House of COMMONS









Thursday 22 October 2009


Evidence heard in Public Questions 68 - 151





This is a corrected transcript of evidence taken in public and reported to the House. The transcript has been placed on the internet on the authority of the Committee, and copies have been made available by the Vote Office for the use of Members and others.



The transcript is an approved formal record of these proceedings. It will be printed in due course.

Oral Evidence

Taken before the Public Administration Committee

on Thursday 22 October 2009

Members present

Dr Tony Wright, in the Chair

Paul Flynn

Kelvin Hopkins

Mr Ian Liddell-Grainger

Julie Morgan

Mr Charles Walker


Witnesses: Rt Hon Lord Adonis, a Member of the House of Lords, Secretary of State for Transport, Professor Lord Darzi of Denham, KBE, a Member of the House of Lords, former Parliamentary Under-Secretary of State, Department of Health, and Admiral Lord West of Spithead, GCB, DSC, a Member of the House of Lords, Parliamentary Under-Secretary of State, Home Office, gave evidence.

Q68 Chairman: Let us make a start and extend a warm welcome to our witnesses, Lord Darzi, Lord Adonis and Lord West. As you know, the Committee is doing an inquiry into the whole subject of unelected ministers and sundry other unelected people who hold various posts. You all bring different distinctions but your unifying characteristic is that you are all unelected and you are all ministers, or have been. We would just like to ask you about some aspects of your experience. Could I just ask a general question to start with, which is, what do you think people like you, coming from very different backgrounds, bring to government that warrants you, as an unelected person, being brought in to help with running our affairs? Andrew, would you like to start?

Lord Adonis: Thank you, Chairman. I would answer that in two ways. First of all, we have always had a proportion of unelected ministers because our constitution has two chambers and there have to be ministers in the House of Lords. The number of ministers in the Lords has not in fact increased much - I was looking at the figures as I was preparing to appear before you but I am also a constitutional historian and I know these things. We have 19 ministers in the House of Lords now; we had 15 ministers in the House of Lords 20 years ago, so the numbers have not changed that much. We need ministers in the House of Lords because of the working of our constitution in any event. What do we bring? We bring a range of different experiences. I had three careers, I suppose, before I became a minister. I was a policy adviser for the years immediately before becoming a minister in Number 10. I was a special adviser in Number 10 and then Head of the Policy Unit in Number 10. That gave me a great deal of experience of the working of government and I developed as a specialist area education and the public services and of course, I became Education Minister in 2005. Before that I had been a journalist. Being a journalist I suppose trains you for nothing and everything but I had seen a lot of politics and I had been an education correspondence so had worked intensively reporting the areas I was later to be responsible for as a minister. In my twenties I had been an academic. That was the range of experience I brought to bear on my life as a minister after 2005.

Q69 Chairman: Do you think the experience of being a special adviser is a particularly useful career route into the life of a minister?

Lord Adonis: For me, I found it invaluable. I found being a special adviser a kind of apprenticeship for being a minister. I worked very closely in the field of education specifically but also the wider public services for seven years before I became a minister, and I was engaging constantly on the development of the Government's education policy and wider policy in respect of the public services, and of course, I got to know the workings of Whitehall extremely well as a special adviser, and got to see a number of ministers, highly effective ministers, at first hand. I have to say, in my experience as a minister since, and now as a Secretary of State, being a special adviser was an absolutely invaluable apprenticeship, not only in the policy areas I was going to deal with but also in the art of being a minister, actually learning the trade. I have to say, if you ask me what was my second most useful experience after being a special adviser, rather to my surprise, I would say it was being a local councillor in my twenties. I was elected as a local councillor when I was 24 and I spent four years as a councillor, including four years on a planning committee, where you are dealing with very powerful vested interests and bureaucracies. Those four years as a member of a local council and on a planning committee were hugely useful to me in the trade of becoming a minister.

Q70 Chairman: Some people say, not least people like Estelle Morris, that, even as a special adviser, you were acting like a minister.

Lord Adonis: I do not think that is a fair description. I do not think it is actually a description that Estelle would herself subscribe to. The Prime Minister of the day had very clear views on education reform because, and in my experience, of course, advisers tend to reflect the preoccupations of their minister, where a Prime Minister or a minister has very strong views on an issue and is determined to put them into effect, of course, their advisers tend to come into the limelight in that respect.

Q71 Chairman: This may all be wrong but I have David Blunkett saying here, "What is the bloody point of my being here? Who is the Education Secretary, me or Andrew Adonis?

Lord Adonis: It was him, for the record, Chairman. It was not me.

Q72 Chairman: Estelle Morris spoke of her frustration with what she said were "the Andrew Adonises of this world. Sometimes they were just plain wrong," she said. "It was my job, not their job. I was elected; they were not elected."

Lord Adonis: She is absolutely correct. It was her job, and she was a very distinguished Education Secretary, who carried through big reforms. It was very much her job to be responsible for those reforms as Secretary of State.

Q73 Chairman: Being a minister is a more natural role for you then being a special adviser, I think, is it not?

Lord Adonis: They are very different roles. I would say rather than one being more natural, I found being a special adviser a very useful training for being a minister in due course but the whole point of being an adviser is that you advise. You are not responsible for implementation or the direction of policy, and it is important that advisers understand that. Where advisers want themselves to become players, then that tends to make the role very difficult.

Q74 Chairman: Let me move to Lord West and ask the same question: what do you think someone like you brings to government?

Lord West of Spithead: I think in my case I brought a deep background knowledge into the area that I was asked to be involved in. The Prime Minister asked me to come into government. I have to say, I was surprised when he asked me that. I thought when he asked to see me he might be asking me to give advice on something, and initially I was very reluctant to do it, for a number of reasons, not least because one is in the public eye, the media are always extremely difficult with politicians, and the family have to go through all of that. It actually meant taking a dramatic reduction in money. Money is not my driver but you have to think of your family in these things. It was a huge drop in income. Also, there are issues of security for my family and, actually, I knew I was going to have a very full and very busy programme. I had done that all my life, and I had had a nice break, earning lots of money and not having to work too hard, which was rather fun. Anyway, the Prime Minister convinced me how important he felt the security of this country was. I felt he really felt that. He showed me the latest threat assessment, which was really very bad, and he said, "I think you could do something to help make the country safer." I said, "I think there are probably people better than me who can do that." He said, "I don't know them, and I would like to ask you to do that." What did I bring? I suppose I had first fought against terrorists, although they were called Freedom Fighters then, 40 years before and I had been involved in counter-terrorism through my career on and off. I had a very deep knowledge of intelligence. I had had three years running naval intelligence and links with NATO, NATO intelligence. I had three years as Chief of Defence Intelligence. I was Deputy Chairman of the JIC for those three years, so very involved in the JIC and understood that. I knew a lot about crisis management, how to organise structures for that. I had helped with Cobra and those sort of areas, and of course, when one gets up to the top level within the military, you are dealing across Whitehall and I understood dealing with civil servants. I think all of those things together were very useful.

Q75 Chairman: No minister has a fraction of that experience, so I can see why you would be turned to for assistance but you said yourself just now that you thought you might have been asked for advice; you did not expect to be asked to be a minister. What would be the difference if the Prime Minister simply said, "We want to tap your expertise. Come and advise us"? What is the difference and what is the advantage in being a minister rather than simply an adviser?

