COMMISSION ON THE POWERS AND ELECTORAL ARRANGEMENTS OF THE NATIONAL ASSEMBLY FOR WALES

MINUTES OF PROCEEDINGS OF THE EVIDENCE OF ROY NORRIS

held at

THE ROYAL WELSH SHOWGROUND, INTERNATION PAVILION ON THURSDAY 8 MAY 2003

Can I thank you very much for coming to Llanelwedd and for taking the time to give evidence to us? What we have asked people to do is to identify yourself and your organisation for the sake of the record. And then if you would be kind enough to speak to introduce the topic for perhaps five minutes or so. And then we can follow whatever issues we would like, if that is alright with you?

Yes, thank you very much for seeing me. My name is Roy Norris, I am at the moment Chair of the Welsh Ambulance Services NHS Trust, but the submission is made as an individual rather than speaking for the Trust itself. I consider my experiences somewhat unusual for an Englishman in Wales. I started working in the agriculture department in Trawsgoed for the old Welsh Office and after a series of evolutions became the Director for Wales of the National Lottery Charities Board from ’95 through to 2002, when I became Chairman of the Ambulance Trust. This gives me an odd or unique, picture of how devolution works, both in terms of a UK quango and then as the Chairman of the Ambulance Trust, which is a body that is now directly responsible through Health Commission Wales to the Assembly.

Yes, thank you very much for seeing me. My name is Roy Norris, I am at the moment Chair of the Welsh Ambulance Services NHS Trust, but the submission is made as an individual rather than speaking for the Trust itself. I consider my experiences somewhat unusual for an Englishman in Wales. I started working in the agriculture department in Trawsgoed for the old Welsh Office and after a series of evolutions became the Director for Wales of the National Lottery Charities Board from ’95 through to 2002, when I became Chairman of the Ambulance Trust. This gives me an odd or unique, picture of how devolution works, both in terms of a UK quango and then as the Chairman of the Ambulance Trust, which is a body that is now directly responsible through Health Commission Wales to the Assembly.

It is quite a struggle for any executive in a UK quango operating in Wales, constantly reminding people that they have got to take account of the changed situation in Wales. I am sure this is true in Northern Ireland, possibly less so in Scotland because there has been a more independent Scottish Office in the past. But I do think that there is this feeling in Whitehall that devolution does not really matter and the Assembly will follow in due course.

The outcome was an independent report commissioned by the Welsh Assembly, which showed that the Trust was under-funded to the tune of some £9-10 million. And we have had, as a result of that report, £3.5 million over two years and, provided we continue to deliver – and I think we are – I am reasonably confident the resources will be found to make up the deficiency that has existed from ’98. It would be my contention that, had it not been for the Assembly, we would still be struggling and grossly under-funded. It is the fact that the Assembly exists and can allocate additional resources, has enabled quite a serious performance problem to be alleviated, and I think in the next two to three years should be well on the way to elimination.

Thank you very much indeed. That is really very interesting. I was interested in what you had to say about the way in which you were received in London. I do not suppose you have much dealings with London direct now, do you?

Paradoxically, through the Ambulance Services Association, which is the UK organisation of which most ambulance services are members, and we are going through the same debate there. They are based in London and they speak of themselves as a UK organisation. One goes through the debate: that if that is so when there is an issue in Wales, why do you not all visit Wales – instead of just sending the paid hacks?

Perhaps you had better fill us in on the facts more. What exactly is the scope of the Assembly’s powers and control and all the rest of it over the Trust?

I would not say they had powers and control; that is not fair. They commission through Health Commission Wales, which is a new body, the Ambulance Service through NHS Wales. So the Assembly, NHS Wales, Health Commission Wales, Ambulance Trust, but quite clearly...

That is a ladder with a lot of rungs, is it not?

Sorry?

That is a ladder with a lot of rungs.

It is the way I have described it, but I think it is actually more seamless in reality.

Who effectively scrutinises you then?

The Health and Social Services Committee of the Assembly.

How often do they do that? Do you see them once a quarter, once a year, or...?

They saw us I beleive in, 2001 – it may have been late 2000. And then they are inclined to keep in touch with us; for example the Minister for Health will be in touch through quarterly meetings with chairs of hospital trusts and other more informal occasions. So, there is quite a tight link, but the NHS itself is now controlled through a director, Ann Lloyd, and she is working to bring together the management lines of accountability which I think in the past has had looseness or slackness within it. But, that is because I am fairly new. There are others who would say that this is unwelcome centralisation.

Are there issues where either the committee of the Assembly or you as a Trust would want to do things differently and are prevented by powers from being able to do that?

