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Sir James Kilfedder : A more immediate example is the appointment of the chairmen of the tourist board and the electricity company. Those and other appointments were made before privatisation by the Secretary of State or one of his Ministers.
Rev. Ian Paisley : As I am sure the hon. Gentleman is well aware, under the legislation that brought in the iniquitous Anglo-Irish Agreement, the Dublin Government have the right to put forward names for all those posts. It is clear to anyone who examines those names that the current political representation in the House of Commons is not replicated on quangos. The official Unionists are not represented ; nor are the popular Unionists, members of my own party or, indeed, members of the SDLP. Those who stand for the Conservative party or the Alliance party and are defeated, however, get on to all the boards.
Each chairman is to receive between £15,000 and £20,000 a year. The Public Accounts Committee has expressed anxiety about the manner in which they have been appointed, and about their management of the trusts' affairs.
The Minister said that the present health and social services system had the backing of the people of Northern Ireland, but adduced no evidence to support his claim. I challenge that claim : who supports the order? Which political party in Northern Ireland supports it ; which
Column 710organisation in Northern Ireland supports it ; which indivdual supports it? Perhaps the Minister will also tell us whether the Conservative party in Northern Ireland supports it. There is widespread discontent about the present system. The new trusts, and the appointment of chairmen and non-executive members, have added to that grave concern. The system will largely remove the element of accountability to elected representatives of the people.
The people of Bangor have demonstrated conclusively that they want to retain both the Banks residental home for the elderly and Enler house, in Dundonald. Under the new system of trusts, however, the people of Bangor-- people who believe in democracy--can be treated with contempt. Where is the democracy that this Parliament epitomises? I ask the Minister to take the order away from the House, and keep it away.
The order breaks new ground in that, for the first time, trusts are taking responsibility for social services work. We are deeply concerned about that, and feel that it deserves much closer examination than it will receive in an hour and a half. In the other place, Lady Denton said that this was a local solution to a local problem ; today, the Minister used the same words. That attracted my attention to the report of the debate in the other place, and I noted that the Minister read out whole slabs of what had been said there. He might at least have made some effort to update his material, in the light of experience.
Neither Lady Denton nor our Minister told us how the "local problem" to which they referred had been created. That might have been enlightening. Both said that the present system had served Northern Ireland very well for 20 years. In that case, why is change now needed? Has the present system been found to be deficient in some respect? Neither Minister suggested that it had, so we must assume that changes in health and social services provision created the "local problem" and that the Government had to make changes as a result.
The people of Northern Ireland have not asked for those changes. They are well aware that democratic input into every aspect of administration in the province has been diminishing steadily for many years. The order will move democratic control from one arm's length to two or three arm's lengths--a serious development that does not sit well with the Government's declared commitment to democracy. This is part of a process that has been going on for far too long, and should have been reversed long ago.
The mere fact that the Government are putting more and more buffers between the people and the delivery of service in itself creates a climate of suspicion, and makes people chary of accepting the Government's view that this scheme will secure public confidence. That is pie in the sky : in reality, the Government are not very widely trusted in Northern Ireland, where people feel that they are being used as guinea pigs in preparation for what will happen elsewhere in the United Kingdom.
The House will recall that when the Government introduced the community charge--to give it its proper title rather than its more popular description--the rest of the United Kingdom was used as a guinea pig. They did not
Column 711get around to introducing the community charge in Northern Ireland as it disappeared before it got that far--thank God that we had the wit to object to it on various grounds. We were right to object and we have been right about many things relating to Northern Ireland. We now say that this is not the right time for the order--in fact, it may never be the right time.
We want answers to a number of questions. What is to be the legal status of the trusts? It is not spelled out as clearly as it should be. If the Government are to embark on this confidence-building exercise, such issues should be spelt out. Are the trusts to be agents of the Government or of the boards? For whom are they acting? How is the perforance of their duties to be monitored?