Lord West of Spithead: What I found - and I was aware of it from when I was First Sea Lord, where one could debate and talk about things but you were very constrained in what you could actually do, because of control of money and things like that - is that as a minister you can actually deliver things and there were a set of things when I came to the job. I looked at what I thought was required, I laid those down in my own mind, I talked to the Prime Minister, and I think I pretty well delivered all that. There was a brand-new refreshing of our counter-terrorist strategy, a new national security strategy for the country. I was very worried about cyber security. We now have a cyber strategy and are pushing forward very fast with that, and a science and innovation strategy, because I felt we were not tying in industry and all the people in this country pulling together to confront terrorists. I was able to actually do that, and I have other things I do. Sometimes one has to be a bit delayed because some things need primary legislation, and I prefer not to get into the legislative thing; it is much better to have less legislation in a way. Some things are a little tricky so one has to be careful how one does that. However, if you are not a minister, you cannot do that so actually it does have utility, being a minister.

Q76 Chairman: Had the Prime Minister asked you to go into the Ministry of Defence, would you have been troubled by that?

Lord West of Spithead: I do not think that would have been appropriate at all. I know a huge amount about defence, if I may say so, but I think it would be wrong to do that. I would have been thoroughly hacked off if I had been the new First Sea Lord, or indeed any of the Chiefs of Staff, to find that West had suddenly lobbed in as a minister. Quite rightly, they would have been very hacked off by it.

Q77 Chairman: Is that not the answer to the Dannatt issue? We had a former Cabinet Secretary sitting in front of us last week who said this was, in his words, "a major error". What do you say? You sound as though you think it is a major error as well.

Lord West of Spithead: I do not know exactly what he has been offered and what he has not been offered or what is going on, to be quite honest.

Q78 Chairman: Let us put it this way: if he were to finish up as a minister in the Ministry of Defence, as a former General...

Lord West of Spithead: Dannatt is a superb officer and a splendid man, who wears his heart on his sleeve. I think he made an error of judgement. He is still on full pay as an army officer until 22 November so he is fully in the army. The thought of saying, if he said this - and I am only going by what I read in the papers, that he is very much a member of the party and that there is an intention to make him a minister within the MoD. If that is what was said, if that is what is intended, then I think that is a terrible error. It was 14 months after I got my final pay packet from the Ministry that I was asked by the Prime Minister to come in, and even that was one of the issues that I thought about when I was thinking about it. I thought "This is quite close." He was asking me to be in a very different area where I think all my skills and expertise that I had got within the military helped, but it was not directly in that department. I know historically the last military man to go into government like that was Earl Alexander of Tunis in a Tory government in 1951 and he did go into the War Department, I think. So it has happened before but I do not think it is a good idea. I think it was an error and a mistake and I think he will regret it.

Q79 Chairman: Thank you very much. Lord Darzi, could I ask you the same question about what you think you brought to government?

Lord Darzi of Denham: Yes. To start with June 2007, as Lord West started, I was more or less in the same position. I got a phone call to see the Prime Minister. I had a 20-minute meeting with him. The first ten minutes was about what I did in life. He was extremely charming, and halfway through he asked me whether I would serve in his government as Health Minister. I really did not know what to make of that. He caught me by surprise. I was reluctant to take office, for all sorts of reasons, but I understand in retrospect probably what his thinking was. If you take yourself back to June 2007, no-one would ever doubt what this Government has done in relation to the NHS when it comes to investment, when it comes to doubling its expenditure, a huge increase in the number of doctors and nurses - I could go on and on. In June 2007, if you look at the whole of the NHS and where it was, you come to one conclusion: the staff were not engaged, there were significant difficulties at the time that happened to some of the PCTs and their financial deficits, there was the MMC fiasco which was going on at the time. What did I bring in? Firstly, I am not a First Sea Lord. I was a private in the NHS, frontline staff, a working clinician, a consultant. What I enjoy in life is to treat my patients. I held the Chair of Surgery in Imperial, so I had a scientific background. What drove me throughout my career was quality and innovation. I did contribute to one piece of work as a clinician in London which I was very proud of, which was to lead the reform of health services in London. As you may know, the capital city has many challenges when it comes to health reform. That is really what I brought into the job. Whether I had to be a minister or an adviser, again, I had no feel as to that in June and in actual fact, I asked the Prime Minister whether I should be appointed as an adviser, and he was very reluctant to do that. His explanation at the time was that you needed to be a minister to make things happen and, in retrospect, I could not agree more with him. You can advise anyone. You have to remember as well, as a minister, as a minister I did receive advice from all quarters. Everyone wants to advise a minister but no-one is accountable to that advice and ultimately you have to make that decision. Being in a ministerial role, I felt certainly more conscious of that. You may know that I came in to do a project, a fairly large project, which was the Next Stage Review. It was highly focused. I had the support of all of my ministerial colleagues, so it was not just deciding on policy but I had the opportunity to implement, and that is very different. As an adviser, you do not actually implement things. You can advise people. I have always felt actually quite concerned about the minister I was advising because I knew that same person is being advised by all sorts of different lobbies, all sorts of different groups, and that is a very different role than a minister. So in retrospect I felt I made the right decision.

Q80 Chairman: Finally from me, looking at Lord Darzi and Lord West really, did it occur to you at all that one reason why Prime Ministers might like people like you on the ticket, a First Sea Lord, a distinguished surgeon, is to give a bit of glitter to the administration?

Lord Darzi of Denham: I do not think that was in any way the motive of such an appointment.

Q81 Chairman: No, but did it occur to you that that could be a motive?

Lord Darzi of Denham: No, not at the time, and certainly not subsequently. What was important for me, being a surgeon working in the NHS, is the credibility in engaging the near enough 60,000 people that I engaged in the process of the review. We were speaking the same language and we were trying to really see how reform... The whole purpose of reform changed, where government became the strategic adviser, empowering the consumer and allowing the professionals to exercise their skills and professionalism.

Lord West of Spithead: If I may say on that, that did cross my mind because, of course, it does add a certain glitter and it would be stupid to think that might not be the case. That was one of the factors that I was weighing up when I was in two minds about not doing it. That is why I made certain that I was convinced myself that the Prime Minister did feel that the security and safety of the nation was the primary concern that he had, and when I had convinced myself that was the case and he had shown me that threat, I was happy to move forward. Of course it adds glitter to the thing; it would be silly to pretend it did not. I could see that there is that as well.

Q82 Chairman: I do not want you to think, Andrew, that the glitter question does not apply to you.

Lord Adonis: I added no glitter, apart from my name, which is very exotic.

Q83 Mr Walker: You talk about your reluctance to accept a peerage. I have to say, it sounds like a dreadful job to me: no elections, no constituents, legislating for life once you finish being a minister. Who would want that? Seriously, given your reluctance to take on this awesome burden, do you think a future Prime Minister, for example, David Cameron, will struggle to find talented people who want to become peers? If that is the case, would it not be better to get rid of this peerage nonsense and actually allow people to become ministers who do not have to take a seat in the House of Lords, move more towards the American system, where we have the separation of powers, for example, so David Cameron or Gordon Brown is free to pick from a talented pool of 60 million people? You, Lord West, would come and serve for three years. You might even be paid more than you are paid now - indeed, I hope so - and then, at the end of three years, when you have either had enough of Gordon Brown or he has had enough of you, or you want to go and earn more money, you can say, "Thanks very much. I have served my country once again. Now I will retire back to private life." Would that not be a good idea? Lord Adonis, you have never been slow in coming forward.

Lord Adonis: Do I think that would be a worthwhile reform? My personal view is yes, I would support such a reform. I think it would be thoroughly worthwhile to make it possible to bring people into government who are not Members of either House, provided they are properly accountable. There would need to be proper arrangements in place in this House and in the House of Lords for them to be questioned. I would support that but I am also a constitutional historian who knows that this mediaeval constitution of ours changes very slowly and I think it would take a huge effort to bring about such a change. I imagine that the Commons collectively and the Lords collectively would be opposed because of course it would breach the closed shop in both cases.

