HC Deb 22 July 1997 vol 298 cc740-1
2. Mr. Gibb

To ask the Secretary of State for Health what proportion of national health service staff are directly involved in patient care. [7943]

The Secretary of State for Health (Mr. Frank Dobson)

Just under two thirds of national health service staff in England in 1996 were classified as direct care staff. That figure is based on the definition used by the previous Government, which included some staff who were not directly involved in patient care and excluded some staff who were.

Mr. Gibb

Will the Secretary of State confirm that the proportion of NHS staff directly involved in patient care increased from 60 per cent. in 1981 to nearly two thirds—the figure that he has just given me—under the Conservative Government? What will his target be for five years' time?

Mr. Dobson

As usual, the statistics produced by Tory central office do not compare like with like. There are now more administrative staff in the health service than ever. There was a 44 per cent. increase between 1986 and 1995, and between 1990 and 1996 the wage bill for administrative staff rose by £700 million. That may be one explanation of why the hon. Gentleman's local health authority entered this year—under the previous Government—£2.1 million in debt.

Mr. Burden

I agree with my right hon. Friend that one of the worst aspects of the previous Government's health reforms was the bureaucratisation of the health service; far too few staff were engaged in direct patient care and it is a considerable tribute to them that they have none the less been able to cope and provide an excellent service. Will he comment on the fact that, despite those efforts, staff have all too often to work in outdated hospitals and unsatisfactory environments? That problem, in Birmingham and elsewhere, was not addressed by the previous Government. Will he ensure that the present Government address it?

Mr. Dobson

I give my hon. Friend the assurance that he seeks. Besides increasing the number of staff exclusively involved in paperwork, the previous Government's reforms massively increased the time that doctors, nurses and other professionals had to devote to paperwork to feed the general bureaucratic system.

Mr. Brake

Is the Secretary of State aware that nurses at the accident and emergency unit at St. Helier hospital in Carshalton, who are directly involved with patient care, are currently balloting for industrial action because of concerns about the quality of patient care at the hospital? Does he have any plans to take action to ensure that the threat of industrial action is averted?

Mr. Dobson

The situation arose under the existing management of the St. Helier hospital and must be sorted out by that management.

Dr. Tony Wright

Has my right hon. Friend seen a recent survey that shows that some doctors, at least, are not as involved with patient care as they should be? In that survey, published in the British Medical Journal, an astonishing number of junior doctors say that they performed their first operation unsupervised. Is not that extremely alarming for patients? Is not it a good job that patients do not know that? Will my right hon. Friend examine the matter?

Mr. Dobson

We must certainly ensure that clinical standards in hospitals are raised rather than lowered. There is no possible excuse for junior doctors conducting their first ever operation without proper supervision. It is necessary for junior doctors to perform operations, however, otherwise they will never become sufficiently skilled to work on their own, but they need to be supervised while they are doing it.

Mrs. Virginia Bottomley

Is the Secretary of State aware of any occasion on which the Prime Minister has spoken of health service managers with appreciation, or even respect? Can he imagine circumstances in which, at the taxpayer's expense, he would host a glitzy reception at No. 10 to celebrate their contribution to the public good?

Mr. Dobson

My right hon. Friend is certainly extremely unlikely to host a glitzy reception at No. 10 to celebrate the right hon. Lady's contribution to the national health service. At the National Association of Health Authorities and Trusts conference last year he paid tribute specifically to the excellent managers in the NHS. He certainly does not pay tribute to the enormous increase in paperwork that occurred at the Department of Health when the right hon. Lady was supposedly in charge.