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Mr. Mike O'Brien (Warwickshire, North): I intend to make a brief speech. I join other hon. Members in expressing regret that there has not been greater attendance of this debate on an extremely important issue. After 15 years of a Conservative Government, government is still Britain's biggest business and the Government are Britain's biggest employer. It is therefore important not only to our economy but to our constitution that we get it right.
I join hon. Members in paying tribute to the hard work of many civil servants throughout the country in various Departments and agencies. It is a very difficult time for them, yet they work hard to serve the public and to ensure that services obtained from Government are provided in the best way that they know. It is important to pay such a tribute because civil servants have gone through a period of great change. For many of them, that change has caused much personal insecurity over their future and, often, caused alarm about the prospects for the areas in which they work. I recently spoke to people who were working in the Insolvency Service. They were desperately worried about the future, not only of the organisation for which they worked, but of the quality of the work if the Government's proposed changes were undertaken. They deserve all the tributes and all the respect that they can get from hon. Members. I welcome most of the Government's response to the Treasury and Civil Service Select Committee report. I was able to join that Committee towards the latter part of its preparation of that report. At times, it seemed as if the report would never end, but it did. Although it has obviously not set the House alight with enthusiasm, it was valuable and workmanlike. The great British institution of our civil service is important to the very foundation of our constitution.
I join in the praise that the hon. Member for Carshalton and Wallington (Mr. Forman) gave to my hon. Friend the Member for Durham, North (Mr. Radice), whose chairmanship of the Treasury and Civil Service Sub-Committee during the preparation of the report was
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an example to us all, displaying the skill needed to achieve a consensus report that all members of the Committee could support. Today I shall talk primarily about one issue--the values of the civil service, especially impartiality. Many values are mentioned in the Select Committee's report and in the Government's response to it--such as the permanence of the civil service, its impartiality, its meritocratic nature, its honesty, accountability and integrity, its financial propriety, its commitment and its high standards. It is important that all those values be present in a civil service, and that we protect them, but the main and central concern of any Government must be to ensure that impartiality is protected. At times during my speech I may appear to introduce a note of partisanship, but that is not my intention. If there is partisanship, it is partisanship not for party but for the constitutional role of a non-party political civil service.There has been concern over many years--it was especially true in the 1980s and to some extent before that--about the way in which the impartiality of the senior civil service has been brought into question. The phrase "economical with the truth"--the words of a head of the home civil service, Sir Robin Butler--has gone into the dictionaries of quotations.
Mr. Radice: No, it was Sir Robert Armstrong who said that.
Mr. O'Brien: My apologies, it was Sir Robert Armstrong. The quotation "economical with the truth" has done great damage to the reputation of the civil service, because people remember it. There was also the television series in which Sir Humphrey Appleby was presented as the image of the civil servant. Okay, that was a joke, but at the same time it helped to give Sir Robin Butler, who took over from Sir Robert Armstrong, the responsibility of ensuring that he enhanced the public reputation of the civil service--and I am sure that that is what he set out to do.
Not only senior civil servants but the Government have the responsibility to protect that impartiality and integrity. The Government hold the integrity and impartiality of the civil service in trust for the nation, and I fear that there is concern that a Government who have been too long in office may begin to treat the senior civil service as a sort of particular party political fiefdom. That is the real danger to the impartiality of the civil service, because the civil service should not get too close to party politics. I fear that there is real concern that it may have done so in recent years.
Certain incidents immediately spring to mind. While the Civil Rights (Disabled Persons) Bill was before the House last year, civil servants were asked to provide certain Government Back Benchers with amendments designed to wreck it. That Bill had wide support in this place--on both sides of the House, to some extent. Yet the Government ordered the amendments to be prepared. The civil servants cannot be blamed for preparing them; they were told to do so, and it was right for them to obey the order. No blame can attach to them.
However, I think that the Ministers who ordered the amendments to be prepared in such large numbers broke the spirit of trust in which they hold the responsibility of government. They should not put civil servants into the
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position where they are expected to wreck a private Member's Bill of that nature, especially when it is known that the Bill has great support in the House.Sir Robin Butler suggested to me in evidence that he knew of previous Governments who had been involved in preparing amendments to private Members' Bills for Back Benchers. That has happened for many years under different Governments. It has not been wrong when the objective has been to assist Members in genuinely putting forward amendments to improve a Bill. However, questions must be asked when civil servants are obliged to provide amendments to wreck a Bill, and particularly a private Member's Bill.
