Area Health Boards (Hansard, 18 July 1973)

§ 1. Mr. David Steel
asked the Secretary of State for Scotland if he will consider political balance when appointing the additional members to the proposed new area health boards.

§ 20. Dr. Dickson Mabon
asked the Secretary of State for Scotland what consultations he had with representatives of the Conservative and Unionist Party in Scotland about recent appointments to the area health boards; and how many members of the Conservative and Unionist Party in Scotland were appointed.

§ The Secretary of State for Scotland (Mr. Gordon Campbell)
I do take into account political affiliations, where they exist and are known, but I do not regard this as a major consideration in making these appointments. The political parties were not invited by my Department to suggest names of persons for appointment. There are many members of these boards whose political affiliations, if any, are not known.

§ Mr. Steel
I agree with the Secretary of State that political considerations are one of the minor factors of importance in making these appointments, but will he accept that on looking down the list lie gave in a Written Answer on 11 th July I was struck by the fact that, while many members have obvious qualifications to serve, most of those whose qualifications are doubtful turn out to be members of the Conservative Party? This raises queries in the minds of certain hon. Members. Leaving aside political considerations, does the right hon. Gentle. man accept that in making further appointments it would be good practice to consult local Members of Parliament, irrespective of party, with regard to the merits of the individuals he is considering for appointment?

§ Mr. Campbell
I do not accept that anyone looking at the list published in HANSARD on 11th July could come to the conclusion reached by the hon.
457 Gentleman from his observation of it. In making the remainder of the appointments we shall welcome suggestions of members to be appointed on their qualifications and the contribution they can individually make.

§ Dr. Mabon
Is the Secretary of State aware that of the 179 lay appointments that he has made to the boards, 29 are identifiable as members of the Labour Party, either as local councillors or taking part in other activities, while slightly fewer than 100 are members of the present governing party in this House but not in Scotland? I am not able to give the precise figures, but the disproportion is about three to one. Is not that a disgrace? Is not it high time that the Secretary of State realised, if he is to keep his reputation for fairness in making the appointments—which is slightly in jeopardy at present—that he will have to make a much better selection than he has done so far?

§ Mr. Campbell
I do not accept what the hon. Gentleman has put forward. The list includes a number of well-known supporters of the Labour Party, some of whom are particularly prominent members of that party, and some who have been appointed as chairmen of the boards. The list includes some known supporters of the Consevative Party and many who have no political affiliation, or whose political affiliation is not known. I do not accept that there is anything like the disproportion that the hon. Gentleman suggests. As far as I can see, there is a reasonable balance.

§ Sir F. Maclean
Apart from political affiliations, will my right hon. Friend bear in mind geographical considerations and, in filling the remaining appointments, will he see that adequate representation is given to North Ayrshire, about which I have written to him?

§ Mr. Campbell
Yes, I shall certainly bear in mind geographical considerations. On the Ayrshire and Arran board, out of the four local government members three are Labour supporters.

§ Mr. Baxter
Does the Secretary of State recollect that I wrote to him some time ago putting forward a suggestion on the lines of that contained in the supplementary question of the hon. Member for Bute and North Ayrshire (Sir F. 458 Maclean)? Will the Secretary of State tell the House—because he did not tell me in reply to my letter—what organisations or individuals he consulted in various areas?

§ Mr. Campbell
I shall be answering this matter, in a manner which I am sure will be satisfactory to the hon. Gentleman, in reply to a later Question.

§ Mr. Ross
I take it that the Secretary of State is sincere in what he says, but in view of the remarks by hon. Members on this subject will he reconsider the matter and check whether there is an overbalance on one side or the other and seek to put it right in remaining appointments?

§ Mr. Campbell
As I indicated in my original answer, this will be one of the considerations in mind, but the main consideration must be the personal qualifications and the value of the contribution which an individual can make. But there are other points relating to geography, and also the question of political balance.

§ Dr. Mabon
In view of the unsatisfactory nature of the answer, I beg to give notice that I shall seek to raise this matter on the Adjournment at the earliest possible moment.

§ 5. Mr. Robert Hughes
asked the Secretary of State for Scotland if he will define the criteria governing the eligibility for service on area health boards of those persons who receive payment from the area health board.

§ The Under-Secretary of State for Health and Education, Scottish Office (Mr. Hector Monro)
Persons whose employment brings them into a line management relationship with the chief officers of a board, for example, administrative and nursing staffs, are not regarded as eligible for membership.

§ Mr. Hughes
Do not the consultants and general practitioners have a contractual relationship with the boards? Do they not advise the boards in relation to the allocation of resources? Does not the chief medical adviser often have to discuss with his board the plans of the consultants? At present these people are making the appointments of chief medical officers. Is not this a wrong concept entirely?

§ Mr. Monro
I cannot accept what the hon. Gentleman says. There is a very special contractual relationship between consultants, general practitioners and the future area health boards which is very different from that of the line management of the nursing profession.

§ Mr. Grimond
In the interests of open government, will the Scottish Office consider publishing a White Paper on the methods of appointment to all public boards covering, for instance, whether paid people are eligible, who keeps the list, who is consulted, how far political affiliations are taken into account, and what priority is given to retired civil servants?

§ Mr. Monro
I think that all the appointments made by my right hon. Friend have been excellent, but he has heard the right hon. Gentleman's views and I have no doubt that he will give them consideration.

§ Mr. Sillars
May I raise with the hon. Gentleman the question of the relationship of consultants with the health boards? Do not consultants have a pecuniary interest in policy decisions of boards about full-time or part-time appointments? Ought they not to declare an interest and take no part in the proceedings when boards decide on appointments?

§ Mr. Monro
These matters must be considered in the light of the fact that consultants and general practitioners have a great weight of experience to give to the boards in relation to the National Health Service. It is that experience that we wish to have.

§ 12. Mr. Lambie
asked the Secretary of State for Scotland if he will appoint the remainder of the members of area health boards before they next meet.

§ Mr. Monro
No, Sir.

§ Mr. Lambie
That is a very unsatisfactory answer. Will the Under-Secretary inform the House which faceless mandarin at St. Andrew's House thought up this undemocratic method of appointing only part of the membership of the area health boards? Surely it could not be a politician like the hon. Gentleman.
Is the hon. Gentleman aware that when these further appointments are announced 460 all the major decisions about management and the appointment of chief officials involving salaries of more than £10,000 a year will have been made? This is not fair to existing members. When is the Minister going to cut out all this nonsense and get a bit of democracy back into these appointments?

§ Mr. Monro
The hon. Gentleman is having one of his brighter sessions today. More than 200 organisations put forward nominations, so there was no question of my right hon. Friend and me drawing them out of a hat. The position was carefully considered. My right hon. Friend has made it plain that political affiliation is only a small part of the consideration.

§ Mr. Robert Hughes
When the hon. Gentleman consulted the nurses before the reorganisation Bill went through the House did he tell them that the right of appointment which they then had would be done away with? Secondly, will he address himself to the point raised by my hon. Friend the Member for Central Ayrshire (Mr. Lambie)? Is it right that two-thirds of the eventual board membership should make all the decisions about the number of districts, appointments, allocations, and so on? Surely the hon. Gentleman must do something about that.

§ Mr. Monro
Nurses have seen the Powell Report, about which the hon. Gentleman knows, dealing with nurses in the integrated health service and explaining the position of line management. As I have said, the other appointments will be made later this year, in plenty of time to make a valuable contribution to area health boards.