Prevented by?

Powers; prevented by powers of the Assembly to provide particular kinds of transport, or to influence other providers, or any cross-border issues, any cooperation with other emergency services?

Certainly cross-border issues are growing in concern, because as the two health services develop their own priorities and their own priorities, it is clear that people in border areas will compare one with another – favourably or unfavourably – very often depending on their condition and their needs. I think that will be an issue that increases in intensity. Certainly in this area, in Mid-Wales, there have been a number of issues with the Robert Owen Hospital at Gobowen and the Countess of Chester Hospital, with whom we have a close relationship. In some cases the Ambulance Service takes patients direct to hospitals in England, the Countess being one.

As regards limitations, I do not think so yet, because I think we are still on the point of exploring what we can do. We are developing things like intermediate transport, which is not quite an emergency ambulance. It is an ambulance that is equipped though to take people with lines in, needing transfusions, and they can be transported more quickly. It is halfway between an emergency ambulance and the ordinary hospital transport service.

Other areas where things can develop would perhaps be in the provision of an air ambulance, now this is not being provided yet. It is not provided in England. At the moment in England and Wales, all air ambulances are funded by voluntary subscription. In Scotland they are provided by the Scottish Health Service; it is actually commissioned. Again, they have got fixed wing aircraft as well, so it is a different situation because of the topography.

I must have misunderstood. I take my family to Cornwall in the summer on holiday and every summer you see on the rocks people being rescued by helicopter and they are taken off to Truro hospital. That cannot all be funded by voluntary subscription, can it?

If it is a Coast Guard helicopter, no. If it is RAF, no. But if it is the Cornwall Air Ambulance, yes.

Bring your chequebook next time!

That is one of the older air ambulances, but they are struggling to raise the funds.

Presumably you want to extend this in Wales and you want to have more funding. And so, does that form part of your £10 million?

No, that does not.

That is over-and-above?

That is over-and-above and that is being raised at the moment by voluntary contributions through an air ambulance charity. It is a good charity and it is raising a lot of money.

Returning to Viv’s question, there has been talk – and we have had some information – of trying to create a unified emergency services: police, ambulance, and fire coming together. Two of the three are actually totally devolved, or virtually devolved; the police side are not. Do you have any thoughts from a Trust point of view, or from the work of you as an ambulance service in an emergency situation, whether or not there should be any transfer of functions on the police side to the Assembly?

At the moment there is no problem in working with the police. We have excellent relationships in North Wales, for example, where we use the police helicopter. One of our paramedics is a trained police observer, and that means that if the helicopter is diverted to criminal work this person can act as a witness. That is an example – it is probably unique in the UK –of how closely we are working with the police. We are working on a joint control room at Camarthen with the police and ambulance service. If you were looking at the bigger picture of a unified emergency service, then I think you would have to be debating with the Home Office about transferring powers and functions, because it just would not happen effectively otherwise.

Is this the way that things are going? Can you see very clearly that interoperability, joint controls, and so on is the way things are going? And if so, does it involve all three emergency services or where is the cooperation likely to be?

At the moment, I would say that cooperation will be between the police and the ambulance service. It is more difficult with the fire brigade at this time.

Is that not just for political reasons, rather than practical ones?

I would say so. I think that organisationally there will be issues. When it comes down to basic things like staffing three control rooms for police, the fire, and the ambulance; all pay different rates, there are different conditions of service, and merging them – even at present – presents one or other of the services with considerable risks of people wanting to transfer to more congenial working conditions or better rates of pay. So, as an idea it is a good one, but the devil is in the detail..

Can I just finish that? Is this the direction things are definitely going? Your command-and-control rooms, for example, being the first of what is likely to be several. Is this a problem of, as you said: if there was more of this kind of joint working, then one would have to address the issue of the police now? Now, on what sort of timescale and how sure are you that that is going to happen, from what you have seen?

Remember, I must speak as an individual on this, because I cannot commit the Trust; it is not something that has been discussed. As an individual, I would say we would be looking – subject to how the fireman’s dispute is settled. Subject to having agreement in principle about the various pay and rations questions, you are looking six years, seven years perhaps – not that far ahead. But maybe that is slightly too short a time, given the genuine logistical issues that have to be resolved. But I would have thought it was going that way. Paramedics now are responsible for telling the firemen where to cut when people are being cut out of cars. That is a simple example of how the services have to work together and where some of the differences between the two services lie.

Can I move on to the paper you were kind enough to submit to us? There are two or three points on that I am interested in your views on: the civil service. I am not quite sure what your point on civil service is; are you saying there should be a Welsh civil service responsible to the Assembly or that we should maintain a UK civil service?

