HC Deb 21 March 1950 vol 472 cc1919-30

Motion made, and Question proposed. "That this House do now adjourn."—[Mr. Popplewell.]

12.9 a.m.

Mr. Boyd-Carpenter (Kingston-upon-Thames)

Tonight I desire to raise the question of certain rather odd happenings in the South-West Metropolitan Regional Hospital Board, events which have caused, and are causing, considerable feeling in my constituency. They also, I think, give rise to rather interesting reflec- tions on what is happening generally on the hospital side of the National Health Service. I understand that it is the policy of the Ministry of Health and, in general, it seems to be the right policy, not to intervene in the actions of these regional boards; and I say at once that I am the last man to suggest lightly that the Minister of Health should intervene in any particular activity more than he does at present. The circumstances which have arisen in this particular case, however, are such that non-intervention by the Minister would really amount to connivance of a grave abuse in the powers of the Regional Hospital Board. If I can satisfy the House that matters have arisen which demand an inquiry by the Minister, I hope the Minister will accept the view that inquiry, at least, must take place.

The House is aware of the general structure of these boards. The regional boards are appointed by the right hon. Gentleman, and they, in their turn, appoint the group management committees, which actually control the group of hospitals. These appointments are generally for short periods, but it is possible to renew them. In the particular case which I have in mind, the dispute has arisen in connection with the appointments to the Kingston Group Management Committee, and so that one may have a proper understanding of this matter, it must be explained that in the background of this dispute concerning appointments, there is another dispute still going on between the Group Management Committee and the Regional Board.

That dispute, into which I do not propose to enter, because the matter is sub judice and no decision has been reached, is whether the Kingston Victoria Hospital shall continue as a small hospital as at present—to which general practitioners may go to treat their patients—or whether it shall be turned into a maternity unit attached to a larger hospital. There has been a dispute of some months between the Group Management Committee and the Regional Board, a dispute which is still continuing and which, unfortunately, has given rise to considerable feeling. One member of the Regional Board has demonstrated, in my view, his complete unfitness to continue as a member by announcing while the controversy was going on, that the views of the Management Committee were a "political stunt."

The question has now arisen of the renewal of appointments to the Management Committee and what has happened in the last few days is that the chairman of the Management Committee and three of the members have not been reappointed. It is significant, I think, that both the chairman, and the three members not re-appointed, are all people who have strongly supported the views of their own Management Committee as against the views of the Regional Board. The chairman is a constituent of my right hon. Friend the Member for Epsom (Mr. McCorquodale) and is a man of considerable ability; a former member of the Surrey County Council, which post he gave up to undertake duties of the Management Committee.

The other three members are all people of considerable distinction, one being the chairman of the House Committee of Kingston Victoria Hospital. All are people who have taken the line which their local experience entitles them to take, that the Group Management Committee's views are more in accordance with local needs and local tradition and local feeling than are the recommendations of the Regional Board. Yet in the middle of this conference as to the future of the Victoria Hospital, the chairman and three members of the Management Committee have not been put back in their appointments.

It would certainly appear that the Regional Board have used their powers of appointment in order, in my view, to force their views upon the Management Committee. It would appear—I say this in parenthesis—equally, that the Regional Board have taken a curious view of their duties under the National Health Service Act. If the Parliamentary Secretary would be good enough to refer to the Third Schedule of the Act of 1946, the relevant part is Part II, he will notice that it is there laid down that before making the appointment to fill vacancies the Board shall also consult the Committee. I understand that, in fact, that consultation has not taken place.

But whatever the consequences of that breach of their duties under the Act, I do not wish to lay particular stress on it, because I am very much more concerned with the merits of the matter and with the fact that people have been removed from duties they have satisfactorily discharged for no apparent reason other than that they disagreed with the Regional Board on a controversial matter which is still at issue.

