Examination of Witnesses (Questions 140
- 151)
THURSDAY 22 OCTOBER 2009
RT HON
LORD ADONIS,
PROFESSOR LORD
DARZI OF
DENHAM KBE AND
ADMIRAL LORD
WEST OF
SPITHEAD GCB, DSC
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.
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