Westminster Hall Sitting of 12 July 2000

Preamble
[MR. MICHAEL LORD in the Chair]

Health Action Zones
Motion made, and Question proposed, That the sitting be now adjourned.—[Mr. McNulty.]
9.30 am
Mr. Jeremy Corbyn: It is nice to start the day in the knowledge that we are adjourning. That always strikes me as odd.
I want to raise the subject of the funding of health action zones and I hope that the Minister will have comfort, if not good news, for them when he replies. I welcome the principle behind health action zones. The Labour Government of 1974 to 1979 recognised that there were serious problems of inequality relating to health and that, in some areas of the country, people lived longer. Similar variations included infant mortality, notifiable diseases and accident rates. The discovery was not new. The relevant work had been going on for a long time. I was fascinated at school by the works of Dudley Stamp on the geography of life and death, in which he demonstrated that people living near steelworks lived for a shorter time than others and that poor housing led to low life expectancy.
The 1974–79 Government saw from the record of the national health service since 1947 that there were serious inequalities in health provision between different parts of the country and commissioned Sir Douglas Black to produce his excellent report on inequalities in health care and the resulting problems affecting life expectancy. The incoming Conservative Government in 1979 promptly banned the publication of the report, because of its implication that much redirection of resources was needed.
I was pleased when the previous Secretary of State for Health, my right hon. Friend the Member for Holborn and St. Pancras (Mr. Dobson), not only recognised many of those issues but also agreed, through the publication of the Green Paper, "Our Healthier Nation", and the establishment of health action zones, to examine health inequality in particular areas. That was very welcome. At the heart of what has been said on public policy direction and reducing health inequalities is that
all policies likely to have a direct or indirect effect on health should be evaluated in terms of their impact on health inequalities…all those policies should be formulated to favour the less well-off and so, wherever possible, will reduce health inequalities…priority should be given to the health of women of child-bearing age, expectant mothers and young children…further steps should be taken to reduce income inequalities and improve the living standards of poor households.
I welcome that approach.
Today is a good time for this debate, because the Government are announcing the reintroduction, after the tragedy of their 20-year lapse, of nutritional standards for school meals. Simple things like the food that is provided for young people in the morning and
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reasonable school lunches have an enormous impact not just on health, but on the ability to study. The Government's strategy of promoting greater health expenditure to deal with health inequalities is important. There are terrifying differences in the levels of serious illness, life expectancy and infant mortality in different parts of the country—for example, in the inner-London ring, by which I mean Lambeth, Lewisham, Tower Hamlets, Newham, Islington, Hackney, Camden, Hammersmith and Southwark. One sees huge inequalities in health in the inner-London ring between those areas and wealthy areas of central London, such as Kensington and Westminster. If one makes a comparison with suburbs further out, such as Golders Green or, even further out, Merton and Kingston, one sees massive inequality. A journey down the Old Kent road from central London to the Surrey suburbs would lead from a place of considerable wealth and high life expectancy through some of the worst cases of public health in Europe. The position changes quickly when one gets a bit further out.
There are many complex reasons why life expectancy is so different, one of which is the conditions under which people work. Building workers, miners, street cleaners, refuse collectors and others in dirty and dangerous occupations are more likely to end up with bronchial-related conditions and more likely to die in accidents at work than people in higher-paid, office-based employment. The Government cannot necessarily solve that problem, but matters can be much improved through rigorous enforcement of health and safety at work legislation.
Inequality in child health often leads to inequality in later life. Children growing up in overcrowded, small flats, where illness is transmitted easily from one child to another, might be unable to do homework properly because there is nowhere quiet to do it. With parents on a low income, they are less likely to eat good-quality, healthy food. They might end up being off school more because they are ill and they might under-achieve at school because they are off so much. They are unlikely to go to college or university or to get jobs for which they might be perfectly capable but for which they could not become qualified.
Those problems cannot all be solved by the Department of Health, but it is important to recognise that much inequality arises from such issues. We must study carefully how the problem is tackled. Merely throwing money at problems does not necessarily solve them. It is a question of approach and how money is spent. I strongly welcome the thrust of what the Government are doing in recognising the causes of health inequalities and in putting together a series of programmes that improve education, access to health care and basic living standards through a minimum wage, although I wish that the wage were much higher.
It is also a question of linking local initiatives, which is where the health action zones come in. Unfortunately, the then Secretary of State did not include the boroughs that I and my hon. Friend the Member for Hampstead and Highgate (Ms Jackson) represent—Camden and Islington—in the initial wave of health action zones, although they were included in the second phase. I can understand the reasons for that—the choices before the Minister were unenviable. He had inherited a terrible situation in the former coalfield communities, where life

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expectancy was low and where there was a high level of industrial illnesses and serious depression because of the loss of the coal industry and the community spirit that went with it. Coalfield communities were rightly in the first round, as was most of the east end of London.
I was pleased when my borough and Camden were included in the second phase of the health action zones because I still find the annual report from the medical officer for the health authority that I represent to be fascinating reading. When reading through it, one sees a pattern of inequality, illness and depression, which is linked to the problems of living in an urban area, of a migrant community and of public services that often fail to meet people's needs, expectations or aspirations. The declaration of a health action zone was an important recognition of the multiplicity of problems.
Our community has, unfortunately, among the highest infant mortality rates in the United Kingdom, one of the highest levels of AIDS, some of the worst housing in the country and a hugely migratory population. In some wards, population turnover approaches 20 per cent. a year, which makes it difficult to build communities or a community spirit. There is a large transient population and the number of homeless people and rough sleepers is high. Public services struggle to make ends meet, to provide services and to survive. Whitehall has to assess the needs of health care services and of local authorities. Although we welcome any support that is given to our public services, it is difficult for Whitehall accurately to calculate the number of people who are sleeping rough or the number of asylum seekers who are passing through, especially if they are in bed-and-breakfast hotels or hostels. Such people, for perfectly understandable reasons, place an enormous demand on local health facilities and services.
The Government did us a service by establishing a health action zone for the area. The broad themes of the health action zone are, first,
Tackling social, economic and environmental factors that are the root of ill health. This will prioritise areas that have particular relevance to children and young adults,
such as early lives, social inclusion and addiction;
secondly,
Improving and integrating services, to increase their effectiveness, efficiency and responsiveness;
and, thirdly,
Developing the infrastructure to underpin the HAZ: for example the capacity for community involvement; better information management and technology; staff education and training; improvements to hospital and primary care premises.
Those are welcome aims. In addition, the implementation of the mental health strategy is an important priority for our own health action zone. In that context, a document on the achievements of the health action zone states:
The added value that the HAZ brings to the work is providing the joint architecture which enables partnerships to flourish.
The mental health services of inner London are under enormous strain. Although we must deal with people who suffer mental illness in the best way possible, long-stay institutions are not necessarily the right approach. Community care is, in general, a much better option, provided there is sufficient funding, support and
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monitoring. Sadly, some patients were taken out of long-stay institutions and moved into community care institutions where the level of support and back-up became negligible. Many deeply disturbed people who needed significant help ended up wandering around the community and becoming social pariahs in their districts. Although I strongly support the principles of community care, I shall be interested to hear what my hon. Friend the Minister has to say about monitoring it.
On overall funding of our health authority, the Government inherited a situation in which Camden and Islington health authority was in the unenviable position of being the only health authority to receive no increase in the last two years of the previous Government's life. The recent per capita cash increase of nearly £60 a head—a 6.79 per cent. increase—is extremely welcome and recognises the situation that we inherited. However, when the Government announced the creation of health action zones, there was substantial press coverage of associated funding. I am not criticising health action zones, but I hope that my hon. Friend will bear in mind a number of factors. How will the staff and facilities of health action zones integrate with community health authorities and hospital trusts and the health authority as a whole in the long term? Although I welcome specialist initiatives to deal with the particular problem, there is a danger that we will end up with a plethora of experienced, well-paid and well-meaning professionals who spend so much time meeting one another that they have no chance to do anything for the public that they are meant to support.
I am not looking through rose-tinted spectacles at the halcyon days of the late 1970s, but I remind hon. Members that a system in which one health authority had overall responsibility at least ensured clarity, as one knew whom one was meeting and at whom responsibility had to be directed.
When I consider similar issues now, I find myself in conversations with the health authority, the hospital trust, the community health trust, the health action zone and the primary care group—and so it goes on. They tell me that they are all working well together. Indeed, I am sure that they are doing so and that they get on extremely well, but I must say that they spend an awful lot of time getting on well and meeting one another. I hope that the Minister will use his examination of the role of health action zones as a spur to improve co-operation and integration—a suggestion that is made in a constructive, rather than a negative, spirit.
I am always depressed when I hear about the time that hospitals spend in trying to persuade elderly and often psycho-geriatric patients to leave hospital care and to go back into their homes, the community, social services care or wherever else. When co-operation works well, it is fine and there is a seamless transfer, but the result is different when it does not. That can happen when everybody is up against budgetary constraints, when the hospital is desperate to get rid of patients because they are blocking beds and it is expensive to keep them, and when social services can afford no more agency staff and can find nowhere to put people, and are therefore understandably reluctant to take on new patients. As a result, people who should no longer be in hospital are often bored out of their brains for weeks on end, blocking a bed that somebody else could use, whereas they should be in a cheaper facility elsewhere. Such

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issues must be resolved. I know that the Minister is aware of them, but will he reflect on them and suggest ways of dealing with the problems?
I turn now to funding the health and social services needs of a community. The Government have at their disposal a vast array of statistics on issues of poverty, inequality and ill health. Figures on free school meal take-up in primary schools can be used as a broad parameter of poverty. One finds enormous inequalities even within individual areas. My constituency is next to that of my hon. Friend the Member for Hampstead and Highgate. In our area, one can go from schools in which 80 or 90 per cent. of pupils have free school meals to schools with a take-up of 25 or 30 per cent. Such schools are situated within a couple of miles of one another, which is, I suppose, a feature of London life. When the Minister reflects on such statistics and evaluates how circumstances change and improve, will he also consider the efficiency with which the various agencies co-operate?
The Camden and Islington health action zone was expecting an income of £4,075,000. It planned developments accordingly for years two and three. This year, however, the amount was reduced to £3,734,000, which meant that some of the schemes that it proposed could not go ahead. Consequently, it has had to reconfigure its plans. The Government made the cut because they were concerned about underspending. I understand their concern, as it is rightly expected that public money that has been made available for a project should be spent. As I understand it, however, the reason for the underspend was that the health action zone was anxious to ensure that its projects were efficient, well funded and well planned. It was felt that throwing money at its goals in the first year would not necessarily be the best way of achieving them. The zone has shown a degree of caution in its plans, but has been penalised for doing so, which seems slightly unfair. There is concern that the message sent by the Government's attitude to funding is that they no longer give the same priority to health action zones as they gave when the first phase was signalled a couple of years ago—or, in the case of the zone to which I am referring, a year ago—in a welcome announcement.
The health action zone is addressing issues of local health inequality and seeking to integrate with other groups. The improvements in relation to mental health are very important, as are those in relation to coronary heart disease, cancer, accident prevention among older people and drugs action team structures. In the case of the latter, it is easy for us to throw money at drugs action zones or groups and tell them to go away and deal with the problems because we are horrified to find that young people are taking hard drugs and becoming involved in drug dealing. However, it is important for any drugs team to be credible within the local community and to be seen to be effective, but that can take a long time to achieve.
The overall aims of the health action zone are to speed up improvements and integration of local services, tackling the underlying causes of ill health and building local capacity to sustain and improve health; aims that I am sure will be welcomed. I want to give some examples of the "early wins" that have already been delivered by local partnerships:
Jointly managed and fully integrated Mental Health teams covering all localities—
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we have had enormous problems with mental health, as I said earlier—
Assertive Outreach and 24 hour access to Crisis Response and Resolution; this has led to a significant reduction in hospital admissions.
Changes in service policy at the Whittington Hospital Trust as a result of the HAZ-sponsored Female Genital Mutilation (FGM) awareness programme;
The introduction of welfare benefits advice in local GP practices;
That is extremely welcome, because cuts in advice services have resulted in many people not gaining access to the benefits to which they are entitled. At least if some advice is available from GP practices, that will be of assistance. The "early wins" also include:
Multi-disciplinary sex education teams; 25 health professionals have been trained and their joint protocol ensures young people are linked into local services.
Various figures are quoted for the number of people who have given up smoking: 160 people in four weeks, although I have no idea how many of those took up smoking again. I get the feeling that some people are eternal quitters; they receive some sort of prize for quitting and then start smoking again, so that they can quit again, so one must be sceptical about figures for a reduction in smoking. However, health education to prevent young people from taking up smoking is very important.
The "early wins" also include:
Increased levels of participation in physical activity particularly among older people.
That is achieved through health fitness and training in day centres, which is very welcome. Indeed, on Sunday, I was involved in the opening of a day's health fair organised by Arachne, a Cypriot women's organisation. The day included a discussion about health and fitness, and various exercises and complementary therapies were featured by a project known as Healthy Islington 2000, which works closely with the health action zone and others.
More "early wins" are:

A number of deprived communities are already more engaged in health promoting activities.

Health Promoting School Scheme in place in nine pilot schools.

Sure Start Initiatives in deprived areas outwith the nationally designated pilot areas.

A training programme for refugee doctors and nurses with qualifications from overseas has been established.

I am sure that my hon. Friend the Member for Bethnal Green and Bow (Ms King) would strongly endorse that. Many asylum-seeking nurses and doctors are extremely well qualified in their own countries, but because of the delays, difficulties and, dare I say, obstructions caused by professional organisations, we are losing the skills of people who want to contribute to our society and who do not want to spend time waiting for their cases to be resolved, as I am sure the Minister appreciates. If we can speed up that process and help with language training, where necessary, those highly skilled people will be able to help the community. Anyone who has seen the effective work of health advocates, who are able to offer translation facilities, will know that they have an enormous impact on the health of individuals and improve the self-esteem of their families.

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I welcome the establishment of health action zones and the recognition of the link between inequality and ill health. However, I am disappointed that, within a year of our health action zone starting, the planned expenditure had to be reduced by such a considerable sum. I hope that my hon. Friend the Minister recognises that the underspending was the result of caution; people want to be responsible with public money and not throw it at projects in order to gain more money in future years.
The question is how public expenditure should be planned. I look forward to my hon. Friend's response. If he would like to visit our health action zone again, those groups would be pleased to meet him and discuss with him the positive work that has been done to try to give everyone a reasonable chance in life and, as far as possible, equality of access to health care. We must overcome inequalities between the suburbs and inner cities if we are to achieve any sort of harmony within our society.
9.55 am
Ms Glenda Jackson: First, Mr. Lord, I congratulate my hon. Friend the Member for Islington, North (Mr. Corbyn) not only on obtaining this debate but on choosing to speak on a subject of such importance. As he said, Mr. Lord—
Mr. Deputy Speaker (Mr. Michael Lord): Order. I remind the hon. Lady that, in this Chamber, the occupant of the Chair is referred to as the Deputy Speaker.
Ms Jackson: Please accept my most humble apologies, Mr. Deputy Speaker, and thank you for enlarging my information pool.
As my hon. Friend the Member for Islington, North was at pains to point out, the Camden and Islington health trust covers several constituencies and boroughs. My constituency of Hampstead and Highgate, which is invariably misrepresented by the popular press as being inhabited exclusively by millionaires who do nothing but sip champagne and chatter, contains areas of grave deprivation. My hon. Friend welcomed the Government's move to create health action zones to try to tackle inequalities in the delivery of health care. Although we were disappointed that we did not achieve a health action zone in the first tranche, we were delighted to be part of the second wave. As my hon. Friend said, the complexities inherent in attempting to tackle inequalities of health provision are themselves a major burden; it takes time, effort and partnership to tackle them.
My hon. Friend the Member for Islington, North mentioned the disappointment felt by the chairman of the Camden and Islington health trust and the director of the health action zone on hearing of the reduction in funding to the HAZ. Richard Sumray, chairman of the Camden and Islington health authority, said that the HAZ leaders conference on 6–7 October 1999 was told that it could assume for planning purposes that it would receive £1,874,000 for the year 2000–01. As we know,
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that amount has now been reduced. Richard Sumray told me in a fax that the allocation for HAZ includes variable funds that are ring-fenced. He went on to say:
Had all of the funds been allocated at the same time, there would not be a problem but it is the timing of such an announcement and consequently the effect of it on our partner organisations which will be extremely deleterious.
I want to speak about the impact of the Government's most recent announcement on those partners that are essential in enabling the HAZ board to achieve genuine equality of health provision in our area. As I said, we were elated by the announcement that Camden and Islington would have a health action zone as part of the second tranche. I believe that that sense of elation was felt by everyone in the boroughs who was involved in delivering health care across a wide range of areas, by the recipients of health care and by those who believed that much better and more integrated work could be done across the boroughs in delivering, improving and targeting health care.
No one was under any illusion that a single agency or organisation could deliver and improve on equality in health care provision. Everyone involved accepted from the very beginning that success would depend on genuine partnerships being put in place. My hon. Friend the Member for Islington, North talked of meetings for meetings' sake. I do not believe that such meetings deliver anything other than, perhaps, the enjoyment of participants of such meetings at seeing each other. Undoubtedly, a great deal of detailed work must be done before partnerships for delivering can be in place. Everyone must be clear about what they are trying to achieve and how to achieve it, and must actively monitor whether they are delivering.
In a fax to me, Gail Findlay, the director of HAZ in Camden and Islington, expressed anxiety that what seems to be a reduction in funding for HAZ programmes might send the wrong message to the partners involved, who are, as I said, central and essential to delivering the desired outcomes. It might be perceived as the Government losing confidence in health action zones, which I and deliverers of health provision in my constituency believe to be innovative and to incorporate in exactly the right way the experience of health professionals, of people who receive the services of health professionals and of people who are active in campaigning organisations. One of those organisations, Age Concern, is holding discussions with a health action zone on a programme to build on the accessibility of exercise for elderly people, to ensure that their health improves.
The partners may regard the development as a lack of conviction on the part of the Government that health action zones will deliver what we all believe that they can. There may be a perceived lack of confidence in the Government in this innovative and exciting venture and a lack of commitment on their part to see the programme through the full seven-year period.
I hope that my hon. Friend the Minister will be able to restore confidence, especially in those in my constituency who are most actively engaged in delivering in the health action zone. Quite apart from tackling, rightly, the scandal of inequality in health provision, as my hon. Friend the Member for Islington, North said, it is not the Government's fault that such inequalities exist. It is a question of time. The root

