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Lord Filkin: My Lords, the position in those respects was made very clear indeed in the Statement that the Lord Chancellor gave to the House in September. He said two things: first, that it was necessary to bring stability in the medium term to this House. That is what those proposals will do. He also made clear that that was not the final stage of reform and there were a range of issues set out in the consultation paper that still await resolution at some point in the future.

However, given where we are in the lifetime of this Parliament, we will be busy indeed putting these measures into legislation. Therefore, I think that it is unlikely that there will be further legislation in the lifetime of this Parliament. As for the manifesto, I am pleased to say that I am not in a position at this stage to say what will be in that.

Lord Carter: My Lords, the proposals that the Government have made for an appointed House were substantially accepted by this House in February, while it rejected the six proposals for an elected element. On the proposal to put the Appointments Commission on a statutory basis, there was an opposition amendment to the 1999 reform Bill which would have put the Appointments Commission on a statutory basis, so I presume they will support that. My noble and learned friend has already spoken about the future of the 92. He has indicated a way forward in which some of them could stay. Is our discussion today, therefore, perhaps a shade synthetic?

Lord Filkin: My Lords, I have no difficulty in agreeing with my noble friend Lord Carter. I shall emphasise why I think there is a degree of manufactured outrage about some issues. Perhaps I may illustrate the weight of the reform that we are proposing at this stage.

First, for the first time in British history, we are ending the Government's ability to control the size and the composition of this House. Never again will a Prime Minister be able to do what has happened in the past; namely, to bias appointments to this House in his own favour. Secondly, we are ending membership by birth and replacing it with membership by merit. Thirdly, we will enshrine in statute that never again will any party command an overall majority in this House. The Opposition Benches had 20 years in which to do that had they so wished. There was not a whiff of that whatever. Fourthly, we are putting in place a statutory Appointments Commission, which will put completely beyond the influence of the Government the ability to appoint people to the Cross Benches of this House and vet those Members of the House who are nominated by their party political leaders.

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Next, we are separating the judiciary—

Noble Lords: Order!

Lord Filkin: Your Lordships have made my point for me: there is not time to list out all the measures in these changes.

Lord Elton: My Lords, might a hereditary Peer be heard?

Baroness Amos: My Lords, we are out of time and we should move on to the final Question.


3 p.m.

Lord Dubs asked Her Majesty's Government:

    What progress has been made in the reconstruction of Afghanistan and the creation of a stable and peaceful society.

Baroness Amos: My Lords, considerable progress has been made in Afghanistan since the fall of the Taliban in November 2001. A broad-based transitional administration has been established and President Karzai has been elected for a two-year period from June 2002. Progress has also been made in economic and social recovery. The economy grew by 30 per cent last year. Schools have reopened. But there remain major challenges ahead and we are committed to help Afghanistan to meet these now and over the long term.

Lord Dubs: My Lords, I am grateful to my noble friend for that Answer. Will she comment on the security situation in Afghanistan outside Kabul? In particular, will she comment on the difficulties posed by the estimated 4 million landmines in the country and the fact that an estimated 740 million square metres of the country are contaminated by landmines or unexploded shells or bombs?

Baroness Amos: My Lords, my noble friend is right to point out the difficult security situation outside Kabul. That is why the provincial reconstruction teams, including one in Mazar-e-Sharif headed by the UK, have been established. As regards unexploded ordnance and landmines, the United Nations mine action service is responsible for co-ordinating the NGOs working in this area. We have provided #5.3 million in funding. At the end of 2002, an estimated 850 square kilometres remained contaminated. However, we have overseen the training of 2.4 million people to identify and avoid mines and, in 2002 alone, the programme cleared mines and unexploded ordnance from about 111 square kilometres of land.

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Baroness Northover: My Lords, is the noble Baroness aware that the US has spent 11 billion dollars on its military operations in Afghanistan but only 800 million dollars on reconstruction? Will she give the House the breakdown for military operations and reconstruction as regards UK expenditure?

Baroness Amos: My Lords, with respect to military expenditure I do not have the figures on that and I shall write to the noble Baroness. With respect to reconstruction, to date we have spent some #147 million and over the next three years will be spending some #300 million.

Lord Judd: My Lords, does my noble friend agree that if we are to win the peace in terms of establishing global stability and combating extremists, we must give the same priority and resources to reconstruction and peace-building as we give to the military operations themselves?

Baroness Amos: My Lords, I agree that it is important to give priority to reconstruction and peace-building. My noble friend may recall that there was an international conference in Tokyo in January 2002 for the international community to pledge its support for Afghanistan. A needs assessment was undertaken by the World Bank, the UN and the Asian Development Bank and donors pledged some 4.5 billion dollars over a five-year period. That total has increased to 5.2 billion dollars.

There is an issue with respect to absorptive capacity. Noble Lords may be aware that at the margins of the World Bank meeting in Dubai there was a further meeting to look at the reconstruction needs of Afghanistan, which I attended. The point is very well recognised.

