§ 1. Mr. Jim Marshall
To ask the Secretary of State for Health if she will make a statement about the future size, number and role of regional health authorities.
§ The Secretary of State for Health (Mrs. Virginia Bottomley)
I announced to the House last week my intention to abolish the 14 statutory regional health authorities. In advance of the necessary legislation, I propose to reduce the number of RHAs from 14 to eight by next April. These changes will help improve the management of the health service, reduce administration and overhead costs and support the continued drive towards a decentralised health service.
§ Mr. Marshall
When I tabled the question, I hardly expected it to be the catalyst for the change announced by the Secretary of State last week. Will the right hon. Lady tell the House how many jobs will be lost and how many extra doctors are likely to work in the national health service as a consequence of the changes? She will recognise that the regional health authorities had as part of their responsibilities the encouragement of regional centres of excellence. Will she tell the House who or what will take over that responsibility?
§ Mrs. Bottomley
I am pleased that the hon. Gentleman should be a catalyst for change. We welcome a sinner who repents—even at a late stage—to the changes which we are introducing in the NHS. The hon. Gentleman makes some good points about the importance of safeguarding specialist centres. The management executive outposts will be working to ensure that there is a strategic role to safeguard precisely the units to which the hon. Gentleman refers.
It is not possible to make a precise estimate of the numbers of jobs that are involved. We have stated previously that the number of staff in management outposts should be reduced from 570 to 200, and we expect a reduction in the number of regions from 14 to eight over the next few months. We have to work with the NHS to make sure that the necessary tasks are performed. No one wants needless duplication or unnecessary layers of bureaucracy. At the same time, NHS management is an important function which will continue in a new and slimlined style.
§ Mrs. Bottomley
The regional director of the management executive will of course be involved in the allocation of resources to the districts, but in line with policies that have been laid down and approved by Ministers.
§ Mr. McCartney
In the Secretary of State's statement to the House last week, she avoided giving any details of 676 the future arrangements for the development of community health councils. Will she now tell the House what those arrangements will be?
Will the right hon. Lady take some time out of her busy day's shopping at Marks and Spencer to comment on a community health council's report in south London on the continuing abuse of elderly people in accident and emergency units? In some units in south London, elderly people are lying for between 15 and 29 hours because no beds have been opened. Is not that a result of the disastrous cuts that have been caused by the Government's budgetary policies?
§ Mrs. Bottomley
The hon. Gentleman makes two different points. With regard to his latter point about accident and emergency centres, he will know that the patients charter has set explicit targets for the time that it should take for people to be treated. Special issues concern the development of primary care in London so that all elderly people can have the services to which they are entitled.