My colleague Lord Philip Hunt reported on the Labour Lords Blog that the new governance arrangements for the new Clinical Commissioning Groups (CCGs) through which most local NHS money will be channelled are odd in the extreme, saying:
“A massive £60bn is to be entrusted to them despite very weak accountability and corporate governance structures supporting what are essentially a federation of GPs. Only two lay members will serve on the Board of each CCG so they will always be outnumbered by GPs who will have little or any accountability to the public. This is even more perverse given that the CCGs may make funding decisions which are advantageous to GPs.
Bizarrely, although the regulations we are debating in the Lords allow for a hospital doctor and a registered nurse to be appointed to the CCG Board, those employed by a local hospital are not. This is apparently because it would be a conflict of interest!”
Last night’s debate in the Lords on the Government regulations setting out how CCGs are to operate showed up the sheer absurdity of the arrangements and the normally-sensible Minister, Earl Howe, tied himself in knots trying to explain why certain categories of person were to be excluded from the Boards of CCGs and why it would NOT be a conflict of interest for GPs on the Boards to so arrange local services so that their practices benefitted.
I rather lost my temper when it was suggested by former Tory Health Minister, Baroness Cumberlege, that local councillors should in all cases be excluded from CCG Boards on the grounds that they would be incapable of making difficult decisions affecting their electorates (what does she think local councillors are having to do at the moment given the budget cuts that the Government has imposed on them?).
However, the debate also highlighted the absurdity of the Government’s proposals which would prevent someone being appointed to be a “lay member” of a CCG Board if they were employed by a local authority anywhere in the country; or – even more bizarrely – prevented someone who is a member (not even a governor) of a local NHS Trust, when in some areas every person who uses the local hospital is automatically enrolled as a member of the Trust!
You can read the full debate here and my rant was as follows:
“In this debate we are perhaps being asked to suspend our disbelief that the governance arrangements for the clinical commissioning groups make sense. We are being asked to suspend our belief on the question of whether pigs may fly. However, the extraordinary statement from the noble Baroness, Lady Cumberlege, that somehow locally elected councillors are incapable of making decisions which affect the livelihoods of the populations that elect them is disgraceful.
Baroness Cumberlege: My Lords, I object to that. I said that they have a role on health and well-being boards, which is where the strategy is set out, and that is where the NHS, local authorities, Healthwatch and other organisations come together.
Lord Harris of Haringey: I understand that. My point is that the noble Baroness does not seem to understand that today, all over the country, locally elected councillors are making decisions about closures because they are having to balance the reductions in budgets that this Government are forcing on them and on their local communities. They are making those decisions on behalf of the people whom they represent. Why is it being said that somehow they have a conflict of interest which means that they are incapable of making decisions along with colleagues about health matters?
There are issues of principle here and issues of sheer practicality. The issue of principle concerns conflict of interest. The noble Baroness, Lady Cumberlege, has talked about conflict of interest. Perhaps we will also hear about that from the noble Earl in a minute. However, the biggest conflict of interest will be the fact that the primary care practitioners are key elements of the boards of CCGs’ governing bodies. They are not being excluded; it is just everyone else who is being excluded. Let us be clear about who is being excluded. It is not simply elected members but any employee not just of the local authority in the CCG’s area but of any local authority in the country. Therefore, any person who, under paragraph (4) of Regulation 12, the CCG feels has knowledge about the area and who does not have the misfortune of being an elected councillor but does have the misfortune of being a part-time employee of a neighbouring local authority is exempt.
When the Minister replies, I should like him to explain to us why every single employee of every single local authority in the country is being excluded from participation in CCGs. While he is about it and we are talking about conflicts of interest, we have already heard the point made by my noble friend Lord Hunt of Kings Heath that any person who has been public-spirited enough to decide to become-and frankly it is a fairly meaningless undertaking-a member of a local foundation trust or a local NHS trust is also excluded from membership of a CCG. Again, what is the point of that? It is being said that any person who is public-spirited enough already to have had some engagement with the local NHS is not allowed to sit on the board of the CCG.
This is frankly fatuous. You have ended up with a situation in which you have enshrined one set of conflicts of interest and excluded from the membership of the CCG all sorts of other people who could make a valuable and useful contribution. I am afraid that for the first time in our considerations I agree with 99% of what the noble Baroness, Lady Jolly, said. The 1% with which I disagreed was that we should allow this instrument to go through and review it again in two years’ time. It is so flawed and riddled with poorly thought-out considerations of what would work at local level, and so dismissive of the best judgment of local people to decide who is best to be part of the board, that frankly we should endorse my noble friend’s Motion. I urge the Minister to withdraw the regulations and bring forward revised, more sensible regulations.”
Standards are falling in the Home Office.
