AS (2014) CR 36



(Fourth part)


Thirty-sixth sitting

Friday 3 October 2014 at 10 a.m.

In this report:

1.       Speeches in English are reported in full.

2.       Speeches in other languages are reported using the interpretation and are marked with an asterisk.

3.       Speeches in German and Italian are reproduced in full in a separate document.

4. Corrections should be handed in at Room 1059A no later than 24 hours after the report has been circulated

The contents page for this sitting is given at the end of the report.

      (Mr Walter, Vice-President of the Assembly, took the Chair at 10.05 a.m.)

THE PRESIDENT – The sitting is open.

1. The alternatives to immigration detention of children

THE PRESIDENT – The first item of business this morning is the debate on the report entitled “The alternatives to immigration detention of children”, Document 13597, presented by Ms Tinatin Bokuchava on behalf of the Committee on Migration, Refugees and Displaced Persons.

I call Ms Bokuchava, rapporteur. You have 13 minutes in total, which you may divide between presentation of the report and reply to the debate.

Ms BOKUCHAVA (Georgia)* – Thank you to all of you who have expressed your interest by being here on this Friday morning. The report that I am presenting rests on the premise that children are first and foremost children, and therefore they should never be detained for migration purposes. They endure physical and mental trauma during detention, even if they are detained for only a short time. My second argument is a more pragmatic one. Not only is the detention of children wrong from a human rights perspective, but it is more costly than the alternatives developed by some States, which are more cost-effective as well as being in the best interests of the child. Those are the two premises that I present to you today.

Why are children migrating? Some of them are fleeing conflict within their own or neighbouring countries. Some are fleeing violence in their homes or dire socio-economic situations. Unfortunately, as with many topics that we consider, statistics are weak in this area. One of the challenges that we encountered in the preparation of this report was the fact that it is very difficult to obtain statistics. United Nations bodies have confirmed that the situation is the same for statistics available at the global level, and European bodies have done likewise. In this Assembly, rapporteur Agramunt once stated that it was very difficult to come by statistics on exactly how many children are migrating.

We know that despite the general prohibition in many countries on the detainment of immigrant children, thousands are still being detained. There have been calls for alternatives. We have heard such calls from the United Nations General Assembly, the United Nations Human Rights Council and the United Nations High Commissioner for Human Rights. In this Assembly, Resolution 1707 on asylum seekers and irregular migrants in Europe stated that “unaccompanied minors should never be detained”. The European Court of Human Rights has a body of case law in which it argues against detention and for alternative measures. We have also heard from the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment on the subject.

As I have noted, States generally prohibit in law the detention of children for immigration purposes, but unfortunately the situation is different in practice. I note the positive changes in the legislation of several countries in the Council of Europe. As parliamentarians, we must all acknowledge that change at the legislative level is important. However, when we look at the executive agencies that implement those laws, we encounter a lot of gaps.

Why have I argued so ardently for alternatives? As I noted in my introduction, I have done so not simply because of the human rights perspective, although of course that is the primary consideration for us, but because the alternatives result in higher rates of compliance. Unfortunately, no comprehensive studies have been done, either at the global level or at the European level, to provide statistically robust conclusions to buttress the argument that I am presenting to you. However, a number of pilot studies have been done on the subject which show compliance rates rising dramatically to perhaps 80% to 90%.

      One of the organisations working on this subject, the International Detention Coalition (IDC), has been extremely useful in helping us to learn more about how alternative measures can reduce the costs to the State of dealing with migrant children. The IDC works not only in Europe, but globally – it has done studies in the United States, Canada and Australia – and it has found that the introduction of community placement models can reduce the costs to the State from 60% to 90%. When we have to push our governments for action, they often want to know about the human rights perspective, but, as we all know, they also always ask the money question. I have emphasised this aspect of the research so that in making our arguments to our own government or to others for ending the detention of children we can present the case for cost-effectiveness.

      How do alternative measures reduce costs? Most migrant children want to reach a place of safety, and they want to be informed about where they are, what is being done and what awaits them. If they are placed in a community environment where they are able to receive information and can work with those involved in the community placement model, they are better informed and more apt to return voluntarily or, if their status is so decided, to integrate more peacefully into the host society. Alternative models also provide better health and welfare conditions. Fortunately, many States have understood that, and are following positive practice; for example, some pilot projects in Belgium are interesting to study. I have provided the detail in the report, so I will not discuss individual countries, but there are several ongoing projects within member States of the Council of Europe that are very positive and that I would be happy to see emulated in other countries.

      To move on to our recommendations, although it is very important for the detention of migrant children to be prohibited in legislation, that is not enough: we must push States to implement such legislation. In addition, children are often detained inadvertently, perhaps for health screening or for age determination. As the committee heard from an asylum seeker, age determination practices are often very invasive and very rarely give the benefit of the doubt to the child. It would be commendable to do more work on the adoption of safer and more uniform age determination practices within the member States of the Council of Europe.

      The last recommendation is for the Council of Europe to continue to support quantitative and qualitative research on this subject. Unless we have real numbers, it is very difficult to decide how to move forward. It would be commendable if countries participated in research, such as that undertaken by the IDC, on how costs can be reduced by the adoption of alternative measures. That would help us to magnify our impact, because we could then make stronger arguments to our own government and to others. I look forward to listening to the debate.

      THE PRESIDENT – Thank you, Ms Bokuchava. You have three minutes remaining in which to speak at the end. I call Mr Xuclà on behalf of Alliance of Liberals and Democrats for Europe.

      Mr XUCLÀ (Spain)* – I congratulate Ms Bokuchava on this excellent report. I am reminded of how, in the Chamber on a Friday morning, we can have a calm debate on reports that are positive for member States and make a genuine contribution to furthering our values.

      Ms Bokuchava spoke about alternatives to detention for immigrant children. We are talking about “children” rather than “minors” because this subject involves the protection of immigrants who are detained because they arrive from third countries without any papers, not because they have committed a crime or have a police record. They tend not to be offenders, but young people or children who suddenly have to cope with being in a very strange and unfamiliar environment. A choice has to be made about whether to put them in the perhaps hostile environment of a detention centre, or somewhere much more appropriate to their health and education needs so that they can grow up in a much more propitious and promising environment.

      The report mentions the best practice followed in quite a few of the 47 States in our Organisation, and it suggests that that best practice should be extended to other countries. Very diplomatically, Ms Bokuchava did not name the countries where there is best practice – Belgium, Denmark, France, Hungary, Ireland, Italy, the Netherlands and the United Kingdom – but I want to mention them because they are exemplary in how they take in migrant children and integrate them in the right environment. The situation in other countries is very different. As I found from a report relating to people’s last wills and testaments, which I presented on behalf of the Social, Health and Family Affairs Committee a few years ago, there can be great differences between countries. If we are to safeguard children and prevent them from being put into detention, it is important to ensure that there is some alternative, and all such things are very positive.

      The rapporteur mentioned the economic argument, which has a lot of clout. It is often actually cheaper to find alternatives to putting the child in a detention centre. This is a cogent, telling and pragmatic argument that we need to drive home to our governments, because policies are often based on rational arguments such as cost. This rational argument backs up the moral one. We need to work on our convictions, principles and values, such as respect for human rights – the report refers to this – but we should back that up with a rational and pragmatic argument such as the economic one in order to address the human rights of these children and give them some alternatives.

      Congratulations, madam rapporteur. Our group will certainly vote in favour.

      THE PRESIDENT – Thank you. The next speaker is Mr Jónasson on behalf of the Group of the Unified European Left.

      Mr JÓNASSON (Iceland) – After hearing the excellent and lucid argument of the rapporteur, Ms Bokuchava, not much more needs to be said. I want to thank her and her assistant for an excellent report that concisely deals with an issue that all human rights bodies agree is of the utmost priority. She referred to these bodies in her speech, and they are mentioned in the report. The United Nations High Commissioner for Human Rights is cited as saying in 2009, when discussing the issue of migration, that “the plight of migrants, and particularly migrants in an irregular situation, is one of today’s most critical human rights challenges.” More recently, the High Commissioner called on States to “explore effective alternatives to immigration detention, particularly for children and other vulnerable groups of migrants.”

      What have we in this Assembly done in this regard? In 2011, we adopted a resolution entitled “Unaccompanied children in Europe: issues of arrival, stay and return”, stating that “unaccompanied children should never be detained”. The report tells us that several States have taken steps to end the immigration detention of children, but it also says that such steps are by no means satisfactory, and that the statistics are very alarming, both worldwide and in Europe. The Migration Committee heard from such youngsters about their heartbreaking experiences, and we have organised seminars on this issue, keeping us well aware of its seriousness.

