Queen's Speech

Lord Morris of Handsworth Excerpts

Thursday 3rd June 2010 Lords Chamber

[Lord Morris of Handsworth]

My Lords, I, too, pay tribute to the gracious Speech and to those noble Lords who have delivered maiden speeches today—in particular, the noble Lord, Lord Hill, who delivered his from the Dispatch Box.

Unlike previous years, in order to explore the true intention of the Government’s programme it is necessary to read not only the manifestos of the two parties in government but the important document The Coalition: Our Programme for Government. The Government, and indeed the gracious Speech, say that the legislative programme will be based on the principles of freedom, fairness and responsibility. Reflecting on what the coalition’s programme commits to in respect of the National Health Service, I find it to be long on expectations but somewhat short on commitment to its users.

For example, as the noble Baroness, Lady Wall, who has just left her place, pointed out in her question, where is the commitment to guaranteeing maximum waiting times for hospital treatment—the commitment to a maximum wait for an urgent cancer treatment referral, or while in accident and emergency? In the context of the debate in your Lordships’ House, these commitments might sound somewhat pedestrian, but if you are on the waiting list they are vital. Indeed, for some it could be a matter of life or death.

Today, though, I will examine the bigger picture, letting the notion of “freedom and fairness” pass. I want to focus on the principle of responsibility. Tucked away on page 25 of the coalition’s programme for government is a paragraph on the NHS. It says:

“We will establish an independent NHS board to allocate resources and provide commissioning guidelines”.

That statement raises questions and gives no real answers. The creation of an independent NHS board, as set out in that programme, challenges the very principle of political responsibility and political accountability. In essence, the coalition Government are proposing the creation of a superquango to run the National Health Service. What, then, of the promises over a number of years of “no more pointless reorganisations” of the NHS? What of the promise in the coalition programme to reduce the number and costs of quangos? In fact, the proposed NHS board will be the biggest, most expensive quango in the history of the NHS.

The coalition Government will argue that their proposed NHS board will prevent “political interference” but, to many, what has been loosely labelled as such is actually political accountability. Ministers will no doubt say that they want to devolve power, but there is a qualitative difference between devolving power and abdicating responsibility. Ministerial responsibility for the NHS cannot be outsourced or subcontracted to unelected quangos. Ultimately, it is the Government who must be held accountable for the funding and service decisions that shape, influence and affect the healthcare of the nation. Democratic accountability demands that Ministers, as we have seen today, come to the Dispatch Box to be questioned about their decisions on the running of the NHS.

The NHS is a public service that spends more than £100 billion of public money each year. It is an essential front-line public service that makes a difference to the quality of our lives, and we are all stakeholders in it. That is precisely why it is with Parliament that the buck must stop, not with some superquango that does not have to face the electorate or stand at the Dispatch Box.

The proposed NHS board raises a number of fundamental questions, and I hope that the Ministers will give us some answers. Will the board both commission and provide services? Who will own the assets of the NHS? Who will have responsibility for managing and monitoring those assets? How are taxpayers’ interests to be protected and safeguarded? What will the relationship be between foundation trusts, primary care trusts and GP services?

If Ministers really want to improve our NHS and devolve decision-making, I am sure that the best way of doing that is to empower NHS professionals—our doctors, our nurses, our front-line healthcare workers. What the NHS does not need is the creation of a superquango that is unelected, unaccountable and unnecessary.