HL Deb 10 March 1992 vol 536 cc1219-21

3.1 p.m.

Lord Dean of Beswick asked Her Majesty's Government:

Whether they will publish the figures for 1986 of the number of nurses and clerical, managerial and accounting staff employed in the National Health Service, and also the latest annual figures available for those categories.

Baroness Hooper

My Lords, in September 1986 and September 1990 the numbers of nursing and midwifery whole-time equivalents in the hospital and community health services were 511,000 and 512,300 respectively. But this is not comparing like with like, since the recent 1990 figures exclude many nurses now doing senior management jobs and the Project 2000 students. The clerical, managerial and accounting whole-time equivalents were 137,200 and 159,200 at the same dates.

Lord Dean of Beswick

My Lords, I am grateful for those figures. Is the noble Baroness aware that authentic figures have recently been produced showing that over the past five years there has been an annual increase of approximately 4,000 people employed in the health service in clerical, financial and management grades? The figures show a downturn of nearly 2,000 nurses —and only nurses—annually. Does not this trend appear to be contrary to what we would expect in an improving health service? Are we not in danger of creating clerical jobs at the expense of nurses' jobs?

Baroness Hooper

My Lords, the figures that I quoted show no downturn in the numbers of nurses. The important point about the increases in clerical and administrative staff is that over a quarter of the staff work in direct support to clinicians. Thus, a greater proportion of health service staff are employed today in direct patient care than ever before.

Lord Mellish

My Lords, the Government are quite rightly accused at times by the Opposition of being the enemy of the National Health Service. It is suggested that they wish to destroy it and privatise it completely with the resulting consequences. I wish to ask the Minister a simple question: how many nurses, doctors and other staff were employed 10 years ago compared with today?

Baroness Hooper

My Lords, there are far more today. The numbers in many categories have more than doubled in the 12-year period.

Lord Ennals

My Lords, the noble Baroness may have been quoting from memory but she was not quoting the facts. Will she confirm that the total number of staff working for the National Health Service has fallen from 824,000 full-time equivalents in 1981 to 796,000 in 1990? That is a substantial fall. Perhaps she was not considering the part-time equivalents. Those are the figures for full-time equivalents confirmed by her own department.

Baroness Hooper

My Lords, the Question on the Order Paper which I am answering relates specifically to nurses. The further question to which I responded from the noble Lord related to doctors and nurses. Those numbers have increased dramatically since the Government took office and since the period during which the noble Lord served as Secretary of State for health. The numbers of clerical, managerial and accounting staff to which we referred have increased in order to free the medical staff to concentrate on their important job of looking after the patients and their health needs.

Lord McColl of Dulwich

My Lords, will my noble friend agree that in this country we spend far less on the management of the National Health Service than any other western country? Will she further agree that as it was the noble Lord, Lord Ennals, who introduced cash limits to the hospital service, it is rather inappropriate for the Labour Party to attack the group of workers charged with keeping the hospitals within cash limits?

Baroness Hooper

My Lords, the reforms that we introduced into the health service were specifically to make it more cost-effective and more efficient in order to enable more patients to be treated. That has happened.

Lord Carter

My Lords, is the Minister aware of the increasing load of administration and accounting now placed on doctors to meet the demands of the increased number of accountants and managers who, as the noble Baroness agreed, are required to operate the internal market? Is she interested to know that a leading cardiologist in the West Country has written to me saying that the extra 10 to 12 hours a week which he has to spend on administration means that he has given up any attempt at research work? The six research papers that he should be writing will have to wait until next year when he takes early retirement. I ask the Minister: is this the best use of scarce resources? Can she tell the House what it has to do with improving patient care?

Baroness Hooper

My Lords, I recommend the noble Lord to read a publication called: NHS Reforms —The First Six Months. It shows beyond doubt that as a result of our reforms there have been dramatic improvements in the numbers of people treated. The numbers of patients waiting for treatment have been reduced equally dramatically. Thus there are more heart bypass operations, more cataract operations and more hip replacement operations being carried out by doctors, backed up by nurses, to the improvement of the nation's health.

Naturally, when changes are introduced there is a transitional period when people have to become accustomed to the new arrangements. If, after the first six months, there are such dramatic improvements, what may we expect after the first year or two years?

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