Another issue that caused great concern to members of the Select Committee when Sir Robin Butler gave evidence was two investigations undertaken by Sir Robin. Again, I speak not from a partisan point of view, as hon. Members on both sides of that Committee raised their concerns. Sir Robin Butler, as the head of the home civil service and the Cabinet Secretary, was ordered to investigate the incidents by the Prime Minister.
The first incident involved the Chief Secretary to the Treasury's visit to a Paris hotel. I do not wish to go into the details of that visit, as I am not particularly interested in the background. I am interested in what happened between Sir Robin Butler and the Prime Minister. Questions were raised about who paid the hotel bill, and the issue became a matter of intense media and political in-fighting. The Government had recently lost a number of Ministers through resignations, and did not want to lose the recently appointed Chief Secretary.
Into that political and media dogfight, the Prime Minister appears to have plunged Sir Robin Butler by asking him to undertake an investigation. Sir Robin was, at best, ill qualified to undertake any such investigation, as he did not in any previous incarnation have experience of being a policeman, a private investigator or a barrister trained in interrogation. He had none of the qualifications for playing the detective, yet it appears that he was supposed to conduct an investigation and give a report to the Prime Minister on what happened.
Sir Robin asked questions, got answers and accepted them. He did not question all the main witnesses for the prosecution; for example, it appears that he did not question Mr. Al Fayed. Sir Robin then provided the Prime Minister with a report. The importance of the report was not just that it was used to give advice to a Minister or a Prime Minister, but that a report prepared by the head of the home civil service and the Cabinet Secretary was used to limit the political damage being sustained by the Government at a particular time. The suggestion being made was that anyone challenging the conclusion of the report was questioning the integrity of the head of the home civil service.
The Prime Minister had put the Cabinet Secretary--a supposedly non- political and impartial figure--in a position where he was being used to prevent questions from being asked by Opposition Members about party political concerns that were being aired legitimately in this place and in the media. That report effectively stopped the damage that was being sustained by the Government. Yet the investigation that was carried out was not thorough, and questions remained to be asked. But how could Opposition Members ask those questions without calling into question the integrity of the Cabinet Secretary, which we had no wish to do?
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The Prime Minister should never have allowed the Cabinet Secretary to become involved in that sort of party political row. It was a dogfight. It was a row in which the Prime Minister got the Cabinet Secretary involved, and when Sir Robin Butler was asked to undertake that investigation, he should have said, "No, Prime Minister. It would not be appropriate in these circumstances to do that." It might have been appropriate for the Whips or the chairman of the Conservative party, or someone else, to undertake that inquiry. Similar concerns have arisen about another investigation in which Sir Robin Butler was asked to become involved, when two hon. Members were the subject of accusations about money. Again, I do not propose to go into the details of the case. The question is: should a Cabinet Secretary ever get involved in investigating the circumstances of Back-Bench Members? No Prime Minister should involve a Cabinet Secretary in such matters as it may compromise the impartiality of the civil service. It may be that it does not; Sir Robin Butler may have acted entirely properly. But the perception of many people outside this place as well as, I regret to say, many inside it, is that that investigation should not have been carried out by that individual and that impartiality might have been compromised. The Prime Minister is in a position of trust in this matter. Perhaps unintentionally, but perhaps also with some malice aforethought, he managed to use the Cabinet Secretary to limit the party political damage that his Government were sustaining. A further issue has arisen in the past day or so. Serious questions are being asked about civil servants' involvement in a particular Cabinet Committee. That Committee's aim appears to be to provide the Government with a way to deal with policy problems and issues that will cause them difficulties in the run-up to the next election. It is about winning the next election, and the chairman of the Conservative party is on the Committee. He is a Minister without portfolio--he has no departmental responsibility--yet civil servants are being asked to advise and assist him in performing his task of winning the next election for the Conservative party.Other questions have been raised over a period about the payment of a Chancellor of the Exchequer's legal expenses and other matters. All those issues have caused many people to question whether there has been what has been called a
"weakening of the moral compass"
in the Government and their relationship with the civil service. Lord Callaghan has expressed concern about politicisation. That concern is, to some extent, justified by what we have seen in recent years.