Q84 Mr Walker: Lord West, what about an idea being proposed by my leader, that Lords if we could not make the constitutional leap, people come into the Lords, serve for three or four years as a sort of acting peer, and then, having finished serving, they would leave the Lords and go back to private life? Do you think that is something that is worth considering?

Lord West of Spithead: I think it is probably worth considering, yes. I have to say, you talk about legislating for life - I do not intend sitting doing political work constantly when I finish doing the job I have.

Q85 Mr Walker: But you will be a crossbencher?

Lord West of Spithead: I will of course be in the Lords, so one has some involvement. One of the things I have found very attractive about the Lords is, although difficult if you are a minister, on any subject you talk about, one of certainly this country's greatest experts, sometimes the world's greatest expert, is there to fire questions at you. In the Lords you cannot shout "Ya, boo, you lot were rubbish last time." You actually have to answer the question. So it is quite tricky, and that is one of the strengths of it. I think the fact that one knew one was going into that chamber and would be in that chamber and how much you got involved in politics thereafter, I think that has an attraction. It is not the ultimate attraction.

Q86 Mr Walker: I would be hugely attracted to it, to be honest.

Lord West of Spithead: That does have an attraction and you have to make things attract because, as I say, actually, people step in from outside and although money might not be the driver, if you have always been in public service, although we are adequately paid, you suddenly discover how much money you can make elsewhere, and not doing that is quite a---

Q87 Mr Walker: You did that for 14 months.

Lord West of Spithead: Exactly!

Q88 Mr Walker: You said you got your last packet and 14 months later you were in the Lords, but in between that you were earning fortunes.

Lord West of Spithead: My income went up dramatically, yes, and I had to give up all that.

Q89 Mr Walker: In the area of defence?

Lord West of Spithead: No, in a number of areas.

Q90 Mr Walker: Lord Darzi?

Lord Darzi of Denham: I would have taken that offer if it was on the table when this was discussed in June but I have to point out in retrospect - because I have left now and I can say what I want to say - being in Parliament, the parliamentary experience, was a very valuable thing to do. I took three bills through Parliament. For me, the learning experience, standing on my feet, debating something - and you may call me an expert but I am not an expert in everything in healthcare - standing up, defending what I am trying to do, being held accountable in the chamber... I was called in three times to the Health Select Committee on my own to defend what I was doing. That is what makes democracy in this country. Do not lose that. I would not do away with that accountability. That I think would have a negative impact. There is a bit of a paradox in the questioning because the Chairman clearly said what gives you the power if you are unelected. I think the accountability in the chamber and also in the Health Select Committee was what kept me, the steer. I enjoyed that, I defended it, and it gave me all the opportunities I needed. In the future, in the next 20, 30 years, whether I am going to be a contributor in debates, I will certainly be there for health debates. I think it is interesting; when I was in the chamber, when I look at the peers who were debating on my Bill, most of them, if I could just say, most of the ones who made some significant contribution to the Bill and improved the health of the Bill were previous and ex-ministers in the last 20 years. That is very important because that experience was very valuable to me in the chamber, but I also consulted many ex-ministers outside the chamber.

Mr Walker: A 15-second question. I think actually the three of you are very talented and you have been huge successes. Would you serve in a Conservative government if you were asked to by David Cameron?

Chairman: Who are you looking at?

Q91 Mr Walker: All of them. Lord West?

Lord West of Spithead: The yes-no answer is rather difficult. I have to say, probably because I am a military officer, I feel a sense of loyalty, and as I was asked to come in, I think that would be disloyal. However, if there was something that was actually, I felt, crucial to the security and safety of my nation, I would do a job and I would not care, almost, who I did it for.

Q92 Mr Walker: We would be lucky to have you. Lord Adonis?

Lord Adonis: No.

Q93 Mr Walker: Oh, come on! Lord Darzi?

Lord Darzi of Denham: I have done my bit as a minister but I am always there to assure the NHS's values and principles - that is what brought me in. I was not recruited for my political experience and expertise. I have none. However, I could tell you that medical politics is sometimes more vicious than politics in Whitehall! I was brought in to really deal with the values and principles of the NHS, and I would advise anyone in relation to the principles and values and how we keep the NHS going, but I am not pursuing a political career. I have no real interest in doing that and I have been frank about that from day one.

Q94 Chairman: Fortunately, Charles will be available to Mr Cameron, so all will be well. Just on one aspect of that exchange, what I would quite like to know is whether when you had that initial discussion about becoming a minister anybody told you what being a minister was all about.

Lord Darzi of Denham: No. I could just tell you also, if I appointed someone in my department, for the first three months, I would sit down and tell them exactly how it works. To be fair, my private office did a lot to get me on the level as far as the policy-making in the department but no-one took me to the side to say what it means to be a minister. To be fair, my views about politics and politicians and ministers and what they do completely changed, because they make a huge amount of sacrifices.

Q95 Chairman: What you say about accountability is interesting. When we had Digby Jones in front of us, who does not, I think, count as one of the conspicuous success stories of the Government, his line was, "I do not want to do all these boring ministerial things. I do not want to give evidence to committees. I do not want to take bills through the Commons. I want to be off selling the country in trade missions, that kind of thing." If nobody explains what the grinding work of being a minister is in terms of this political accountability, it is a funny thing to sign up to, is it not?

Lord West of Spithead: It was an enormous failure. You are absolutely right. It was like doing an A-level a night on some of these things, which were not to do with security. When I find I am answering questions on female genital mutilation, drug testing on gorillas, this is something I had not quite expected to do. It has been very good for my brain. I can actually learn poetry again now, that is not quite what I expected, I have to say, and it is a very broad spread. I think I am probably a better person for it at the end of it, because one has to get to grips with all of that and that is good.

Lord Darzi of Denham: I think the success of a minister is to convert yourself from being an expert into a generalist. A lot of what I did in the chamber was a more generalist thing and I thought that was very useful, bringing an expert view into a generalist debate.

Lord Adonis: On the issue of accountability, if as a minister you are not prepared to be fully accountable to Parliament, you have no place in being a minister. A good part of the job of being a minister is to explain the policy of the Government to Parliament, to answer questions and to engage in a constant dialogue. I think it was Attlee who said that democracy is government by discussion. Unless you have ministers who are constantly prepared to discuss, including in Parliament, you have no democracy. You asked what was the most surprising aspect of being a minister. I had been an adviser before so I had some idea of what the job of a minister was. What most surprised me on reflection, looking back at it over the last four years, was the impact that public exposure has on your life. As an adviser I had been occasionally in the news. I had not realised that you become public property when you become a minister. The first day I was a minister I had a bank of cameras outside my house, because it was an appointment of some transient controversy. Nothing really prepares you for that, except, I think, possibly being an MP. I think actually being an MP in terms of the public exposure probably prepares you for that side of being a minister quite well. There are very few other professions where you get the degree of public exposure and, at times, controversy, which prepares you for that side of being a minister. I know from some of my colleagues who have gone into the House of Lords and become ministers that that can become quite an issue. They suddenly become public figures to an extent that they had not realised would happen when they became ministers.

Q96 Chairman: Yes. That cannot be true of Lord Mandelson, can it?

Lord Adonis: He had had quite a lot of experience before.

Q97 Julie Morgan: Following on from Charles's questions, do you think to be a successful minister you should be a member of the same party as the governing party, or at least have sympathy with the views of the governing party?