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causes are many and varied, and there may be a tradition of expectation and aspiration not being encouraged by individuals, families or communities about the level and quality of the health provision that they receive.
We are beginning to tackle those central and essential issues via health action zones and many other innovative programmes that the Government are introducing in health care. On one level, in dealing with health action zones, prevention is better than cure. I have already mentioned encouraging elderly people and making it easier for them to exercise to ensure that they maintain mobility and that their health improves.
At the other end of the age scale, we have the Sure Start initiative's marvellously imaginative approach to children, which will make an amazing difference for far too many children who have been allowed to live in poverty for far too long. That programme will give them a start in life to enable them to discover what is best in them and what can be developed. None of that is possible without constant monitoring to ensure that health provision is in place.
More than 30 schools are taking part in Camden and Islington's programme to tackle health in schools. One of those schools, Beckford school, is operating a befriending scheme whereby 25 nine and 10-year-olds are helping to look after the emotional health of younger pupils by becoming "playground buddies". Although I do not necessarily like the Americanisation—the name "buddies"—the scheme has immense value, not only for the young children who will be assisted to find their feet in the wider environment of a secondary school, but for those who participate because they wish to help younger children. That is not only part and parcel of delivering on a health requirement and outcome, but intrinsic to ensuring that we have healthy communities. It encourages a sense of community in young people from the earliest possible age.
My hon. Friend touched on the issue of targeting by the health action zone in Camden and Islington to encourage smokers to quit. As a smoker who has never had the desire to quit, I should not linger too long on this incentive. Although I would not go so far as to use the phrase "professional quitters", I agree with my hon. Friend that some people seem to quit as part-time entertainment—
Mr. Corbyn: Serial quitters.
Ms Jackson: That is precisely the phrase that I was stumbling to find. Those of us who are still trapped by nicotine know who those people are. They invariably say that they have quit, but then say that they are having difficulties, and ask, "Could I bum a cigarette off you?" I am making light of a serious issue, especially as far as young people are concerned. It is one of the areas in which health action zones can make an enormous difference.
My hon. Friend touched on the special difficulties in our part of inner London. Those difficulties are not exclusive to Camden and Islington, but are shared by all inner London boroughs. They are related to the peripatetic life style of people suffering mental health problems, and perhaps drug and alcohol-related
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problems. In relation to homelessness and rough sleeping, our constituencies include large refugee populations, who have difficulties because English is their second language. That is exacerbated, in many instances, by cultural and traditional approaches not only to the treatment of illness but to access to health professionals. Health action zones can make a major difference because they involve a wider range of partnership in which health delivery professionals had not previously engaged. A wealth of expertise exists, on which health action zones, by virtue of their partnership basis, can deliver. That would be extremely difficult to define on a simple accountancy cost-benefit basis. None the less, the benefits can be enormous and incalculable.
I hope that my hon. Friend the Minister will be able to calm the fears of those who are enthusiastic and committed to the idea of health action zones, and that the work will continue, involving not only the health trust but all those partners who are actively engaged in tackling the kind of issues that we have touched on. I hope that he will give an assurance that the Government are as confident of supporting the schemes for the first seven years as they were when they were introduced. I regret the reduction in funding, for the reasons that I have given, and the timing of the announcement. My hon. Friend the Minister apologised for the delay in his letter to the chairs of the health action zones, which was courteously copied for the relevant Members of Parliament. He said that he was concerned about what he perceived as an underspend in the first year of funding for the zones.
It is time consuming and difficult to set up the partnerships in the first instance. The zone director in my area was adamant that no purpose would have been served by throwing money at the problem and regarded it as a grievous waste of public money to do so. Structures are now set up within their partnership structure that can successfully deliver. I hope that my hon. Friend the Member for Bethnal Green and Bow (Ms King) will make the point to our hon. Friend the Minister that the underspend in the first year was not due to a lack of willingness on the part of the HAZ directors or partners, or a dearth of problems on which to spend the money. The underspend came out of a desire to ensure that public money was well spent and delivered services in not only the short but the long term.
10.11 am
Ms Oona King: I thank my hon. Friend the Member for Islington, North (Mr. Corbyn) for securing the debate.
I commend the Government for focusing on, and rooting out, health inequalities. An impediment to equality has been a compartmental approach to health problems; one of the key aims of the health action zones is to break down that type of compartmentalisation. The best thing about the zones is that, for the first time, British Government thinking embraces a wider definition of ill health and its causes, such as poverty. That can only be a good thing for hon. Members such as myself who represent deprived inner-city areas that are stricken by poverty and inequality of opportunity, manifested perniciously in life-long health inequalities.
The Government's Sure Start programme is another example of that cross-departmental approach. On the Ocean estate in my constituency, 480 children under the

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age of four have been identified as needing help. Throughout Tower Hamlets, £1 million will be spent on trying to improve the early years of some of our most vulnerable children.
That brings me on to one of the main problems with the HAZ programme. The Sure Start programme, which I welcome, exposes the many cracks that HAZ attempts to paper over. One local general practitioner asked me whether I thought it made sense for money to be spent on Sure Start when, in Tower Hamlets, the most basic health services—the ability to get an appointment with one's doctor, or even to be on a doctor's register or to have health visitors—cannot be consistently delivered. My hon. Friend the Member for Hampstead and Highgate (Ms Jackson) said that prevention was better than cure, and one of the fundamental elements of health action zones is that they encapsulate that approach. However, the same GP—the situation is replicated in surgeries around Tower Hamlets—has one health visitor, who is supposed to cover 250 under-fives, but covers 570 young children because resources are so stretched. A young child in Tower Hamlets has half the attention from a health visitor that he or she would receive if registered in a more affluent area, yet has two, three or four times the need.
Another example of a basic service that Tower Hamlets cannot adequately provide is midwifery. In the Evening Standard last week, a distressed pregnant woman in east London wrote:
we are told that east London is a Health Action Zone with millions of pounds in extra funding. But the health authority is clearly on its knees. Its staff are obviously overworked, you can't get an appointment for weeks, the opening hours are few and far between, there's never a light or toilet paper in the loos and the system is bursting at the seams with frustrated patients.
The article appeared under the headline, "Pregnant? Well you can't see your doctor this year". She tried to get an appointment with a doctor in November and was told to come back in January.
Most people not living in deprived areas do not have such experiences, and I recognise that the Government set up the health action zones to deal with such problems. However, we need to be careful about mainstream funding, which HAZs are not intended to replicate or substitute for. The methodology behind the HAZ in Tower Hamlets is such that it will focus on young people. It will also target heart disease and mental illness, which are the biggest causes of early death.
I welcome the notification of funding for health programmes from April 2000 to March 2001. As my hon. Friend the Member for Hampstead and Highgate said, we recognise that my hon. Friend the Minister explained some of the delay in a letter, which was courteously copied to relevant Members of Parliament. None the less, there has been great uncertainty among HAZ services. I sincerely regret the reduction in funding that has befallen the East London and City HAZ programme. We have taken into account the allocations made to it, and although we are thrilled to have received an increase of—depending on how it is calculated, and there are many ways to skin a cat—14 per cent., we note that the overall increase for HAZ budgets has been around 36 per cent.
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We are shocked to have received not even half of that in Tower Hamlets, given that we have the highest concentration of poverty in the country. No other area in Britain has more poor people. Health problems are manifest, and I cannot help but be distressed every time I visit my constituents, go round the estates and find families of 12 living in two bedrooms with water dripping from the walls, condensation, all the kids having asthma and none having places to study. As my hon. Friend the Member for Islington, North explained, that inevitably cripples those children's chances for life.
My hon. Friend the Member for Hampstead and Highgate made the point, but I shall make it again. I appreciate that in my hon. Friend the Minister's letter, he said that he was surprised and disappointed at the size of many of the 1999–2000 HAZ underspends. My hon. Friend the Member for Hampstead and Highgate explained some of the reasons for that, but it might be because Tower Hamlets is so full of amazing ready-to-go ideas and has the most incredible need that it has an underspend of 2.04 per cent.—the smallest in the country, I am proud to say. Although many other health action zones may face reduced funding, they will be able to cushion themselves with large carry-forwards. Tower Hamlets is looking at a cut compared with 1999–2000 and will receive £2.37 million as opposed to the previous funding of £3.139 million. That is a great disappointment, especially given the serious health problems in the area. Substantial savings will need to be made in the HAZ budget, leaving a significant shortfall to make up.
East London HAZ is committed to delivering on the Government's national health service priorities, but feels that it is being punished for its success. Will the Minister consider that and the more significant point that, without adequate funding in the NHS, the lessons learnt from HAZ cannot be heeded or acted on? The central fact is that, despite increased resources, the demand for health care in east London outstrips supply. The HAZ cannot bridge that gap, nor should it be responsible for doing so because, although the programme is for seven years, that is a relatively short time.
We are grateful to have been included in the HAZ programme because it has resulted in many initiatives. The emphasis on partnership and the recognition that the local health economy comprises more than the NHS are critical in Tower Hamlets. The multi-agency work to identify and carry through health improvement programmes is also important. GP surgeries have benefited from the funding streams in IT equipment and training. The link between the programme and schools is an important step in the right direction. Nine projects based on the work with the communities fund are up and running, including a Bengali and Somali men's health scheme with 90 participants. All those initiatives contribute to the community. The best HAZ initiatives should be incorporated into mainstream practice and should not just be a bolt-on.

Better communication is needed between the Department of Health and regional health action zones. I hope that HAZs will address people's experiences of the health service and begin to tackle its inequalities. They have expanded provision in health services, but the deprivation uplift of £1.6 million has already been committed for service developments in cancer, coronary

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heart disease and mental health. Tower Hamlets merited the average increase in HAZ funding, as opposed to the 14 per cent. that we received.
We are anxious that expanded provision, which was overseen by the health action zone, will have to be cut back and taken out of mainstream budgets. The best way to prevent that from happening would be to improve the central funding allocation and ensure that the overall formula is fairer. Thus, the work expected of health care professionals in Tower Hamlets, based on the number of people served by Tower Hamlets and the East London and The City health authority, would be founded on fact, not fiction.
I welcome the Government's historical initiative, which, for the first time, recognises that poor health is linked with poverty and enables the more effective delivery of health care services to young children and adults, some of whom have the worst health in the United Kingdom.
10.26 am
Mr. Nick Harvey: I congratulate the hon. Member for Islington, North (Mr. Corbyn) on securing this interesting debate. He justified health action zones most convincingly and rightly spoke about the problems that they try to solve.
I represent a rural constituency and I am familiar with pockets of deprivation; rural areas have many problems, such as the cost of running basic services, which are not properly recognised in formulae, but that is a discussion for another day.
Areas such as north Devon do not have to struggle with the extraordinary deprivation that many inner cities have faced for decades. There are no overnight solutions to their problems, but switching additional resources to those areas is justified. The health action zones, which I welcome, will have fewer resources at their disposal in the coming year than they expected. Overall funding to the health action zones, and the total funding at the disposal of individual HAZs has increased. However, not for nothing did the draft letter from the Minister to the health action zones state:
I appreciate that programme funding is less than we had previously indicated.
Only by taking the special earmarked deprivation allocations into account can it be said that, in some cases, HAZs will have more resources at their disposal. It is not surprising that civil servants warned:
We can anticipate that, following receipt of a notification which will, in effect be announcing cuts to anticipated HAZ budgets this year, there is likely to be some negative financial, management and political feedback from HAZ partners.
They stated:
This will not be received as good news and we would not recommend a press notice.
That is prudent advice, but unfortunately it got out anyway, despite the advice of another civil servant that the health action zones
should not be made aware or played into these discussions.
The Department recognised that there was bad news. Even if the health action zones have more cash, they have not received what they had anticipated. They made plans on the basis of what they anticipated would be at their disposal.
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The hon. Member for Islington, North made a good point about the number of bodies that need to be involved to make HAZs work—it is dangerous to have too many bodies with too many budgets and too many programmes. I enjoyed his point about the need to ensure that everyone gets on, because they must spend an awful lot of their time working together. I am not sure whether I recognise his description of the halcyon days of the late 1970s, but we shall pass over that for the moment.
Mr. Corbyn: I was being perverse.
Mr. Harvey: Yes, I thought so.
The hon. Gentleman made some good points about the dangers inherent in stopping and starting—or boom and bust, as the Prime Minister likes to say—in such services. It was right that HAZs were set up for seven years and told at the outset that they had the right to carry over funds. That encourages sensible phasing and sensible planning.
It should surprise no one that HAZs did not necessarily spend all their funds in the first year of getting up and running from a cold start and that they had reckoned on the basis of being able to carry over those funds. I wish that they could have done so, because they were probably just being responsible and prudent. The Government have changed their view and said that that is not allowed, which is a mistake. If HAZs are no longer allowed to carry forward funds, I hope that the Minister will reassure us that mechanisms will be put in place to spot early the HAZs that will not use all their funds for the year and to redistribute those funds to any other HAZs that could use the funds for programmes on their books during that year.
Many hon. Members will be aware, from experience of the public sector or involvement in it, that problems arise when a budget must be spent in one year. I have sat on the governing bodies of higher education institutions, and the director appears in mid-February and says, "Does anyone have any good ideas how we can blow a couple of million pounds by the end of March? If we don't, the money won't be there next year." It would be regrettable if HAZs were driven in a direction where that perverse logic applied. I urge the Minister seriously to reconsider the matter and recognise that it is not surprising that HAZs have not used up in the first year all the moneys allocated.
The hon. Member for Hampstead and Highgate (Ms Jackson) said that local HAZ leaders were disappointed that they would not receive the funds that they had anticipated. I am not surprised about that. Other organisations were encouraged by the formation of HAZs. The hon. Lady mentioned Age Concern, which was impressed and signed up to the programme, anticipating making a seven-year commitment with the Government. Those organisations believed that the Government were right behind HAZs, but their faith will have been somewhat shaken and they will be wondering how things will work out in the time left for the programme.
I was also struck by the remarks of the hon. Member for Bethnal Green and Bow (Ms King). She is absolutely right to say that programmes such as Sure Start expose in her constituency the problems that HAZs might have

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conspired to paper over. There are real problems on the ground in Tower Hamlets and many other areas. I welcome the new money coming onstream. However, it would be a pity if it were handed down with too many strings attached. When a Government Department makes new funding available it understandably does not want that money to be swallowed up in bureaucracy or used to cover historic debt. Nevertheless, we need to have faith in local people, who understand the priorities for their areas and can therefore sensibly judge how the sums should be used. Too much diktat about how funds should be used is not welcome.
Despite the injection of the funds, serious problems remain to be solved. As the hon. Member for Bethnal Green and Bow said, demand for health services far outstrips supply, and is likely to continue to do so for a long time. It would be a pity if some of the extra funds earmarked for deprivation allocations had to be used quietly to cover up shortcomings.
We must be honest and say that the resources anticipated by health action zones have been reduced. That is regrettable. The programme is a good idea, but the Minister needs to make a fresh commitment to pursuing it fully. He needs to answer some of the questions about the ability of those responsible for implementing the programme to plan ahead and make sensible commitments over seven years. He also needs to set out the future arrangements for carrying over resources. As I said, people should not have to rush around in the last few weeks of the year finding ways to spend money to ensure that they do not lose it in the future.
10.36 am
Mrs. Caroline Spelman: I shall endeavour to be brief, because we are running out of time. I should like to hear a full response from the Minister, and there is no need to repeat some points that have already been made well. I congratulate the hon. Member for Islington, North (Mr. Corbyn) on securing the debate. I understand why the three Government Back-Bench Members who spoke have a particular interest in commending the restoration of funding to their areas, which have high levels of deprivation. Those hon. Members made their cases well. I am surprised not to see some other Members of Parliament, whose health action zones are even more adversely affected. The subject is particularly suitable for an Adjournment debate, because it concerns a large number of people.
My constituency contains many contrasts. There is a seven-year difference in life expectancy between people on one large council estate, which has its origins in the Birmingham slum clearance, and people in a more affluent area. Although my constituency does not qualify for health action zone money, I am well aware of the pockets of deprivation that exist in several other constituencies.
The programme budgets of 11 health action zones have been reduced dramatically with effect from this month. My research shows that the biggest casualties are the South Yorkshire coalfields health action zone in Barnsley, whose budget has been slashed by £789,000; Tyne and Wear HAZ, whose budget has been cut by
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£1.2 million to £3.5 million; Manchester, Salford and Trafford HAZ, whose budget has been cut by £1 million; and Lambeth, Southwark and Lewisham HAZ—the "inner-London ring" constituencies to which the hon. Member for Islington, North referred—whose budget has been cut from £3.65 million to £2.713 million. The hon. Member for Bethnal Green and Bow (Ms King) described well the position of the east London health action zone.
Before I came here, I spoke to my hon. Friend the Member for South-West Devon (Mr. Streeter) and the hon. Member for South-East Cornwall (Mr. Breed). They told me that the Plymouth health action zone's budget will be cut from £1.037 million to £771,000. I know that the budgets of many health action zones have been cut by less than that, but Luton, Sandwell, Bradford, Northumbria and North Cumbria HAZs are nevertheless affected. It is important to mention all the affected areas, because one of the purposes of Adjournment debates is to raise wide-ranging issues.
The nub of the debate is whether the money to those areas, which we all agree need additional support, is being cut. The argument has run along the lines—I expect that the Minister will make this point—that the money is not really being cut because the health authorities in those areas will receive other moneys. That does not persuade the local Member of Parliament or those running health action zone projects. We know exactly how public money works. It is parcelled up for particular projects and it is difficult for a project to recover its position if its core funding is cut.
The Liberal Democrat leader made that point rather well at Prime Minister's Question Time. He showed the sequence of internal documentation, which the hon. Member for North Devon (Mr. Harvey) has read out. The Prime Minister replied:
I think that he will find that, when taken with the money given to health authorities in those areas, the funding has gone up, not down.—[Official Report, 28 June 2000; Vol. 352, c. 901.]
We all know that it does not work like that in practice. Handing out extra money for anti-smoking campaigns, for example, does not mean that core funding for the health action zone project is restored. Other initiatives will go to the wall because it is not easy to cross-subsidise from another pocket of funding to the project that has lost its core funding.
That is the nub of today's debate. We agree that health actions zones are a good idea. They are needed in the areas where, for many complex and diverse reasons, as the hon. Member for Hampstead and Highgate (Ms Jackson) fairly pointed out, there are life expectancy and health inequalities. Those inequalities are complex to tackle and, regrettably, are getting larger. There is hence an understandable political need to target money into the areas concerned. When a seven-year programme has been agreed, it is most disheartening for those who have to deliver the project to have their core funding cut at such an early stage. It sends all the wrong signals to the people on the ground.
I have some straightforward questions for the Minister. Will there be further cuts next year, or will the core funding be restored? I am not persuaded that providing parcels of money to fund other health-related projects in those areas, which is a loose way of describing where the money is going, will restore

