§ 9. Mr. Philip Hollandasked the Secretary of State for Social Services what will be the net change in the number of official bodies to which he makes appointments, other than civil servants, resulting from the abolition of the area health authorities.
§ Mr. Patrick JenkinAt present I appoint the chairmen of 90 area health authorities. In order to achieve our aim of much more local decision taking in the Health Service, those will be replaced by between 180 and 200 district health authorities, whose chairmen will again be appointed by me.
§ Mr. HollandHas my right hon. Friend noticed that when his Department seeks solutions to problems in the Health Service it invariably ends up with either more official bodies or more official appointments—or both? Does the DHSS find considerable pleasure in dancing the quango with its basic one step forward and two steps back? Will he try to stimulate a little more enthusiasm for that healthier outdoor pursuit, hunting the quango?
§ Mr. JenkinI am sure that the House admires the work of my hon. Friend in his pursuit of the case for reducing the number of official bodies. The logic of his argument about health authorities is that the National Health Service should be run not by health authorities but directly by my Department. That would give rise to a wholly unacceptable and unworkable degree of centralisation. I am sure that both the House and the Health Service want a greater degree of decentralisation. That must postulate more local health authorities.
§ Mr. HordernIs my right hon. Friend fully satisfied with the balance between the provision of services and the 137 recruitment of personnel to the NHS, bearing in mind that the NHS has continued its recruitment every year for the past 20 years, and last year alone increased its numbers by some 25,000? Does not my right hon. Friend agree that it is time for a careful check on the numbers employed in the NHS to determine whether it needs, for example, so many clerks and administrators?
§ Mr. JenkinI understand my hon. Friend's anxieties. I am sure that he recognises that in a programme such as that of the NHS, which is virtually the only programme that is growing during this period of severe economic restraint, and where 70 per cent, of costs are manpower costs, the growth of its services inevitably means growth in the number of doctors, nurses, midwives, health visitors, and all the other health care professionals who provide a service for patients. We are maintaining a very tight control on administrative costs. During the course of the reorganisation we shall be looking for significant savings in administration through the application of firm administrative cost limits. I understand my hon. Friend's desire to cut the cost of administration in the Health Service.
§ Mr. SpriggsIs the Secretary of State aware that since reorganisation of the NHS the St. Helens and Knowsley area health authority has done a tremendous job in reorganising all the requirements in the NHS? Does he realise that to abolish an area health authority such as that would be nothing less than scandalous?
§ Mr. JenkinI have not yet received proposals from the regional health authority. I shall consider them carefully when they arrive, and take account of the hon. Gentleman's remarks.
§ Mrs. DunwoodyIs it not the case that the NHS needs good administrators, not necessarily fewer administrators? Will the Minister take on board the fact that if he continually seeks both to bully the trade unions in the NHS and constantly to have a go at the administration, he will not get the professional service that he purports to seek?
§ Mr. JenkinI agree that we need the highest quality of management in the NHS that we can secure. I deny entirely that I am bullying the trade unions. I happen to enjoy an extremely good relationship both with the health services committee of the TUC and with the individual unions involved.