HL Deb 21 October 1997 vol 582 cc608-10

3 p.m.

Lord Dean of Beswick

asked Her Majesty's Government:

What steps they are taking to ensure that National Health Trust board members are resident in the areas of the boards to which they belong.

The Minister of State, Department of Health (Baroness Jay of Paddington)

My Lords, under the Government's new procedures, candidates are expected to live in the area served by the trust involved. Only in exceptional circumstances would we be prepared to depart from that: for example, where there are severe local recruitment problems—and I am glad to say that, as far as I can see, that is not the case at the moment; or where a particularly strong candidate has demonstrated in some other way his commitment to the local community; or where there is someone living only just outside the borders of the trust whom it might be sensible to appoint.

Lord Dean of Beswick

My Lords, I am grateful to the Minister for that reply. Is she aware that people have been pressing for such a decision for a long time? During my political career, I have been associated with two major cities, Leeds and Manchester. Is the Minister aware that in both places, the chairmen of their trusts are from well outside the city? Does it not seem strange that in two of the biggest cities in the country someone suitable could not be found and that the positions were filled by people living miles away? That looks extremely odd to people who live in those cities.

Baroness Jay of Paddington

My Lords, I am grateful to my noble friend for drawing attention to those local examples. The primary aim of the new policy has been precisely to make trust boards much more representative of the communities they serve. I hope that under the new practice that will indeed be the case and that examples like those quoted by my noble friend will not happen again.

Earl Howe

My Lords, will the noble Baroness clarify the range of criteria by which an individual's suitability for board membership of a trust will be assessed? In particular, does she agree with me that it is unfortunate that the issue of private medical insurance should have been raised in that context? Will she remove the uncertainty which persists about whether, in the Government's view, holding such insurance is compatible with board membership?

Baroness Jay of Paddington

My Lords, perhaps I may first welcome the noble Earl to the Dispatch Box with his new portfolio. Having served in the last government in the departments of agriculture and defence, I am not entirely sure whether he will find the area of health more or less controversial. Let us hope that we both find it a tranquil backwater which we can explore together.

A list of essential criteria for membership of a trust board has been widely published. It includes the issue raised by my noble friend Lord Dean of Beswick about living in the area of the trust. Another important element is that someone should have a very strong personal commitment to the NHS; it is also a desirable qualification that such people should have experience as carers or users of the NHS. That represents very clearly the Government's policy. People will not be excluded automatically because they have private medical insurance but the two criteria I have described—a strong personal commitment and being a user of the NHS—makes it very clear where our preference lies.

Lord Taylor of Blackburn

My Lords, is my noble friend aware that the terms of office of quite a number of people filling those posts at present will end shortly? When will the department make a statement as to the new occupiers of those posts?

Baroness Jay of Paddington

My Lords, I am grateful to my noble friend for raising that matter. It is the case that more than 1,000 appointments are due for renewal or for reappointment during this coming month. That is more than one-third of the total number of trust appointees. It has been a very substantial task to look through all the applications, so many of them based on the new criteria which I explained in answer to the previous question. Perhaps we have been a little dilatory in trying to get through all those new appointments but we are aware of that. I should like to take this opportunity to say that they will all be processed as quickly as possible but if the number of appointment forms sitting on my desk is matched by those on the desks of my ministerial colleagues—I believe, in fact, that theirs are more substantial—we certainly have a major task ahead of us. However, we hope that it will lead to a very great improvement in the quality and character of the trust boards.

Baroness Robson of Kiddington

My Lords, the Minister described the criteria for appointments. In her original Answer, she mentioned exceptional circumstances in which someone could be appointed from outside the area of the trust board. Can she assure me that one of those exceptional circumstances will not be political allegiance?

Baroness Jay of Paddington

My Lords, yes, political allegiance is not a criterion mentioned either in the essential or desirable list.

Lord Evans of Parkside

My Lords, does my noble friend agree that more important than where members of trust boards reside is the performance of the trust boards themselves? In particular, their affairs should be conducted in a more open fashion. For example, should the press and public not be invited to attend meetings and should not the salary and expenses of all board members be public knowledge?

Baroness Jay of Paddington

My Lords, on the first point, I agree entirely with my noble friend that the clarity and transparency of trust business is extremely important. As my noble friend may be aware, my right honourable friend the Secretary of State has already given guidance to the health service which will be brought forward in a more formal way in December asking that all trust board meetings should be made open. That is consistent with the policy practised for some time by health authorities. We believe that that will increase transparency and communication between the trust boards and local communities and will make it much more useful as a way of reflecting the interests of those communities.

Lord Dean of Beswick

My Lords, do I take it from the Minister's reply that where a chairman lives outside the area of the trust board which he chairs, if a suitable replacement can be found within the area a change of appointment will be made?

Baroness Jay of Paddington

My Lords, it is not our intention to exclude people who presently hold posts from those chairs because of their place of residence. However, when that appointment is due for renewal, that will certainly be a guiding criterion.