HC Deb 25 February 1986 vol 92 cc801-2
8. Mr. Simon Hughes

asked the Secretary of State for Social Services if he will make a statement on the implementation to date of the Griffiths report on National Health Service management.

The Secretary of State for Social Services (Mr. Norman Fowler)

Implementation is proceeding well. All regional arid district general managers have been appointed, as well as over two thirds of those at unit level. I expect the process to be complete by May or June this year.

Mr. Hughes

Will the Secretary of State take notice of the fact that there is some concern at the time it has taken his Department to approve plans for the devolved administration under Griffiths? Will he ensure that, if possible, that is speeded up in the months ahead? Will he reconsider whether nurses should be represented at management level and whether nursing directors should be appointed in each unit or area? Will the Secretary of State accept that the House would welcome an opportunity to debate the implementation of the Griffiths scheme?

Mr. Fowler

We have debated the implementation of Griffiths on a number of occasions. However, I would certainly welcome a further debate on it. On the issue of the speed of the process, I do not think that anyone has complained that there has been any delay in the introduction of general managers. On the question of nursing, let me make it clear that in most cases there are directors of nursing services. In every case there must be access to professional nursing advice. I want to see more nurses becoming managers, because I believe that they represent a tremendous professional asset to the service.

Mr. Watts

Is my right hon. Friend aware of the nursing profession's concern about implementation at unit level, and especially about the fact that in some large hospitals there is no professional nurse of greater seniority than a ward sister?

Mr. Fowler

I shall look at any such example. That is certainly not what has been reported to us. We would not want such conditions to exist. Forty three nurses have been appointed as unit general managers. As I have said. I should like more nurses to be appointed as general managers in the Health Service.

Mr. Pavitt

Why is the right hon. Gentleman brushing off all the expertise of, and the representations made by, the Royal College of Nursing? That is hardly a revolutionary body. Is he aware that nursing morale at ward level is at its lowest point since 1939? Is he aware that the Rayner and Griffiths reports have made a large difference to the bedside attitude of nurses because there is now a unit manager to tell nurses what to do?

Mr. Fowler

The hon. Gentleman is wrong about that. We are in no way brushing aside the concerns of the Royal College of Nursing. The college has accepted the principles of general management. We share its concern that those principles should be implemented in a way that enhances patient care. Inquiries such as that at Stanley Royd show the defects of the system that general management seeks to replace.

Mrs. Currie

Does my right hon. Friend agree that the campaign of the Royal College of Nursing, which calls in aid the coccyx, the humerus and other anatomical bits and pieces, is quite inappropriate? Does my right hon. Friend not prefer the statement of the National Association of Health Authorities that the NHS needs the best managers it can get, whatever the profession from which they come?

Mr. Fowler

That is right. I think that there is not a great deal of difference between the views of the Government and those of the Royal College of Nursing. We all want more effective management in the Health Service, because that is to the benefit of patients.

Mr. Dobson

If implementation of the Griffiths report is proceeding so well, why does the right hon. Gentleman think that the Royal College of Nursing has spent £250,000 on its campaign against it? Does the right hon. Gentleman agree that most sensible people, if they were in hospital, would prefer the nurse on the ward to turn for advice to a person who had qualified as a nurse rather than someone who had qualified at the London Business School?

Mr. Fowler

That is a rather silly comment. There have been a number of local cases in which the Royal College of Nursing was right to express its concern.. The royal college and the Government believe in the general principle of the Griffiths reforms and in the introduction of general managers. I think that the hon. Gentleman would be the first to acknowledge that in a case such as Stanley Royd, where the present system has been going wrong.