HC Deb 31 January 1990 vol 166 cc305-6
12. Mr. Darling

To ask the Secretary of State for Scotland what estimate he has made of the number of health boards where annual expenditure is likely to exceed their budgeted expenditure in 1989–90.

Mr. Rifkind

One health board has indicated that its actual expenditure could exceed budgeted expenditure in 1989–90.

Mr. Darling

The Secretary of State will be aware that Lothian health board is one of the best funded in the country, yet its members—hand-picked by him, mainly because of their loyalty to the Conservative party—have said that they cannot make ends meet because they are so underfunded. Does not that show to the Secretary of State the dire straits that the Lothian health board and health boards generally are in? What does he intend to do about that? Does he further accept that the inquiry that he announced, being carried out by Mr. Cruickshank, is being viewed with some scepticism and that it would be better to have an independent inquiry to look at the health board funding rather than to have a public brawl between officials?

Mr. Rifkind

I am delighted that the hon. Gentleman has confirmed that Lothian health board is one of the best funded in the country. Other boards that are less generously funded have maintained their expenditure within their budgets, so it is not unreasonable also to expect that of the Lothian health board.

There has been an independent inquiry by an independent firm of accountants, which today reported to the chief executive. The report suggests that there have been serious failings in the board's management and reporting systems. We shall be discussing those matters with the board to ensure that the necessary steps are taken to rectify those problems. However, we must do so in a way that does not damage the interests of patients in Lothian, which I believe to be paramount.

Mr. Bill Walker

Does my right hon. and learned Friend agree that any service, such as the National Health Service, that is demand led must be managed efficiently, effectively and properly and devolved at local level—that is, regional health board level? If that does not happen, it will not be surprising if it runs into difficulties, because that is what happens in a demand led service.

Mr. Rifkind

I have nothing but praise for the work of the health boards, including the Lothian health board. I am sure that we are all concerned that, during the current year, certain problems appear to have led to the board's being unable to contain its expenditure within its budget. The priority must be to ensure that that failing does not lead to any damage to the interests of the patients. That will be the priority of the chief executive of the NHS in his discussions with members of the board and its staff.

Mr. Eadie

Is the Secretary of State saying that the Lothian health board is guilty of financial mismanagement? Are not its members mainly his appointees? Is he aware that, despite what we have heard today about the great increase in nursing staff, I have received a letter from a constituent who works in the Princess Margaret Rose hospital claiming that nurses are worried that they may be made redundant soon because of closures within the hospital? Will nurses in the NHS in Lothian be made compulsorily redundant?

Mr. Rifkind

I am happy to reassure the hon. Gentleman on that matter. As I said last week, there is no question of hospitals being closed or of other crisis measures being taken because it has become apparent that there has been overspending within the Lothian health board area. We wish to discuss with the board, in a considered, sensible and sensitive way, how it can bring its expenditure under control. I have already given the assurance that no hospital, including the Princess Margaret Rose, is in danger of being shut because of the problems that have arisen.