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confidence in the health action zones project. Can the Minister assure us that the capacity to carry over from year to year will be restored? A number of hon. Members said that the underspend by their health action zones had resulted in some of that money being taken away. In modern government we are trying to move away from the idea that, unless money is spent on something at the end of the year, it will be taken away or, in this case, cut back. At the outset of the project, there was a commitment to allow health action zones to carry forward their underspend, but it appears to have gone. Can the Minister reassure us that the capacity to carry over from year to year will be restored?
The integrity in the core funding must be maintained if the health action zones are to work and if their seven-year programme is to be completed. I look to the Minister for a clear assurance on that point. It is essential for the confidence of all of those who work in difficult situations. For them, the money never seems enough because the degree of inequality is so large and, regrettably, getting larger.
10.43 am
The Minister of State, Department of Health (Mr. John Denham): This has been a useful debate and I congratulate my hon. Friend the Member for Islington, North (Mr. Corbyn) on securing it. I welcome the contributions made by my hon. Friends and others. My hon. Friend the Member for Islington, North has a keen interest in health action zones. He has raised a number of points today and he spoke about them recently in an Opposition day debate in the House. This timely debate sets out the position.
In his opening remarks, my hon. Friend welcomed the priority that the Government attach to areas of highest deprivation and to the need to tackle health inequalities and rebuild and modernise the national health service. He also welcomed our practice of launching health action zones. I wish to reassure hon. Members of our continuing support for this programme. I noted what the hon. Member for Meriden (Mrs. Spelman) said. I have to say in passing that there was no such programme during 18 years of Conservative Governments. In the light of the shadow Chancellor's announcement that he is abandoning commitment to any of the spending programmes, I shall probably write to the hon. Lady asking her whether what we heard from her was a spending commitment to the future of health action zones. However, I doubt whether she will be able to reply as I shall reply today. We are committed to health action zones.
Many of the issues raised by my hon. Friends reflected those that Ministers must consider when deciding on the overall allocation of funding for areas covered by HAZ programmes. There is common ground on the importance of areas where some 13 million people suffer particularly harsh deprivation receiving extra money, over and above what they would have received through the usual allocation formula for such areas.
A persistent theme of the debate was that we should ensure that we strike the right balance between the innovative and ground-breaking work of new partnerships that are formed by HAZs and the allocation of mainstream resources for those areas. We have sought to achieve that balance in a series of
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decisions that the Government have taken on funding HAZ programmes and allocating resources. When the total figures are seen, it will be clear that they represent a substantial and increasing commitment to tackling the poverty, inequality and health deprivation that have been described.
We are strongly committed to improving the health of the most deprived communities. The work of HAZs is key, in that much is being done to reduce health inequalities, to modernise services and to tackle social exclusion. The partnerships that have been formed—they have been well described today—between local authorities, local health services and other agencies, including the voluntary sector and local community organisations, play an important part in driving through those changes. That is very different from the fragmentation and lack of partnership in the internal market in the health service under the previous Government.
My hon. Friend the Member for Islington, North essentially asked how we should act to make the cooperation achieved through HAZs a more mainstream feature of operating what I shall call the local health economy. In the past two years, we have instituted health improvement programmes that bring together health authorities, with their strategic leadership role, trusts, primary care groups and trusts and local authorities. We have consulted widely with the voluntary sector and have set out areas' health priorities. As well as the range of services provided by the national health service, those priorities include many of the issues that have been raised this morning. The funding that we give to local health authorities and primary care organisations is intended for locally agreed priorities in the health improvement programme, which of course also reflects national priorities set by Government, such as work on coronary heart disease, mental health and so on.
HAZs can be seen as giving a kick-start to the health improvement programme process, which works across all local health authority resources rather than as a separate, detached element. HIPs have been part of the local planning system for only two years. Hon. Members will have received from their local health authorities copies of the HIP, which is only the second version of the document. The process will evolve over time as the HIP becomes the focus for the sort of cooperation that has been spoken about today. I hope that I can reassure my hon. Friend the Member for Islington, North that we have a clear strategy to develop coherence in health planning and the promotion of good health across the local health economy that goes beyond the partnerships formed through health action zones.
Mr. Corbyn: The Minister will have heard what I said earlier. Can he offer us any comfort with regard to the perverse effects of budget planning in the health service and the local health economy, whereby it becomes a positive incentive not to take patients from a hospital into community care or vice versa because whoever takes them must pay for them and whoever has them is already stuck with the bill? I know that the problem

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sounds minor, but squabbling about who should and who should not have a patient causes an enormous waste of time, energy and resources.
Mr. Denham: That problem is partly addressed through, for example, the local winter planning groups, which were established for the first time last year. They led to much more integrated planning between social services and health services locally and were able to pinpoint places in the system where bed blocking and delayed discharge could occur. We shall build on the experience of last winter for the coming winter. I think that that will become a permanent feature of the system. In many areas, the co-operation has been so productive that the planning process has been extended year round, rather than focusing only on the key winter months for which it was originally developed.
In addition, the Health Act 1999 introduced new legal flexibilities to enable local authorities and health services to pool budgets, to have an integrated provider of health and social care and to have a variety of other means for overcoming problems in developing partnerships locally. Those powers became available only towards the back end of last year, but there is considerable local interest in developing them. We have pointed to the potential role of primary care trusts working with social services departments to use the new powers to avoid individual patients falling down the gaps between the health and social care systems, as we all recognise has happened too often in the past. Although I would not pretend for one moment that all those measures are in place on the ground, the planning mechanisms and the organisational powers are now in the system to enable such problems to be tackled more effectively.
In view of the lack of time, I want to ensure that I deal with the key funding issues that have been raised, although I should like to say more about health action zones. First, however, I will respond to the several hon. Members who asked for signs of our commitment to health action zones.
I have already said that we regard the zones as a key tool in tackling health inequalities locally. We have worked with health action zones in two areas. First, we have rightly impressed on the zones the need, when spending public money, to develop programmes that not only address individual problems but that have clear targets and outcome measures, so that we can evaluate their effectiveness and be sure that the investment is achieving the desired impact. In the first year, we worked closely with health action zones to help them to do that and to encourage them to take the process further.
Secondly, we have worked with health action zones on the mainstreaming of programmes to ensure that their activities, for example, work on coronary heart disease, do not become detached from the mainstream work and the developments of the national service framework on that disease. Real progress is being made on those issues locally, but we shall continue to work with health action zones.
It is important to recognise that the extra funding going into the areas covered by the health action zones this year represents an overall increase of 37 per cent.
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compared with last year. It is true that there have been changes in the balance of streams through which that money goes into the zones, but, by any measure, the resources have substantially increased.
When we launched the health action zone programme, we gave the zones a general indication of the funding that they might expect to receive over the comprehensive spending review period. Everybody recognised that that budget, like any indicative budget, could change in the light of experience and developments. Two significant developments occurred. First, last December we decided to provide through the deprivation allocation an extra £30 million to the health authorities covered by health action zones. That expenditure was not envisaged or predicted this time last year. We had built an initial £30 million of extra funding into the health action zone areas in the previous year, but the new expenditure raised that total to £60 million.
Secondly, it became apparent that there was a substantial underspend of health action zone funding. We had agreed to give some flexibility to allow for slippage and for the development of local partnerships. However, out of the £88 million that was available to health action zones in 1999–2000, about £23 million was unspent and carried forward into this year. Although every zone will give reasons for that slippage, it was much higher than we had anticipated or thought to be justifiable when we agreed to the year-end flexibilities. That is why we have decided not to allow slippage at the end of this year, although we will conduct precisely the sort of exercise that I think was mentioned by my hon. Friend the Member for Bethnal Green and Bow (Ms King) and by the hon. Member for North Devon (Mr. Harvey). We will review progress in about October to ensure that we can take action on any apparent problems. It is clearly important for public money that has been allocated for tackling health inequalities and deprivation to be spent on delivering the services that people want.
Ms Glenda Jackson: As far as my local HAZ is concerned, the Government's attitude is an indication of their desire to push HAZs into the mainstream delivery of NHS services—an approach that ignores local realities on the ground and sends markedly the wrong message to the partners. Early wins can be achieved, but they do not deliver in the long term, which is what most HAZs want to do.
Mr. Denham: My hon. Friend makes a very important point. We must engage the health service more effectively in the wider agenda of tackling health inequalities and ensure that the zones are properly engaged in shaping the mainstream delivery of national health services. I do not see the two matters as juxtaposed. What is important is an effective partnership to tackle the broader issues that are being tackled by the zones and by the national health service.
For this year, health action zone areas will receive a £60 million allocation on top of what would usually have gone to the relevant health authorities. Other resources include £40.5 million in programme funding for joint projects with other agencies; £10 million for smoking cessation, which had already been allocated; £7 million in innovations funding; and £2 million for

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drugs funding. That makes a total of £120 million. It compares with last year's total of £87 million and represents an increase of 37 per cent.
In the Budget, an additional £660 million was allocated to health authorities throughout England. I do not pretend that that point is central to the debate, but it is worth making it clear, especially as health authorities in the health action zones received an additional £215 million of that money. The funds were allocated according to the formula, but there was arguably an increase on last year's investment of more than £200 million in those areas. Although the balance of funding has varied, health action zones received substantially more from both the health action zone project and the wider increase in resources than they would have expected this time last year. They are an important Government initiative and will continue to receive our backing.
Mr. Deputy Speaker (Mr. Frank Cook): Order. The next debate is on the report of the Commissioner for Public Appointments.

NHS Appointments
11 am
Mr. Graham Brady: I am grateful for this opportunity to raise the important matter concerning the report of the Commissioner for Public Appointments, but I preface my remarks with a note of regret: that we are having this debate in Westminster Hall when the House of Commons Chamber is not in use. That is indicative of the way in which the Government treat the matter. It is also regrettable that it is necessary for an Opposition Member of Parliament to raise this subject for debate. The issue is of great importance. It has arisen from a report presented to the Government by an independent public body. The Government should have responded quickly in the House and, ideally, allowed an opportunity for debate.
It is almost four months since the report was published. It is unacceptable that the Government have taken that long to make a serious response to the commissioner's findings. It is typical of the Government's arrogance and their contempt of parliamentary scrutiny. It is also typical of their contempt for the public, who deserve an open exposition and discussion in Parliament of the findings of Dame Rennie Fritchie's report as part of our country's proper democratic process. The fact that the Government have sought to avoid that process and scrutiny is unfortunate.
However, as I say, I am pleased to secure the debate. I am fortunate that the balloting process has allowed me to bring the Under-Secretary of State for Health, the hon. Member for Birmingham, Edgbaston (Ms Stuart), to this Chamber to comment on the matter, but had the Government been prepared to make a statement or to allow debate in Government time, hon. Members of all parties would have found it easier to take seriously the Government's commitment to improve the process of public appointments in the national health service. It would also have been easier to accept that they were taking seriously such a careful and rigorous piece of work.
The Government's failure for so long to respond to the report reveals an unfortunate attitude towards the Nolan process and the drive to improve standards in public life. The Nolan rules were not intended to be a party political tool for the use of the Labour party when in opposition. They were a serious attempt to raise standards in public life and, in this context, to raise standards in the public appointments process. The Government's treatment of the report shows that they want to take Nolan à la carte. They want to decide when it suits them and when it is politically expedient to listen to the Committee on Standards in Public Life, without understanding the important principle that the public have a right to fairness and higher standards in public life and in the Government's conduct with respect to public appointments.
The Government have abjectly failed to take seriously a matter which is vital, not just because of the need for political balance in appointments—although of course that is important, as a matter of natural justice and because the general public do not like the smell of an appointments process that is patently politically biased. The most important aspect of the question is that

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relevant appointments are being made to the boards of health authorities, NHS trusts and, now, primary care trusts. The people concerned are entrusted with the responsibility of providing, through the national health service, health care of the standard that the public have a right to expect. It is a matter of serious concern if appointments to those senior national health service positions are not based on ability or merit, because the public are being short-changed by the appointment of people who are not up to the job.
I have said that the Government have not taken the matter seriously. The report from the Commissioner for Public Appointments was published on 22 March. Ironically, in an example of what has perhaps become a new hallmark of the Government—the failure of their attempts at spin and news management—the report happened to be published on the day when the Prime Minister presented a rather empty statement in the House on NHS modernisation. Hon. Members may recall that he offered little besides platitudes. However, one significant matter was on the agenda: the report on the Government's actions with respect to public appointments in the national health service.
My right hon. Friend the Leader of the Opposition raised the matter, telling the Prime Minister that he had
produced a system of appointments debased, corrupted and contorted by the crony culture that he has built all around him.
The Prime Minister did not even respond to that point. The hon. Member for Isle of Wight (Dr. Brand) may be pleased to hear that his party leader, the right hon. Member for Ross, Skye and Inverness, West (Mr. Kennedy), to his credit managed to wring a little more from the Prime Minister. After he had raised his concerns following the publication of the report, the Prime Minister began his response with the comment:
On that last point, the Secretary of State is announcing our proposals in response to what Dame Rennie Fritchie said.
That is all well and good, but the Prime Minister gave no details of his views on the matter or of the importance that should be attached to it.
When I was fortunate enough during the same exchanges to be called to put a question to the Prime Minister, I asked what action he would take to root out those who had been appointed other than on merit, and to appoint to NHS boards the best people for the job to ensure an adequate and appropriate standard of management. Frankly, the reply that I received was insulting. The Prime Minister said:
I shall simply refer to the following sentence of the Fritchie report.
He quoted not a sentence, but part of a sentence—a tactic that we have seen more often than we would like from the right hon. Gentleman. He quoted:
"The issue of…politicisation…is not new. The practice of inviting MPs to comment on the shortlists of candidates was first introduced by the Conservative Government…"—[Official Report, 22 March 2000; Vol. 346, c. 986–94.]
Had the Prime Minister completed the sentence, he would have added the words:
but has gained a new momentum since the last general election.
At the very least, the Prime Minister's response was evasive, and it set the tone for the Government's reaction to an important public document that raised a
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matter of public concern. The Prime Minister told us that the Secretary of State for Health would set out the Government's response to the report—but when? It was not later that day, when the Secretary of State for Health had the first opportunity to do so during debate on the Budget resolutions. The Government were hardly short of opportunities to put the matter before the House and stress the seriousness with which they regarded the commissioner's report. They were hardly short of opportunities to demonstrate their commitment to improving the process. Nevertheless, the Secretary of State did not set out the Government's response during the following month of April—nor in May, nor in June. I cannot help but think that he would not have done so in July had it not been for my good fortune in securing this debate.
We have already seen increasing press interest and speculation in the matter. A report in The Times suggested that the Commissioner for Public Appointments was "irritated" that the Government had not replied to her report, and reported that she had suggested that politicisation was still occurring in appointments to the new primary care trusts that oversee general practitioner services. Again, the Government do not appear to be taking those matters sufficiently seriously.
Mr. Crispin Blunt: I suppose one of the reasons why the Secretary of State for Health would not have been keen to reply in May was that the Labour candidate in the Romsey by-election was Andrew Howard, who was my opponent at the general election. Following the general election, he was appointed as chairman of the Croydon and North Downs Community Health NHS trust, but he resigned after 18 months to fight the Romsey by-election for the Labour party, leaving behind a bad taste among the people at the health trust whom he had abandoned. I am not alleging that Andrew Howard would not have been up to the job, but the fact that he has been popping in and out of a political career has not done the service of that health trust any good. I hope that my hon. Friend, and perhaps the Minister, will comment on that.
Mr. Brady: I am grateful to my hon. Friend, who makes an interesting and valid point. Perhaps, in the best tradition of political expediency, there has been a similar reason in each month since the report was published why the Prime Minister or Secretary of State for Health has found it inconvenient to respond to a report that has called into question the whole process of appointments in the NHS during this Government's term of office.
We saw little activity until Wednesday 5 July, when I heard that I had been successful in the ballot for a debate in this Chamber. Miraculously, two days later, on 7 July, the Minister sent a letter to the Commissioner for Public Appointments, partially responding to the report. The letter was placed in the public domain only yesterday by means of a written answer in the House of Lords, and the text of the reply was available only in the Library.
The Parliamentary Under-Secretary of State for Health (Ms Gisela Stuart): Will the hon. Gentleman remind me in reply to whom that answer was given? Is