Lord Elton: My Lords, when will the elections be held in Afghanistan next year and will the security situation be sufficient for them to be effective?

Baroness Amos: My Lords, the Bonn process set out a timetable which will see elections in, I think, July. I shall write to the noble Lord if I have the month wrong. There will be a Loya Jirgah in December to look at the constitutional issues, which will then lead into that process. We are working hard as an international community to improve the security situation. The Germans are leading on policing; the Americans are leading on reform of the Army; and the Italians are leading on reform of the justice sector. At present, we have no reason to believe that the security situation will prevent elections taking place.

The Earl of Sandwich: My Lords, does the Minister agree that elections have been postponed beyond the original date of June and that that was due in part to the donors not coming up with the funds—including, I am afraid, the United Kingdom Government?

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Baroness Amos: My Lords, I am not sure to what the noble Earl is referring. My understanding is that the constitutional Loya Jirgah, which was due to have been held earlier, will be held in December and that the proposed election date under the Bonn process will go ahead.

Legal Deposit Libraries Bill

Read a third time, and passed.

Health and Social Care (Community Health and Standards) Bill

3.7 p.m.

The Parliamentary Under-Secretary of State, Department of Health (Lord Warner): My Lords, I beg to move that the House do now again resolve itself into Committee on this Bill.

Moved, That the House do now again resolve itself into Committee.—(Lord Warner.)

On Question, Motion agreed to.

House in Committee accordingly.


Clause 2 [Independent Regulator of NHS Foundation Trusts]:

On Question, Whether Clause 2 shall stand part of the Bill?

Earl Howe: I hope that the Committee will allow me to dwell for a few moments on this clause. It contains only three sentences, yet carries huge implications for the working of this part of the Bill. Perhaps the most bandied-about epithet relating to the regulator is that he will be independent. I am reminded a little of Lewis Carroll's Through the Looking Glass, where Alice remonstrates with Humpty Dumpty that the word "glory" does not mean the same as "a nice knock-down argument". The reply she receives is,

    "When I use a word, it means just what I choose it to mean—neither more nor less".

It is a strange reading of the Bill that allows one to believe that the regulator is truly independent of political control. We shall be seeing in later amendments how many aspects of the regulator's existence and remit are subject to the prior approval of the Secretary of State. I shall not anticipate those debates now.

No one can argue with the need for some regulation of foundation trusts. I would not seek to wish away the regulator. Nevertheless, the degree of control that he will be able to exercise over foundation trusts is unnecessarily large. What concerns me at least as much as that is the regulator's lack of accountability. As I read the Bill, the regulator is not accountable to Parliament or to anyone else. In theory, the Secretary of State, as the employer of the regulator, may have some residual accountability to Parliament for the regulator's actions. But, as I understood it, the whole

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aim of Shifting the Balance of Power is to remove the Secretary of State from responsibility for the front line of the NHS. Therefore, it is a tenuous line of accountability at best.

Clause 3 confers on the regulator the same duties as those borne by the Secretary of State, yet nowhere in the Bill are we told what happens if the regulator fails to fulfil those duties. If the Secretary of State or the Government do things that the electorate do not like, they can be questioned in Parliament. If that does not work, there is an easy remedy—they can be voted out through the ballot box. If the regulator does things that the public do not like, they can only complain. Foundation trusts will be in exactly the same position. The regulator has no obligation to make a response.

The relationship between the regulator and a foundation trust will be dependent on the content of the licence that he issues. But there is no requirement on the regulator to consult local people on the content of that licence, on the property which the trust may not sell off or on the services that it must provide. The regulator does not have to consult any of the 28 strategic health authorities, whose role is to maintain important services, such as intensive care and child and adolescent mental health services across an area. He is not even bound to consult the PCTs, which will commission services from the foundation trust. That is an extraordinary state of affairs as, nine times out of 10, the regulator will have absolutely no grassroots knowledge of a particular area and no awareness of what local people want or value.

Until now, Ministers have simply deployed a stock answer. They have said that it is incumbent on the regulator to act reasonably and proportionately and that, if he does not do so, he is liable to judicial review. That does not seem satisfactory. To me, judicial review is not a remedy of choice; it is expensive, cumbersome and time-consuming. It is also, by its very nature, retrospective. By the time an issue is determined by a judge, it can be too late to protect patients from the effect of failing services. It really should not be necessary to go to law every time someone voices a serious grievance against the regulator.

To the extent, therefore, that the regulator is, indeed, an independent being with considerable powers, the absence of a legal remedy against his errors or omissions is serious. I do not know what the Government can do, if, indeed, they want to, to address this accountability vacuum. However, I hope that the Minister will take these concerns away with him. We are in danger of replacing central control by elected officers of government with central control by an unelected bureaucrat. I cannot believe that that represents a step forward.

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