      In the light of all this, the text of the draft recommendation is fitting. It states: “The Assembly stresses that States which engage in the immigration detention of children contravene the principle of the best interests of the child and commit a child rights violation. They deprive children of their fundamental right to liberty and put them at risk of severe and lifelong physical, mental and developmental harm. They may also violate other fundamental child rights, such as the rights to family, health, play and education.”

      I support the resolution.

      THE PRESIDENT – Thank you. The next speaker is Mr Voruz on behalf of the Socialist Group.

      Mr VORUZ (Switzerland)* – Although the subjects the Assembly deals with are extremely important, the one presented this morning by Ms Bokuchava is particularly so. In fact, it is constantly top of the topical list of such subjects. We have to think of the vulnerability of children who are often just let loose when conflicts arise in all parts of the world.

      Who are the people most affected by such conflicts? It is the poorest families: those who cannot bear the effects of such conflicts, and who are in any case often in a vulnerable situation. This excellent report proves the point, and the Socialist Group accepts it and urgently demands that we pay particular attention in our respective countries to the conditions to which children and young people in detention are subject. We ask that the detention of children be forbidden. They should not be sent back to their country of origin, according to the Schengen Agreement, because this is not a worthy solution. I remind you that the United Nations Convention on the Rights of the Child has been accepted by the great majority of members here. The draft resolution and recommendation must be accepted. Importantly, we are calling on the Committee of Ministers to collect quantitative and qualitative data on the detaining of migrant children, to establish a procedure to provide alternative solutions, and to establish the age limits that should be applied. We must consider the details carefully.

      THE PRESIDENT – Thank you. The next speaker is Ms Kyriakides on behalf of the Group of the European People’s Party.

      Ms KYRIAKIDES (Cyprus) – I congratulate the rapporteur, Ms Bokuchava, on this excellent report which addresses many of the important issues concerning the violation of children’s rights – in this case, the detention of children. The Convention on the Rights of the Child states that arrest, detention or imprisonment of a child shall be used only as a measure of last resort and for the shortest appropriate period. Every child in detention needs to have access to legal representation, and respect for all their rights should be shown, as stated by the convention.

Unfortunately, this is not always the case today. In many countries, a large number of migrant children, frequently unaccompanied, end up in detention each year, depriving them of their liberty, their right to family, education, and child-centred services. I point out that 53 of the 350 Syrian refugees who were recently saved in my country from a boat caught in a bad storm at sea were children, and almost 40 of them were unaccompanied. They were unaccompanied children put on a boat by their families, who were trying to send them out of a war zone for a better future.

      Testimonies from detained children regularly report physical, verbal and sexual abuse while in detention. Health assessments are rarely child-centred and frequently violate the child’s right to physical integrity. Age assessment of unaccompanied minors must always be based on the presumption of minority, and all countries need to follow the same practices.

As the Parliamentary Assembly of the Council of Europe, we need to ensure that methods of alternative detention are always a priority for children. We need to implement the laws that many countries have, but do not adhere to. Where those laws do not exist, we need to pass new legislation and establish guidelines on the procedures concerning the treatment of a child. We need to highlight the devastating effects of detention on a child’s physical and emotional development.

Ending the detention of child immigrants must be a priority. Multi-agency cooperation must be encouraged. There needs to be political commitment by all member States on this issue. We must all be aware of the far-reaching effects that detention has on a child. Children are a vulnerable group, and unaccompanied children are the most vulnerable. We need to ensure their guardianship and representation, we need them to be able to understand the procedures, and we need to ensure that they do not fall victim to trafficking and exploitation.

We support the recommendation and the resolution. We support what it clearly states on the need for a uniform approach to be adopted and the need for guidelines to be implemented, with the best interests of the child always as a priority. I again congratulate the rapporteur.

      THE PRESIDENT – Thank you. That concludes the speeches from the representatives of the political groups. The rapporteur will reply at the end of the debate. Ms Bokuchava, do you want to respond at all at this stage?

      Ms BOKUCHAVA (Georgia) – I will reply at the end of the debate.

      THE PRESIDENT – Thank you. In that case, we move to the general list of speakers. I call Mr Schennach.

      Mr SCHENNACH (Austria)* – I congratulate Ms Bokuchava on this excellent report. It is striking. This issue is one of the hardest things that member States have to deal with. No member State of the Council of Europe could honestly say that they do not have this problem. There are three types of migration where children may be in danger and need to be taken into care. There is asylum and flight, migration and organised crime. Ms Kyriakides just spoke about asylum and flight from another country.

As the rapporteur has said, some things have to end. In detaining children in detention centres, there is this terrible process of trying to find out how old they are, which is always bound up with a suspicion that they are lying. There are instances of the police going into schools and taking 10-year-old kids out of class to lock them up in custody. Such cases do occur. Seven-year-old girls are being taken out of school by the police when, for example, the mother is in a clinic with mental health problems and the father is not there. The girls are then detained. That happens, even in my country. We should not always point the finger at other countries. We should look at what is wrong at home. It is absolutely out of order; there has to be a complete ban on putting unaccompanied children in detention. There has to be a ban on the police marching in to a place where children should be safe, whether that is a school, kindergarten or nursery. The Dublin rules should not apply to children. These children are traumatised and we do not need to make it worse.

When it comes to migration, it is a bit more difficult, because different influences are at play. When integration does not work, the question of deporting young people when they are not doing so well at school is raised too quickly.

Organised crime is a difficult issue in Europe. Children are being bought and groups of children are being brought to other countries for the purposes of crime and for organised begging. It is difficult to get hold of these children, because they tend to be organised in groups and the places where they are kept are changed regularly. What can a State do about those children? They are victims of abuse. Are they to be deported to the country that the smugglers of children come from? This issue is one of the biggest and most difficult challenges that we face.

      THE PRESIDENT – Thank you. The next speaker on the list is Mr Selvi from Turkey, but I do not see him in his place, unless he is hiding. I call Mr Le Borgn’.

      Mr LE BORGN’ (France)* – There is no more beautiful cause than that of protecting and guiding children and awakening their awareness. Children are fully fledged citizens, but they are vulnerable and fragile beings when faced with the uncertainties of life. They never choose to confront such issues, but nonetheless have to do so. All children have the same entitlement to education, health and the protection of their family. Those rights are enshrined in the United Nations Convention on the Rights of the Child, as well as in several other texts published by the Council of Europe, which establish the principle of the child’s best interest. Under no circumstance should that best interest be ignored or sidelined.

Having said that, every year, tens of thousands of migrant children—the number is rising—end up in detention in different Council of Europe member States, despite the law and in violation of their rights. That is a crying shame and is intolerable. It is in contradiction of the European values that make up our common destiny. These children have committed no crime. They are the first victims of migration caused by extreme poverty, hunger and war. Soon, migration will be caused by climate change. They often come from a long way away with their families, and sometimes without their families. They end up on the roads or in makeshift boats, with their lives in grave danger. They are the victims of Mafia trafficking gangs. They are at the mercy, basically, of destiny. They find themselves deprived of freedom, in a prison universe—behind bars—only because they do not have the right documents.

What world are we living in? Where is the best interest of the child when the detention imposed on them exposes them to the most dreadful trauma and the risk of violence? Where is their best interest when their detention removes them from school, health care, their family and the protection that should be afforded to them? Detention violates the letter and the spirit of international and European law on children. It is our duty as parliamentarians to uphold that spirit. No member State of the Council of Europe should carry out the detention of children. It should be forbidden. If there is not a law on that, it should be drafted and voted on, and it should be applied everywhere, without any tolerance or accommodation.

There is no doubt that this tolerance, certainly in relation to procedures relating to assessing someone’s age, has caused the unacceptable situation we are in today. Let us draw on what has happened in European States that have put in place alternative solutions to detention of children that keep them with their family or guardian while waiting for a decision to be taken on their migrant status. I am thinking in particular of the Swedish reception programme, whereby once migrants have been registered and had an ID document issued, they are given accommodation and have access to health care and school, and support is provided by a social worker.

      We must not allow cynicism, fear of other people, rampant xenophobia and a barely concealed inhumanity become the norm to such an extent that we forget the sacred duty that we have as citizens and as parliamentarians in Europe. Let us all work together to ensure that the rights of children and the right to childhood are fully respected.

