Previous Section Back to Table of Contents Lords Hansard Home Page

Baroness Gardner of Parkes: I thank my noble friend for that reply, but of course I am disappointed that she is not accepting the amendment. If the NHS is to be so primary care-led, I find it difficult to understand why primary care is not of sufficient importance to be represented on the authority. My noble friend said that there would be seven members. I did not specify any particular person because I thought that to have one out of seven would be asking too much.

The right reverend Prelate the Bishop of Liverpool, who spoke on Tuesday in the debate on primary care and its great importance in Liverpool, wished to support the amendment but was unable to be here today. He would like to have that mentioned, because he said that people involved with primary care did such a marvellous job in Liverpool.

I hope that my noble friend will think again.

30 Mar 1995 : Column 1731

Baroness Cumberlege: I want, for the record, to make it plain that the normal number of non-executive members will be five and, in exceptional circumstances, seven.

Baroness Gardner of Parkes: I thank my noble friend for that clarification. I thought that the number was to be five, but when I heard my noble friend mention seven I thought that was to be the norm. The one good bit of news that came out of my noble friend's reply was that some of the people I have mentioned will in any case be appointed and they are not ruled out. I hope that that will be the position. I accept entirely my noble friend's point that there will be a good method of consultation, but consultation is not the same as being represented on the authority. That is why I believe that the amendment is a good one. My noble friend gave a most interesting reply. I shall discuss the matter further with her at a later stage. In the meantime, I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Amendments Nos. 21 and 22 not moved.]

Lord Tope moved Amendment No. 23:

Page 20, line 4, at end insert ("and
(c) must on appointment declare and record in a public register any private interests which may be material and relevant to NHS business").

The noble Lord said: In the absence of the noble Lord, Lord Dean of Beswick, I move the amendment which stands in his name and mine. I understand that the noble Lord's wife has been taken ill and that he has had to return home at short notice to see her. He is naturally very sorry at being unable to be here to move the amendment. I am sure that the Committee would wish to send its good wishes to his wife for a speedy recovery.

This is a modest amendment which draws attention to an important omission from the Bill in an area which is currently of great general concern. It is at least a start. As I said earlier, my experience is primarily with local government rather than with the health service. I cannot help but contrast the absence of any provision in the Bill with the requirements placed upon members of local authorities.

Under the Local Government Act 1989, the Secretary of State has made regulations which require local authorities to keep a statutory register of members' interests. Those regulations require councillors to enter details of employment and the name of any employer or firm of partners of which the councillor is a member. They must name any sponsor who has made a payment to the councillor towards expenses as a councillor, including election expenses—which clearly would not be appropriate in this case. They have to enter current contracts with the council of which the councillor is aware in which the councillor may have an interest whether as an individual or as a director or shareholder of a company. They must enter any freehold, leasehold or short tenancy of any land in the area of that council, such as houses, buildings, mortgaged property, including joint tenancies. They must enter any licences of over a month to occupy land—for example, for an allotment plot—and any property owned by the council

30 Mar 1995 : Column 1732

which is rented by a company of which the councillor is a director or shareholder. They must enter the name of any companies or other bodies in which the councillor has shares, securities or deposits, except building societies, which to the councillor's knowledge have a place of business in the area of that council, the shareholding or investment of which has a nominal value of over £25,000 or is more than one-hundredth of the total share capital. The amount of the investment does not have to be declared.

That is the requirement which the Government consider necessary for a register of interests for members of local authorities. If the Minister will not accept the amendment, I hope she will explain why it is necessary to have such a detailed and prescribed form of statutory register for members of local authorities but nothing for members of health authorities.

Local authorities meet almost entirely in public. They are subject to much greater scrutiny by the press and by the public in the areas they represent than is the case with health authorities. Members of local authorities may be subject to investigation by the district auditor; they may be surcharged; they may be disqualified; and in extreme cases they may even be imprisoned. Above all, they are subject to the ballot box every four years; in other words, members of local authorities are already subject to public scrutiny to a much greater extent than are members of health authorities. Yet the Government consider it necessary to impose upon them a statutory register of interests. Most good local authorities have kept a voluntary register containing all that information and more.

Health authorities have none of that. As has been mentioned in previous debates on the Bill, the matter has caused much anxiety in recent months. The amendment is modest and refers only to declaration on appointment. If it were to be carried we should require at least that the register be kept up to date, otherwise it would be of diminishing use. It relates only to matters of interest and relevance to the NHS; in other words, it is narrower than is the case with local authorities.

