—savings to business that should result in more money being available to creditors. The regulations we are considering today ensure that the relevant references across the statute book are amended in consequence of the changes being introduced. I commend these draft regulations to the Committee.
Lord Stevenson of Balmacara
My Lords, I am grateful to the Minister for her extensive introduction to what is quite a narrow SI. It has a good history. I recall the debates that led up to the changes and also the paperwork that was provided at that time. I think that I recall correctly that this measure was welcomed by the industry when it was proposed. The consultation revealed that those involved were pleased by the direction in which the policy was going. The only significant issue was the pressure to go electronic, which came late in the process and was requested by the industry itself. I understand from my consultations with people from the industry that they are very pleased that the regulations have come out the way they have.
This is a good-news story—possibly so good that there is very little that I want to say about it, except simply to say that it was a game of considerable pleasure to read the very small amendments to the wording that had to be looked at if one was to do justice to the scrutiny that we are supposed to have in this House. Small words were changed that made a difference to the process: an individual has to be "adjudged" bankrupt as opposed to being "made" bankrupt. It was an exercise of great skill that I enjoyed processing.
However—there is always a "however", is there not?—I of course noticed the change that led to the amendment to the draft statutory instrument that was inserted into the copy that I have. I slightly extend the point; I did not notice it, but I was very pleased to receive it. However, I cannot make sense of it, so could the Minister make clear to me what I am supposed to read into page 5, Schedule 1, paragraph 14(1), line 2? I could read that the first change, which is in the original, is in the earlier corrections and is obviously correct, because it should read:
"Paragraph 9 … to Schedule 6 (freezing orders in respect of property liable to forfeiture)".
I am not sure about the change of "of" to "to" in the second line, because it seems to me that that paragraph needs to relate to a primary piece of legislation, which presumably is the International Criminal Court Act. If there is not time to be briefed in the short period of time that I am giving the Minister, I would be very happy to receive a Keeling schedule that clearly indicates what we are supposed to read into that.
That is really all that I had to say. I notice that there is no impact statement because of the assertion that there no impact at all on business from this. It says, in fact, that there is no impact on business, charities or voluntary bodies. I find that slightly difficult to believe because, presumably, the impact of insolvency always has a third-party engagement. But I understand the spirit in which this was made—which is, as the Minister said, that this is relatively small in the great scheme of things. It does not come to much, and, as insolvencies reduce, it will get even less. With that, I am happy to support this.
My Lords, I thank the noble Lord for agreeing that this is a good news story. It is always nice to put through this House legislation that helps to move things forward. As he says, we have changed the reference to paragraph 9 "to" the Schedule to the Act to "of" the Schedule to the Act. I understand that this reflects the conventions of writing these kinds of SIs. I am reading a book about Cicero at the moment and I am afraid that this point seems rather arcane, but that is the correct convention, which is why we have made the change.
If Cicero had been involved, I think that the noble Baroness's speech would have been about 17 times longer. He was not short on words. Quite honestly, I do not look for a response today. If in one of her excellent letters the Minister could write out what it is expected to mean, I would be very happy to receive that.
I would be delighted to do that. These arcane points of parliamentary drafting are an improvement. Actually, I would like to defend Cicero: he was a great orator. I agree that he tended to speak at length, but some of the phrases that he coined are probably still influencing our language and our oratory, even in this House today. The Committee seems happy and I commend the draft regulations.
Motion agreed.
Conduct of Employment Agencies and Employment Businesses (Amendment) Regulations 2016
That the Grand Committee do consider the Conduct of Employment Agencies and Employment Businesses (Amendment) Regulations 2016.
My Lords, our manifesto promised to help businesses to create 2 million new jobs over this Parliament. To meet this, we need a strong and efficient labour market that gives people opportunities to find jobs that are right for them and allows employers to access the right type of labour that matches the skills that they need. We need to make sure that it is fair and that workers in Great Britain have the same access to job opportunities as those elsewhere. The recruitment sector plays an important role in the labour market by matching demand for jobs to demand for workers. According to the Office for National Statistics in 2014, there were around 19,400 employment agencies and employment businesses within the recruitment sector.
The sector is regulated by the Employment Agencies Act 1973 and the Conduct Regulations. Last year the Government consulted on a package of measures—building on the previous consultation during the coalition Government—to remove a number of the business-to-business regulations, and at the same time to strengthen the existing legislation that prevents employment agencies and businesses from advertising jobs in other EEA countries without advertising them in Great Britain and in English.
It is important that we reduce the regulatory burden on employment businesses and employment agencies as far as possible, while increasing the opportunities for workers in Britain to apply for jobs that are based in Britain. However, we also need to balance the need to reduce the burden on business with maintaining all the fundamental protections for agency workers that these regulations ensure. None of these regulatory changes undermines worker protections. We are not changing any regulations that entitle them to be paid for all the hours they work, and they will still be protected from being charged fees for work-finding services.
Regulation 9 of the Conduct Regulations currently prevents employment agencies and employment businesses from claiming to be acting on one basis to the work seeker while stating something different to the hirer. We are removing this provision as there is little evidence that it serves a useful purpose. We do not need free-standing regulation to underpin a standard that would be enforceable to some extent through contract law—or, in cases of fraud, through the general criminal law.
Regulation 11 ensures that agencies and businesses cannot enter into a contract with a hirer on behalf of a worker, and vice versa. It currently applies to all employment agencies and employment businesses but is relevant mainly to those operating in the entertainment and modelling sector. We are removing this regulation as we consider that there are sufficient protections elsewhere in the provisions specifically relating to those sectors.
Regulation 17 currently requires employment businesses to obtain agreement to terms with hirers. While it is important for employment businesses to agree terms with hirers, we believe that this already happens in practice and it is not for the Government to prescribe the terms of any business contract. Failure to do so should not be subject to a criminal penalty, as is the case currently. We therefore propose to remove this regulation.
Regulation 23(1) covers situations where more than one agency or employment business is involved in the supply of a work seeker. We propose to remove the provision that requires agencies and businesses to make checks on one another. Where employment agencies or businesses are involved in this kind of arrangement, we are also proposing to remove the requirement that they agree the capacity in which they are acting. We also propose to amend Schedule 4 to remove the requirement to include certain particulars in records kept by employment agencies and businesses relating to work seekers. These records will no longer need to include the date the application was received, details of any requirements specified by the work seeker in relation to taking up employment, and the date the application was withdrawn or the contract terminated.
The final deregulatory measure we propose is to amend Schedule 5 and remove Schedule 6 of the regulations to reduce the regulatory burden in relation to record keeping. These are the requirements to include certain particulars in records kept by agencies and businesses relating to the hirer. These records will no longer need to be as comprehensive and the removal of this requirement will have no detrimental effect on work seekers. The amendments proposed to Schedules 4 and 5, and the removal of Schedule 6, will reduce the burden of unnecessary record keeping on agencies and businesses, while having no detrimental impact on the protection of workers.
We are also proposing to extend the current Regulation 27A, which prevents employment agencies and businesses from advertising specific vacancies for a job based in Great Britain in other EEA countries without advertising it in Great Britain, and in English, either before or at the same time. We propose to extend the regulation so that it will apply to generic recruitment campaigns carried out by employment agencies and businesses. This will close a loophole that currently exists and increase the opportunities for workers in Britain to apply for all jobs that are based in Great Britain. We are not proposing to stop agencies recruiting from overseas or in additional languages.
This package of measures will both reduce the burden on business and increase job opportunities for workers in Great Britain. I hope that noble Lords will feel able to support the regulations.
My Lords, I am, again, very grateful to the Minister for introducing this statutory instrument and for giving us such a full context in which it is operating. I have slightly more trouble with this one than I had with the last one, in three regards. The first is just to check that I am not missing something. The problem said to be under consideration appears in the helpful Explanatory Memorandum which is attached to the impact assessment. It states:
"The United Kingdom has one of the most lightly-regulated labour markets in the developed world for permanent employees. It is also the third least regulated labour market after Canada and the US in terms of temporary contracts".
That seems to be quite a good situation, but we read further down:
"The Employment Agencies Act 1973 sought to ensure that there was a consistent approach across Great Britain".
It gives the reasons for that—there were, I think, a number of scandals at the time and it is good that the Government of the day decided to legislate in this way. It goes on:
"Since then there have been many amendments to the legislation, which has resulted in a very complex set of regulations which place a burden on business, and are not fit for purpose in the UK's modern labour market".
The Government cannot have it both ways: it is either one of the most lightly-regulated labour markets in the developed world or it is a very complex set of regulations which place a burden on business and are not fit for purpose. I am not accusing the Minister in any sense of bad faith—I am sure she spoke absolutely from the heart about what she was trying to do—but perhaps she will reflect after this on the bombastic nature of the briefing with we have been provided, because I do not think that it stacks up.
My second point is an exemplification of that. I stray here into politics, which I know is almost a forbidden thing to do here. But we are told in paragraph 7.1 of the Explanatory Memorandum, headed "Policy background"—a very helpful innovation—that the reason we are amending Regulation 27A of the Conduct Regulations 2003 is that,
"there was a specific commitment from the Prime Minister during his speech on immigration on 21 May 2015 that the Government would make it illegal for employment agencies to recruit solely from abroad without advertising those jobs in Britain and in English".
That sounds good—it must have been a wonderful soundbite to have prepared, ready to be picked up by the papers at the time. As we read on, the truth is that existing Regulation 27A goes some way towards resolving the problem that the Prime Minister identified, since it is already illegal to advertise specific—not generic—vacancies in other EEA countries without also advertising them in English in the UK.
Again, I do not wish to make a major point, because presumably some people will benefit from the fact that a generic advertisement placed not in English in Lithuania will now have to be placed in English in the UK. I do not want to demean that in any way but, again, I wonder about the tone being adopted here. It did not need to be quite as bombastic as it is. I am sure that the gap has been filled and that is a good thing.
My third point is a very trivial one but I would like an explanation. On the question of implementation and review—my favourite topic—the noble Baroness will be aware that I have an interest in common commencement dates. I was doing all right on this one until I got down to Regulation 1(2), which says:
"These Regulations come into force on … 6th April 2016".
I like that. It is one of the two common commencement dates for reducing the burden on business. However, it goes on to say that,
"if later, at the end of the period of 21 days beginning with the day on which they are made".
You cannot have it both ways. It is either a common commencement date or it is not. As we seem to be ahead of 6 April, can I have confirmation from the Minister that we are talking about 6 April and that the conditional phrasing was just a cover in case something went wrong in the great process that we are going through.
Finally, I notice that the review period is covered in the sense that there seems to be a series of reviews stemming from the 2003 regulations, which are said to be in Parliament every five years. The Explanatory Memorandum does not seem to imply that there will be any other reviews going forward. The provision of the existing regulations seems to be for one review and one review only. I just want clarification about the date. It may well be otiose to have a periodic five-year review, but I think that we should be clear whether there is to be a review—and, if so, whether it is a single review after five years or a periodic review.
I thank the noble Lord for his extremely intelligent questioning of this proposal. I agree that there is a dichotomy. The regulations are quite complex, and we are seeking to change them so that they are deregulatory. I tried to take the noble Lord through paragraph by paragraph because I felt that that was useful to the Committee. At the same time, I think that the memorandum is correct to say that the UK is more lightly regulated in respect of the labour market than other EU member states. So I do not think that the things are contradictory, although I can see that there is the potential for confusion there.
The regulations will come into force 21 days after the beginning of the day they are made. Unfortunately, it is not a common commencement date. Like the noble Lord, I am always asking the department to put things on a common commencement date. Obviously, given the timing, the common commencement date would have to move to October because I do not think that things can be done in time. Therefore, we are commencing the regulations 21 days after they are made, and I will make them tomorrow or the next day. Perhaps I should write to the noble Lord with more information about the conventions. Spiritually, I am with him—I think that common commencement dates are extremely helpful. We have tried to get one here but the timing has overtaken us.
I do not wish to pressure the noble Baroness in any way whatever, but we have previously had insolvency regulations which are quite clearly coming into effect on 6 April—no buts, no buttons, no relationship, no 21 days here, there or everywhere. They are coming in on 6 April.
I think that this has caused some confusion in our ranks. I will look into it, but I hope that the Committee will agree that these regulations should come in as soon as we can manage it. They are deregulatory, and I would like to pass them today. So I crave the indulgence of the Committee on this matter, but I will certainly look across the board at the phrasing of commencement dates in future. We always need to learn from feedback, and the noble Lord, as so often, makes a very good point.
I obviously did not explain the point about recruitment agencies adequately. The change we are making is on generic recruitment, which is not covered by the existing regulations. So we are essentially closing a loophole in the existing system of regulation, which currently just covers adverts for specific jobs—for example, an advert for a carpenter in Luton—but it does not cover generic recruitment. It should of course, so we are seeking to make that change.
