HL Deb 27 June 1989 vol 509 cc582-5

3 p.m.

Lord Dean of Beswick asked Her Majesty's Government:

Whether they will review the criteria for membership of the National Health Service Policy Board as stated to the House by Lord Henley on 14th June.

Lord Henley

My Lords, the criteria for membership of the National Health Service Policy Board reflect the board's role, which is to advise my right honourable friend the Secretary of State for Health on the formulation of NHS policy and on the strategic oversight of the NHS. Unless the board's role is revised, there can be little reason to review the criteria for its composition.

Lord Dean of Beswick

My Lords, is the Minister aware that he could have given a more simplistic Answer by just saying "No"? The Government have decided to totally ignore the suggestions and requests from all corners of your Lordships' House on this subject. The Minister will also recall that in answer to me on the previous occasion he said that the nurses must not view this as a "kick in the teeth"—his words. Is the Minister aware that since the Prime Minister herself, who normally pays fulsome tribute to the nurses and the profession, has point blank refused the nurses an opportunity to discuss this problem? If that is not a kick in the teeth from the Prime Minister, can the Minister explain what is?

Lord Henley

No, my Lords, it is not a kick in the teeth. On the same day as the previous Question was asked my right honourable friend had a meeting with the leader of the nurses, Trevor Clay, and a press release was issued following that meeting.

Lord Molloy

My Lords, is not the noble Lord aware that every single professional organisation in this country upon which our National Health Service depends is deeply upset by the omission from the board of the chief nursing officer? Will the Government discuss this with representatives of all the professional organisations and be prepared to listen to their recommendations to change the structure, which they urgently ask the Government to reconsider?

Lord Henley

My Lords, I am aware of the noble Lord's views, but I think they stem from a misunderstanding of the role of the policy board. The policy board has been formed to bring wide-ranging management perspectives to bear on the development of National Health Service policy. It will be there to advise Ministers, and purely to advise Ministers, on the tasks and objectives which they should set for the management executive. I should stress that the deputy to the chief nursing officer is represented on the management executive.

Lord Winstanley

My Lords, is the noble Lord aware that some of us are every bit as concerned about what, if anything, the National Health Service Policy Board will be able to do concerning who sits on it? The noble Lord told the House that the board will advise the Secretary of State on the formulation of policy. Is the board entitled to advise the Secretary of State on policy that has already been formulated? For example, can the board advise the Secretary of State to defer the introduction of some of the proposals in the White Paper until pilot studies have been held, or are decisions of that kind still to be made wholly and single-handedly by the Secretary of State? If the board cannot do much, it does not greatly matter who sits on it.

Lord Henley

My Lords, I stressed that the board is advisory. My right honourable friend cannot delegate all decisions that are his by right to make.

Lord Hunter of Newington

My Lords, now that the National Health Service Policy Board and the National Health Service management executive have started work, can the Minister tell the House whether the Government envisage any change in the role and position of the regional health authorities and the committee—that is, between them and the Secretary of State—who have in the past advised him on policy?

Lord Henley

My Lords, the committee of chairmen of the regional health authorities will continue to meet as normally; but, as I have stressed, the policy board's role is advisory.

Lord McCarthy

My Lords, this is the fourth time that the Government have taken this attitude with the nurses. The Government took them off the regional executives, they took them from the supervisory boards, they have taken away their budgets and this is the fourth time they have tried to take away the managerial functions of the nurses. Why do the Government do this?

Lord Henley

My Lords, I am sorry that the noble Lord takes that view. My right honourable friend still has the greatest respect for the chief nursing officer and for the nursing profession, as I stressed on the previous occasion that this Question arose.

Baroness Masham of Ilton

My Lords, does not the Minister agree that Florence Nightingale was a very good manager, in that during the Crimean War she reorganised the whole of the hospital and nursing services? Surely among the thousands of nurses now working in the National Health Service there must be one who is an excellent manager. Would not such an appointment give a boost to the morale of all nurses?

Lord Henley

My Lords, I take the point made by the noble Baroness, but my right honourable friend has announced membership of the policy board. He has also announced membership of the management executive, which contains a nurse.

Lord Prys-Davies

My Lords, will the Minister confirm the information which I have received from the Department of Health that the terms of reference of this new policy board will not be agreed until a meeting on 6th July? If that is so, that gives the Government an opportunity to review the criteria for membership in the light of the terms of reference which are yet to be agreed.

Lord Henley

My Lords, to correct the noble Lord, I believe the meeting is on the 7th July and not 6th July. If I am incorrect I will advise the noble Lord. The terms of reference will come before the board but, as I stressed, the board will remain an advisory board.

Lord Dean of Beswick

My Lords, I am sorry to rise at this late stage but, referring to his earlier reply, is the Minister aware that yesterday the Royal College of Nursing issued a press statement to the effect that the Royal College general secretary, Trevor Clay, has expressed his disappointment at the Prime Minister's refusal to meet with the Royal College of Nursing council deputation on the genuine concerns of nurses in regard to the policy board? How does that tie up with his earlier reply? Something is different somewhere.

Lord Henley

My Lords, there is no difference at all. It is up to my right honourable friend the Prime Minister as to who she meets. I stress the fact that my right honourable friend the Secretary of State for Health has met the nurses' leader, Trevor Clay.

Lord Bruce of Donington

My Lords, is it the Government's policy to set up advisory boards without having the remotest clue as to what will be their terms of reference?

Lord Henley

My Lords, it is entirely up to my right honourable friend, or any of my right honourable friends, as to what advisory boards they set up. My right honourable friend has set up the policy board and the noble Lord will see from the White Paper what the policy board is to do. I have stressed that it is an advisory board. There are terms of reference which will come up for discussion at the first meeting.

Lord Taylor of Gryfe

My Lords, may I have an assurance from the Minister that the principle of "not one of us" has not been applied in various appointments to regional health boards throughout the country?

Lord Henley

My Lords, that is quite beyond the Question on the Order Paper. We are discussing the policy board, not regional health authorities.

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