HL Deb 16 February 1960 vol 221 cc58-64

3. The Board shall consist of a chairman appointed by the Minister and nine other members so appointed, and— (a) the chairman and one other member shall be fully registered medical practitioners; (d) two members shall be appointed from among persons holding office as medical officer of health of a local authority; (e) two members shall be appointed from among persons having administrative experience.

5.22 p.m.

LORD TAYLOR moved, in paragraph 3, to leave out sub-paragraph (a) and insert— (a) one member shall be an officer of the Ministry of Health; The noble Lord said: I beg to move the Amendment standing in the name of my noble friend Lord Amulree and myself. I hope that the noble Viscount the Lord Privy Seal will feel that these Amendments are not moved in any frivolous spirit, as indeed was not the last one, but in a serious attempt to give legal precision to something with which I do not know quite how to deal. Again, I think it would be convenient if I might take the general principle underlying all these Amendments before we consider them in detail.

On Second Reading, I said that there were two types of public board: the first non-categorised, where the Ministry were left free to appoint whom they would, without having to fit them into different categories, and the second, of which this was an example, where they had to fit them into a sort of jigsaw which was laid down in the Act. I should prefer the first type, but one is satisfied that in this case the Government are probably right to categorise. That categorisation is virtually complete. There is a chairman and nine other members and the peculiarities are laid down for every one of these members, except probably one.

The chairman and one other member shall be fully registered practitioners (that is two), two members shall be appointed after consultation with the Medical Research Council (that is four), two shall be people of experience in bacteriology (that is six), two are to be medical officers of health (that is eight), and two are to be appointed from among persons having administrative experience (that is ten—in other words, nine plus a chairman). There is only one member about whom the Minister could exercise much freedom and that is the one other member mentioned in paragraph (a). The Minister is free to select any kind of fully registered medical practitioner, and possibly not a fully registered medical practitioner, because that person may well be covered in one of the subsequent categories.

I think this is a basic decision, and we should like to know what the Government are thinking about it. It would be possible for this Board to be heavily weighted with Ministry of Health officials or to be a balanced board of experts and users, but not excluding officials. Under the Bill as it stands, heavy Ministry of Health weighting is possible, and it is certainly believed in the Public Health Laboratory Service that that is the intention. I must say that I was greatly encouraged by the remarks of the noble Viscount the Lord Privy Seal on Second Reading, when he drew a simile between this Board and a Regional Hospital Board. Those are indeed the agents of the Minister of Health, but they are balanced boards of experts and users and are not composed of Ministry of Health officials. And very good indeed they have been. Therefore, we should hope that the noble Viscount will give your Lordships a clear statement of the Government's intention about the members of the Board who may or may not be civil servants.

First of all, the Government intend to have a medical chairman. I pointed out on Second Reading that throughout the entire life of this Board—and it has been in existence for about six years as part of the Medical Research Council—it has never had a medical chairman. I cannot see why on earth they want to specify that there should always be a medical chairman for this Board. I see no objection to there being a medical chairman sometimes. Why should this not vary from time to time? I should like to know what is behind this. Again rumour has it that the intention is that the chairman should be the Chief Medical Officer of the Ministry of Health. I must say that one thinks that that is a very bad idea, not because one has anything against the Chief Medical Officer—he is an excellent person—but because his time is so fully occupied already. He is a very busy Governmental official, and it would be far better to have someone who can devote a great deal of his time to the work of this Board, particularly as in all probability the Chief Executive will be retiring in the course of the next few years.

The first effect of our Amendments is to get rid of this restriction and leave the Minister free to vary the chairman. We have sought not to increase the size of the Board, but if one more member could be appointed, one would willingly accept one more official of the Ministry of Health. In Amendment No. 4, we suggest that one of the members should be an officer of the Ministry of Health, to replace the provision about the chairman. I can see no objection to there being two members who are officers of the Ministry of Health, providing that the total number can be increased by one. It is only fair to say that on the present Board there are two representatives of the Ministry—Sir John Charles and Dr. W. H. Bradley, who is an observer. Paragraphs (b) and (c) of the Schedule are perfectly satisfactory. Paragraph (d) brings us to users of the Board. The only users recognised on the Board are medical officers of health, but, as was pointed out by a number of noble Lords and myself, the Service is widely used by the hospitals and very often works as a hospital bacteriological laboratory. Yet there is no representation on the Board of the hospital administration and of general practitioners, although general practitioners also make use, and should make use, of this Service. One cannot see why either hospitals or general practitioners should not be substantial users, because it is in everybody's interest that they should be.

Therefore, we have reluctantly suggested that the number of medical officers of health should be reduced from two to one, and one representative of the hospitals, perhaps a senior administrative medical officer of one of the Regional Hospital Boards, should be appointed. We suggest that a practising general practitioner should be introduced, and finally, in place of these two persons having administrative experience, we suggest having one person having experience in industry, which is a little more realistic. Again it would mean that we brought in someone from outside rather than putting on two more civil servants. So the first point is to clarify whether the Board is primarily to be composed of civil servants, plus experts, or to be truly based on the principle of having experts and users with some Ministry of Health representation. If the latter, then it must, I feel, include the hospitals and the general practitioners. If the Government do not like the precise proposals in the Schedule that we have made, we shall be only too happy to vary them or to try to work out something that is reasonable but does not impose the limitations imposed at present.