In no sense do I wish to delay things, but my point was not that the change in itself is not a good thing—it is a good thing, and the loophole should be closed—but that the bombast had rather got ahead of the action.
We will watch our bombast for the future. Finally, the noble Lord knows that I feel the same way as him about the importance of periodic review. I will look at how the review clauses of relevant legislation interplay, and in coming back to him I will explain what our intentions are. With those reassurances, I commend the regulations to the Committee.
Environmental Permitting (England and Wales) (Amendment) (No. 2) Regulations 2016
Lord Gardiner of Kimble
That the Grand Committee do consider the Environmental Permitting (England and Wales) (Amendment) (No. 2) Regulations 2016.
My Lords, I am pleased to introduce these regulations, which replace the existing flood defence consents scheme with a new scheme under the environmental permitting framework. This debate follows one in the other place and one in the Welsh Assembly earlier this month.
Certain activities in or near watercourses or sea defences can increase flood risk. The Water Resources Act 1991 requires people to seek prior consent before they start such activities on main rivers, to make sure that they are not undertaken in a way that increases flood risk. Main rivers are designated as such due to their higher flood risk, and about 20% of watercourses in England and Wales are designated as main rivers.
The devastating floods we saw this winter demonstrate how important it is that people do not unwittingly increase flood risk to themselves or to others. With no regulation, activities might block or restrict watercourses or the effective operation of the flood plain, leading to flooding of other property that might not have happened otherwise. Equally, flood defence structures might be damaged with the same effect.
Under the current scheme, everyone must submit an individual, detailed application for a bespoke consent whether their proposed activity on a main river has a high or low risk of increasing the risk of flooding. The new flood risk activity permitting scheme introduced by these regulations uses the framework of the environmental permitting regulations to reduce the administrative burdens of applying for a permit. A public consultation on these proposals was held from December 2014 to February 2015, and the proposals were broadly supported. We made a number of improvements as a result of comments made: for example, to include conditions to protect priority river habitats.
The new scheme uses a risk-based and proportionate approach to permitting activities. We will, of course, continue to ensure that flood risk is not increased. High-risk activities will continue to be closely controlled, but activities that cause no increased flood risk to others can be removed from superfluous close scrutiny. As a result, half of all permits that are issued under the current scheme will be eligible for a simpler permit or could be exempt from the need for an application. Under the new scheme the Environment Agency and Natural Resources Wales have used their experience under the current scheme to categorise activities on main rivers into four bands.
Bespoke permits will be written specifically for activities which are unique or of higher risk. Half the current consents will need a bespoke permit under the new scheme. For example, building a new weir for a hydropower scheme or changing the course of a river will require a bespoke permit. Activities needing bespoke permits will be subject to the same close assessment of potential impacts as under the current scheme.
Some 20% of applications will qualify for standard rules permits. These permits are for low-risk activities. Standard requirements and conditions are set out so that applicants can see in advance whether the permit is applicable to their proposals. Standard rules permits are quickly applied for and issued. They are available, for example, for repairing and protecting up to 20 metres of riverbank or for up to 20 metres of temporary scaffolding.
Lower-risk activities are exempt from needing a permit. For these activities the person needs only to register and then follow the conditions set out in these regulations. Some 27 activities have been defined for exemptions; including, for example, putting electric cables under the watercourse and dredging up to 1.5 kilometres. The dredging exemption allows land managers to remove silt from just under a mile of man-made ditches, land drains, agricultural drains and previously straightened watercourses in England. This exemption will make it easier for landowners and others to drain their land and to maintain the flow of water in low-lying areas—an important contribution to lowering local flood risk. We have been engaged with the National Farmers' Union throughout this process, and have been alerting both national and local stakeholder groups to the new scheme.
The lowest-risk activities are identified as exclusions. So long as people are able to follow the conditions laid down in these regulations, they are able to undertake the activity without any permit or registration. An example of an exclusion is the laying of electrical cables under an existing structure, such as a bridge. Some 30% of current applications will be eligible for an exemption or exclusion. In many situations people will be able to change the way in which they do the work so that they will be able to move from needing a bespoke permit to a standard rules permit or even an exemption or exclusion.
Regulators will be able to issue a single permit for ongoing activities that could typically last up to five years: for example, maintenance of flood defences or other structures. Currently, a separate consent is required each time work is proposed or for a series of structures on a watercourse. People will also be able to apply for a single permit that covers multiple activities on one site, such as a farm.
Another key benefit of using the environmental permitting framework is that applicants will need to make only one application to cover a number of different schemes. They will save the time and cost of putting together the necessary information for an application.
The Government intend to review these regulations in 2019 as part of a more general review into the environmental permitting regulations. In the mean time, we will keep the activities permitted under exemptions, exclusions and standard rules permits under review to make sure that we have the right balance between removing red tape and protecting people and property from flooding.
These are proportionate and important regulations and I commend them to your Lordships.
My Lords, I thank the Minister very much for his introduction. He will know, and has just described, how particularly sensitive the issue of activities on or near watercourses is at the current time, given our recent history of flooding disasters. In particular, we are becoming much more aware of how seemingly small changes upstream can have a cumulative effect further downstream. There is a danger that the impact of relatively small activities is not necessarily contained within a localised area. This has been acknowledged in our trend and that of the department of talking about river flows within a whole catchment area, but we also still have a great deal more to learn about how water flows and the detail of flood management. I think that we are all on a steep learning curve with regard to that. Similarly, I think that it has been acknowledged by the Environment Agency that it has to rethink where its interventions can be most effective.
I can of course see the sense in simplifying the environmental permitting framework, in terms of its paperwork and in the way that the Minister described of not having to make multiple applications for what is effectively one task. But can we be assured that the new emphasis on permits concentrating on larger projects—we have talked about larger risks on or near rivers—will not curtail the Environment Agency's scope for having a more holistic approach to river management? I am taking into account particularly how a number of small interventions might interact as the river flows on.
As has been said, the proposals claim to put greater focus on risk-based management of watercourses. Do we have the scientific understanding to know what the risks really are, and therefore what practices should be acceptable or unacceptable? It seems that we are in the middle of a rethink on all these issues, so what will be the process of deciding what is high or low risk? Will that judgment be made ultimately by an individual at the Environment Agency?
Can the Minister also reassure me that these proposals are not driven simply by the need for the Environment Agency to make efficiency savings? The truth is that many communities are reassured by seeing that agency's officers on the ground, working alongside them and often actively anticipating and responding to problems large and small. Can we be reassured that the new risk assessment process that he described will not leave some smaller communities having to face localised problems on their own? Where will the ongoing support be for those small communities?
I also want to ask about the communication process because, while I fully acknowledge that the current permit system is probably far too complex, it seems to have the advantage of alerting a wider group of people that river activity is planned in their area. If there is to be a simplified application process, can we be assured that all those bodies that have been notified in the past and will have an interest in the planned activity will still be made aware of it before the actual activity commences? I am thinking in particular of local authorities and highways authorities, which might have a view on what is proposed.
On the issue of communication, can the Minister clarify how individual householders who may be affected by localised river activity—for example, dredging or bank clearing—will be made aware of this? Such activity could have an impact on their property even if there is no wider flood risk. How will the new permit regime be publicised? How will individuals find out what is being proposed?
Finally, it feels as though we are making changes—the Minister has referred to this—to what might prove to be a rather outdated approach to the whole environmental permit regime. The Cabinet Office review of the flood defence strategy is taking place at the moment and, as I said, the Environment Agency is also looking again at its strategy. The Minister said that there would be a review in 2019. I very much welcome that because it seems to me that, somewhere down the line, we need to look again at taking a more holistic approach to this and at whether the environmental permit scheme that we have is the right way to go about it. Obviously I realise that the review will take some time to be reflected on and worked through, and it may be that the reviews that are taking place are looking at that anyway. It is important that local communities have faith that their interests will be protected in the most effective ways. I look forward to hearing the Minister's response.
My Lords, I thank my noble friend for introducing these regulations this afternoon, which will, I think, make life easier for those having to cope with flooding. I have just a couple of issues. First, in the recent flooding of this past year—for example, up in Pickering in Yorkshire—temporary logs were put in to stem the rapid flow of water down the river. Presumably, that did not need any approval—but, if it did, how quickly was that gained? These things can happen very quickly and I am not quite sure how immediate the response to something like that would be. It was a very good initiative and it worked wonders for them. That is just one practical query.
Secondly, of the 53 responses that the Minister had, 74% supported the proposals and, as a result, further discussions took place, for which I am very grateful. He mentioned that they had discussions with the NFU —here I should declare that I am a member. But are there any outstanding issues that could not be included but that the Government wish to think about further? Was there just a small handful of queries or have they managed to resolve all those that were raised?
From my point of view, I welcome anything that eases regulation, providing that the regulations that are in place work. I gather that this will be cost-effective as well, so I welcome the regulations. It is just a matter of making sure that whatever we do is an improvement on the river flow as well as protecting the wildlife and habitats that surround the river. One of the examples given was the whole question of having to put up fencing to keep cattle off at certain times.
I thank the Minister for introducing the regulations, and my query was only a very small one. But sometimes things happen very quickly, and I am not sure whether that is covered by these regulations or where that authority would have to go to get permission to do what it did.
My Lords, following on from the excellent questions from my colleagues in the Room, I want to ask the Minister for a little more clarification on the point mentioned by the noble Baroness, Lady Jones of Whitchurch, about review. Like my colleagues, I am not opposed to these regulations, but we need to make sure that they work.
The Minister referred to a general review of the environmental permitting regulations in 2019. Is he prepared at this stage to say a little more about what the purpose of that general review at that time is? I think it is quite important, given that there has been a lot of discussion over recent years about cutting back on red tape, that we see not only what the purpose of that is but how reviewing these regulations fits into that.
As a supplementary to that, the Minister mentioned that, in the mean time, before that 2019 review takes place, these regulations will be kept under review. I wonder if he would be prepared to say what exactly that review's form will be—what monitoring would be undertaken, and what resources would be available—given that, as mentioned by the noble Baroness, Lady Jones, there have been some issues relating to funding for both the Environment Agency and Defra in recent years. So the Liberal Democrats are not unhappy with this approach, but it is a new approach and it needs to be reviewed—and we need the resources to ensure that that will happen.
My Lords, I am most grateful for those remarks, and I am also grateful that there is a general understanding of the purpose of what we want to do. We feel that there are a variety of activities, so it would not be proportionate to have the same sort of approach to permitting for everything; it would be much better if we could direct resources in a more targeted way.
I do not think that anyone can quite comprehend—I certainly cannot—what it was like to have withstood the sort of flooding that we saw in Cumbria, Yorkshire, parts of Durham and Lancashire over the winter. The level of rainfall and the conditions were devastating. Nothing involved in this work here is in any way seeking to shortcut anything that we must do to ensure that we are as well prepared as we can possibly be in this country for those sorts of extreme weather events—or the change in weather patterns or climate change, whatever we want to call it. I assure the noble Baroness, Lady Jones of Whitchurch, who referred to the reports and ongoing work, that nothing in this piece of work is intended to do anything other than work through sensible permitting arrangements for a range of activities, which I hope are utterly common-sensical and could not possibly increase flood risk. None of us is in the business of doing anything other than reducing and managing flood risk for people. That is absolutely right, because we are all thinking about the holistic basis on which river flow is managed in the whole catchment area of rivers.
The noble Baroness, Lady Jones, asked how the two regulators will be able to manage river flows on a holistic basis. For instance, the dredging exemption, which has been designed to be used in specific areas, is not about suddenly enabling dredging everywhere: it is about specific areas and for specific purposes. It is framed to deal with any cumulative effects, so it is certainly not, in any way, going to help increase flood risk downstream: quite the reverse. The exemption is limited to the removal of accumulated silt and sand, and expressly prevents the removal of natural gravel or the deepening or widening of the watercourse. Those of us who understand a bit about ditches and drainage know that there are low-lying areas where ditches in good heart prevent flooding, rather than accumulate it further down the river course. It is specifically designed for that sort of work.
Indeed, the noble Baroness rightly asked about how best these matters could be assessed. It is fair to say, and it is the truth, that the public service often gets brickbats and you have to have the hide of a rhinoceros. But the truth is that the people who work for the Environment Agency and Natural Resources Wales have around four decades of technical and practical experience of assessing the risks of proposed activities in or near watercourses. Their cumulative knowledge is very considerable indeed.
I am very conscious of the way that we look at river courses in the whole catchment area but, having met many Environment Agency staff, I know that they have a very strong local knowledge and interest in how best to manage those watercourses. Over this time, they have advised applicants on how to undertake activities to reduce or remove the risks. I shall say more about resources, but I am confident that on the technical side of those parts of the public service, there are people with immense knowledge.