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he suggesting that there was collusion between a member of another party over that question in the House of Lords?
Mr. Brady: I am sorry; I did not hear the Minister.
Ms Stuart: Does the hon. Gentleman know who asked the question in the House of Lords and to which party that Member belongs?
Mr. Brady: Yes, I do know, but I fail to see its significance.
Ms Stuart: Would the hon. Gentleman mind telling the Chamber to which party the Member who asked that question belongs?
Mr. Brady: I understand that it was Lord Clement-Jones, the Liberal Democrat Whip. I still fail to see the significance of the momentous point that the Minister is drawing to our attention.
Ms Stuart: It has been suggested that there was a connection between the timing of that question and our response. I have failed to establish a connection.
Mr. Brady: I now see what the Minister is driving at. Even if one leaves aside the obvious, well known and public connections that exist from time to time between the Labour and Liberal Democrat parties—I shall leave it aside, Mr. Deputy Speaker—the Minister will be aware that the Department of Health had another opportunity during the previous week, when I asked in a written question when a reply would be given to the Commissioner for Public Appointments. The response, which I received on 4 July, the day before the ballot for Adjournment debates in Westminster Hall, was that a reply would be given shortly.
Perhaps I am being uncharitable, but if Ministers had it in mind to sign a letter that was to be sent on 7 July, just three days later—they are not always punctilious about the timing of their written answers—would they not have either delayed the written answer so that they could give a substantive reply or said when a response would be given?
Mr. Philip Hammond: Will my hon. Friend remind me when the ballot took place that selected this subject for today's debate? Could that have influenced the timing of the Minister's letter?
Mr. Brady: Indeed; I draw what I think is the inescapable conclusion that it did influence the timing of the Minister's letter. The ballot took place on Wednesday 5 July. I say this in a charitable sense, because the Minister is an honourable lady and she used to live in Altrincham—I have a great affection for people who used to live there—but the reply was rather bland and anodyne. It did not add much to the sum of public knowledge, and it left Ministers with the flexibility to reply to the Commissioner for Public Appointments during July, or even during the summer recess, when they might have thought that they could sneak something out without scrutiny.
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Ministers might have found further reasons why it was not yet possible to reply—perhaps because another great review, this Government's favourite tactic, was being undertaken—and might not have replied before the autumn. We would then have had the wonderful prospect of returning in the autumn and once again trying to encourage Ministers to reply. If they had the best interests of the national health service at heart, and if they took seriously the importance of rigorous and proper scrutiny, fair conduct and the proper application of the Nolan rules in the appointments process, they would have chosen to reply much sooner than yesterday.
Instead, however, a report in The Times—not a theological text, but generally reliable—suggested last week that the Commissioner for Public Appointments had not been invited by Ministers to discuss the contents of her report, which was published nearly four months ago on 22 March. Ministers have now given a partial reply, but it is somewhat disturbing that that reply should be sent before they had taken the trouble to speak to the commissioner and to discuss her findings in detail. What kind of a reply can that be?
I started taking an interest in the matter owing to my experiences locally. It was impossible to avoid noticing the way in which the Government operated a process of political appointment in my area. It was so obvious, determined and regular that it was plain to everyone, whether greatly interested in politics or not, that a deliberate politicisation of national health service management was taking place. The term of the chairman of the Salford and Trafford health authority was not renewed—she was effectively removed—and a Labour councillor from Salford replaced her. A Labour councillor from the borough of Trafford joined as a non-executive director, which meant that a third of the non-executive directors on the health authority not only supported the Labour party, but were active Labour party politicians. That was compounded by the situation in my local health care trust, the chairman of which was replaced by a Trafford Labour councillor. The Government were not content merely to give him a single companion; instead, they added two further Trafford Labour councillors as non-executive directors.
The borough of Trafford has always been an interesting political microcosm. It is a mixed borough, and there are sharp divisions between different parts of it, not least in politics. The political make-up of the borough is now broadly even. The Labour party has a narrow majority on the council, but in each of the past three years—the whole electoral cycle—more people in the borough have voted for the Conservative party than the Labour party. In the local elections this year, that was an absolute majority.
I shall not argue for proportional representation—immediately the Liberal Democrat spokesman, the hon. Member for Isle of Wight perks up to contribute—on NHS boards. It would not be viable for the Government to argue that it was necessary to appoint three Labour councillors to the board of the Trafford Healthcare NHS trust to reflect the views of the local community. Doing so emphatically and demonstrably did and does not reflect those views.
Mr. Nicholas Winterton: I am following the good case that my hon. Friend makes, and he is clearly as concerned as I am that there should not

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be flagrant politicisation of appointments to the national health service. In his view, were the people who were not reappointed as chairmen and non-executive members of the health authorities in his area competent? In my area, we currently have an outstanding chairman, who is well respected across the political spectrum. He has done a wonderful job and has increased the morale of health service staff, but is threatened with non-reappointment, on grounds about which I have no idea. It would be a disaster for the continuing success of my trust if he were not reappointed later this year.
Mr. Brady: I am grateful to my hon. Friend, who is right to raise that important matter. In the local instances to which I referred, able people were not reappointed. I shall not comment generally on those who replaced them, as I should make it clear, from a sense of even-handedness, that I am not saying that all political appointees are not up to the job.
Ms Stuart: I ask the hon. Gentleman to comment on the letter sent to him by the chairman of the north-west branch of the NHS executive, Professor Joan Higgins, who wrote:
We looked for the relevant experience, appropriate skills and the potential to make a success of this challenging new post. The two candidates whose names have been submitted both scored very highly on these criteria. There was certainly no intention to promote individuals with a particular political affiliation at the expense of better qualified candidates.
Is the hon. Gentleman saying that there were better qualified candidates who were not promoted because they were not affiliated to the Labour party?
Mr. Brady: That is possibly so. I know of candidates of other political persuasions who, strangely, find that they are never called for interview or are called once and never again. That picture is reflected throughout the country. The Minister waves the letter in front of her but, in the case in question, I believe that there might have been people at least as well qualified, but with different political views, who were not offered the job.
The Minister raises an interesting case. An initial letter was sent to me on 11 April, in which my comments were sought on the shortlist for the appointment of chairman of the Trafford South primary care trust. I gave limited comments on the candidates because I know only one of them a little, but I commented on the process. I did not criticise the regional chairman, who was left to implement the rules given to her by Ministers and the Department of Health. I will not be diverted into a discussion of the political affiliations of the people involved in the process, because I do not know those of the regional chairman.
Mr. Hammond: The Minister is seeking to cite a particular case and has asked my hon. Friend to comment on it. Does he think that the Minister is in any way disputing Dame Rennie Fritchie's conclusion that less successful candidates have been brought forward to replace those already identified on merit? Dame Rennie's report was categoric about that, and the Minister's citing of an individual case will not alter those conclusions.
Mr. Brady: My hon. Friend makes an important point and is right to underline the significance that the
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commissioner's report attaches to the matter. The Minister has been bold enough to quote an example of an appointment, in relation to which an interesting situation has developed. I raised the issue of that appointment with the Commissioner for Public Appointments because I was concerned that it was evidence that the Department of Health had taken no action following her report of 22 March. I mentioned the fact that Members of Parliament were still routinely consulted on shortlists. One of those two candidates was a local Labour councillor who had already been appointed as a non-executive director of a health authority. We are getting into a compound situation in which such appointments are flowing thick and fast.
I was told by the regional chairman that the Labour councillor was the preferred candidate and that the process had been properly observed. I was left to conclude that that was the end of the matter and that the appointment would go ahead. I received no further communication until I received a newsletter from the health action zone, the front page of which told me that Professor Norma Raynes, a dynamic new chairman, had been appointed to the primary care trust. It is hard to understand what happened behind the scenes of that appointment. It was certainly a closed and odd process, in which the preferred candidate was not appointed. Perhaps the Minister can enlighten me further when she replies, or write to me on the matter.
I am conscious of time and of the fact that several hon. Members want to contribute to the debate. However, I want to raise some specific examples. I want to return to the point made by my hon. Friend the Member for Macclesfield (Mr. Winterton) about the competence or conduct of those in office. Last year, I was greatly concerned about the conduct of the Labour councillor who was appointed to chair the Trafford Healthcare NHS trust. That concern was shared by the medical advisory committee of the trust, which, as the Minister will know, complained that the Labour councillor had made a decision on party political grounds.
The decision in question related to the closure of wards, which was announced just one working day after the local elections. Statutory consultation would have been necessary prior to the decision, and it was explicitly stated that the decision should be kept quiet until after the local elections. I raised concerns about the matter, as did clinicians in the trust. In response to their complaint, an internal investigation was held. That investigation may have been thorough, but, ultimately, it sat on the fence a little. However, some of its comments were interesting. It stated:
a very real suspicion has been created in the minds of the senior doctors (who are actually very reasonable and feel they have a genuine grievance), and with some other senior staff who are not prepared to articulate this.
One can only speculate on why they are not prepared to articulate. None the less, when the decision on the chairman's term of office came up, she was duly reappointed.
I mentioned that story in an Adjournment debate last year on ward closures. I am pleased to say that, because due statutory process had not been followed, we managed to reverse the ward closures. I am therefore delighted that the three wards at Altrincham general hospital are now open.

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I raise that issue because it relates to the important point made by my hon. Friend the Member for Macclesfield. It shows the contrast between the reappointment of a Labour councillor whose conduct, at least in one instance, has been open to serious question, and the failure to reappoint other people who have done outstanding work for the national health service. I will give another example to show the contrast. It concerns a gentleman by the name of John Dutton, who has never been interested in politics or been a member of a political party, but is an active servant of the local community. He is a magistrate in Trafford, and I met him in that connection. His story gives rise to considerable concern.
Having been made a non-executive director of the Salford Royal Hospitals NHS trust in—I think—1996, John Dutton's appointment was terminated at the end of October 1999, despite outstanding service. Notably, he led a disabled access and disability discrimination programme, which became accepted as a leader in its field and was taken as model of best practice for many other hospitals. He was the chairman of the audit committee for three years, and the district auditor said that he had moved the hospital trust into the top three of his regional portfolio. His ability, commitment to the national health service and record of success in post could not be open to doubt. His only sins were that he was not politically affiliated, not a woman, and not a member of an ethnic minority.
In responding to concerns about the removal of capable members of trusts and health authorities, the Government claim that it has been necessary to increase the representation of women and ethnic minorities. I have no objection to that. Indeed, I support the increased representation of women and members of ethnic minorities in national health service management positions—but not under any circumstances, if those people are less able than those whom they replace.
Mr. Winterton: My hon. Friend has been extremely courteous in responding to my earlier intervention, so perhaps he would further say whether he is as concerned as I am that people who have given devoted service and outstanding commitment to the health service, and who are wedded to it, are being removed. He talked earlier about the process of appointment or reappointment. Is he not worried that the individual who has a major say in the north-west—the chairman of the north-west branch of the NHS executive—could be a member or strong supporter of the Labour party, as is my personal belief? She was appointed by the Government. I work closely with her; she is an able person, but might she not be prejudiced against people who do not meet what she perceives to be the Government's requirement in respect of appointments to such important positions? I am committed to my East Cheshire NHS trust and the work of its chairman, who is highly respected throughout the medical profession and political parties.
Mr. Brady: I am grateful again to my hon. Friend. The Minister challenged me on the political affiliations of Lord Clement-Jones. I do not know the political affiliations of the regional chairman, but perhaps the Minister does. Can she enlighten me?
My local experience led me to table some written questions, which yielded some important statistics. Between 1 May 1997 and 11 November 1999, a large
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number of councillors were appointed to trusts and health authorities. It amounted to one in seven of all appointments—that was noted in the Fritchie report—and meant that there was at least one councillor on most NHS boards. There was always someone with a political allegiance to communicate with others with the same political view.
Of those councillors, 284 were Labour councillors—83 per cent. of the total—36 were Liberal Democrats and 23 were Conservatives. In 1997–98, 27.8 per cent. of all appointments were politically active. In the following year, 22.8 per cent. of all appointees were politically active and in 1999–2000, the figure was again 27.8 per cent. Of appointees who had a political affiliation but were not local councillors, Labour party supporters comprised 77.7 per cent. in 1997–98, 77 per cent. in 1998–99 and 62.3 per cent. in 1999–2000.
Contrary to the views of the hon. Member for Brent, East (Mr. Livingstone), we are all grown up. I fully accept, as did the commissioner, that there may be political appointments. That is not a new worry, but after exhaustive scrutiny of what has been happening, she found that the process had gained new momentum and that the NHS had become subject to systematic politicisation.
The only other evidence that was available on previous political activity came from a survey conducted in late 1995 and early 1996. It stated that 8.5 per cent. of appointees declared no political activity, while 8.9 per cent. were Conservative and 7.6 per cent. were Labour. Quite rightly, the commissioner notes that it is not possible to say whether that was representative of the preceding years.
Ms Stuart: As we are all being grown up, I point out that, judging from the success rate according to political activity of those shortlisted in the hon. Gentleman's region of the north-west for NHS appointments since 1 January 1999, someone who declares a Labour activity has a 39 per cent. chance of being appointed, whereas a Conservative has a 56.3 per cent. chance. Will he comment on that?
Mr. Brady: I am tempted to take that as a compliment from the Minister. Perhaps I am making some headway on the matter. I suspect that it would be more relevant to consider the large number of appointments of Labour party members and councillors in my region. If the Minister looks at the numbers involved, a rather different picture may emerge. The commissioner stated in her report that
Certainly the figures since the General Election reveal a large influx of appointees who were and are politically active, particularly on behalf of the Labour party.
That is not new, but it has gained momentum since the election.
Dame Rennie Fritchie uncovered in her report an appallingly corrupt political culture, which is prepared to appoint people to public office entirely on the basis of their political outlook, without reference to their ability—a clear breach of the code of practice that the commissioner was appointed to uphold. Political affiliation dictates appointment and the best people for the job may not be appointed. The commissioner noted that

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many of the principles in my Code of Practice have either been, or risk being, breached in both their letter and spirit.
On political bias, the report states:
It is clear from the evidence presented to the Group that there have been examples of this, and that appointments have not always been made on merit… I would go further and conclude that the process has become politicised in a systematic way.
There are clear doubts about whether appointments have been made on merit. The commissioner was moved to comment:
Appointees are not honorary or "grace and favour", but full working members of the board.
If members appointed to NHS boards take the view that their appointment is a sinecure to reward them for other service, for loyalty or for keeping quiet, that is of particular concern.
I established from written answers that in March 1999 around £1.4 million was paid annually in fees via NHS boards to Labour councillors. Again, I do not claim that they were in all instances doing a bad job or were not fit for purpose, but as the commissioner pointed out in her report, in some instances they were—and that is wrong. The report states:
on occasion, the Government's goals for the representation of women and ethnic minorities have taken precedence in the process over the needs of a board.
I say in the strongest terms that, although increased representation by women and people from ethnic minorities is welcome, if those objectives take precedence over the needs of a board, the quality of NHS health provision will suffer for women, ethnic minorities, and the whole population. It is bad practice, which must be stopped.
It is disturbing that a recent written answer, which I received on 4 July, said that the process for appointments to primary care trusts is continuing in much the same tone. Not so many councillors are being appointed—I do not know whether that is because Labour is running out of councillors or because it is worried about the publicity that the process is attracting. Of those declaring political activity who were shortlisted for appointment to primary care trust non-executive director positions, 28.9 per cent. declared Labour party activity; of those appointed, 17.3 per cent. declared Labour party activity. Of the primary care trust chairmen, 30.6 per cent. of those shortlisted were affiliated to the Labour party and 23.5 per cent. of those appointed are Labour party supporters.
A week ago, a headline in The Times stated: "Milburn chided over NHS trusts". The article noted that there had been no response to the commissioner's report. Yesterday, however, there was a response from the Under-Secretary, which was sent to the Commissioner for Public Appointments. It was, at best, half-hearted. It is obvious that it was rushed out because the political imperatives were starting to catch up with Ministers.
Mrs. Virginia Bottomley: Does my hon. Friend think that it is disgraceful that the reply came from the Under-Secretary, not the Secretary of State? Is not that an indication of how insignificantly the Government regard the matter? Does my hon. Friend share the worry of those who believe that combining the
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role of chief executive in the NHS with that of Permanent Secretary means that integrity and propriety in public life will not be so carefully safeguarded?
Mr. Brady: I am most grateful to my right hon. Friend, who makes an important point about the proper management of the national health service. As the debate is being held in this odd hemicycle, I had not noticed that my right hon. Friend was here; her very presence shows the importance that some former Secretaries of State attach to these matters. They are still prepared to devote their time and energy to proper management and structures in the national health service and Ministers could learn a great deal from their example.
I have annotated the Minister's letter; I do quite a lot on education policy and I have been accused of behaving like a school teacher. I have marked the hon. Lady's response because it is at best half-hearted and inadequate. It does not say what it means, which is typical of Ministers in this Administration.
The Government say that they will "implement immediately" several recommendations of the Fritchie report. On recommendation 4, their response is halfhearted. They say:
We already make it clear that nominees are treated in exactly the same way as candidates from other sources.
That suggests that what is recommended has already been done, but although it is in the rules, it is not being enforced or implemented. The response continues:
The Government accept that Members of Parliament should not routinely be consulted on short lists for appointment,
which is welcome. It goes on:
We agree that secondary appointments should be exceptional and subject to open competition.
They have agreed to publish the full guidance about NHS appointments on the internet, which is also welcome.
Under the heading
Recommendations on which action has already been taken
are recommendations followed by the action that the Government claim to have taken:
Recommendation 1. Ministers should commission a fundamental look at the role and purpose of NHS boards.
That is what they say is being done.
Recommendation 2. In the light of that review, Ministers should draw up fresh job descriptions.
The Government reject that recommendation completely; they state:
The job description and person specifications have been satisfactory in recruiting people currently on NHS boards.
That is not what the Commissioner for Public Appointments stated in her report; she found that the specifications were inadequate and resulted in people being appointed who were not fit for the purpose.
Recommendation 3 is that there should be a review of the appointments process. The Government responded as follows:
We have introduced a system of regular appraisal to assess the performance of those who have been appointed.
That does not answer the point. Recommendation 8 was not accepted, and nor was recommendation 12, although recommendation 13 was agreed to.