Let that be a warning to the Government and the civil service that the values of the civil service must be held in trust and protected, not only by civil servants but by the Government. The Olympian Sir Robin Butler should not allow himself to be dragged into the gutter of partisan politics, nor should any civil servant. Some members of the Select Committee fear that impartiality has been undermined, and that should never happen again.
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9.29 pmMr. Giles Radice (Durham, North): We have had a good and thoughtful debate, in terms of quality more than quantity. We have heard interesting speeches from the hon. Member for Carshalton and Wallington (Mr. Forman), who played a prominent role in drawing up our Select Committee report, and from my hon. Friend the Member for Motherwell, South (Dr. Bray), who made some perceptive remarks and put us on our mettle in the Treasury and Civil Service Select Committee. We shall bear his remarks in mind.
I congratulate my hon. Friend the Member for Warwickshire, North (Mr. O'Brien) on mentioning some important matters. It would have been wrong if the debate had passed without mention of those issues, and I shall refer to them later. I also congratulate my hon. Friend the Member for Kingston upon Hull, North (Mr. McNamara) on his excellent speech.
Perhaps I may say a word to the Parliamentary Secretary, Office of Public Service and Science, who is to reply to the debate. His appointment drew some rude remarks from some areas of the press about rats joining sinking ships, which was unkind as I do not believe that he is a rat at all, although he has perhaps changed his mind more frequently than most. I have known him well in several guises, and when we started out as rookie Labour Members of Parliament I certainly would not have supposed that he would end up as a Conservative Minister; nevertheless, I wish him well in his new post.
The report of the Treasury and Civil Service Select Committee has in some senses dominated the debate, and it is perhaps fair that it should. The background to our report was great managerial change, the next steps process--we have been told by the Chancellor of the Duchy of Lancaster that that now greatly exceeds 60 per cent. and is likely to be 75 per cent. of the civil service in the future--and from 1992 onwards market testing, contracting out, privatisation, and so on. Many people have regarded those changes as increasing the danger of fragmenting the civil service. That argument was made to us by several of our witnesses, including former heads of the Civil Service.
There is no doubt that problems of morale result from all the great change that is going on. Although we were unable to carry out a survey ourselves-- I shall discuss that in a moment--a number of other surveys of Government Departments have shown that there is a problem of morale in the civil service. Difficulties are also caused by bringing a great many private enterprise people into the public service. When the Comptroller and Auditor General, Sir John Bourn, appeared before the Committee last February, he emphasised that some of the private sector managers being attracted into the public sector do not always understand that special care is needed when one is in charge of public money. That is obviously part of the background. One political party has been in power for a long time, having been elected at four successive general elections. Although there is no evidence of general politicisation of the civil service, as Lord Callaghan told us, inevitably the younger civil servants pick up the scent, and I believe that that is true. As an Opposition Member of Parliament, I had indeed noted a difference between the attitude of the younger civil servants and that of those who have known
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another Administration. With the possibility of a change of Administration ahead, perhaps things will improve in that respect. The Scott inquiry has revealed a great deal about the workings of Government, hovering like an angel above our deliberations--or perhaps like a black cloud over the Government and Whitehall, but it has certainly influenced both sides.Two things emerged strongly early on in the Committee's hearings. The first was the importance of the civil service. I believe that all who have taken part in the debate have paid tribute to the civil service as a great national asset, and our report begins by saying just that. We go on to say:
"Since the 1870s, it has been the permanent and impartial instrument of all administrations. Governments have always seen it as their duty to preserve its efficiency and honesty for their successors. The Civil Service's commitment to the highest standards of performance and conduct is a guarantee of constitutional and financial propriety and good government."
It is therefore very important in our constitution and in the running of our democracy.
