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House of Lords
Monday, 6 October 2008.
The House met at half-past two: the LORD SPEAKER on the Woolsack.
Prayers—Read by the Lord Bishop of Liverpool.
Introduction: Lord Judge
Lord Judge—The Right Honourable Sir Igor Judge, Knight, having been appointed Lord Chief Justice and created Baron Judge, of Draycote in the County of Warwickshire, for life, was introduced between the Lord Woolf and the Lord Phillips of Worth Matravers.
Death of Members
2.43 pm
The Lord Speaker (Baroness Hayman): My Lords, I regret to inform the House of the deaths during the Summer Recess of the noble Lords, Lord Russell-Johnston, Lord Varley, Lord Bruce-Lockhart and Lord Thomson of Monifieth. On behalf of the whole House, I extend our condolences to those noble Lords’ families and friends.
Government: Ministerial Changes
2.44 pm
Lord Strathclyde: My Lords, perhaps I may be the first after the Summer Recess to welcome the new Leader of the House and Lord President of the Council, the noble Baroness, Lady Royall of Blaisdon. We very much look forward to working with her, as we have with her predecessors. We wish her good fortune in that job, particularly offering our support in her dealing with House matters as Leader of the whole House.
I should also like to pay a special tribute to the noble Baroness, Lady Ashton of Upholland, who has been tremendously promoted to European Commissioner. It is a post which, I think, surprised her almost as much as me, since, on Friday, I was having lunch with her when the Prime Minister rang her mobile telephone. He, I have to say, was even more surprised to hear that she was having lunch with me. In the relatively short time that the noble Baroness was Leader, she demonstrated most ably how she led for the whole House by finding that balance between representing the whole House and still being a party politician. That should remain as an example for us all. From this side, we wish her the best of good fortune in her post and we hope to see her from time to time in your Lordships’ House.
Lord McNally: My Lords, I associate these Benches with the good wishes expressed by the noble Lord, Lord Strathclyde. I am not surprised that the noble Baroness, Lady Ashton, has gone to Brussels. Anyone watching the skill and knowledge she deployed during the passage of the Lisbon Bill will know that our Commission portfolio in Brussels is now in very safe hands, and the noble Lord, Lord Pearson, will have at least one friend when he wants to go over there.
Turning to the noble Baroness the Leader of the House, Lady Royall, the noble Lord, Lord Strathclyde, pointed out the skills and attributes needed in a Leader of the House. I think that one is needed above all—to be a good listener. When we recall that the noble Baroness spent so many years working for the noble Lord, Lord Kinnock, we know that she must have that skill in spades. She also left a vacancy that has been filled by the noble Lord, Lord Bassam. The noble Lord has often been the good soldier Svejk of this Government, going out into no man’s land to defend the indefensible. It is a great encouragement to see that he did after all have a field-marshal’s baton in his knapsack. We wish them both well.
Baroness D'Souza: My Lords, on behalf of the Cross Benches I, too, add my congratulations to the noble Baroness, Lady Ashton, on her appointment as
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The Lord Bishop of Portsmouth: My Lords, on behalf of these Benches I offer my congratulations to the noble Baroness, Lady Ashton. I have particular memories of working with her on an education Bill and on various debates. It always struck me that no one else in the House could speak as quickly as her. At the end of one debate I passed her a note with a Gilbert and Sullivan quotation:
“This particularly rapid, unintelligible patter
Isn’t generally heard, and if it is it doesn’t matter”.I would not quite want that to be my last word about her because it is not absolutely true, and I am sure that she will bring that sharp and engaging way of speaking to her new job. All I can say about the noble Baroness, Lady Royall, is that my hair was once the colour of hers, but it has all gone now. However, I can assure her that I have sired three offspring redheads because the red gene is very strong. Finally, I offer my congratulations to the noble Lord, Lord Bassam, on his appointment. We have very much enjoyed working with him.