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Recommendations 16, 22 and 26 were not accepted. They are listed under
Recommendations on Which Action Has Already Been Taken
but many of them are flatly rejected by Ministers who say one thing and do another. Those recommendations are followed by a list of
Recommendations Which We Do Not Intend To Implement.
With unusual candour, the Government say that they do not agree that local authorities should not be permitted to nominate people for such purposes. In response to recommendation 9, which questions whether having so many councillors on NHS boards is a good thing, they say:
Councillors constitute only 10.6 per cent. of non-executives on NHS boards.
That seems quite a lot.
I am conscious of the time. I wish that I had time to go through all of the requests, platitudes and drivel in the rather rushed reply from the Minister to an important, serious, thorough and rigorous report. It is sad that the Government have not taken the commissioner's report seriously. It is even sadder that they do not take the fundamental issue seriously and are not concerned about whether the right people are being appointed to do the best possible job in NHS trusts and health authorities.
Several hon. Members rose—
Mr. Deputy Speaker (Mr. Frank Cook): Order. I have reserved the comments that I am about to make until this point because I wanted to make certain that I did not engage in the argument of the day. The hon. Member for Altrincham and Sale, West (Mr. Brady) gave the impression in his opening remarks that this Chamber is somehow subordinate to other parts of the House. I must correct that for the benefit of all hon. Members present. This is as much part of the House as any other Chamber. Any right hon. or hon. Member seeking a 90-minute Adjournment debate, which this debate is, used to be free to apply for a 90-minute slot in debate on the Consolidated Fund Bill. It is not possible at the moment to get a 90-minute slot any other way than in this Chamber under the system that the House has decided to operate.
11.52 am
Mr. Andrew Tyrie: I shall be very brief. My hon. Friend the Member for Altrincham and Sale, West (Mr. Brady) has said a great deal, very effectively, about an issue that has become of increasing concern to many of us over the past three years. Perhaps I should make things even briefer by asking three questions. Where has the problem come from? How bad is it? What should we do about it?
On the origins of the problem, it is clear that the Government decided early on to put large numbers of councillors on NHS trust boards. At first, it seemed like a reasonable attempt to increase local representation, but soon people became concerned that it was a ruse to put a higher proportion of Labour and Labour-inclined people on trust boards. At the time, the Conservatives had been in power for so long that Labour was
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disproportionately represented in local government. We heard that concern in our constituencies as early as late 1997.
Independently, Sir Len Peach, Dame Rennie Fritchie's predecessor, also became concerned. In particular, he noted that the consultation process for getting nominations from councillors to the boards had been sent to council leaders and not to chief executives. As a result, many Conservative councillors never got to hear about it and could not apply. As the ultimate in bias, they were not even given the opportunity to put their names forward.
I raised the matter with the right hon. Member for Holborn and St. Pancras (Mr. Dobson), the then Secretary of State for Health, when he came before the Select Committee on Health in February 1998. He denied that a slapdash approach had been taken to soliciting nominations impartially. I did not accuse him of political bias. I did not know whether political bias had been involved, but I was aware of widespread anxiety about at least the impression of political bias.
The then Secretary of State's response was that the issue
has only generated an impression of political bias with the Conservative Party
and that the suggestion had been generated
by the Conservative Party and most of the things that they have drawn attention to have been factually incorrect.
He dismissed my anxieties by repeating those words over and over again.
We now have some evidence, in the report. I shall not go through all the evidence, because I do not have time, but it is overwhelming. I draw the Minister's attention to page 15, which shows that, of local councillor appointments made between 1 May 1997 and 11 November 1999, the number of Labour appointments was 284 and the number of Conservative appointments was 23.
Is that a fair reflection? I am not suggesting that the figures should constitute an exact proportional representation of the current disposition of political forces in this country, but what possible justification can there be for 284 against 23? Might it be that Conservative councillors were of such poor quality that they could not be appointed on merit grounds, whereas Labour councillors were of such outstanding quality that they were all swept into appointments? It is absurd and disgraceful that such an appointment rate should have been allowed to persist.
The first of Dame Rennie Fritchie's conclusions has already been clearly set out by my hon. Friend the Member for Altrincham and Sale, West. She says clearly and unequivocally that
the process has become politicised in a systematic way.
The Government have a great deal of explaining to do if, in light of those numbers, we shall not have to conclude that she is right.
Dame Rennie Fritchie's second major conclusion is that her code of practice for appointments has been completely ignored. The conclusion of the section on the code of practice, on page 33 of the report, states:
This assessment reveals that many of the principles in my Code of Practice have either been, or risk being, breached in both their letter and spirit.

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That is strong stuff from the public appointments commissioner, and I am deeply worried that the Government have been rather cavalier in their response.
It is true that anxiety has been expressed about public appointments for many years and that many accusations have been made by Labour Members about Conservative appointments to trust boards and other quangos. In the past, the Conservatives appointed a disproportionate number of business men to such posts, and in particular to NHS trust boards. They did so with the worthy intention of trying to bring more business practice and understanding into the NHS, which was a valuable step forward. As Conservatives may be more plentiful in the business community than in other parts of the community, that may have resulted in some bias, but nothing could possibly compare with the figures—284 to 23—that I cited.
We desperately need, as a response from the Government, a clear statement that they will do what is required to restore public confidence on the issue. Public confidence has been badly compromised as a result of the findings in Dame Rennie Fritchie's report. In particular, it is essential that the Government get out of their state of denial on the issue—their conviction that nothing has gone wrong. We need to hear the Minister admit today that mistakes have been made in the appointments system—that there has been some political bias, and appointing on grounds other than merit—and that the Government will do something about it. The best thing that they can do is endorse the recommendations in Dame Rennie Fritchie's report. I hope that the Minister will feel able to do that, because it is the only way in which we can restore public confidence on this crucial issue.
12 noon
Dr. Peter Brand: I congratulate the hon. Member for Altrincham and Sale, West (Mr. Brady) on securing the debate. However, I am not too sure whether his concern is about the national health service or the scoring of party political points, which he did at tremendous length.
A long time ago, I served as a member of a health authority for some 10 years. I was nominated by our local medical committee, the British Medical Association and my royal college, as was my consultant colleague. We had nominations from the voluntary sector and from local authorities. That made for a broadly based health authority, which, although not very efficient, was certainly effective in meeting the criteria of involving the community that the hon. Member for Southampton, Itchen, (Mr. Denham), the Minister of State at the Department of Health, mentioned.
The first warning signs went up under a previous Government when nominating bodies were told that they had to nominate more people to fill a post than the number of vacancies in it, to ensure an opportunity for central direction by the Secretary of State. I am pleased to say that the bodies that nominated me failed to heed that instruction because it was thought to override local interest. We then had one of the organisations that we in
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the NHS suffered as time went on. The nature of health authority members changed dramatically and they became more akin to the non-executive members of public quoted companies. It was clear that the Secretary of State was seeking a different type of being to serve on that board. There was no longer a requirement to live in the area that one was serving, and all the concentration was on getting people with business and financial experience.
It is in the nature of such people that they do not have time to enter public life through the political process. Therefore, it may be true that no overt political activities were involved with those appointees. From my experience, however, it was also clear where their political allegiances lay. Today's debate is something of a sterile exercise. I am not surprised that the Government made changes after the last general election. They did so most inelegantly, somewhat brutally and at times stupidly. They overdid it, and I believe that they have recognised that things did not go well.
I am amazed at the tone of this morning's debate. It has been suggested that there is something disreputable about being politically active, that the political process should not be a route to making a contribution within the NHS. That is wrong. I welcome people of all persuasions taking an active part in public life rather than doing so through—
Mr. Tyrie: The hon. Gentleman says that people of all persuasions should participate. Does he think that participation of 284 Labour councillors and 23 Conservative councillors is participation of people of all persuasions?
Dr. Brand: I pointed out that the Government overdid it and that we were critical of them at the time.
I am concerned not about the politicisation of the process but about the continued patronage involved. That has gone on under succeeding Governments. Appointment to a national health body has become a second or even first career for some people, leading to well-paid appointments in quango-land. Those appointed have lost the independence of spirit and mind that comes from being democratically elected by a hinterland representing the community.
I shall differentiate between commissioning bodies and provider bodies. The democratic deficit in commissioning bodies is regrettable. The Government should rethink their response to Dame Rennie's report, which is extremely useful as a starting point for dealing with the issue. Commissioners of health services should be firmly based in the local community and democratically accountable, perhaps at local authority level and certainly at regional level. In provider trusts, it is right for a spread of expertise in the non-executive functions to be available to managers and commissioners. I welcome the fact that people from different backgrounds are being appointed on the merit of their contributions. Dame Rennie Fritchie's recommendations in that regard are extremely important.
In the past 20 years, the process has involved an unhealthy power of patronage. I applaud the many people who have made enormous contributions as non-

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executive members of health authorities and trusts, but they have always had to look over their shoulders in exercising their functions. It is important that the Government produce a substantial response to the report, which also examines the role of NHS boards. Is it the purpose of the boards to control the bottom line—the financial outcome? Is it their prime function to guide officers and managers of authorities and trusts in providing the service mix most suited to their locality? I am sorry that we have not devoted more time to that important issue, instead of having a slightly cheap knockabout.
12.7 pm
Mr. Philip Hammond: I cannot agree with the final remark made by the hon. Member for Isle of Wight (Dr. Brand). My hon. Friend the Member for Altrincham and Sale, West (Mr. Brady) highlighted two important issues: the damning conclusions of Dame Rennie Fritchie's report and the Government's contemptuous treatment of those conclusions.
I congratulate my hon. Friend on securing the debate and on his interest in the subject. I know that his interest was originally stimulated by particularly nasty examples in his constituency of the practices that he described. My hon. Friend has done Parliament and the health service a great favour with his persistence in bringing such matters to wider attention, culminating in today's debate, which has forced the Minister to make a response, however interim.
It is somewhat ironic that although the Government came to office claiming that they would clean up public life, remove suspicions of impropriety and sleaze, and depoliticise the appointments process, they have presided over a massive increase in the politicisation of that process. They have introduced a culture of cronyism into the national health service and elsewhere. The Minister's interventions on my hon. Friend seemed dangerously close to displays of complacency. She appeared to suggest that there was no problem; that Dame Rennie got it wrong and that there is nothing to worry about.
My hon. Friends the Members for Altrincham and Sale, West and for Chichester (Mr. Tyrie) recited many of the findings of Dame Rennie's report. I shall summarise the most important points. The report concluded that the process of appointments to national health service bodies had been politicised in a systematic way and that the code of practice, which is supposed to govern those appointments, had been ignored. It said that there were clear examples of a candidate's political association acting as the decisive factor in his or her early selection and appointment and found evidence of the parachuting in of candidates at the instigation of Ministers at a late stage in the process as a result of lobbying by Members of Parliament.
Those practices meant, as my hon. Friends said, that 83 per cent. of councillors who were appointed during the first three years of the Government's term in office spent the first two and a half years as Labour councillors. It is important to recognise that that is against the backdrop of a significant decline in the number of Labour councillors. Four or five years ago, the Labour party had great plurality in the total number
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of local councillors, but the number of councillors from the two main parties is now almost equal. That makes the disproportion in appointments more shocking.
My hon. Friend the Member for Altrincham and Sale, West referred to the Prime Minister's partial quote of Dame Rennie's finding that politicisation of appointments is not new. We know and accept that. The Labour party identified politicisation in NHS appointments before the general election and said that it would do something about it. What it did not say is that it intended to accelerate that process and bias it in favour of one political party. Dame Rennie noted that the process
has gained a new momentum since the general election.
It has indeed taken a quantum leap. She also noted that, as a result of the process,
less successful candidates have been brought forward to replace those already identified on merit
on the grounds of promoting equal opportunities.
Real talent has been lost to the national health service. The NHS is too important to be a plaything of political correctness. The boards run one of the largest organisations in the country. They spend a budget which, over the next three years or so, will rise to £68 billion. That is a tremendous sum of money. They face an enormous task. Anyone who has talked to people who are engaged on the boards will know that the work load and demands are significant. My hon. Friend the Member for Macclesfield (Mr. Winterton) made the point that the process has driven many people from providing their expertise to the NHS.
Let me give an example of the way in which the Government, especially in their first year of office, treated people who gave their time to benefit the NHS. People in my constituency who had served on the boards for a long time and whose appointments were due for renewal were sent letters explaining that, because their appointments were coming to an end, they should refrain from participating in significant decisions in the period before their last day.
Mr. Tyrie: Thank you and goodbye.
Mr. Hammond: It was worse than that. They received no further communication, although in one case the retiring chairman of an NHS trust received a letter two weeks after his appointment had terminated informing him that the Secretary of State had decided to reappoint him. His reply was, "Too late, mate; I've already found something else to do"—another valuable talent lost to the national health service as a result of the Government's incredibly incompetent process.
Mrs. Virginia Bottomley: Does my hon. Friend recall the head of a Newcastle trust, Ann Galbraith, who led for the NHS on the citizens charter team? She did not know that she was not to be reappointed until her successor telephoned to ask whether she could make arrangements for handing over.
Mr. Hammond: My right hon. Friend is absolutely right. There are examples from all over the country. I do not want to cite dozens of individual cases because we do not have the time, but I would like to quote an additional global figure, which is telling, that neither my

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hon. Friend the Member for Altrincham and Sale, West nor my hon. Friend the Member for Chichester gave, although I am sure that both of them are aware of it. The figure was produced by the Library and shows that of the 87 appointees to national health service trusts in the Greater London area from May 1997 to 3 April 2000 who had declared political allegiances, 76 had allegiances to the Labour party. That figure is shocking.
What staggers and worries me so much is that the Secretary of State already has enormous power to direct and to control the national health service, which is a hugely centralised bureaucracy. Yet the Labour party apparently feels it necessary to install a second shadow control network, almost like the system that used to operate in the red army, in which there was a formal command structure and a system of political commissars who shadowed decisions and checked on the political correctness of what was being done. Many chairmen of NHS trusts and health authorities find that it is not unusual for them to be in direct communication with politicians. Two systems of control now operate in the NHS—the formal one and the political one, which operates at a different level. That should give us great cause for concern as we proceed with the plans for the development of the NHS that the Government are to announce shortly.
I want to leave adequate time for the Minister to respond to my hon. Friend the Member for Altrincham and Sale, West, so I will ask just a couple of questions. When will the Government make a full response to the findings of Dame Rennie? Dame Rennie has made it clear that she regards the Minister's letter to her as no more than an interim response. Will the Minister tell us why it has taken so long to deliver even that inadequate interim response? Will she say why the Government were so reticent in talking about the issues after the Fritchie report was published and why they have chosen not to offer Dame Rennie the opportunity to discuss her findings with Ministers?
The Government's behaviour following the publication of the report has been a gross discourtesy to Dame Rennie and to Parliament. A report so damning of the Government has simply been ignored and only now, through the securing of this debate, have we dragged any response from them. We need to hear an assurance today from the Minister that there will be immediate action to implement the report's recommendations and that she will review the appointments that have been made under the flawed process since 1 May 1997. Further, she must ensure that all appointments were appropriate. She must assure us that, where they were not appropriate, and the postholders have not been performing the required function because of the way in which they were appointed, she will take steps to ensure that proper appointments are made in their place.
12.18 pm
The Parliamentary Under-Secretary of State for Health (Ms Gisela Stuart): I start by congratulating the hon. Member for Altrincham and Sale, West (Mr. Brady) on securing the debate. Unlike him, I am extremely proud to be in Westminster Hall, which provides us with extra time in which to discuss issues.
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The hon Gentleman was extremely misguided to treat it as a secondary Chamber—it is as important as the House. I acknowledge the hon. Gentleman's longstanding interest in public appointments and I welcome the opportunity to respond to Dame Rennie Fritchie's comprehensive report. Time is short, but I want to respond to a couple of specific points that have been raised.
The hon. Member for Runnymede and Weybridge (Mr. Hammond) asked when there would be a full response. I am very sorry that the right hon. Member for South-West Surrey (Mrs. Bottomley) regards it as an insult that an Under-Secretary, and not the Secretary of State, wrote to Dame Rennie Fritchie. However, in that letter I made it clear that, as part of the national plan, we are examining the whole process relating to accountability in the national health service. The role of non-executive directors will be extremely important.
I recollect that, in a Select Committee, an Opposition Member who had formerly served in the Department of Health described the appointments process at that time as highly politicised, with civil servants involved at a great distance and outcomes determined by chance, because it was not possible to foresee what would happen. The implication that the world was well, holy and wonderful before 1 May 1997 and has now gone down the drain suggests the need for Opposition Members to get in touch with reality.
Mrs. Virginia Bottomley: The hon. Lady would be well advised to consult the Nolan report. That was favourable about the new procedures for health authority appointments, which have been established in no small measure because of Dame Rennie Fritchie's work. My point was simply that the matter is of such importance that the Secretary of State should have responded to Dame Rennie.
Ms Stuart: As I have said, what we are doing is part of the development of the national plan. Dame Rennie Fritchie's report was extremely helpful to us. In our initial response, we outlined the areas in which implementation has already taken place. We disagree over one or two aspects of the report, but as the national plan developments become clearer, we shall work closely with Dame Rennie Fritchie on further development.
Mr. Brady: Will the Minister give way?
Ms Stuart: I should like to continue. Time is needed for a proper response to a one-and-a-half-hour debate.
To listen to the debate, one would think that serving on an NHS board is some kind of gravy train on to which Labour councillors have jumped, with decisions made in smoke-filled rooms. The record should be put straight. The vast majority of members who serve as non-executive directors are lay people who ensure that the needs of their community are represented. They carry out an extremely important function. There are 3,000 of those public-spirited individuals. I agree with the hon. Member for Isle of Wight (Dr. Brand) about the decline in volunteering to serve in such public capacities. However, I remind Conservative Members that, in the past three years, one in four or one in five of