      THE PRESIDENT – Thank you. I call Ms Pipili from Greece.

      Ms PIPILI (Greece)* – On 13 September, on the shores of Crete, we had yet another naval disaster, and this tragedy really hit the headlines in the newspapers and in the media. But a miracle occurred. A small child, 17 months old, was found alive after three days at sea. Nadia from Syria had parents who had understood that they were not going to survive, so they handed over their child to their 19-year-old daughter to look after. Now almost all Greeks want to adopt this child. I am telling you this by way of example to show that the protection of children is a primary cause and objective for States but also for citizens. Nadia, in the end, was lucky. She is not going to a detention centre; she is going to a foundation for children and then she will be adopted by a Greek family according to legal procedures.

It is fine and fancy to discuss this subject. The report by Ms Bokuchava is excellent, and I fully concur with it. The recommendations also concern Greece, because migrant children, whether accompanied or not, arrive every day on our borders, and we have to protect them. In 2013, we had 1 550 applications for non-accompanied children, 34 of which were for children under the age of 12. This means that we are dealing with several problems at the same time. We have been able to resolve some of them. For example, we have set up a special department and introduced a special law to define children and young people. These young people, instead of hiding away from the law, are now able to ask to be found a place to stay. Of course, they are very vulnerable and their needs are great.

      Everyone is familiar with Greece’s economic crisis, but despite this, the protection of children must be carried out. However, nothing can be done if the countries of the west do not rapidly provide aid and support to make sure that the countries that receive these migrants are able to overcome the problems that they pose. Other European countries must share the burden with the countries of the south and the countries where these children arrive. I am sure it is useful to make progress in this respect.

      THE PRESIDENT – Thank you. I call Mr Spautz from Luxembourg.

      Mr SPAUTZ (Luxembourg)* – Recently the United Nations announced that hundreds of children are being used as suicide bombers in Iraq. Hundreds of other children are being tortured and killed by extremist groups. Other children are forced to witness massacres of hostages with a view to turning them into hardened killers willing to copy the barbaric acts of these terrorists.

      In the armed conflict that is being played out in Ukraine, countless numbers of families, with their children, have been forced to abandon their homes and are desperately looking for refuge. This is being played out within the very borders of countries that make up the Council of Europe. The international community is being called on to provide urgent help to people fleeing their homes. It goes without saying that it is our most fundamental duty to defend the interests of human beings, particularly children, and for us all to take action to avoid yet another humanitarian disaster.

      I congratulate Ms Bokuchava on her report. Placing children in detention is unfortunately a phenomenon that occurs far too often in large numbers of countries, including those that are members of the Council of Europe. Children are often arrested because they do not have the right ID or legal documents. It is not the children’s responsibility if this is the case. Placing a young person in detention deprives them of any form of mental health, educational or school-related help and strips them of their fundamental rights. A child placed in detention can suffer from mental scars and behavioural problems throughout their childhood and later on in life. This can in no case be an environment that is respectful to and acceptable for a child. We can be relieved to hear that some countries have reacted to the situation by promoting alternative solutions to placing children in detention, but this relief is only partial when we find that it cannot in fact be guaranteed that these solutions will be applied. We must continue to put in place legal frameworks that forbid placing children in detention, and we need to heighten the awareness of officials and law enforcement agencies in this respect.

      A large number of undocumented children state that they are minors. Whether this declaration is true or false, authorities should always be asked to consider the possibility that it could indeed be a child unless proven otherwise. The procedure should not resemble placing someone in detention or in custody until the exact age of the person has been determined. There is no advantage to be found in imprisoning a migrant child. Apart from the dramatic consequences of confining such a child, it costs a great deal of money to administer and places an additional burden on the accommodation centres.

      We can see the figures with regard to changes in policy. Some countries are systematically forbidding the detention of children, whereas others are currently preparing a legal framework on this. A series of other countries still choose the option of placing people in detention, whether they are adult or child migrants. A common position should be drafted and adopted in a uniform fashion so that we can give an example of good management and coherence to persons who are fleeing their homes.

      THE PRESIDENT – Thank you very much. I call Mr Van Dijk from the Netherlands.

      Mr VAN DIJK (Netherlands) – I compliment Ms Bokuchava on the report.

      This is an important subject, as everyone wants the very best for every child and everyone is concerned about children’s well-being. I want to express my deep concern regarding the fact that unaccompanied minors, in particular, seem to find ways of reaching Europe. The people-smugglers must benefit from this, and we have to trace, prosecute and punish them severely. Parents and guardians have a great responsibility in this regard. I get the impression that too many have a hidden agenda, sending their kids ahead and following them later to reunite in Europe.

      The problem addressed in this report starts in the country of origin. If we tackled the problem there, and if those responsible took their duties seriously, we would not have minors roaming the world.

      As said, we are all fond of children, especially those in need, but some countries, such as the Netherlands, are overcrowded, yet the number of immigrants – most of them economic migrants – continues to grow. The annual cost of immigration in the Netherlands is more than €7 billion. The problem of minors should not be the problem of the host countries. Every child has someone responsible for them, and if they did what they were meant to do, there would not be any child on the run.

      THE PRESIDENT* – Thank you. I call Mr Florea.

      Mr FLOREA (Romania) – Dear colleagues, ladies and gentlemen, migration is not a crime. We are all migrants, even if we rarely think it. We treat migration as if it was an anomaly, whereas it is the normal condition of mankind – we have always migrated.

      Some countries treat irregular migration as a criminal activity, but crossing a border without documents or extending a stay in another country is not a crime against persons, property or State security. Even if migrants violate an administrative requirement regarding documents when crossing a border, irregular migrants are not criminals and should not be treated as such.

      By detaining people, we endanger their health and well-being and do them serious harm. Empirical research shows that detention leads to serious depression, anxiety, post-traumatic stress disorder and even self-harm, especially in children, who are more vulnerable. Despite this, however, States continue to use detention, because they remain convinced that it is the best way to manage asylum and migration flows.

      It is noteworthy that all European Union and Council of Europe member States are also parties to the Convention on the Rights of the Child, to which the European Court of Justice and the European Court of Human Rights often refer in their judgments. First and foremost, asylum-seeking and refugee children must be treated as children and their rights and needs must be given priority in all migration policies. The “best interest of the child” principle applies to all, including those in the migration determination procedure.

      Article 37 of the Convention on the Rights of the Child states that detention should only be used against children as “a measure of last resort and for the shortest appropriate period of time”. Detention is damaging and unnecessary. Instead, governments can use community-based alternatives, which are more dignified for migrants and more cost-effective for States. In addition to cost savings, resolving people’s immigration cases in the community is much less stressful for migrants and States alike than doing the same in a detention centre. Above all, community-based alternatives preserve people’s human dignity. As an alternative, migrants could be accommodated in the community, with little to no restriction on their movement, and be allowed to live with much greater liberty than would be possible in a detention centre.

      Contributions from other organisations and institutions are also welcome. A paper entitled, “Immigration detention: looking at the alternatives”, written by Philip Amaral, advocacy and campaigns manager at Crisis Action, sets out just two alternatives: unaccompanied minors living in a home run by a Protestant charity in Germany that provides comprehensive services and access to legal support, and undocumented and asylum-seeking families being place in community housing in Belgium. We can resolve people’s immigration cases in the community, instead of exposing them to harm in a detention centre.

      THE PRESIDENT* – Thank you. I now call Mr Fournier.

      Mr FOURNIER (France)* – I commend our colleague, Ms Bokuchava, for a report that is full of humanity and which complies with the values of the Council of Europe.

      It is our duty to underline that a child should not be placed in detention. It is down to States to find appropriate solutions and return migrant families without locking them up. The argument that a child should not be separated from their parents is not admissible. Locking up a child not only traumatises them, but is a violation of the United Nations Convention on the Rights of the Child, which dates back to 1989. On this sensitive issue, the European Court of Human Rights plays a pivotal role, and its case law has a direct impact on the legislation of some member States.

      The report underlines the wide variety of national situations and mentions that France has taken action to stop detaining migrant children. Our country is a good example of the influence the Strasbourg Court can have. France was not spared by the increase in the number of foreign children placed in detention centres – according to some estimates, the number doubled between 2004 and 2010 – but we took measures to limit the detention of children after being convicted by the Court. The decision on 19 January 2012 led to an instruction on 6 July 2012 introducing the widespread use of house arrest as an alternative to placing families with minors in detention.

