HC Deb 30 April 1986 vol 96 cc1071-6

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Lennox-Boyd.]

12.58 am
Mr. Kevin Barron (Rother Valley)

I shall not detain the House for too long in discussing the position of the Rotherham health authority. The authority is in perhaps a unique position in Britain in that it does not at present have a chairman.

Hon. Members will know that the Government introduced new faces into the National Health Service looking for what could be described as the "myth of the market". The Government are trying to create a market, but it is a myth to think that that will be beneficial to the National Health Service.

The structure of management in the National Health Service has been altered, and hon. Members will recall that that was started by the Griffiths report. At the same time, the Government decided to replace some chairmen of district health authorities. In Rotherham, they decided not to re-appoint Mr. Vernon Thornes who for a long time had been chairman of Rotherham health authority. The decision not to re-appoint Mr. Thornes caused anger and shock in the area. It angered me when I heard about it.

Vernon Thornes wrote to me and to two other hon. Members in June 1985 a confidential letter in which he said he had heard about some intrigue over the appointment of chairmen of district health authorities. He said why he believed that Rotherham was a target, and that that might mean that the chairman would be replaced. I discussed the matter with a Minister, but he did not agree with my analysis of the non-appointment, or sacking, of Vernon Thornes.

One of the prime motivations behind the non-appointment of Mr. Thornes is the stand taken by Rotherham health authority against privatisation. The authority has issued tenders and has gone along with Ministers, but it has said on all tenders that the people tendering must fulfil obligations on the protection of earnings of people who work for them. Those obligations are on the hourly rate, the sick payment rates and holiday benefits.

The Minister knows that his Department has not looked favourably on any health authority that has taken such a stand. For a long time, the Department through the regional office has advised the health authority to withdraw the clause about working conditions on contracts going out to tender. The Department has told the authority to play the game and to stop telling people that they must pay certain wage rates and offer certain protections to people who work for them.

Rotherham health authority took advice on the matter and found that the requests from the Government, made through the regional office, were not legally binding. The authority's advisers said there was nothing illegal in what the authority was doing. Perhaps the Government thought it was immoral to have such clauses in the tender forms. Wage rates are sometimes less than £2 per hour, and there is nothing immoral in the authority trying to protect people.

Mr. Thornes appears to have been victimised because of the stand taken by Rotherham health authority on privatisation. If that is the case, it is unfair because, like any good chairman, he was merely carrying out the wishes of the representatives on the health authority. He has an outstanding record in Rotherham in the National Health Service. One of the ironies of the case is that in a letter that he received from the chairman of Trent health authority on 18 March this year, shortly after that chairman had told Vernon Thornes that he would not be re-appointed, he was assured of: our sincere gratitude for all you have done for the Health Service for the last twenty-two years. Your contribution to the development and organisation of Health Services in Rotherham has been exceptional. I can say quite unreservedly that largely due to your decisive leadership, great skill and extensive personal involvement you have been able to carefully and effectively steer the District through two major reorganisations. I know also that your personal initiative and sustained efforts have played a significant part in the development of the District General Hospital. That is a glowing tribute and one that most of those who have come in contact with Mr. Thornes would say was well deserved. It seems to many people that what has happened to him recently under the directorship of the Secretary of State has been a shabby farewell. The vast majority of the people in the Rotherham area feel that Vernon Thornes should not have been treated in this way.

The Minister received a letter dated 13 March 1986, from the Rotherham health authority, signed by Mr. Terry Sharman, who is the vice-chairman of the health authority, and the mayor of the Rotherham borough council. In the letter, which was drawn up after the meeting of the Rotherham health authority, on that day, the council said, for three reasons, that it wanted Vernon Thornes reappointed for the next two years, until someone could be trained into the position of chairman of the health authority. The reasons were:

Vernon Thornes has been an outstanding Chairman and has acquired considerable experience of the health care needs of the Rotherham people over the last thirteen years. 2. He has the total confidence of the professions within the health service in Rotherham and of the Rotherham community. 3. The Authority has, at the moment, a number of projects that have not yet been brought to fruition that need Mr. Thornes' personal guidance in seeing their successful completion; furthermore, we feel, most strongly, that Mr. Thornes is given an opportunity to see these projects through. It is right that that should happen. Mr. Thornes has indeed seen the health authority through two major reorganisations, and the latest is not yet complete.