There was general support from our witnesses for the values which underpin the civil service, including its non-partisan nature. No one argued, for example, that we should have a "spoils system". Everyone agreed that we should have an impartial civil service, with integrity, the ability to act objectively, selection for promotion on merit, and accountability. Above all, it was agreed that we should have an honest civil service. A number of our witnesses reminded us just how important it is to have an honest civil service. One only has to go to countries where civil servants are not honest to realise the economic cost of that and how it undermines the democratic process. We must therefore preserve those good qualities.
In the past, the shared values of the civil service were associated with shared ways of working, and shared systems of pay, grading and departmental organisation within the service. The intangible values to which I have been referring were linked to more tangible unifying factors. With reform and fragmentation, however, many of those tangible common elements have disappeared.
It seemed to us that in the new era of managerialism, the old methods of ensuring that the values of the civil service were maintained were no longer sufficient. That was the case for having a proper code, which has distinct advantages over the plethora of existing codes. It offers far greater clarity about civil service values, and about the duties and responsibilities of civil servants and Ministers in relation to civil servants. The code applies to all civil servants, not just to mandarins, and is both concise and comprehensive.
I stress the importance of the second paragraph of the code, which states that civil servants owe their loyalty to the Government "subject to the provisions of this Code".
That is the first time that any external authority has been brought into the relationship between Government and civil servants. I agree with the hon. Member for Carshalton and Wallington that we need to enshrine that aspect. That is the case for having statutory backing in the way that he described.
The code contains a new duty on Ministers to familiarise themselves with its content and not to ask civil servants to act in breach of it. That is important. It asks Ministers to behave with propriety. It reminds civil
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servants of the importance of obeying the law, of dealing with the public honestly, fairly and without maladministration, and of ensuring the proper use of public money. It reminds them of their duty in relation to the separation of public and private interests and their confidentiality, and of their political impartiality. We say that it should be a condition of employment that all civil servants should read the code and conduct themselves accordingly. We also say that if the code is to work effectively civil servants should have the assurance that if Ministers or heads of departments ask them to do things which are unconstitutional, illegal or improper, the civil servants should be able to appeal to an independent, outside body--hence the case for a civil service commission based on statute. The statute is important, and I endorse everything that the hon. Member for Carshalton and Wallington said about that. A subsequent Government or Administration must not be able to remove it: it must be part of our permanent constitution.I am delighted that the Government have broadly accepted the code. I am delighted that they have accepted that there should be an independent element in the appeal system and I am delighted that they are open minded about statutory backing. I am grateful for the support of my hon. Friend the Member for Kingston upon Hull, North and of the Labour party for the idea. I am also grateful for the support of the Liberal party, which is major progress.
All those factors add up to a big triumph for the Treasury and Civil Service Select Committee. Select Committees occasionally take a bit of stick--as happened for different reasons earlier this week. The study was long running. I agree with my hon. Friend the Member for Warwickshire, North (Mr. O'Brien)--I, too, thought that we would never finish it. The inquiry was very comprehensive and I give thanks to my colleagues on both sides of the House for enabling the Committee to reach a consensus. It is interesting how the process of argument during the Committee hearings changed our minds and that of the Government. I do not pretend that the Government's change of heart was due only to the brilliance of our arguments or even to the power of Conservative Back Benchers who served on the Committee. The changing political situation--the fact that the Scott report was pending--also had an effect. The Government argued strongly against the Committee's proposals for 18 months, but then they changed their minds and I give them credit for making that excellent decision. The time remaining is short and I should like to give the Minister the opportunity to answer some of the questions raised in the debate. I shall therefore not mention a number of issues to which I wanted to refer, such as the selection of top civil servants and the fact that the senior appointments committee has not been abolished as we had hoped in favour of the Civil Service Commission, although there has been some improvement.
We are sceptical about fast-streaming and I do not believe that the Government response has been adequate on that point. We proposed project teams and the idea of policy audits, but we have not had much joy in those areas either. With regard to managerial changes, we support the "next steps" process, but it should not serve as a stepping
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stone to privatisation. Market testing and contracting out must not be used in the doctrinaire way in which the Government have used them in the past.My position is this: efficiency changes, yes; permanent revolution, no. I do not believe that reducing civil service numbers as an end in itself-- irrespective of the effect on function and morale--is a sensible way to proceed. It is a pity that the Government did not accept our request to commission a survey of civil servants and we drew our own conclusions from that refusal: the Government were clearly worried about the final results.