The chairman, whose obvious capacities for the duties he was successfully discharging no one has ever disputed, has been replaced by a distinguished admiral who comes from outside the hospital area and who, in the circumstances, may find it somewhat difficult to confirm his acceptance of the appointment. I do not know. In any event, the matter strikes local opinion, and I must confess strikes me, as bearing only one possible interpretation. I would like to quote, in that connection, the words of the removed chairman, made in a letter to the local newspaper: As one of the victims of the 'purge' I should like to make public my experience as the chairman of Kingston Hospital Management Committee: the whole administrative set-up of the hospital system is thoroughly unsatisfactory … In the first place, as I have already stated to your representative, the position of chairman of the Management Committee is not defined. The view of the Regional Board, as expressed by their chairman, has however been made most abundantly clear to me. It is that the chairman of a Management Committee should bludgeon his committee into accepting the policy of the Regional Board. The same word "bludgeon" is, in my view, very appropriately used in a leading article in that local newspaper of the same date, which reads: Last Saturday we suggested that members of the Kingston Group Hospital Management Committee who opposed the Regional Hospital Board's plan to annex Kingston Victoria Hospital had been thrown off the committee because of their opposition. All those opponents whose term in office had expired, although they could have been re-appointed, were cast aside. The only reason for that action was obviously the one we gave—that these members fought for what they thought right instead of doing what they were told, and so were ousted. It is clear that is part of an attempt, and I believe it is not the only attempt, this particular Regional Board has made to exercise its powers of appointment in order to override the Group Management Committee. As I understand it, the Group Management Committee's whole object is to secure that local feeling and local views are properly represented. Of course, it makes an absolute mockery of the discharge of the duties if the Regional Board who appoint their members is to indulge in abuse of their power of appointment. That it is not anything but part of a consistent attempt to do that is illustrated by two ancillary matters.

At the same time of these appointments, the local advisory committee was asked for recommendations of appointments to the Group Committee. They nominated four medical men in order of preference. The Regional Board appointed the last two—the two at the bottom of the order of preference—and it is perhaps significant that the doctor whose name appeared first in the order of preference on the list is a very distinguished man, prominent in the activities of the British Medical Association, who shares the views of the Group Management Committee on the future of the Victoria Hospital. It is equally interesting to note that there remains on the Group Management Committee another gentleman who, I should have thought, was very disadvantageously placed there in as much as he is not only a member of the Regional Board but is also in his medical capacity an employee of the Group Management Committee.

It appears, therefore, that this is no isolated error of judgment. On the contrary, it appears that it is part of a deliberate effort to override the Group Management Committee and to enable the Regional Board to get its way by what I must confess I regard as a gross abuse of its power. That being so, it seems to me that it is imperative that the Minister should intervene. I do not ask the Parliamentary Secretary to accept merely the version of the facts which I have given to the House tonight; all I ask him to do is to give an assurance that the matter will be investigated, that the Minister will discuss the matter not merely with the Regional Board but with the members and former members of the Group Management Committee and will make up his own mind, in an impartial manner, on the facts. That is all I ask and, in justice to my constituents. I do not think I can ask for less.

12.22 a.m.

Mr. McCorquodale (Epsom)

In spite of the lateness of the hour I rise to support what has been said by my hon. Friend the Member for Kingston-upon-Thames (Mr. Boyd-Carpenter) and to express my apprehension as to what is going on in the district I have the honour to represent in regard to hospital administration. My hon. Friend has raised the question of the dismissal—and that is what it is—of a very worthy chairman of the Kingston Hospital Group Committee. His appointment has not been confirmed for a further period and all he got was a curt letter of three lines from his superiors. If that is not tantamount to a dismissal I do not know what is.

This gentleman is a very prominent constituent of mine, and a very good friend. He is an ex-alderman of the borough and an ex-member of the county council. He gave up his other public work to have plenty of time to concentrate on hospital administration. A distinguished lawyer, a man held in high regard in our area and a man with a long and successful experience of hospital administration, he seemed an ideal choice, and I cannot help thinking that to allow him to go with a curt letter of three lines is not in the best traditions of the Ministry of Health. It is contrary to the views expressed by the Minister himself in recent Debates and Debates last year when he himself highly commended the disinterested work of the chairmen of these boards and committees.

