Examination of Witnesses (Questions 100
- 119)
THURSDAY 22 OCTOBER 2009
RT HON
LORD ADONIS,
PROFESSOR LORD
DARZI OF
DENHAM KBE AND
ADMIRAL LORD
WEST OF
SPITHEAD GCB, DSC
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 10 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.
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