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Lord Dean of Beswick: My Lords, I am grateful to the Minister for that reply. Is she aware that people have been pressing for such a decision for a long time? During my political career, I have been associated with two major cities, Leeds and Manchester. Is the Minister aware that in both places, the chairmen of their trusts are from well outside the city? Does it not seem strange that in two of the biggest cities in the country someone suitable could not be found and that the positions were filled by people living miles away? That looks extremely odd to people who live in those cities.

Baroness Jay of Paddington: My Lords, I am grateful to my noble friend for drawing attention to those local examples. The primary aim of the new policy has been precisely to make trust boards much more representative of the communities they serve. I hope that

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under the new practice that will indeed be the case and that examples like those quoted by my noble friend will not happen again.

Earl Howe: My Lords, will the noble Baroness clarify the range of criteria by which an individual's suitability for board membership of a trust will be assessed? In particular, does she agree with me that it is unfortunate that the issue of private medical insurance should have been raised in that context? Will she remove the uncertainty which persists about whether, in the Government's view, holding such insurance is compatible with board membership?

Baroness Jay of Paddington: My Lords, perhaps I may first welcome the noble Earl to the Dispatch Box with his new portfolio. Having served in the last government in the departments of agriculture and defence, I am not entirely sure whether he will find the area of health more or less controversial. Let us hope that we both find it a tranquil backwater which we can explore together.

A list of essential criteria for membership of a trust board has been widely published. It includes the issue raised by my noble friend Lord Dean of Beswick about living in the area of the trust. Another important element is that someone should have a very strong personal commitment to the NHS; it is also a desirable qualification that such people should have experience as carers or users of the NHS. That represents very clearly the Government's policy. People will not be excluded automatically because they have private medical insurance but the two criteria I have described--a strong personal commitment and being a user of the NHS--makes it very clear where our preference lies.

Lord Taylor of Blackburn: My Lords, is my noble friend aware that the terms of office of quite a number of people filling those posts at present will end shortly? When will the department make a statement as to the new occupiers of those posts?

Baroness Jay of Paddington: My Lords, I am grateful to my noble friend for raising that matter. It is the case that more than 1,000 appointments are due for renewal or for reappointment during this coming month. That is more than one-third of the total number of trust appointees. It has been a very substantial task to look through all the applications, so many of them based on the new criteria which I explained in answer to the previous question. Perhaps we have been a little dilatory in trying to get through all those new appointments but we are aware of that. I should like to take this opportunity to say that they will all be processed as quickly as possible but if the number of appointment forms sitting on my desk is matched by those on the desks of my ministerial colleagues--I believe, in fact, that theirs are more substantial--we certainly have a major task ahead of us. However, we hope that it will lead to a very great improvement in the quality and character of the trust boards.

Baroness Robson of Kiddington: My Lords, the Minister described the criteria for appointments. In her

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original Answer, she mentioned exceptional circumstances in which someone could be appointed from outside the area of the trust board. Can she assure me that one of those exceptional circumstances will not be political allegiance?

Baroness Jay of Paddington: My Lords, yes, political allegiance is not a criterion mentioned either in the essential or desirable list.

Lord Evans of Parkside: My Lords, does my noble friend agree that more important than where members of trust boards reside is the performance of the trust boards themselves? In particular, their affairs should be conducted in a more open fashion. For example, should the press and public not be invited to attend meetings and should not the salary and expenses of all board members be public knowledge?

Baroness Jay of Paddington: My Lords, on the first point, I agree entirely with my noble friend that the clarity and transparency of trust business is extremely important. As my noble friend may be aware, my right honourable friend the Secretary of State has already given guidance to the health service which will be brought forward in a more formal way in December asking that all trust board meetings should be made open. That is consistent with the policy practised for some time by health authorities. We believe that that will increase transparency and communication between the trust boards and local communities and will make it much more useful as a way of reflecting the interests of those communities.

Lord Dean of Beswick: My Lords, do I take it from the Minister's reply that where a chairman lives outside the area of the trust board which he chairs, if a suitable replacement can be found within the area a change of appointment will be made?

Baroness Jay of Paddington: My Lords, it is not our intention to exclude people who presently hold posts from those chairs because of their place of residence. However, when that appointment is due for renewal, that will certainly be a guiding criterion.

NATO Enlargement: Progress

3.8 p.m.

Baroness Ramsay of Cartvale asked Her Majesty's Government:

    What progress has been made towards NATO enlargement since the Madrid Summit of 8th July.

Lord Whitty: My Lords, I am pleased to report that good progress has been made since Madrid on a wide range of practical issues, with a view to ministerial agreement at the North Atlantic Council in December. Poland, the Czech Republic and Hungary have all submitted details of their forces to NATO planners and have begun discussions with NATO on the political, military and financial aspects of acceding

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to the North Atlantic Treaty. We expect that the ratification process for all three countries will be completed by April 1999, which, incidentally, is the 50th anniversary of the Washington Treaty.

Baroness Ramsay of Cartvale: My Lords, I thank my noble friend for that reply. I should declare an interest here as chair of the Atlantic Council of the United Kingdom. Will my noble friend comment on the costs of enlargement? Does he agree that, on present figures, the costs seem manageable; and also that the benefits are enormous? As the Prime Minister said, the benefit of a generation not going to war in Europe in their lifetime, nor sending their children to war, is a prize beyond value.

Lord Whitty: My Lords, I think that the whole House will concur completely with the latter sentiments of my noble friend. Clearly, the extension of NATO is one symbol of the end of the Cold War in Europe and one reason that the next generation will not live in fear of a European war.

Clearly, there are costs involved in enlargement. NATO is currently analysing requirements with a view to assessing those costs in time for the December meeting to ensure that NATO's continued military effectiveness operates with the new members. Those costs will be divided over a long period of time among 16 existing allies as well as the three new members. The UK currently contributes nearly one-sixth of NATO's common budgets, and the European allies together account for about 70 per cent. of those budgets. We expect that those shares will apply equally to the NATO budgets of the enlargement process. But as my noble friend says, those costs give us the great prize of peace in Europe.

The Earl of Lauderdale: My Lords, can the Minister tell the House what progress has been made in assuaging Russian anxieties in this respect?

Lord Whitty: My Lords, the House will be aware of the founding act agreement between Russia and NATO. It is the intention of the British Government, and indeed our allies in NATO, to ensure that the new security process in Europe is an inclusive one to which the Russians are party. Therefore, we are attempting to establish a positive relationship for the new security regime in Europe. On the other hand, there is no Russian veto over acceding countries to the NATO Alliance.

Lord Jenkins of Putney: My Lords--

Noble Lords: Cross-Benches!

Lord Richard: My Lords, we have just a few minutes left of Question Time. I wonder whether my noble friend will allow the noble and gallant Lord, Lord Craig, to ask the next question and then my noble friend can ask his afterwards.

Noble Lords: Oh!

Lord Craig of Radley: My Lords, given the much increased workload that Central Region headquarters is

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undertaking to integrate the armed forces of the three new NATO nations, and given the amount of work which AFNORTHWEST undertakes in "Partnership for Peace" and liaison with the Leningrad Military District, do the Government now agree that this is not the time to be considering the closure and disbandment of the latter headquarters?

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