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them has responded to requests for nominations. If Conservative Members do not put names forward, they should not be surprised at not having any selected.
Mrs. Bottomley: Every name that I put forward was effectively black-balled. I put forward several names and every time the other individual was chosen. The hon. Lady might want to investigate that. The people whom I suggested were not, as far as I know, Conservatives.
Ms Stuart: That brings me to a useful point made by the hon. Member for Isle of Wight, who said that presenting the choice of two names was a positive step. I am terribly sorry to come across the attitude among Members of Parliament—it has come up in a previous Adjournment debate—that, having made their choice of who should be selected, their wishes have been ignored. The process involves an independent panel and a proper review. On the basis of the assessment, a choice is made. Sometimes those who are involved will not think that the best person has been chosen, but the proper process will have been used.
The achievements in the appointments process since 1997 have been not insignificant, not least because a far greater number of women now serve on NHS boards. That number has increased from 39 per cent. before the general election to 48.9 per cent. Even more dramatically, the number of black people and members of ethnic minorities has increased from 5 to 12 per cent. We should be careful when we use words such as "merit" and "ability". If the definition of merit is having a white, middle-class background, it is hardly surprising—
Mr. Brady: Will the Minister give way?
Ms Stuart: No, I shall not, as I want to make progress.
An equally successful but more important change is the increase since 1997 in the number of appointments of people with a community background. The proportion of people who are appointed from the voluntary sector and who are primarily users or carers has increased to 20 per cent. We do not for one moment deny that our boards still require the skills of business people, but the need for far wider representation remains. Dame Rennie Fritchie's report should be considered with those increases in mind.
I remind hon. Members that an independent auditor's report has been produced by Ernst and Young, which was employed by the commissioner. The report found that
in 1999, 75% of applicants for posts on NHS boards in the Northern and Yorkshire and North West Regions had declared "no political activity".
It went on to state:
The data available suggest that the proportion of candidates declaring political activity at the application stage of the process are similar to the proportions declaring political activity at the appointment stage.
Before anybody is appointed or even shortlisted, an independent panel conducts a sifting and assessment process. It would be disingenuous to suggest that anybody is parachuted at the last moment without having gone through that process, as that is not happening.
Mr. Tyrie: I am grateful to the Minister for giving way, as I realise that she does not have much time. She
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is saying that there is no problem and that we are making all of this up. Will she explain the fact that 284 Labour councillors were appointed between 1 May 1997 and November 1999, while only 23 Conservatives were appointed in that time? Does she believe that that can be described as anything else but political bias?
Ms Stuart: It is important to remember the number of people who put forward their names. I would not be at all surprised if more Labour councillors were prepared to put their names forward and to enter the selection process after May 1997. I would like to hear not merely about disagreements, but about evidence of widespread and systematic abuse of the system in the interview and selection process. The Government are responding to the needs of the whole chain of accountability in the national health service. I deeply reject the notion that everything was fine before 1997. Dame Rennie Fritchie referred to the courtesy with which people who are retiring are treated and to delays in appointment. We have addressed those points and moved forward.
I should like to correct the impression that the previous Secretary of State, my right hon. Friend the Member for Holborn and St. Pancras (Mr. Dobson), wrote only to council leaders. An administrative error occurred when the first round of letters was sent, but now all of them go to council chief executives, so the opportunity to put names forward is shared equally among other parties.
Our response to the report lists a number of improvements that we have already put in place and others that we are considering. We agree with Dame Rennie's recommendation that Members of Parliament should no longer be asked to comment on shortlists for chair appointments. We inherited the practice from the previous Government—
Mr. Brady: Will the Minister give way?
Ms Stuart: No, I will not. There are two minutes left, and the hon. Gentleman spoke for 45 minutes. If he wants to hear an honest response, he should listen for a moment.
The practice of allowing Members of Parliament to comment on shortlists gave the impression that the process was politicised. We are happy to change it and are writing to hon. Members about it.
We part company with Dame Rennie on her view of local councillors, whose role we believe to be extremely important. They bring to their posts local knowledge of the community, which our NHS boards are supposed to reflect. There is no presumption, however, that being a councillor is an advantage in the interview and assessment process.
We will proceed with our proposals on the national plan. It is important that the right people are appointed, but we want more people from the regions to come forward as part of the plan. We shall announce further details, but we shall work closely with Dame Rennie to make that process more accountable and open, and to ensure that people see it as such.
Mr. Deputy Speaker (Mr. John McWilliam): Order. I am sure that the Under-Secretary would not wish to

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mislead the Chamber. The hon. Member for Altrincham and Sale, West (Mr. Brady) spoke for 52, not 45, minutes.
Mr. Brady: On a point of order, Mr. Deputy Speaker. I did overrun, but only because I gave way generously to all hon. Members, including the Minister.
Mr. Deputy Speaker: That is not a point of order. I call Mr. Livsey.

Hyder
12.30 pm
Mr. Richard Livsey: I am grateful for the opportunity to debate the impact of the proposed takeover of Hyder plc on water, gas and electricity services. In the mid-1980s, the Liberals initiated a debate on the future of the water industry. When the then Secretary of State for the Environment, the late Nicholas Ridley, was challenged on whether he would privatise the water industry, amazingly, he said yes. He was then asked whether he would include that policy in the next Conservative party manifesto. Again, he said yes—much to the amazement of the Conservative Members sitting behind him, as he was announcing an entirely new policy off the cuff.
The Thatcherite juggernaut steamrollered on, and we have now reached a point when Hyder, one of the successor companies to the water authorities, could be taken over by a Japanese bank or an American power company. As for the Welsh assets, the choice is between a rock and a hard place. John Elfed Jones, chairman of Welsh Water, or Dwr Cymru, built up the company in the late 1980s. It was meant to be an enterprise icon for the new Wales, and it might have happened. However, once Mr. Jones retired, the Government's golden share was abandoned and the public veto therefore disappeared. Hyder was created by a new management team and in its early days that company, too, was successful.
We could dwell on why Hyder failed, but I do not want to speak of the past except to say that the Government levied a windfall tax of nearly £300 million, the regulators imposed full-value cuts on the company and the City forced it to borrow to buy Swalec. The Government and the City took £400 million out of the company, the regulators took another chunk, and the shares lost half their value; the company is now said to be £1.5 billion in debt.
After that debacle, Wales wants a phoenix to arise—a company based in Wales that will take over the water, electricity and gas businesses and which can provide services of good quality and value. I want the Minister to ensure that that will happen because the Government contributed to Hyder's downfall. The Welsh word "hyder" means confidence. I ask the Minister to give us confidence that the company will have a good and successful future.
Hyder has one of its headquarters in my constituency, where it has 60 employees. Its water division, Dwr Cymru, has 14 major reservoirs and associated land in my constituency. The three Taf Fechan reservoirs supply Cardiff, Talybont reservoir supplies Newport, Crai reservoir supplies Swansea and the four Elan valley reservoirs supply Birmingham and so forth. We want to be assured that the former massive public investment and the jobs that go with it will be in safe hands. Hyder employs about 9,000 people in its water, electricity and gas businesses. Their future must be secured.
Mr. Nigel Evans: Does the hon. Gentleman remember that, when the windfall tax was introduced, we were told that it was a victimless crime? However, it has put Hyder into an impossible situation and it is now up for grabs, with two companies

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interested in buying it. Does he agree that if it goes wrong, the victims of the windfall tax will be those employees who work for the company and consumers in Wales who receive their utility supplies from it?
Mr. Livsey: I certainly agree that that is the case; the cause is partially the Government's, but it is not theirs alone. The Liberal Democrats believe that the successful new deal ought to have been financed differently.
The Minister will know that two takeover bids for Hyder are on the table—one from the Japanese bank Nomura and the other from Western Power Distribution, an American subsidiary of Southern Power that generates electricity. It distributes electricity in the west of England and has its headquarters in Bristol. WPD wants to run Swalec and arrange for United Utilities, which is based in Warrington, to run the Welsh Water business in conjunction with North West Water. There are serious reservations about competition regulations connected with the WPD bid. Those issues must be handled in the United Kingdom. Nomura International, through St. David's Capital plc, is bidding for Hyder, and it intends to make it a Welsh-based company, operating from its Cardiff headquarters.
All political parties in the Welsh Assembly have agreed a strategy, which must succeed in the interests of Wales, Welsh consumers, the company's employees and the company and its assets. I can do no better than to state that strategy. It says that any new company should:
preserve the integrity and identity of Hyder as a distinctively Welsh business and keep its headquarters in Wales…preserve the maximum number of jobs and, as a minimum, limit the number of job losses to those already announced by Hyder plc and agreed with trade unions.
It then states that it must be
committed to investment and development of the regulated and non-regulated businesses of Hyder plc
and that, as a minimum, it must
maintain Hyder's environmental record and implement the Dwr Cymru investment programme within existing price limits.
It states that it must
note that the Assembly has a duty under section 121 of the Government of Wales Act to promote sustainable development (and that the Assembly has powers to call in applications for planning permission for decision under section 77 of the Town and Country Planning Act 1990 where an application raises planning issues of more than local importance).
Next, it states that a new company should
recognise the potential of Welsh water as an economic resource and acknowledge the wish of the National Assembly that the people of Wales should benefit from the use of this resource, especially when water is sold outside Wales…provide a high quality water and sewerage service for the people of Wales, and a high quality electricity service for the region of Wales that depends on SWALEC.
Finally, the strategy stated that the new company should
operate a fair pricing policy and consider the formula set by the industry regulators as setting the maximum charge to be levied, rather than the norm.
I cannot underestimate how important water is as a natural resource to Wales, especially as water will one day be in short supply worldwide. The First Secretary of the National Assembly endorsed the views of the Environment, Planning and Transport and the
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Economic Affairs Committees, which drew up the statement that I just quoted. The Liberal Democrats in the Welsh Assembly endorsed that statement only too willingly.
The First Secretary has written to the Secretary of State for Trade and Industry about the competition worries resulting from the Western Power Distribution bid. He endorses the Assembly Committees' calls for the bid to be repatriated to the United Kingdom from the EU competition authorities under the provisions of article 9 of European Community Council regulation 4064/89 as amended by regulation 1310/97; he also confirms that the UK should be enabled to take appropriate measures under the provisions of article 21. I hope that the Minister will deal with that matter.
Our main concerns are the combination of two neighbouring electricity distribution businesses, Swalec and SWEB, and the fact that the United Utilities company, under its other aegis of North West Water, will be supplying water in two contiguous geographical areas. Those concerns are to the fore in Wales. The link between the two water companies—United Utilities and what is at present Dwr Cymru—will not be conducive to the promotion of competition in the water industry. Hon. Members will know that the Assembly issued a joint consultation paper with the Government on the subject earlier in the year.
The separation of the ownership of Dwr Cymru's assets from its operations, as well as the possible creation of a mutual company to own it, raises wider regulation issues. The resulting modifications that the Director General of Water Services proposed to the Dwr Cymru licence might raise the possibility of the Assembly using its powers of direction under section 13 of the Water Industries Act 1991. If it did so, the director general would have to consider whether he wanted to pursue the proposals by way of a reference to the Competition Commission and section 14 of the Act. No apparent implications from the bid give rise to competition considerations outside the UK. Such considerations in the UK are sufficient to provide grounds to seek repatriation under article 9. Wider measures may be appropriate under article 21, as well as public interest issues and concerns such as those identified by the Assembly Committee, which have been communicated to the commission.
The First Secretary and all the political parties in Wales believe that there is strong reason to refer the WPD bid to the Competition Commission. The Minister should be able to assure us that that will be done. The bid must be repatriated from the European Union competition authorities, in particular its electricity supply aspects. I have already mentioned those concerns as they affect the water industry. At present, it appears that the Nomura International bid satisfies UK competition criteria but the WPD bid does not. In the public interest, I ask that public documents relating to WPD's relationship with United Utilities are made available and placed in the Library. They have a material influence on how the company proposes to manage Welsh Water, given that there will be two water companies operating geographically side by side.
The deal is complex and it also affects other businesses and professional services operated by Hyder. Another factor that must be accounted for is that the United States controlling company, Southern Power, must

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clear its bid with the US Securities and Exchange Commission. So far, it has not done so. There may well be conflicts with Southern Power taking over, through its WPD subsidiary, a water company, for example. That process must be monitored and examined in the United Kingdom not only by the Office of Fair Trading, but more importantly by the Competition Commission.
Will the Competition Commission exclusively handle the WPD bid for Hyder? What key points can the Minister assure us will be primarily considered by the Department of Trade and Industry in the investigation? I am especially concerned about those matters that will have a material influence on the final decision. Will the Minister give us the timetable leading to the conclusion of a Department of Trade and Industry decision? What time scale would that process have? Time is not on Hyder's side and an early conclusion of any investigation will give confidence to its customers in Wales, its work force and its shareholders and give security to its assets. Decisive action is required now for the benefit of all concerned.
12.45 pm
The Minister for Energy and Competitiveness in Europe (Mrs. Helen Liddell): I take this opportunity to congratulate the hon. Member for Brecon and Radnorshire (Mr. Livsey) on securing this important debate, although the timing is inappropriate for me and I am constrained in what I may say in reply.
The hon. Gentleman has made a cogent explanation of his position that will appear in the Official Report and will, I am sure, be borne in mind by the relevant authorities. I am constrained because, as a Minister, I have responsibilities in relation to the competition process. Therefore, it would be inappropriate for me to respond to some of the hon. Gentleman's specific points.
The hon. Gentleman will be aware that I am accompanied by my hon. Friend the Under-Secretary of State for Wales, the Member for Delyn (Mr. Hanson). He is listening closely to the debate, as Wales has a legitimate interest, and my hon. Friend the First Secretary will soon address the National Assembly for Wales on the matter. The Secretary of State, other Ministers and I have been in communication about the issues that my hon. Friend the First Secretary raised.
The hon. Member for Brecon and Radnorshire referred to the windfall tax; he may care to reflect that the tax was a consequence of the bungled privatisation of the utilities by the previous Government. That tax was not some wheeze dreamt up at the last minute; it was presented by the Labour party in opposition as a clear route for finding resources to help young people into work. Today, as we celebrate the lowest unemployment figures for 25 years, the hon. Gentleman will recognise that many of our constituents have benefited as a consequence of that tax. As it appeared two years ago, company managements have had time to reassess liabilities and put their companies into a position in which they can continue to operate.
Mr. Lembit Öpik: Would the Minister accept that Hyder's situation is a consequence
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not only of the windfall tax but of the City squeezing that company dry for dividend shares? One does not need to lay all the blame at the Government's doorstep.
Mrs. Liddell: I am sure that the hon. Gentleman would not want me to comment, especially in subjective language, on the behaviour of City institutions. Rather than talking about the past, we must deal with the situation as we find it.
The proposed acquisition of Hyder by St. David's Capital plc was considered by the competition authorities under the merger provisions of the Fair Trading Act 1973. The Secretary of State for Trade and Industry decided, in accordance with the recommendation of the Director General of Fair Trading, not to refer the case to the Competition Commission. The Department announced the merger clearance on 7 June.
The bid by Western Power Distribution for Hyder has fallen, as the hon. Gentleman knows, to the consideration of the European Commission competition authorities under the European Commission merger regulations. My hon. Friend the Minister for Competition and Consumer Affairs announced on 7 July that the United Kingdom had decided not to request the European Commission to refer the proposed acquisition by WPD of Hyder to the United Kingdom competition authorities under article 9 of the EC merger regulations, as it did not satisfy the relevant criteria in the regulation.
Mr. Livsey: Will the Minister ask the Secretary of State to reconsider that decision, because many issues will affect the United Kingdom? I drew her attention to them earlier, not least the fact that two electricity companies will be running side by side in the south, as will two water companies further north. Surely such matters should be considered within the United Kingdom.
Mrs. Liddell: The decision was made in accordance with the advice of the Director General of Fair Trading and the sectoral regulators, and we must act within the terms of that advice. It may help the hon. Gentleman to know that the European Commission will decide by 14 July whether to initiate a detailed investigation of the case.
The hon. Gentleman referred to the situation in which WPD proposes to procure certain services from United Utilities. I understand why he wants documentation relating to that matter placed in the Library, but he will appreciate that such information is commercially sensitive. The documents have been made available to the United Kingdom competition authorities in confidence and it is beyond my powers to place them in the Library, given that UK merger legislation protects such information from release unless the relevant companies agree to it being made public.
Mr. Livsey: Does the Minister agree that such matters are in the public interest? A monopoly-type situation is being created, which it is in the public interest to investigate. Such documentation should be in the public domain, so that people can judge the matter for

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themselves. The issues are more important than those of commercial confidentiality to which the right hon. Lady refers.
Mrs. Liddell: The hon. Gentleman should take into account the fact that Ministers can act only within the terms of what is available to them. It would not be possible for them to place such commercially sensitive information in the Library without the express permission of the two companies involved. The action that the hon. Gentleman wants to be taken is not at my disposal.
As my hon. Friend the Minister for Competition and Consumer Affairs said on 7 July, the WPD proposal did not fall within the remit of the EC competition authorities. I confirm that the United Kingdom competition authorities, including the sectoral regulators, are examining carefully whether the transaction falls to be considered under United Kingdom competition law and whether considerations are on-going. Irrespective of the changes in ownership of the licensed utilities involved in the bids, the regulatory regimes will continue to apply. That is of direct relevance to the hon. Gentleman's constituency.
I shall outline how the regulatory regimes operate. In response to each of the bids for Hyder, the Director General of Water Services and the Director General of Gas and Electricity Markets issued a joint consultation paper on the consequences of the bids for Hyder-regulated subsidiaries, Dwr Cymru and South Wales Electricity.
First, on the water issues, the Office of Water Services, the economic regulator for the water industry, is required to discharge the functions in the manner best calculated to ensure that the regulated utilities perform their functions properly and can therefore finance the performance of the company. Subject to that requirement, it must secure protection for water and sewerage customers on charges and the quality of service, promote efficiency and facilitate effective competition.
Ofwat considers that proposed mergers and those competition and regulatory issues raised before the Director General of Fair Trading are a legitimate area for the regulator to have in mind. Ofwat has to identify necessary licence modifications that deal with concerns that might arise from proposals. I am sure that the points made by the hon. Member for Brecon and Radnorshire will be taken into account.
As an example in relation to the bid for Hyder, Ofwat was interested in whether any prospective owner of DC would be fit and proper to assume the role of statutory water and sewerage undertaker, and whether DC's conditions of appointment might need to be strengthened so that any involvement as part of a larger group should not impede its ability to discharge its duties. In the bids by St. David's Capital and WPD, the director general secured the bidder's agreement to the modification of DC's conditions of appointment, which dealt with the consequences of its possible absorption into a much larger group than Hyder.
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The WPD bid raises wider issues, because WPD intends to separate DC's roles as statutory undertaker and owner of the core assets from the day-to-day operation of the business. It proposes an initial contract with a company that is to be purchased by United Utilities, which owns North West Water, the statutory water and sewerage undertaker for the north-west of England. Ofwat considered in particular whether such a proposed operating arrangement would be acceptable.
As a result of negotiations with WPD on the issue and following a public consultation, Ofwat secured WPD's agreement that, if the bid were successful, DC's conditions of appointment would be modified to include a new obligation to replace the initial contract with a programme of competitive outsourcing acceptable to the regulator. As the DTI press notice of last week stated,
irrespective of changes in the ownership of the licensed water and sewerage undertaker (DC) owned by Hyder, the water regulatory regime will continue to apply to it.
The hon. Gentleman raised several other matters. If I am not able to answer them all in the few minutes left to me, I shall write to him. On the electricity issues, Hyder distributes through Swalec, so the Office of Gas and Electricity Markets also took an interest in the competing bids for Hyder. Ofgem's function is clear. It is to protect the interests of consumers, ensuring that they have genuine value and choice by promoting effective competition in gas and electricity markets. It also regulates the monopoly elements. Ofgem considers the competition implications of any proposed merger on its individual characteristics, taking into account the precedent that applies from previous policy statements. It consults the public and third parties, and examines the issue internally before making recommendations to the Director General of Fair Trading.
Ofgem considered the competing bids and took a balanced approach to the consideration of the merger. It applied similar conditions to the equivalent aspects of the offers, and plans to seek licence amendments and assurances from any successful bidder for Hyder. The hon. Gentleman made several points, which I shall ensure that the director general can consider.
I cannot comment on the two bids, or on some of the broader issues that the hon. Gentleman invited me to consider. However, I want to emphasise what all the regulators require from the bidders. They need to ensure that the regulated utilities will comply with their legal obligations and that the quality of service to customers is at least as good as that presently provided. Whoever owns Hyder must ensure that staff and systems are in place so that networks keep working, necessary investments for reinforcement and improvements are made, emergencies can be handled quickly and professionally, and customers continue to be at the centre of the business.
I have not answered all of the hon. Gentleman's questions. I shall happily answer those that I can legitimately answer, within the constraints of my position as a Minister, in a letter and I congratulate him on securing the debate.

