NHS Management: Breaches of Regulations (Hansard, 9 May 1994)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)
My Lords, the appointment of Anne-Marie Nelson to a second health authority was the result of an oversight by the department. Mrs Nelson has since resigned from the West Kent Health Authority and been correctly appointed as chairman of the Special Hospital Service Authority. The earlier mistake was made in good faith and does not give any grounds for legal action. North Cheshire Health Authority, which succeeded the Halton Health Authority, is taking legal advice about the recovery of payments to the last district general manager of Halton. Court action is not appropriate for other people named in the district auditor's report.

§ Lord Dean of Beswick
My Lords, I am grateful to the Minister for her reply to my two-part Question. With regard to the appointment of the lady mentioned in the first part, will the Minister confirm that it was an illegal 1339 appointment made by the Secretary of State and authorised by her? If that is the case, does she accept that the Secretary of State should be called into question in the courts of the land for an illegality? Can she say whether the money that was paid to the lady in that illegal appointment has been repaid? If not, should not that be done? As regards the second part of the Question, is anybody to be prosecuted? Is the money to be reclaimed or do the codes of conduct mean nothing?

§ Baroness Cumberlege
My Lords, with regard to the first part of the Question, the appointment is not illegal but it contravenes two sets of regulations. The difference in the regulations was overlooked by the department; that is why Mrs Nelson was appointed in error. As for the second part of the Question, I have already said that the health authority is taking legal advice on the matter.

§ Baroness Jay of Paddington
My Lords, does the Minister agree with me that the persistence of my noble friend Lord Dean on these matters has been very helpful in restoring public service values to the health service? When will the Government play their part and introduce appropriate sanctions so that the codes of conduct are worth more than the paper that they are written on?

§ Baroness Cumberlege
My Lords, being a member of a health authority, the noble Baroness will appreciate that the codes of conduct have only just been published. At this very moment health authorities are in the process of adopting those codes. We have every confidence in them and the people who serve with such integrity on health authorities and trusts.

§ Lord Tordoff
My Lords, will the noble Baroness answer the second part of the question of the noble Lord, Lord Dean, regarding the presumed double payment of salaries? Have steps been taken to recover those moneys?

§ Baroness Cumberlege
My Lords, as I understand the situation, Mrs. Nelson never took both salaries.

Lord Dean of Beswiek
My Lords, is it not the case that other people have been appointed against the regulations in the same manner? I refer, for instance, to the former Chairman of Wessex, who was made Chairman of the National Health Supplies Authority at the same time in contravention of the then standing orders, or however the noble Baroness would describe them. We are not talking in the strictest sense about the present code of conduct. The regulations under which those people were appointed were introduced by the Government in 1990. Their appointment is in contravention of the system then introduced. Is it not therefore strange that people can be appointed contrary to the law of the land and no action is taken against them? It is about time that the Secretaries of State, who appeared to want the power given to them in legislation, were prepared to wear the crown of thorns rather than the laurel leaf.

§ Baroness Cumberlege
My Lords, the generality is that there is not cross-membership between regional, district and family health service authorities. However, 1340 some special health authorities are permitted to hold dual appointments. I refer to the Dental Vocational Training Authority, the Mental Health Act Commission, the Microbiological Research Authority, the National Blood Authority, the NHS Supplies Authority—to which the noble Lord referred—and the UK Transplant Support Services Authority. Only three are not allowed dual membership; that is, the Health Education Authority, the Prescription Pricing Authority and the authority which was drawn to our attention, the Special Hospitals Service Authority.
Before this situation came to light it was the intention of the Secretary of State and the department to establish closer links with the Special Hospitals Service Authority which, as your Lordships will realise, does a difficult job in looking after patients who are extremely vulnerable and difficult, many of them having been before the courts in severe psychotic situations. It was the intention to bring that service closer into the mainstream of the National Health Service that prompted this appointment, in addition to which, Mrs. Anne Marie Nelson is a person of exceptional calibre.

§ Baroness Jay of Paddington
My Lords, I accept what the Minister said regarding the integrity with which most members of the health authority serve and I am glad that she includes me in that category. But I am sure that she will be pleased to learn that the health authority of which I am a member takes the codes of conduct extremely seriously and responsibly. We need to return to the question raised before in your Lordships' House: why do not the same sanctions which apply to local authorities apply to health author ties?

§ Baroness Cumberlege
My Lords, that ground was covered on a previous occasion in a Starred Question. There is no question of members of health authorities being surcharged. They are totally different from those elected to local government. Councillors are locally elected and are answerable to the Secretary of State for the Environment. The board members of NHS trusts and authorities are appointed by the Secretary of State who answers to Parliament and the Public Accounts Committee. No accounting officer is accountable to the accounts committee in local government In the NHS the Permanent Secretary and the Chief Executive of the National Health Service Executive are both accounting officers and answerable to the PAC. I have in front of me seven distinct differences between local government and the National Health Service members who serve on health authorities and trusts.