As I set out in my opening remarks, the Environment Agency and Natural Resources Wales have used this experience to categorise activities on main rivers into higher and lower risk, and thus into the four bands. Removing the lowest-risk activities from the need for a permit enables the two regulators to concentrate their efforts on considering applications for standard rules permits and bespoke permits. They will publish guidance setting out clearly which activities need consent and when standard rules permits, exemptions and exclusions apply, as well as other aspects of the scheme. It is obviously very important in communications to local householders, businesses or farmers that the new scheme is understood.
In response to a point raised by the noble Baroness, Lady Jones—I think that the noble Baroness, Lady Parminter, also referred to this—I reassure your Lordships that there will be no reduction in the number of Environment Agency staff that will be seen on the ground as a result of this scheme. Indeed, in last week's Budget the Government announced an increase in maintenance expenditure in England of £40 million a year. As a result, I believe that their presence on the riverbank will increase as they undertake more maintenance activities around the country.
I am also very happy to reassure the noble Baroness, Lady Jones of Whitchurch, that these regulations have not been motivated by any question of efficiency savings by the two agencies—far from it. These regulations were drawn up in recognition of the fact that we could safely reduce oversight of the many low-risk activities that are undertaken and thereby reduce red tape for applicants. The new scheme will also reduce administrative burdens for the regulators. These savings mean that their costs will be lower, and thus fees under the new scheme will also be lower than they would otherwise have been.
I was asked a number of questions, which I hope to be able to answer, but if I do not provide the fullest detail I will write to noble Lords. My noble friend Lady Byford was absolutely right to mention the issue of slowing the flow. We know that the Pickering scheme has been deemed to be very successful and I am sure that we will hear much more about it, but I must not pre-empt any reports that come out. The response from my guardians behind me is that, if people need to take action to avoid flooding in any sort of emergency, they do not need to apply for a permit; this sort of activity is covered by an exclusion. In that case, we would want the capability to deal with an emergency as promptly as possible.
My noble friend Lady Byford also asked about the consultation and whether the Government were considering any other proposals. Of course, we would be open to any suggestions for further exclusions, exemptions and standard rules permits, but we would need to examine any proposals very carefully to ensure that the conditions of use could be applied across the country. Clearly, with the exemptions and exclusions, we have sought to take what I would call the common-sense approach about what is sensible to have in an exemption or exclusion so that we can concentrate on the large proportion of work that will need bespoke permits, because that is where we need to ensure that we get everything absolutely right.
The noble Baroness, Lady Jones of Whitchurch, asked about the notification of local authorities in particular. Although the environmental permitting framework does not require prior consultation on the take-up of standard rules permits, exemptions or exclusions—these are low-risk activities and a consultation on the conditions for them was undertaken in 2014-15—when we move to bespoke permits, clearly we need to be working extremely effectively to ensure that there is notification. For instance, local authorities will be notified of any bespoke permits that have the potential for a significant effect on the environment, which is very important indeed.
The noble Baronesses, Lady Parminter and Lady Jones of Whitchurch, asked about the review, and again I hope that I can provide some reassurance on this matter. As I said in my opening remarks, we will review the new flood risk activity scheme in 2019 as part of the general review into the environmental permitting regulations. Clearly, in the mean time, we will keep the activities permitted under exemptions, exclusions and standard rules permits, and their conditions, under review, and will introduce new exemptions or revising conditions if it is necessary or appropriate.
As to the purpose of the 2019 review, it must assess the extent to which the objectives of the review have been achieved, whether the objectives remain appropriate and whether they could be achieved in a less burdensome way. That is the basis of the review. But clearly, as experience of this new scheme comes along, I am sure the Environment Agency and others in Wales will reflect on this, as I said. The important thing is that there will be this opportunity for a general review in 2019.
Clearly, it is absolutely essential that no one unwittingly increases the flood risk, either for themselves or for others. The intention of this permitting scheme is to ensure that all activities are properly assessed and that action is taken if people act outside the conditions of a permit. These regulations remove the requirement to fill out unnecessary forms prior to carrying out low-risk activities and enable the Environment Agency and Natural Resources Wales to focus their resources on evaluating higher-risk activities.
I will reflect on all the points that have been made. I hope that I have covered them to your Lordships' satisfaction, but this is a proportionate move in terms of seeking to direct our resources to where people and their property can derive the most benefit. For those reasons, I commend the regulations to your Lordships.
Third Parties (Rights against Insurers) Regulations 2016
Lord Faulks
That the Grand Committee do consider the Third Parties (Rights against Insurers) Regulations 2016.
The Minister of State, Ministry of Justice
(Lord Faulks) (Con)
My Lords, the draft regulations extend the range of people who are potentially within the scope of the Third Parties (Rights against Insurers) Act 2010. Subject to the prior approval of both Houses of Parliament, the draft regulations are to be made by the Secretary of State under the power in Section 19 of the 2010 Act. Section 19, in its present form, was inserted into the 2010 Act by Section 19 of the Insurance Act 2015. The purpose of the power is to make provision for adding or removing circumstances in which a person is potentially within the scope of the 2010 Act. The present circumstances within that scope are currently set out in Sections 4 to 7 of and paragraph 1A of Schedule 3 to the 2010 Act.
The draft regulations make a series of textual amendments to the 2010 Act, as amended by the Insurance Act 2015. The effect of the amendments in general terms will be to include corporate and other bodies that are subject to certain sectoral insolvency regimes or, within limited exceptions, have been dissolved within the scope of the 2010 Act. The purpose of making these amendments is to correct omissions from the 2010 Act so that it can be brought into force without adversely affecting people who are currently within the scope of the 1930s legislation that is to be replaced by the 2010 Act.
It may be helpful at this point if I explain the principles that underlie the third parties legislation in a little more detail. It has existed since the 1930s and is so called because the claimant is a third party in relation to the contract of insurance. The current legislation is the 1930 Act, which applies to England, Wales and Scotland, and the Third Parties (Rights against Insurers) Act (Northern Ireland) 1930. The purpose of the 1930 Acts, and indeed of the 2010 Act, is to protect the interests of claimants against insured persons who have a liability to the claimant but who no longer have effective control of their assets, typically because they are insolvent. The basic effect of the third parties legislation is to transfer to a third party to whom the insured has incurred a liability the contractual rights of the insured against the insurer as regards that liability. This means that the proceeds of the insurance policy are paid to the claimant, not to the creditors of the insolvent insured generally.
The 2010 Act is intended to extend and improve the protection conferred by the 1930 Acts. To trigger the application of the 2010 Act, an insured must both incur a liability to a third party against which it is insured and undergo an insolvency or analogous event specified in the 2010 Act. Unfortunately, following the enactment of the 2010 Act it was found, in some respects, to have a narrower scope than the 1930s Acts. This was partly as a result of the terms used in the drafting of the 2010 Act and partly because of developments in insolvency law following the financial crisis in 2008.
Had the 2010 Act been commenced immediately after its enactment, the effect would have been to deny insurance proceeds to claimants and to pass them to be shared out among the insured's creditors. This would have frustrated the very purpose of the 2010 Act and had the effect of undermining the purpose of compulsory insurance, such as that which employers are required to maintain. The operative provisions of the 2010 Act have therefore not yet been brought into force and will not be so until these defects have been remedied. The remedial process is therefore essential to realising the benefits of the 2010 Act. Part of the remedial process was effected by the amendments to the 2010 Act made by the Insurance Act 2015. The draft regulations will complete the process.
I will now describe the working of the amendments to be effected by those draft regulations. First, they would extend the list of such insolvency or analogous events by adding the sectoral insolvency or administration procedures listed or referred to in the provisions to be inserted in the 2010 Act by Regulation 3 of the draft regulations. These additions cover the possibility of insolvency or administration under special legislative regimes that generally follow, but are distinct from, the Insolvency Act 1986 in a wide range of important business sectors where company failure has the potential to damage public interest or cause market contagion—for example, financial services and postal or energy companies.
Secondly, Regulation 4 of the draft regulations extends the scope of the 2010 Act to dissolved bodies, other than unincorporated partnerships and bodies that are no longer treated as dissolved by reason of subsequent events. The 2010 Act currently applies to dissolutions under Sections 1001, 1002 or 1003 of the Companies Act 2006 but not to other dissolutions, even though dissolution, after which a body will certainly not have effective control over its rights and assets, would appear to be the paradigm case in which a transfer of rights should occur. Regulation 4 therefore broadens the scope of the application of the 2010 Act to these other dissolutions.
The one exception to the proposed coverage of dissolutions generally is the dissolution of unincorporated partnerships. This exception is sensible, as technically a partnership dissolves each time a new partner leaves or is added. This would extend the scope of the legislation too widely, as many such partnerships would be going concerns. In the case of a partnership which is no longer trading, the insured would need to proceed against the individual partners.
The remainder of the draft regulations deal with ancillary matters. Regulations 5 and 6 amend Section 9 and paragraph 3 of Schedule 1 to the 2010 Act respectively. Section 9(3) and (7) of the 2010 Act provide that a third-party claimant does not have to satisfy a condition of the insurance policy regarding provision of information or assistance to the insurer by the insured if it cannot be fulfilled because the insured has died or is a body corporate which has been dissolved. Paragraph 3 of Schedule 1 to the 2010 Act gives a claimant the right to request information from officers, employees, insolvency practitioners or official receivers of a defunct body corporate, other than when the dissolved body has been restored or ordered to be restored to the register of companies. The draft regulations extend these two provisions to all dissolutions, other than those of unincorporated partnerships, irrespective of whether subsequent events result in the body in question being treated as if it is no longer dissolved or as if it had never been dissolved.
The reason for the wider application of these provisions as against the provisions relating to dissolved bodies inserted into the 2010 Act by Regulation 4 is that most such situations reversing a dissolution—for example, restoration to the register of companies—are temporary and unlikely to result in there being a person who is responsible and able, on behalf of the body in question, to assist the claimant by being able to fulfil the condition or to supply the information in relation to the liability.
Before I conclude, I should like to express my department's thanks to all those who have contributed to the preparation of the draft regulations. It is not a simple matter, as I suspect noble Lords will concede. Insolvency law is fast moving and complicated. The Insolvency Service, the Accountant in Bankruptcy in Scotland and the Department of Enterprise, Trade and Investment in Northern Ireland have all made significant contributions to what has been a very difficult technical exercise. I am very grateful to them. I am also very grateful to the Commercial and Common Law Team at the Law Commission, which for most of the period in question was led by David Hertzell and Tammy Goriely, without whose expert knowledge and legal skills the draft regulations could not easily have been prepared. Finally, in a more general sense, I thank the Law Commission and the Scottish Law Commission for their continuing support for the reform of third parties legislation generally. I hope that in the not too distant future we shall be able to make that reform a reality.
In conclusion, the reforms to be introduced by the 2010 Act are supported by insurers and claimants alike. They apply to insurance of all kinds and will be particularly beneficial in cases of long-tail industrial diseases, such as mesothelioma. The approval of the draft regulations by your Lordships' House will be widely welcomed and will be a key step on the way to the commencement of the 2010 Act.
I am afraid that I am not yet in a position to state when the Act will be brought fully into force, as the draft regulations remain subject to your Lordships' approval and to approval in the other place. Nevertheless, I can say that, subject to allowing all parties affected no less than three months from the making of the regulations in which to prepare for commencement, the Government's intention is to bring the 2010 Act, as amended by the 2015 Act and by what will then be the Third Parties (Rights against Insurers) Regulations 2016, into force as soon as reasonably practicable. I beg to move.
Lord Hope of Craighead
I am grateful to the Minister for his explanation and also for bringing this set of regulations forward for our consideration and for the House's approval in due course. It is an extremely important area which I think anybody practising in the common-law field values very much. I have only one question and that is to ask for reassurance in relation to part of Regulation 3, which deals with the relevant bodies in insolvency or administration under sectoral legislation. This is an extremely sophisticated area of law and I join in the Minister's congratulations to all those who have played a part in putting all this together.
A feature of the list of enactments set out in Schedule A1 is that all except the last deal with areas of regulation which are common to the United Kingdom, with the special provisions made in the case of Northern Ireland which are set out in the schedule. Aviation, energy, financial services, postal services and railways apply equally to Scotland as they do to England and Wales. But the question of water and sewerage has occurred to me, because Scotland, I believe, has its own legislation relating to sewers and water: there is the Water (Scotland) Act, the date of which escapes me, and I believe that there is a sewerage Act for Scotland as well.
I fear that without detailed research, which is beyond my resources at the moment, I am not sure whether the Scottish legislation provides for administration under a legislative scheme. I am fairly confident that the Water Industry Act 1991, referred to here, does not extend to Scotland. It may well be that those who have been looking at this in detail have reassured themselves that there is no need for a mention of the Scottish legislation, perhaps because it does not actually provide for this kind of administration. If that is right, of course I understand why there is no mention of those statutes, but it might be as well to be absolutely sure that there is not a gap here that ought to be plugged before the regulations are brought into force.