      The instruction has a two-stage system. First, the text calls on French prefects to apply the house arrest procedure to families with minors, rather than placing them in detention. Families can be placed under house arrest, even if they do not have very strong guarantees, if their overall behaviour reveals a clear will to commit fraud or not to comply with their obligations. In such cases, special vigilance should be applied. Alternatively, they could be placed under arrest in another place, such as a hotel, in which the police or gendarmerie services can conduct surveillance more easily.

      Secondly, the instruction provides for circumstances in which a family fail to comply with the conditions of house arrest. For example, if they refuse to board a plane, the prefects can note that they have deliberately failed to comply with the obligation to leave French territory. If so, the family will no longer benefit from the system of house arrest, and if they are arrested later, will be placed in detention in an appropriate centre, but for no longer than is strictly necessary to prepare for their removal. This is in line with the case law of the Court, which has not explicitly condemned the principle of placing children in detention, but has provided a proper structure for it.

      The instruction has led to a drop in the number of families with children being placed in detention, but the system could be further improved so that an end can be put, once and for all, to the detention of minors.

      THE PRESIDENT* – Thank you. I now call Ms Johnsen.

      Ms JOHNSEN (Norway) – Thank you, Ms Bokuchava, for your important report on child detention, which is a growing phenomenon in Europe. Regrettably, there are no signs that immigration to Europe will decrease – on the contrary, it is likely to increase, owing to wars and troubles nearby.

      The statistics present a challenge. Eurostat states that there are about 41 000 immigrant children in Europe, but the number is probably much larger. In the United Kingdom alone, there are estimated to be between 44 000 and 144 000 undocumented children. The detention of children has a negative impact. For example, research shows that it has short and long-term effects on children’s health, especially their psychological health. Children are vulnerable and easily traumatised. The longer they are detained, the more damage it does. It affects children’s ability to learn, and education is important. Children are also at high risk of being subjected to different forms of violence and abuse, and they are easily exploited.

It is said that it takes a village to raise a child. It requires proper economic resources, education, and health care, and at the very least a safe environment and the support of a family. Raising a child in detention breaches all those rights. The Parliamentary Assembly has condemned the detention of child migrants, particularly unaccompanied children. Resolution 1707(2010) on the detention of asylum seekers and irregular migrants in Europe states that unaccompanied children should never be detained. There is still a lot of work to do. The European Court of Human Rights has also delivered judgments on the inadmissibility of detention in numerous cases.

Forced returns of families with minors are a challenge. Even though we in Norway have quite successful return programmes, some families with minors refuse to use them and refuse to leave. How do we deal with that? In Norway, forced return is used only for migrants and asylum seekers. The number of forced returns is very small, and there is a time limit of 48 hours for detention near an airport. In the detention area, families with children are held separately, in a child-friendly environment, although that will still be traumatic for children.

Alternatives to detention must be found. The only solution is legislation, as is suggested in the draft recommendation. I fully support the draft recommendation and thank Ms Bokuchava for raising this issue.

THE PRESIDENT – Thank you. The final speaker on my list is Mr Khader, Partner for Democracy from Palestine, but I do not see him in his place.

That concludes the list of speakers. I call Ms Bokuchava, the rapporteur, to reply. You have three minutes.

Ms BOKUCHAVA (Georgia) – Thank you, dear colleagues, for your positive debate and your principled position that children should never be detained for immigration purposes. I thank Mr Schennach for his honesty in saying that we must call out our own States, where this practice may be taking place, before turning to other governments. However, we must encourage each other as well, and I think we have done so today.

I would like to respond to Mr Van Dijk’s concerns about why such children are migrating. Of course, in a perfect world, they would stay home, but as some colleagues have reminded us, even as we speak, conflicts are ongoing that are causing children to migrate. The argument that I have tried to put to you is that once such children arrive at our borders, we must treat them as children. It is never in a child’s best interests to be detained.

I thank colleagues for reminding us of the United Nations Convention on the Rights of the Child; in fact, this year marks its 25th anniversary. In connection with that anniversary, the Committee has been invited by the International Detention Coalition, which I mentioned in my statement, to join a global campaign to end the detention of children. The campaign was launched in 2012 at the United Nations Human Rights Council, and more than 100 organisations have joined it already. The Committee is honoured to join the campaign, and we hope to launch it during the April part-session with a number of activities. I hope you will all be there to join that debate.

I give the floor now to the Chairperson, who has a few comments to make. Thank you again for this very positive discussion.

THE PRESIDENT* – Thank you. I call Mr Rouquet on behalf of the Committee. You have two minutes.

Mr ROUQUET (France)* – The Committee on Migration, Refugees and Displaced Persons of the Parliamentary Assembly unanimously supported Ms Bokuchava’s excellent report on alternatives to detention of migrant children. I welcome this opportunity to thank her for the report, which seems to be unanimously supported here.

The report recalls the principle that children are first and foremost children, and should under no circumstances be detained for immigration reasons. Our Committee believes that the Council of Europe has an important role to play in putting an end to such inhuman treatment by providing alternatives to detention for children and giving them pride of place. As a member of this Assembly, I had the opportunity some time ago to accompany Mr Mignon on a visit in Greece to a detention centre in which children were being held. All the participants on that mission returned profoundly upset by our visit. From the bottom of our hearts, we remember that important and touching event. We would like the report to address such questions.

The report’s reception in this Chamber shows that we have all been made aware of the problem, which is why we ask the Committee of Ministers to set up a study to collect quantitative and qualitative data on the detention of children of migrants, find alternative solutions that are non-custodial and involve placing children with families and promote such practices throughout Europe. Colleagues, I invite you to support this important report and adopt the resolution and recommendation.

THE PRESIDENT – Thank you.

We come now to the draft resolution, to which no amendments have been tabled.

A simple majority is required.

We will now proceed to vote on the whole of the draft resolution contained in Document 13597.

The vote is open.

We now come to the draft recommendation, to which no amendments have been tabled.

A two-thirds majority is required.

We will now proceed to vote on the whole of the draft recommendation contained in Document 13597.

The vote is open.

I congratulate the Committee, and particularly the rapporteur.

2. Towards optimum breast cancer services across Europe

      THE PRESIDENT – The next item of business this morning is the debate on the report entitled “Towards optimum breast cancer services across Europe” in Document 13572. It will be presented by Ms Stella Kyriakides on behalf of the Committee on Social Affairs, Health and Sustainable Development.

      I call Ms Kyriakides, who is the rapporteur. You have 13 minutes in total, which you may divide between your presentation of the report and your reply to the debate.

      Ms KYRIAKIDES (Cyprus) – Thank you, Mr President.

      Dear colleagues, a diagnosis of breast cancer is the beginning of a journey, just as preparing this report has been. I start by thanking all members of the Social Affairs, Health and Sustainable Development Committee for supporting this effort, with special thanks to Europa Donna and all the members of the secretariat of the committee for all their help and guidance leading to bringing this report today to plenary and establishing yesterday the second breast cancer awareness event held at the Assembly. This event would not have been possible, of course, if it was not for the unwavering support of the Secretary General of the Parliamentary Assembly of the Council of Europe, Mr Sawicki.

      This report comes for discussion at a rather poignant moment for the Parliamentary Assembly, as a friend and colleague of many here at the Assembly, Helena de Assis, lost her life after having been diagnosed with breast cancer a few years ago. Helena’s determination and inner strength is a legacy that she leaves with all of us, and I would like to dedicate our effort and this report to her memory.

      The life experiences of breast cancer are similar for women across boundaries, religion and race. There are, however, many parts of the world where disparities still exist. Across our Council of Europe member States, women continue to hide their diagnosis and do not have access to optimal treatment and care. This is despite the fact that it is recognised today that providing breast cancer care of guaranteed quality leads to an increase in survival in the medium and long term, and to a better quality of life. It is therefore necessary to call upon all our member States to ensure optimal minimum standards of care for all patients diagnosed with this disease.

      Over the last decades, the advocacy and scientific communities have joined their efforts in increasing awareness of the issues that are relevant to breast cancer: issues such as diagnosis, screening, treatment, the rights of women in employment, insurance and the importance of palliative and end-of-life care.

      The aim of this report is to highlight these issues and to ensure that in Council of Europe member States efforts are directed to reducing disparity and inequality, so that the lives of the hundreds of thousands of men, women and their families who are affected by this disease have the level of care to which they are entitled.

