NHS Trusts: Executive Appointments (Hansard, 2 December 1997)

§ Baroness Jay of Paddington
My Lords, the terms of office of 570 chairmen and non-executive directors of NHS trusts came to an end on 31st October. We have still to confirm 57—that is, 10 per cent.—of these appointments. We will be sending valedictory letters as soon as possible to all board members who have not been reappointed. We agree that there have been some unfortunate delays, but they have been caused by the
1240 Government's determination to open up the process of selecting people to serve on trust boards. That has led to 1,800 nominations from Members of Parliament and local authorities. I must point out that no trust board is, or has been, inquorate.

§ Baroness Cumberlege
My Lords, I thank the Minister for that Answer. I should like to make it clear that I appreciate the fact that any new Administration wishes to appoint people in whom they have confidence and who meet the Government's criteria. However, does the Minister recollect her reply to her noble friend Lord Taylor of Blackburn just six weeks ago when she said that she and her colleagues had been "a little dilatory" in making appointments? Does she not agree that it is not so much dilatory as deplorable that chairmen and non-executive directors have had to attend meetings not knowing whether that meeting is to be their last or whether they should continue to run their organisations, some of which have budgets in excess of £100 million? Does she agree that it is no wonder that waiting lists and waiting times have shot through the roof when there has been such uncertainty in the leadership of the NHS?

§ Baroness Jay of Paddington
My Lords, I am very surprised by the last point raised by the noble Baroness. We are trying to ensure that the organisation of trust boards more adequately represents the communities that they serve. Your Lordships may be interested to hear that at the moment approximately 70 per cent. of members of trust boards have what is loosely described as a "business background". That does not seem to have produced a very successful business outcome given the state of the NHS that we have inherited.
On the more general point about the criteria for assessing nominated candidates, perhaps I may advise the House that all candidates now have to meet a rather rigorous number of criteria in order to be considered; the appointments then have to be sifted; people have to he interviewed; regional chairmen have to make suggestions and recommendations at various levels and finally to the Secretary of State. It is a long process. As I said in my Answer, we realise that some of the delays have been unfortunate, but we think that the outcome is worth it.

§ Lord Taylor of Blackburn
My Lords, is my noble friend aware of the widespread congratulations that have been extended to the Government on the way in which they have appointed these new people and not merely followed political dogma? The Government have ensured that the best people are chosen to fill these positions.

§ Baroness Jay of Paddington
My Lords, I am grateful to my noble friend. As I said, there are now tight criteria, particularly relating to commitment to the NHS, involvement in the local community, and acceptance of a particular type of responsibility for the public ownership values and public sector ethos of the NHS. I believe that we have succeeded in meeting those criteria.

Earl Howe
My Lords, is the Minister aware that my noble friend Lady Cumberlege made an extremely 1241 pertinent point about waiting lists? It is precisely when leadership is absent that waiting lists and waiting times are all too easily prone to drift in the wrong direction. If there was a difficulty in making the appointments in a timely fashion, why did not the department simply extend the term of the incumbents by a month or two rather than leave the trusts without proper leadership?

§ Baroness Jay of Paddington
My Lords, we have done that. Some board members have been reappointed for a short period; for example, to take the board through a possible reconfiguration or through the winter. On the noble Earl's point about waiting lists, what is needed is leadership and that is precisely why on 18th November the Government announced a national strategy for dealing with waiting lists, which included setting up a national taskforce within the NHS with eight regional organisers deliberately tasked to look into waiting lists at their local level.

§ Lord Peyton of Yeovil
My Lords, is the Minister aware that a measure of courtesy shown by governments does them no harm?

§ Baroness Jay of Paddington
My Lords, I think that we have been extremely courteous. I apologise for the fact that the valedictory letters are still in the post. I have been directly involved in dealing with the individuals concerned with the appointments system and every exchange has been extremely courteous.

§ Baroness Robson of Kiddington
My Lords, having once upon a time been vaguely involved with the health service, may I ask the Minister why the appointments could not have been made more swiftly? I refer to the fact that it is now five months since the Government came to power. I know that five months is not very long, but the Department of Health has a department specifically to deal with reappointments and that work would not have stopped. I had hoped that the Government might have implemented their choices more speedily.

§ Baroness Jay of Paddington
My Lords, in view of the previous question, I hesitate to appear to be anything but extremely courteous to the noble Baroness whose extremely distinguished service to the NHS is well recorded. The point was precisely not to go solely through the Department of Health's appointments office but to cast the net much more widely. We asked individual Members of Parliament of all parties and all local authorities to make nominations. That resulted in 1,800 names coming forward—there were many others—all of which were worthy of consideration by local health authorities and regional chairmen.

§ Lord Hunt of Kings Heath
My Lords, is my noble friend aware that delay in making appointments to non-executive positions in the NHS has been a consistent feature over the past 10 to 15 years? Does my 1242 noble friend agree that the little extra care that is now being taken in making these appointments will pay dividends in the years ahead?

§ Baroness Jay of Paddington
My Lords, I am grateful to my noble friend Lord Hunt for his intervention given his considerable experience of looking at the health service on a national basis. That is precisely what we seek to achieve.

§ Baroness Seccombe
My Lords, is the Minister aware that some non-executive directors were telephoned from the region last Friday, which was at least four weeks after they had received the heartless letter? They were told that they would receive a letter. Believe it or not, 24 hours later they did receive a letter. It was identical to the one that they had received four weeks before, but this time it informed them that their contract would end on 30th November. Is the Minister aware of what is going on in Leeds? Does she have any confidence in the corporate affairs division that is based there?

§ Baroness Jay of Paddington
My Lords, I have a great deal of confidence in the corporate affairs division of the National Health Service Executive. I suspect that the noble Baroness is referring not to the national office but to the individual practices of regions. If she would care to write to me giving me specific examples of local regions I shall try to reply to her.

§ Lord Belstead
My Lords, can the Minister inform the House whether the appointments will be made by the end of this year?

§ Baroness Jay of Paddington
My Lords, as I said in my original Answer to the noble Baroness, there are two strands of appointment: those which formally came to an end at the end of October, of which there are only 57 outstanding appointments to be dealt with, and those which came to an end at the end of last week. Those are still being dealt with but we hope they will be completed by the end of the year.

§ Baroness Cumberlege
My Lords, the noble Baroness has referred to courtesy. Does she believe it is courteous that those who have spent a lifetime in the NHS, some chairing very complex organisations, should learn through their successors that they are not to be reappointed? I believe that that is the height of disregard for the tremendous commitment that people have made to the National Health Service, and it is disgraceful.

§ Baroness Jay of Paddington
My Lords, as I said in reply to a previous question, I suspect that the noble Baroness is referring to individual regional offices' practices of which I do not have detailed experience. If the noble Baroness will pass on that information to me I shall try to reply. As regards discourtesy, I am probably the wrong person at whom these accusations should be fired. I speak as someone who was appointed a health authority chairman five years ago but was politically vetoed by one of the predecessors of the noble Baroness.