The Lord President of the Council (Baroness Royall of Blaisdon): My Lords, I thank noble Lords who have spoken today for their kind remarks about my noble friends Lady Ashton and Lord Bassam, and for what they have said about me. I am very grateful. That is perhaps an understatement. Someone once said that a week is a long time in politics. From my own experience of the changes to Government announced by my right honourable friend the Prime Minister, clearly a day is now a long time in politics. The noble Lord, Lord Strathclyde, told us that my noble friend was lunching with him when she got the call from the Prime Minister; I was in the swimming pool. It was an enormous surprise.
My noble friend Lady Ashton is unable to be with us today. Her duties as the UK’s Commissioner-designate in the European Commission are already heavy and undoubtedly will get much heavier. I echo and share the tributes that have been paid to her. My noble friend Lady Ashton—I am sure she will be appalled to hear herself called Lady Ashton rather than Cathy—has been for the last year a spirited and dynamic Leader of the House and, of course, a highly effective Minister in your Lordships’ House for a great deal longer. Her enthusiasm was contagious and her energy boundless. She had an extraordinary capacity to master a brief and I watched in awe her handling of the European Union (Amendment) Bill. Although she will, of course,
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I am deeply honoured, privileged and humbled to stand here as Leader of your Lordships’ House. I believe that we have a strong and exciting government team in the House of Lords and I look forward to working with it. Cathy Ashton—my noble friend Lady Ashton—very much saw herself as Leader of the whole House as well as of these Benches. I entirely agree that that is the role of the Leader of the House, and I shall discharge that role and the privilege of carrying it out to the very best of my ability. The job of the Government is to serve. I have a very high and warm regard for this House. In fact, I love the House of Lords. It is an immensely special place and, as I pledge myself to be its Leader, I pledge myself also to be its servant. My Lords, I look forward to working with you all.
2.51 pm
NHS: Expenditure
Lord Naseby asked Her Majesty’s Government:
Baroness Thornton: My Lords, the percentage of NHS expenditure on drugs was 14.3 per cent in 1996-97, which is £4,735 million, and 13.1 per cent, which is £10,545 million, in 2006-07. However, I am afraid that we are not comparing like with like because funding for the NHS in 1996-97 was on a cash basis and in 2006-07 it had changed to a more accurate measure of resources. By using restated figures, we are in fact spending more money than before.
Lord Naseby: My Lords, I doubt that anyone is convinced by these new statistics. The Compendium of Health Statistics, which is the official version, states that the cut is from 11.7 per cent to 10.5 per cent—in effect, a cut of £1 billion. Is that not, in effect, the reason why our cancer patients do not get the drugs they deserve and which other countries provide? Is it not about time that the NICE management was brought to task so that its methodology is published and that it takes a reasonable, not immense, amount of time evaluating these drugs? Finally, will the Minister recognise that these poor patients, who have a very short life, deserve these drugs?
Baroness Thornton: My Lords, that is a compendium supplementary question. I shall do my best to cover some of the points raised by the noble Lord; if I do not cover them all, I undertake to write to him. The growth in drugs over that period has been higher than the growth in overall NHS expenditure. The average growth of drugs was 5.6 per cent clear above inflation compared to the average growth of 5.2 per cent in overall NHS expenditure. The noble Lord referred to issues around cancer patients. He will know that from next year we are abolishing prescription charges for all cancer patients. He may also be aware that the review
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Lord Desai: My Lords, does my noble friend agree that the way to measure our expenditure is to see what the outcomes are? Does she agree that satisfaction with the NHS is much higher now than it was 10 years ago?
Baroness Thornton: My Lords, my noble friend is right that satisfaction is much higher than it was. Indeed, the Government are working hard to ensure that we use our resources in the best possible way. For example, we have issued guidance to the NHS saying that it is not acceptable to use a lack of NICE guidance to refuse treatment, and that the funding is available for the treatment that people need.