I know that some may feel this is a statement of the obvious, but I know that it is important that these things are evidenced….
So here is an example – albeit a small one – but not so many years ago such sloppiness would never have occurred.
Yesterday, the Home Secretary announced that she was proscribing the organisation “Muslims Against Crusades”, saying:
‘I have today laid an Order which will proscribe Muslims Against Crusades from midnight tonight. This means being a member of or supporting the organisation will be a criminal offence.
‘I am satisfied Muslims Against Crusades is simply another name for an organisation already proscribed under a number of names including Al Ghurabaa, The Saved Sect, Al Muhajiroun and Islam4UK. The organisation was proscribed in 2006 for glorifying terrorism and we are clear it should not be able to continue these activities by simply changing its name.’
In my view, this is an entirely sensible move, although some would say long overdue and – of course – it is inevitable that the people involved may simply create a new organisation with the same name doing much the same sorts of things.
However, my concern about falling standards relates not to the decision but to the briefing that goes with it. Amongst other things this says:
“Groups like MAC – which pedal hate and glorify terrorism – are not welcome in the UK. They do not speak for British Muslims and are reviled by the vast majority of decent people. We will continue to use all legal powers at our disposal to stop them from operating here.”
As Private Eye might say “Shome mistake …”
All I can say to Home Office officials is: get your homophones right and the policy will take care of itself.
* For a helpful guide from the University of Hull see this.
I am not getting too excited about it – in fact, I am not getting excited at all – but “Total Politics” have been publishing their latest ranking of political blogs in the UK. This year, the arrangements changed requiring a lot more effort from those who wanted to vote and I don’t know what that did to the level of participation in the exercise, as the background data is not published.
However, for what it is worth, this blog has been rated as 228th in the list of the top three hundred political blogs in the UK. Apparently, this is an upward move: I was (although not aware of it) in 271st place last year. At least, I am above Lynne Featherstone who comes in at 252nd.
The blog is also 33rd in the list of the top one hundred Labour blogs and personally I am 87th in the list of the top one hundred Labour bloggers (this is presumably not a bad result as David Miliband is at 72nd place and Ed Balls at 73rd with Tony Benn in the 90th spot).
The four candidates* to be the next Commissioner of Police for the Metropolis are being interviewed by a Panel of members of the Metropolitan Police Authority tomorrow. This will be the second interview that the candidates have had – last week a Panel of Home Office mandarins led by the Permanent Secretary, Dame Helen Ghosh, put them through their paces.
The purpose of these first two interviews is to whittle the number of candidates down to, perhaps, two who will then be interviewed by that marriage-made-in-heaven, the Home Secretary Theresa May and Mayor Boris Johnson (the two are rumoured not to like each other) next week.
After that, the Home Secretary will formulate a recommendation to The Queen who will formally make the appointment.
So whose fault will it be if the wrong candidate is selected?
The answer is simple: Keith Vaz MP.
The astute reader of this blog (I know who you are) will already have realised that the Chair of the House of Commons Home Affairs Committee does not have a formal role in this convoluted appointment process. So how does he get the blame, I hear you ask.
Keith Vaz has scheduled a hearing of the Home Affairs Committee for tomorrow morning and has summoned before him, not only Deputy Mayor Kit Malthouse AM, Chair of the Metropolitan Police Authority, who would have been chairing the MPA interview panel, but also two of the Commissioner candidates (Tim Godwin and Sir Hugh Orde).
When asked whether these witnesses could be heard on Thursday morning, when the Home Affairs Committee is also holding a hearing, the answer from Keith Vaz was that such a change would not be possible.
The result: the start time of the interviews has been postponed; Kit Malthouse will arrive hot and sticky (do not dwell too long on this image) at the MPA offices having given his evidence and chair the interviews of the two candidates not required by Keith Vaz; and Tim Godwin and Hugh Orde will rush direct from their grilling by the Select Committee to their respective interrogations at the MPA (not necessarily the calm preparation time that people up for one of the most important jobs in the country would normally hope to have).
And, if that doesn’t potentially skew the outcome, the most damaging consequence of the Vaz intervention in the process, is that I will no longer be able to participate in the MPA interviews because of the changed timings.
So, if it all goes wrong, blame Keith Vaz.
* The four candidates are:
Tim Godwin, the current Acting Commissioner, substantive Deputy Commissioner and former Assistant Commissioner for Territorial Policing.
Bernard Hogan-Howe, the current Acting Deputy Commissioner, substantive HM Inspector of Constabulary and formerly Chief Constable of Merseyside and before that an Assistant Commissioner in the Met.
Steve House, currently Chief Constable of Strathclyde, putative Chief Constable of the proposed all-Scotland Police Service, and before that an Assistant Commissioner in the Met.