Lord West of Spithead: I do not think you have to be a member of that party. Clearly, you have to take the government whip. It would be wrong to be a minister and not take the government whip, I think. I think you have to have sympathy. I think it would be impossible if every fibre of your being was against things that were their policy. I cannot see how that could work but I do not believe you have to be a member of the party and fully tied into it all, but I think you have to have a sympathy for it. If you are the opposite, I just do not think you could do it. I do not think you could be a minister of the government.

Q98 Julie Morgan: So did you join the Labour Party?

Lord West of Spithead: I am not a member of the Labour Party, no.

Q99 Julie Morgan: From your responses, you would feel from a sense of duty that you would be able to serve under a Conservative government?

Lord West of Spithead: No, I said I would not do it because I am a loyal sort of chap and I have worked for Gordon, but I said if in the future at some stage there was something where I felt and people thought they needed me to do something for the security of my nation, then certainly, as I think I did two and a bit years ago, I would do it, possibly - my wife might not let me but we would see.

Lord Adonis: You have to be completely in sympathy with the ideology of the government to be a successful minister. Parties are broad churches and you often have members of parties that form governments who are not in sympathy with the predominant ideological stance being taken by the head of the government but you could not be a successful minister if you were not, and indeed, it would be a bizarre act on the part of the Prime Minister to appoint as a minister somebody who was not broadly in sympathy with the policy of the government.

Q100 Julie Morgan: And you are a member?

Lord Adonis: I am of course a member of the Labour Party, yes.

Lord Darzi of Denham: I do not think being a member is relevant here, certainly in my task. I said it earlier: this is the government which for ten years has done huge amounts for the NHS, and I truly believe in the NHS's values and principles and what it is trying to achieve and contribute. With the Next Stage Review on High Quality of Care for All, one of the most gratifying comments I heard towards the end was that we had depoliticised the NHS. If you look at where we are as far as satisfaction rates of patients, public, staff - and I am not in any way claiming that it was because of me. One thing we have not touched on is that I felt very much a member of a team. I had a boss who was extremely supportive and sympathetic in everything I did, Alan Johnson. What I brought in my role was not party politics. It was NHS-related and how do we reform it, but I was very sympathetic to what this Government has done and always have been in relation to the NHS.

Q101 Julie Morgan: So did you join the Labour Party?

Lord Darzi of Denham: Yes, but I had no affiliation to any party before I started. I felt at the time it was very important. You are part of the government. You cannot just say "I have different views and I am out here." That is very, very important. You go in there to do a job and that is what I went to do.

Q102 Julie Morgan: In the 20-minute discussion that you had with the Prime Minister did he ask you about your political sympathies and whether you were prepared to join the party?

Lord Darzi of Denham: Absolutely not, no.

Q103 Julie Morgan: Was at the same with you, Lord West?

Lord West of Spithead: He said to me that as a minister I would have to take the government whip. That was all, and I understood that, and I think that is right. I think you do have to have a sympathy. I could not possibly do it if I felt everything they were doing in other areas was wrong. It would be impossible. You have to have sympathy with it all, or I do not think it would be possible.

Q104 Julie Morgan: Lord Darzi, now that you are not a minister, do you sit as a Labour peer?

Lord Darzi of Denham: I have not been back to the House, and I think all of that depends on what you are doing. I hold all sorts of other roles in life, leadership roles, and I think I would need to get the consent of different people to see whether that has any impact on my role as a clinician and an academic. I have not been back to the chamber.

Q105 Chairman: Just on the roles, could you tell us, because we are looking at tsars and those sort of people that we do not quite understand. You have become something else, have you not? You have become - is it an ambassador?

Lord Darzi of Denham: Yes, an ambassador for health and life sciences, which I was very grateful to receive. It took me a while to understand what it actually meant. Ambassador was not a title I was accustomed to before. What does that role entail? I have certainly been involved over the last few months in all sorts of different debates relating to health care and life sciences. I could go through them if you wish.

Q106 Chairman: It relates to other people who have similar roles. Do you get support from the official machine to do that?

Lord Darzi of Denham: There is one activity that I am doing at the moment called NHS Global, which is something we are doing the thinking through, and I have civil service support in relation to that. This whole concept is, if I can just say, all to do with aspirations. That is, I think, one of the things that I was very keen to bring to the Department of Health at the time. We spend 110 billion of taxpayers' money and any chief executive of any company which has a turnover of 110 billion a year should have some global aspirations. There is a lot that the NHS has done for the last 60 years that could be beneficial to many countries across the globe, and we are working on that piece of policy and I have support for that. That is not necessarily the ambassadorial role. That is a piece of work I am doing for the department. The ambassadorial role, if I need support, I could always contact certainly my ex-office or a couple of individuals whose names I have been given to contact. I could give you a few examples of what I did. I stepped down on 21 July and I decided for the first time that I would take two and a half or three weeks holiday, which I have never done before. I found myself within my first week, while I was on a beach somewhere, picking up the paper on the way back, and the headline was some of the right-wing attacks on the NHS and death panels and all sorts of things like that, which was quite alarming for me. The reason it was more alarming for me was because I work in the NHS. We recruit people from abroad and we actually send a lot of our gifted people to the US and other places. The NHS brand is very important for all of us. So I found myself while I was there writing an editorial with someone at Imperial for the Washington Post. My inbox was filled with 3,000 emails from the US. I went to the US to do an interview with CNBC, C-SPAN, just making the case for what the NHS is all about, and I felt very strongly about that. In actual fact, I feel more strongly about that than anything I felt very strongly about during my ministerial post, because this was the pride of our nation. That was not party political; to be fair, all parties actually supported that cause and what we were trying to do in defending the brand of the NHS. That is what I have been doing. That probably could be defined as an ambassadorial role.

Q107 Chairman: And bits of surgery?

Lord Darzi of Denham: Oh yes, very much.

Kelvin Hopkins: Charles Walker rather stole my question, which was the question I was going to ask about whether you would serve under a Conservative government. I may say that the prospect of Charles Walker being a minister is for me one of the few attractions of a Conservative government.

Mr Walker: No chance!

Kelvin Hopkins: Seriously, you are three very distinguished, immensely able people and you have made a significant contribution, but was your role made easier by the almost infinitesimal philosophical difference between Tony Blair and the core of the Conservative leadership? I say this because it is not just my view. I was speaking to a senior Conservative backbencher shortly after the last election and he said, "If Tony Blair came to our party tomorrow, he would be our leader tomorrow." Did that difference make it easy to be a member of a government which was no different at the leadership level, from the alternatives? Did it make it easier for you, given that some of you came from non-party political backgrounds? Andrew obviously came from a party political background.

Q108 Chairman: I think the question is, because the tent was so big, was it easier to get inside it?

Lord Adonis: I was inside it already, Chairman, so for me it was not an issue. I think it is more a question for my colleagues who were not. Can I make one point about this partisanship issue? One of the features of the House of Lords which is simply a characteristic of an assembly that includes a lot of experts, people who have not fought elections, is that it tends to be less partisan than the House of Commons. So as a minister in the House of Lords, you tend to act in a less partisan way by nature of the assembly that you are part of. It does not mean to say you do not hold your views as strongly as ministers in the House of Commons but it does not operate as an essentially partisan assembly in the way that the House of Commons does. Ministers who act in a very partisan way in the Lords tend to go down very badly in the chamber. The House of Lords is essentially a chamber of experts in the way that it sees itself. It does not see itself as essentially a hard-edged, party political assembly. The bipartisanship can appear much more powerful in the Lords than in fact it is; underlying the extremely decorous proceedings and the absence of party political cut and thrust in fact are people who do have strongly held views, as you have heard from the three of us.

