HL Deb 20 May 1982 vol 430 cc798-800

3.6 p.m.

Lord Orr-Ewing

My Lords, I beg leave to ask the Question which stands in my name on the Order Paper.

The Question was as follows:

To ask Her Majesty's Government to what extent the proportion of administrative and clerical workers among the staff of the National Health Service have been reduced and how these figures compare with the increase in medical staff.

The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Trefgarne)

My Lords, administrative and clerical staff account for just over 13 per cent. of all staff employed in the National Health Service in England. This percentage has remained fairly constant since 1976. The proportion of medical and dental staff as a percentage of total staff has risen slightly from 4.6 in 1976 to 4.8 in 1981. There has, however, been a marked increase in the proportion of staff involved in direct patient care—that is, doctors, nurses and professional and technical staff—from 57.7 per cent. of all staff in 1976 to over 60 per cent. in 1981.

Lord Orr-Ewing

My Lords, will my noble friend understand that many of us are very pleased to see the right tendency in these figures—less administration, less bureaucrats and more medical staff—which is a satisfactory movement in the right direction? Could he assure us that, in connection with the cleaning staff, the ancillary staff and the like, we are not denying them automatic equipment for cleaning, for washing and all the many processes in the health service, so that their productivity continues to increase and does not diminish?

Lord Trefgarne

My Lords, the health service is, I think inevitably, a very labour-intensive operation and there are limits to the improvements in productivity which one can make by employing more technical equipment, for example. But I can say that the number of in-patients treated has increased by 5 per cent. betwen 1979 and 1980, while the number of NHS staff has increased by only 2.4 per cent. which is a measure of the improved efficiency of the organisation.

Baroness Jeger

My Lords, would it not be a better way of increasing productivity in the NHS if the Government would take some positive action to bring this industrial dispute to an end? Surely that is the most destructive aspect of the productivity problem.

Lord Trefgarne

My Lords, the noble Baroness asks a rather different question, if I may say so. But if she is meaning that we should make greater resources available to the health service—for example, by acceding to the demands of the unions—I would have to say that that would result in a reduction in the level of services available and not in an increase.

Lord Segal

My Lords, will the Minister confirm that the number of senior medical staff has fallen, but the number of junior medical staff has increased?

Lord Trefgarne

My Lords, I have the figures for the total number of medical staff, which I gave in my original Answer. If the noble Lord will allow me, I will write to him with the precise break-down of the different categories of medical staff involved.

Lord Davies of Penrhys

My Lords, will the noble Lord tell me if I am deaf, but I think he said in his original Answer, "The health service in England". Does he not consider Wales and Scotland part of that service, and do the figures apply to both or just to England?

Lord Trefgarne

My Lords, the figures I gave did indeed apply to the health service in England, which is, of course, far and away the largest of the different regions in the United Kingdom. That is not, of course, to detract from the importance of the other areas, but the figures are, I think, less indicative of the general situation.

Lord Auckland

My Lords, is my noble friend aware that the figures he has given are very encouraging so far as they go, but is he further aware that in the long stay mental hospitals, particularly in the grey areas, there is still an acute shortage of trained and student nurses? What plans have the Government to try to put this situation right?

Lord Trefgarne

My Lords, my noble friend is right to point to the long-stay mental hospitals, where it is true that certian difficulties do exist. We are making a number of efforts to improve the recruitment levels for those particular hospitals, and I hope that our efforts will have some success.

Lord Molloy

My Lords, is the noble Lord aware that the point made in the supplementary question asked by the noble Lord, Lord Orr-Ewing, regarding the improvement and increase in technology in the auxiliary staff work of the health service, is a very real and important issue? Would he not also agree that the use of modern technology in the health service might be improved, particularly as regards preventive medicine? What we really want to see is a decrease in the productivity of doctors, nurses and specialists, and not an increase which means that more people are becoming ill. The ideal of any medical profession should be to work itself out of a job.

Lord Trefgarne

My Lords, I certainly look forward to the day when the number of patients treated is reduced because there is a reduction in the demand for the services of the health service. However, that is not the same as reducing the productivity of the health service, which is an undesirable aim.

Baroness Masham of Ilion

My Lords, would the Minister not agree that, now that the area tier has gone from the National Health Service, good monitoring should be undertaken of administration at regional level to see that there is a good balance kept at the district level?

Lord Trefgarne

My Lords, yes, indeed. I and my right honourable and honourable friends are particularly concerned to see that the monitoring of these matters continues and is, indeed, improved. We have taken certain steps to that end.

Lord Underhill

My Lords, in view of the Minister's comment that the figures which he gave are for England only, would he not agree that that is a rather unusual procedure? Is there any reason why the figures are confined to England? Has the noble Lord the figures for the United Kingdom as a whole?

Lord Trefgarne

My Lords, I do not have figures in front of me for the whole of the United Kingdom, which I understand are collected on a different basis. But I will certainly see what additional information there is that I can pass to the noble Lord.