There is one further provision which we suggest, and that is that there should be two assessors to represent the staff, and that this should be written into the Bill. In fact, there are two assessors who do represent the staff on the Public Health Laboratories Board. These people have been there, so far as I know, ever since the Board has existed. In the Annual Reports of the Medical Research Council one finds staff assessors at the bottom of the Board, and there they are. These two gentlemen, we understand, have no voting rights, and we merely suggest that this provision should be written into the Bill, so that the Board, after consultation with any appropriate bodies, shall appoint two assessors from among the staff of the Public Health Laboratories Service, with the right to attend meetings, but not to vote. Again, if the phraseology of this new paragraph is not right, we should not wish to stick rigidly to it, but merely ask that the principle be written into the Bill rather than that it should be left to the administration.

I do not want to enter into a long argument about public Boards, but I do feel that if we are going to have portions of our public services administered by public Boards it is much better if those Boards are not composed of civil servants, or at least not primarily composed of civil servants. One has in mind that the best of all public Boards was probably created by a Conservative Government when the B.B.C. was brought into operation. When we had a Labour Government a number of public Boards, including Regional Hospital Boards and new town development corporations were created, and they worked very well just because they were not civil servants. It is no criticism of the Civil Service—that is the last thing I have in mind—to say that it is a good thing to introduce other elements into the running of the public service, because the Civil Service can so easily get too big. I must say that I very much hope that this will be one of the kinds of Boards which is not primarily civil servant but which will be composed primarily of people who want to do a good job of public service, who are highly skilled, well equipped and representative of the users, and also that there will be real delegation and not just pseudo-delegation. If we have a large number of civil servants on such a Board, then the delegation becomes a false delegation, an apparent delegation without reality. I very much hope that, even if much of the detail may not be acceptable, the principles underlying the Amendment will be. I beg to move.

Amendment moved— Page 4, line 31, leave out sub-paragraph (a) and insert the said new sub-paragraph.—(Lord Taylor.)

5.35 p.m.

VISCOUNT HAILSHAM

Again my right honourable friend and the noble Lord appear to some extent to have changed places. The Bill as drafted contains fairly precise provisions for the constitution of the Board, and the Amendment as drafted by the noble Lord contains fairly precise provisions, differing to some extent, for the constitution of the Board. On Second Reading the noble Lord said [OFFICIAL REPORT, Vol. 220 (No. 34), col. 1011], and I was very much impressed with his remarks: In my experience, I must say that it is usually best to leave the selection of some new board to the individual Minister, while at the same time saying that he must consult with various people before he does it. That is, in fact, what happened under the National Health Service Act in respect of Regional Boards. The Minister consults, but then he appoints whom he thinks fit, regardless of whether they fit into a series of neat little categories. That was the noble Lord's view then, and I gathered from his first remarks in moving this Amendment that that is his real view now, but that he presented his precise Amendments out of deference to the view of the Government that they wanted a fairly precise Board. In the interval of time between the Second Reading and the present time my right honourable friend has studied with respect and admiration the noble Lord's remarks, and he hopes to have for the Report stage an Amendment of the Bill which will conform to the noble Lord's first specification but not to his second. In view of that, I am not sure that the noble Lord would wish me to enter into the merits of his particular Amendment, because he may feel so gratified that his advice on Second Reading is being taken that he will not wish to press the Amendment which he devised out of deference to the Government.

There is only one other thing that I would say. As regards the assessors, it has, as the noble Lord said, been the practice to have staff assessors sitting with the Board to which the Medical Research Council have delegated the administration of the existing service. This has been a most useful arrangement, and it is not intended that it shall cease. There are naturally many matters coming before the Board on which it is most important that staff members should have the opportunity of expressing their views to the Board. This has been done and is being done, and it is intended to continue it. The attendance of staff assessors can be, has been and will be, arranged administratively, but the view of the Government is that it is neither necessary nor desirable to write them into the constitution of the Board, which is, after all, the creation of a legal entity to which the function of administering the Service is actually given by the Act of Parliament. So that on that part of it my right honourable friend agrees with the policy which the noble Lord has enunciated, though he would rather not have it in the Bill. In view of what I have said about the proposal to provide that the Board should consist of certain persons appointed by the Minister after consultation with different categories of bodies, I hope that the noble Lord will not at this stage press his Amendment, and then he can come back on the discussion on the Report stage and avoid what I fear would now become a somewhat academic discussion.

LORD TAYLOR

I am amazed and delighted at the result of my Second Reading speech. I quite thought that as there was no Amendment at this stage I had better have a shot at what was left. The only reason that made me a little hesitant about rejecting the Government's original proposal out of hand was to make sure that the Medical Research Council were fully brought into consultation and that the bacteriologists were brought in, so that the research function could continue. I am sure it is best that the Minister should have the widest discretion in composing his Board, though I hope that (a) the consultations will be sufficiently wide-flung to include the hospital services and the general practitioners; and (b) that in practice, when he comes to appoint, he will not forget those two sides, and, even more important, the Medical Research Council and the bacteriologists. In view of what the Lord Privy Seal has said, I beg leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Schedule agreed to.

House resumed.