      We have seen advances in early diagnosis and treatment. Many women now receive individualised care, and this has led to increased survival. However, in preparing this report and presenting it today, I felt that I needed to keep a balance in respect of an overly pink approach, an approach that does not allow for the objective interpretation of realities and statistics. We are all aware that no matter how much science has progressed, women and men still lose their lives to this disease.

      We need to ensure that women have access to quality-controlled screening programmes in accordance with European guidelines. We know today that screening benefits women and improves mortality rates when combined with modern treatment, and it is truly unacceptable that in many of our member States such programmes are not available to women. Breast cancer is not a single disease. Evidence has shown that if breast cancer patients are treated in a multidisciplinary breast unit, they have increased chances of survival and an improved quality of life. All women across the world should have access to fully equipped, quality-assured, dedicated breast units. We need to make sure that these breast units offer care for women living with metastatic disease and women who are at the end of their lives.

      Recent studies show that there is still so much discrimination, that one-fifth of all breast cancer patients do not return to work after their diagnosis, even though they are deemed fit to do so. Furthermore, frequently in some countries, women who do return to work often face income reductions. We need to pay special attention to young women with breast cancer, who face a whole lot of different issues and who need services and information.

      I will not take up all my time but will just end by saying this. Advocating for a cause has been part of people’s behaviour for centuries. The personal experience of breast cancer can leave one feeling angry and asking, “Why did this happen to me?”, or one can turn personal experience into a political one, advocating for change, keeping the fight against breast cancer on the top of all our health agendas, and ensuring that all women, and men, diagnosed with this disease have access to optimal services across Europe.

      This is the importance of personal experience: using it in a political way to effect change. We need to be well informed, we need to be well educated, and we need to use advocacy to break taboos and stigmas. Breast cancer has been one of the most dynamic fields in which advocacy has resulted in changing the face of the disease. Pink is not just a colour – it is an attitude that means that together we can create this momentum for change. Discrimination is often hard to fight in this disease, because the silence surrounding the disease is louder than the voices of the women.

      Supporting this report will break the silence in many of our member States. It will take the voices of patients diagnosed with breast cancer to their national parliaments, allowing us to make a difference and change the realities for men, women and their families.

      Thank you for your attention.

THE PRESIDENT* – Thank you, Ms Kyriakides. You have six minutes remaining in which to reply at the end of the debate.

We now come to the debate and speeches by the spokespeople of the political groups. First, I call Ms Guţu, from the Republic of Moldova, on behalf of the Alliance of Liberals and Democrats for Europe.

Ms GUŢU (Republic of Moldova) – Thank you, Mr President.

Ladies and gentlemen, on behalf of the ALDE group I congratulate Ms Kyriakides on this report, which has come just in time, because the issue of breast cancer affects all of us. Of course, the draft resolution will not be any relief to women who have breast cancer now, but the report and the draft resolution, which will be sent out to our Parliaments and will reach our governments, combined with measures taken by specialised hospitals, will certainly help in the prevention and treatment of cancer in women who are also wives and mothers.

The Republic of Moldova has been very much affected by this illness. In 2012, breast cancer caused 486 women’s deaths. In terms of morbidity, it is the second most serious illness. The number of women diagnosed is about 10 000 and, of course, we can assume that many women who have not yet been diagnosed also have the disease. It is treatable in 90% of cases in European Union countries, but to give a comparative figure, in the Republic of Moldova only 30% of cases are treatable and lead to a cure. The general reasons for this are late or incorrect diagnosis of the illness or incorrect treatment, because of the modest possibilities in our health service.

October has been declared breast cancer month in Moldova. The oncological hospital and the Association of Oncologists in Moldova are running an awareness campaign, saying, “Check yourself. If you are ill, it hurts me too.”

Mobile teams go into the countryside quite regularly to check rural women, who are overworked and less likely to notice physical ailments. Apparently, rural women especially are affected, largely due to the overuse of pesticides during the Soviet era. We are an agricultural country and the major part of the land is devoted to agriculture, so there has been massive overuse of chemicals. The Chernobyl event in 1986 has made morbidity much worse for all sorts of cancers, including breast cancer. Children tend to be affected early with cancer, because of the unhealthy atmosphere.

Aurelian Gulea, a Moldovan professor and chemist, after 20 years of research in our laboratories and also in Canada, recently discovered an anti-cancer molecule, following experiments carried out with living cells. In three years’ time, people will be able to buy medicine based on this molecule in our pharmacies. This discovery will, of course, provide relief not just to women suffering from breast cancer, but also to others suffering from cancer, which has cut through our populations over the centuries.

The ALDE fully supports the report and the draft resolution, and we will vote in favour with no reservations at all.

THE PRESIDENT* – Thank you.

I now call Mr Kox, from the Netherlands, on behalf of the United European Left.

Mr KOX (Netherlands) – Thank you very much, Mr President.

I thank our rapporteur, Ms Kyriakides, for her excellent report and a short but clear resolution. I thank you for all the work that you have done for this Assembly in this regard.

During the week we dealt with a lot of political controversy here in the Assembly and now, at the end of the week, we deal with political cooperation internationally and with cooperation of politics with science, to reach for something that is to the benefit of all. I assume that no members will vote against your report, Ms Kyriakides, because it will serve us all, especially all women who are confronted with breast cancer.

Sometimes these things come close and you know it. Yesterday we buried our group secretary, Helena de Assis. She fought for five years against breast cancer; it was a brave struggle. We admired her very much. However, in the end she lost her battle. In certain circumstances, breast cancer still is a deadly disease.

The good news is that important progress is being made. Some 25 years ago, breast cancer meant death. Now, breast cancer means you have a chance as well as a risk. Thanks to the progress in science and international cooperation in this regard, we in Europe have succeeded in getting a decrease in those who die of breast cancer. However, still far too many women die, and many of them could still be alive if we had, in all member States of the Council of Europe, the services that Ms Kyriakides proposes that we should have.

This is an urgent matter and we should convince our member States that such provision is available. Of course, it costs a lot of money, but in my opinion it is better to invest money in saving people’s lives than to invest in machinery to kill people. That is a personal opinion.

This is work in progress. As the rapporteur says in her proposals to our member States, it is something that is to be wished for; but it is also something that is doable and that we can achieve. Even in a continent where we have so many political controversies, it is something that we could and should do. My group of the Unified European Left agrees with all the rapporteur’s proposals.

Not everybody can win his or her battle against breast cancer. And if you have breast cancer there is nothing wrong with you as a human being. I very much applaud Ms Kyriakides’ saying, “Listen, if you have breast cancer there is no reason at all to be sabotaged or discriminated against because of that disease.” That would be the worst thing to do.

Our group secretary, Helena de Assis, almost succeeded in working until the very last day when she had to leave us. I thank the rapporteur for her kind words. Her report will have a special place in the offices of our group. Thank you very much.

THE PRESIDENT – Thank you very much, Mr Kox.

Now, on behalf of the Socialist Group, I call Ms Bonet Perot, from Andorra.

Ms BONET PEROT (Andorra)* – President, I thank Ms Kyriakides for such a thorough, full report. She touches on an important problem that concerns all of us, as Mr Kox said. All of us know family members or friends who have been affected by this disease, which cuts people down and is today the most prevalent disease in women, with a very high rate of incidence, which is increasing by 2% every year and has been for some time.

There are important factors to highlight and take into consideration. First, prevention and early screening is important in treating this disease in good time, to ensure that the consequences are the least tragic possible. Prevention and early detection should take place at a very young age, and that should start with teenagers – adolescents. People should learn to palpate their breasts regularly, so that this becomes a regular health check. Society as a whole should be involved in preventive efforts and measures.

There should be an increase in sporting activity and a decrease in obesity, and a drop in drinking and smoking. These are general preventive measures, but early screening is important, too, as I have said, as is diagnosis. We have also talked about axial mammography. It is important that all women in all Council of Europe countries should have access – in the same way and in the same conditions – to screening services, otherwise there will be tragic consequences. We are all worried about the consequences and we all want to avoid them.

      I will now return to what Ms Guţu said about mammography. In Andorra, we provide mammography and ultrasound scans for young women, as mammary density can make some cancers hard to detect. Some aggressive cancers may also be much harder to find than other cancers. Such measures are investments, rather than health expenditure. Any health budget that is used to combat breast cancer is not expenditure but an investment that the State makes to improve its citizens’ quality of life and to decrease the number of patients. Those of us who work in the health sector know that prevention is much less expensive than treatment and, furthermore, can help us to avoid the loss of much-loved people, as Mr Kox said on behalf of his political group.

