Queen's Speech

Lord Alderdice Excerpts

Thursday 3rd June 2010 Lords Chamber

[Lord Alderdice]

My Lords, several noble Lords have observed how the eloquence, elegance of presentation, experience and commitment of the noble Lords on the Front Bench add greatly to the positive prospects for governance in this new Parliament. The maiden speeches of the noble Lords and the right reverend Prelate also bode well for this as a thoughtful, engaged and reflective new Parliament.

It is a new Parliament and a new Government, but also a new type of Government and Parliament. It was interesting to listen to the noble Lord, Lord Elis-Thomas, and my noble friend Lord Kirkwood of Kirkhope speaking about those of us from the Celtic fringe, who have some experience of these questions. This is one of the marvellous things about our great United Kingdom: it is not all one country with one set of experiences. There are some of us who have experience of fairer forms of voting, which bring different ways of forming Governments. It is interesting now that many of those who said, “We can’t have proportional representation because it will bring coalition government”, now discover that first past the post may also—not only on this occasion, but perhaps in the future—bring coalition government.

One of the things that has interested me and several colleagues from Wales and Scotland is that it is clear that the institutions here at Westminster and in Whitehall, and many of those who are involved in them, have not yet quite understood what coalition government is. It is not merger government. It is not even a political marriage. It is coalition government in which parties bring their own sets of principles and ideas and decide that they will contract to work together for the better of the country. They do not, on that basis, give up either their principles or their policies. Anyone in this Parliament who thinks, for example, that Mr Martin McGuinness and Mr Peter Robinson no longer want to see, on the one hand, a united Ireland, or, on the other, a more united United Kingdom, clearly does not understand much about either the peace process or the politics of my part of the world. If they are sent to the Northern Ireland Office, they will find it a rather rude awakening.

Those of us on the Liberal Democrat Benches have Liberal Democrat principles and policies. We believe that—together, on this occasion, with our Conservative colleagues—we can see those brought into operation. It was gratifying to listen to noble Lords on the other side of the Chamber making clear that they had observed that this Government indeed have a different set of policies than would have been the case had they been wholly a Conservative Government or wholly a Liberal Democrat Government. That is all to the good. It is all part of the new approach to politics that we are seeing develop over time. We saw it in the approach of the previous Labour Government to a number of matters, and we see it going further.

Having heard my noble friends, Lady Walmsley, Lady Sharp, Lord Addington and Lord Kirkwood speak about education, children, sport and welfare, I want to concentrate on health, as it is very close to my heart and experience. I have just retired after working for 30 years in the health service, particularly in mental health. My wife is a pathologist; my brother is a dermatologist; my sister-in-law is a paediatrician; my brother-in-law is a general practitioner; and my sister and her husband are scientific officers in a medical laboratory, so I have some insight into the way the health service works.

The previous Government were undoubtedly committed to achieving fairness in healthcare. They put substantial amounts of money into organising and reorganising healthcare to try to get a good outcome. However, I am afraid that there was a modest outcome and the morale of professionals working in the health service was remarkably low. I give an example. John Reid moved from the Northern Ireland Office—he moved through different ministries—and spent some time in healthcare. He had a notion, which he shared with the previous Conservative Administration, that half the consultants were out on the golf course most of the time. Therefore, he required all consultants to produce a diary showing what they did every half hour for a month, so that he and his colleagues could then clamp down on these lazy fellows and girls who obviously were not paying attention to what they were doing. The result was that consultants began to discover that they were doing far more work than they were contracted to do. They decided that if the Government were going to treat them with suspicion and say, “We will pay you only for this and this”, they would drive a hard contract and reduce their commitment to working only the hours for which they were contracted. The result was a health service contract for consultants that cost the Government more and reduced output, and doctors, who were paid more, having lower morale. It was not that the Government were not committed to fairness—they were—it was a matter of how people were handled and a belief about the way that things work.

