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Lord Strathclyde: My Lords, until 18th September, it was government policy that the party of government and the main party of opposition should, in relative terms of strength, be in broad parity. Since 18th September, that position has changed and the Labour Party now says that it should have a majority over the other political parties. Is that another sign of the Government breaking an undertaking?

Baroness Amos: No, my Lords. Perhaps the noble Lord, Lord Strathclyde, would like to read again what we said. We said that no one party should have an overall majority. That remains the position, but there are a number of proposals for considering the percentage of votes cast in an election and asking the statutory Appointments Commission, once it has been established, to determine the number of Peers across the House on a party political basis as well as with respect to the Cross Benches.

Baroness Williams of Crosby: My Lords, can the Leader of the House confirm that it remains the Government's position that they will base the appointment of new political Peers on the share of the electorate at the previous election, which affects the main party of opposition and the effective party of opposition alike?

Secondly, will the Appointments Commission, some of whose members were appointed by virtue of having been outstanding contributors to this House, ensure that all those appointed are informed that they can make a contribution beyond their own expertise to the work of the House? That would be extremely welcome.

Baroness Amos: My Lords, I entirely agree with the second point made by the noble Baroness. On her first

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point, she will be aware that a consultation document is out. The Government's position has always been that we should consider the percentage of the vote, but we have also asked in the consultation document whether we should consider the percentage of seats that parties hold in the other place.

Lord Peston: My Lords, while echoing the views of my noble friend Lord Barnett on converting the remaining hereditaries into life Peers, which is a matter that we can debate when we receive the Bill, can my noble friend explain why the commission is the body being used to make those appointments? If your Lordships' House has a future—and I hope that it does—it will be as a working House. With one obvious exception, the members of the commission who are Peers seem not to take part in the workings of the House; they seem to have no knowledge of the hard slog—of last night, for example. Where Peers are involved, would it not be better if the appointments were made by Peers who are committed to this House and do its work?

Baroness Amos: My Lords, my noble friend will be aware that we currently have an Appointments Commission. Those on the commission were reappointed in July. The Government have proposed that we move to a statutory appointments commission. My noble friend's point about the knowledge that members of that commission should have will be taken into account when we move to that process.

Lord Smith of Clifton: My Lords, will the Minister reassure us that the noble Lord, Lord Stevenson, the chairman of the commission, has rid himself of his prejudice against considering hairdressers? I declare an interest: my father was a hairdresser.

Baroness Amos: My Lords, I was not aware that the noble Lord, Lord Stevenson, had a prejudice against any particular group. It is gratifying to know that the noble Lord's father was a hairdresser.

Lord Craig of Radley: My Lords, while I greatly welcome the Government's indication that hereditary Peers who sit in the House may well return as life Peers—that is within a party's gift—has the noble Baroness any suggestion about how hereditary Peers who sit on these Benches may find their way back as life Peers after the removal of the 92?

Baroness Amos: My Lords, my noble and learned friend made it clear in the Statement that, when time allowed, we would move towards some kind of legislation. As part of the process of taking that legislation through, I have no doubt that such issues will be discussed.

Lord Stoddart of Swindon: My Lords, rather than fiddling around, as the Government are doing, with a

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hybrid system, would it not be better if they now decided that it was right to have a fully elected House of Lords and pursued that as a policy item?

Baroness Amos: My Lords, the noble Lord will be aware that there is a difference of opinion between this House and the other place. We intend to move to the next stage, which involves a fully appointed Chamber.

General Practitioners: Performance Tables

2.52 p.m.

Lord Campbell of Croy asked Her Majesty's Government:

    Whether they favour the recording and publication of tables of general practitioners' performance in their work in the medical profession.

The Parliamentary Under-Secretary of State, Department of Health (Lord Warner): My Lords, after 1st January 2005, the Freedom of Information Act will provide the public with a general right of access to information held by public authorities, including the information held by primary care trusts relating to the work of GPs. We will consult key stakeholders, including the British Medical Association, about the arrangements for doing that to ensure that the rights of patients and practitioners under the Data Protection Act are safeguarded.

Lord Campbell of Croy: My Lords, I thank the noble Lord for that reply. While performance tables are being compiled in some areas, does he agree that although such tables promote friendly competition, they do not everywhere provide choice for patients because there is a national shortage of general practitioners?

Lord Warner: My Lords, there may be a misunderstanding. The issue arises out of the arrangements under the new contract in relation to a quality and outcomes framework, which was agreed by the profession—the profession wanted it. That will show how well GPs are treating patients with 10 common chronic illnesses. It is a method of paying GPs, not for compiling league tables.

Lord Clement-Jones: My Lords, in all the publicity, contrary to what the Minister said, the official tables show that GP vacancies are up by 800 this year and that total GP vacancies are now at 3,500. Is it not grossly misleading for the Government to give the public the impression that they can judge quality in a GP when they cannot even get access to one?

Lord Warner: My Lords, the noble Lord has been joining us in our midnight—and later—activities on the Health and Social Care (Community Health and Standards) Bill. He will know that that Bill will implement a number of major improvements, which

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have been agreed by the profession. They will provide an even higher quality of primary care service than we currently have.

Lord Roberts of Conwy: My Lords, can the Minister offer any explanation of the fact that GP vacancies are up by one-third to, I believe, 3,435 and that deprived urban areas are particularly badly affected?

Lord Warner: My Lords, I did not think that this Question was about deprived areas and GP practices. We are addressing the problems around GP supply. There has been an increase in the number of GPs under this Government. There are some longstanding problems in particular areas and the new contract will improve the quality of primary care widely across the country.

Lord Colwyn: My Lords, if details of GP performance are recorded and published as tables, how can we be reassured that they contain an accurate reflection of performance rather than a view of patient health, which varies enormously across the country and which is intrinsically linked to patient poverty?

Lord Warner: My Lords, the noble Lord is quite right—any information about performance by any health professional does not necessarily indicate that the health of the general population in that area is improving; wider issues, apart from healthcare, affect the population's health in any particular area.

Earl Howe: My Lords, was the specific idea of GP league tables discussed with GP representative bodies prior to the Government's announcement?

Lord Warner: My Lords, I must try to nail this issue. The idea is getting abroad because there is a proposal, which has been agreed by the profession in the new contract, for a quality and outcomes framework, which will enable GPs to be paid on the basis of the quality of the services that they provide. Incidentally that information will tell one something about the point score under the framework that a particular GP attained in order to get the payment that he deserves as a result of that work. We are merely saying that under the Freedom of Information Act, it is possible that that information could be available to the public. They will have that right under the Freedom of Information Act after 1st January 2005. We will be discussing with the BMA how that information might be made available publicly while safeguarding the rights of practitioners and patients under the Data Protection Act.


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