That aside, I regard this as a very fine piece of fine-tuning which I am sure will be greatly welcomed in order to avoid any further gaps in the valuable legislation.
My Lords, I, too, thank the Minister for his explanation of this statutory instrument. I confirm that it is not controversial in the slightest. We are happy to support it, as we supported, of course, the 2010 Bill as it went through Parliament. Indeed, I hope I may be forgiven for reminding the Grand Committee—it was some time ago now—that I was the Minister who took that Law Commission Bill through this House, using the special procedure. I was assisted then by an excellent team from the Ministry of Justice and I suspect—indeed, I am sure—that the Minister has been so assisted today.
The Minister will know that we on this side have many criticisms of much that the Ministry of Justice does these days, but in this area of complex but important law-making and law revision, we have nothing but praise. I have a couple of questions and comments for the Minister's consideration, but they are brief.
The first point is about paragraph 8 of the Explanatory Memorandum, which deals with the consultation outcome. It says that the APIL and the ABI—the Association of Personal Injury Lawyers and the Association of British Insurers—have been consulted and are broadly content. The memorandum states:
"Both organisations expressed general approval of the Regulations".
Is there a particular meaning to the word "general" in that particular context? I am pretty reassured that there is not, because I have a letter here from APIL itself, which suggests that it is happy with the regulations, but I wonder what the expression means in that context—probably nothing.
Secondly, we are very pleased that the charitable sector is content, which is an important point. It is very important that charities are happy with this, as they often have to deal with complex legal situations without necessarily having the resources that are available to government.
The final point is on paragraph 10, which is about the impact of this measure. It is argued that the amount of money or funding that is relevant here is too low for the threshold for there to be an impact assessment. Paragraph 10.4 deals with a number of uncertainties about what is likely to happen and with the Government's estimates. Would the Minister be able to tell the Grand Committee what the threshold is? Might this not be an example of where an impact assessment would be of some value by the time the matter comes to the other place in April?
I do not claim that any of the points I have made so far are very important, but I would be grateful if the Minister would deal with them. I end by welcoming this statutory instrument and by thanking the noble Lord and his team for presenting it so clearly to the Grand Committee this afternoon.
I am very grateful for those observations and for the support for the regulations which was expressed by the noble and learned Lord, Lord Hope, and by the noble Lord, Lord Bach. As I am sure many in the Committee well remember from what became the 2010 Act, the noble Lord has been involved in this for some time and is familiar with this complex area of law.
The noble and learned Lord, Lord Hope, with his customary forensic skill, identified the absence of a specific reference to water and sewerage in Scotland. The question is whether the Scottish legislation needs to be mentioned. The UK Government have consulted the Scottish Government and the Accountant in Bankruptcy about the water legislation, and are content that no special mention is necessary. I am none the less extremely grateful to the noble and learned Lord for having mentioned it. This is such a complex area that it is not impossible to omit something, although I glad that in this instance it had been specifically considered.
The noble Lord, Lord Bach, made a number of comments, and I very much echo what he said in tribute to those who work in this area in the Ministry of Justice, and the extreme skill and dedication that they have to it. I am grateful for this comments in that respect. As to his specific questions, the use of the word "general" was not, as I understand it, in any sense supposed to imply that while they generally approved of it, they did not approve of specific aspects of it. As he may remember, the 2010 Act represents a compromise between insurers and claimants, designed by the Law Commission after extensive consultation.
The changes made in the Insurance Act 2015, and to be made in these draft regulations, are supported both by the ABI and APIL, as the noble Lord said. Both have expressed the clear view that they would like these regulations to be brought into force as soon as possible—there is no reservation about it. Therefore, the use of "general" in the Explanatory Notes is supposed to convey that. I accept that there could conceivably be considered to be some ambiguity, but I assure noble Lords that there is not.
I can confirm that the charitable sector, along with all stakeholders, is content with the change in the law which this will bring into effect.
Finally, the noble Lord asked about the impact assessment and, in particular, paragraph 10 of the Explanatory Memorandum. The point made in paragraph 10.4 is that the costs are,
"not easy to quantify … The Ministry … expects that when 2010 Act, as amended by the Insurance Act 2015 and the Regulations is commenced, it will generate a small net benefit to business"—
mainly insurers and claimants because of the ease with which the process should now be able to be undertaken—
"but that any aggregate impacts will be significantly less than £1 million per annum".
The Explanatory Memorandum goes on to explain that,
"the circumstances added by the Regulations will probably only account for a fraction of this. However, we do not know how often these circumstances will apply; how many people will be affected".
However, it seems that it comes well within the range of those regulations that do not require a specific impact assessment.
Our submission is that these regulations are very much to be welcomed. I am grateful for all the hard work that has gone into providing their final realisation during what has been quite a long process to get here. They will extend the scope of the 2010 Act to include the specific sectoral insolvency and administration regimes and most dissolved bodies, and the benefits of the 2010 Act will now be delivered without exposing some claimants who are protected by third-party legislation to a worse situation than they currently are in because of the omissions in the original Act. In those circumstances, I commend the draft regulations to the House.
Question for Short Debate
Asked by
Baroness Browning
To ask Her Majesty's Government what steps they are taking to improve the speed and quality of autism diagnoses in the United Kingdom.
My Lords, I refer to the register of my interests as a vice-president of the National Autistic Society, and to an outside interest in leadership training in the NHS. I should also declare that I am patron of Research Autism and the Autism Diagnostic Research Centre in Southampton.
Why is there a need to improve both the speed and the quality of a diagnosis in autism? It seems to me a pretty straightforward question, and that the answer is rather obvious. Speed is very important, particularly when one looks at some of the more complex cases, but in order for that to be processed and for someone to be referred to the right person, it requires sufficient people to be trained both for children and adult diagnosis. A recent case was brought to my attention of a 50 year-old man in full-time employment in Kent. It has taken two years for him to receive a diagnosis.
The latest Public Health England waiting times show that from the first referral to the first appointment—in other words, not the whole process of diagnosis but that very first step—takes up to 95 weeks in the south-west and, in Yorkshire and Humber, 84 weeks. We are looking at a postcode lottery. I am aware that in some areas the situation is better than that, but around the country we see people waiting for far too long. The quality of the diagnosis is important, too, as well as what happens after it is given. Autism, as we know, is a lifelong condition, and the diagnosis is the passport to an improved quality of life, including support not just for the autistic person but for parents, siblings and carers.
There are still too many problems at each stage of what the NHS refers to as the "pathways". It is terminology that I absolutely hate but I am going to have to use it today, because I think everyone will know what I mean by it—that is, the various steps taken from the time that someone presents, or someone is noticed or a problem arises and somebody along the line says, "Well, could this be autism?". The National Autistic Society has done a lot of work on this, and its recent assessment is that it is very important that every area has a clear route, from raising concerns to being referred for a diagnosis, having the assessment and then getting the care and support that necessarily must come afterwards.
Sometimes people get a referral only after visiting their GP multiple times. This can be down to poor GP awareness as well as people being wrongly diagnosed with other conditions such as anxiety, depression or obsessive-compulsive disorder. There is a need for GP training and for GPs to become more established as the important gatekeepers that they are. I am pleased to welcome the initiative of the Royal College of General Practitioners. Two years ago it set up a clinical priority group under the chairmanship of Dr Carole Buckley, who has been doing some excellent work around the country. We need GPs to be aware enough to make an appropriate referral in a timely way, together with social workers, teachers, educational psychologists and in fact many others—not just professionals but people who have an awareness and understanding of autism, who can say, "This could be autism". If that is the case, it needs the appropriate referral.
That is particularly so now with girls as well as boys. Ten or 20 years ago, girls were reckoned to be about one in 10 of people diagnosed with autism. That perception has changed quite dramatically in the last five to 10 years. We now know that there are a lot more girls on the autistic spectrum but they often present differently from boys and therefore diagnosing them requires specialist knowledge. It is a communication disorder, of course, which means that very often the way in which girls communicate can be different from the way that boys communicate. That can raise challenges in terms of the diagnosis.
Across the country there is wide variation in the length of time that people wait for an assessment after being referred. NICE guidance says that it should be no longer than three months, which the Government have repeatedly stated that clinical commissioning groups should be meeting. They are not meeting it. I say to the Minister that the Government need to be far more proactive with clinical commissioning groups. Adult data show that the average in England is 13 weeks while in areas of the south-west, as I said, it is as long as 95 weeks. This is from the 2014 local authority self-assessment on the Autism Act.
It would be very helpful if the Government could collect diagnosis waiting times for adults and children centrally and hold CCGs to account on meeting the NICE targets. One of the other problems about these waiting times is that there is no true picture of the number of people being diagnosed or the number who are waiting, which leads to a lack of provision to cope with the numbers and the reality. It would be very helpful across the piece for health, education and social services to have a much better feel for how many people there are, where they are and what the timescale is that they are working to.
Once people get a diagnosis, too many report that they are not getting the support they need, including in those essential areas of mental health, speech and language therapy and social care. It is of course included in the Autism Act's statutory guidance for adults, but autistic people tell us that, far too often, this is not happening. What will the Government do to make sure that NHS England's work under the Mental Health Task Force to create a care pathway for autism will include post-diagnostic support for all autistic people and will hold areas to account?
There is another area which the Government need to address urgently. Part of the reason is, I believe, the lack of leadership within NHS England on autism. Currently, the lead for autism is the clinical lead for learning disability and autism. It is quite true that there are people who have a dual diagnosis, but the lead sits within the transforming care team, which of course leads important work on closing inappropriate in-patient units for people with complex needs. But there is a strong case for a national clinical director for autism to drive progress within NHS England across the autism spectrum. Clinical directors exist for other conditions including learning disability, dementia and mental health, and we have seen great strides forward in areas where there is a dedicated clinical lead. I ask my noble friend again today: will the Minister support the call for NHS England to develop leadership on autism, because that is where the driver is and where it could so improve the situation?
I also draw my noble friend's attention to the question, which I have mentioned already, of the implementation of the Autism Act 2009. When I was in another place, I was delighted to have the opportunity to be part of the team that took the Autism Bill through to become an Act. Apart from mental health, it is the only medical condition which has its own Act of Parliament. That should be a clear indicator of how important Parliament considers this condition.
However, I say to my noble friend that I am concerned. Despite the fact that it was written into Section 3 of the Autism Act that local authorities and NHS bodies have a duty to act under guidance, I get the impression that that part of the Act is not being implemented as robustly as it should be by the Minister.
I remind people of what that very important part of the Act says. It says that,
"an NHS body is to be treated as if it were a local authority within the meaning of",
the Local Authority Social Services Act 1970, and that,
"the functions of an NHS body",
mean that the Minister can call it to account if is not implementing guidance as it should. It gives statutory backing and power to the Minister—on NHS bodies and of course on local authorities—to make sure that this guidance is being properly implemented.
My noble friend may want to write to me on this. I would like to know just how many times the Minister has exercised Section 3 of the Autism Act, since it was put on the statute book, with either an NHS body or a local authority. It seems that this should be used by the Minister to drive forward the very issue that we are talking about, among other parts of guidance—to make sure that people not only get their diagnosis in a timely way and that it is an effective diagnosis in terms of its quality, and that the follow-up on the services identified by the statutory guidance for the Autism Act is implemented as well.
I am very grateful to colleagues across the House who have attended this debate today and I hope that when she sums up, my noble friend will be able to reassure us.
Lord Touhig
My Lords, I am grateful to someone whom I am proud to call my noble friend—the noble Baroness, Lady Browning—for securing this debate. She is a formidable, constant and doughty champion for people and families with autism.
When a couple whom I have known for many years told me that they suspected that their child was autistic, I advised them to keep a diary along the lines suggested by the National Autistic Society, of which, like the noble Baroness, Lady Browning, I am a vice-president; I must declare my interest. They did this and took the diary to their GP, who tossed it aside and said, "I have seen these sorts of things before". I became rather angry, and when I discovered that the senior partner in the practice was someone I knew, I rang him up and, quite bluntly, said, "Pull your bloody finger out and get this child a diagnosis". That should not have been necessary but in so many cases, the hardest part about living with autism is getting a diagnosis in the first place.
The National Autistic Society's research indicates that adults have to wait more than two years for a diagnosis and children are waiting three years, even though the NICE guidelines clearly state that the time between referral from a GP and diagnostic appointment should be three months. A diagnosis begins to unlock the door to getting support and help and to gaining a better understanding of an autistic person's needs, yet there is often a barrier put up by the National Health Service and those working in the service. I am sure that it is not meant that way, and that those working in the health service would be horrified to think that it is, but too many in the NHS erect a barrier —for whatever reason—prolonging the time that it takes to get a diagnosis. That barrier must come down. The diagnosis is the first step for autistic people, enabling them to access the right support and begin a better quality of life. A survey carried out by the National Autistic Society revealed that 61% of people who responded felt relieved to get a diagnosis, while 58% said that it led to them getting new or more support.
