International Development (Official Development Assistance Target) Bill

Debate between Lord Butler of Brockwell and Baroness D'Souza

Friday 6th February 2015 Lords Chamber

[The Lord Speaker (Baroness D'Souza)]

Amendment proposed, “Page 1, line 2, leave out the second “the” and insert “a”.

[Lord Butler of Brockwell (CB)]

My Lords, I support the amendment, the purpose of which is to remove a fixed target—“the”—and to replace a flexible target, “a”. That is the purpose of the amendment and it seems desirable.

I contribute to this debate as a former Permanent Secretary of the Treasury in charge of public expenditure, where the noble Lords, Lord Lawson and Lord MacGregor, who have put their names to the amendment, were my bosses. However, I support the amendment not out of Treasury niggardliness but because, like other noble Lords, I believe that this country has both an economic and moral interest in promoting the growth of the developing world.

However, there are good Treasury and government reasons against hypothecation of expenditure against a rigid target. The reasons are set out in the report of the Economic Affairs Committee. However, one reason that is not in the committee’s report is that at each public expenditure review departments have to come to the Treasury to make a case for the expenditure for which they are bidding. If there is a rigid amount hypothecated in this way, it relieves departments of having to make that case for expenditure. The removal of that discipline is likely to have the result that the expenditure would not be as effective as we would all like it to be. It would be a mistake to remove that discipline from DfID’s expenditure on development aid.

This is a matter for each Government to decide. There should not be a rigid amount and, therefore, I support the amendment to substitute the second “the” with the word “a”.

Health and Social Care Bill

Debate between Lord Butler of Brockwell and Baroness D'Souza

Monday 28th November 2011 Lords Chamber

109A: Clause 20, page 17, leave out lines 33 and 34 and insert—
“(5) In discharging its duty under subsection (1), the Board must publish guidance for clinical commissioning groups that includes the option to opt out and explains the extent of compliance with—
(a) the quality standards prepared by NICE under section 231 of the Health and Social Care Act 2011;(b) indicators included within the NHS Outcomes Framework; and(c) minimum standards set by the Board on patient related outcomes measures.”

[The Lord Speaker (Baroness D'Souza)]

My Lords, I advise the Committee that if the amendment is agreed to, Amendments 110 and 110ZA cannot be moved by reason of pre-emption.

[Lord Butler of Brockwell]

My Lords, with the agreement of the noble Lord, Lord Newton, I move Amendment 109A, which stands in my name and his. I can do so briefly, although the amendment is important and, I hope, helpful. I declare an interest as the chair of King's Health Partners, an academic health science centre. Part of the centre's mission is to accelerate the translation of research into patient care—getting a faster process from bench to bedside. It is in that capacity that I move the amendment.

The focus in the Bill on outcomes for patients is very welcome. It is also welcome that Clause 20 gives the Commissioning Board a duty to promote compliance with the quality standards prepared by NICE, as well as guidance published by the Secretary of State. There may be circumstances in which there are good local reasons why NHS providers should not comply with NICE guidelines. One such circumstance may be where there are innovative treatments that have been approved but with which NICE guidance has not yet caught up. We do not want the clause to stifle the introduction of such initiatives, which the creation of AHSCs is designed to promote and which are greatly in the interests of both British industry and patients. For this reason, Amendment 109A introduces an element of flexibility through a comply-or-explain regime. It will give providers the opportunity, in cases where there are good reasons why they should not comply with the NICE guidelines, to depart from them provided they can explain their non-compliance satisfactorily. That is all I need to say about the amendment. I beg to move.