Mr Cameron and Mr Clegg have said that this Government will operate on the basis of freedom, fairness and responsibility. Nobody is going to stand up in your Lordships' House and say, “I am against fairness”. We are here because we genuinely want to see a fairer country. However, fairness does not come from the top down through imposition; it comes through freeing and inspiring people. Of course, there is a need for an element of regulation. The noble Earl, Lord Howe, knows very well that I have been working on regulation in psychotherapy for some time. I am sure that he is awaiting the letter that he will get from me in the next week or two which asks if we can have a chat about how regulation in the psychological therapies should move forward. I am not against regulation at all. However, it has to be done in such a way that people feel that they are valued and are not being pushed away from their professional commitments. That is why one of the things that appeals to me about the approach that the coalition Government are taking is that they are saying, “We are not only going to try to work together in this way but we are going to try to give responsibility back to professionals”.

One of the disastrous things that occurred in healthcare happened as a result of it becoming a question of managerial approach and a business ethos. Businesses never produced healthcare in the first instance; it came out of voluntarism, faith communities and professionalism. When you turn it into a business, you eat away at some of the key commitments that people have to this work. They do not do it for the money, but they are not going to do it if they are not paid. They want to make a commitment to people and to feel that it is valued, and they want to feel that those with whom and for whom they work are part of the world which they inhabit.

One way that the Government can get rid of a lot of the funding that is not going to front-line services is by reducing the degree of managerial input and returning a lot more decision-making to clinicians of all kinds—not just doctors—and to patients. We can start this new Parliament not by giving over many of the achievements of the previous Government but by building on the possibility that we can have real change for the better in our politics and in all the areas of work that we have been speaking about today, not least in healthcare.

Health: Dementia

Lord Alderdice Excerpts

Thursday 3rd June 2010 Lords Chamber

[Earl Howe]

My Lords, the answer to the specific question about whether the money is safe this year is yes, but we want to ensure that the strategy is sustainable over the following three years. We will do that principally by driving up quality standards through a tariff for dementia patients, by better regulation of providers and by better commissioning of services, including public health interventions. Alongside that, as I said to the noble Baroness, Lady Greengross, we plan to provide better information to people with dementia so that they have a good understanding of their local services, and local organisations will be expected to publish how they are delivering on those standards.

[Lord Alderdice]

My Lords, the strategy is set out in an ambitious and sophisticated document that says that it is not just for five years, but that:

“There is no expectation therefore that all areas will necessarily be able to implement the Strategy within five years”.

I wonder if, even at this early stage of the coalition Government, my noble colleague has been able to identify whether all 17 objectives are to be carried forward at the same time or any priority areas that might be moved forward more quickly.

[Earl Howe]

We are looking at the implementation plan at the moment. I say to my noble friend that there are perhaps four key dementia priorities for us. One is promoting awareness and early diagnosis and referral; the second is the care of people in hospital; the third is the care of those in care homes; and the fourth is a reduction in the use of anti-psychotic medication. That is not to say that the other objectives are trivial—by no means—but we think that these will yield the most tangible results in the shorter term.

Health: Contaminated Blood Products

Lord Alderdice Excerpts

Wednesday 2nd June 2010 Lords Chamber

[Earl Howe]

My Lords, I am well aware of the noble Baroness’s personal interest in this matter and feel deeply for her. She is of course correct that the Skipton Fund was not designed to support bereaved relatives. It was designed to alleviate the suffering of those infected with hepatitis C. Sympathetic as I am towards those who have lost their loved ones in this tragedy, that fund does have a specific purpose and it would require a major review to alter that purpose. However, I note her concern on this matter.

[Lord Alderdice]

My Lords, I share in the congratulations and good wishes to the noble Earl, who has served this House so well on health issues, and offer my congratulations to the noble Lord, Lord Morris of Manchester, and the noble and learned Lord, Lord Archer of Sandwell, on their tenacious pursuit of this issue. Does the noble Earl agree that the High Court judgment shows a confusion of thinking on the part of the Department of Health not only in regard to this matter but on the whole question of dealing with adverse health events? Does he accept, as the Scottish Executive have done, as the Chief Medical Officer did in 2003 and the National Audit Office did in its report in 2004, that much more money would be available in compensation if it were not being spent on legal fees and court cases, and that the introduction of a no-fault compensation scheme could achieve that?

[Earl Howe]

My Lords, I share the noble Lord’s antipathy to taxpayers’ money being shelled out in legal fees, but what has happened has happened. In the current constrained financial climate, every department of Government will look very carefully at its legal activity.