HC Deb 15 March 1983 vol 39 cc116-8
4. Sir David Price

asked the Secretary of State for Social Services whether he is satisfied with the efficiency of district management teams as the base for the running of the National Health Service; and whether he will make a statement.

The Minister for Health (Mr. Kenneth Clarke)

I am sure that the revised arrangements for running the NHS, which form the basis of the 1982 reorganisation, will lead to a better managed service and that teams properly accountable to their authorities under the new structures and arrangements will discharge their functions more efficiently. As my hon. Friend knows, a management inquiry has recently been set up, headed by Mr. Roy Griffiths, to advise us further on the effective management of manpower and related resources in the NHS.

Sir David Price

Is my hon. and learned Friend aware that, in the absence of a clearly designated chief executive in each district, there is often a good deal of doubt about who is in overall day-to-day charge?

Mr. Clarke

The Health Service has had the system known as consensus management for several years. We look to the new chairman and to members of the district and regional health authorities to provide the leadership that the NHS needs. It is to them that the teams of officers should be properly accountable.

Mr. Pavitt

Will the Minister reconsider the appointment of his team to consider efficiency and reorganisation? Does the hon. and learned Gentleman recall that last time this happened and business consultants familiar with business methods were called in the McKinsey committee charged the taxpayer £250,000 to make a complete mess of the NHS? When the hon. and learned Gentleman receives the report of the consultant team, will he please take it with a large pinch of Sainsbury's salt?

Mr. Clarke

The most recent reorganisation of the Health Service has eliminated a tier of management and led to much clearer accountability and improved performance. The inquiry headed by Mr. Griffiths is to advise Ministers on good management practice generally.The more good management practices that are adopted by the Health Service, the better able it will be to devote its resources to the care of patients.

Mr. Crouch

Will my hon. and learned Friend confirm that he still sees a real advantage in decisions being taken at the district level, because it is nearer to the patient?

Mr. Clarke

Exactly. We have also strengthened the position of what is known as unit management below the district level, so that, in an individual hospital, there can be a clear line of accountability to an administrator and a senior nursing officer.

Mr. Cryer

Will the Minister ensure that the district management teams also enforce the 1962 code of practice about the hospitality of drug companies? Is the hon. and learned Gentleman aware that drug companies often provide much lavish hospitality in the form of meals and booze to hospital administrators in their attempt to sell drugs? Does he accept that that contributes to the massive cost of providing drugs and that the drug companies make massive profits from the NHS?

Mr. Clarke

There are strict rules about such things in the Health Service, as there are in the rest of the public sector, and they should be adhered to. We continue to make them clear whenever we have the opportunity. The pricing system enables us to recoup any expenditure on pricing and advertising above the permitted level, and each year we recoup sums of money for the Health Service.

Sir William Clark

Is my hon. and learned Friend aware that many of us think that consensus management has led to inefficiency and been responsible for much of the overmanning within the NHS? Is it not about time that we got the old-fashioned matron back in charge?

Mr. Clarke

Consensus management has its critics. It is one of the matters upon which Mr. Griffiths and his team will no doubt be advising us.

As to the old-fashioned matron, the new reorganisation has enabled us to re-establish clear accountability for nursing services in units such as large hospitals. The Whitley council has chosen to call the modern successor to the matron a director of nursing services. I hope that such officials will carry out the same services as the matrons did, but many of them are now male and would rather not be called matrons. I hope, too, that they will carry out their duties with the same efficiency as a matron.