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14 Nov 2002 : Column 203—continued
3.53 pm
Virginia Bottomley (South-West Surrey): Now we understand why the Secretary of State had such a pressing prior engagement this afternoon. I greatly appreciate the opportunity to speak in this debate as, in part, it identifies the Government's priorities. There were many omissions from the Queen's Speech, which worry many of my constituents and my colleagues—most notably, the whole issue of pensions.
There is rising panic about people's security in old age. In their first flush, the Government rushed in and raided pension funds to the tune of #5 billion. The right hon. Member for Birkenhead (Mr. Field), my first boss, was appointed to think the unthinkable, but he has disappeared from the Government and we have heard all too little about that. When all are united in the view
that one of the greatest priorities is protection and safety for people in their later years, it is extraordinary that there is such silence on the subject.The fact that there was no mention of a civil service Bill is a serious error. I was disappointed that the right hon. Member for Tyneside, North (Mr. Byers) did not refer to that issue. I am sorry that I am making that point in his absence from the Chamber, because I welcome him back to speaking in the House. The Government have found it particularly difficult to resolve questions about the boundaries between political engagement and the role of a public servant.
I commend the Public Administration Committee, whose work on the public service ethos is extremely important. I remind the House that my right hon. Friend the Leader of the Opposition made an excellent speech yesterday—and my hon. Friend the Member for Woodspring (Dr. Fox) made an excellent speech today. The three of us have a shared background: we have spent most of our lives working in the public sector. That contrasts sharply with the majority of Labour Members who have contributed to the debate.
Those of us who care so much about the public service and its traditions are worried about what is happening to the civil service—the public service—and the degree to which there is a real erosion of its values and principles, so it is disappointing that the Government could not find time to introduce a civil service Bill, especially as the distinguished outgoing Cabinet Secretary, Sir Richard Wilson, made it clear in some of his valedictory speeches that the time had come to do so.
That point is closely related to the issues that we are discussing today. The challenge for public services is not about policies; it is about delivery, leadership and management. There is confusion at the heart of the Government about the nature of leadership in a public service for which, inevitably and rightly, there is political accountability.
I ask hon. Members to make a contrast with the way in which the BBC is managed. Nobody thinks that Greg Dyke's speeches are written for him by the Secretary of State for Culture, Media and Sport. The clarity of his role and his relationship with the people who work for the BBC contrast sharply with the problems faced by people in other parts of the public sector. We have heard far too many accounts of bullying, intimidation, blame culture, micro-managing and too many targets. Those are serious issues in the public sector, especially the health service, at present.
Health service managers are among the best public servants whom I have come across. Indeed, I should have declared an interest earlier, as I currently spend a lot of time in executive search, especially in the not-for-profit sector. Few charities would not give their eye-teeth for someone who had been an NHS manager to lead them, yet in the health service and in this place those managers all too rarely receive the praise and recognition that they deserve. When we get to the point where health service managers are found to have been fiddling the figures to please their political masters, everyone in the NHS and Parliament should take that very seriously indeed.
I welcome many of the initiatives that have been introduced. The extra money is an opportunity that the health service should seize with open arms. The national
service frameworks and, after attempts at modification and improvement, some of the agencies and commissions for health audit and inspection, are making an important new contribution.At the same time, however, it is important to let go and to trust the people who are leading the service. For that reason, I entirely disagree with the right hon. Member for Holborn and St. Pancras (Mr. Dobson). I do not doubt his commitment and I am sure that he does not doubt mine, but we see public sector leadership and management in a very different light.
I commend to the House Onora O'Neill's Reith lectures. She talked at length about what is happening in the public service, and about the appalling problems created by ever more targets, ever more micro-management and ever more audit. Since the Government came to power there have been 8,000 targets; the NHS plan alone introduced 400 targets.
The Government were criticised—gently—by Lord Simon of Highbury, who pointed out that Ministers have muddled ideas about accountability and responsibility and that politicians now see themselves not only as accountable for defining the overall direction and main objectives, but also as providing the services. He said:
- XMinisters and civil servants should not, and cannot, be responsible for producing the desired outcomes. That is the job of managers of those services".