Q109 Kelvin Hopkins: Partisanship we can talk about, but in the Commons there are two sorts of partisanship. There is tribal loyalty, "Ya boo, we are Labour, you are Conservative" and all that, but there are also philosophical differences between people who call themselves Social Democrats or Socialists and people who call themselves free market neo-liberals or whatever. That is the real difference.

Lord Adonis: Of course, that difference is present in the House of Lords too.

Q110 Kelvin Hopkins: Yes, but that difference can be evident when members put forward a view which is an alternative view to yours but even in the same party.

Lord Adonis: All of the parties represented here today are broad churches and they have people who hold a range of views, but of course, there is a broad division between left and right which is as marked between the political parties in the House of Lords as it is in the House of Commons.

Q111 Kelvin Hopkins: Lord Darzi mentioned democracy - he was I think the first of you to mention democracy. When the electorate votes, they are, in theory at least, offered a choice between two different philosophies, and these philosophies they expect to be represented in Parliament, both in the Lords and in the Commons. Has it not been a disappointment to the electorate that they have not got what they expected, and that people like yourselves, admirable and intelligent and capable though you are, do not present philosophical choice, if there is a swing to the left or the right?

Lord Adonis: I think you have heard from the three of us, and speaking for my colleagues, that we do hold views strongly. We are not, as it were, above the fray, experts acting independently of ideological convictions at all. On the contrary; we hold strong views which are in sympathy with the party that we serve in government. I do not think the fact that we are not elected makes any difference to the strength of our convictions or the strength of the choice that is offered to the electorate.

Q112 Kelvin Hopkins: Do you not represent the ultimate point in the drift towards managerialism in government, where there is no philosophical difference? In fact, you are managers representing a predetermined and decided philosophy, and you are all pursuing that. Would you feel comfortable, for example, if there were to be a government of the left elected?

Lord Adonis: I believe there is a government of the left in office at the moment, and I am proud to be a member of it. I do not think I share that analysis. I think the issue in respect of ministers who are not Members of the House of Commons is whether they can add to the strength of the government as an executive. I do not believe that their role is to dilute the clarity of the choice that is offered to the electorate or to make the government in any way less committed to the programme on which it was elected.

Q113 Kelvin Hopkins: Right at the beginning you said you were pleased to serve as a special adviser to the Prime Minister, as Head of Policy at Downing Street and so on. You were admiring of Tony Blair's drive, his determination to drive through a particular view from the centre. In the process, of course - and it happened before as well as after, but particularly after - those forces in society which act as a kind of break on wilful Prime Ministers have all been diminished. I am talking about the Cabinet, especially the Cabinet; the Civil Service, which has been brought into line in a sense, I think; local government, which has I think been cut off at the knees, trade unions equally so; the political parties - in our own political party there have been enormous efforts to strip out opposition within it. The only opposition that we finish up with is the media, which is why Tony Blair, no doubt, with your assistance, was so concerned about the media, because it is the one area which he could not actually control.

Lord Adonis: I do not agree with any part of that analysis. Would you like me to go through it?

Q114 Chairman: Unfortunately, we do not have time to explore it.

Lord West of Spithead: I have to say I could not agree with that analysis either but one thing that has surprised me, because I was not aware of it before - I was not a political animal at all because I do not think it is right that you should be when you are in the services - is that I was surprised that Parliament does not have more power. I was surprised that the power of some of these committees, which I think are important to come before, does not seem to be as great as it should be, and it does seem to me that Parliament seems to have lost some of the power that I remember from lectures way back in time it had, and the executive is able to have really quite a lot of power.

Chairman: I think we would like to hear more from you on that.

Q115 Kelvin Hopkins: That was my last question about Parliament.

Lord West of Spithead: There were some other things. I am sorry, I could not agree with a whole raft of those, I am afraid.

Q116 Chairman: We might come back to what you just said right at the end, if we may, because that is extremely interesting for us.

Lord West of Spithead: Mr Chairman, I have a problem and I will have to go shortly after 11.

Q117 Chairman: In that case, say it to us now. Having dangled that in front of us, tell us how we could do better.

Lord West of Spithead: I do not think I am able to say how---

Q118 Chairman: Tell us how inadequate we are then.

Lord West of Spithead: I just think that, bearing in mind that you are an elected House, which gives you huge power effectively, because people have voted for you and elected you, it does seem when I have been talking to people and seeing what is going on that an awful lot of the backbenchers have very little ability to actually impact on what is going on and the ability of the House sometimes to call the Government to account - and I approve of the things this Government have done but any government needs to be called to account, and I do not think we are as good at that as I think probably historically, but I am not, I regret, very knowledgeable of this, as you are, Mr Chairman, but I do not think it has the same ability to do that as it used to, and I think that is very dangerous if you lose that ability. I think we need to look very carefully at how that can be done in the future. I am not very clear, I am afraid, because I do not have great detailed knowledge.

Q119 Paul Flynn: Can I ask something before you go? You were appointed as an independent expert. There was some speculation about a change of mind you had on the 28 days' detention and whether it was as a result of your own knowledge of security or whether there was any political pressure. Can we take the contemporary situation, where we hear opposition parties and the Government saying that the greatest security risks come from Afghanistan and from the Taliban when the evidence suggests that all the security threats to Britain have come from Pakistan and from Al Qaeda or are home-grown. Do you go along with what appears to be a self-serving political fiction of suggesting that there is a terrorist threat from specifically Afghanistan or the Taliban or do you go on your own judgement?

Lord West of Spithead: I do not think the way this has been put across is exactly as you say. I have no doubt whatsoever that our actions in Afghanistan, the initial invasion, did actually stop huge training camps that were there. We actually dismantled laboratories that were beginning to produce some very nasty things. We drove the people involved in that, a large number of them, across into the FATA in Pakistan. I have no doubt whatsoever that if we just disappeared from Afghanistan tomorrow, just went, that that space would be filled again with a lot of those from the FATA and it would be a real risk for us. So I do believe that this has a direct relationship to this country. There is no doubt that 80 % of all the cases that come across my desk have a link to the FATA area and therefore I do believe this has a real impact.

Q120 Paul Flynn: I am just wondering about the political pressure on you. Other judgements would be that the incubation areas for terrorism are Yemen, Somalia, Pakistan and other countries there, and in fact the Taliban having a vested interest in excluding Al Qaeda and potential terrorists.

Lord West of Spithead: I could go into the detail. The answer is that I am not put under political pressure to give evidence or advice. For example, this afternoon we will be having a sub-committee of one of the NSID(A)[1] committees talking about the Horn of Africa and the advice I give will be pure advice. However, having said all that, clearly, if you are in a government, there will come a stage, as it did when I was Chief of Staff, where as a Chief of Staff at committee you will make a corporate judgement, and you may have fought very hard against certain parts of it but, if you accept that, you either then resign or you accept it. It is Cabinet responsibility, the same sort of thing. Clearly, that does apply as well.

Paul Flynn: At the Merchant Navy Memorial Service you were glittering as Baron West of Spithead in your magnificent uniform. Are you not tempted to add a little glitter to this Committee by livening our drab apparel up by wearing your uniform more often?

Q121 Chairman: Paul's first question, this change in mind about the detention period, the story was that you were leant on.

Lord West of Spithead: I can honestly say that I was not leant on. I had already organised to go to Number 10 that day because I was going there for a breakfast that was being given for the team who had worked with me on one of the aspects of safety and protective security. They had done some really good work and the Prime Minister said, "I would like to have them for breakfast". I made that statement on the Today programme and then, of course, I was due to go to Number 10 already. When I was in there the Prime Minister did say, "Do you really believe, Alan, we shouldn't have 42 days?" and I said, "It's something that I'm still looking into in great depth". He did not say, "Well, you've got to say this, got to say that". He did not say that at all.