      We must continue to raise awareness of breast cancer. Yesterday, Ms Kyriakides talked about activities in Cyprus, where street marches have been organised. Events are taking place in many countries. A women’s organisation has organised a marathon to raise people’s awareness of preventive action against cancer. Those actions are very effective, and they should happen in all our countries.

(Ms Brasseur, President of the Assembly, took the Chair in place of Mr Walter.)

      THE PRESIDENT* – Thank you. The next speaker is Ms Kovács, on behalf of the Group of the European People’s Party.

      Ms KOVÁCS (Serbia) – Thank you, distinguished President. As you all know, breast cancer is the most common type of cancer and has the highest mortality of any carcinoma in women worldwide. On behalf of my political group, I therefore start by saying that we should raise awareness, inform and educate women about the importance of prevention and early detection of breast cancer. It is essential to raise public awareness and remind women to have a medical check-up once a year. If detected early, breast cancer can be successfully cured, or at least an individual patient’s quality of life can be improved.

We fully support the report, and we thank and congratulate our dear colleague, Stella, on her excellent and dedicated work. We agree with her that prevention and early diagnosis is the most effective approach to improving health, and especially the control of malignant diseases. Early diagnosis increases the chances of a cure, so screening programmes are successful when the coverage of women is as high as possible, as that leads to a significant decrease in the mortality rate.

The EPP believes that the strategy of constantly defending against cancer, maintaining a passive attitude and relying on therapies and drugs is not sufficient. Instead of waiting for patients to become ill, we should provide enough digital and analogue mammography and other forms of screening. We should invite all women of the appropriate age to have screenings, and we should not give up until a mechanism of preventive examinations has been established that leads to more detections of cancer in its earliest stages. Doing all that will allow us to cut it at the root.

There can be no hesitation on breast cancer. We should not make excuses about the health system being disorganised and weak, and as the previous speaker said, we must not make excuses about not having enough money to prevent cancer, because prevention saves huge amounts of money and lives. We should ensure that our women—mothers, sisters and daughters—are protected by the standards common to societies that have a responsible attitude towards the life of every citizen. We are committed to empowering women across Europe not only by giving them the opportunity to grow and prosper but by helping them to achieve a better position in society.

I hope that our message of encouragement will reach all women in need of support, because we want them to know that they are not alone in this fight. As we heard from the honourable rapporteur, it is vital that the hundreds of thousands of women, men and families affected by this disease have the level of care to which they are entitled.

THE PRESIDENT* – Thank you. The next speaker is Ms Kountoura, on behalf of the European Democrat Group.

Ms KOUNTOURA (Greece) – I congratulate Stella Kyriakides on her report, which the European Democrat Group is pleased to support. Breast cancer is the most common cancer, and worldwide it has the highest mortality rate of any cancer among women. All women in Council of Europe member States, and across the world, should have access to fully equipped, quality-assured, dedicated breast units that provide comprehensive care. Screening carried out according to European guidelines provides a significant benefit to women by decreasing mortality rates from breast cancer when combined with modern treatment. It is therefore important for women to have access to screening programmes that meet the guidelines and provide evidence-based information.

Mammography screening is the best form of early detection for breast cancer available today, and it improves mortality rates. The fight against breast cancer must return to the top of the health agenda in every country. Breast cancer is not just a problem for women; it is a problem that affects men and women in all societies. Women and genetically predisposed men should have the right to access quality screening programmes, proper diagnostics and quality-assured, modern treatment in specialised multi-disciplinary breast units. Those rights should not only exist on paper but be implemented in reality. Every member State should have a national cancer registry that provides reliable data.

I am honoured to be a member of Europa Donna, the European breast cancer advocacy organisation that represents groups in 46 European countries. I represent Greece, which continually reviews all the evidence and supports population-based mammography screening programmes carried out in accordance with the European guidelines for quality assurance of breast cancer screening and diagnosis. Some of our goals are to promote breast awareness, to emphasise the need for appropriate screening and early detection, and to campaign for the provision of quality supportive care throughout and after treatment. Our priority is cancer advocacy that breaks taboos, stereotypes and stigmas and that presses all governments to return the fight against breast cancer to the top of the health agenda. It is important for us to spread that message and to convince our parliaments and governments that these are the priorities that we must support.

THE PRESIDENT* – Thank you. The next speaker is Ms Rawert.

Ms RAWERT (Germany)* - I thank the rapporteur, Stella, for this excellent report. Breast cancer is a question for not only health policy but social policy. There is also the question of social inclusion. I am responsible in the Bundestag for women’s health issues, and the usefulness of mammography and screening is a topical debate.

A series of international studies has reached very different conclusions about the matter, which has made women feel insecure and uncertain. Even doctors are unsure. We introduced screening quite late, and breast cancer mortality in the German mammography screening programme has been researched and evaluated only over the past few years. A long observation period has been required, and valid results will probably emerge by 2015.

In Germany, we have three-stage quality-assured screening for women between the ages of 50 and 70, which allows us to detect carcinoma. Mammography can identify breast cancer at an early stage, and it is recognised as a useful method. We have heard today about access to screening for different age ranges, and research must focus on that question. Do younger women need to have greater access to screening? Are we right to stick to the 50 to 70 age group? We are going to have that debate in Germany. Perhaps women aged over 70 should have access to screening.

Morbidity has fallen as a result of quality assured mammography screening, but more research is needed. It is vital that women have access to scientifically based, neutral and comprehensive information about the desirable and undesirable effects of early detection. That is why we send out the invitation to women along with a leaflet, and it is important to word that leaflet correctly so that women know exactly what they are entitled to. Perhaps they are also entitled not to know. I welcome comprehensive cancer registers, and particularly transparency of data across Europe. Unfortunately, in Germany we only established the cancer register in 2013, so we are at a very early stage of providing those data. We all want to bring down the death rate of women with breast cancer. We want to enhance patients’ quality of life. Above all, we want to reduce over-diagnosis and overtreatment. It is a scandal if doctors misdiagnose and that leads to too much treatment, aggressive chemotherapy and even mastectomies.

THE PRESIDENT*– Thank you, Ms Rawert. The next speaker is Mr Moreno Palanques.

Mr MORENO PALANQUES (Spain)* – Thank you, Madam President. More than 140 000 women die each year of breast cancer. We have made a great deal of progress in the fight against breast cancer, but the battle is not yet won. One of the women who died from the disease was my wife.

I thank Ms Kyriakides for drawing up this report. We have been fighting breast cancer with all the weapons that we have: mammographies, protocols for treatment and the discovery of certain genes that predispose women to breast cancer. In the past, I have worked on the human genome, and I know that medicine, which has so far been curative or palliative, will become predictive, preventive, participative and personalised. We are already able to detect genetic predisposition to a disease. The presence of a gene may tell us that someone has a predisposition of a given percentage to a certain disease, and that process can also be used to exclude certain diseases such as colon or breast cancer. We also have genome-wide analysis, which could be used as a tool to detect genetic predisposition to certain diseases. That is important, because it could help us to take decisions on our lifestyle to change our outcomes.

Genome studies not only enable us to use predictive medicine, but allow us to improve diagnosis and treatment. Genetic predisposition affects the rate at which certain drugs are metabolised, because of the way in which drugs are eliminated from the body, so treatment results may differ from person to person. We do not really know precisely how it works, but we are researching the matter. We know full well that people react differently to coffee. You might think that that is absurd, but human beings metabolise caffeine in the same way as they do some other drugs. We will soon be able to sequence our genomes, and we will know what our risks are. When that happens, we will have predictive, personalised medicine, treatment and analysis in which people will be called on to participate individually. We need to make headway with what we are doing, which is what the report is about. The report reminds us of the essential aspects of our fight against breast cancer: screening, preventive and curative treatment, and follow-up and monitoring of patients. We must make those things a true priority.

THE PRESIDENT* – Thank you, Mr Moreno Palanques. I call Ms Kyriakidou.

Ms KYRIAKIDOU (Cyprus) – In the past couple of decades, important progress has been made in understanding all the parameters concerning breast cancer, from early diagnosis to treatment and psychological care for patients and their families. The whole process has led to increased survival rates, so it must remain a top health priority of all member States of the Council of Europe. We must keep close to our hearts and minds the well-being of breast cancer patients. I consider it imperative that all women across the globe have, among other things, full access to competent breast units that can provide them with necessary and often life-saving comprehensive care. I fully agree with the rapporteur that the most valuable thing is to ensure that women have access to quality-controlled, nationally organised mammography screening programmes that are set up in accordance with European guidelines. She contributed a lot towards their adoption and ensured that they had at their disposal the correct information on the benefits and risks of such programmes. It is the responsibility of us all to ensure through our national parliaments and more generally through our respective policies that we keep these people’s well-being at the top of our agenda.