If the Government are not prepared to accept the amendment, or at least to indicate that they will bring forward regulations requiring a register of interests to be kept for members of health authorities, I hope that the Minister will explain clearly today why it is deemed necessary to have a statutory register for members of local authorities, who are democratically elected and accountable and subject to constant public scrutiny through their local press, but to have no statutory register whatever for unelected and locally unaccountable members of health authorities. I beg to move.

Baroness Jay of Paddington: In the absence of my noble friend Lord Dean, I wish to support the amendment. I join the noble Lord, Lord Tope, in sending best wishes to Lady Dean for a speedy recovery.

The noble Lord, Lord Tope, clearly outlined the purpose behind the amendment which is to try to bring health authorities a little closer in line with the proceedings that are acceptable to and demanded by local authorities. I expect that in reply the Minister will

30 Mar 1995 : Column 1733

say that the codes of conduct for health authorities, which will become operational from April this year, are sufficient to meet the anxieties which the noble Lord expressed so well. However, I am sure that if my noble friend Lord Dean were present he would have referred to the scandalous proceedings in the Wessex Regional Health Authority. In that respect he, among many others, was instrumental in bringing to public attention anxieties about considerable interests that were held by members of that health authority and its managers in various computer businesses. That caused the problems with which all Members of the Committee will be familiar.

It is interesting to note that the codes, which will be effective from April, were introduced only under pressure as a result of the recognition of inappropriate actions by members of health authorities throughout the country, by the Public Accounts Committee in another place and by other public bodies and scrutineers.

I understand that according to the part of the new codes to which the amendment refers, members of health authorities will simply be required on their honour, as it were, to declare an interest as an issue arises in debate. That is rather like the convention in this Chamber. Surely it would be better—as I believe it would be better here—to have a published register in which all interests are pre-recorded. If that were enshrined in legislation, as required by Amendment No. 23, it would be much more forceful than merely being included in a code of conduct, which can be only a guideline. There can be nothing in guidelines which suggests sanctions if they are broken or which will carry the same weight as legislation.

I hope that in the spirit of openness, which the Minister and members of the Government have expressed throughout the passage of this Bill, the Government will be prepared to go one step further and, rather than rely on codes of conduct and guidance, will accept the amendment.

4.45 p.m.

Baroness Cumberlege: I too send my best wishes to Lady Dean for a speedy recovery. I sincerely hope that if she requires the services of the NHS it does her very proud. I am disappointed that the noble Lord, Lord Dean, is not in the Chamber today because I know that he feels most strongly about the issue. Indeed, we have spoken on many occasions about it. I am sure that he will be totally satisfied with the introduction of the amendment by the noble Lord, Lord Tope.

The noble Baroness is accurate; I shall refer to the codes of conduct and accountability. They were published in April 1994 by my right honourable friend the Secretary of State for Health. They make clear the expectation that those who serve the NHS should maintain very high standards of corporate and personal conduct.

30 Mar 1995 : Column 1734

On the subject of public business and private gain, the codes are quite clear and I wish to quote from them. They state:

    "Chairmen and board members should act impartially and should not be influenced by social or business relationships. No one should use their public position to further their private interests. Where there is a potential for private interests to be material and relevant to NHS business, the relevant interests should be declared and recorded in the board minutes, and entered into a register which is available to the public. When a conflict of interest is established, the board member should withdraw and play no part in the relevant discussion or decision".

As Members of the Committee can see, the codes are specific in their expectation that chairmen and board members will declare any interests that may be relevant to NHS business and that such information should be made available to the public. In order to ensure that those appointed to serve on NHS authorities and trusts are aware of the provisions of the codes of conduct and accountability, they are all expected to confirm, on appointment and in writing, that they are willing to subscribe to the codes.

Having introduced the codes of conduct and accountability, we have begun the process of monitoring their implementation. An initial early check will be completed next month and the results will be reported to Ministers shortly afterwards. The noble Lord, Lord Tope, drew a comparison between local authorities and health authority membership. He will be aware that the two are very different in that councillors are directly accountable to their electorate and can raise a local tax. Of course, health authority members cannot raise a local tax and the Secretary of State is accountable to Parliament for the finances of the National Health Service. She is subject to scrutiny by Parliament and the Public Accounts Committee, which local authorities are not.

It is a little naive to think, if I may suggest it, that the press does not also scrutinise health authorities. I can assure the Committee that those who serve on health authorities feel that they are under very close scrutiny. Therefore, we have absolutely no objection to the principle of the amendment. However, we do not believe that it is necessary to make specific reference to such a requirement in the Bill. We believe, and I hope that I have been able to reassure Members of the Committee, that the steps that we have taken are the right ones to ensure that public service values remain at the heart of the management and operation of the NHS. I believe that we have taken a strong line and therefore I hope that the noble Lord will withdraw the amendment.

Next Section Back to Table of Contents Lords Hansard Home Page