We have not solved the problems in the area of accountability, and we were certainly not impressed by Sir Robin Butler's distinction between accountability and responsibility. The problem with his explanation is that no one would ever be responsible for their actions. We were also not impressed by those Ministers who appeared before the Committee and said that there were occasions when Ministers could lie to the House of Commons and get away with it. Committee members appreciated the difficulties with agencies and the way in which responsibility could fall between Ministers and agencies, with the result that no one would take the rap in the event of a disaster. Several examples of that were cited in today's debate. One proposed solution is that chief executives could be responsible to select committees for framework documents. However, I do not pretend that we have answered all the questions and I think that we should examine the subject of accountability again.
In conclusion, I endorse what my hon. Friend the hon. Member for Warwickshire, North said about impartiality. We all want an impartial civil service. I warn that we must be very careful in the run-up to elections because that is when Governments are most tempted to take short cuts, and they must not do that. I have written to Sir Robin Butler about the Cabinet Committee which is serviced by civil servants. I am sure that every hon. Member would seek the reassurance that civil servants will not be used for party political purposes. I do not believe that the civil service has been politicised, although some worrying incidents have been reported by the First Division Association. I believe that civil servants would be able to serve another Administration and I hope that they will have the opportunity to do so quite soon. The existence of a code with an independent appeals system which is backed by statute will underpin this great British institution and help to maintain the impartiality, non-partisanship, honesty and efficiency of the British civil service.
9.44 pm
The Parliamentary Secretary, Office of Public Service and Science (Mr. John Horam): We have had a very timely debate, because, as theHouse and all aficionados of the subject who are gathered here tonight know, we have had the first White Paper and the highly regarded report from the Select Committee. I pay tribute to the hon. Member for Durham, North (Mr. Radice) who, as one of my hon. Friends said, gave wise leadership to the sub- committee that prepared the report.
We have also had the Government's response in the shape of the second White Paper, which accepted the proposed code and went into discussions on the possibility
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of legislation. We hope to settle the code after further discussion before the summer recess and have it promulgated in the second half of the year. Included in the consultations will be further discussions with the Select Committee and the Opposition spokesman, obviously taking into account all views that have been expressed during the debate.The debate was not only timely but has been conducted mainly in a relatively bipartisan spirit, for which, in the long run, both sides of the House will be grateful. Where it was not bipartisan or where political points were made, I accept that they were serious and not irrelevant.
We are all aware of the importance of the subject. The hon. Member for Eastleigh (Mr. Chidgey) regretted that so few were here to discuss it, and so do I. He characterised himself as a gatecrasher to a rather small coterie who were used to discussing the matter. That is a pity, and I am glad that he was not a party pooper and is still in his place, as he said that he might have to leave the Chamber. The seriousness of the subject was reflected in all the contributions to the debate. The hon. Member for Kingston upon Hull, North (Mr. McNamara) made a number of points. I was disappointed by the relentlessly negative approach that he seemed to adopt, and I would contrast that markedly with the Select Committee report, which was positive about much of what the Government have done in the past 15 years. It is a pity that he did not take a more balanced view of the true picture.
I echo the remarks of the hon. Member for Warwickshire, North (Mr. O'Brien). My right hon. Friend and I are certainly concerned that there should be good morale in the civil service. Any such group of Ministers is bound to have great regard for that fact, and any thought that there might be poor morale gives us genuine concern.
Mr. McNamara: Do something about it.
Mr. Horam: The hon. Gentleman should listen to what I have to say.
As the Select Committee said, morale is bound to suffer during periods of continuous change, but that is not a reason for not embarking on those changes. As my hon. Friend the Member for Carshalton and Wallington (Mr. Forman) said, the public sector cannot be exempt from changes, nor can the private sector. We cannot ring fence the public sector and say that it must be exempt from changes that are happening elsewhere.