Q122 Chairman: You do not strike me as a man who would be easily leant on anyway. I know that you have got to go at 11, so please do. It was kind of you to come along. Thank you very much.

Lord West of Spithead: Thank you.

Chairman: We are grateful to you two for staying a little longer. I know Paul has a particular reason to be grateful to Lord Darzi so I am going to ask him to turn his attention to you now.

Q123 Paul Flynn: Last time we met was under rather unusual circumstances. I was actually lying on the floor of the Members' Dining Room and, while I was comforted to see your presence, in my semi-conscious state I did have a moment of alarm when I remembered that you were a surgeon, but then noticed you did not have your instruments with you. You were extremely kind. It was the day after you saved the life of Lord Brennan in the House of Lords. You have had an extraordinary political career that most politicians would be happy to look back on after a lifetime in politics, but you have been there for just two years. Why have you left?

Lord Darzi of Denham: Thank you. I was not sure whether you would remember because I tried to make sure you did not see my face! Sometimes surgeons are much more precise than physicians. On that note, I am delighted you are much better. It is very kind of you to say that. Within three months of my appointment - it might be an attribute of my being a surgeon - I was very clear what my objectives were. I knew exactly what my tasks were. I wanted to lead a major review of the NHS, re-engage the staff, the public and the users of the service, which took me a year of very, very hard work. For the first time I felt that we managed to communicate the messages of reform. Although I am not a politician, we were talking about the means of reform, but the language was not right. The language was about payment by results, regulation and foundation trusts. That is what the language of politicians has become whereas, in actual fact, the language should be what patients want and what politicians promise to deliver, which is quality care. For me, that was quite a big task to do and I was not sure what the outcome of that would be. My confidence was built more and more throughout that first year because I felt that many staff across the NHS were engaging with this. I had a lot of cynicism in the beginning, people were very sceptical, "Why do we need another review?" There was review fatigue when I first took this job on. Building that confidence and building this from the bottom up was my one and most important objective. As an expert you constantly need to pinch yourself that you do not bring your own ideas of what this should be because experts sometimes have baggage and you have to remember that. I remember reading a couple of books about this. I had to challenge myself in relation to the thinking. I worked with exceptionally bright people in the Civil Service. They still recruit the highest quality people. It was a fantastic year and was very well received by all the stakeholders, including the media who were very supportive of what I was trying to do. Once I did that I felt it was very important that at least I see through the implementation of some of the enabling policy that I could promise as a Government minister to make those local visions happen, so I stayed for another year to make sure I got all of those policies through. At the end of those two years I felt that I had achieved what I could achieve through my expertise, what I had brought to the job. I have never extended my stay in any role in life, and I have held many leadership roles in the past. It was time to move on. On an individual basis, I was doing two jobs. What brings me to work is my patients, that is what I want to do. That might sound very strange to a lot of people and even in my own organisation when I came back they said, "Well, what are you going to do now?" That is what I love, that is what I do, and I went back to what I enjoy doing the most.

Q124 Paul Flynn: Can you consolidate the value of the work that you did in your new position now, particularly in the international debate that is going on in America? Are you satisfied that it is not over now and your successors are not going to trash your legacy, the effect will continue and you are in a position to influence the future of those reforms?

Lord Darzi of Denham: Very much so. The privilege of serving has also provided me with future opportunities to keep more of the responsible guardian role in what is happening in reform, and I will always speak in any forum in relation to where we are going as far as the NHS journey is concerned, whether that is national or, more importantly, international. We have this hang-up. We have an amazing healthcare system and sometimes we may beat it locally in the odd newspaper but on an international basis we have a lot to share with other people and to learn from. Whichever way you look at it, certainly at a time of economic downturn the cost of provision of healthcare, healthcare expenditure, is challenging to any government across the globe. We have to share our experiences, we have to learn from other people and we have an important leadership role to play here in the external side of things. I have been given this opportunity to do that and I promise I will do my best to make that happen. I very much hope that we will keep that momentum because the NHS is great to its citizens but it has a much bigger contribution to make globally.

Q125 Paul Flynn: We can look forward to you saying that on FOX News in the future.

Lord Darzi of Denham: I would be delighted to. I have done that and I have had all sorts of weird and wonderful phone calls, but that is life and you just get on and defend what you believe we have in this country.

Q126 Paul Flynn: Lord Adonis, we remember you well as an Observer journalist and a Financial Times journalist as well. You are the odd one out in this group this morning in that you did not come in with a body of expert knowledge on one particular subject but you rapidly became the world's greatest expert on education and you are now the world's greatest expert on transport.

Lord Adonis: I would not describe myself in those terms, Chairman. It is very kind of Mr Flynn to give me that appellation.

Paul Flynn: Nothing but the plain truth from this Committee.

Q127 Chairman: I think there was the slightest hint of irony there.

Lord Adonis: I think Lord Darzi may have a better claim to being the world's greatest expert in his area.

Q128 Paul Flynn: Would you say the way you have sort of butterflied around from subject to subject, unlike the other two, makes you more of a politician rather than someone who is plucked from outside because of your expert knowledge?

Lord Adonis: I think that is absolutely a fair comment. As a special adviser, of course, you develop a body of expertise. I had been a special adviser for seven years before I became a minister and a good part of that had been spent working with a particular focus on education, so when I arrived at the Education Department as a minister in 2005 I had a good body of knowledge both of the education world in general and of the specific reform programmes which were being carried through. Whilst I certainly would not describe myself as the world's greatest expert in anything, apart from myself, I did have a body of knowledge and experience of government that was immensely useful when I became a minister.

Q129 Paul Flynn: You were associated with something call the ABA, which is sometimes known as the Adonis-Blair Alliance, I believe it was, or Axis, as a plan to wrest control of education from public authorities. Was that part of the truth of things?

Lord Adonis: I have not heard that one before as a secret movement that had not been revealed to the public. The prosaic truth is that I was the Prime Minister's adviser on education and we were carrying through a big programme of reform in schools that did seek to change the relationship. I will be quite open about it. It was no matter of secret policy at all. We were quite open in wanting to change the relationship between schools and local authorities so that headteachers and governors of schools could play a bigger role in directly managing their institutions because all the evidence is that having strong and effectively managed institutions that are responsible for their own fate tend to produce better results. It was no secret alliance and I was fulfilling a perfectly legitimate role as the Prime Minister's adviser.

Q130 Paul Flynn: I am assured that ABA stood for Adonis-Blair Axis among the polite or Andrew Bloody Adonis among the less polite, which is disgraceful.

Lord Adonis: It is very kind of you to point that out to me.

Q131 Paul Flynn: Looking back at your political affiliations, which seem to be malleable, you were in the Liberal Democratic Party, which was more or less a political party, and you moved from there seamlessly to the Labour Party. What does it mean to you to have political convictions? Are these superficial and unnecessary?

Lord Adonis: My political views have not changed substantially in my adult life. I was a member of the SDP when I was a student; the SDP ceased to exist and merged into the Liberal Democrats. How can I put this politely? The Labour Party under Tony Blair came to have more in common, indeed a very substantial identity of interest, with the Liberal Democrats on ideological matters and much more so than some of those ideological strains in the Labour Party which had predominated in the 1980s. For me, it has not involved any change in my fundamental political views. I am a modernising Social Democrat now and I was a modernising Social Democrat when I was a member of the SDP in the early to mid-1980s.