I was apprehensive about this matter and I became much more seriously alarmed when I learned that the same treatment was being meted out in the group hospital committee next door. The distinguished chairman of the St. Helier Committee, in spite of the unanimous approval of his leadership by his own committee—I think I am right in saying this—has been told that his appointment has not been confirmed. I submit that there is obviously something wrong between the Regional board and the Group Hospital Committee. The Regional Board is under the authority and is the responsibility of the Minister and I would reinforce the plea of my hon. Friend that the Minister himself should look into the matter. I do not want to go into the reasons for some of this trouble, although I think I know something about it. I am convinced that if the Minister wishes he can easily find out the cause of the trouble, and then I would urge him to take action to rectify these distressing events. It is only in this way that he can get the good and economical administration which we all hope to see in the conduct of our hospital affairs.

12.25 a.m.

Mr. Messer (Tottenham)

I sincerely hope that the Minister will not give in to the appeals which have been made to him. I remember the Debates on this Act when, as a Bill, it was passing through the House, and I recall how strongly the Opposition said that there must be no interference from Whitehall. They said that the Minister of Health must not do anything to interfere with the responsibilities placed on the shoulders of the regional hospital board. They were planning bodies, it was claimed, and if they were to be subjected to the directions of the Minister of Health the result would be a central bureaucratic machine against all the interests of this human service.

We have an instance here where, because it suits the Opposition, they want interference from Whitehall, but I want to tell the Minister that this is far more important than this incident appears to suggest. It is important because the boards could not possibly do their job if they always had to be looking behind their shoulders to see whether what they were doing met with the approval of the Minister. Indeed, the defence is contained in the fact that the regional boards are independent and, under the Act, have certain authority and powers. They have powers, for instance, of appointing management committees, and it is ridiculous to talk about a purge. It is ridiculous because what has not been said tonight is that the board before they get the recommendations receive them from the area committee, and they do not get them from the management committee. The hon. Member for Kingston-upon-Thames (Mr. Boyd-Carpenter) said there was no consultation. Is he not aware that all the bodies mentioned in the Schedule to the Act were approached?

Mr. Boyd-Carpenter

The consultation I referred to was not consultation with other bodies but consultation with the committee, as laid down at the end of Part II to the Third Schedule.

Mr. Messer

That consultation took place. I have a copy of the letter which was sent. When that letter was sent, the Management Committee sent forward nominations. Those nominations did not go to the Regional Board. They first of all went to the South Surrey Area Committee, and it was this Committee which sent the recommendations to the Regional Board.

Mr. Boyd-Carpenter

So that there was no consultation with the Committee.

Mr. Messer

There was consultation to the extent that the area committee was the agent of the Regional Board for this purpose. The hon. Gentleman cannot have it all ways. I know that he likes it all ways, but he must be logical. His forensic skill should make him recognise that some degree of consistency is required. I suggest that if the Minister of Health permits an inquiry into this then every regional board will be faced with this prospect when it declines to renew an appointment.

That was the case here. These members have terminated their appointments, and what is more, I can say now what I would not have said if he had not quoted from the newspaper report—that the chairman resigned and, after that resignation, asked for it to be withdrawn. That resignation was withdrawn, so that it is absurd to suggest that this was a question of victimisation merely because the Regional Board disagrees with the Management Committee about the use of a hospital. What is the position of a regional hospital board to be when it plans a service, and has to look not at an individual hospital but at the Health Service as a whole? I regret that time does not permit me to develop that as I would like, in a way which would show that the Service would break down if the Minister gave in to this appeal.

12.30 a.m.

The Parliamentary Secretary to the Ministry of Health (Mr. Blenkinsop)

am a little surprised and very sorry, that the hon. Member for Kingston-upon-Thames (Mr. Boyd-Carpenter) and the right hon. Member for Epsom (Mr. McCorquodale) should have indulged in what I can only describe as special pleading before the House in the case of the non-reappointment of certain members of the Kingston Group Hospital Management Committee. Quite properly, I believe, my right hon. Friend has no power whatever to deal with the appointment of hospital management committees, which is the statutory job of the regional hospital boards. Indeed, if that were not so, what we would get presumably, in this House, would be a repetition on a much wider scale of the sort of pleading we have listened to tonight.

