HL Deb 25 November 1992 vol 540 cc958-60

3 p.m.

The Countess of Mar asked Her Majesty's Government:

Why the Secretary of State for Health consults representative bodies when she considers an order to vary the area of a district health authority when there is no statutory duty for her to do so under the National Health Service Act 1977 as amended by the National Health Service and Community Care Act 1990.

The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)

My Lords, because this is a matter of good practice.

The Countess of Mar

My Lords, does the noble Baroness agree that organisations which are consulted spend a great deal of time and go to a great deal of expense to produce a reply to the consultation paper, and that it is extremely disheartening for them to learn that they need not have bothered? The Minister will know the particular case that I am talking about: the amalgamation of Kidderminster with Bromsgrove and Redditch district health authorities. Papers for that amalgamation were signed several days before the consultation was complete. Is this not a pseudo-democratic function?

Baroness Cumberlege

My Lords, when she makes her decision on mergers, the Secretary of State has to take a number of factors into account: the improvement of services to patients, the efficiency of the organisation and better value for money. She also takes into account local views. On the specific case that has been raised, 34 organisations and individuals were formally consulted, including local authorities, local medical and nursing bodies, local Members of Parliament and the surrounding health authorities. Of these, 11 opposed and 23 did not oppose. We had inconclusive replies from others. But there was full consultation and people had a say in what was going on.

Lord Boyd-Carpenter

My Lords, is it not somewhat unusual to criticise a Minister for consulting representative bodies? On the contrary, is not the Minister to be applauded for consulting these bodies, even though not statutorily so bound?

Baroness Cumberlege

My Lords, I thank my noble friend for those comments.

Lord Desai

My Lords, is the Minister aware that there is a feeling that interests of economy rather than local needs have been taken into account in some of these mergers? Is she aware that there is great disquiet that local needs are not being met when such mergers take place?

Baroness Cumberlege

My Lords, there have been 11 mergers since the 1990 Act and only one that I am aware of has caused great disturbance. It is perfectly proper and right that the Secretary of State should take into account the efficiency of an organisation, particularly in the health service, which consumes so much of taxpayers' money.

Lord Carter

My Lords, does the Minister recall that when we debated this on 9th November she said: There is no statutory requirement to consult but a reasonable expectation that there should be consultation".—[Official Report, 9/11/92; col. 47.] What machinery does her department have to ensure that "reasonable expectations" are met?

Baroness Cumberlege

My Lords, it is through the review system operated by the management executive that regions and districts are accountable.

Lord Gridley

My Lords, with regard to the supplementary answer, is it not right to assume that the Secretary of State, being head of a large department, has a perfect right to consult local authorities about any objections to such matters in order to be quite sure that she has all the information necessary to be able to come to a proper decision?

Baroness Cumberlege

My Lords, I should like to thank my noble friend for that. Clearly, that is the case. Although there is no legal obligation, the Secretary of State ensures that regions do consult before mergers take place.

The Countess of Mar

My Lords, the noble Baroness does not seem to get my point. In the case of Kidderminster with Bromsgrove and Redditch, the decision had been made before all the consultation papers had been received. To say that only 11 were against the merger is not true. Only about five were for it.

Baroness Cumberlege

My Lords, the decision was taken after consultation. The application for a merger was put out to consultation. Clearly, there has to be an application before a decision is made. That is the time to consult the public.

Forward to