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House of Lords

Tuesday, 17th October 2000.

The House met at half-past two of the clock: The CHAIRMAN OF COMMITTEES on the Woolsack.

Prayers--Read by the Lord Bishop of Bristol.

Lord Jordan

William Brian Jordan, Esquire, CBE, having been created Baron Jordan, of Bournville in the County of West Midlands, for life--Was, in his robes, introduced between the Lord Christopher and the Lord Faulkner of Worcester.

Lord Luce

The Right Honourable Sir Richard Napier Luce, Knight, having been created Baron Luce, of Adur in the County of West Sussex, for life--Was, in his robes, introduced between the Lord Weatherill and the Lord Fellowes.

St Helena and Ascension Island

2.48 p.m.

Lord Waddington asked Her Majesty's Government:

    Whether they will commission a study of the impact on the economy of St Helena of changes in the financing of public services on Ascension Island.

Baroness Amos: My Lords, proposals for changes in the financing of public services on Ascension Island have been the subject of a recent study by consultants from the University of Portsmouth. They visited St Helena and held extensive discussions on the economic and financial relationship between the two islands. Financing options are being considered in full consultation with the St Helena Government. This represents the best way forward. Consequently, there are no plans to commission any further studies on this issue.

Lord Waddington: My Lords, I thank the noble Baroness for her reply. Does not she agree that St Helena's frail economy would be bound to be affected adversely if a local authority with tax-raising powers was responsible for the provision of public services on Ascension? What would happen, for instance, to the revenue from licences for fishing in the waters round Ascension which at present go to St Helena? Although, obviously, there is a strong case for bringing democracy to Ascension, most people who work on Ascension are St Helenians, so would it not be far better for them to send representatives to the St Helena Legislative Council, rather than for Ascension to have

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its own representative institutions and to run the risk of the islands developing quite separately, to the disadvantage of both?

Baroness Amos: My Lords, the fiscal and economic survey that was carried out was done in full consultation with the St Helena Government. The report's main conclusion was that responsibility for the provision of common services should pass to a public authority and that revenue for the authority should be collected equitably from those using Ascension, through a system of taxes and charges. No decisions have yet been made about how to carry the report further. A number of options are being considered. The people on Ascension and those on St Helena are being fully consulted through this process. We should not want to do anything that would impact adversely on St Helena.

Baroness Rawlings: My Lords, St Helenian civil rights were granted by Charles II in 1673 by Royal Charter. At a time when Britishness and human rights seem to be high on the Labour agenda, why have the Government not granted the St Helenians British nationality? Why do they want to keep a minority of our people in a bureaucratic entanglement that denies those citizens their full rights?

Baroness Amos: My Lords, the principles on which the overseas territories Bill granting British citizenship has been agreed will mean that the people of St Helena will have citizenship rights. We have bid for parliamentary time; we have sought authority for preparing the Bill in advance from the Cabinet committee that controls the parliamentary timetable. We do not consider that any legislation to offer British citizenship to the citizens of overseas territories needs to provide a separately for St Helenians. The principles are exactly the same.

Lord Waddington: My Lords, surely the noble Baroness will agree that great concern has been expressed in St Helena at the fact that the report to which she has referred on a number of occasions paid scant attention to the implications of change in Ascension for the economy of St Helena. It is complete nonsense to say that the report canvassed in depth what the implications of that change would be. There was nothing of that nature in the report. Will the noble Baroness please think again, at least on that aspect of the matter?

Baroness Amos: My Lord, I cannot agree with the noble Lord. The survey was carried out in full consultation with the people and government of St Helena. We are currently examining the options that have arisen from the report. As the noble Lord said in his supplementary question, the majority of those who are resident on Ascension are closely linked to the people of St Helena. So what we do with Ascension and with St Helena has to take into consideration what is best for both Ascension and St Helena.

Baroness Hooper: My Lords, having said that there has been full consultation with the people of St Helena,

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will the noble Baroness give them the reassurance that the Government will closely monitor all that is happening as a consequence of the new arrangement with Ascension Island and take any necessary action?

Baroness Amos: My Lords, I can give the noble Baroness that assurance. I can do so because, as I said in my Answer, we are considering a number of options; those options will be fully consulted on before any decision is made.

NHS Administrators: Qualifications

2.54 p.m.

Lord Peyton of Yeovil asked Her Majesty's Government:

    What skills administrators in the National Health Service require before they qualify for appointment as business managers exercising control over medical staff.

The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath): My Lords, it is for National Health Service employers to determine what skills are required for any post involving management of NHS staff, including medical staff. For the most senior posts, a rigorous selection process is required, including the appointment of an external assessor.

Lord Peyton of Yeovil: My Lords, I wonder whether the noble Lord has troubled to assess the effect on morale in the health service when an experienced and skilled person who has spent years acquiring those skills is obliged to submit a business plan to someone who is half his or her age, with little experience and no knowledge of either medicine or health. Is it not time that there was a widespread appreciation within the health service that accountants have never yet made anyone feel better in any way? Is it not time that people who sometimes magnify their own importance should appreciate that they are there to serve their colleagues?

Lord Hunt of Kings Heath: My Lords, I think it was the internal market introduced by the previous government that brought many more accountants into the health service. Much of the managerial and other decision-making responsibility in hospital trusts is devolved to clinical directorates which are usually headed by doctors, and by nurses and other professionals in a limited number of cases. Business managers are there to advise and support those clinical directors, not to dictate to them. I should be very surprised if, in the NHS, there were situations such as those described by the noble Lord. It would be the clinician who would have ultimate responsibility for the way in which matters were conducted and who would then be reporting to the senior management of the hospital trust.

Lord McCarthy: My Lords, the noble Lord, Lord Peyton, mentioned business skills. Does the Minister

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agree that certain skills are required of the medical staff, including consultants, when they are put in charge of non-medical staff? I refer, for example, to general managers. If, as I believe, what is required of them is very little in the way of management skills, does the Minister further agree that it may be just as well for patients that someone in the hospital knows something about management?

Lord Hunt of Kings Heath: My Lords, if we are to modernise the National Health Service, we need high calibre leadership and high calibre management. We have a very skilled and committed workforce in the NHS, including managers. Many of our managers are doctors and nurses who have transferred or who continue in clinical positions but also take on management responsibilities. I accept what my noble friend says in that we need to do more to support people in leadership positions. That is why we are making all NHS employers accountable for the training and development of all their staff, and why we are establishing an NHS leadership centre to help to develop the skills of everyone in the health service.

Lord Clement-Jones: My Lords, many of us agree with the Minister that in order to go forward the health service needs high-quality leadership, whether that comes from clinicians or from managers. Will the Minister give more details about the setting up of the leadership centre which was promised in the national plan by 2001? Can he say also what budget is being devoted to the setting-up of the centre?

Lord Hunt of Kings Heath: My Lords, I cannot give the noble Lord details of the budget yet. I shall be happy to supply that information when it becomes available. Among other things, we envisage the centre providing, first, an overarching leadership framework for the National Health Service to confirm and disseminate common leadership values, which is important to ensure consistency of approach throughout the health service. We envisage that it will also set competencies and standards for leadership activity at all levels. Again, I make the point that leadership will involve not merely general managers but many clinicians, nurses and other professional staff.


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