HC Deb 04 March 1954 vol 524 cc1345-9
29. Dr. Stress

asked the Minister of Health how many of the regional boards allow transfer from whole-time to part-time consultant medical service.

Mr. Iain Macleod

All do in suitable cases, subject to the needs of the service.

Dr. Stross

Can the Minister say what is his view about the matter? Has he noted that the service is not normally well served, or best served, by men in full-time service transferring to part-time service? Would not the right hon. Gentleman consider giving some further thought to, or direction in, this matter?

Mr. Macleod

I do not think that any such generalisation can be drawn. The policy which I have indicated in my original answer, that all boards allow transfers, subject to the needs of the service, is based on the 1948 circular, and there has been no change in that. I believe that a part-time consultant service is a very good thing, and I have certainly no evidence to show that there is any deterioration in the service provided to the people.

Mr. Blenkinsop

Is the Minister aware that he is giving some encouragement to the transfer from full-time to part-time service? Is it not the case that some regional boards are offering the maximum number of part-time sessions, as an alternative to full-time sessions, to the great detriment of the service, and to its added cost?

Mr. Macleod

Boards may well interpret circulars—in particular the 1948 circular—in different ways. As the hon. Member knows very well, there are different trends in different regional boards. I have no reason to think, however, that the boards are not applying their general policy to individual cases—which is what matters—in a reasonable manner.

Mr. K. Robinson

Will the right hon. Gentleman consider asking regional boards to inform him of the number of these transfers which have been made during the last year or two, in view of the fact that he could not give this information to the House when I asked a Question some months ago?

Mr. Macleod

Speaking offhand, the reason I cannot give that information is the form in which the information is at present collected. It may show the number of posts, but it does not necessarily follow that that is the number of persons in those posts, because people may hold more than one. If it is worth while, I shall see if I can get that information, but I am not anxious to put additional paper work on to the boards.

30. Dr. Stross

asked the Minister of Health whether he will give an estimate of the financial saving that would follow the abolition of the part-time consultant service and its replacement by a service employing only full-time specialists.

Mr. Iain Macleod

No, Sir. I do not think the financial effect of such a hypothetical circumstance can possibly be assessed.

Dr. Stross

None the less, is the Minister aware that some of us think that the saving would be very considerable? Is he further aware that men working full-time as consultants are not allowed any of the perquisites, such as expense allowances and so on, that follow service of a part-tune nature? If there could be a switch over to full-time service, would it not be possible to make that full-time service much more attractive, even financially?

Mr. Macleod

I am aware of the way in which remuneration of all forms is treated rather differently as between whole-time and part-time specialists. As the hon. Member knows perfectly well, that goes back to the Spens Report. The first half of his supplementary question —I do not know whether I am to take it as an expression of opinion from the Opposition benches—is in direct conflict with the 1949 amending Act. Any suggestion of part-time service being abolished would certainly be a breach of faith with the profession.

Mr. Hastings

Does the right hon. Gentleman realise that great cost is in-flicted upon the service by the payment of travelling time and expenses? Would not the withdrawal of those facilities—which apply only to part-time officers—save him a lot of money and give him an opportunity to improve the service in other directions?

Mr. Macleod

I understand the point but I do not agree with it. I think the question is perhaps more appropriate to Question No. 44.

44. Mr. Blenkinsop

asked the Minister of Health whether he is aware of the financial advantages enjoyed by part-time specialists employed by hospital authorities in comparison with those employed full time; and whether he will refer the matter to the Guillebaud Committee for their consideration in view of the heavy cost of payments for travelling time and domiciliary visits charged by part-time specialists.

Mr. Iain Macleod

I am aware of the arrangements which were agreed in 1949. In reply to the second part of the Question, it is open to the committee to consider the point made by the hon. Member, but I do not think that it would be appropriate for me to ask the Committee to inquire into particular topics.

Mr. Blenkinsop

Would the right hon. Gentleman not agree that very heavy expenses are being involved in travelling time from a specialist's home to the hospital, and from hospital to hospital, and in the charges for domiciliary visits; and would it not be right that the Guillebaud Committee should consider this matter as one which concerns the economy of the service?

Mr. Macleod

These matters, as I indicated earlier, stem from the Spens Report on consultant specialists and its implementation by the late Government in the terms and conditions of service. I think that if there is to be any adjustment, whatever form that may take, in these terms and conditions of service, it is far better left in the ordinary way to the Whitley Council, where it can be fully discussed, and in part is being discussed in connection with the claim to which I referred earlier, before the medical Whitley Council. I think that is a better forum than the Guillebaud Committee.

Mr. Blenkinsop

Does the right hon. Gentleman not agree that he cannot divest himself of some responsibility in this matter in view of the fact that it is bound up with the treatment of patients and the waiting time in hospitals?

Mr. Macleod

I am not suggesting that I should divest myself of responsibility. I merely say that I think the Whitley Council is the best forum to discuss it. There is no reason at all, as this clearly falls within the terms of reference of the Guillebaud Committee, why that committee should not discuss it as well.