§ Mr. Hoosonasked the Secretary of State for Wales whether he has decided on the way in which the principles of the recommendations of the National Health Service management inquiry are to be implemented in Wales; and if he will make a statement.
§ Mr. Nicholas EdwardsYes. I have today issued to district health althorities in Wales and copied to other interested bodies instructions on the implementation of the190W principles in the form of Welsh Office circular 15/84. I have sent a copy of this circular to each Member of Parliament representing a constituency in Wales, to the Select Committee on Welsh Affairs, and I have placed a copy in the Library of the House.
This circular is issued following my careful consideration of the many responses received to my proposals set out in a consultation letter of 13 December 1983 and made to me in person at the meeting of the All-Wales Health Forum when it discussed this matter on 24 February 1984. Copies of the consultation letter and of the note of the meeting of the forum have already been sent to all Members of Parliament in Wales and are in the Library of the House.
The circular requires district health authorities in Wales to set in train a programme of action to strengthen the general management function at all levels of the NHS. In particular, it requires them to appoint district general managers by 1 April 1985, in accordance with minimum requirements of the job set out in an annex to the circular. It requires them also to appoint unit general managers, again in accordance with the prescribed minimum requirements of the job, the timetable for which will be set for individual units during 1985. There will be a formal review of progress by my Department during 1987.In making these appointments authorities must keep costs within existing provision for management. The circular also confirms the changes in the management of the NHS by my Department which were proposed in the consultation letter, including the creation of a health policy board, under my chairmanship, which will have an executive committee chaired by a director for the NHS in Wales. I intend that the board should begin its work and that the director should be appointed as soon as possible.
I believe firmly that these arrangements provide the best means, building on the reorganisation in 1982, to ensure that decisions are delegated as close as possible to the level of direct patient care so as to achieve maximum patient care from the record levels of resources we are providing for the NHS in Wales.