The Lord Bishop of Portsmouth: My Lords, there are serious ethical, as well as financial, issues in the noble Lord’s Question. Do the Government agree that a starting point might be to speed up the processes of authorising new drugs, particularly the work of the National Institute for Clinical Excellence? I am told that Scotland is quicker than England in this regard, so perhaps we have some catching up to do south of the border. Another starting point might be a much more robust and transparent discussion of what costs are, both in developing drugs and in using them. We must not forget that this is not about balancing books; it is about anxious patients, of which I have been one, who are sometimes brought into the discussion and are involved in some of the judgments made about how long people might live.
Baroness Thornton: My Lords, the right reverend Prelate is correct that this is not about balancing the books. The Government have recently expressed the opinion that NICE needs to be quicker with its guidance.
NICE’s guidance is based on a thorough assessment of the best available evidence, and it is recognised across the world as a leader in its field. The reason that Scotland occasionally reaches a decision more quickly is that it does not go into the same detail that NICE does; it does not use the same evidence. That is why that happens.
Lord Hamilton of Epsom: My Lords, is not the problem with NICE that it is not actually nice at all? It is designed to be nasty and to ration the amount of money that is made available for drugs in this country. Clearly, we cannot spend indefinite sums, so NICE has the invidious task of deciding who should have drugs and who should not.
Baroness Thornton: My Lords, NICE issues guidance about the appropriate drugs for the appropriate conditions. It is then, quite rightly, up to the doctors to decide how those are prescribed.
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The NHS has some of the most efficient prescribing practices in the world. It has long had a policy of encouraging generic prescribing to ensure that lower-cost generics are used as soon as higher-cost branded medicines lose their patent rights, for example, so the rate of generic prescribing has risen from 51 per cent to 83 per cent, the highest in Europe. We are not spending unnecessary money on branded drugs, but we are making sure that those drugs that need to be available are available.
Baroness Finlay of Llandaff: My Lords, does the Minister agree that Britain has done extremely well, partly through NICE, in decreasing the prescribing of drugs for weak clinical indications, but that the criteria that NICE uses when assessing potentially life-saving drugs such as cancer drugs may need to be viewed differently from the criteria for those that are much more symptomatic and for more minor conditions? Does she agree that the current position of withdrawing NHS funding from patients who have purchased drugs has damaged people’s confidence in the whole NHS and the system as it stands?
Baroness Thornton: My Lords, the noble Baroness is, as ever, very informative. With regard to her question, that is why the Secretary of State asked Professor Richards to do a very quick review of top-up fees and report shortly on it.
Baroness Barker: My Lords, when will the NICE review be concluded, and how soon after that do the Government expect to implement its findings?
Baroness Thornton: My Lords, is the noble Baroness referring to the top-up fees review? We expect that Professor Richards will make his report to the Secretary of State in October—this month. When he has considered it, he intends to publish its findings as quickly as possible.
Railways: Network Rail
2.59 pm
Lord Dubs asked Her Majesty’s Government:
The Minister of State, Department for Transport (Lord Adonis): My Lords, Network Rail is a private sector company, limited by guarantee. The company has significantly improved its overall performance in recent years, and its efficiency targets for the five-year period from 2009 to 2014 are in the process of being determined by the independent Office of Rail Regulation. The Office of Rail Regulation is expected to issue its final determination at the end of this month.
Lord Dubs: My Lords, I congratulate my noble friend on his new post. Does he agree that, notwithstanding some improvements, weekend journeys by rail are still difficult, if not impossible, and that this
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Lord Adonis: My Lords, I am grateful to my noble friend for his opening remarks. My call came while I was in the Wallace Collection and the custodian asked me to turn off my mobile phone. I toyed with the idea of telling him that it was the Prime Minister on the line but thought that he might not believe me, so I made a rapid exit and took the call in the street.