My intention was to say that there should be a UK civil service. The Assembly should be sold across the UK as a good career move for any aspiring civil servant in England or the rest of the UK. It will give them a picture of a whole administration that cannot be picked up from operating in any one Whitehall department, where I suspect there is much more of a silo mentality.

Sir Michael Wheeler Booth

Much more of an asylum...?

Silo, silo mentality.

So, with all your own experience, where you have gone through a range of public services within Wales – I mean, and gone from a civil service into a quango and through – we have had some evidence presented to us that this combination could create a kind of new Welsh public service and be self-sustaining. But that is not your view based on your past experience?

No, I think you can see it being self-sustaining to a point, but I came to Wales in 1985 having worked in the Ministry of Pensions and the Department of Social Security. I think you need to have a perspective with which to see the advantages of how things are organised in Wales. Otherwise, there is a tendency to assume that all patrs of Whitehall operate like Wales, it does not, and it is easy to miss the advantages that you can have working in Wales of taking a view across a whole range of central government departments.

Yes, the sentence that I was interested in was one that said a Welsh Assembly civil service would be to their [inaudible].

To the Assembly.

In other words, it would be Assembly civil servants.

Yes.

So you think people should move in and out of that job in exactly the same way as they do elsewhere in the UK.

Yes, I do.

The other thing I am interested to hear your views expanded on is tax. We have heard it said that you can give the Scots the powers to raise taxes because they will not use it, but if you give the Welsh Assembly the powers to raise tax, that is one of the first things they would do. How would you see the importance of having tax-raising powers?

Well, I think it would concentrate the public mind.

[Inaudible]

Well, yes. Thinking about the evidence that I heard this morning, there is not the public interest that there should be in a very powerful institution. I think to make the institution relevant to the public, they have got to be aware that the decisions of the Assembly can affect them in the pocket. For right or wrong, I think that they will then start to elect members with a bit more enthusiasm and interest, whether they want to have more money spent on public services or whether they would like to see public services reduced, or the share going to public services reduced. I suppose the counter to that is that local authorities have the community charge and they do not get very good turnouts either. But it just seems like one wing of a bird, where you are just issuing tax revenues without having any responsibility for raising revenue, or for considering other ways in which the money could be raised, and putting that before the electorate.

Lord Richard

Anyone else on tax?

Vivienne Sugar

I wanted to ask about pay and conditions of service. You said that bringing together people from different services into one control room would give you problems of negotiating that through to some degree of commonality. What about the wider picture? I am assuming that the pay and conditions for the people employed by the Wales Ambulance Trust is similar to the pay and conditions of Ambulance Trusts across the UK. Is there a national body or do you negotiate locally?

Roy Norris

We negotiate locally, but the Assembly gives us the pay remit.

Vivienne Sugar

Right, so you negotiate locally. How easy is it for you to attract people into employment? One of the arguments we have heard which does relate to tax was that if there was tax raising powers in Wales, people would be less inclined to move into Wales for employment.

Roy Norris

I am not sure that is the case in Scotland, where I know they have not implemented anything. We pay paramedics more in Wales and therefore we do not have any difficulty recruiting. Also, Casualty gives people an impression of the job of which they then have to be sadly disillusioned. Most ambulance crews would say they would never work with Josh because a) he always works on Saturday, and b) terrible things always happen when he is working. He would be called Jonah and no-one would work with him.

But I think we pay a fair rate of pay. It is a good rate for paramedics. I think our rates for admin staff are competitive; they do not need to be as high. I think it is right that we pay well because we need to keep the skills up. We need to encourage people either to stay in Wales or come across from English services so we can get the benefit of new ideas and different approaches.

Vivienne Sugar

How free are you to pursue different approaches? Are you regulated by anybody like a General Training Council or something like that?

Roy Norris

There is the Health Professions Council (HPC), and that has just assumed responsibility for paramedic registration. Paramedics are now a recognised health profession. There are a number of training schools. The one at Swansea is recognised probably internationally as being the best, so we have had great recognition for that. I would say though that the basic training is the same, but each service is governed by protocols. One of the things we have had to do since ’98 is weld five different protocols for treatment together. Putting it in crude and over-simplistic terms, if you called an emergency ambulance in North Wales they might be able to give you an injection of a pain killer of a certain type. In South Wales, they might not have been able to have done that – or they might have been able to give you an aspirin, or something else.

