Procedure of the House

Debate between Lord Northbourne and Lord Hunt of Kings Heath

Wednesday 9th January 2013 Lords Chamber

[Lord Northbourne]

My Lords, I will speak just for a moment from the point of view of a Back-Bencher on the Cross Benches without political commitment. Many noble Lords in my position—other colleagues, although perhaps not all—believe that the best way that we can serve the House is to have a specialist interest which we take a deep concern in and spend a great deal of time studying and following. Mine happens to be disadvantaged children and parenting, but there are others. If I come across a situation in which I believe a Question needs to be asked of the Government, all I have to do is give up my lunch, go in an hour earlier and I will be at the front of the queue. If we had a system of ballots there would just be a pot of Questions there and people would put down a Question on the odd chance of it coming through. The value of the Questions would not be so good because they would not be pressed by the deep interest and commitment of the noble Lords asking them. I would plead for a continuation, if necessary, of queuing, but not for a ballot.

[Lord Hunt of Kings Heath]

My Lords, I am sure that the House will be anxious to come to a conclusion. This is of course a matter for the whole House and not for the Opposition or the Government. I have attended Oral Questions regularly for 15 years now and I echo the point raised by my noble friend Lord Reid—that the quality of Question Time at the moment is of a very high order. It is the focal point of our day: Ministers are held to account, the House is full and Members are attentive. I believe that one should be very wary of changing a part of our daily life that is so successful. I wonder whether the Chairman of Committees—having heard the debate today and that there is some disquiet, to say the least, about this change—would agree for his committee to be asked to give further consideration to this matter.

I carefully intervened on the noble Lord, Lord Laming, whom I respect enormously, on the question of whether this has been subject to a consultation with Members of the House. I think his answer was that the members of the committee are broadly representative of the House. However, given today’s debate, surely it would be entirely appropriate for the committee not only to set out its proposals but to pick up some of the very useful suggestions that noble Lords have made about how Question Time could be enhanced in the future and to engage in a proper consultation with Members of the House. At the end of that process the committee would be well able to reach conclusions, come back to the House with suggestions and arrange for a trial period. We would then see that this process has had the ownership of all Members of the House. I am very wary of a situation where a major change is made to the way we are allowed to table Questions but which clearly does not have ownership among a significant number of Members of the House. On that basis, it would surely be appropriate for the committee to be asked to think again.

The current quality of Questions is particularly high. Looking through the list of Questions, one sees that they are almost all of a very high order and on key issues of the day. As a number of noble Lords—such as the noble Lord, Lord Northbourne, and the noble Baroness, Lady Knight—have suggested, there is a clear pathway to asking Questions on a certain day. On International Women’s Day, World AIDS Day or similar occasions, it is entirely possible for there to be a Question that was put down four weeks before. We will lose any way of doing that in the future. Choosing Questions out of a hat is no guarantee that we will have high-quality Questions and the House may well end up debating second-order issues of little interest to members of the public or your Lordships’ House. I will not go through all the questions that have been raised about the practicalities of balloting but will just make three points.

First, it is not at all clear why research assistants should have any role to play in this matter—I see the shaking of heads. However, it is clearly set out that Questions will be accepted from researchers if the text is also confirmed by the Member in person or by telephone. Why does a research assistant have anything to do with this at all? My understanding is that in December, when the committee discussed this matter, it was stated clearly that Questions would not be accepted from third parties.

The second area, which my noble friend Lord Harris raised, is that of no more than one Question on a subject being accepted for inclusion in the ballot. This follows the current practice for topical Questions. However, the topical Question is different: a bar is set that it has to be topical. We are talking here about all Questions being subject to this test, presumably set by officials in the Table Office, as to whether the Question is a general one which can be accepted—

Health and Social Care Bill

Debate between Lord Northbourne and Lord Hunt of Kings Heath

Wednesday 8th February 2012 Lords Chamber

[Lord Hunt of Kings Heath]

My Lords, as this is a new stage of the Bill, I should declare a number of interests which are also listed in the register; I am chairman of the Heart of England NHS Foundation Trust, a consultant and trainer with Cumberlege Connections, president of the British Fluoridation Society and of the Royal Society for Public Health.