I of course appreciate my noble friend’s concerns about the impact of engineering work. I know that he is particularly concerned about the work that has been taking place on the west coast main line. As he knows, Network Rail was fined £14 million for the late running of work at Rugby over Christmas and the new year on the west coast main line. However, although there has been unavoidable inconvenience for passengers in the completion of the work—this is a huge, £8 billion programme to upgrade the line—when it is completed, by the end of this year, journey times will significantly reduce and the inconvenience to which my noble friend and others have been subjected will be at an end. The gains will be considerable; for example, the journey time from London to Lancaster, the route that my noble friend uses, which in 2004 took three hours 13 minutes, will reduce to two hours 24 minutes. So, to use a railway metaphor, there is a light at the end of the tunnel.
Lord Hanningfield: My Lords, I, too, congratulate the noble Lord, Lord Adonis, on his new appointment. I very much look forward to working with him across the Table. However, a lot of us regret his departure from education and children’s services, because he was doing a really good job there. We hope that his successor will carry on that good work.
About 200,000 passengers were inconvenienced and in considerable difficulties last Christmas and Network Rail was fined £14 million. Are the Government taking any steps to ensure that there is not similar chaos this year? Rail transport passengers need some assurance that they can travel in comfort this Christmas time.
Lord Adonis: My Lords, I am grateful to the noble Lord for his remarks and look forward to working with him closely, as we do in this House, across the Dispatch Box. I hope that the £14 million exemplary fine on Network Rail will indeed ensure that the company is much more careful about ensuring that engineering work is completed in future. But work on the west coast main line, which was the cause of those delays last year, will be completed by the end of this year, so there will not be any recurrence.
Lord Taylor of Blackburn: My Lords—
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Lord Hunt of Kings Heath: My Lords, shall we let the Lib Dems go first?
Lord Bradshaw: My Lords, to continue in the same vein as the answers given, the efficiency of Network Rail and the train operating companies would be greatly improved if they could be encouraged to work closely together to make services better and cost less. But the Department for Transport has apparently told both parties that, if there are any savings as a result of these improved efficiency measures, the department will claim them, so there is no incentive for the two parties to co-operate.
Lord Adonis: My Lords, the noble Lord speaks with great knowledge and experience in these matters and I very much look forward to working with him, too. Network Rail has seen a significant improvement in efficiency in recent years—admittedly that has been from a low base, but it has been significant. In the five years up to 2009, we are projecting efficiency gains of 30 per cent. The regulator’s ambition is for about a 20 per cent efficiency gain over the five years to 2014. We see those as appropriate efficiency gains if the Office of Rail Regulation determines that it wishes to proceed with them.
Lord Taylor of Blackburn: My Lords, is my noble friend aware that while the majority of us who travel on the west coast main line are concerned about journey times, we are more concerned about reliability? We do not care if a journey takes 20 minutes longer as long as we can rely on being in Euston or Lancaster at a certain time.
Lord Adonis: My Lords, I completely understand my noble friend’s point. When modernisation of the west coast main line is complete, we expect reliability to improve as well. However, I am glad to say that reliability has improved on the railways in recent years. The most recent figures, for August of this year, show more than 90 per cent of trains arriving punctually, compared to barely 81 per cent only five years ago. The reliability of the network is improving, but it still has further to go.
The Duke of Montrose: My Lords, the Minister will be aware that the west coast line north of Preston went under water in January due to flooding. Have steps been taken to ensure that this does not happen again?
Lord Adonis: My Lords, I do not think that the determination of the weather is among my many powers—I have yet to discover their full extent—but I will see whether I am invested with such a capacity. However, I am sure that whatever is humanly possible is being done.
Lord Wedderburn of Charlton: My Lords, I congratulate my noble friend on his new post. Will he and his department keep in mind that all judgments on British railways must be conditioned by the memory of the cruel axe wielded on them by Dr Beeching, which has recently had more attention in the media?
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