The hon. Member for Kingston upon Hull, North exaggerated the problem of morale. The Select Committee report used the expression "unease". The hon. Gentleman used very different words and mentioned a blanket of fear. Although we are concerned to maintain good morale and we were disappointed that it was bad, the hon. Gentleman has clearly exaggerated the feeling inside the civil service.
Mr. McNamara: I assure the Minister that if I felt morale in the civil service was high, I would say so and I would praise the Government of the day, but I know from my experience, and from those in the civil service whom I have met and know personally, that there is a blanket of fear, which results from their not knowing what
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will happen to them and from the ethos of the public service that they entered being undermined by the Government.Mr. Horam: No, I must disagree totally with the hon. Gentleman. That really is not true. I am glad to see that he is winking. I think that he is making a point about which he is not wholly serious.
Mr. Horam: The hon. Gentleman also made an important point about pay delegation. I agree with my right hon. Friend the Member for City of London and Westminster, South, (Mr Brooke), who has great experience in personnel management. I think that he would agree that the delegation of pay in the civil service brings closer a matching between performance and reward, which will be wholly beneficial to an efficient civil service. That is what we intend. I think that the hon. Member for Kingston upon Hull, North will find that his fears about low pay and so on are in many respects groundless. In fact, pay may be higher for many civil servants as a result of that approach. The hon. Gentleman referred to contracts. Contracts for senior civil servants do not change the existing terms of employment and they will not expose civil servants to political or other pressures. As now, decisions on performance will be a matter for departmental management, not Ministers. My right hon. Friend the Member for City of London and Westminster, South gave a marvellous evocation of the real qualities of the civil service--"elegaic" was one word that might be used. He relished it like an old wine that he loved well over many years; that was the feeling that came across. I liked his analogy of civil servants as regulars and Ministers as territorials. I was very glad of the speech that he made.
The hon. Member for Motherwell, South (Dr. Bray) made some interesting and serious points about information technology, the importance of which I fully accept. As he pointed out, I too have a particular interest in that area. I understand his point about EDS, but it is not my immediate responsibility; it is the immediate responsibility of the Treasury. None the less, I have taken careful note of what he said and I shall look into the matter. In a recent report the National Audit Office pointed out that over a 10-year period EDS would save the taxpayer £225 million. That is not an inconsiderable sum. I put that into the balance against the considerations that he legitimately raised.
The hon. Gentleman also made a fair point about the Sainsbury scheme. As he will know, my right hon. Friend and I are responsible not only for the public service, but for science policy, including technology and engineering. I am interested in that scheme and I shall certainly take account of what he said.
The hon. Gentleman regretted the disappearance of a serious, restrained, competent discussion--those were his words--on many issues. He cited disastrous economic policy. That was a rather unfortunate example. He may have seen the article by Wynne Godley in the Financial Times recently. [Interruption.] The hon. Gentleman and I have discussed the matter over many years and he knows well that Wynne Godley is certainly not a Conservative supporter. He is a distinguished economist and the hon. Gentleman will be
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satisfied of his mathematical and statistical qualities. After criticising Government economic policy since 1970, he has had to admit that during the past two years Government economic policy has been virtually perfect and that it would simply be vulgar to carry on criticising the Government. Government economic policy has been virtually perfect in the past two years. That is why now, for the first time in my life, we have an export-led economy with real prospects in the world. [Interruption.] That is absolutely true. I am glad to have support from quite independent economists on that subject. There is nothing like a good economist who is running his own business; I speak from considerable experience. I am glad that the hon. Member for Motherwell, South concluded that he was not a pessimist on these matters.My hon. Friend the Member for Carshalton and Wallington asked about secondments and two-way movement between the civil service and the private sector. I have some figures for him. Long-term secondments have increased threefold since 1979. In 1993, there were 400 outward secondments and 200 inward long-term secondments. In 1994, just over 1,700 civil servants undertook a secondment of some kind outside the civil service, so it is going pretty well.
My hon. Friend also advocated fewer Departments and fewer Ministers. There are, of course, no fewer than 89 Ministers at the moment, although people tend to say that there are far more than there were 15 years ago. There are not, of course. There were 86 Ministers in 1979, and there are 89 now. My hon. Friend may have been thinking of the time in Disraeli's period when there were only 24 Ministers--13 in the Cabinet and 11 outside. I have to tell him that the 11 outside included a Minister for the Horse, who was the Earl of Bradford. I am not sure whether my hon. Friend really wants to go back to that particular period, but I have some sympathy with him for his general position.
