§ 12. Mr. Rentonasked the Secretary of State for Social Services what further savings he can make in the hospital service by reducing administrative and bureaucratic costs.
§ Mr. Patrick JenkinThe changes we have announced to the structure and management arrangements of the National Health Service should enable management costs to be reduced by 10 per cent. 180 by 31 March 1985, excluding transitional costs such as compensation and protection.
§ Mr. RentonIn abolishing the area health authorities, however, has not my right hon. Friend just melted the tip of the iceberg? Is it not a fact that the administrative and bureaucratic tail in the NHS has more than doubled in size in the past 10 years, and that it is for that reason, rather than public expenditure cuts, that our financial resources have not produced more hospital beds and more operating theatres?
§ Mr. JenkinIt is true that the number of people engaged in management and administration has grown. I accept broadly what my hon. Friend has said. It is not only the elimination of the area tiers that we are seeking in our reorganisation; it is a substantial slimming down of the management structure between the level of the district health authority and the unit, be it the hospital or the community services. We intend to set district health authorities clear management cost targets, so that they may introduce management structures which achieve what we are looking for. But, of course, there have been other changes which have increased the administrative load. For instance, now it is almost inevitable that in wards there are lay clerks doing clerical work that used to be done by nurses. It is right that nurses should be left free to exercise their professional skills and that laymen should do the jobs that they—
§ Mr. SpeakerOrder. That reply was inordinately long, as have been many supplementary questions this afternoon.
§ Mr. MoyleDoes the right hon. Gentleman agree that the best way of cutting administrative costs would be to reduce useless planning? Will he, therefore, issue the long-promised and long-awaited code of practice under section 5 of the Health Services Act, and in that code of practice will he issue a prohibition to health authorities concerning the sale of human tissue and human blood as a way of raising money?
§ Mr. JenkinMy hon. Friend the Minister for Health has made it abundantly clear that we entirely accept the point that transfers of human tissue and human blood are not a proper area for 181 commercial operation. I give the right hon. Gentleman that assurance.
§ Mr. Anthony GrantIs my right hon. Friend aware that there could be vast savings in administrative and bureaucratic costs if a greater proportion of the ancillary services of the NHS were handed over to private enterprise? Is he aware that, in view of reorganisation, administrators are tending to go back more to direct labour? Will he see that the sensible circular on this subject which he sent out in the summer is heeded by health authorities?
§ Mr. JenkinThe circular that we sent out was a draft circular for consultation. We are currently consulting within the Health Service. We have it in mind to send out a full circular on this subject in the near future.
§ Mr. EnnalsWill the right hon. Gentleman accept that most of the slimming down that is going on is of the Health Service itself? Does he accept the deep concern expressed by the National Association of Health Authorities about the cuts that authorities are having to make in wards, nurse training and essential building tasks?
§ Mr. JenkinIt is fair to point out that this year we are spending more in real terms on the NHS than was spent in any year under the right hon. Gentleman.