HL Deb 29 October 1992 vol 539 cc1206-8

3.13 p.m.

Lord Desai asked Her Majesty's Government:

What was the growth of expenditure on management personnel in relation to NHS provision over the last five years.

Baroness Cumberlege

My Lords, a better managed NHS is leading to better patient care and more of it. In the past five years, overall resources for the NHS have risen by over two thirds. Within that total, expenditure on management personnel in England has risen from £ 25.7 million in 1987 to £ 251.5 million in 1991.

Lord Desai

My Lords, I thank the Minister for that reply. However, does she share my concern that, while management is necessary, the growth in expenditure on management is crowding out growth in expenditure on personnel concerned with health care? Does she also agree that the number of managers has grown fast while the number of nurses has declined slightly?

Baroness Cumberlege

My Lords, for every £ 1 spent on senior managers another £ 43 is spent on NHS professionals such as doctors and nurses—a ratio which compares well with any other organisation. In 1984 the Government were concerned about the strength of NHS management and introduced an inquiry, which was chaired by Sir Roy Griffiths. He said that the management was poor and: In short, if Florence Nightingale were carrying her lamp through the corridors of the NHS today she would almost certainly be searching for the people in charge".

Lord Skelmersdale

My Lords, in her original Answer my noble friend showed that management costs over the past five years have increased by some nine times, I presume in real terms. Can she correlate that figure by saying how much the number of in-patient treatments has risen over the same period?

Baroness Cumberlege

My Lords,7 per cent. more patients were treated during last year. We now have virtually no one waiting over two years for treatment and the number waiting over a year has halved.

Lord Carter

My Lords, is the Minister aware that the total number of direct patient care staff has been virtually static over the past five years while the numbers of administrative and clerical staff have increased by 21 per cent. in the same period? Do the Government think that that is the best way to improve patient care?

Baroness Cumberlege

My Lords, I believe that I have proved very convincingly that the NHS has become more efficient. It is treating more people, both as in-patients, out-patients, and day patients. Much of the credit for that must go to better management.

Lord Jenkin of Roding

My Lords, does it not make sense that administrative tasks should not be performed by people who have had an expensive clinical training? Is not part of the explanation for the figures which have been quoted from both sides of the House that increasingly, on the wards and elsewhere, administrative tasks are performed by administrators and managers leaving the clinically trained staff actually to look after patients?

Baroness Cumberlege

My Lords, my noble friend Lord Jenkin of Roding has summed up very accurately the Government's policy.

Lord Jenkins of Putney

My Lords, is the noble Baroness aware that the belief that the NHS has improved recently is not widely shared?

Baroness Cumberlege

My Lords, without a doubt the NHS has improved beyond all bounds.

Lord Carter

My Lords, further to her reply to the noble Lord, Lord Jenkin, is the noble Baroness aware that the number of ancillary staff, who are the people who would be performing the tasks which the noble Lord described, has decreased by 40,00 in the past five years?

Baroness Cumberlege

My Lords, ancillary staff also covers catering, portering and general maintenance staff. As we know, many of those staff are no longer employed by the NHS but by private companies. Again, the quality of the work being done has improved beyond all doubt.