For many with autism, it is the first chance to get an insight into why they feel and act differently. Naoki Higashida, a young Japanese autistic boy who wrote The Reason I Jump—a book which I have quoted a number times—posed a number of questions about people with autism. He asked, "Why do people with autism talk so loudly and weirdly? Why do people with autism do things they shouldn't, even when they are told not to do them a million times? Why do people with autism take ages to answer questions?" People with autism ask these questions of themselves, often not getting an answer or an understanding. Not until they have a diagnosis does support and understanding of their needs follow.
The families of people with autism often say that delays in getting diagnoses led to the development of serious mental health problems, both for the individual and for their family. It is therefore important that people with suspected autism are able to access a timely diagnosis wherever they live in the country. When, in February 2015, I asked a series of Written Questions about autism diagnosis, the then Minister, the noble Earl, Lord Howe, replied that data on:
"The number of children diagnosed with autism is not collected centrally".
However, if we do not know the extent of the need, how can we really respond to it properly? The best thing would be to create an autism register to be registered with every GP. The National Autistic Society, in its autism diagnosis crisis campaign, is calling on the Government and the NHS in England to take this action; already, 12,000 people have signed a letter in support. Surely, the NHS should collect, publish and monitor key information about how long people are waiting for a diagnosis and how many people's autism is known to their GPs.
The NHS should ensure that waiting time standards on mental health, currently in development, reflect national guidance and that no one waits longer than three months between referral and being seen for diagnosis. The Government must share in this commitment, ensuring that the NHS in England meets its aims. Timely access to an autism diagnosis should be written into the Government's mandate to the NHS in England.
I am conscious that some people might want to speak in the gap, so I will cut my remarks accordingly. I will end by sharing with the Grand Committee a case study that expresses more eloquently than I can how an early diagnosis might have made a huge difference to the life of one young person. The names are changed to protect the families' anonymity. Jane is 50 and Michael, her husband, is 51. They have a son, Dan, who is 15 and they live in the south of England. It took Dan's parents almost six years to get a diagnosis from the point where they started seeking an autism assessment, although they had started looking for answers two years before that. During those years, his parents were repeatedly told by professionals that he was not on the spectrum. The diagnosis happened only when they went private to get a diagnosis. Dan was diagnosed with autism only last year, six years after his parents raised the issue of autism with professionals and eight years since they first sought help. The delay had a huge impact on his health, his mental health, his education and his family. His mother wrote that:
"With the help of the firm diagnosis, I was able to fight successfully to get funding for Dan to go to an independent school which specialises in children with various difficulties, including autism. The school understands anxiety and has small classes, so Dan can learn without stress. The impact on Dan's education of not receiving an earlier diagnosis cannot be overestimated: he lost four years of his school education and is having to repeat a year so that he can take his GCSEs. He is a bright boy and loves learning, so he is delighted to be back at school again. The delays also had a huge impact on Dan's mental health, as well as our family's … What makes me really angry is that I know there are plenty of children who still don't have the help they need",
in order to fulfil their life potential. We have an opportunity in Parliament, as politicians and as Ministers, to do something about this. We have an opportunity to make a difference. That is why we are here. I hope that the Government are listening; I am sure that they are, but we really have to keep pressing for some improvements.
Lord Addington
My Lords, it is a pleasure to be backing up the noble Baroness on this subject. If we are breaking the rules and saying "my noble friend", then to hell with the rules, basically.
We are returning to a subject on which I feel there is going to be a tremendous amount of agreement; the downside is the fact that we are having to say it again. We have had to say this very often. The main thrust is that we have specific legislation that backs up other general legislation, giving rights to these people and responsibilities to the state that are simply not being enacted. That is the long and the short of it. There are a series of rights and, as the noble Lord, Lord Touhig, has just pointed out, the people who get them are the ones who fight and get it recognised. There is an old cliché about anyone who has been involved in any part of the disability movement: if you want to be a successful disabled person, choose your parents very carefully. I think that the best combination is a journalist and a lawyer—a person who will tell you about the law and someone to tell those who are not enacting the law publicly that they have failed. I have seen over and again that the person who shouts, with the right language and in the right way, gets their rights. The rest do not.
The experiences of autism are so similar to the world that I come from—that is, of dyslexia—that it is not worth setting out any differences between them; the principle applies to both. Then we have the joys and delights of co-occurrence of disability, which is very common. All these things come down to the fact that we have a series of pieces of legislation that are not being enacted correctly, and we have to drag people into enacting them.
Before I move on to my main point, I want to back up one point that the noble Baroness made. All these hidden disabilities seem to suggest in their initial stages that the males with the condition greatly outnumbered the females. Then a combination of practice and new social mores when looking at people showed that this was not the case, or at least that the discrepancy was not nearly as great as had previously been conceived. I hope that the Minister will have some way of looking at that and saying exactly how often this occurs. It is quite clear in all these hidden disabilities that the female of the species is much better at keeping its head down, not getting spotted, not causing trouble and not attracting attention. If we can look at that, we might start to get an idea of the true picture because it is also true in all these cases that the male who follows that example is ignored. Can we have a look at that type of behaviour?
I want to draw attention to something that the noble Baroness, Lady Browning, mentioned in passing: education. At the moment, when it comes to special educational needs, a teacher who is going to receive dozens of groups and several predominant groups might receive an afternoon or a couple of hours on the subject. I met a young man, introduced to me by a volunteer in my office, who had missed his special educational needs unit because he had had a doctor's appointment that day and was under no pressure to go back and take it. Two hours. Could noble Lords learn to spell dyscalculic, dyslexic or autism, if they did not know already, in two hours, even if they do not have one of those conditions? I rather doubt it. Effectively, what we seem to be assuming in teacher education is a slap in the face.
Remember how much time people spend in classrooms. Remember how much time those at the higher end of the autistic spectrum, those who do not have the glaringly obvious problems, will spend there. There is so much opportunity for a teacher who has at least some awareness training to be able to say, "I think this child has a particular problem. They will need to be told about it and they need strategies in their learning and social behaviour to enable them to function in society". Even if you do not go to a formal diagnosis but have some awareness that you might be there, just think about how much potential that could release. Think about how you might be able to get somebody in a position where they could handle further education better, or higher education. We have passed Acts and done things that enable people to get through this. We give them extra money, extra time. We have just passed things that gave them this ability. If you do not identify and support in the teaching staff, you are missing the chance to make a person aware that they are doing this and you will not be able to say, "You need to take a slightly different teaching strategy to get the best out of this person and you will get them through". How much waste is actually built into the system there?
Is this a wonderful revelation from me? No, it was first put forward in the Lamb review. I think that was in 2009; I cannot remember off the top of my head. The difference between dyslexics and autistics is that we do not like facts and figures in nice, straight lines. I do not know how co-occurrence happens. It is an established principle that we have badly trained teachers in this area. Unless we can get in there, we will ensure that we do not identify them, and, even if we have identified, we will make sure that that teacher does not know how to adapt the lesson to get the best out of it. This is made even more absurd when we take on the fact that they have a legal duty to teach that person.
Effectively, in this huge part of a person's life, teachers at the moment have a legal duty to do something which they are not trained to do. That is a disaster for anybody who has problems with learning patterns that are not of the mainstream. Autism just happens to be one of the more glaring examples.
Lord Warner
(Non-Afl)
My Lords, I am sure we are all grateful to the noble Baroness, Lady Browning, for giving us the opportunity to debate this important subject and for sharing with us her expertise and experience in this area. Despite my four years as a Health Minister, this is my debut on this subject. That probably indicates how hidden the subject of autism often is. My involvement arises from my experience with my six year-old grandson, who is on the spectrum and probably suffers from Asperger's—I should declare this interest.
Normally, I never bring family matters into discussion of public policy in this House but, although I have not formally consulted my grandson about using his example, I am sure he would approve of my doing so today. He likes to star in stories about himself and his alter egos. One of his favourite alter egos is Seal, so I shall describe him as Seal for the rest of this speech.
My experience is that Seal has been jolly lucky with the individuals that he has encountered on the journey that he has travelled so far. That has nothing whatever to do with any NHS system. The NICE guidance could have been written in Mandarin Chinese as far as Seal's NHS encounters go. What has happened is that he has never been through a CAMHS system and never really been referred by a GP, yet he has progressed through the system. Seal is a quirky, infuriating, endearing, courageous, vulnerable, obsessive, controlling, physically strong little boy who, for some of the time, is great fun to be with and, at other times, would drive a saint to distraction.
If, as a family, you have a diagnosis, you can learn how to cope with the predictable unpredictability of the young person's condition. Perhaps more importantly, you can help the child to learn coping mechanisms for processing and dealing with this very strange world that he inhabits. Seal now knows that he is a very different person from the children around him in his mainstream school, but he also knows that there are a number of adults and other children who are trying to help him. Without that diagnosis and its follow-up, Seal would almost certainly not be in a mainstream school or have many friends his own age. Whether his family would have been able to cope with him must also be very open to doubt.
Seal is where he is not because of the NHS but almost despite it. An energetic nursery school manager pressured a local children's community team to observe him and diagnose him. That team produced an excellent profile of him, and when he moved house the team did the right thing and passed the assessment to the GP practice in his new area. The practice promptly filed it and did nothing. Some time later, what I like to describe as a "House of Lords intervention" ensured that he was seen by a community paediatrician, who then worked with the school that Seal was placed in and produced a diagnosis. Seal has the services that he needs because of that school's excellent SENCO, not because of the NHS. The school drove the preparation of an education, care and health plan and ensured that the community paediatrician gave a clear diagnosis. That has led to this child being in the system; the NHS has contributed very little to getting him into the system. It has taken three years, but I have to say that his experience has been very different from what I hear from many parents of children with autism who Seal and his family meet in the local support group.
I have told this personal story to illustrate the lack of any kind of easy-to-use system for many of the parents of autistic children. I have read the NICE guidance, and they are worthy, professional documents. However, I suspect that their recommended timescales for diagnosis are observed more in their absence rather than in the actual experience of parents. Relying on a GP referral to CAMHS is simply not a credible system unless there is to be a massive investment in GP training and CAHMS. Building alternative routes through nurseries and schools, and accessing community paediatricians, might offer the prospect of speedier diagnoses in some areas.
That does not mean I want the NHS to be let off the hook. It should certainly be capturing more data and comparing local health areas on the total time taken to secure an autism diagnosis. The NHS would be helped by working with local education systems if there were more progress on a common identifier for children who need both health and social care services. The Minister might like to give us some advice on how much progress is being made in this area, where change is long overdue. Will she also ask NHS England to separate the commissioning of autism services from learning disabilities, starting especially with children? If she cannot answer my questions today, I would be grateful if she could write to me.
Baroness Rock
My Lords, I add my thanks to my noble friend Lady Browning for bringing to this House such an important debate.
People on the autistic spectrum perceive the world differently from others. They find the rest of us strange and baffling. Why do we not say what we mean? Why do we tolerate such a confusion of sensations of light, smell, sound, touch and taste without screaming? Why do we have such complicated emotional relationships? Why do we send and receive so many social signals to each other and how do we make sense of them? Why are we so illogical?
More than 700,000 people in the UK today are currently diagnosed with autism. If you include their families, autism touches the lives of over 2.8 million people. I am one of them. As the mother of a child with special educational needs, I have experienced at first hand the challenges and stresses of raising a child who sees the world differently and finds frightening the things that we take for granted. However, and I really cannot emphasise this enough, I have also experienced the rewards and joys of raising a child who is atypical and unique, and who brings so many unexpected qualities that surprise and enrich our lives. We are lucky; we managed to access the right support and the right schooling.
Why is speed and quality of diagnosis so necessary? It is simply because a diagnosis clarifies special educational and behavioural needs and the means to get those needs met, and gives entitlement to services and financial support. It is the first concrete step on a long journey. We are making progress. Autism diagnosis has increased by a factor of 25 in the last 30 years, but still only two-thirds of children and one in 10 adults with autism have a diagnosis. However, a critical question is: how can parents recognise that their child is on the autistic spectrum? Every child presents differently, and children with the same label may be more different than they are alike.
Early-years educationalists and childcare workers have the insight and ability to recognise communication and behavioural issues, and therefore can take more responsibility in helping parents to assess their child's difficulties and enable specific diagnosis on a timely scale. I am not advocating that every teacher or childcare worker needs to be a neurodevelopmental expert; on the contrary, it is their collective experience and observation of children with difficulties in school and their close communication with parents that puts them in a unique position. With training, they can enable parents to articulate their concerns and to have those concerns acted upon, wherever that might lead, whether it is diagnosis or other support.
