HC Deb 27 January 1976 vol 904 cc231-3
8. Mr. Beith

asked the Secretary of State for Social Services whether she plans to introduce proposals to change the administrative structure of the reorganised National Health Service so as to make it more accountable to the community and to reduce its administrative costs.

Mrs. Castle

I do not intend to make any sudden drastic change in the structure of the reorganised NHS in England so soon after the major changes in 1974 but we will continue to consider and introduce where appropriate evolutionary changes so as to minimise some of the disadvantages of the 1974 reorganisation. I believe our decisions to increase the proportion of local authority members on health authorities and to strengthen the role of community health councils, which are being implemented within the structure we inherited from our predecessors, will make the service more responsive to the views of the community. I have already asked health authorities in England to review their administrative costs in all disciplines.

Mr. Beith

I thank the right hon. Lady for that reply and recognise that this costly, over-administered and undemocratic structure was bequeathed to her by the previous Government. However, does she not agree that when we are talking of devolution, the redemocratisation of the National Health Service should be a priority and that even more of a priority is to deal with the number of administrative and supervisory posts which were created, many of them taken up by people whose professional skills would be better used at the bedside and in medical facilities? Does she not agree that the Health Service is one of the main areas which has more Chiefs than Indians?

Mrs. Castle

I am grateful to the hon. Gentleman for recognising that I have been bound by the administrative structure that I inherited from my predecessors. It was impossible for me to reverse all their work within a matter of weeks of taking over my new responsibilities. All that we could do, as I have explained, was to take democratisation as far as we could within the legislative and administrative structure that we inherited. As for the administrative top-heaviness of our predecessors' structure, I have been in touch with the health authorities to do what we can to streamline without turning the whole new system upside down. I therefore told the health authorities that the filling of vacancies or additional posts should take place only after full consideration of both the need for the post relative to a specific job of work and the real priority of that job of work. We have also been trying to cut out unnecessary duplication through tiers and to secure the maximum devolution, thereby streamlining within the existing structure.

Mrs. Renée Short

Will my right hon. Friend give an undertaking to the House that she will respond favourably to the growing number of community health councils, including every one in Birmingham, which are demanding greater facilities for the termination of pregnancy in NHS hospitals now that they have reviewed the inadequacies in different parts of the country?

Mrs. Castle

The community health councils bring pressure to bear upon their appropriate health authorities. This is going on all the time. I am glad that many health authorities are increasingly paying attention to and co-operating with the community health councils over a large number of issues.