There have been historically different approaches to what paramedics are expected to do. We are bringing them together in Wales and they will develop very significantly now. We will be seeing paramedics administering clot-busting drugs, which in places like Mid-Wales is essential because the ‘golden hour’ before treatment can elapse in the back of an ambulance. What we are looking at is telemetry, 12-point ECGs; in a sense to move the casualty department into the back of the ambulance, because that is where the patient is going to be. Hopefully, as technology develops all the doctor will not know is what the person looks like when they arrive in the casualty department; the doctor will have all their medical history, and they will have competent paramedics giving treatment that would otherwise have to take place in hospital.

Ted Rowlands

Can we tease out of you a bit more about your experience with the lottery side of things? And particularly because there has been all that discussion about reorganising the lottery, and again the role and function of devolution in that process. I wondered if you could share with us your thoughts on your role as Director. Should it just be totally devolved and a fixed percentage of budget? I mean, tell us what your thinking is on it.

Roy Norris

My view is that the National Lottery Distribution Fund, which is where the money gets passed from Camelot to government – it goes into a distribution fund – should be divided into four. It would then be for the Assembly to decide the allocation in Wales to the various good causes. It has nothing to do with the actual awards, but it would give the Assembly the power to determine that, for example, arts might have slightly more or slightly less, heritage more or less, the New Opportunities Fund might have a different remit, which is possible under that sort of scenario.

It would mean that the Assembly was kept out of actual grant making, which I suspect it would prefer to be, but it would give the Assembly the power and the responsibility for drawing up a lottery strategy and it would give them the meansl to direct the funds. At the moment it is an impossibly convoluted process. If any one of the UK distributors disagreed with an Assembly proposition, all they have to do is talk to their London headquarters, who would talk to the Department of Culture, Media, & Sport and it would just go straight into the sand. So, there is a good opportunity for the Assembly to take an initiative..

I think the opportunity that is created by the merger of the New Opportunities Fund and the Community Fund is one that the Assembly could seize if it had the resources to think through the implications. I would quite like to see that as a first step, where we could see whether or not there is an opportunity for merging all five distributors to have one lottery distributor in Wales. I suspect the issues are too complex. I believe that arts and sports – and indeed heritage –would have to remain as distributors because of their specialised knowledge of the various fields and how they handle the bids within those fields. But I think giving the Assembly the responsibility by dividing the distribution fund to the four countries would be a way of ensuring there was strategic Wales control over local decisions. It has certainly been interesting to see how, when I was working with the Assembly, although one would try to involve MPs and some responded, many did not. We would have much more contact with Assembly Members looking at lottery bids. There was an honourable exception. (This refers to Mr Ted Rowlands close interest in the lottery when representing his constituency)

Lord Richard

I hope so.

Vivienne Sugar

Can I follow up on that and just say that I have been told that Wales in the past has not had its share of lottery money, and that also Wales is overlooked when it comes to the location of projects that might have beyond UK significance. Would your idea of dividing up the fund into the four constituent countries actually reinforce that position?

Roy Norris

No, I do not think it would. Firstly the debate on the amount of money that went to the four distribution funds would have to be more sophisticated than simply population. It would need to refer to Parliament for Parliament’s views on where the priorities lay. Certainly the old Community Fund share of the lottery money was based on poverty and deprivation, as well as population. That was taken up by the New Opportunities Fund. Arts and sports is based on population, but it is wrong to say Wales did not get its fair share, it is demonstrably wrong. The Heritage and the Community Fund managed in the early days to siphon money across from England, where there was less demand for some projects. If you look, Wales has done very well.

The reason why I suggest the National Lottery Distribution Fund should be divided and a high level debate take place, is that I am very anxious that we do not lose out by simply saying that tickets sold in Wales should be the determinant of the amount of money that goes to Wales. If that argument is pursued, all that happens is the Southeast of England get an awful lot more money, because although they spend a smaller proportion of the income on the lottery, it amounts to a very large amount of money. We have to be very careful about how that debate is taken forward.

On the UK side, I think when it comes to grants, criticism is right. It has always been an issue for the three countries that whenever there is a UK award, you look at where the organisation is based and it is either based somewhere in central London, or Islington, or somewhere close to the centre. Really, when an award is made it has an impact at the organisation’s head office. We were trying at the Community Fund to ensure that at least 5% of the money was going to be spent in Wales, but with a £100,000 award, 5% is not enough to make any impact in Wales

I would argue that by putting the power down to lottery distributors in Wales, taking the Community Fund as an example, if there was a UK bid then the four country chief executives and their committees would have to sign up to the award being made, and they would have more power to say, ‘No, this is not a UK bid. It is a two-country bid or it is an England bid.’ I think that way we would enable the countries to keep more money for country activities. Certainly in the voluntary sector, I think the power and the vitality comes from local groups addressing local needs.