Q132 Paul Flynn: Finally, you seem to be not only willing but eager to answer questions in the House of Commons.

Lord Adonis: Absolutely.

Q133 Paul Flynn: Would you like to talk about that?

Lord Adonis: I think it is right that ministers in the Lords should be as accountable to the House of Commons as the House of Commons wishes to make them. Since I became Secretary of State on this particular issue, to have a head of department in the House of Lords, I have made it very clear that I would be willing to answer questions in the Commons in any way that they wish to make that possible. I already answer questions regularly in the Transport Select Committee. After I became Secretary of State I agreed with the Committee that after each Question Time session on the floor of the Commons I would engage with them in a departmental question session in the Transport Select Committee. There are departmental questions on Transport in the House today and the week after next I appear before the Transport Select Committee so that they have an opportunity to question me directly. That is apart from any subject inquiry. I also appear before them when they do specific subject inquiries. After the Speaker made his speech in August suggesting that Lords ministers who headed departments might answer questions in the Commons I made it clear that I would be very happy to do that. Indeed, as it happens, I met him this morning to discuss the idea further and we agreed that if the House was willing to do so it would be thoroughly desirable that the two heads of department who sit in the House of Lords would answer questions in an appropriate manner in the House of Commons. The discussion centred on whether that might work best in Westminster Hall rather than in the chamber. As I say, since I am already answering departmental questions in the Transport Select Committee this will be just a next step along that road.

Q134 Chairman: Lord Darzi, similarly I have your letter to the Speaker in front of me, a rather fulsome tribute to the new Speaker followed by this offer to appear in the Commons. I wonder if this is going to be true of all unelected ministers, whether they are going to express a similar willingness to attend upon the House of Commons, even in the Chamber of the Commons?

Lord Darzi of Denham: I use every opportunity I can to engage as many people as possible. The Select Committee was probably the best opportunity I had to give and explain the policies that I was doing. As far as the Commons is concerned, the rules do not allow you to do so but if the rules changed I cannot see a problem. We have to remember there is a slight difference here: I was the boy, the junior minister in the department. I had a very able secretary of state. I always felt I was part of a team that defended the case and the cause of what we were trying to do through the Next Stage Review in the most eloquent way in the House of Commons. If the House of Commons wanted me to appear in a different forum, or even in the Chamber, I could not see any difficulty. In actual fact, I went off and engaged Opposition spokespeople during my review, to have coffees with them to explain what I was trying to do, which was also very atypical.

Q135 Chairman: You are right to make the distinction between a junior minister and a secretary of state. It particularly arises in relation to a secretary of state. Despite the figures on the whole being consistent on the number of unelected ministers since the post-war period, I think we are at a high point at the moment in terms of non-elected secretaries of state and that is where the issue particularly cuts.

Lord Adonis: It is true in that we do have two secretaries of state in the House of Lords but, of course, the Lord Chancellor, pre the latest reforms, was tantamount to a secretary of state. The Lord Chancellor ran a department, and a very important one. It was quite often the case that you had a secretary of state in the House of Lords and, of course, the Lord Chancellor, so having three Cabinet ministers in the Lords, of whom two headed departments, has been a frequent occurrence in recent decades.

Q136 Mr Liddell-Grainger: I am intrigued at you taking something in a Labour Government because you seem to be so above the common fray. Had you given any donations to the Labour Party or had you gone to fundraising events?

Lord Darzi of Denham: Before I started, absolutely no donations. Since I started there was the membership of some club, or something like that, which I registered to, but I had not given any donations before.

Q137 Mr Liddell-Grainger: I am absolutely intrigued that you took it on. The other point that I find interesting is that you continued to work when you were a minister.

Lord Darzi of Denham: Yes.

Q138 Mr Liddell-Grainger: I have just been quickly reading something that says you like Top Gear and you have just about Saturday afternoon and Sunday morning to see your family, which I suppose resonates with some of us. It is a fairly remarkable achievement to be able to continue to work and push through some health reforms in two years. Were you completely knackered by the end of it?

Lord Darzi of Denham: No way am I going to say it was not challenging, it was challenging, but it was very important for me to do my clinical work. I did say what brings me to work is to do what I do. Also, it kept me grounded. The idea of faffing around for three days a week and your private office and car and everything else, when I arrived on Friday the nurse in the theatre reminded me who I am; I was not a minister in the operating theatre. That was very important for me in all sorts of ways. I could tell you on numerous occasions I discussed ideas of policy with my colleagues. That was very important for me. You are right, it was very atypical. I have looked at the history of Parliament and I know that you have never had an active clinician holding a ministerial post.

Q139 Mr Liddell-Grainger: That is the point I am coming on to. What makes it more remarkable is that you were doing two jobs. We are castigated for doing two jobs. You did it and you did it successfully, which I find remarkable. Could you have done four years if you wanted to? Do you think it would have been too much?

Lord Darzi of Denham: Yes. I was giving it full drive for a period. You have to remember, I was operating all day Friday and all day Saturday. I finished work at seven o'clock on Saturday evening and then they would give me the dreaded Red Box on Sunday that you have to go through and be completely ready for the week after. It was quite tough. That was not the reason why I left, I must say, although that was partly the reason. I felt I had done what I was brought in to do and that was what was very important. It is a bit like surgery, you need to know when you have done the job and discharge the patient.

Q140 Mr Liddell-Grainger: I think there is a benchmark here. I think that somebody of your standard can come in and do a proper job whilst doing what you did, which is a remarkable achievement, but also it is a time set procedure, you can only do it for so long. Lord West is retired and can pretty well do what he wants, but you are not, you are still a practising clinician and want to continue to do the job and that is a remarkable achievement. Every single MP has constituents, I have 78,000 - they vary slightly with the size of the seats - and one of the things that keeps us on the ground is our constituents coming to see us at surgeries and to an extent it is the same with you, you see your patients and, depending on whether they are conscious, they will tell you what they are thinking. It is a very good barometer for us. I know that I get a lot of Health Service complaints, I write to the minister and the minister will reply with "Yes", "No" or "Sorry". Do you think that the very basic raw data that you get from a lady or a gentleman who has got a problem is something that you miss?

Lord Darzi of Denham: Absolutely. I could not agree with you more. My constituency is larger than yours!

Q141 Mr Liddell-Grainger: You have the whole of the United Kingdom.

Lord Darzi of Denham: The answer to your question is yes, absolutely. Always at the end of the consultation, even during the two years I was in office, I used to have a social discussion about the NHS with my patients, "What do you think about it?" and that was extremely important feedback. It is amazing that you remember these things, but before I joined when there was a fair bit of noise about the NHS in 2006-07, the commonest question was, "Well, what do you think?" and constantly they used to say, "We need to get an expert to run it" and it was a bit of a funny moment when I was called in to this post. That feedback is very important and I think I used that quite successfully for the two years I was in office.

Q142 Mr Liddell-Grainger: If you were going to advise somebody coming in, a very eminent person from any walk of life who wants to continue doing what they do plus becoming a minister - it does not matter which party, it is irrelevant - what would you say to them now that you have done it, you have been successful? What fatherly advice would you give them?

Lord Darzi of Denham: Define the purpose of why you are there. Unlike an elected Member of Parliament you are not going there for the same reason. Define what you are trying to achieve. What is the purpose of your appointment and structure yourself to achieve that goal. Do not go to an organisation, any department in Whitehall, and try to change its culture because it is different from the culture of the organisation you have come from and the amount of emotion and energy you put into that. Try to use what levers you have to bring people with you to make sure they help you to achieve that purpose. Always remind yourself of the purpose you are there for. That was really how I did it. As I said, I had a very enjoyable period with the Civil Service, getting them to engage with me and help me. I had a superb time with my political colleagues. We had a fantastic department led by Alan Johnson and subsequently by our new secretary of state. Make sure you have collective accountability. These are mostly process advice, but do not forget what the purpose of your appointment is.