I put my name to Amendment 2, tabled by the noble Baroness, Lady Finlay, which has perhaps not received as much enthusiasm as I would have wished from noble Lords, who have pointed to Clause 6. Behind her amendment is real concern to ensure that we will train enough health professionals in the years ahead and that they will be of sufficiently high quality. There is some history here. I very much support devolving as much as possible decisions about the commissioning of training places to local NHS organisations. I warmly welcome the work of Dame Julie Moore and her team, who have produced the report. She is chief executive of the UHB Foundation Trust in Birmingham and brings a lot of expertise to that position. Some noble Lords will have been to a seminar where the report was debated. I have no argument with its general thrust, but we know from experience that when money is tight, the NHS reduces the number of people that it trains and its training budget. That always happens and, a number of years later, the NHS then pays the consequences. If we are to have a highly effective National Health Service in future, we need to recognise that the quality of our professional staff goes to the core of what we seek to do. Therefore, it is right that the Secretary of State should be seen to have major responsibilities enshrined in legislation. That is the essential point of Amendment 2, whatever the technical deficiencies to which noble Lords have kindly drawn our attention.

In that regard, let me say that I welcome the government amendments in this area and the work of the noble Earl, Lord Howe. Of course, he is also responsible for research in the department, and I think that he well understands how the education and training of our professionals very much ties in to the research agenda. I know that we will come to research later tonight.

In relation to the other amendments in this group, I have already welcomed the government amendments, but perhaps I may pick on Amendment 63. It is right that the national Commissioning Board should have regard to the promotion of training of clinical staff in any provider from which it commissions services. There is essentially a parallel amendment—Amendment 104—which applies to clinical commissioning groups. The whole point here is to ensure that there is a level playing field. If, regrettably, the Government persist with this lunatic idea of a competitive approach within the health service, it is essential that when it comes to commissioning decisions all qualified providers contribute to education and training. It would be an absolute disgrace if clinical commissioning groups and the national Commissioning Board started to commission services from organisations that did not play their full part in education and indeed research. I hope that the noble Earl, Lord Howe, will make it clear that that is what his Amendment 104 means when it says, in parliamentary counsel terminology, that clinical commissioning groups must,

“have regard to the need to promote education and training”.

I take that to mean that the amendment does not permit CCGs to place contracts with qualified providers who do not make a contribution to education and training.

Overall, I echo the words of the noble Lord, Lord Walton, regarding the work of postgraduate deans and his question about their future. Where are postgraduate deans going to lie in the future? Are they going to lie in the local branch offices of the national Commissioning Board; are they going to be aligned with the clinical senates; or are they going to float free? I think we should be told.

I also echo the words of the noble Lord, Lord Willis, regarding the role of universities. It should not be an option; they need to be round the table. It needs to be what I would describe as a “hard partnership”. I think we are all well aware of the issues and concerns surrounding the quality and outcome of nurse training. The noble Earl, Lord Howe, himself has often commented on issues such as dignity, nutrition and so on, where matters have been raised by patients and there is concern about whether today’s nurses are getting the kind of training that is required. It is very important that those who commission from universities do so in as vigorous a way as possible and hold those universities to account. However, equally there has to be a partnership. The noble Earl, Lord Howe, will know about the intention to expand academic clinical science networks. That is a very good example of universities and the health service coming together, and we need to encourage that in the future.

Finally, the noble Lord, Lord Walton, raised a point about the duty on any willing provider regarding training or research. I think that I have covered that, but he also mentioned NHS foundation trusts. I am not aware of any situation in which NHS foundation trusts are ignoring their responsibilities but I certainly agree with him that, as they are more independent of the Secretary of State than other parts of the NHS, some assurances from the noble Earl in that regard would be welcome.

[Lord Northbourne]

I wonder whether the noble Lord could clarify a point for me. In his Amendment 62 he speaks of the “healthcare workforce”, whereas the noble Baroness, Lady Finlay, in her amendment talks of “healthcare professionals”. Are these identical groups of people? I am particularly interested in whether nursing staff are included in one or both of those terms.

[Lord Hunt of Kings Heath]

My Lords, that is a very good point. As I say, it is always helpful when noble Lords point out errors and omissions in the drafting of amendments. Amendment 2 refers to “health care professionals”, and I am clear that nurses must be embraced within that definition.

On Amendment 62, I would not detract from the use of,

“education and training of the healthcare workforce”.