In one respect, the Minister went some way to clearing up an issue that was troubling me. He said that social workers would be introduced at trust level. Surely they will be doing a job that is already being done by someone else, so who will lose their jobs? If no one is to lose his job, why do we need the new folk? The Government should have done a great deal of thinking before the order got this far, but it seems that that was not the case.
The order will affect very vulnerable groups. One has only to read schedule 2 to see who will be affected. Schedule 2 states that the order will repeal various provisions of, among others the Children and Young Persons Act (Northern Ireland) 1968, the Health and Personal Social Services (Northern Ireland) Order 1972, the Nurses, Midwives and Health Visitors Act 1979, the Mental Health (Northern Ireland) Order 1986, the Adoption (Northern Ireland) Order 1987 and the Disabled Persons (Northern Ireland) Act 1989. These Acts and orders deal with some of the most vulnerable groups in society. I do not think that this is the way to proceed. Baroness Denton made it perfectly clear in another place that the functions that will be transferred to the trusts flowed from the legislation that I have cited. When people on the ground realise what is happening, their distrust of the Government's intentions will be greatly increased. Article 92B deals with the improvement of the economy, services and so on. It states :
"The Department may appoint auditors to undertake comparative or other studies to promote economy, efficiency and effectiveness" in the provision of services. The first issue to be studied is the question of how effective, efficient and economical the present services are so that we shall at least have something with which to compare the new body when it is, unfortunately, established. It is clear that the Government are intent on introducing the order and will whip their cannon fodder through the Lobbies this evening. Their cannon fodder comprises hon. Members who have not heard the debate and who know nothing about it. If they did, successive Governments would probably have suffered more defeats. When dealing with vulnerable groups, economics is surely not our prime concern--or is it? If we think only of economics, those who have been disadvantaged for whatever reason will suffer grievously. Such folk should not be treated as mere chattels. We are not talking about the efficiency of the provision of goods or groceries ; we are considering the services that are to be provided for vulnerable people.
Social services provision in Northern Ireland has been integrated and has worked well for 20 years but is now being deliberately fragmented. I see no good reason for
Column 712that. If the order is passed, as I fear it will be, we need a truly independent and highly critical element--a bit of sand--to be introduced into the works. We need to ask the nasty questions which far too many people are willing to brush under the carpet. The Government have set up shadow trusts and have proceeded as if the opinion of the House did not matter, because they know that they can win the necessary majority. They have also appointed the shadow staff. I wonder whether they are already being paid--I assume that they are. We are aware of the cost of the salaries alone, but that is not the only expenditure that will arise. A new bureaucracy is being created which must duplicate the existing system. If it does not, people in post will have to get the sack, no doubt with very large redundancy payments which are not mentioned in the order. Article 6 deals with chemists. Why is the article included? Is this merely a convenient vehicle? What is the purpose of article 6? Why are these changes being made? The Minister should say a word about them.
My final comments relate to the need for proper ministerial accountability to the House or to the elected representatives of the people of Northern Ireland. The legislation highlights yet again the need for proper legislative processes in the House. Despite his chattering, the Minister knows perfectly well that if the order had to be dealt with in Committee, and if it were amendable, and if the Government had to answer probing questions and provide for Northern Ireland the information that they are required to give on legislation for other parts of the United Kingdom, the Government would have more explaining to do than could possibly be extracted from them in a one-and-a-half-hour debate.
Today's proceedings also highlight the need for a Select Committee on Northern Ireland--
Mr. Raymond S. Robertson (Aberdeen, South) indicated assent.
Mr. Ross : I am glad to see the hon. Gentleman nodding. The Government will no doubt have the support of the Labour party. If members of the Social Democratic and Labour party catch your eye, Mr. Deputy Speaker, they will also complain that they are unable to ask probing questions to find out what is happening. I advise the Labour party and the SDLP not to throw away this opportunity but to join those of us who oppose the order. Of course, a Bill would have been most welcome, but that is an idea to be pursued at some other time.
Rev. Ian Paisley (Antrim, North) : There are some issues to which we are all anxious to hear the Minister's reply. Those of us who have read the record of the proceedings in another place discovered that pertinent questions were asked and reference was made to a debate in the Northern Ireland Committee. It was reported that there was a consensus among the political parties about the issues that were causing grave concern to the people of Northern Ireland.