Q143 Mr Liddell-Grainger: I think you said you had not really been back into the House of Lords since you retired, was that right?

Lord Darzi of Denham: Yes, I have been away.

Q144 Mr Liddell-Grainger: That is fair enough. Will you continue to be an active member of the Lords? Do you see yourself getting involved with the Lords, not as a ministerial appointment but within the committee system and all the rest of it? Will you be coming in to do the job of a peer still?

Lord Darzi of Denham: Yes, in my own area of expertise I will be, absolutely.

Q145 Mr Liddell-Grainger: That was what I meant.

Lord Darzi of Denham: Beside me contributing to the job, the job contributed a lot to me, do not forget that. When you bring someone and put them in a ministerial job you really equip them with all the necessary competences you require to be a good parliamentarian. Say, in a hypothetical way, I entered the House of Lords through the Appointments Commission, that was an amazing learning curve and the job taught me a lot I could bring back as a successful parliamentarian. There is a very important question here. You asked me, "Did anyone tell you what a minister is?" and the answer was "no". Does anyone tell you what a parliamentarian is? The answer is definitely no. They will tell you where the restaurants are and where the bathrooms are and that is it. They will tell you the rules of the House and how to address a noble Lord but you do not get anything. There is a lot you learn from the job that you can use in the future to be a good debating parliamentarian.

Q146 Chairman: One rather precise question is a suggestion that is around is that when we have unelected ministers we ought to have something like a confirmation hearing in the Commons to approve them. Is that a sensible suggestion and is it one that you would have been happy to expose yourself to?

Lord Adonis: I would have been happy to expose myself to it but, of course, it is a very significant infringement of the prerogative of the Crown exercised by the Prime Minister to appoint members of the Government. You asked me the personal question would I be prepared to have undergone it and my answer is "yes". Do I think it is a desirable reform? I think it would need extremely serious consideration because it would be a fundamental constitutional reform regulating the exercise of the prerogative on appointment of ministers.

Q147 Chairman: If prime ministers were increasingly to bring non-elected people into government that would also be an extension of the prerogative, would it not, and would require a response of some kind?

Lord Darzi of Denham: As I said in my opening remarks, the facts do not bear out there has been much of an increase. There has been a modest increase. If you were asking me would I have been prepared to have undergone questions, I certainly would have been. Any more due diligence and any more evidence to say you can do the job, the better.

Q148 Chairman: Can we just have a word on the problem to which unelected ministers is the answer. It has been put to us that the problem is there is not enough talent amongst the elected people. People have referred to the "poor quality of the gene pool" from which the executive is recruited. Is that the problem to which non-elected ministers are the answer?

Lord Adonis: I do not think that is how I would describe it. I would put it in two parts. Firstly, by the nature of our constitution at the moment we have to have a number of unelected ministers. To do the Government's business in the House of Lords requires somewhere between 15 and 20 ministers. The House of Lords legislates with as much conscientiousness as the House of Commons, there are questions to be answered, debates to be responded to and so on. As Lord Darzi would also endorse, the parliamentary work of being a Lords minister is very demanding. You are the only minister in your department in the Lords so you have to cover the whole of the waterfront in that department and the Lords can be a demanding taskmaster. As the constitution works at the moment you would need 15-20 ministers in that House in any event. When it comes to the broader question of is it desirable to have ministers who are not MPs, the fact that it is possible to appoint from outside the restricted body of those who have been elected to the House of Commons appears to me to be very desirable because it allows there to be a larger pool from which you can draw ministers rather than a much more tightly defined and narrow pool. That is not to in any way decry the importance of ministers both being accountable and the importance of the great majority of ministers being elected Members of Parliament, which to my mind is an important element of the operation of our democracy.

Q149 Chairman: But you can be accountable. As we have heard, Lord Darzi has been vigorously accountable and you are accountable without being elected and these are different things, are they not?

Lord Adonis: They are distinctly different. At the moment we do not answer questions in the Commons, so there could be a further reform there. It is not simply the question of accountability, the democratic character of the government is materially affected by whether or not there is a body of ministers who are themselves directly elected rather than appointed. In fact, in most countries - not all - that make it possible to have ministers drawn from outside the legislature, most ministers are either members of the legislature or, as in France, formerly members of the legislature who resign on appointment, have deputies who take their seats and then they return to the legislature immediately afterwards, so tantamount to parliamentarians in our sense.

Q150 Chairman: If having unelected ministers is a good thing, and we have seen some conspicuous success stories today, perhaps we should have more of them. Perhaps this is a direction of travel that we should encourage. There is an idea that possibly we are moving ever so slowly towards a more separated system of powers in this country. If we do that then a prime minister will look for the best people wherever he or she can find them. It might relate to Lord West's point about Parliament not being terribly effective. It may be that we need both a way of finding a more effective executive, and this may be a way of doing it, but at the same time it might enable Parliament to become more effective too. Do you recognise this as a direction, Lord Adonis? You are a constitutional historian.

Lord Adonis: 20% of ministers are drawn from the House of Lords at the moment, and that is 19 ministers in the present Government. That gives the Prime Minister fair scope for appointing eminent experts and outsiders like Lord Darzi. My own view is that the balance is probably about right. To my mind, it works fairly well and I think a future prime minister would find that this gave him or her sufficient scope to bring in outsiders. You could clearly move to 30%, a larger proportion, without it fundamentally affecting the nature of the constitution. If you were to move significantly further than that you would be getting into what would be a fundamental change in the relationship between the House of Commons and the executive. My own view of that, since you ask me, is that I think the relationship at the moment benefits from the presence in the House of Commons of ministers who are drawn from that House. Whilst I do not think it needs necessarily to be the precise number that you have at the moment, it could be fewer, to break the link substantially or entirely would be a fundamental constitutional change and I am not sure it would be a beneficial one, I think it might have the effect of isolating the executive more both from parliamentary opinion and perhaps also from public opinion.

Lord Darzi of Denham: I know something about genes and I think you are under-selling yourself by saying the gene pool is small. I think that is wrong.

Q151 Chairman: I think it was said to us by a former Cabinet Secretary, I have not just invented it.

Lord Darzi of Denham: I would question that. There are instances in which there might be a gap in an area of expertise and you may wish to look at that and make an appointment in relation to what the issue or purpose of that appointment is. I am not going to go into the constitutional side, I am not an expert in that field, but I saw myself coming in for a specific task. This is my own experience. I took that task and delivered what I thought needed to happen as far as the third phase of reforming the NHS.

Kelvin Hopkins: In relation to the gene pool analogy, the reality is that there is a big gene pool but there are lots of rogue genes that are unacceptable to the Prime Minister. If he had agreeable genes he would be much happier. There are lots of talented people on the backbenches of the governing party who are not acceptable because they are not acceptable in genetic terms, if you like.

Chairman: My Lord, you know more about genes than we do and I think we should leave it there. We are extremely grateful to you for coming along and talking in a very open and frank way to us. Not to exclude you, Lord Adonis, but the fact we have been able to bring people like Lord Darzi into government has made a huge contribution, and as a heavy user of the Health Service I can say it has had a transforming effect on the Health Service as well. It is something worth exploring. Thank you very much indeed for coming along and talking to us.

[1] National Security, International Relations and Development (Africa)