Iranian Jews
12.59 pm
Mr. Jim Murphy: I am delighted to be able to lead this debate on the plight of Iranian Jews falsely imprisoned for espionage. I have a constituency interest and an interest in international affairs. The constituency interest is that I have the pleasure of representing the majority of Scotland's Jewish community. I also have the unconditional honour of representing a small number of holocaust survivors. My interest in trying to prevent the persecution of and discrimination against Jewish people, in this country and internationally, motivated me to apply for this debate.
Unfortunately, it is impossible to consider the plight of the Iranian Jews without considering the context of the domestic power struggle in Iran, between the moderates on the one hand and the conservatives on the other. I am worried that Iran's wider Jewish community, which numbers 25,000 I think, may be caught up in that power struggle. However, the purpose of today's debate is to focus on the 10 Jews who have been imprisoned.
Mr. Gareth R. Thomas: I am pleased that my hon. Friend mentioned the more general context before moving on to the specific case. Does he not agree that this case is a powerful example of the wider concern about Iran's attitude to Israel and the Jewish community in general? For example, Iran remains one of the leading state sponsors of terrorist organisations such as Hamas which, as we know, wants to disrupt the middle east peace process. Furthermore, Jews in Iran are still forbidden to teach the Hebrew language.
Mr. Murphy: I absolutely agree with my hon. Friend the Member for Harrow, West (Mr. Thomas), who has raised the matter diligently during Foreign Office questions. Ayatollah Khamenei—a leading conservative who is involved in the power struggle in Iran—chose, on the first day of the new Christian millennium, to celebrate that date by demanding the destruction of the state of Israel. On the other hand, the reformist President Khatami was elected in May 1997—as Britain was electing a new Government, so was Iran—on a 69 per cent. popular vote. His slogan was "Iran for all Iranians". To many friends of the reformists in Iran, that slogan signalled a change in policy and approach.
Unfortunately, persecution continues. The domestic press in Iran is stifled, and, as we know, student demonstrations have been violently put down. The Bahai minority, who number 300,000, have been subject to violent and continued persecution. It is important to recognise where the 10 persecuted Jews fit into that context. Despite my hon. Friend's correct comments, the purpose of the debate is not to consider the wider issue but to focus on those 10 individuals.
Unfortunately, the analysis of the arrests, trial and sentences in The Economist was correct. It stated:
The sentences were severe enough to pacify Iranian hardliners but lenient enough to save Iran from diplomatic punishment.
Perhaps The Economist was right about the former point, but it must be shown to be wrong about the latter. Iran cannot escape diplomatic pressure and punishment
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if the sentences are allowed to stand. The charges were false and the trial was a violation of human rights. I shall remind my hon. Friend the Minister of some of the details. In January 1999, 13 Iranian Jews and three Muslims were arrested, but no charges were publicly identified at that time. Six months later, in June 1999, the Iranian revolutionary court charged the Jews with spying for the
Zionist regime, the USA and World Arrogance.
The 13 Jews included a Jewish teacher, a chief rabbi, a kosher meat preparer, a cemetery attendant and a 16-year-old boy. I understand that the charges of spying for the United States of America were dropped, although I have no idea why. Perhaps they were dropped on the understanding that it would be difficult to spy for two countries at once.
The trial was flawed and fundamentally violated human rights. There was no physical evidence whatever. There were only confessions, which were not given in court. The solicitor, a respected former Iranian judge, complained that the alleged confessions were obtained after a period of solitary confinement. I have never been in that situation and I do not know how I would react. What would any ordinary human being do when asked to confess after a period of prolonged solitary confinement? The Jews were secure in the knowledge that they were being used as political pawns in a domestic power struggle. They had been denied access to a lawyer for prolonged periods. They knew that 17 Jews had been executed in Iran since the revolution in 1979. Under all those pressures and worries, perhaps the confessions were, in their minds, an attempt to receive leniency.
With all the mitigating circumstances, the lawyers strongly believed that the confessions should have been inadmissible. I find it absolutely astonishing that the solicitor, who had been appointed by the state, was not allowed access to the accused. It is incredible that the Jews were not allowed access to their solicitor, but television time was given for the alleged confessions to be aired publicly. The solicitor complained that he could not have access to the accused; the television journalists had no such complaint. That is no form of justice as I understand it.
I was absolutely amazed to learn that revolutionary court Judge Nourani was not only the prosecution; he also appointed the defence solicitor and handed down the verdicts. That sums up much of what is wrong in this case of trumped-up charges. One of the accused, Shahrohh Paknahad—I apologise if my pronunciation is not perfect—is a 30-year-old Jewish teacher, charged with passing military secrets to Iraq during the Iran-Iraq war. I have no idea how the Iranian Government reach the understanding that a Jew is passing military secrets to Saddam Hussein's regime. Even if they can make that leap of logic, the fact is that he was eight years of age at the start of that war. The charges do not bear even the most superficial examination, never mind the examination of a fair hearing.
Ultimately, 10 of the accused were found guilty and six were acquitted—three Jews and three Muslims. The sentences ranged from four to 13 years in confinement. The international reaction to the trial and judgment is a matter of considerable public record. The trial process was condemned by the European Union, the United

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States and—I am pleased to say—strongly condemned by Her Majesty's Government. Our Ministers played a leading role in trying to secure a public hearing and a transparent trial. The reaction was in many ways even stronger when the judgments were passed. Some people had speculated that death sentences might have been passed and suggested that we should therefore be relieved that they were not. However, one can take no joy in the fact that these innocent individuals are faced with jail sentences of four to 13 years.
I was given a categorical assurance during Foreign and Commonwealth Affairs questions, when I asked whether the Government would do all in their power to ensure that the trial would be open and transparent, and that the accused would have access to legal advice of their own choosing. My right hon. Friend the Foreign Secretary had been told that those things would happen, but that did not occur. I believe that he gave those assurances in good faith. The source of the problem is not our Foreign Secretary, but the Iranian authorities and the Iranian Government, who misled the British Government and gave them false assurances. What do our Government intend to do in response?
Amnesty International condemned the trial process and the sentences as a violation of international human rights law, saying:
The proceedings in this closed trial fall far short of international standards for a fair trial.
In a letter to the President of Iran, the Council of Christians and Jews demanded that the trial be transparent and just and said that the accused would be in its prayers. The signatories to that letter are hardly radicals or people who would apply pressure without due consideration. They include the Archbishop of Canterbury and the Moderator of the Church of Scotland. They are honourable people who do not take these actions without proper consideration. I can only hope that their prayers have been more successful than their letter to the Iranian President.
What action can be taken by this and other Governments throughout the world to secure a successful appeal process? International pressure helped to ensure that death sentences were not handed down. International pressure can help to ensure that these appeals are successful when they are heard. Britain is in a unique position for two reasons. First, we have now established diplomatic relations at ambassadorial level with Iran. Our ambassador in Tehran and Iran's ambassador here should be in no doubt of the strength of feeling that exists in the Foreign and Commonwealth Office and the House of Commons about this issue. We should use the channel of diplomatic relations to ensure that maximum pressure is applied.
Secondly, the UK and Iran are strong trading partners. Our economic ties with Iran are close. In 1999, Britain exported the equivalent of $244 million to Iran and we imported the equivalent of $36 million from Iran. The former Conservative Minister, Mr. Jeremy Hanley, recently led a trade delegation to Iran to try to forge new business links.
On 26 June 2000, the Iranian news agency reported that one of the leaders of that delegation, Mr. John Hill, said that the delegates would report back to British companies to tell them about their experiences of the improvement in the political climate. I do not doubt the
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sincerity of his comments and there is no limit to my hope that there will be improvements in the political situation in Iran: that will be the hope of the friends of Iranian reform throughout the world. British business cannot ignore the persecution of these individuals, however, and the wider discrimination that occurs in Iran.
I make an appeal to my hon. Friend the Minister and to all Ministers for joined-up government, so that we can ensure that these innocent Iranian citizens can be reunited with their relatives. I appeal to my right hon. Friend the Foreign Secretary, who will visit Iran in the near future, publicly to state Britain's view on the matter and our disappointment that our Government were misled earlier this year and to ask for assurances that the appeals process, unlike the trial itself, will be open and transparent.
I understand that our Government's position is that the people involved have been treated as pawns in a domestic power struggle. However, it is not good enough simply for the Foreign and Commonwealth Office to apply pressure. In the spirit of joined-up government, the Department of Trade and Industry and other Government Departments should play their part to ensure that it is not only a political matter but an economic one and that Mr. Hill's comments and the efforts of Mr. Hanley in taking British trade to Iran and bringing Iranian trade here are not made in a vacuum that ignores the oppression of Iran's Jews.
We should constantly remind Iran that we shall consider the matter in a wider context. I understand that Iran wants to apply for membership of the World Trade Organisation, which is to be welcomed. If Iran opens up to international economies and liberalises its economy, that too is to be welcomed. We should make the case, through whichever Government Department is involved, that Iran's application for membership of the WTO will bring it under closer international scrutiny, including scrutiny of this case.
I make a statement not so much for our own Foreign Office but for Iranian representatives here in London. The issue will not go away. Members of Parliament from all political parties will continue to press the matter as long as those 10 Iranian Jews remain in prison. Indeed, questions on the matter have already been tabled for the next Foreign Office questions.
At stake is Iran's long-term standing in the international community. If the appeals are unsuccessful, the spirit of tolerance and international hope for a new, more tolerant Iran—an Iran "for all Iranians" as the President said very publicly—will be seen to have been put to the test and to have failed. The matter raises much wider issues than the fate of 10 Iranian Jews. Iranian justice and political reform are on trial. If the appeals fail, the Iranian justice system will be found guilty, not 10 Iranian Jews.
1.17 pm
The Minister of State, Foreign and Commonwealth Affairs (Mr. Peter Hain): I thank my hon. Friend the Member for Eastwood (Mr. Murphy) for having raised the issue of the Iranian Jews found guilty of espionage in Shiraz. I pay tribute to his energy in raising this matter and others. He is highly respected in his own constituency, especially among the large Jewish

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community there, as well as for his energetic pursuit of human rights issues in Parliament generally. That is important, because his approach to the issue is part of a wider commitment to human rights across the globe. I agree that the Iranian authorities here in London will have to acknowledge that the issue will not go away.
As my hon. Friend knows and has, indeed, been fair in acknowledging, the Government are deeply worried by the news of the sentences imposed on 1 July on 10 Jewish and two Muslim defendants tried for espionage in Shiraz. I agree that, to use his words, the trial was "deeply flawed". We and our EU partners have consistently expressed our anxieties about the conduct of the trial, and in particular about its closed nature. He is absolutely right that, despite earlier assurances to us from the Iranian authorities—indeed, from Iranian Ministers—that the trial would be open, it was not. That is unacceptable.
Dr. Rudi Vis: My right hon. Friend the Foreign Secretary said that the trial would be fair because he had been assured that it would he. Is that assurance in writing? If so, should we not go through it line by line and ask the Iranian Government or the Iranian embassy in London what is their reaction to the trial not having been fair?
Mr. Hain: I acknowledge my hon. Friend's close interest and, in particular, that of his constituents in the matter, and I am happy to respond to his question. The problem is that our interlocutors in the Iranian Government are Ministers. The court system is run by the revolutionary court, which is largely opposed to the reform process. So, to be open about it, there is a power struggle in Iran between the reformers in the Government, led by President Khatami, who has the overwhelming support of the people, and the entrenched interests that retain control of the court process. The assurances, which were given, accepted and represented in the House by the Foreign Secretary in good faith, got caught in the middle of that power struggle.
Both the Prime Minister and the Foreign Secretary raised the issue with Foreign Minister Kharrazi during the latter's visit in January and I pressed the matter with deputy Foreign Minister Sarmadi when we met in March. More recently, the FCO director for the middle east and north Africa raised it with the Iranian ambassador on 1 June, and the EU presidency in Tehran presented demarches on behalf of all EU partners to the Iranian authorities on 29 April and 23 May. The Secretary of State discussed the matter with members of the Board of Deputies of British Jews when he met them on 14 June. Therefore, we have been fully engaged throughout the process and I am grateful to my hon. Friend the Member for Eastwood for rightly commending our leading role in the matter.
Immediately after the announcement of the verdicts on 1 July, we issued a statement expressing our deep concern, which we have subsequently reiterated with Iranians in London and Tehran. I welcome the fact that no death sentences were passed; 17 Iranian Jews have been executed since 1979. The sentences are however extremely heavy, particularly given the nature of the charges and the character of the trial. It is important to
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note that provision is made for an appeal to the Shiraz revolutionary court within 20 days of sentencing and, if need be, to the supreme court. We will continue to monitor the proceedings, on which the eyes of the entire world will be directed, closely.
We regularly raise our concerns about the plight not just of a single minority in Iran, but of the Bahais, students, intellectuals and others, many of whom are Muslims, who also face serious threats.
Mr. Lembit Öpik: What constructive action does the Minister believe that the Government or hon. Members can take to reverse the death sentences that have been passed on a small number of Bahais in Iran, where the Bahai faith is not formally recognised and they are afforded no state protection?
Mr. Hain: I acknowledge the hon. Gentleman's close involvement with the Bahais, in Britain and internationally. We remain concerned at reports of the death sentences passed on three members of the Bahai faith in Mashad on 3 February. We and our EU partners have raised those concerns with the Iranian authorities. We welcome the news that one of the three, Mr. Khulusi, has since been released. We regularly raise with the Iranian authorities our serious concern about the treatment of the Bahais because persecution of individuals on religious grounds is unacceptable.
Mr. James Clappison: Will the Minister give way?
Mr. Hain: I have to make progress first.
In line with our policy of constructive engagement, we continue to raise our concerns privately with the Iranian authorities. Some hon. Members have argued that we should have no dialogue with Iran. We believe, however, that the best means of encouraging the forces most likely to promote human rights is through critical engagement—the pursuit of political dialogue wherever it can produce benefits. The reformist Government need to be able to show that progress on human rights can bring benefits to their country, through trade and other means. However, engagement does not mean suspending judgment. To engage with Iran, we have not refrained from raising the difficult issues. A number of positive developments support a broader relationship with Iran—a country with a population of more than 60 million, which is rapidly becoming a key player in the region. Its neighbours are seeking rapprochement, and Iran is playing an increasingly constructive role in regional issues, such as Iraq and Afghanistan.
We also benefit from bilateral co-operation on drugs. More than 90 per cent. of the heroin on our streets originates from Afghanistan, and most of it goes through Iran on the way to Europe. Iran has seized more drugs than any other country; last year, the Iranian authorities were responsible for more than 60 per cent. of the world's opiate seizures, but they paid a heavy price for the fight against the drug traffickers. More than 3,000 Iranian drug enforcement officers have been killed in confrontations with smugglers and their gangs in the past 15 years.
Our co-operation with the Iranians in the matter helps them and directly benefits people in Britain. We are developing that co-operation, especially in tackling