Will the Minister tell the House who responded when the draft order was published and what was their response? If 95 per cent. of the responses were against the order, should not that have been a warning bell to cease pressing ahead with it, or is the consultation process a charade and a farce?
Column 713The Minister has recently been appointed and we wish him well in his task. He may not believe this now, but when he has been in his job for longer and when he has listened to the people of Northern Ireland, he will find that many of them, including members of his party, have grave concerns about meaningless consultation. People may marshal their facts and lobby a Minister, who will listen but not heed anything they say because the decision has already been made. When Government Departments continue to behave in that manner, it causes grave resentment and bitterness in the hearts of people. Why have a consultation period and ask people to make representations if, when 95 per cent. of people say no to a proposal, the Government say yes? The Minister's party preaches to us that it would be wonderful if we could only get the elected representatives of the people of Northern Ireland to show unity. What is the Government response when Northern Ireland Members, whose opinions are diverse on many matters and between whom an unbridgeable and wide gulf exists on others, come together and agree on a proposal? They use their majority in the House to thumb their nose at the unanimous opinion of Ulster representatives and proceed with business. That is not the way to develop good relations in Northern Ireland and to give people confidence in the democratic process.
Accountability concerns all hon. Members and it has been mentioned in every speech tonight. The Minister's noble Friend spoke on the proposal in another place and I trust that he wii interpret what she meant, because I do not know what she meant. She said :
"Accountability is to boards, to the department and then to me. That position does not change. There is another line in the structure."
What did she mean by that? Does the line of accountability run from the boards to the Department and then to her? If so, why did she mention another line in the structure? Why did she not say that the line of accountability ran from the trusts, the boards, the Department and then to her? She left out trusts, but she described another line :
"There is a line to the social work person on the board of the trust ; a dotted professional line, which is of benefit in this case."--[ Official Report, House of Lords, 31 January 1994 ; Vol. 551, c. 1152.]
What has that to do with accountability? Will the trust be accountable in the same way as the boards, the Department and the Minister? We want that question answered tonight.
Hon. Members are aware that the taking of children into care is a serious matter. We have received phone calls from distracted parents saying that they have had domestic trouble and that their children have been "lifted", and that no one will now talk to them. Will we be able to discuss such matters with anyone? Has the line of accountability moved so far that there will be no way of bridging the gulf?
Dr. Joe Hendron (Belfast, West) : Does the hon. Gentleman agree that it seems crazy and foolish for the House to be discussing this order today when on Thursday we shall discuss the proposal for a Children (Northern Ireland) Order? Many activities of the proposed trusts will be to do with the care of children. As we have not sorted out the proposals on the care of children, why should the order be passed tonight?
Column 714allow us to debate the other order and then return to this matter. I do not know what the Government were up to when they decided to debate the order today. Perhaps they decided that, as the House would be dealing with orders all day, they could throw in another for discussion by Northern Ireland Members, who would be present to discuss the order on the airport.
They may have done it for convenience, but it is not convenient to those hon. Members who work in difficult circumstances that are unknown to Ministers and who are the only elected representatives in contact with the Government. We have councils in Northern Ireland, but they have relatively little power. We are the elected representatives and we have to carry out all the duties that councillors on this side of the water carry out. We have to do everything and the Minister should help the public's representatives to stand up for their constituents and to bring their constituents' complaints to them as part of the process of accountability. The Minister's noble Friend said that a trust was a "statutory body". Would the Government define that? Do the inverted commas around those words mean they are not really statutory bodies or that they have a higher breeding? Perhaps the Minister will explain the standing of these organisations.
Seven of the units will work in areas that have no acute hospital services and only five will work in areas that have acute hospital services. We do not know for how long those five areas will have acute hospital services. We have heard a cry from Bangor loud and clear tonight. I could raise a cry from the North Antrim hills and from the Larne area, which has been brought to the House's attention by the area's representative and myself on numerous occasions. We can all cry about what has happened to our hospital services. Will the Minister tell us what accountability we can expect?
