Appointments to NHS Boards (Hansard, 6 April 1998)

Earl Howe
asked Her Majesty's Government:
What account was taken by Ministers, when making recent appointments to NHS trust boards, of candidates' declared party political affiliations.

§ The Minister of State, Department of Health (Baroness Jay of Paddington)
My Lords, the Commissioner for Public Appointments, who naturally the Government support, makes clear that merit and not political affiliation should be the basis for public appointments. This Government have been determined from the outset that NHS boards should be more representative of the communities that they serve. To this end last summer we expanded the group from which candidates are drawn and changed selection criteria. That approach was specifically endorsed by the Commissioner for Public Appointments. In the recent round there was a large number of successful candidates who declared support for the Labour Party, as I am sure the noble Earl will point out. There was a substantial increase in the number of women appointed. The number from ethnic minorities has almost doubled. We are confident that these boards will be successful in developing the new NHS based on traditional public service values.

Earl Howe
My Lords, I am grateful to the Minister for that reply. In the light of what she has said, is it not remarkable that of the 264 recent appointees to NHS trusts who declared that they have been politically active, no fewer than 206, or 78 per cent., are Labour and that of the 142 local councillors appointed no less than 82 per cent. are Labour compared to 4 per cent. Conservative? How do the Government explain that imbalance and how do they justify it?

§ Baroness Jay of Paddington
My Lords, it perhaps reflects more on the appointments made by the previous administration than on anything that is being done now. I also point out to the House that the number of people who declared political activity was 30 per cent. of the total appointed. So even with the rather extravagant numbers, as the noble Earl described them, of previous appointments, that was simply a redress of the balance. Very many of those appointed to NHS trusts were either already appointed or declared no political affiliation.

§ Lord Hunt of Kings Heath
My Lords, does my noble friend recollect the approach of the party opposite to the appointment of first-wave trust boards in 1991? The boards were packed with Conservative members, 496 supporters and sympathisers and independents who nonetheless responded to the call of the Conservative Party. Does she recollect that?

§ Baroness Jay of Paddington
My Lords, indeed I do. My right honourable friend the Secretary of State said, when introducing the new arrangements for expanding the pool from which members of NHS boards should be drawn, that he had no intention of replacing Tory "deadheads" with Labour "deadheads". That is why all the new appointments are made on the basis of merit. Perhaps I may also point out that we have distinguished members of the Conservative administration, including, notably, the noble Lord, Lord Newton, as a new chairman of an NHS trust.

§ Lord Elton
My Lords, can the Minister tell us how many appointments to trusts which were due to be made by November last year are still vacant and why that is so in view of the wealth of non-deadhead Labour candidates?

§ Baroness Jay of Paddington
My Lords, of the 2,500 appointments, approximately 140 are still vacant. But some of those vacancies are owing to personal reasons. People were appointed and then decided that either for business or personal considerations they could not take up the positions. The regional offices have been asked to address in particular the question of ethnic minorities. We are delighted that trust boards draw 9 per cent. of their membership from the ethnic minorities. But there are some places where no ethnic minority candidate was put forward. We have asked the regional bodies to look at the matter again.

§ Lord Taylor of Blackburn
My Lords, does this not reflect the representation on boards both at local and national government level of those who have been elected in other directions?

§ Baroness Jay of Paddington
My Lords, that is precisely what it reflects. It is also the case that in trying to extend the pool from which candidates were drawn, my right honourable friend the Secretary of State asked all Members of Parliament of all parties to recommend local people. Local authorities were also asked. Given the political breakdown of the country, it is not surprising that the majority came from Labour backgrounds.

§ Baroness Cumberlege
My Lords, does the Minister share my view of real disappointment at the growing number of people on waiting lists? Does she agree that the waiting times set and met by the last government have been broken by this Government? Does the Minister also share my view that the necessary grip on these and other issues depends on strong leadership from chairmen and non-executive directors? Does she agree that the inability and incompetence of this Government to make appointments have caused a huge vacuum and unnecessary misery and suffering to those waiting for hospital treatment?

§ Baroness Jay of Paddington
My Lords, I am extremely pleased to answer the question of the noble Baroness, which is very wide of the original Question on the Order Paper. Clearly, she has not read last week's announcement in which there was a measure to improve the waiting list situation. The commitment to all those who had breached the 18 months' guarantee set by the previous administration has been achieved. The previous government's Patient's Charter required that people should not wait in excess of 18 months. They have now been taken off that waiting list as a result of action by this Government. As regards people giving leadership, if she believes that the 70 per cent. of those on boards who came from business backgrounds is the reason why we inherited a situation where a record number of health authorities and trusts were in debt, then the noble Baroness's view of success is different from mine.

§ Lord Monkswell
My Lords, is my noble friend aware that one of the matters that greatly concerned the nation about the appointments system of the previous administration was that very many members of trust boards came from outside the area of the particular trust board and had virtually no connection with it? Can my noble friend tell the House what steps have been taken to remedy that situation?

§ Baroness Jay of Paddington
My Lords, that was a matter that we specifically sought to improve in the recruitment process last summer. It is now a requirement that members of NHS trust boards should live in the area that they serve. That has been achieved, with only a minor number of exceptions in metropolitan areas, where members of trust boards occasionally live just across a borough frontier.

§ Lord Stoddart of Swindon
My Lords, when my noble friend is making such appointments—and, indeed, in respect of appointments which she has already made—will she remind boards of the desirability of phasing out mixed-sex wards in our hospitals? I thank her for all that she has done since her appointment to phase out mixed-sex wards which, I can assure her, cause great distress, especially among women patients.

§ Baroness Jay of Paddington
My Lords, I am grateful to my noble friend. I acknowledge the extremely important part that he has played in trying to achieve that change in hospitals. My noble friend is right that mixed-sex wards have caused concern and distress. I hope that he will be pleased to hear that, apart from making improvements in the number of hospitals achieving single-sex wards in the past few months, we are now producing a management analysis of the way in which boards can be kept up to the mark in that respect in the next few years. We shall of course ensure that new trust boards use that management initiative.