|Legislative Programme and Pre-Budget Statement
Mr. Elfyn Llwyd (Meirionnydd Nant Conwy): Does the right hon. Gentleman agree that it is unfortunate that the reconfiguration of the health trusts was pushed through before the Assembly came into being? The Assembly would have been in a far better position to reconfigure them, and thereby provide a better and cheaper service.
Mr. Davies: I do not know about that. To use the jargon, I would like to see some ``reconfiguration'' and will try to argue for it.
The Conservatives bequeathed not only underfunding in the national health service in Wales but an extremely undemocratic structure. That is true outside the health service as well. Baroness Thatcher talked about rolling back the frontiers of the state, and she may have done so in some respects, but with regard to the administration of public services, all that she achieved was the lessening of accountability at the frontiers of the statea lessening of transparency to the democratic process in Wales and the whole United Kingdom. My right hon. Friend the Member for Caerphilly called for a bonfire of the quangos. That may have been unrealistic. It has never happened, as far as I can see. Things have certainly not improved. They are getting worse.
I do not know if my right hon. Friend mentioned quangos in the paper that seems to excite the Welsh National party, but the bonfire of the quangos was never even started. Perhaps we should start againnot necessarily with a bonfire, but certainly with a thorough examination of what needs to be done towards proper devolution of democratic Government in Wales. All that I see is quangos that are partners of other quangos and agencies that are partners of other agencies. All of them result in a proliferation of committees and sub-committees, and spawn facilitators, rapporteurs, convenors and various others. There is concern among people in Wales about where the money is going. Perhaps it is getting through, but people are worried that the plethora of committees, quangos and next-steps agencies is having a deleterious effect on the distribution of funds.
In the health service we inherited, for the most part, a structure that was established with the internal market. The internal market established various institutions, one of which would send an invoice to another, which would send a cheque back. The prices on the invoices were artificial and managed, and an enormous bureaucracy managed that so-called internal market. Our party has on the whole done away with the internal market, but we have not addressed our mindsand a Government cannot do everything in their first three yearsto the structure of the health service, much of which owes its existence to that internal market.
There is a small district general hospital in my constituency, but an amazing number of bodies are involved with it. We have the Dyfed Powys health authority, which has an interest. The hon. Member for Meirionnydd Nant Conwy mentioned reconfiguration; the Carmarthenshire hospital trust looks after the hospital and one or two other hospitals. The primary care group, something set up under the present Government, also has concerns relating to the local hospital. The Commission for Health Improvement, which may be a good thing, has also been concerned with it. Apparently, the district auditor examines the structures of the health authority and the hospital trust.
Body after body and committee after committee are involved. Why on earth cannot small district hospitals in Wales be accountable directly to the Assemblyto the Health and Social Services Secretary and the civil service of the Assembly? It is not necessary for all those different bodies to deal with smaller hospitals in Wales. Perhaps the Assembly and the House can work in partnership to change the arrangements.
The people of Llanelli, like people in other areas, collected money for a hospice. They collected enough to build it, but could not collect enough to cover the revenue costs of about £500,000 a year. I took a deputation to see Jane Hutt, the Health and Social Services Secretary, about providing more money, as a result of the Chancellor's announcements. She was helpful and I do not criticise her, but of course she had to hand over most of the money to the Dyfed Powys health authority, which took the decisions according to its own priorities. That authority is not accountable to the people of Llanelli. It does not take its decisions in a transparent way. The people of Llanelli, for good or ill, would like some of the money to be spent on the hospice, but they cannot make their case to a bureaucratic body, because that body is not accountable to them, not subject to elections, and at the end of the day can ignore their wishes.