For many parents, it is difficult and frightening to comprehend what is "normal" behaviour and what is a cause for concern that needs professional input. In my case, my child was my first-born and I had no basis of comparison. It is truly overwhelming to be in that position, but harnessing the good sense of educationalists early on is a really important resource. We need to acknowledge that they are a crucial part of the diagnostic process. As professionals, they have an empathy and perspective that can be nurtured and encouraged to support parents. Timely identification of social communication problems puts parents and children on to specific autism pathways, as my noble friend Lady Browning mentioned, which can then initiate and expedite diagnosis.
The impact of living with a child with autism can be devastating for many families. The high incidence of marital breakdown where a family has a disabled child speaks for itself, and there is growing concern about the mental health costs to siblings and other family members. Being the parent of a child with autism can be one of the loneliest places in the world. Acknowledgment and affirmation of the valuable contribution of early-years educationalists and childcare workers towards supporting parents to get the right diagnosis will lead to the right help. This transforms lives.
Baroness Hollins
My Lords, I refer to my interests in the register, including my chairmanship of an expert reference group on workforce learning disability services, and congratulate the noble Baroness on this debate.
My own expertise with autism as a psychiatrist is with the 30% of people with learning disabilities who also have autism. Some people with autism have a learning disability but most do not, which is a very important point to bear in mind. The Royal College of Psychiatrists joins the National Autistic Society and others in their concerns that the later someone is diagnosed, the worse it is for the quality of their life.
According to the National Autistic Society, 70% of autistic adults say they are not getting the help that they need from social services, and at least one in three autistic adults experiences severe mental health difficulties due to a lack of support. Without tailored support, people with autism can find it difficult to communicate their needs and make good use of mainstream health and social care services. This increases the pressure on families and carers and creates pressures within primary care and mental health services as they struggle to meet people's needs, often when they are undiagnosed or misdiagnosed.
Individuals with the diagnosis, and their families, can feel overwhelmed without help and understanding. The absence of a diagnosis may mean that families are not communicating in the best way or that people are taking medication that is not needed and may be harmful. We already know that people with autism are vulnerable to mental health problems, with late diagnosis increasing this risk, and that 70% have at least one other mental or behavioural disorder, while 40% meet the criteria for two.
One man with autism, Chris, who waited until adulthood for a diagnosis, told the National Autistic Society that in his view before his diagnosis his needs were never met, and at times he felt suicidal. Having a diagnosis helped him to reach a place of acceptance and opened doors that were previously closed to him. He said that without the diagnosis he would have taken his own life.
We know that people with autism are also vulnerable to physical health problems. A recent study published in the British Journal of Psychiatry revealed that people with autism die 16 years earlier on average compared with the general population, and that suicide is the second commonest cause of death for them after cardiovascular disease. One problem with the study was that it was not known how many also had a learning disability, a known risk factor itself for earlier death, for which there is good research evidence.
We know that without proper recognition and diagnosis, children with autism may not be in the appropriate school environment and are at risk of being bullied, leading to isolation, depression and anxiety. Behavioural difficulties, if not properly understood, can put them at risk of being suspended, with profound implications for their future. We know that only 15% of people with autism are in full employment.
Autism, as we have heard, is a multidimensional neurodevelopmental disorder. It presents differently in each person, and diagnosis requires a multidisciplinary team to accurately decode behaviours and observations which may overlap with other conditions. There is no definitive medical or genetic test for autism.
There might be gender differences in how autistic traits present and are interpreted. The stereotype of a person with autism is an obsessional person somewhat locked into themselves; but girls present with more subtle difficulties. While in conversation they might be able to take turns to speak, make eye contact and engage in small talk, but they frequently do not understand the subtext. They tend to be better at social formatting, cutting and pasting someone else's behaviour and trying to make it their own without understanding why they are doing it. There is no research on the number of women on the autistic spectrum but clinicians now suggest that there are probably a significant number of undiagnosed cases referred to adult mental health services for conditions such as depression, OCD, eating disorder or self-harm. Staff at an eating disorder clinic in Birmingham recently identified that between 60% and 70% of women in their 20s attending their clinic had undiagnosed autism.
A teacher at Limpsfield Grange School in Surrey, a school for girls with special educational needs and communication difficulties, noticed that a high percentage of the learners were showing behaviour on the autistic spectrum. Some of the girls were helped to write a book, M is for Autism, which asks the reader to view the world through the eyes of a girl with autism—for example, not having friends, not fitting in and feeling worried all the time.
Autism also presents differently in adults and children. People are less closely observed after leaving school, and many adults learn to limit their autistic behaviour. They face numerous misdiagnoses and potential iatrogenic harm before getting correctly diagnosed with Asperger's or autism. There are also issues for older adults, whose autism might come to light at a time when they lose a spouse or in retirement because of their inability to adjust, or behavioural difficulties that present.
The Royal College of Psychiatrists expresses concern that there are insufficient trained staff to carry out a diagnosis. In order to tackle this, it has developed a quicker aid to diagnosis for psychiatrists and a training package. It is looking at how a basic essential knowledge of autism can be added to the training of all psychiatrists to ensure that general psychiatrists have knowledge and skills about autism in their core skillset. On its website, there is good-practice guidance on diagnosis.
Part of the conundrum is that autism has no cure and no single or clear causation. Prevalence is probably going up, and diagnosis certainly increases the number of children and adults identified with autism. Every person with autism is different, but receiving a diagnosis is a crucial step in their journey. For many people, diagnosis leads to better understanding of individuals for their families, as well as for education, health and care services and employers. For many people, diagnosis leads to adjustments in expectations, education and care. For others, more specialist support and long-term interventions are needed. The growing awareness of issues faced by people on the autistic spectrum is welcomed, but there are still too many people whose needs go unrecognised, misdiagnosed and unmet. We have made strides in the right direction, but we need to speed up the process. Will the Minister commit to sharing examples of good practice across England, and encourage areas that are lagging behind to implement it?
Lord Wigley
(PC)
My Lords, I will intervene in the gap in 60 seconds flat. I thank the noble Baroness, Lady Browning, for her work over many years in this area, and I congratulate the noble Baroness, Lady Rock, on her very moving speech. I declare an interest—technically lapsed—as former joint patron of Autism Cymru, which was brought to an end last year for the simple reason that a new Welsh Government-sponsored strategy was taking over and is very relevant to the issues that we are discussing today.
In talking about these matters as an attendee of several meetings and conferences of Autism Europe, it has become clear to me that there is a great jealousy among many European countries of the initiatives that have been taken in the four nations of the United Kingdom. There is significant envy about these. However, I flag up one warning from our experience in Wales: it is one thing to have a strategy on paper; it is something else to have it rolled out evenly in every community that needs those services. There need to be the resources for the local authority and the medical fraternity in order to do the job. That is what my appeal will be: to make sure that good theoretical policies work out in practice.
My Lords, it is a great pleasure to comment for the Opposition in this very important debate, on which I congratulate the noble Baroness, Lady Browning. She made a very persuasive case for the early diagnosis of autism. She made the point that currently, although we have seen an improvement, there is a huge variation in practice in many parts of the country. I come back to my noble friend Lord Wigley's comment that it is good to have a strategy but you need to have an implementation programme to ensure that there is consistency across the country. The debate has shown that at the moment there is a postcode lottery and widespread inconsistency in the availability of diagnosis and access to treatment. The principal question for the Minister is what action she can take to ensure that clinical commissioning groups are kept up to the mark and monitored over the issue of diagnosis. The issue of transparency, and the availability of comparative information so that individual CCGs can be monitored and held to account, is crucial in this area.
My noble friend Lord Touhig suggested that a difficulty in getting diagnosis may in essence be a rationing tool, in that if you do not get a diagnosis you do not get access to treatment. If that is the case, that is entirely unacceptable. The same issue applies to access to treatment. If we are to understand the challenges that we face, we have to have local and comparative information about the difficulties of access. I hope that at the very least the Minister will take this away and consider with her colleagues how that might be brought about.
The noble Baroness, Lady Browning, said that we ought to have one single national clinical director to focus solely on autism. I very much agree with that. However, the current set-up of national clinical directors is wholly unsatisfactory. They are given very little time and virtually no support, and it is not fair to ask them to do what they have been asked to. The noble Baroness, Lady Hollins, mentioned her membership of expert groups. She may well know that NHS England has a consultation, which I think has now finished, on the membership of clinical reference groups, which are crucial groups that advise NHS England on policy development. My understanding is that the proposals that were sent out on 9 February proposed reducing the numbers of those CRGs and their clinical members. That is a matter of great regret and I hope the Minister will be able to comment on it.
Resources have been mentioned. The noble Lord, Lord Prior, said recently in response to an Oral Question about the excellent Mental Health Task Force report that £1 billion per annum will be spent by 2020. The problem is that that is not ring-fenced; it is part of the overall allocation to the NHS. As we know, the NHS is facing very severe financial pressures, and I know no one who believes there is any chance whatever that that £1 billion will actually be spent on mental health services.
I end by referring to the excellent Autistica report that came out last week. It shows that people with autism are more likely to die at a younger age compared with the general population. It makes a strong argument that we need to build the research and knowledge base; that the learning disability mortality review should include a new national autism mortality review; that standardised mortality data about all autistic people should be collected nationally and locally; and that the Department of Health should include preventing premature mortality of autistic people as a key outcome in the 2017-18 deliverables. Will the Minister's department take very careful note of the Autistica report and perhaps in due course let noble Lords who have taken part in this debate know what the outcome of those considerations might be?
Baroness Chisholm of Owlpen
What an excellent debate we have had this afternoon. As is normal, I am going to have to try in a short time to get through answering all the questions, which have been so incredibly interesting. I am grateful to my noble friend Lady Browning for raising this important issue. I pay tribute to her many years of support for those who have autism and indeed to the support in the contributions of all our speakers.
Parents can find themselves in a frightening and bewildering place, first, when they sense that there is something wrong with their child and, secondly, once they are given a diagnosis. Autism is particularly bewildering, partly because it can manifest itself in so many various ways. Obviously, as my noble friends Lady Browning and Lady Rock, and the noble Lord, Lord Touhig, said, a timely diagnosis of autism is essential to ensure that the relevant health, care and educational interventions can be implemented for the maximum benefit. The noble Baroness, Lady Hollins, also mentioned that if there has been an early diagnosis, problems can be sorted out before they become too desperate. It is essential to ensure that families do not spend a long time in limbo, uncertain of how best to support a child or young person. Indeed, the same can be said for staff in schools and other settings. As the noble Baroness, Lady Hollins, mentioned, a diagnosis may make a massive difference for adults if they have struggled through their life without support. As our understanding of autism and its impact has improved, we have become better at early identification and more nuanced approaches to therapeutic interventions.
NICE has recommended that following a referral for a clinical assessment, a person should wait no longer than three months before the assessment process begins. NICE also highlights that given the complexity of autism, this process cannot be rushed. This is a challenge for the NHS and its partners. There is no doubt that in some parts of the country the demand placed on services, often through the sheer weight of numbers, means that they can struggle to meet the standards. NICE guidelines recognise that there is evidence of girls being one of the groups at risk. It is looking into better guidelines on this issue.
I will set out some actions that we are taking centrally to deliver improvements in how the NHS and its partners are able to deliver timely diagnoses. Diagnosis is of course a process which should be driven locally by clinical commissioning groups, working in partnership with their local authorities, to develop the right pathways to assessment and packages of care which result from a diagnosis. The noble Lord, Lord Hunt, and my noble friend Lady Browning talked about meeting targets and holding CCGs to account. The Department of Health and NHS England, along with the Association of Directors of Social Services, are visiting CCGs and local authorities. These visits aim to develop a better oversight of the challenges in securing timely diagnosis across all ages. They will consider data on waits, which are so essential, and the design of pathways—as a nurse, I really dislike that word, as the noble Baroness does, but I cannot think of a better one to use. They will also consider many of the critical issues raised so that they can make an effective assessment of how information is made available to the public, the links to mental health services and social care services, how initial referrals are triaged, and who provides leadership locally for autism support. NHS England will complete its work in April and then report to the cross-government autism programme board.
Effective commissioning must start with effective identification of needs. The Department of Health issued guidance in 2014 for health and well-being boards on children's complex needs, including autism, which provides key insights to effective assessments. The noble Lord, Lord Warner, mentioned that there should be specific commissioning for autism to take it away from other learning disabilities. I will write to him further on that but, as the noble Baroness, Lady Hollins, suggested, it can be difficult to separate the two when symptoms and behaviours can so often overlap. Quite often with diagnoses, somebody appears with a different kind of symptom than a natural autistic symptom. That can perhaps lead to finding that the child is also on the autistic spectrum, so I am nervous about separating the two.
The noble Lord, Lord Addington, spoke about higher education. It is essential that school staff are able to recognise and meet the needs of children on the autistic spectrum. The Department for Education has funded the Autism Education Trust to provide training for early years, school and further education staff across the spectrum of need. To date, the AET has provided training for around 87,000 education staff. I know that the AET is aiming to reach a key milestone of 100,000 trained staff in the summer of this year.