The council said that it would like to bring a delegation to see the Minister if it would do any good, to bring further pressure to reinstate Vernon Thornes. I understand that the Secretary of State is about to appoint a local business man to the chair of the area health authority, and if my information is correct, the business man has no dealings with the NHS, and certainly none with the Rotherham health authority. In those circumstances, it would be better all round that Mr. Thornes should be appointed for a further two years, so that, on his retirement, somebody with experience of the NHS in Rotherham can take over.

I have had conversations with the Minister and the chairman of the Trent regional health authority, both of whom gave different reasons why Vernon Thornes was not reappointed. I still believe that I have been given no good reason why he should be replaced in this way. Even at this late stage, I ask the Minister to reconsider his position, and reappoint Vernon Thornes. As everyone in the Rotherham area has always said, he has done first-class work for a long time. He has served the NHS 22 years in south Yorkshire, and his reappointment would be the best thing for the Rotherham district health authority, and for all concerned in the area. Of course, in two years' time he will be replaced because Vernon has already said that he wishes to retire after 24 years caring for people in the NHS in our area.

1.9 am

The Parliamentary Under-Secretary of State for Health and Social Security (Mr. Ray Whitney)

I am grateful to the hon. Member for Rother Valley (Mr. Barron) for giving the House the opportunity to consider this matter—because it caused much anxiety in the Rotherham health authority area—and for the opportunity to put the facts on the record. May I make some general points before dealing with the specific issues relating to Mr. Thornes.

When talking about the Government's approach to the National Health Service, the hon. Gentleman used the words, "the myth of the market". We are trying to ensure that the huge public resources which are devoted to the Health Service—resources which have been increased by 24 per cent. in real terms since the Government came to office in 1979—are used most effectively. Therefore, we must find every way to ensure that the resources are used to best effect. That is not the myth of the market; it is sheer common sense, and anyone who knows what is happening in the Health Service will accept that that must be the way forward.

The hon. Gentleman mentioned the altered structure of management. He is right to do so, because our new approach of focusing responsibility exactly where it should be centred is producing good results in the cost improvement programmes and, therefore, the release of additional resources which can be used for health care and the continuing improvement of the Health Service. I hope that the hon. Gentleman accepts what is happening.

The appointment of health authority chairmen is an extremely important and difficult exercise, as any issue of this sensitivity must be. District health authorities are an important undertaking. Typically, a district health authority will have a budget of about £50 million and a work force of about 5,000. The provision of the necessary leadership and direction to an undertaking of that size is a considerable task. In making the appointments, my right hon. Friend the Secretary of State must seek candidates of the highest calibre. Not least in the considerations that must weigh with him is the fact that the district health authority is, in many respects, the local face of the NHS, and its members will be drawn from the locality that it serves. This provides the means for local views on the quality and organisation of services to be made known.

The chairman must be sensitive and responsive to those important matters, as well as having the experience and ability to enable him or her to direct the affairs of an organisation that touches the lives of most people within its boundaries and that is often the largest employer in the district.

As the hon. Gentleman knows, the exercise to find the chairmen for most of the 191 district health authorities was launched by an announcement in the House on 18 April last year by my predecessor, the hon. Member for Oxford, West and Abingdon (Mr. Patten), who is now the Minister for Housing, Urban Affairs and Construction. The results were made known on 17 March this year when my right hon. Friend the Minister for Health announced the names of about 170 chairmen appointed to those important posts.

In launching the exercise in selection, my predecessor invited hon. Members to express any views on existing chairmen and to submit nominations to us by 3 June 1985.

When we undertook that consultation exercise, we took advice from a number of sectors but, within the National Health Service, the advice of regional chairmen was particularly relevant and valuable. We sought to take account of the advice and views of those hon. Members who responded, and consulted further with them, where necessary, throughout the year-long exercise. There were inevitably some areas where very finely balanced decisions had to be made, and either my right hon. Friend the Minister of Health or in some cases, the regional chairmen on our behalf, approached individual hon. Members to clarify or discuss their views. It is true to say that every effort was made to involve hon. Members in this decision-making process. At the same time, however, it must be made quite clear that these appointments are made at the sole discretion of my right hon. Friend the Secretary of State and that there was no question of clearing these appointments with hon. Members or, for that matter, with anyone else.

Having said that, I want to stress that in the case not only of Mr. Thornes but of very many others the question of non-reappointment was in no sense a condemnation or an expression of loss of confidence in a particular individual. One of the factors was inevitably the question of age. The average age of the new chairmen appointed in this round is something of the order of 54 years, which compares favourably with the average of 62 of the retiring chairmen.