The Minister in the other place continued :
"The draft order seeks to preserve this integration and to enable services to continue more or less in their present form."--[ Official Report, House of Lords, 31 January 1994 ; Vol. 551, c. 1125.] I do not understand that, because this is indeed a real change that demands the appointment of a chairman, executive members, a director and a social service worker. As the hon. Member for Londonderry, East (Mr. Ross) said, there will inevitably be redundancies. Where will they begin and where will they end? We cannot establish the new structure without redundancies. The integrated system that we have at present is perfectly good and I do not see why we have to inject into it a new arrangement altogether. Those are some of the questions to which the order gives rise. I have been able to refer to very few of the issues because our time is limited and I join my hon. Friend the Member for North Down (Sir J. Kilfedder) in saying that matters as serious as this, which have a bearing on the family and the civil liberty of the subject, should be discussed in a debate on a proper Bill, which can be amended. We cannot amend this order ; we can only vote against it. That is not the way in which business should be conducted.
The Minister would do well to heed my advice tonight. He would then be lauded by the people who thought it worth while to make representations to him about their objections to the order, and by the people of Northern Ireland and their representatives in this House, all of whom are saying, "Take this order back. Let us have a debate on
Column 715the important order that is to be considered by the Northern Ireland Committee and come back to this order when we have dealt with that." That, more than anything else that the Government could do at the moment, would inspire hope and confidence in democratic principles. This is a personal matter--it has to do with persons, children, families and welfare. Let the Minister be a man tonight. Let him stand up and say, "Yes, I will consider the order further and withdraw it in the meantime."
Dr. Joe Hendron (Belfast, West) : As someone who has spent the past 30 years in primary health care in the constituency of Belfast, West, let me first pay tribute to those involved in community care not only in that territory but throughout Northern Ireland. The past 20 years have been very difficult for all of them--especially for social workers who have to implement much of the legislation. I pay tribute to social workers, community and psychiatric nurses, medical practitioners and ordinary community workers on the ground who are not necessarily professionals.
The order has been introduced becasue the legislation introduced in 1991 was inadequate. We know about the trusts that we already have and about the trouble in relation to various hospitals, although that is not relevant tonight.
Like other hon. Members, I have studied the speech of the Minister responsible for health in the other place. On 31 January, Baroness Denton said :
"Since the proposal for legislation was published last June many people have voiced anxieties about its effect on services, particularly in relation to those for children."
Children are the most important subject that we are discussing tonight.
Baroness Denton continued :
"Some have expressed doubts about the accountability of trusts within the new arrangements. Questions about fragmentation and inequality of provision have been raised. My noble friend and predecessor and, more recently, I have considered very carefully the anxieties raised and have devoted much time and effort to listening and then explaining the issues."
I have devoted a fair amount of time to reading Baroness Denton's speech to establish exactly what she proposes.
The Minister's speech continued :
"I think it is fair to say that many of the anxieties expressed stemmed from a misunderstanding of the role of trusts, and perhaps I can clarify that point.
Health and social services trusts are state bodies, established firmly within the health and personal social services in Northern Ireland They are not independent companies and are bound by the same guidance and directions that govern the operation of health and social services boards at present. Like my noble predecessor, I recognise that people have anxieties".
That is true : all the people of Northern Ireland and all the professionals have great anxieties about the proposals.
"I appreciate their concerns. They are genuinely held, but they have not been ignored. Regardless of which side of the debate we are on, we have one interest in common--the welfare of children and other vulnerable groups in our society. For that reason, the shadow trusts and boards concerned have been working very hard"--
here are the key words--
"to establish procedures which will ensure that those who are entrusted with the discharge of statutory responsibilities at local level will be clear about their role and fully accountable for all that they do."--[ Official Report, House of Lords, 31 January 1994 ; Vol. 551, c, 1125- 26.]