In brief, local authorities and CCGs are required to work together in joint arrangements to assess the needs of individuals and develop education, health and care plans designed to focus on the outcomes that will deliver the biggest impact for the child and their family.
Raising the skills and awareness of the workforce is of course key to diagnosis. The Department of Health has provided financial support to the Royal College of General Practitioners to make sure that there is a priority programme on autism, with practical work on autism awareness and training for GPs. This will enable people who may have autism to be supported more effectively from the start of their assessment process.
Last year, the Department of Health also provided funding to a number of organisations, including the Royal College of Nursing, the Royal College of General Practitioners and the National Autistic Society, to upgrade their autism e-learning training tools and materials. The department has also funded the development of two e-learning tools which can help people working with autistic children, young people and young adults to provide better services.
As people with autism are susceptible to mental health conditions, it is also worth noting that this Government are driving forward the transformation of children and young people's mental health services, improving access and making services more widely available across the country. The transformation programme, backed by additional investment of £1.4 billion over the course of this Parliament, will deliver a step change in the way that children and young people's mental health services are commissioned and delivered.
Also very important is the work done under the auspices of the 2014 Think Autism strategy. There are three key new proposals in the strategy that I think will make a difference. Think Autism community awareness projects will be established in local communities, and there will be pledges and awards for local organisations to work towards. The Autism Innovation Fund provides funding for projects that promote innovation, local services and projects, particularly for low-level preventive support.
The noble Lord, Lord Touhig, mentioned better data collection, and this is indeed very important. There will be more joined-up advice and information relating to services, including a new way for social care staff to record a person's condition. There is also a commitment to make it easier for people with autism to find information online, including information about how their local authority is performing.
The noble Lord, Lord Hunt, mentioned finance, which is always at the top of everything. The Government have allocated £4.5 million for the Autism Innovation Fund and the autism community awareness programme. This funding has been announced for one year.
What will make an enormous difference to diagnosis is effective local engagement with parent forums and other groups. That is critical to CCGs being more effective in meeting complex needs locally. They have expertise and experience, and they can interpret and provide a voice for their children.
We have heard today from my noble friend Lady Rock, very emotionally, about the difficulties she had with the diagnosis of her child. We should listen much more to what parents are saying. They know if there is something wrong with their child, and when they go to see a GP they need to feel that that GP is going to listen to them. Parents are often co-ordinating and managing a complex range of services and interventions as part of their caring role. NHS England has undertaken considerable work in this field to promote the value of engaging with parents.
I know I have left out several things that various noble Lords brought up and will make sure that I get back to them on all those issues. The noble Lord, Lord Touhig, asked whether Ministers will work with NHS England to commission an autism register in GP records. It is felt that a register per se is not necessary to their primary care work in supporting people with autism. GP practices already maintain registers for people with learning disabilities under the quality outcomes framework.
Commissioners are now beginning to realise that awareness, diagnosis and support needs to be of a high quality across the country. It is debates such as this today, though it was far too short, that keep autism firmly on the radar. I thank all noble Lords for their participation.
Sendai Framework for Disaster Risk Reduction
The Earl of Selborne
To ask Her Majesty's Government what progress has been made towards implementing the Sendai Framework for Disaster Risk Reduction 2015–2030.
My Lords, it is now a year since the Sendai Framework for Disaster Reduction 2015-2030 was agreed in Japan and later endorsed at the United Nations General Assembly. Therefore, it seems appropriate to table this Question for Short Debate to review how we are doing on our share of the implementation.
The Sendai framework was the first of three landmark agreements made as part of the United Nations' post-2015 agenda. The other two were the sustainable development goals, finalised in New York in September last year, and the Paris climate change agreement in December. The Sendai framework builds on the legacy created by the Hyogo framework, which embraced the 10 years from 2005 to 2015. This emphasised disaster-risk reduction as a priority within regional, national and local agendas. The Sendai framework gives greater emphasis to the need to address disaster-risk management, to reduce existing vulnerability and to prevent the creation of new risks. In other words, the key message is effective risk management, which will in turn lead to risk reduction.
What Governments around the world are ultimately required to deliver by their citizens can be summarised in very simple terms as the delivery of health, well-being, resilience and security. All these depend on social, physical and natural infrastructures, and we are all critically dependent on these being maintained for the essentials of life. When they fail, whether by reason of, for example, epidemic, flooding, the collapse of a structure or any other such disaster, it is the national Government who will be held to account.
The Sendai framework does not in any way reduce the primary responsibility of each state to reduce disaster risk but recognises that co-ordination and partnership between regions and nations is essential for disaster-risk management. In order to reduce risk, we need to identify and roll out best practice, we need to promote the collection, analysis, management and use of scientific data, and we need to ensure that these data are available to everyone.
The United Kingdom has a lot to offer to the international community in the field of the assessment and management of risk. It is one of the few countries to have a publicly available national risk register, based on a classified national risk assessment, with a strong and deeply embedded civil contingencies secretariat and well-rehearsed disaster prevention and management protocols and procedures.
The Government Chief Scientific Adviser, Sir Mark Walport, in his first annual report published in 2014—that is, before Sendai—said that the United Kingdom should continue to develop the role for innovation, as well as evidence and risk evaluation, in the delivery of resilient infrastructure. He said that the United Kingdom would need further to develop the national risk register as a key part of the debate on national infrastructure and resilience investment. I suspect that our national infrastructure in respect of electricity generation in this country is now looking less fit for its purpose than it was when he wrote that in 2014, with margins between demand and supply now tighter than had been previously predicted. Of course, shortage of electricity would certainly risk disastrous consequences. Can the Minister tell us whether the national risk register has, indeed, been further developed and, if so, how?
Disaster experts are cautious of labelling any disaster a natural disaster, although clearly nature may be the catalyst which sets off a disastrous chain of events. Environmental hazards become disasters as a result of the risks and vulnerabilities that people are exposed to on a daily basis. As a result of technological change, environmental depletion and climate change, the complexity of the risks faced by humanity increases year by year. Policymakers must define an acceptable level of risk. Developed economies typically have regulation in place which is designed to protect their citizens and limit such risks, whether generated by environmental change or man-made disaster. However, this could be at the expense of other parts of the world where regulation may be less appropriate.
Looking back at what is now almost history, the Bhopal gas tragedy in India of 1984 was a notorious such example. The consequence of that disaster was political unrest generated not just by the explosion in the chemical factory but by the failure of the recovery and accountability process. It was such scandalous examples of disaster management that led the United Nations to convene the first world conference on natural disasters in Yokohama in 1994.
Disaster impacts are strongly influenced by such issues as poverty, inequity, poor urban planning and inappropriate land use. The Sendai framework recognises that essential to addressing these issues, which lead to communities' exposure to risk, is the contribution of science and technology. We are, of course, the leading European country in terms of scientific output and we are rightly proud of our contribution to generating scientific evidence, which will, in turn, underpin risk management. It is through mobilising the expertise residing in our research institutions and commissioning the appropriate research that we can make the greatest contribution to implementing the Sendai agreement.
I commend the initiatives of Public Health England that were listed in the helpful briefing pack produced for this debate by the House of Lords Library. It included a paper from PHE's global health committee which refers to, among other health disaster issues, its contribution to controlling the outbreak of Ebola in Sierra Leone. I hope that PHE is now adding an assessment of the contribution that UK science should make to the control of the Zika virus.
In answer to a Parliamentary Question from the noble Lord, Lord Crisp, in November, the Minister said that the Government were still assessing the full implications of the Sendai framework for DfID programmes. I wonder whether she is now able to give us any further information on DfID's response.
I have no doubt that in responding to the Sendai framework we will benefit greatly from our membership of the European Union, which in this respect has a supporting competence. Will the Minister confirm that in addressing this 15 year-old non-binding agreement, which recognises that each state has the primary role in reducing disaster risk, we benefit enormously from close collaboration with our fellow EU members and from the European Union's supporting competence?
In Europe, over 80% of current disaster losses are caused by weather-related hazards and these are expected to increase in frequency, yet only a minority of the flood risks, for example, can be attributed to climate change. The rest can be attributed to human behaviour, such as building in risk areas. Most so-called natural disasters are nothing of the sort. With effective contingency planning, risk assessment and risk management, we can enhance resilience. Above all, we need to identify clearly and explicitly how our impressive science and technology capacity in the United Kingdom can underpin our contribution to global risk disaster and risk reduction.
Lord Hunt of Chesterton
My Lords, I congratulate the noble Earl, Lord Selborne, a very distinguished chairman of the House of Lords Science and Technology Committee, on having this debate at an appropriate time, one year after the Sendai framework, which is the result of steady progress over the past 30 years in reducing the impact of natural disasters.
There was a decade of natural disasters from the late 1980s to the 1990s. Then, as the noble Earl implied, there was the Yokohama meeting, which I attended as head of the Met Office, when the technical challenges were outlined. For example, some of the important developments were the advances in warnings for many kinds of disaster. At that time there was tremendous resistance to the sharing of data; some disasters could have been considerably reduced had there been a better exchange. By the time we got to Hyogo, 10 years later, some of this exchange of data was improved but there were also new technologies for the dissemination of data.
In the past few years we have moved on to the question of climate change effects. At the IPCC, in which Dr Murray was involved, there was great progress in understanding how natural disasters can become more severe and frequent with climate change. The Sendai meeting and framework began to focus on the social and governmental role. One of the important points was that this has stimulated much more work in universities and institutions in the UK on social vulnerability and post-disaster resilience. I have a colleague here this afternoon from UCL's institute, which is a result of this movement.
I emphasise the continuing need to understand natural disasters, predict them and warn about them, realising that we still have a very big task, particularly with earthquakes. When Dr Wahlström came to London before the Sendai meeting, we discussed the question of major challenges to establishing improvements. I think it has generally been accepted in all fields of endeavour, including science and technology, that some of the greatest challenges can be overcome when there are targets—a man on the moon is one example, cancer is another—and meteorology is no exception. It has to be remembered that in the 1990s, textbooks in the United States said that it was impossible to improve the accuracy of forecasting for tropical cyclones, hurricanes or tornados. In fact, a few years later, there was very significant improvement.
There is still considerable uncertainty about earthquakes, which cause some of the greatest problems and really are national disasters—there is nothing that causes such disasters like the natural disturbances in the earth. Research groups in Russia and China and some run by private individuals in the United States are working on that problem, and I find it very disappointing that these most important events, in which tens or hundreds of thousands of people can die, are not mentioned as a target by the Sendai framework. Targets are really important.
The framework is very good at saying how we should use science and technology, but if we had this as a major United Nations goal and used all the technologies—I know about some of those in the defence sector—there could be improvement. All our newspapers today were covering Prince Harry, who is in Nepal supporting the people there following the recent earthquake. These new developments will come from integrating massive computational studies covering areas from the outer atmosphere to the bottom of the ocean and through the layers of the earth. Some of the physical processes are still quite uncertain.
The framework, quite rightly, points out how physical processes and social impacts from natural disasters differ between regions. The framework has some important recommendations about how these goals might be agreed and promoted through a committee of the United Nations natural disaster body or through its science and technology advisory group. I am very pleased to see that this advisory group has specialised groups in the different regions of the world, because one of the things we know is that natural and meteorological events, including pollution, flooding and many others, vary greatly from one region to another. There is much local expertise. I make this perhaps trivial point because many of the computer models used for climate are used the same way all over the world, and people now realise that that may not be the best way to do it.
In the past, the United Nations agencies had strong records in reducing certain risks, such as those in meteorology that I mentioned, but there are other geophysical risks that have had less resources focused on them. I hope that the UNISDR STAG will have the strength to divert resources to the critical areas, one of which remains hydrology and the question of floods. The other important point is about practice in other parts of the world: the Philippines, for example, has the most advanced system in the world, using modern communication methods and online computer modelling to see how floods move through areas and through different houses. Comparing how they are doing it there with, I am afraid to say, some of the ways that we are doing it here in the UK, could offer good examples of exchange from the south to the north.
I believe that the Foreign Office also has a role in co-ordinating UK representation at these agencies, and in that sense it needs to collaborate with the European Union. I continue to think that the proportion of funds devoted to water resources and flooding is too small. Having made these points, I look forward to hearing from the Minister.
Lord Collins of Highbury
My Lords, I, too, thank the noble Earl, Lord Selborne, for initiating this extremely timely debate. As he indicated, the Sendai Framework for Disaster Risk Reduction is a 15-year, voluntary, non-binding agreement which recognises that the state has the primary role to reduce disaster risk but that the responsibility should be shared with other stakeholders including local government and the private sector.
Last week, as the noble Earl indicated, was the first anniversary of the framework, which was adopted in 2015 in Japan. Sendai also held the 2016 Symposium for Disaster Risk Reduction and the Future this month.
