Griffiths Report (Hansard, 8 May 1984)

§ 1. Mr. Colvin
asked the Secretary of State for Social Services if he has yet completed his consultations on the Griffiths report.

§ 9. Mr. Marlow
asked the Secretary of State for Social Services if he will make a statement on the implementation of the Griffiths report.

§ The Secretary of State for Social Services (Mr. Norman Fowler)
I have now completed formal consultation and the report was debated in the House last Friday. I shall be reaching final conclusions on how to carry forward the report's recommendations, in particular on the establishment of the general management function in the Health Service. I hope to issue guidance to health authorities in the next few weeks.

§ Mr. Colvin
Does my right hon. Friend agree that, notwithstanding the fact that the Conservatives have doubled expenditure on the National Health Service since coming to office in 1979, it is vital that we get value for money and that that is what the Griffiths report is all about? Will he confirm that during his consultations he had direct talks with nurses at the hospital level, because they see waste and inefficient management at first hand? Will he confirm that that could be a great deal more useful to him than relying on the views of the NHS establishment, which may well have a vested interest in maintaining the status quo?

§ Mr. Fowler
We have had consultations with all the professional bodies, including the Royal College of Nursing. In the main, most of those whom we have 718 consulted have supported the broad thrust of the Griffiths report. I agree that basically we are trying to secure the best possible value from the increasing amount of money that the Government spend on the Health Service.

§ Mr. Marlow
Will my right hon. Friend draw aside the curtain slightly and let the House know when and at what rate he anticipates general managers being introduced into the Health Service?

§ Mr. Fowler
As I said in the debate on Friday, We expect that to be done in a phased manner and we shall set that out in the guidance that is given to health authorities in the next few weeks.

§ Mr. Boyes
Will the right hon. Gentleman give the House an assurance that he will not be influenced by a document written by the hon. Member for Norfolk, North (Mr. Howell), produced by a tuppenny-ha'penny outfit called Aims of Industry, in which he argues that, because patients spend a shorter time in hospital, we do not need as many members of staff, when he ought to understand that the fact that people spend a shorter time in hospital means that they get much more intensive treatment?

§ Mr. Fowler
I always listen carefully to my hon. Friend the Member for Norfolk, North (Mr. Howell). I have pointed out consistently on this subject that the best way of making comparisons on efficiency is in terms of patients treated. Over the past five years the number of patients treated in NHS hospitals has risen by 500,000 a year.

§ Mr. Meadowcroft
Has the Secretary of State yet had time to reflect on the calls from both sides of the House on Friday for flexibility in the implementation of the Griffiths report? Does he now feel that it would be inadvisable to force general management functions on those parts of the Health Service which both sides of the House believe to be functioning well under the present consensus arrangements?

§ Mr. Fowler
As I said on Friday, we support the concept of flexibility. We do not support the idea of having pilot or experimental areas, as was one once put forward, I think, by the Liberal and SDP parties. As I say, we will be setting out the plans in the guidance.

§ Mr. Couchman
Although the Select Committee received memoranda of evidence, and, indeed, oral evidence, from many quarters, it did not receive direct evidence from many of the health authorities. Is my right hon. Friend able to say whether the regional and district health authorities in the main welcome the thrust of the Griffiths report?

§ Mr. Fowler
Yes, as a generalisation, I think that the health authorities have welcomed the thrust of the Griffiths report, and certainly the direct talks that I have had with the regional health authority chairmen fully confirm this. Virtually all the district health authorities have also put in their proposals.

§ Mr. Bell
In the light of the widespread concern at local level among those who work in the Health Service that national pay agreements will be replaced by district pay agreements, will the Secretary of State take this early opportunity of agreeing with Griffiths that local pay negotiations and local pay agreements are not practicable?

§ Mr. Fowler
I have nothing to add on pay arrangements to the statements that I have already made.

§ Mr. Favell
Has the Secretary of State yet made a decision on whether he will make what is regarded as the most important appointment of all, namely, that of a chief executive in overall charge of the National Health Service?

§ Mr. Fowler
We have advertised for a general manager, which is, I think, rather different in concept from the chief executive which has been proposed from time to time. That advertisement was placed some weeks ago. We are therefore in the process of seeking names for recruitment, and I will tell the House immediately I am in a position to make an announcement.

Mr. Meache
In view of the rising tide of criticism of and scepticism about the Griffiths report, will the right hon. Gentleman give a committment that this fresh upheaval will not be imposed nationwide on the National Health Service either until the sixth evaluation studies already made are published, or until genuine experiments are carried out in specific areas to test the advisability of these changes, especially at unit level, where the recipe for conflict is greatest?

§ Mr. Fowler
No, I do not agree with almost anything that the hon. Gentleman has said. [Horn. MEMBERS: "It must be right, then."] The rising tide of dissatisfaction to which the hon. Gentleman refers is not borne out by the evidence. I made it absolutely clear in response to the hon. Gentleman, who is still, surprisingly, on the Front Bench, that the health authorities are perfectly free to publish that evidence. There is nothing on our part to stand in the way of that. As to experiments and trial and error, I think that it would be absurd to approach the problems of general management inside the Health Service in that way. I think that that would be absurd and counter-productive, and we certainly do not intend to do it.