Bureaucracy (Essex) (Hansard, 27 January 1998)

§ 8. Mr. Bob Russell
What plans he has to reduce bureaucracy in (a) North Essex health authority, (b) Essex Rivers Healthcare, (c) North Essex Mental Health Trust and (d) New Possibilities Health Trust. [23420]

§ Mr. Milburn
In December 1997, I announced that, in 1998–99, an £80 million saving will be secured from reductions in management costs for investment in front-line patient services. Regional offices will shortly set targets for all health authorities and trusts to reduce management costs.

§ Mr. Russell
May I suggest to the Minister that further savings could be made if quangos were abolished and those trusts were amalgamated and brought under some form of local accountability—thereby releasing thousands of pounds into the front-line services that he mentioned? We have also the nonsense in which trusts operate side by side. I draw his attention to, for example, Colchester general hospital, which operates from a cramped site because the next-door NHS trust is busily selling off that site. Why do we not bring back the NHS under one control, so that it is the people's NHS?

§ Mr. Milburn
That is a very radical approach for the hon. Gentleman to take, and a useful policy initiative at which we shall take a good, close look. Meanwhile, as he is aware, a process of trust mergers is under way across the country. However, those mergers will occur as a product of local discussion and local agreement rather than because of national edict. If local discussions are occurring in his area and if they produce a trust merger proposal that results in improvements in patient care, Ministers will examine the process very carefully. The acid test, however, is whether that type of structural change leads to improvements for patients.

§ Mr. Ruffley
Does the Minister understand that—although he talks tough on cutting costs—he is proposing to add a new dimension of bureaucracy with the White Paper's primary care commissioning units? What will be the cost of that new bureaucracy? Has his Department calculated the cost? If so, what is it?

§ Mr. Milburn
The answer is that we shall be cutting bureaucracy by £1 billion during the course of this Parliament.