Sir Hugh Orde, currently President of the Association of Chief Police Officers, former Chief Constable of the Police Service of Northern Ireland, and before that a Deputy Assistant Commissioner in the met.
I gather that the Total Politics Blog Awards are now in progress. I want to make it quite clear that I will not be in the least bit affronted should you chose to vote for this blog by clicking here.
I was going to comment on an extremely perceptive review by David Marquand of Vernon Bogdanor’s “The Coalition and the Constitution” which appears on page 8 of the Guardian’s Review section. But after ten minutes of unsuccessfully trying to find it on www.guardian.co.uk so that I could link to it, the urge has passed…….
Sorry about that.
It is the Second Day of the Report Stage of the Parliamentary Voting System and Constituencies Bill. Yesterday, in a very tight vote the Government was defeated by 219 votes to 218 on the issue of whether there should be a minimum turnout requirement before the referendum vote on the alternative vote would be binding.
There has just been another very close vote with an even higher turnout of members of the House of Lords. This time the Government won by 266 votes to 262. The issue was whether there should be local inquiries into the recommendation of the Boundary Commission on particular constituency boundaries. In the Committee Stage the Government had promised that they would bring forward their own amendments to make this possible (this was the offer that helped bring the Committee Stage proceedings to a close after seventeen days of detailed consideration of the Bill). In the event, the Government’s proposals were so weak and watery (it in practice only provides for the Boundary Commission to hold some public hearings) that there was a widespread feeling in the House that the Government had reneged on their promise – hence the amendment to strengthen the arrangements which was in the end narrowly defeated.
What is notable is the size of the vote: 528 members of the House voted (more than two-thirds of the House). This is almost certainly the highest number of votes cast since most of the hereditary peers lost their right to sit and vote in the House. And it approaches the record vote on the ratification of the Maastrict treaty, when a total of 621 Members voted in a division on the European Communities (Amendment) Bill on 14 July 1993 – and that was the largest recorded vote since 1831.
The figures, of course, reflect the wholesale creation of new members of the House of Lords since the Conservative Coalition was formed last May – 88 so far with more to come.
It is, of course, a fact universally acknowledged that no Londoner can fully understand the nuances of Scottish politics. The converse is usually true that no Scot can fully appreciate London politics.
Tom Harris (just for the record, no relation – although I do get a lot of his Parliamentary emails) has today, however, proved he at least understands the way in which the mind of Mayor Boris Johnson works with this post which I quote in its entirety:
“STATEMENT issued by the office of Boris Johnson, Mayor of London:
Comments I made in an interview this morning to BBC London radio have been entirely taken out of context. When I said that I would rather share a cell with Slobodan Milosovic than be in the same room as David Cameron, I meant, of course that the Prime Minister has my full and unambiguous support.
It was deliberately misleading of journalists to report my comment about George Osborne being “an incompetent oik” entirely out of context, then ignoring my tribute to George as “one of the best Chancellors the country has had since May.”
As for my reported comments about the entirely reasonable, fair and welcome changes to the proles’ rent handouts, it should be patently clear to anyone with a First in Literae Humaniores from Balliol that my comparison of the reforms with “ethnic cleansing on a scale not seen since the collapse of the Yugoslavian Tourist Board” was simply an endorsement of Iain Duncan Smith’s critical faculties.
So, gosh, well, I hope that clears that up, what?”
Yesterday’s Radio 4 “Beyond Westminster” programme, “A Touch of Ermine” contained an interesting discussion featuring Mehdi Hasan and Meg Russell debating the role of patronage in British politics and the future of the House of Lords.
I provide some local colour being interviewed by Michael Dobbs (author of “House of Cards”) recorded over coffee on the Lords Terrace last month (with the extraneous noises of the police helicopter and motor launches edited out, along with my response to one question “As somebody once said, you might say that, but I couldn’t possibly comment”).
I thought two important points emerged. The first was (I said it, so it must be important) that we have not yet had the debate about what we want the Second Chamber of Parliament to do – and that really needs to take place before we embark on the next round of reform. The second came from Meg Russell who pointed out that electing the Second Chamber would not necessarily remove the element of patronage from who become members of the new Chamber.
The BBC reports today on the loading of the first nuclear fuel at the Bushehr reactor in Iran tell us that the international community can be reassured on the basis that (1) the nuclear fuel rods are all being supplied by Russia and (2) the spent rods and waste will go back to Russia.
At the risk of sounding like an unreconstructed cold warrior, I have to confess to not finding this at all reassuring.
Why does Russia want to do this and what do they expect to get out of it?
And as for the waste, the work I have been doing in recent months on the safeguards (or lack of them) at reprocessing plants hardly makes any of this sound any better.
Please somebody persuade me that this is good news ….