Baroness Denton used the words "establish procedures", but I am certainly not aware of any procedures that have been established. Earlier today I attended a meeting of the Eastern health and social services board to
Column 716discuss the order. The hon. Members for Mid- Ulster (Rev. William McCrea), for Belfast, South (Rev. Martyn Smyth) and the representative of the Alliance party were also there, as were representatives of the social work and legal professions and of Queen's university.
As the hon. Member for Antrim, North (Rev. Ian Paisley) said earlier, the cart is being put before the horse. Some of the most important legislative proposals are contained in the Children (Northern Ireland) Order, which we are to discuss on Thursday. Not all the aspects of that proposal have been worked out. We shall have to address a great many questions to do with children in need and in care, sexual or physical abuse, and children who are in some way involved with paramilitary people. All those matters will have to be dealt with under the Children (Northern Ireland) Order, yet the trusts dealt with in the order before the House tonight will have to implement those provisions.
Baroness Denton and Baroness Faithfull both referred to accountability. Where is the accountability? We all know that, if a child tragically dies, everyone asks, "Where is the social worker? When did he or she last call?" Who should those on the ground speak to and seek guidance from? Is it the trusts? I am well aware that there will be a qualified social worker on the trusts. We must also consider the accountability of the trusts to the four boards and of the four boards to the management executive or the Department and eventually the Minister.
Rev. Martin Smyth (Belfast, South) : We are told that procedures have been put in place. Does the hon. Gentleman agree that there is great concern that, although a social worker is to serve on the directorate, there is no clear line management right down to grass roots level?
Dr. Hendron : I thank the hon. Gentleman for that remark. There is no line management. I am not criticising the excellent professionals involved in shadow trusts because they themselves have not been given guidance. The boards do not seem to know where they are. As regards the Children (Northern Ireland) Order, anyone who has time to attend the Committee on Thursday--which I understand will sit for at least four hours- -may glean some understanding of how complicated the problem is.
Another aspect relevant to the debate tonight and even more relevant to that on Thursday is the role of the police. Northern Ireland has many problems, similar to those in Britain but exacerbated by violence and by the fact that we have so many one-parent families. Children go before the courts, and the police are often involved. If we are to develop a comprehensive strategy for children and young poeple, we must involve the police. How on earth will we bring together the police force right across the north of Ireland, the 12 new trusts and four boards?
What we really need is a comprehensive system for dealing with child care. I sincerely believe--I have studied the order carefully--that it is a grave mistake on the part of Government to move it this evening. I do not want to repeat what other hon. Members have said, but I pay tribute to the British Association of Social Workers, Health Care in Northern Ireland, Barnardo's and various other bodies which have briefed us for some time. I ask the Minister to withdraw the order.
Column 7177.39 pm
Mr. Tim Smith : Much of the debate has focused on trusts. To some extent, we have had a rerun of the debate that took place in 1991 on the original order. There is a misunderstanding about the scope of the order. It is not unimportant, but it is relatively narrow. There was a misunderstanding by quite a number of those who responded during consultation who were inclined to criticise the concept of the trusts.
The concept of trusts in Northern Ireland was accepted when the House approved the 1991 order. That order provides for a clear distinction between the purchaser and provider and for the delegation of services from boards to trusts. What it does not do is provide for delegation of all functions of boards to trusts--only for some of them. I explained that mental health functions were transferred, but many other functions were not. I think that that was because at the time we were largely focusing on hospital trusts and not on the possibility of integrated trusts--combined health and personal social services trusts.
Frankly, it will simply not be possible for the trusts to operate most efficiently if those functions are not transferred to them. I am sorry that there has been a misunderstanding about that point. There has not been a deliberate attempt at obfuscation. The matter is relatively straightforward if the principle on which the 1991 order is based is accepted.
Dr. Hendron : The Minister could resolve many of our problems if he explained in simple language. If there is non-delivery of a service within the ambit of the order, who is responsible? Will it be the trust, the board, the Department or the Minister, all four, or any of them?