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terrorism. I acknowledge the point made by my hon. Friend the Member for Harrow, West (Mr. Thomas) in that respect; we raise the matter continuously.
Despite the outcome of the Shiraz trial, which gives grave cause for concern, there has recently been progress on some aspects of the human rights situation in Iran.
The latest United Nations Commission on Human Rights resolution on Iran, adopted on 17 April, and drafted and sponsored by the European Union, noted positive developments on human rights, including the recent elections, movement towards greater freedom of expression and progress on the status of women, although at the same time expressing its deep concerns on remaining issues. We continue to urge Iran to co-operate with the United Nations on such matters, including allowing a visit by Maurice Copithorne, a United Nations special representative on human rights.
The Iranian people want reform, as shown by the election in May 1997 of President Khatami, who advocates the development of an Islamic civil society based on respect for the rule of law. Since then, in municipal elections in February last year, and in parliamentary elections in February and May this year, the people of Iran have overwhelmingly shown their continued support for President Khatami: 80 per cent. of the electorate support reform, including the vast majority of women and young people. Sixty per cent. of Iranian citizens are under the age of 25 and they all want reform.
However, opposition to reform remains in some quarters. The closure of 18 pro-reform newspapers in the run up to the election is an example. However, the new, largely reformist Parliament, which first sat on 27 May, has already declared its intention to tackle the problem. New legislation is being proposed to safeguard the independence of the press and to curb the powers of intervention of the judiciary. We welcome the comments of the recently elected Speaker of the Parliament, who said that it
must seriously try to meet the wishes of the people…we are sure that the people are after freedom of expression.
The new Parliament also declared its determination to tackle economic issues and the need to streamline Government. It is not for us to intervene in the internal situation, but isolation is not the right policy if we want to engage the process of reform. Only through constructive engagement can we show our support for
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the will of the Iranian people while maintaining our ability to raise concerns such as the trial, which I mentioned earlier, when they arise.
Mr. Clappison: I am grateful to the Minister for giving way. Earlier, he mentioned the Shiraz revolutionary court. Is there a risk of the court increasing the sentence or can it impose only a less severe sentence?
Mr. Hain: I do not think that it could increase the sentence; that would be unthinkable.
I am aware of the statement signed by hon. Members calling for a change in United Kingdom policy towards Iran. We and our European Union colleagues have continuing anxieties about human rights violations, which we regularly draw to the attention of the authorities. We must base our analysis on unbiased sources, however, such as the reports of Maurice Copithorne and the latest United Nations resolution adopted in April, both of which recognise improvements in Iran, rather than the propaganda of the National Council for the Resistance of Iran mentioned in the statement, which appears largely to have inspired it.
Some of my hon. Friends may not be aware that NCRI is dominated by the terrorist Mujahedin-e-Khalq organisation, the MKO, which claims responsibility for a number of terrorist attacks in Iran. The NCRI and the MKO are on the USA State Department's proscribed list of terrorist organisations. We do not recognise either of them, neither did the Opposition when they were in government. The MKO is despised by most Iranians—it is important that hon. Members understand that—as it supported Saddam Hussein in the Iran-Iraq war.
The Government believe that it is right to promote human rights, but we must choose the right way of doing so. That means responding to human rights challenges in a way that is most likely to help the people whose freedoms are being restricted. The way in which the case of the Shiraz defendants is dealt with through the appeals process will be a big test of that strategy and of the future of Iran and its people. The eyes of the world will be on Iran. It is important that the Iranian authorities respect the freedoms of those defendants.
Mr. Deputy Speaker (Mr. John McWilliam): Order. Before we start the next debate, it may be convenient to allow the Minister to take his seat reasonably gently. If he wishes to, he may address the Chair from a seated position.

Policing (Public Events)
1.30 pm
Mr. David Heath: I sympathise with the Minister in his incapacitated state. My incapacity—such as it is—is my throat. I hope that it will last the duration of the debate.
I am grateful for the opportunity to raise an issue that was raised with me by constituents, but has wider relevance. I shall talk about the policing of outdoor public events and, specifically, the traffic management role of police at one-day agricultural shows, Pony Club events, village fetes and the other voluntary or semi-professional events that are held each summer that many people want to attend, but which cause some disruption to local traffic and need to be organised with a little care.
The issue was first brought to my attention by Mr. Charles Bradley Hudson, whom I met at Wincanton races. I do not raise everything that I am told at Wincanton races on the Floor of the House, but the gentleman involved was responsible for stewarding the races and therefore had relevant expertise. He was concerned that police policy had changed and he thought that that would have knock-on effects for commercial organisations such as his and for voluntary organisations.
As I pursued the issue, I found that it was not confined to Avon and Somerset police, with which the Minister knows that I am familiar from my past career. The guidance given by the Association of Chief Police Officers and the public safety policy that it issued on 28 April 1999 mean that the issue is relevant across the country.
The policy represents a shift in police thinking, probably for good reasons. The chief police officers are anxious to use their human and financial resources to best possible effect, and the best use of a uniformed constable is not necessarily directing traffic. I understand that. I have argued for many years that we require additional police officers in Somerset and elsewhere and I understand the difficult decisions that police management must take.
There is concern, which is also expressed in the public safety policy document, about the liability of police officers in such circumstances. The point that has been repeatedly made to me is also made in the introduction to the policy document, which says:
the Police have no general duty to preserve public safety at any public event, except where there are imminent or likely threats to life.
That is clearly a statement of fact about the responsibility of the police. The introduction continues:
Legal opinion suggests that the responsibility for public safety rests with the organisers of an event, the owners of the land on which it takes place and possibly the Local Authority if the event takes place on a road. However, other persons or agencies who undertake actions regarding public safety at an event may assume a duty of care and, therefore, also become responsible.
In the past, the service—
the police service—
has taken the lead and undertaken actions to facilitate public events, acting for what they believed to be the public good. However, with the emerging spectre of civil litigation, a more
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focused approach, confining Police action to those issues that are part of our core responsibilities and where there is legal authority, is becoming necessary.
The consequence of that view is that the police should not be directly involved with policing outside public events. That should be the responsibility of the event organisers, and the police should be employed only in the circumstances that I described earlier: where there is an imminent threat, or where there is no reasonable alternative. The outcome of that change of policy has been a withdrawal of police presence at outside public events this year. I understand some of the arguments for that, but I also want to explore with the Minister some of the consequences for others of that outcome and consider how that vacuum might be filled.
There is a vacuum in preparation and planning for events, in training and accreditation of people who take on the role of directing or assisting traffic movements and in terms of signage, liability and powers. During the past few months, I have addressed people in the various Government Departments who have partial responsibility for that area in an attempt to obtain some answers. Indeed, I received a helpful answer from the Minister of State, Home Office, the hon. Member for Norwich, South (Mr. Clarke), who said:
I understand from the Association of Chief Police Officers that each Local Authority has a Safety Advisory Group on which the police are represented and they consider the risks associated with any proposed site for an organised local event such as a horse show or agricultural fair.
Actually, that is not the case. I do not deny that the Minister was given that advice, but according to the House of Commons Library researchers, local authorities have not set up safety advisory groups. The Association of Chief Police Officers would like such groups to be set up, but there is no mechanism to make that happen. Indeed, the Local Government Association is wary of following that course. There is a question about which authority is responsible. The responsible authority for licensing a particular area to be used for an event will almost certainly be the district council, which is not the highway authority. Therefore, there is a dichotomy between the responsibilities of the various local authorities.
It would be extremely helpful to have a system that permits a proper exchange of views. That would cure some of the problems, but I suspect not all of them. I also wrote to the public safety committee of ACPO, chaired by Mr. Sean Price, the assistant chief constable of Nottinghamshire. He wrote me an extremely helpful letter and offered to meet me—an offer that I intend to take up to enable me to discuss these issues with him. He said that the intention was for the traffic management policies that emerge from those advisory groups to be self-policing, but I do not believe that that is the case. For example, I do not believe that the Frome cheese show, a significant one-day agricultural show, will be self-policing. However sophisticated the signs and cones, traffic management will not simply happen of its own accord; it will need direction and support.
The likely result of an absence of police, traffic wardens or some other uniformed presence is chaos. Chaos is good for no one and is certainly not good for organisers of events. There is also a potential danger to public safety if emergency vehicles, for instance, have to get through. That is what concerns me.

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Mr. Price continued by referring to the point that I had raised with him about the training of those who control or who seek to control traffic. His opinion was:
As to the issue of training traffic management officers, I feel that in the light of what I have said above this becomes an unnecessary measure.
Again, he prays in aid the traffic management policy because he believes that that will be self-policing and that there is no need for stewards to be on the road directing traffic. First, I do not accept that premise and, secondly, people will in any case want to assist those attending their event. They will go out on the road and don orange jackets, but they will have not the slightest idea of what they are doing in terms of traffic management. They will not have training or accreditation because that is not available.
People whose job it is to organise events, such as Mr. Charles Bradley Hudson, to whom I referred, want their stewards to be trained properly and to be able to do the job properly. They want accreditation, which could best be provided by the police, to enable that to happen.
Adequate temporary signs could make a major contribution in the absence of police but, again, we have a little policy vacuum. Lord Whitty tells me that signs can be put up only with the agreement of the relevant traffic authority, which again puts the onus back on event organisers. He also tells me that the Department of the Environment, Transport and the Regions is reviewing and updating traffic sign regulations—the code of practice and guidance on the provision of temporary signs to special events.
That is all well and good, but to implement half a policy and then wait for the other half to come along is not a sign of what we have come to call joined-up government. The people caught in the middle are those least able to find their way through the jungle—those trying to raise money for charity and to organise events. I worry about the situation.
My final major point is liability. People who have no training or accreditation in directing traffic are personally liable for their actions. They have no power to stop vehicles. If a driver gets fed up in the traffic and does not like the look of the chap in the orange jacket, he could drive past irrespective of the consequences. That was confirmed by my local chief superintendent, Ted Allen, who told me:
In respect of a member of the public directing traffic on a public highway they have no legal standing and would do so at their own risk with any incident resulting being investigated accordingly.
There is a premium on people who are trying to improve public safety and to do a job for their local community, but who are liable for anything that happens as a result. What worries me is the duty of care that a person with that responsibility would have not to do something reckless or rash—for example, not to call someone forward in front of a moving vehicle. I understand the point; that liability is reasonable. I wonder, though, whether the organisers of an event have a more general liability for circumstances such as those that I have described. When an ambulance or fire engine needs to get through but cannot because a mess of traffic is blocking the road over which the organisers have no powers, are they liable for any injury as a result of their inability to direct traffic effectively? There is a difficulty in the situation.
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I could mention in passing the Road Traffic Regulation (Special Events) Act 1994, but that is a different issue as it concerns road closures and smaller organisations. For example, I could mention its effect on west country carnivals—a matter of great importance in my part of the world, which has a superb carnival season and circuit. The new restrictions are justified in public safety terms, but they become very onerous for many event organisers. However, I do not want to divert the discussion into such matters.
I should like to leave the Minister with the final conclusion of ACPO in its policy document. It states:
The current policing dilemma is created by a number of conflicting issues, although the lack of legislation to regulate public events is a major factor. Inconsistency has resulted. This has the potential to cause disaffection between the police and the public and significantly damage community relationships, which are vital to the Police Service.
I agree with that view and I do not criticise the police for applying their resources in the best way possible to serve the local community. That is why I want to ensure that public events are supported by a proper policy framework and to avoid allowing a unilateral withdrawal of police support without ensuring that there is something to take its place. That requires the concerted action of the Home Office, the DETR, local authorities and the police. Such action should ensure that everyone understands where the responsibilities lie, how support can be given and how the events can be controlled in a managed way.
We should not allow well-meaning people, who are trying to serve their community by putting on events for the public good, to be put in the impossible position of not managing the traffic satisfactorily and in a way that the public will accept and, more importantly, of not ensuring public safety. I invite the Minister to consider the matter and to try to find ways in which the Government can help to resolve these issues, some which have been left open to discussion. No clear solutions are being evolved to many of the problems, either at local or national level.
1.46 pm
The Parliamentary Under-Secretary of State for the Home Department (Mr. Mike O'Brien): I thank the hon. Member for Somerton and Frome (Mr. Heath) for raising this important issue, which he has done reasonably and sensibly. His quotations from the Association of Chief Police Officers sub-committee on public safety policy were all accurate. The final paragraph of its study states:
The Police Service will, therefore, encourage the promotion of legislation to properly regulate and control such events in future.
We will discuss with the police their proposals for the proper and effective regulation of future events.
The hon. Gentleman raised a number of issues and I shall try to deal with each in its turn. We all realise that the police have a difficult job and we have recently witnessed a number of public events in which their involvement was crucial. We have seen a number of instances of organised disorder, in which protest groups or others acting under the guise of a legitimate cause have sought to cause havoc on our streets or at public events. In the events of 18 June and 30 November last year and of 1 May this year, the police faced a difficult task in containing those groups and maintaining order in our streets.

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Certain police roles are important and central to the handling of such events. The police are expected to prevent and detect crime, to prevent disorder and breaches of the peace and to ensure action is taken together with the other emergency services in the event of any major crisis. That work involves a good deal of preparation, planning and consultation, especially when it relates to sizeable events. The wider community and other agencies must also be fully involved in such work. The police always have a role to play in public events that are likely to result in problems of disorder or that might do so. As far as organisers and the general public are concerned, they also have a role in events that are less likely to result in serious problems, to ensure that they are properly policed and that the core functions and responsibilities of the police are properly attended to. Those functions are preventing crime and disorder, maintaining the peace and investigating offences, which are essentially operational matters. It is for the police to determine the level of resources that they can devote to particular events.
The police are not the only public organisation involved in ensuring public safety at organised events and it is not a core police task to organise or manage traffic or to organise the events themselves. That task falls primarily to the organisers of the event. Other agencies—in particular local authorities—must also play their part. As the hon. Gentleman said, the Association of Chief Police Officers has issued guidance on public safety policy, which clarifies the police role and the tasks of other agencies.
Over several years, a creeping involvement of the police in the management of public events had come about. They had taken over responsibility because the organisers of events had been willing to let them do so. The police therefore were organising traffic management schemes and sometimes advising on the layout and organisation of an event. Those are not core police roles, but the responsibility of the organisers. The police should by all means consider the extent of their involvement in advising on such matters, but it is for the organisers to deal with them.
The premise of the hon. Gentleman's reasoned and carefully argued speech was that the police are better trained to manage the types of event in question. The assumption behind that is that somewhere police officers are being trained in traffic management of more than a basic type—by which I mean standing in a street and directing traffic. As I understand matters, traffic control officers are trained in such traffic management techniques, but ordinary police officers receive only basic training on how to direct traffic.
Some of the events in question require considerable traffic planning. Specially trained traffic control officers would not normally be involved in that. They would be on the motorway, or dealing with large and complex incidents, or the transport of heavy goods. We would not expect specially trained officers to become involved in smaller events such as fetes or carnivals, often in rural areas. That brings us back to the ordinary officer with basic training in traffic management. There is no reason why an organiser of a public event could not investigate such training, assuming that it would be relevant—it might not—or obtain advice on traffic management
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from other properly trained and skilled people. There are plenty of consultancies. Doing so might require resources and some of the organisations concerned might be charities, but it is the responsibility of people who organise events to ensure that they can do so properly and not to transfer to the police a responsibility beyond their core job of protecting society against crime and disorder.
Mr. Heath: I am grateful to the Minister and I accept his basic premise. The difficulty is that the police officer, however well or badly trained, has one great advantage: the power of his office of constable and the fact that he is in uniform and that if he puts his hand up the traffic will, by and large, stop. That is an attribute that the volunteer or even the professional steward does not have. That is why some training is important. Some organisations find it difficult to provide that training for their staff.
Mr. O'Brien: The hon. Gentleman is right that a police uniform conveys authority and that a uniform worn by a steward may not do so. However, we need to ensure that the authority of the police is used in a way that senior police officers feel will best contribute to preventing crime and preserving order. A senior police officer might decide that the best allocation of resources would be to have a police officer on the beat patrolling a particular area, or to use him to investigate a particular crime, rather than making him spend the day directing traffic outside a rural fete. That does not undermine the importance to the local community of that fete, but it avoids placing an additional burden on the police.
When people decide to use their land for a car boot sale, a music festival or a garden party for their friends, they should not be able to call on the police to direct traffic because we have given them a statutory responsibility to do so. That would allow everyone to call in police resources to direct the traffic as they see fit. Too often, the police have taken over the virtual management of an event on behalf of the organisers. That is regrettable.
However, the hon. Gentleman raised a number of concerns. He said that safety advisory groups have not been established in all local authorities. We will have to discuss that with the Local Government Association and ACPO. He also suggested that there is a vacuum in training with regard to how to assist traffic movement and to sign appropriately. We shall also want to discuss that with ACPO.
The subject raises the issue of where power and responsibilities lie. Advice from ACPO properly indicates that there is, to some extent, a lacuna in legal provision. We are trying to engage with ACPO and local authorities to decide how to proceed, but this is not a simple situation. I do not want to create a lot of extra duties for police officers that give public authorities and private individuals the ability to take control of the placement of police officers. That power should remain in the hands of chief constables. I accept that responsibilities should be more carefully defined, but we must not transfer all the responsibility to the police because that would place substantial demands on resources.
The hon. Gentleman asked which authority would have responsibility. In some areas, such as the hon. Gentleman's and mine, the county council is the traffic

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authority, but the authority that gives permission for events is sometimes a district council. We need to clarify which authority would be responsible. He said that if the police are not involved, public safety would be put at risk by the ensuing chaos. I do not accept that argument. The police in my area are often not directly involved in traffic management at an event and stewards are used instead. That happens in many parts of the country, but the practice varies from place to place depending on the resources that are available to chief constables. I do not envisage any great threat to public safety by allowing the police to be consulted and to give advice, but people who arrange private events must ensure that they are properly organised. It is their job to ensure that traffic is not disrupted. It is up to the police to ensure that if
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public safety is at risk, or if a crime might be committed, they are there to do their job in the proper way, but they must decide how best to allocate their resources.
The hon. Gentleman mentioned liability. People should be aware that if people organise a private event they might be liable for the consequences. However, in the case of Wincanton, I understand that the Avon and Somerset police reviewed the role of their officers who attend race courses and a great deal of good work has been done in properly stewarding the Wincanton races.
We will consider the issues. I hope that the hon. Gentleman accepts that we have given an appropriate response to an important issue.
Question put and agreed to.
Adjourned accordingly at one minute to Two o'clock.