Tom Jones

Can I comment and ask for your response? The National Lottery distribution body is really symptomatic of a process where devolution is not a process, but an event – in the sense that the first legislation for the lottery distribution was pre- the Government of Wales Act, in which case the responsibility rests with now the DCMS, the department in those days, the Home Office, if I remember. Then there was then a second distribution act, but the thing is that there has been no change. In other words, I think the minister last week emphasised once again following this current review of lottery distribution, that she was the minister with responsibility for lottery matters generally and distribution in particular.

Therefore, although there has been the creation in the interval of a National Assembly with a different programme for culture, sport, community, and new opportunities; because it was there before devolution the government is now sort of hanging on to that responsibility and is unwilling to actually let the Assembly take and make these changes, or certainly if it will be able to make changes it will be very difficult and will depend a lot on influence. What are your comments on that?

Roy Norris

I think that is right. With the wisdom of hindsight, I am sure that the whole lottery distribution would have been different had people realised the amount of money that was going to be raised. In 1994 I was told that it would raise about £50 million for good causes, voluntary sector, charities, sport, which is a relatively small sum of money. You would not set up an office for that amount because the percentage – be it 5% or be it 6.4% – of £50 million just did not warrant it. Of course in the first year the Charities Board received over £300 million, but that was something that was simply not expected in those early days. Had we known then what we now know I suspect the Welsh Office would have taken a very different view of the lottery arrangements.

I think now we need to be revisiting what has happened. There is still merit in changing the legislation, even though the lottery receipts are declining. In fact, there is probably more need to have better lottery distribution that is more appropriate for Wales because the funds are shrinking. So, yes, I am sure had the events been transposed, we would be looking at a different system and I am sure the Assembly would have been much more involved than it is at the moment.

At the moment it is slightly bizarre because while the Sports Council is directly responsible to the Assembly; you have the New Opportunities Fund which works closely with the Assembly and there are slightly tighter administrative arrangements for selecting programmes; and the Heritage and Community Fund which – although it never has and I hope never would – has the power to just say, ‘Thank you very much. We have noted what you have said,’ and carry on doing exactly what it wants to do.

Tom Jones

Just to qualify what you just said there, I think the chief executive of the Arts Council was saying to us that actually it is a split accountability. In other words, the responsibility for lottery distribution by the Arts Council as far as accounting procedures are concerned [Welsh phrase] still has an element of UK but minus the Celtic countries discussions still taking place.

Roy Norris

Yes, the DCMS control the National Lottery Distribution Fund and obviously if there is a UK arts issue, no doubt this will be top sliced for the UK

Sir Michael Wheeler Booth

Can I ask a slightly different question before we stop? You seem to suggest on page two of your paper that it would be right to have fewer Welsh MPs and in their place – so to speak – there should be more members of the National Assembly. That is correct, is it not?

Roy Norris

I think so.

Sir Michael Wheeler Booth

And my second question is: you refer to the legislative process on page two and you appear to be saying that you think there should be more so-to-speak ‘co-legislation’ between the Westminster Parliament and the Assembly – is that what you are suggesting? – rather in the way that the Welsh Select Committee [inaudible]?

Roy Norris

Yes, I suppose I am anxious at the moment too much is lost through lack of parliamentary time and the fact that officials know that parliamentary time is not going to be available limits their aspirations and their advice. If the Assembly had more legislative powers, there is clearly an issue of iwhether there going to be a second chamber of some sort. That could be Parliament reviewing legislation, or it might be a role for list AMs . Very undeveloped initial thoughts I know; that may not work at all.

I think that what we need to do is now look at the numbers, because we have changed the situation. I think 635 Westminster MPs looks unwieldy. I think if we combine that with expanding the representation of devolved administrations, it then looks as though there is a coherence and a balance; things are not just being left as they were in the past and adding things on incrementally.

Sir Michael Wheeler Booth

A last question: you said you came from the UK civil service and worked in Wales in 1985. You said you thought it would be a good thing if more people were coming from England to work in Wales. Since the Government of Wales Act was passed, is it your impression that this flow has continued, or has it dried up?

Roy Norris

I do not know the answer to that.

Lord Richard

Thank you very much indeed Mr Norris, it has been refreshing.

Roy Norris

That sounds a bit like ‘courageous’.

Lord Richard

Generally you have ideas which we have not heard expressed before. It was very useful for us. Thank you very much for coming.