Government Policy on Health

Baroness Merron Excerpts

Tuesday 10th September 2024 Lords Chamber

[Lord Kennedy of Southwark (Lab Co-op)]

Before the Minister responds, I make it clear that these should be questions, not speeches.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, to set out some key points in respect of the right honourable Alan Milburn, he has no formal role in the department. Therefore, the conflicts of interest the noble Lord referred to do not even arise. The main thing I would like to set out is that it is very important to make a distinction between the areas of business and meetings in the department about generating ideas and policy discussion—it is those in which Mr Milburn has been involved, at the request of the Secretary of State—and the very different meetings about taking government decisions. If I might summarise it for your Lordships’ House: Ministers decide, advisers advise.

[Lord Wallace of Saltaire (LD)]

My Lords, I declare a certain puzzlement at this Question. I recall, when the Conservatives were in office, reading regularly on the front page of the Times that donors had been talking to the Prime Minister or various Cabinet Ministers about government policy and expressing strong views on which direction they should take in various areas. As an academic, I am also well aware of the extent to which expertise comes into government through informal channels.

On one now famous occasion, which was not reported at the time, a number of experts on the Soviet Union whom I knew well were invited by Margaret Thatcher to an informal seminar in No. 10 to advise on whether the Foreign Office or Margaret Thatcher’s advisers were correct in their attitude to the Soviet Union. A number of the academics suggested that the Third Secretary of the Communist Party, then a man called Gorbachev, was a good person to get to know. Mrs Thatcher took their advice rather than that of her advisers and it had a remarkably positive impact on British foreign policy. Do the Government accept that all informal contact with outside experts is desirable and that it is a good thing, where possible, that it should be reported?

[Baroness Merron (Lab)]

It is right that people from outside government come into departments to lend their expertise and share their views and that Ministers make decisions without those people involved. That was the line I was trying to draw. The Secretary of State for Health is very fortunate to be able to turn to every living former Labour Health Secretary, from the right honourable Alan Milburn through to my noble friend Lord Reid, Andy Burnham and many others, because all of them have offered to roll their sleeves up and assist us. Perhaps I could remind your Lordships’ House that, between them, they delivered the shortest waiting times and highest patient satisfaction in the history of the National Health Service. I hope that we will be able to do justice to their experience.

[Lord Foulkes of Cumnock (Lab Co-op)]

My Lords, does the Minister agree that this is very different, because the Minister is taking advice from people with huge experience, and it is open and above board? This is unlike when Boris Johnson was Prime Minister, and his wife Carrie Johnson apparently made a number of decisions, including the appointment of Ministers. Was that not something we ought to be worried about, rather than this open and sensible arrangement we have now?

[Baroness Merron (Lab)]

My noble friend makes an important distinction, and I would certainly share that view. It is worth reminding your Lordships’ House that ministerial meetings that are attended by third parties are declared in a quarterly transparency publication in the established way. Of course, this will be done. I can tell your Lordships’ House that I had a meeting with the right honourable Alan Milburn, and it was very useful.

[Baroness Finlay of Llandaff (CB)]

My Lords, I should declare an interest because I was on the Times Health Commission. We took evidence from a wide range of people, including the person mentioned. Can the Minister provide assurances that, whenever people are consulted, they are routinely asked to declare their interests; that any declaration of interest is repeated not only at the first meeting but whenever other people are present so that it is well known; that the consultation goes widely; and that there is no overreliance on a small number of people? We at the Times Health Commission found that, by consulting widely, we were able to hear very conflicting views, which was helpful and formative.

[Baroness Merron (Lab)]

I thank the noble Baroness for sharing her experience of consulting widely. It is certainly entirely legitimate for government departments to do just that. However, those who do not have a formal role are not required to declare interests; it is different for those who have a formal role. Requiring them to do so would mean, for example, us sending forms in advance to Cancer Research UK before it comes in to talk to us about cancer and to assist us. Would we want that? We would not. Of course, where there is a formal role, we absolutely do that.

It is probably worth saying that a particularly high-profile invitation went from the Secretary of State to the noble Lord, Lord Darzi. He will report shortly on the true state of the National Health Service. He does not have a specific role in the department but he has been invited by the Secretary of State to assist; I believe that he will assist both your Lordships’ House and the other place.

[Baroness Bennett of Manor Castle (GP)]

My Lords, when the Green Party consults on health policy, among the organisations it consults are the Socialist Health Association, Keep Our NHS Public and 999 Call for the NHS—all organisations that are greatly concerned about the continuing privatisation of the NHS. Can the Minister tell me whether the Secretary of State or she herself have had meetings with any of those three organisations since coming into government?

[Baroness Merron (Lab)]

I cannot answer that, I am afraid. I would be very happy to look at it for the noble Baroness.

[Lord Markham (Con)]

Although I understand completely the role of advisers—obviously Alan Milburn is a very reputable adviser—where is the line? My concern is that, when an adviser has a pass, has been in meetings without Ministers present and has perhaps directed civil servants in those meetings, a line has perhaps been crossed. I would welcome assurances from the Minister that this has not occurred and that there have not been any meetings where Alan Milburn has been there without Ministers—in effect, directing policy with no formal role.

[Baroness Merron (Lab)]

The right honourable Alan Milburn has not been directing policy; he also has no pass. I hope that is helpful to the noble Lord.