HL Deb 19 January 1995 vol 560 cc753-5

3.16 p.m.

Lord Dean of Beswickasked Her Majesty's Government:

What is their policy towards the issues raised by the statistics cited in the article on NHS trust chief executive pay in IDS Management Pay Review, January 1995.

Baroness Cumberlege

My Lords, we need high quality management to ensure that the multi-billion pounds of taxpayers' money we spend each year on the National Health Service are used to secure maximum improvements in healthcare. Decisions on the salaries of chief executives must be matters for local determination in the light of performance and other criteria.

Lord Dean of Beswick

My Lords, I am grateful to the Minster for that Answer. However, is she aware that a report in the press highlighted that those producing the report were meeting great reluctance from some trusts to provide the fullest information as to where salaries ended and expenses began? Can the Minister tell us whether there is a limit on expenses, a maximum, that can be drawn by the chairmen of the new health trusts and the chief officers? Does she agree that if there is not, it is about time that one was imposed?

Baroness Cumberlege

My Lords, there is not a ceiling. However, my right honourable friend the Secretary of State has been very firm and has put out guidance to the service that, in future, health authorities and trusts must publish in their annual report the remuneration and expenses of managers in the National Health Service; and also that they should set up a remuneration committee to scrutinise terms of service in line with the Cadbury Report on corporate governance.

Lord Carr of Hadley

My Lords, given the fact that the driving energy of the present system of organisation depends on a high degree of decentralisation of responsibility, can the Minister assure the House that she will rigorously resist attempts to standardise the way in which the different trusts conduct their affairs? But at the same time, will she also rigorously insist that the trusts comply with the necessary corresponding discipline to report most fully and accurately on what they do? It is quite clear at the moment that they are not all doing so.

Baroness Cumberlege

Yes, my Lords. I can give my noble friend that assurance. I endorse his view that local decisions are much more pertinent: they take into account local conditions, and indeed the talents and expertise within an organisation. That is bearing fruit already; as we see, there is improving service in the National Health Service. Waiting-lists have almost halved in the past five years, and more and more patients are being treated every year.

Baroness Jay of Paddington

My Lords, will the Minister accept, however, that this is a very disturbing report—not simply in relation to the levels of pay for trust executives to which my noble friend referred, but also in relation to the points that were made by her noble friend about accountability? How do the Government respond to the following quotation from the report: As last year, the availability and disclosure of pay information in the accounts left much to be desired. Many trusts ignored requests for copies of annual accounts"? How can that situation be redressed?

Baroness Cumberlege

My Lords, it is up to non-executives to ensure that those conditions are complied with. As I said, from 1st April health authorities and trusts will have to publish in their annual reports all the details that are being sought by your Lordships this afternoon and remuneration committees will be set up.

Lord Dean of Beswick

My Lords, from what the Minister has just said to my noble friend on the Front Bench, does she understand that some people have refused to do it and have got away scot-free? What sanctions can be used against those who dig in their heels and say that they will not do it? Does she agree that in the report there was an element which implied that that had in fact happened?

Baroness Cumberlege

My Lords, the National Health Service is very extensively audited. There is not only the local audit, but there are also audits by the National Audit Office and the Audit Commission. In the final analysis, the Treasury also takes a very keen interest in the matter.

Lord McIntosh of Haringey

My Lords, it is very encouraging to hear the Minister speak out so sturdily for local discretion and local judgment. Bearing in mind the respect with which she is held in this House, will she use her influence to ensure that other parts of government, notably those dealing with local government, take the same view?

Baroness Cumberlege

My Lords, the noble Lord will be aware that I am a staunch supporter of local government. I served in it for many years. But local government has to comply with the national policies of this country. I found it distressing in 1976 when I saw a whole change in local government and it declared UDI. I think that it went off the rails. I was very disappointed by that. I believe that local government has a role in this country, but once it tries to ignore what the national Government are doing, it runs into trouble.