Examination of Witnesses (Questions 120
- 139)
THURSDAY 22 OCTOBER 2009
RT HON
LORD ADONIS,
PROFESSOR LORD
DARZI OF
DENHAM KBE AND
ADMIRAL LORD
WEST OF
SPITHEAD GCB, DSC
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 appointmentit might be an attribute of my
being a surgeonI 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.
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