This important report concerns us all. I congratulate the rapporteur, Ms Kyriakides, on bringing it before us. I also congratulate her on her lifetime dedication and commitment to the cause of breast cancer, even before her election to the House of Representatives in Cyprus. She is also the president of Europa Donna. She managed to break the silence and has fought prejudices on this matter, both in Cyprus and beyond. As someone whose family has been deeply affected by cancer, I will be eternally grateful to her for her fight on this noble cause. I thank the rapporteur and encourage her to continue doing what she does. I assure her that she can rely on all our support in this journey, which affects us all.

      THE PRESIDENT* – Thank you, Ms Kyriakidou. I call Mr Schneider.

      Mr SCHNEIDER (France)* – The Pink October campaign for 2014 has just been launched throughout the world. It highlights the progress that has been accomplished, as well as the battles that still need to be fought to tackle breast cancer.

      I want to focus on the scientific progress that has been made and its consequences for the management of this disease. On genetic research, 5% of breast cancers result from a major genetic predisposition that carries a high risk of developing a tumour. It is estimated that 2 500 of the 52 000 new cases of breast cancer in France per year involve hereditary cancers. For women who carry the BRCA gene mutation, the risk of developing breast cancer is between 65% and 85%. Approximately 130 000 women in France have the BRCA gene mutation, but only 10 000 of those cases have been detected, which means that 120 000 women are unaware of the risks. Although there are about 100 genetic cancer units in France, they are not sufficiently promoted for screening purposes and specialist monitoring.

      Preventive surgery can of course be undertaken, but that option is not often used because it is a form of mutilation. Instead, our hopes lie in the development of drugs with an anti-oestrogenic effect. That is an interesting avenue to explore, and clinical tests are currently being carried out. In addition to the specific case of women affected by the BRCA gene mutation, important headway has been made in the development of anti-breast cancer drugs. At the annual congress of the European Society for Medical Oncology, the Roche laboratory recently unveiled a new anti-cancer drug, Perjeta. Tests have demonstrated that the administration of Perjeta in combination with an existing drug such as Herceptin can reduce mortality rates by 32% for women affected by metastatic cancer. That holds out extraordinary hope.

      However, the enthusiasm triggered by that news has, to a large extent, been tempered by the cost of such treatments, because both drugs are very expensive. Anti-cancer drugs are among the most expensive medicines on the market. It is estimated that treating someone in Europe costs more than €4 600 a month. That is a real problem, because the cost creates de facto inequality between sick women in Europe and those elsewhere. In countries where the health insurance system does not cover such costs, only women from an affluent background can access the drugs. Discussions should be held on funding drugs and pharmaceutical research in Europe, and proper thought should be given in particular to the use of public money. Such discussions should bring together all the protagonists concerned, but especially the pharmaceutical industry. Thought should also be given to the new drug on the market to treat and cure hepatitis C, particularly given how much emotion that disease stirs up throughout the world.

      I conclude by extending to the rapporteur my most sincere thanks for and congratulations on her report on the war being fought against breast cancer, which is something that touches us all.

      THE PRESIDENT* – Thank you, Mr Schneider. I call the last speaker on the list, Mr Reiss.

      Mr REISS (France)* – Every year, about 50 000 women in France, half of whom are of working age, are affected by breast cancer. It is the most frequently occurring cancer, and it is the primary cause of death in women in France. These terrible facts show the importance of this debate. The main objective is treatment, but this subject also concerns how best to handle cancer cases, screen for the disease and manage life post-cancer.

We know that the most effective way to fight cancer is through screening: early diagnosis of breast cancer means that the treatment will be more effective and that there is a positive impact on the prognosis. Nevertheless, even in countries with prevention programmes, such as France, about one woman in three does not attend screening or does not do so regularly. We therefore need to consider information campaigns and access to screening equipment in certain countries or regions, particularly rural areas.

      The Agency for Cancer Research only recommends screening for women aged between 50 and 69. That is not sufficient because women with a family history of cancer or a genetic predisposition to it are at higher risk. Above all, many such women experience the onset of the disease between the ages of 30 and 50, so it is vital to extend screening to that cohort. I am pleased that in France, under the cancer plan for 2014 to 2019, the screening programme has been extended to people at higher risk.

      Another challenge relates to life after cancer. Going back to work after treatment is very much part of the rehabilitation process, but it is a major psychological hurdle. People undergoing treatment have to stop working, and only 5% of women in France who have had cancer are still in work. It is difficult to go back to work, so we need co-ordinated measures involving the woman concerned, as well as occupational physicians, human resources departments and oncologists or cancer specialists. In that context, the German scheme that obliges employers to give such women back their jobs is very interesting, showing that those women need not be punished in the workplace because of their disease.

      Adaptations to conditions in the workplace are not always implemented – they can be difficult to make, particularly in farming or cottage industries, and they may not benefit everybody – but we should not turn our backs on the psychological aspects of suffering from cancer. Vulnerable people are sometimes not seen with the most benevolent eye by others in society. Psychological care is very important, even if it is only through patient self-help groups. Women need to have the confidence to go back to work and hold people’s gaze, perhaps not be as competitive as they were and recognise that they get tired more quickly or even have memory problems. All of that goes hand in hand with returning to work after a long absence.

      Breast cancer, because it affects women most of all, brings out the existence of social inequalities in relation to precarious jobs, financial matters associated with childcare during treatment and extra risk premiums on insurance policies. All that needs to be dealt with through having a co-ordinated multidisciplinary approach to the woman’s personal life and her job.

      Thank you very much, Ms Kyriakides, for this excellent and very important report.

      THE PRESIDENT* – Thank you, Mr Reiss. I now ask the rapporteur, Ms Kyriakides, to take the floor to reply. You have six minutes left.

      Ms KYRIAKIDES (Cyprus) – I thank all colleagues for their comments and especially for sharing personal experiences relating to breast cancer.

      Tiny Kox said that what we say in the report is doable, and that is why this is so important. It is doable if we put breast cancer as a health priority on the agendas of our member States. We need to do much more. We need to invest in research and in care. It is true that we will continue to lose lives to this disease, but it is unacceptable. I know it is Friday and everybody has had a long week and is tired, which is why I did not go into detail about the statistics. However, scientific evidence shows that the survival chances of women who are treated in specialist breast units from the beginning are increased by 30%. That said, this is not about numbers; it is about lives. We need to do a lot more across our Council of Europe member States to bring this issue to our national parliaments.

      When I dedicated this report to Helena, it was not just an emotional moment. I am a firm believer that we need to use difficult events – sad events happen in our lives – creatively, as voices for change. Getting this report in plenary has been a journey, but it does not end here. For us, the journey continues by taking this report – hopefully it will be voted for – back to our national parliaments, using our voices to break the silence in our own countries, and the Council of Europe then seeing how it is being implemented.

      I thank everyone – especially the committee, its Chair, the Secretariat and the Secretary General – for their support, for putting this subject in plenary and for organising our events in the Parliamentary Assembly.

      THE PRESIDENT – Thank you.

      I call the Chair of the Committee on Social Affairs, Health and Sustainable Development.

      Mr GHILETCHI (Republic of Moldova) – Whenever a report is presented on behalf of the committee, as Chair, you feel that your role is to convince the Assembly to support it. Today, the situation is different: I do not think we need to convince each other that the report and the draft resolution need to be supported. It is obvious: it is about lives, not statistics or procedures, as our speakers and the rapporteur said.

      I want to thank everybody who contributed to the report, but most of all I would like to thank the rapporteur, Stella Kyriakides, the Secretariat, and Europa Donna for launching the campaign yesterday to raise awareness. When I put the picture that was taken there on Facebook, I was immediately contacted by several women from my country, asking about this campaign. As Ms Guţu said, we have this problem in Moldova, but the sad news is that it is a problem not only there but across Europe. However, there is some good news, some signs of hope. We need to support this campaign and to do whatever we can to save more lives.

      I was touched that this report was dedicated to the memory of Helena de Assis. I was touched to hear from Mr Moreno Palanques about his wife. This issue touches our personal lives – our relatives and close friends. This is an occasion when our Assembly can be unanimously united in supporting this report. It is about lives. Let us do what we can to save lives in Europe.

