HC Deb 12 May 1993 vol 224 cc483-4W
Mr. Congdon

To ask the Secretary of State for Health if she will announce the terms of reference and membership of the NHS management functions and manpower review; and if she will make a statement.

Mrs. Virginia Bottomley

The continuing development of the national health service reforms requires the structure of the NHS above the level of local purchasers and providers to be examined. I have set up a review to consider what management processes and organisational structures will best deliver measurable improvements in health and effective and efficient services, through the operation of the NHS internal market, while minimising management costs and ensuring proper public accountability. I have asked the review team to complete its work in July.

The review team's terms of reference are as follows:

  1. 1. To carry out an organisational analysis of the main work and functions required to:
    • Ensure that the Government's reforms of the NHS are fully effected.
    • Ensure effective oversight of purchasers and providers operating in the NHS internal market.
    • Ensure that the Secretary of State is able to discharge her statutory responsibilities for the management of the NHS. Ensure that the proportion of NHS expenditure devoted to direct patient care is maximised.
  2. 2. In the light of the above:
    • To determine the statutory responsibilities and the core functions which must continue to be discharged by bodies which are part of, or directly accountable to, central Government.
    • To make recommendations on the organisational structure required for this.
    • To consider possible future changes to the configuration of NHS purchasers—including DHA mergers, joint DHA/ FHSA working and the development of the GP Fundholding scheme.
    • To make recommendations on the discharge of other essential functions, e.g., Estates Management and Information Management and Technology.
    • To determine the financial and manpower consequences, for the NHS and the Department of Health (including the NHSME), of conclusions reached.
  3. 3. The review team should take particular account of:
    • The need to achieve a balance between the benefits of decentralisation and the essential requirements of public accountability.
    • The need for an internally consistent regulatory framework to support the operation and development of the internal market. The need for the development of effective purchasing in the NHS.
    • The conclusions of the Cadbury Report on corporate governance.

Ms Kate Jenkins, a member of the NHS policy board, will chair the review's steering group and lead the review team itself. The other members of the review team are:

  • Mr. Alan Langlands—(Deputy Chief Executive, NHS Management Executive)
  • Mr. Peter Griffiths—(Formerly Chief Executive, Guy's NHS Trust)
  • Mr. Ian Carruthers—(Chief Executive, Dorset Health Commission)
  • Mr. John Sherring—(Regional Director—West Midlands, Audit Commission)
  • Dr. Carol Propper—(NHS Management Executive on secondment from University of Bristol)

Members of the review team providing professional advice on specific areas are:

  • Professor Andrew Pettigrew—(Centre for Corporate Strategy and Change, Warwick Business School, University of Warwick)
  • Dr. Graham Winyard—(Medical Director, NHS Management Executive)
  • Mrs. Sue Williams—(Deputy Director of Nursing, NHS Management Executive)

Other sources of professional advice will be identified as necessary.