- XFor those of us in the public sector the new accountability takes the form of detailed control. An unending stream of new legislation and regulation, memoranda and instructions, guidance and advice floods into public sector institutions. Many . . . will have looked into the vast database of documents in the Department of Health website, with a mixture of despair and disbelief. Central planning may have failed in the former Soviet Union but it is alive and well in Britain today. The new accountability culture aims at ever more perfect administrative control of institutional and professional life."
We have heard a series of such comments. Charles Leadbetter, in the Demos pamphlet, talked of the centralised, micro-targeted approach. Will Hutton has also been making some important points—I hope that the Government will listen to him—about the plethora of institutions at the centre within the health service. There is the modernisation agency and there are different teams within the Government, such as the delivery unit. There is an endless brain drain up the service to the centre, instead of down into delivery on the front line. The perception remains that those who can, think. Time and again, career progression hinges on managing upwards rather than motivating and managing staff to deliver more efficient, high quality services. Plum jobs in the civil service remain in the private offices, and in the policy-making units in No. 10, the Cabinet Office, the Treasury and the Foreign Office.
We should welcome the opportunity offered by the move to foundation hospitals and see it as a move for the delivery of quality public services not only here but throughout the world. One of the frustrations of coming
out of government was hearing the right hon. Member for Holborn and St. Pancras blaming public officials or, more likely, blaming those benighted Tory Ministers who had Xled the country to rack and ruin" for the past 18 years, only to be asked to visit countries that were emulating examples of the new style of public service management. I am pleased that with primary care trusts and foundation hospitals we are returning to that example. It would be better if members of the Government had the generosity of spirit to recognise the origin of some of their ideas. I do not expect them to be nice to members of the previous Government, but they could have greater generosity of spirit towards people in the service. Ministers getting the credit every time something goes right and officials getting the blame every time something goes wrong is not the way to bring out the best in people.
Mr. Dobson: Can the right hon. Lady give a single example of my blaming any health service official when I was Secretary of State for Health? I cannot think of one.
Virginia Bottomley: It may have been after the right hon. Gentleman's time, but when the chief executive of the Bedford trust was fired, it caused a great ripple throughout the service. If he really wants to debate the matter here, I can inform him that many people in the service—including many of his political persuasion—felt that his treatment of Sir Colin Walker was extremely harsh because his ethos and values in the Cambridgeshire and East Anglia area reflected the NHS values of equity, efficiency, access and innovation.
Mr. Dobson: The right hon. Lady seems to forget that those on the Conservative Front Bench welcomed my decision to sack Sir Colin Walker, because he was doing a bad job.
Virginia Bottomley: I think that the right hon. Gentleman knows that one reason why I am leaving party politics is that I am less concerned about going backwards and forwards across the House in this vein; I would rather say what I want to say about the delivery of public services and the improvements that can be made in the national health service at a critical time.
A further omission from the Queen's Speech that is a great disappointment to many people is that of the mental health Bill, which the Secretary of State mentioned today. His failure to mention that Bill to the Queen is extraordinary, given that he managed to slip it out today. My constituents are bemused by the priorities—how we can apparently find more time to bring to a conclusion the question of hunting with dogs when we cannot find time for other legislation is beyond me.
My constituents would feel that I had failed them if I did not remind the House that 125 people are now waiting more than a year for treatment in west Surrey. They would feel that I had failed them if I did not say that another five criminal justice measures will not help with problems in Surrey and the home counties, where we have to lose even more police.
The Secretary of State constantly points to equality of outcome. There is a growing inequality of service, whether in social services, policing or the health service.
We should welcome the opportunities that foundation trusts will provide to allow greater flexibility in pay and greater responsiveness to local people. I only hope that the Government will think carefully before they encourage the election of trust governors. Sir Cyril Chantler and many others have talked of trusts becoming more like universities. If governors are to be elected, it may bring a whole different agenda to their leadership and management. People are reluctant to become involved in elections at present. I fear that many of the most distinguished trust and health authority chairmen, as well as many chancellors of universities, will not be prepared to stand for election. I welcome the trusts, but I hope that hon. Members will think carefully about their governance.
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