      THE PRESIDENT – Thank you. Before proceeding to the vote, I would like to congratulate you, Ms Kyriakides, not only on your report and the work you have done but on your personal commitment. Through you, I would like to thank all those who set up this fantastic organisation in order to help us remove the taboo associated with breast cancer, and to improve prevention and save lives. Thank you very much for all you did. You really deserve our applause, as do all those who are combating breast cancer.

      (The speaker continued in French.)

      As there are no amendments proposed to the draft resolution, we will now proceed to vote on the whole of the draft resolution contained in Document 13572.

      The vote is open.

3. Progress report of the Bureau (Doc. 13608 Addendum 2)

      THE PRESIDENT* – The Bureau has proposed a number of references to committees for ratification by the Assembly, set out in Addendum 2 to Document 13608.

      Is there any objection to the proposed references to committees?

      There is no objection, so the references are approved.

      I invite the Assembly to approve the remaining decisions of the Bureau requiring ratification by the Assembly, as set out in Addendum 2 of the Progress Report, Document 13608.

      The Progress Report of the Bureau and the Standing Committee is approved.

      Before dealing with the best attendees of votes – our voting champions – and closing this session, I would like you all to stand and observe a minute’s silence in memory of what happened in the Mediterranean one year ago today, when 368 Eritrean nationals lost their lives close to Lampedusa. It is our duty to pay tribute to their memory.

      The Assembly observed a moment’s silence.

4. Voting champions

      THE PRESIDENT – I am pleased to be able to announce the names of our voting champions – those members who have taken part in the most votes during this part-session. They are: Ms Bonet Perot, Ms Christoffersen, Mr Cruchten, Ms Mateu Pi, Ms Maury Pasquier, Mr Moreno Palanques, Mr Schennach and Mr Ghiletchi.

      Please come to the front once the part-session has been closed. We have a gift for you to collect. There is a perfect gender split among the champions: four men and four women.

5. End of the part-session

      THE PRESIDENT* – We have now come to the end of our business.

      I would like to thank all those who contributed to making this part-session a success. My particular thanks go to the rapporteurs of the committees, who have carried out sterling work. I also thank the Secretary General and through him all the staff who work very hard behind the scenes, not only during the part-session, but in the run-up to it and afterwards. Our work is over, but their work is far from over. I ask you, Mr Sawicki, to thank all members of your staff. I thank our interpreters for helping us understand each other better. If there are misunderstandings, it is not your fault. It is down to the parliamentarians and not the interpreters.

      The first part of the 2015 session will be held from 26 to 30 January 2015.

      I declare the fourth part of the 2014 session of the Parliamentary Assembly of the Council of Europe closed.

      (The sitting was closed at 12.10 p.m.)


1. The alternatives to immigration detention of children

Presentation of report, Document 13597, by Ms Bokuchava, on behalf of the Committee on Migration, Refugees and Displaced Persons

Speakers: Mr Xuclà (Spain), Mr Jónasson (Iceland), Mr Voruz (Switzerland), Ms Kyriakides (Cyprus), Mr Schennach (Austria), Mr Le Borgn’ (France), Ms Pipili (Greece), Mr Spautz (Luxembourg), Mr van Dijk (Netherlands), Mr Florea (Romania), Mr Fournier (France), Ms Johnsen (Norway), Mr Rouquet (France)

Draft resolution contained in Document 13597 adopted.

Draft recommendation contained in Document 13597 adopted.

2. Towards optimum breast cancer services across Europe

Presentation of report, Document 13572, by Ms Kyriakides, on behalf of the Committee on Social Affairs, Health and Sustainable Development

Speakers: Ms Guţu (Republic of Moldova), Mr Kox (Netherlands), Ms Bonet Perot (Andorra), Ms Kovács (Serbia), Ms Kountoura (Greece), Ms Rawert (Germany), Mr Moreno Palanques (Spain), Ms Kyriakidou (Cyprus), Mr Schneider (France), Mr Reiss (France), Mr Ghiletchi (Republic of Moldova)

Draft resolution contained in Dcoument 13572 adopted.

3. Progress report of the Bureau (Document 13608 Addendum 2)

4. Voting Champions

5. End of the part-session

Appendix I

Representatives or Substitutes who signed the Attendance Register in accordance with Rule 11.2 of the Rules of Procedure. The names of Substitutes who replaced absent Representatives are printed in small letters. The names of those who were absent or apologised for absence are followed by an asterisk


ALEKSANDROV Alexey Ivanovich*

ALLAIN Brigitte*

ALLAVENA Jean-Charles*

AMON Werner*




ARIB Khadija*

ARIEV Volodymyr*


BAĞIŞ Egemen*



BALLA Taulant

BAPT Gérard/LE BORGN’ Pierre-Yves



BARREIRO José Manuel*


BECK Marieluise*


BENEYTO José María*




BERNINI Anna Maria*

BERTUZZI Maria Teresa*







BOCKEL Jean-Marie*




BOSIĆ Mladen*

BRAGA António*


BRATTI Alessandro*

BÜCHEL Gerold*







CHITI Vannino*

CHIUARIU Tudor-Alexandru*

CHOPE Christopher


CHUKOLOV Desislav*

ČIGĀNE Lolita*


CIOCH Henryk*


CONDE Agustín*








CSÖBÖR Katalin*



DECKER Armand*





DIJK Peter

DİŞLİ Şaban*

DJUROVIĆ Aleksandra




DUMERY Daphné*

DUNDEE Alexande*r

DURRIEU Josette*




EßL Franz Leonhard*



FENECHIU Cătălin Daniel

FETISOV Vyacheslav*





FLEGO Gvozden Srećko*



FRÉCON Jean-Claude*


FRONC Martin

GALE Roger*





GIRO Francesco Maria*

GOGA Pavol*


GORGHIU Alina Ştefania*


GOZI Sandro*


GROOTE Patrick*

GROSS Andreas/VORUZ Eric


GÜLPINAR Mehmet Kasim*

GULYÁS Gergely*

GÜR Nazmi





HÄGG Carina*


HALICKI Andrzej*

HAMID Hamid*



HEER Alfred








HÜBNER Johannes*

HUNKO Andrej*





IWIŃSKI Tadeusz*






JENSEN Michael Aastrup*










KATIČ Andreja*



KLICH Bogdan*

KLYUEV Serhiy*

KOÇ Haluk*




KORODI Attila*





KOX Tiny

KRIŠTO Borjana*



LE DÉAUT Jean-Yves*


LÉONARD Christophe*

LESKAJ Valentina*



LONCLE François*



LUND Jacob*

MACH Trine Pertou*


MAHOUX Philippe*

MARIANI Thierry*



MATEU PI Meritxell




McNAMARA Michael*





MENDONÇA Ana Catarina*


MIGNON Jean-Claude/REISS Frédéric

MIßFELDER Philipp*





MULARCZYK Arkadiusz*

MULIĆ Melita*


NACHBAR Philippe*




NÉMETH Zsolt TILKI Attila*




NIKOLOSKI Aleksandar*

NYKIEL Mirosława*



OEHRI Judith*


O’REILLY Joseph*



PALACIOS José Ignacio*



PIPILI Foteini



PREDA Cezar Florin*


PUCHE Gabino*


REPS Mailis*


RIGONI Andrea*


ROSEIRA Maria de Belém*



RZAYEV Rovshan

SAAR Indrek*



SASI Kimmo*



SCHOU Ingjerd/JOHNSEN Kristin Ørmen



SEARA Laura*

SEDÓ Salvador

SEKULIĆ Predrag*


SENIĆ Aleksandar

ŠEPIĆ Senad*












STROE Ionuţ-Marian*


SYDOW Björn*



TIMCHENKO Vyacheslav*




TÜRKEŞ Ahmet Kutalmiş*

TÜRKEŞ Tuğrul*

TZAVARAS Konstantinos**




VALEN Snorre Serigstad/HAGEBAKKEN Tore

VASILI Petrit*

VECHERKO Volodymyr*





VORONIN Vladimir*

VRIES Klaas*



WACH Piotr

WALTER Robert*




WOLD Morten*

WURM Gisela*

ZECH Tobias*



ZINGERIS Emanuelis

ZIUGANOV Guennady*



Vacant Seat, Cyprus*

Vacant Seat, ‘‘The former Yugoslav Republic of Macedonia’’*

Vacant Seat, United Kingdom*


Representatives and Substitutes not authorised to vote




Partners for democracy