Throughout the country, whenever regional hospital boards thought it desirable to have changes in the membership of hospital management committees, as they are fully entitled to do, we would have members on both sides of the House putting their impassioned cases in support of particular members of the committees who might not have been reappointed, and creating complete disorder—which they may desire to create for all I know—in the working of the hospital system.

Mr. Boyd-Carpenter

Is the hon. Gentleman saying that, assuming there to be grave abuses on a regional board his right hon. Friend is absolutely helpless?

Mr. Blenkinsop

I am saying that he has no power at all to question the appointments to hospital management committees. That is the point we are dealing with tonight. I am interested to observe that hon. Members opposite are taking this line of opposition to the Regional Hospital Board concerned, and are clearly attempting to do all they can to make the work of that Board as difficult as possible. It is another example of what I suppose hon. Members opposite call their great anxiety to help develop the hospital service.

Mr. McCorquodale

Is the hon. Gentleman suggesting that any effort we on this side may make to see that the hospital administration is carried on decently, which all people in the country wish to see, is pure party politics, because, if so, that is not worthy of him?

Mr. Blenkinsop

What I am saying is that the attempt to introduce the Minister into the appointment of hospital management committees would be an entirely retrograde step, and would bring into operation the sort of political intervention which it would be our desire to avoid, and which we imagined at one time, perhaps foolishly, that hon. Members opposite would also desire to avoid. It is clear from Part II of the Schedule that management committees shall consist of the chairman and such other members as the board think fit, and that the members shall include persons appointed after con- sultation in various ways. We are satisfied that the Regional Hospital Board here has carried out its duties to the letter, and there is no basis at all for my right hon. Friend to intervene in any way.

I would add this: my right hon. Friend has, as he is fully entitled to do, sent advice in circulars to regional hospital boards generally on the question of the size of management committees, and the different bodies that should be consulted in addition to those laid down in the Schedule, and on the desirability for change from time to time in the membership of hospital management committees. The desirability of getting new personnel to serve on these committees is a matter which we also consider from time to time in the appointment of regional hospital boards. We would hope that we would not have when we make changes on these boards to be checked in the way suggested. If that were the attitude then it would be impossible to make any changes that we might want to make in order to bring new blood on to the boards. Also, we want to encourage the regional hospitals boards, in their turn, to bring new personnel in to the management committees.

Instead of that hon. Members want to criticise every time that this is being done. The hospital boards are fully responsible to the Minister for the organisation of the hospital services in their region. I suggest that it would be quite undesirable for the regional hospitals boards to be attacked when they desire to make changes in the membership of their managements committees in the way we now suggest they should be. If that were done I cannot imagine that very many members or the chairman of the regional hospital boards would be willing to accept the very heavy and real responsibility imposed upon them under the Act. My right hon. Friend and I have on many occasions called attention to the most valuable work which is being done both by the regional hospitals board members and by members of the hospital managements committees throughout the country, and they are doing this work voluntarily to the great advantage of the community.

I would suggest that it is a great pity that issues of this kind should be raised in the House in a way which can only be interpreted as an attempt to introduce party political motives into a service which we would all desire to see kept outside that arena. This is all the more so because I imagine that hon. Members opposite as well as hon. Members on this side of the House desire to ensure the greatest freedom of action to regional hospital boards to make sure they should not be influenced unduly in the carrying out of their duties by interference in matters which are wholly their responsibility.

Obviously, on this matter I cannot say anything about the Management Committee which was referred to by the right hon. Member for Epsom, but the same issue applies. There, again, we would certainly not interfere with decisions taken by the regional hospitals board upon the appointment of a chairman. All we would point out is that the powers of the Minister, which are frequently used, are to give advice upon the conduct of their work and to take into consideration the various proposals that are put forward by regional hospital boards and to consider the various objections which may be made by management committees. We have to hear the representations made to see that all points are considered, but on this particular issue of the appointments to this committee, where it has been expressly laid down in the Act that the responsibility should be wholly upon the Board.

The Question having been proposed after Ten o'Clock on Tuesday and the Debate having continued for half an hour, Mr. DEPUTY-SPEAKER adjourned the House without Question put, pursuant to the Standing Order.

Adjourned at Twenty-one Minutes to One o'Clock a.m.