I would like to reiterate what has been said by my right hon. Friend the Minister for Health and also by the chairman of the Trent regional health authority, that Mr. Thornes has given exceptional service to the National Health Service. We pay a great tribute to his dedicated service in the Rother Valley district for no less than 22 years. Rather than this being seen as an attack on Mr. Thornes or an attempt to embarrass him, I hope that the hon. Gentleman and everyone else will accept that this was a job well and truly done, and that it was perfectly reasonable, after 22 years, that some new blood here, as in many other districts, should be sought.

It is always a question in such cases of keeping a balance between the need for stability and continuity and the need to introduce new blood, and to have fresh insights and ideas and continuity in the longer term. For those reasons, something like one third of the appointments that we have made were new ones. That was also the case in Rother Valley.

As it happens, the decision left Rother Valley without a chairman, due to an unfortunate but unforeseen series of events. A letter of invitation was sent out on 19 February to a new chairman who had, I understand, already indicated his willingness to serve, and a letter accepting the appointment was sent by the prospective chairman on 24 February, only to be followed two weeks later by a further letter, regretfully declining the appointment, due to the already heavy demands on his time. As I am sure the House will appreciate, this further letter coming, as it did, out of the blue meant that we had to reconsider an appointment that we had had every reason to believe had been settled. There may have been other reasons of which we were not aware, but this was accepted by the new appointee.

I am glad, however, to be able to tell the House that, as I think the hon. Gentleman is aware, a new appointment has now been made. Mr. A. G. Baker, a local man, has accepted my right hon. Friend's invitation to serve as the new chairman of Rotherham health authority. We have every confidence in him and wish him well in this new and challenging post.

I repeat that there was no question of intrigue—one of the words used by the hon. Gentleman—or of any lack of confidence in Mr. Thornes, and there was certainly no question of what the hon. Gentleman referred to as privatisation but which more correctly should be called competitive tendering. The competitive tendering approach is precisely to ensure that Health Service resources are used in the most economic and effective way. We are looking for laundry, catering and cleaning service arrangements that will provide services of the right standard at the most economical cost. Most of the competitive tendering exercises result in the success of the in-house tender. There was no problem about competitive tendering.

The position adopted by the district health authority on the fair wages clause was contrary to the advice given by the regional health authority and the Department. By stipulating such matters, the district health authority may find that it results in an effect that is detrimental to the competitive tendering process in general. More specifically, it may deny the district health authority the opportunity to maximise savings in order to provide the maximum resources for health care. My understanding is that the former chairman, Mr. Thornes, advised members of the authority against retaining the fair wages clause. Ministers still hope that the district health authority will remove the clause.

I emphasise that Mr. Thornes has given very fine service for 22 years to the Health Service. There should be no interpretation of intrigue, or political manoeuvring, or lack of confidence. The decision was taken against the background that I have described. The Government should always be sensitive and responsive to the legitimate interests of hon. Members—

Mr. Barron

The Minister asks me to believe that, but in reality it is very difficult to make, in relation to Mr. Thornes, the argument about age, since a person of 65 has been reappointed for a two-year period in the neighbouring Sheffield district health authority. I can only assume that the district health authority wants to introduce new blood. The Minister said that a Mr. Baker has been appointed as chairman of the Rotherham health authority. I hope that Mr. Baker will be as successful as Mr. Thornes. The appointment has been made, and we shall all work together with the new chairman of the Rotherham health authority to try to improve the services provided by the National Health Service in the Rotherham area.

The Minister referred to the fair wages clause that is included in the tenders submitted by the Rotherham health authority. What will happen if the new chairman is instructed, as Mr. Vernon Thornes was instructed, by the health authority to continue to include it in the tenders? I presume that he will be so instructed and that there will, therefore, be no change.

Mr. Whitney

It would be wrong to go into too much detail about competitive tendering and the fair wages clause now, but the fair wages clause is contrary to the policy of the regional health authority and the Department. We spend £1 billion nationally on catering, cleaning and laundry services, and the objective must be to provide proper levels of service at the proper cost. That is generally accepted. Perhaps only three out of 191 health authorities are having difficulties. The interests of the patients must have priority.

As for the age of a chairman, it would be wrong for me to go into individual cases, but I hope that the hon. Gentleman accepts the general approach of introducing new and younger blood. I am pleased that the hon. Gentleman welcomed the new chairman and I hope that Mr. Baker's stay is profitable and helpful and that it will further promote the development of health care in the hon. Gentleman's constituency.

Question put and agreed to.

Adjourned accordingly at twenty six minutes past One o'clock.