§ 1. Mr. Nigel Griffiths
To ask the Secretary of State for Scotland what are his criteria for appointments to health boards in Scotland.
§ The Secretary of State for Scotland (Mr. Malcolm Rifkind):
Individuals are appointed on the basis of the contribution that they can make to the duties and responsibilities of the health boards.
§ Mr. Griffiths
Does not the Secretary of State realise that the cuts and panic closures affecting hospitals in Lothian region made by the right hon. and learned Gentleman's Tory-appointed health board are an indictment of his system of appointment? Will he come with me to Longmore hospital in Edinburgh, where an excellent breast screening clinic and facilities for geriatric patients are threatened by a panic closure in eight weeks rather than in eight years? Will the Secretary of State give an assurance that Lothian health board will receive proper funding—or will he go?
§ Mr. Rifkind
I share the hon. Gentleman's anxiety to ensure that the health board's recommendations are considered on the basis of their implications for health care in the region. The hon. Gentleman should not suggest that the problem has been caused by underfunding. As he knows perfectly well, all Scottish health boards are funded in exactly the same way. The fact that Lothian finds itself to be seriously overspending is clearly a result of its own internal financial management—as the report now published by Peat, Marwick Mitchell clearly demonstrates.
§ Mr. Kirkwood
Will the Secretary of State guarantee that if health board appointments become more business oriented, as is presaged in the White Paper, he will pay particular attention to the successor bodies to the health 614 councils, to ensure that they are properly funded and properly accountable, so that effective patient and consumer consultation boards can be established within the Health Service?
§ Mr. Rifkind
The hon. Gentleman makes a reasonable point. We shall certainly want to ensure that the boards offer the widest breadth of experience, consistent only with the important criterion of avoiding any conflict of interest between those who serve on health boards and those who have financial associations with the provision of health care.
§ Mr. Marlow
If Scottish health boards were to be financed and paid for by a Scottish Parliament or Assembly that raised taxes in Scotland, as opposed to being funded by the general Exchequer, what would be the increase in the taxes due from Scottish people?
§ Mr. Rifkind
If there were to be a Scottish Assembly and it had to fund Scottish health provision entirely from Scottish resources, there is no doubt that that would lead to a substantial increase in the amount of income tax paid by people in Scotland. Health expenditure in Scotland is about 25 per cent. higher per capita than that south of the border.
§ Mr. Galbraith
Surely ultimate responsibility for the current shambles in Lothian health board rests directly with the Secretary of State for Scotland. Is not the crisis due to the sheer and utter incompetence of the board members—all of whom were directly appointed by the Secretary of State, and half of whom have either direct or indirect connections with the Conservative party? Is not it the case that unless increased funding is made available to Lothian health board, the crisis will be resolved only by the Secretary of State reneging on his promises, closing hospitals and introducing measures that will directly affect patient care?
§ Mr. Rifkind
The Government have already been helpful with regard to the problems of Lothian health board by saying that it will not be required to pay for last year's overspend in the current year, but it is crucial that the health board, like all other health boards in Scotland, should gain control over its expenditure and resources. The hon. Gentleman knows perfectly well that if he were speaking from this Dispatch Box, he would be the first to insist that all health boards in Scotland commit themselves to no more expenditure than the resources provided to them. If Lothian is the only health board in Scotland to have found itself in this difficulty, clearly that is a result of financial mismanagement within the health board.