Mr. Smith : I can deal with that because a number of hon. Members raised the question of accountability. It is important. The position is no different in England and Wales, where we have trusts. The trusts are responsible for the delivery of the service and they are accountable, but there is a clear line of accountability from the trusts--[ Hon. Members :-- "To whom?"] The chief executive. I would normally expect, if I had a complaint about the operation of a health service trust in my constituency, to write initially to the chief executive. If I was not satisfied with the reply, I would take it to a higher level. The higher level goes from the trust to the board, to the Department and, finally, to the Minister in charge of the health service. That seems to be straightforward.
Rev. Martin Smyth : This is an important point. As I understand it, health trusts are to provide the service and the health authorities purchase the service. In Northern Ireland, the community trusts will be responsible not only for providing services but for purchasing the service. There is a dichotomy. It is bureaucratic logic going astray to extend it to community trusts.
Mr. Smith : The whole point of the order is to achieve a total split between purcha to trusts. We shall achieve a total transfer only if we accept the order, otherwise we shall be left with something of a halfway house which will not enable the trusts that are due to come into operation on 1 April to operate satisfactorily. I am sorry that it has been so difficult to explain all this, but I suspect that it is based on the fact that some people have a misconception about what trusts are
Column 718really about. They are statutory public bodies. There is no question of them having any other constitutional status. They will be fully accountable for their actions and will be fully accountable to the boards, the Department and the Minister. It is vital that we should make the change in the order. I commend it to the House. It being one and a half hours after the commencement of proceedings on the motion, Mr. Deputy Speaker-- proceeded to put forthwith the Question necessary to dispose of them, pursuant to order [11 February].
The House divided : Ayes 296, Noes 266.
Division 122] [7.44 pm
Ainsworth, Peter (East Surrey)
Alison, Rt Hon Michael (Selby)
Allason, Rupert (Torbay)
Arnold, Jacques (Gravesham)
Arnold, Sir Thomas (Hazel Grv)
Atkinson, David (Bour'mouth E)
Atkinson, Peter (Hexham)
Baker, Rt Hon K. (Mole Valley)
Baker, Nicholas (Dorset North)
Banks, Matthew (Southport)
Banks, Robert (Harrogate)
Beresford, Sir Paul
Biffen, Rt Hon John
Blackburn, Dr John G.
Bonsor, Sir Nicholas
Bottomley, Peter (Eltham)
Bottomley, Rt Hon Virginia
Boyson, Rt Hon Sir Rhodes
Browning, Mrs. Angela
Bruce, Ian (S Dorset)
Carlisle, John (Luton North)
Carlisle, Kenneth (Lincoln)
Channon, Rt Hon Paul
Clark, Dr Michael (Rochford)
Clarke, Rt Hon Kenneth (Ruclif)
Coombs, Anthony (Wyre For'st)
Coombs, Simon (Swindon)
Cope, Rt Hon Sir John
Currie, Mrs Edwina (S D'by'ire)
Curry, David (Skipton & Ripon)
Davies, Quentin (Stamford)
Davis, David (Boothferry)
Deva, Nirj Joseph
Douglas-Hamilton, Lord James
Durant, Sir Anthony
Emery, Rt Hon Sir Peter
Evans, David (Welwyn Hatfield)
Evans, Jonathan (Brecon)
Evans, Roger (Monmouth)
Fenner, Dame Peggy
Field, Barry (Isle of Wight)
Forsyth, Michael (Stirling)
Fox, Dr Liam (Woodspring)
Fox, Sir Marcus (Shipley)
Freeman, Rt Hon Roger
Gardiner, Sir George
Garel-Jones, Rt Hon Tristan
Goodlad, Rt Hon Alastair
Goodson-Wickes, Dr Charles
Gorman, Mrs Teresa
Grant, Sir A. (Cambs SW)
Greenway, Harry (Ealing N)
Greenway, John (Ryedale)
Griffiths, Peter (Portsmouth, N)
Grylls, Sir Michael
Gummer, Rt Hon John Selwyn
Hamilton, Rt Hon Sir Archie
Hamilton, Neil (Tatton)
Hampson, Dr Keith
Hannam, Sir John