§ 2. Mr. TouhigTo ask the Secretary of State for Health when he last met the chairmen of NHS trusts to discuss the administrative costs of purchasing contracts. [31695]
§ 7. Mr. BennettTo ask the Secretary of State for Health what representations he has received about administrative costs in the NHS. [31700]
§ The Secretary of State for Health (Mr. Stephen Dorrell)I meet NHS trust chairmen regularly. The Government are committed both to the effective management of the NHS and to the reduction of unnecessary bureaucracy.
§ Mr. TouhigWhile I recognise that an extra £1.4 billion was put into the national health service in 1993–94, every penny of it went on administrative costs. Is that obsession with bureaucracy, as opposed to front-line services, the reason why three quarters of NHS trusts have yet to make a local pay offer to nurses four months after Ministers pledged action on the matter? Is that another broken Tory promise?
§ Mr. DorrellThe Opposition's concern about bureaucracy would be a great deal more convincing if they had not voted against the abolition of the regional health authorities, which was the biggest single element in the £300 million programme for shifting resources out of unnecessary bureaucracy into front-line patient services.
The Government have made it clear that nurses' pay arrangements are a matter for local agreement between employers and local nurses groups, against the guarantee of a minimum increase of 2 per cent. on a national basis.
§ Mr. BennettWill the Secretary of State now confirm that there are 20,000 extra NHS managers and 50,000 fewer nurses as a result of the Government's programme? Is that by design on the part of the Government or by accident?
§ Mr. DorrellThe hon. Gentleman persists in deliberately misreading figures, despite repeated explanations of what the figures he quotes mean. He might do well to remember the words of the previous shadow health spokesman, who said:
I don't think it's really in question any more that the NHS has been under-managed in the past.That is why the Government strengthened NHS management and why the NHS is now delivering more patient care to higher quality more efficiently than it has ever done before.
§ Sir Sydney ChapmanDoes my right hon. Friend agree that administrative costs in the health service should be kept in proportion? Does he further agree that, if increased administrative costs result in more medically qualified people undertaking less administrative work, and in the more effective targeting of the ever-increasing funding of our national health service for the benefit of patients, they are justified.
§ Mr. DorrellMy hon. Friend is on a very important point. He underlines the interest that every taxpayer and every patient of the NHS has in its efficient management. The question that should be asked of the Opposition Front-Bench team, particularly of the hon. Member for Darlington (Mr. Milburn) in the light of press reports at the weekend, is why the Labour party wishes to disfranchise 6.5 million people who take out private health insurance and prevent them ever playing any part in the management of NHS trusts and health authorities.
§ Mr. ThomasonCan my right hon. Friend confirm that the proportion of NHS staff who are involved in the direct care of patients has increased in the past decade?
§ Mr. DorrellMy hon. Friend is on to an important point. We have increased commitment to front-line services, delivering more treatment to more patients than ever before in the history of the NHS. The Labour party is more concerned with dogma. [Interruption.] The hon. Member for Darlington says that I should not believe everything that I read in the newspapers. Perhaps he would like to deny the story in the weekend newspapers, since it appeared in quotation marks, attributed to him.
§ Ms HarmanCan the right hon. Gentleman confirm that the bill for bureaucracy for his NHS internal market is an extra £1.5 billion every year? Is he aware that, because of the market, St. Thomas's and Guy's hospitals now have to send out 57,000 invoices every year? How can he justify children being turned away from intensive care and their parents being told, "Sorry, there is no bed"? How can he justify patients waiting for hours on trollies? How can he justify patients being told at the last minute, "Sorry, we are cancelling your operation"? How can he justify any of that while he squanders precious NHS resources on red tape to run the market?
§ Mr. DorrellRather than uttering these repetitive soundbites, the hon. Lady might do better to explain to the NHS and to the public what she means when she says that she will abolish the internal market. Her policy document is clear. She retains the purchaser system. She retains the principle that purchasers should be free to place their contracts where their patients' advantage lies. How will she do that while delivering the commitment that she professes to abolish an internal market?
§ Mr. CongdonDoes my right hon. Friend agree that one of the benefits of the internal market is that it has enabled health authorities to focus on the real issues of health need and effectiveness of health care? Does he agree that it is nonsense for people to pretend that the NHS can be managed without managers, and managed on a system based on ignorance? Have not the changes led to real improvements in the quality of health care given to the people of this country?
§ Mr. DorrellMy hon. Friend is right. The interest of every patient and every taxpayer is that the health service should be efficiently managed and that health resources should be targeted at real health need. That is the purpose of NHS management. The hon. Member for Peckham (Ms Harman) professes to mean that, but consistently commits herself to undermining the structure that makes it possible.