Mr. David Hunt: Only for three weeks.
Mr. Horam: Indeed. A Ministry with two Ministers is infinitely more efficient and productive than a Ministry with three, four or five Ministers. [Interruption.] I do not know how many the Department of Health has.
My hon. Friend the Member for Carshalton and Wallington also raised the constitutional role of the civil service. He pointed to the code and seemed to be saying that my right hon. Friend had not made a clear distinction between the various parts of the code, and was talking about the qualities of the civil service rather than the constitutional position. The fact is that the code, which is excellent, spells out the clear relationship between Ministers, the Crown and the civil service. It also says, as has been pointed out, that the civil service acts subject to the provisions of the code. That meets squarely the point that he was making.
My hon. Friend the Member for Carshalton and Wallington asked about Lord Nolan, and I can confirm that my right hon. Friend has written to Lord Nolan, sending him a copy of the proposed code, and the Government will, of course, take account of any point that the Nolan committee may make about that.
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I was interested in the remarks of the hon. Member for Eastleigh on absenteeism. The Occupational Health Service, which is one of our agencies, is taking a look at that. There are differences between the Departments that we cannot wholly explain at the moment. None the less, the point that he made is relevant. I noted his other points, although absences are not necessarily always related to sickness. The hon. Member for Warwickshire, North made a serious and good speech about the potential politicisation of the civil service. I recognise the threat that he outlined, but the Select Committee itself--the hon. Member for Durham, North reaffirmed this--did not think that the civil service had been politicised. I do not think that anyone seriously thinks that it has been, and that is precisely what the code, which now has all-party support, has been drawn up to deal with.I thank the hon. Member for Durham, North for his kind words. Neither of us expected to find ourselves in this situation after 26 years in politics. We are where we are, however, and I pay tribute to the code that he produced. As he says, it is concise and comprehensive and applies, importantly, to all the civil service.
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The work of the Select Committee shows the improved relationship that has occurred between Parliament and Government since Select Committees were established some 20 years ago. The iterative process that has occurred over the Treasury and Civil Service Select Committee's report has been profoundly helpful both to Parliament and Government as a whole.The Government's policy, as we know, is continuity in values and change in performance. We have, I think, shown that we are concerned--that the whole House is concerned--about the continuing good value of the civil service. We have, however, achieved a remarkable change in the performance of the civil service, and the public service as a whole, in the past 20 years.
I pay tribute to the civil servants who have taken part in that change, as well as the Ministers who have pushed it along. Ultimately it was the civil servants who bore the heat and the burden, and I feel that the main tribute should be paid to them for all the effort that they put into making the reforms work. I believe that we now have the best public administration in the world, and--these are not my words, but those of Simon Jenkins in The Times the other day--the most cost-effective and efficient.
It being Ten o'clock, the motion for the Adjournment of the House lapsed, without Question put.
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Neuro-surgery Services (Thames Region)Motion made, and Question proposed, That this House do now adjourn.-- [Mr. Wood.]
10 pm
Mr. John Austin-Walker (Woolwich): Tonight's debate takes place against a background of chaos--the chaos of cuts, closures and confusion in the national health service in London and the Thames region--and in the wake of the tragic death of a patient for whom a bed could not be found in greater London.
On the radio today, the hon. Member for Hendon, North (Sir J. Gorst) described the consultation about cuts and closures in his area as a sham. A fortnight ago, the Minister responsible for the citizens charter--who has just left the Chamber--said he was astonished that there was nowhere in London where one of his constituents could be treated. The Secretary of State for Health, however, seems to suggest that there is no problem in London and the south-east.
Let me remind hon. Members of the tragic events that led to my request for this debate. On Monday 6 March, at about 10.55 pm, Malcolm Murray was involved in a road accident. An ambulance was called at 10.57 pm, and arrived about 10 minutes later to take the patient to Queen Mary's hospital in Sidcup, arriving at about midnight. While doctors, nurses and ancillary staff fought to stabilise the patient and save his life, the senior house officer--the junior doctor--spent hours on the telephone trying to find a specialist neuro-surgery bed.