Talking of Dyfed Powys, the first task that we should perform in the next Parliament is to get rid of the health authorities in Wales. They are completely unnecessary. Hon. Members may have heard me talk about this before, but I must mention it again. Dyfed Powys health authority placed an advertisement in The Guardiannaturallyfor a deputy chief executive. I apologise, I am not altogether correct: a firm of management consultants in Hertfordshire placed the advertisement. I do not know why it was necessary to employ a firm of management consultants in Hertfordshire to place an advertisement for a deputy chief executive of Dyfed Powys health authority. I must say that the Welsh translation is excellentsomebody managed to translate the jargon in the English part of the advertisement.
First, we are told that the salary will be £70,000. Perhaps that does not seem a large sum from a London perspective, but in an area where incomes are low and are being depressed because of competition, it is a lot of money. It is certainly a lot of money when people are not sure what the functions of the health authorities are, or how they relate to the health services that they get in their communities.
Leaving aside the £70,000, the advertisement is amazing. It is full of the management jargon that we have come to expect. That may be all right for the private sector, but it has no place in the public sector. We are told that
We are given a list of those paradoxes. I will not list them all, but the successful applicant for the job must
The successful applicant must also
Why is it necessary to have these health authorities? They are struggling to find work for themselves. That is not a criticism of the people who work for them, who, I am sure, do their job conscientiously. The structure is wrong, and we need to do something about it. I understand that the party hierarchy is looking for radical ideas for the next election.
I learned my Latin at Carmarthen grammar school, and ``radical'' means ``going to the root'', so let us start reform at the root of the whole quango state in Wales, and not just the health service. We can work in partnership with the Assembly. It may be necessary to introduce some primary legislation. The right hon. Member for Caernarfon and the hon. Member for Ceredigion want the Assembly to have legislative powers. That is their prerogative, but if we want more democracy in Wales, let us first examine the huge areas of expenditure in Wales that are outside of democratic accountability. Let us try to bring them under the control of the Assembly and the House and work together to promote legislation that will do that.
Sadly, local government also is losing its traditional place as a bulwark of local democracy. My saying that may imply criticism of some things that the Government have done. I am amazed at the number of local authorities that now have cabinets. We have a Cabinet here, and that is seen as the old politics of Westminster. I am not an historian, although I understand that my right hon. Friend the Secretary of State is a distinguished historian who went to an elitist university to learn history. My understanding from doing O-level history in Carmarthen years ago is that Walpole invented the cabinet system and the concept of primus inter pares. Now everyone wants to be a primus. I do not know about the pares. The right hon. Member for Caernarfon really wanted to be a primus.
The Chairman: I call Mr. Primus Thomas.
Mr. Thomas: I am very pleased to be a primus, Mr. Jones.
The right hon. Gentleman referred to the cabinet system in local government and said that everyone wanted it. Is it the Government's policy to force a cabinet system, or something similar, on local authorities?
Mr. Davies: It is something that we should be very careful about. Since we are looking at radicalising, modernising measures, let us get rid of the old-fashioned Walpolean system of the cabinet.
The Government of Wales Act 1998, which established the Assembly, was drafted in a sophisticated way, achieving a balance between the old politics of a cabinet and a wider committee system. I consider the legislation very well drafted. However, my right hon. Friend the Member for Caerphilly wanted a cabinet, the right hon. Member for Caernarfon wanted onehe obviously had visions of a black car and a red boxand somehow even the Conservatives wanted one, because Lord Roberts moved the amendment to the Bill in the House of Lords that allowed a cabinet system. All the people who wanted a new politics were desperate for a cabinet system in the Assembly. Now we have moved on to a cabinet system in local government. The effect of such a system, as hon. Members know, is very often a reduction in the power of ordinary councillors and a feeling that local democracy has been compromised.
The Queen's Speech was excellent, and the money that is to come to the health service and other services in Wales is welcome, and badly needed. We should examine the structure of government and think about democratic accountability. It is not necessarily our fault that we do not have that, but if we want to be radical and modernising, our next step should be along the road to greater democracy in Wales.
|©Parliamentary copyright 2000||Prepared 11 December 2000|