When I was thinking about this debate this morning, I was listening to Radio 4 and I heard Professor Jim Al-Khalili, presenter of "The Life Scientific", introduce the environmental scientist Professor Carolyn Roberts. In doing so, he mentioned that barely a month goes by without news of another catastrophic flood somewhere in the world: we had the Boxing Day tsunami in 2004, the flooding in New Orleans and Hurricane Katrina a year later, and the typhoon in the Philippines in 2013, with the role of climate change being strongly mooted. Jim also reminded us of the events here this winter when, once again, flood victims were caught in a cycle of despair and anger as they tried to make sense of why their homes were flooded and what could be done to prevent it happening again.
I immediately tuned in to the radio, bearing in mind the potential for the Sendai framework to structure how all communities, both locally and globally—I am sorry for the interruption, but I cannot decide which glasses to wear at the moment. I have a slight problem with cataracts and I am finding it difficult to focus. As I was saying, I tuned in to the radio, bearing in mind the potential for the Sendai framework to structure how all communities, both locally and globally, are able to respond and protect people when disasters occur, and for science and technology to contribute. Professor Roberts applies water science in particular to work out why such events occur and the role that we humans play in them. One thing she mentioned that I thought had huge resonance for today's debate was her recollection of a local politician, who was responsible for planning policy in a council, asking what a flood-plain was. What this brought home to me—and to her; this is the point she was making—was the importance of bringing a better understanding of science to the public and ensuring that public policy development works hand in hand with scientific progress.
The Sendai framework recommends that national and local government work closely with the private sector in their area across the four priorities for action, benefiting from industry expertise—the examples given in the framework are insurance and risk sharing, as well as lessons in good practice such as resilient building codes, and resilient tourism and the business community.
My noble friend Lord Hunt of Chesterton has stressed how the Sendai framework and its priorities for action have been developed based on the 10-year experience of implementing the Hyogo framework and the ones that went before that. These priorities are key to enabling disaster management agencies to move beyond improved disaster management to address the underlying disaster risks. However, as my noble friend stated, it is also important that government agencies and the research community are encouraged to improve the technologies of prediction and warning, especially where the current methods fail, such as the warnings for earthquakes, as highlighted by my noble friend, and for certain kinds of typhoon, such as that which occurred in the Philippines.
I am also pleased to see that we have here today Professor Virginia Murray, head of extreme events and health protection at Public Health England. I read the extract from her excellent blog in the briefing that we received from the Library in which she illustrated how Public Health England works internationally alongside other Governments and in partnership with organisations such as the WHO, and, of course, collaboratively with DfID. She pointed out that through the Sendai framework Public Health England would be able to build a structured response using a greater level of detail and clarity, and to consider the potential for science and technology to contribute.
My noble friend also mentioned the role of the EU, which has, of course, strongly supported the Sendai framework's extension of the traditional focus on natural hazards to include man-made hazards and associated environmental, technological and biological hazards, which brings it in line with progress made at a European level in recent years. What contributions have the Government made to the development of the EU action plan on the implementation of the Sendai framework?
As Professor Murray highlighted, the Sendai framework also includes targets to reduce damage to infrastructure and disruption to basic services, including health and education facilities. In recent times we have seen a particular impact in Africa from epidemics and other risks. Some disaster experts have said that the lack of a firm commitment in the agreement to ramp up international aid for risk reduction would undermine poorer countries' efforts to make progress on the SDGs.
In February a special session on the gender-related dimensions of disaster risk reduction and climate change was convened in Geneva by the UN Committee on the Elimination of Discrimination against Women. Countries were urged to act on the emphasis that the Sendai framework placed on gender issues. What efforts are the Government making to reflect this and to work with disaster-prone countries to ensure that women are involved in the disaster risk decision-making process and resource management, and to ensure that they have access to social protection measures, education, health and early warnings?
As the noble Earl, Lord Selborne, has already mentioned, in response to a Written Question from the noble Lord, Lord Crisp, last November, the noble Baroness the Minister said that the department remained committed to supporting the most vulnerable countries to better withstand and recover from the impact of disasters. However, she indicated that DfID was still assessing the full implications of the Sendai framework for its programmes.
Disaster risk is costing countries more than $300 billion a year. If disasters strike in developing countries, they can wipe out 20% or more of GDP. Many experts argue that if we want to address sustainable development, disaster risk has to be incorporated in development planning. Evidence shows that Governments are failing to incorporate disaster risk in the planning of their economic development. What measures are the Government taking to address this, and will they highlight the importance of this issue at the next session of the Global Platform for Disaster Risk Reduction in 2017?
What efforts are the Government making to promote the need to integrate disaster risk reduction and climate change adaptation efforts, particularly given that 90% of disasters are now climate-related? Can the Minister indicate what the Government's current priorities are in the vital area of disaster risk reduction?
The Parliamentary Under-Secretary of State, Department for International Development
(Baroness Verma) (Con)
My Lords, I, too, thank my noble friend Lord Selborne for securing this debate, and I thank all noble Lords for their excellent contributions. The debate has demonstrated that we did not need lots of speakers—its quality has been excellent. I share the same breakfast listening in the mornings as the noble Lord, Lord Collins. It was a really interesting programme this morning and I listened to it when I was stuck in traffic, trying to get to the department.
I see on a near-daily basis how the lives of poor people are threatened by the effects of disasters. A changing climate, combined with rising populations, urbanisation, environmental degradation, war and conflict, is challenging progress to end extreme poverty and is tipping more people into crisis. We know that early action and work to build the resilience of countries, communities and people can save lives when disaster hits. Indeed, early action and resilience building helps protect livelihoods, safeguards development gains and offers better value for money.
We have had a range of questions. I hope that I will be able to respond to some of them from my notes. I have also taken note of some of the questions that noble Lords asked, but if I fail to respond to any of them today I undertake to write to noble Lords.
Since 2010 we have significantly improved the quality and speed of our humanitarian response. We have prioritised disaster preparedness. In the new UK aid strategy, we identify strengthening resilience and our response to crises as one of our four strategic objectives. We are committed to doing more to strengthen the resilience of poor and fragile countries to disasters, shocks and climate change.
DfID and the Cabinet Office have worked with the UN Office for Disaster Risk Reduction on developing the Sendai framework. In March of last year my right honourable friend the Minister of State for International Development, Mr Desmond Swayne, spoke at the third UN world conference in Sendai. The framework is coherent with other international processes. It builds international co-operation and global partnerships, strengthens disaster risk governance and takes account of the particular needs of countries that are at risk of conflicts and insecurity as well as natural hazards. It ensures that development investments are disaster-proof.
Over the past five years since the publication of the humanitarian emergency response review, chaired by the noble Lord, Lord Ashdown, my department has focused on building the resilience of poor and vulnerable people to disasters. Here we have seen real leadership. The UK was the first donor country to define and frame disaster resilience, and we have successfully influenced the funding strategies of others. Internally, we have embedded disaster resilience in all our country programmes, integrated resilience in our work on climate change and improved the coherence of our humanitarian and development work.
I have some examples. In Ethiopia we contribute £276 million to a £2.2 billion programme that provides guaranteed employment for more than 8 million people on activities to stop soil erosion and preserve scarce water. This has transformed formerly famine-stricken areas of Ethiopia. El Niño has hit Ethiopia hard, but a combination of this kind of preparedness work and concerted action by the Ethiopian Government and donors has meant that there has been no repeat of the horrific famine of the 1980s.
The noble Lord, Lord Hunt, mentioned Nepal. Prior to the devastating earthquakes in April and May 2015, the UK was already supporting a five-year programme to build Nepal's disaster management system. This included measures to strengthen legislation on land use and building codes to retrofit key buildings such as hospitals to withstand earthquakes, to build the capacity of the Government and communities to organise, and to pre-position goods and train people to save lives in the immediate aftermath. So when the earthquake hit, the first relief was distributed within hours. When more relief was needed, the humanitarian staging area that the UK had built with the United Nations at Kathmandu airport helped accelerate the response by approximately three weeks. The experience in Nepal shows how the Sendai framework can be implemented and how it can directly save lives.
The UK is also leading the way in understanding and sharing what works best. The Building Resilience and Adaptation to Climate Extremes and Disasters programme, known as BRACED, will help more than 5 million people, especially women and children, cope with the impacts of extreme climate events by creating new coalitions of civil society, government, media, universities and meteorological offices to build community resilience, as the noble Lord, Lord Collins, alluded to in his opening remarks. Lessons from this will be used to improve local and national policies and build institutional knowledge.
But we know that timely responses depend on finances also being in place well before disasters strike. Here, the UK has a strong story to tell, with the Africa Risk Capacity programme using modern finance mechanisms to enable African Governments to obtain natural disaster insurance, reducing the losses incurred by extreme weather events and natural disasters, and helping protect livelihoods. After the poor rains in late 2014, the system paid out £18 million to Senegal, Mauritania and Niger, providing food for 1.3 million people and fodder for nearly 600,000 livestock.
Before I conclude, I will respond to some of the questions asked by noble Lords. My noble friend Lord Selborne asked about the national risk register. He rightly drew attention to the importance of the role that that plays in the discussion on national infrastructure and resilience investment. The national risk register and the national risk assessment are based on, and rooted in, scientific evidence. The Government Office for Science and the broad range of stakeholders that it represents are important partners in delivering a rigorous and evidence-based assessment of the hazards and threats faced by the UK.
My noble friend also asked about DfID building resilience to pandemics such as Ebola. The UK led the international response to the Ebola crisis in Sierra Leone, and we have committed £427 million. The response brought together 10 government departments and four other non-public bodies, along with non-governmental organisations and charities. While huge challenges remain to help Sierra Leone rebuild its economy, the rapid and flexible cross-government UK action helped to save several thousand lives and put a halt to the outbreak of the disease spreading further. We must also pay great tribute to the people of Sierra Leone themselves, who were on the ground working very closely with UK personnel.
The noble Lord, Lord Hunt, mentioned targets and earthquakes. Sendai is designed as a broad framework with guiding principles and priorities for action and increased strengthening of the role of the Science Advisory Group. Our expertise has long played a strong role and will continue to do so, but it is important to ensure that all forms of disaster are covered. We also need to make sure that we work with partners so that they will also be able to strengthen their systems.
The noble Lord, Lord Collins, mentioned gender, and how we are supporting and protecting women and girls in disasters. As the noble Lord is aware, it is a subject very close to my own heart and very much at the centre of all the programmes that DfID is working in. We know that data are limited and that there is evidence that more women are likely to die after a disaster than men. Similarly, child sexual abuse has historically increased after emergencies, perhaps just because of the breakdown of social structures. The risks to survival of transactional sex are high, and the needs of women and girls are often overlooked during humanitarian crises. It is really important not only that we are only constantly mindful of that ourselves but that we remind donor partners with which we work and the countries in which we work that we should not overlook those challenging needs that particularly face women and girls. We are in a unique position, with both humanitarian operations and long-term development programmes, to address the immediate needs of survivors of disasters and those who are prey to sexual violence in emergencies. Ultimately, we need to tackle the underlying root causes of abuse so that gender inequality and discrimination are eradicated.
The noble Lord, Lord Hunt, asked about funding. As he is aware, we have scaled up our support to meet our share of the developed countries' commitment to provide $100 billion towards climate change activities. That is an increase of 50%, so our own contribution is $5.8 billion.
Does it focus enough on water?
Baroness Verma
My Lords, I hope that our response is comprehensive so that it takes into account all the issues that the noble Lord and indeed all of us should be concerned about on the effects of climate change. I am pretty certain that we will talk to colleagues to get a more detailed answer around the issue of water. While I was a Minister at DECC it was very much part of the wider debate, so I am pretty certain that it is not an overlooked subject matter.
Funding for work in response to climate change, for meeting our commitments and to meet other donors is done through the International Climate Fund. We work with our colleagues at DECC and Defra to make sure that not only do we reduce poverty and provide clean energy but we make sure that we are part of the economic growth agenda. Disaster financing should focus on the vulnerable, the poorest and those furthest away from help. It is likely that, while we are looking at development issues, we need to constantly make sure that humanitarian finance, which is currently under massive strain, is not overlooked and keeps pace with the rising need. Consequently, there is a need for Governments, businesses and individuals to build resilience against these disaster risks and develop rigorous disaster risk management strategies. Plans for risk financing, including insurance, should be an integral part of that.
I think I have run out of time, but I conclude by saying that the UK will meet its commitments under the new UK ODA strategy to strengthen resilience and our response to crises. The world humanitarian summit in May is a once-in-a-generation moment for the UK to showcase its experience and change the way that we work in the poorest and most fragile countries. As we come together to agree new ways of working to save lives and reduce hardship around the globe, the UK will play its role in making the summit a success. I pay tribute to my noble friend Lord Selborne, who reminds us of the work being done but also reminds us not to take our foot off the pedal in making sure that, as a lead development partner, we press other donors to implement and carry out their responsibilities, as the UK so successfully does.
Committee adjourned at 6.37 pm.