The nearest neuro-surgery unit--at Brook general hospital, with which the hon. Member for Eltham (Mr. Bottomley) is familiar--was closed that evening: it was not accepting referrals, because of an outbreak of gastric flu. I understand that the junior doctor contacted some nine units in the Thames region, and eventually a place was found; as we now know, the nearest that could be found was in Leeds. I am aware that an inquiry is currently taking place. At about 5 am, an RAF Sea King helicopter travelled from Wattisham to Sidcup to airlift the patient to Leeds, where he arrived at about 8 am. He went into theatre at about 9 am, and was there for several hours. After surgery, his condition was critical and, tragically, he subsequently died.
In advance of the inquiry, I wish to pay tribute to the staff at Queen Mary's, Sidcup, who did all in their power to save the patient's life. I also pay tribute to the RAF for its rapid response, and to staff at Leeds general infirmary, who also did all in their power to save the patient.
During that week, in a damage limitation exercise, the Prime Minister said:
"Mr. Murray required a highly specialised form of treatment with which Leeds was particularly able to help".--[ Official Report , 9 March 1995; Vol. 256, c. 454.]
Leeds infirmary is indeed a specialist unit, which had the skill and expertise to treat the patient, but that skill and expertise is not unique to Leeds; it was available in the nine or 10 specialist neuro-surgery units in Greater London and the south-east, where no bed could be found for a patient from south-east London.
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In a letter to me, the Under-Secretary of State for Health wrote that it was often"very difficult to strike a balance between wasteful over-provision of services and effective use of the resources available."
In a parliamentary question, I asked what was the capacity and occupancy of those units on the night concerned; that information, surely, would show whether there was wasteful over-provision and over-capacity. The Minister said:
"Information on units' capacity and occupancy rates on the night of 6 March is not available centrally."--[ Official Report , 13 March 1995; Vol. 256, c. 409. ]
If that information is not available to the Minister, I do not see how he could make the statement that he did in his letter to me. The Minister also suggested in his letter that one in six existing beds is inappropriately used, and therefore not always available for the life-threatening emergencies for which they were primarily intended. Is he suggesting that, perhaps, some consultant surgeons in London were refusing to take admissions, waiting for a more interesting case? Again, I should like to know the substance of what he said.
What is beyond dispute is that the south-east quadrant has been poorly served in neuro-sciences because of uncertainty about the future. For example, the Brook hospital has had great difficulty in recruiting a neuro- anaesthetist.
I accept the argument that any specialist centre needs a high volume to gain expertise, not just for the surgeons but for the whole team. One health service planner in my region has suggested that a critical mass would be a unit with five or six intensive care beds. I understand that the Maudsley has two, and the Brook three. Both size and uncertainty may have contributed to recruitment problems. The Government's favoured option appears to be to move the Brook further into central London and so further away from south-east London and Kent, the area that it is supposed to serve. Despite the Secretary of State's recent statement to the House--in which she said:
"A generation ago, people travelled from the home counties to the London hospitals"--
now:
"Patients and GPs rightly say that they would rather have treatment close to home than travel to London.--[ Official Report , 20 February 1995; Vol. 255, c. 33.]
I do not dispute the need for centres of excellence, but why not one in south-east London? If the Brook is to close, why could not neurology and neuro-surgery facilities be located at the Queen Elizabeth hospital in Woolwich or Queen Mary's hospital in Sidcup? They are extremely convenient for the M2, the M20 and the M25. Indeed, the Queen Elizabeth has its own helipad.
In a recent debate, the Secretary of State asked how we could deal with the issue of hon. Members having great affection for their local hospitals, which cannot provide the critical mass for sub-specialties and the costly equipment needed for state-of-the-art services. In Greenwich, the Queen Elizabeth or Queen Mary's could house the Brook units. North of the river, Oldchurch, with its accident and emergency and maternity and gynaecology intact, could also continue to provide neuro-surgery services. We do not need to move the units into central London to provide critical mass.
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