HC Deb 28 February 1978 vol 945 cc196-200W
Mr. George Rodgers

asked the Secretary of State for Social Services (1) if he will examine the appointment of consultant staff to regional health authorities with a view to those regions that have been allocated extra finance to meet their above average needs being allowed to use some of it to employ more medical staff;

(2) if he has received any representations relating to the appointment of an appropriately balanced consultant staff by the North West Regional Health Authority; and if he will make a statement on the situation whereby finance is available to meet this requirement through the Resources Allocation Working Party formula but approval for such appointments has not been given by his Department;

(3) if he will follow through the Resources Allocation Working Party recommendations that those regions that have a higher need for health services should be provided with more money to cope with their higher morbidity by carrying the philosophy through to the allocation of additional consultants to such regions;

(4) if he will put in hand an urgent review of the distribution of additional consultant posts to the regional health authorities in order that the extra revenue provided through Resource Allocation Working Party moneys may be utilised to greatest effect;

(5) if he will introduce a formula which will allow the allocations of consultants to a regional health authority based on a population weighted similarly for the population calculations set out in the Resource Allocation Working Party report.

Mr. Ennals

The system used by my Department to allocate additional consultant posts has been raised with me by the Chairman of the North Western Regional Health Authority. The question of allocating new posts in shortage specialties has been studied in some detail by my Department in discussion with the medical profession in the Central Manpower Committee and with officers of all the regional health authorities. The consensus view among those consulted is that the present system should continue.

I should stress first that it is only necessary to limit the approval of new posts in a small number of specialties, so that there is ample scope for regions to employ more consultant medical staff if they wish. In the specialties in which approvals must be limited, I agree that the allocation of posts should follow the philosophy of the Resource Allocation Working Party that most should be given to the regions with the highest need. The difficulty arises in finding a suitable objective measure of need for the highly specialised services provided by particular consultants. A greater need for health care generally, as measured in the way suggested by the working party, may not indicate a greater need for the services of a doctor in a given specialty. Thus, for example, the fact that the death rate from a particular condition is higher than average in a region may be a reason for allocating that region more money, but it is not a reason for allocating more posts in a specialty not involved in the treatment of that condition. For this reason, the Resource Allocation Working Party formula cannot be used for the allocation of posts.

My Department is continuing to study the problem to see whether a better measure of relative need than population at risk can be found. Before changing the present system of allocation, however, I would wish to be sure that any new system was regarded as fair by all concerned.

Mr. George Rodgers

asked the Secretary of State for Social Services (1) how many requests for appointments of consultant anaesthetists were made by the North West Regional Health Authority in each of the years 1975–76, 1976–77, 1977–78, and 1978–79; and how many were approved by his Department on each occasion;

(2) how many requests for appointments of consultants in geriatric medicine were made by the North West Regional Health Authority in each of the years 1975–76, 1976–77, 1977–78, and 1978–79; and how many were approved by his Department on each occasion.;

(3) how many requests for appointments of consultant radiologists were made by the North West Regional Health Authority in each of the years 1975–76, 1976–77, 1977–78, and 1978–79; and how many were approved by his Department on each occasion.

Mr. Ennals

Authorities may appoint consultants to existing posts without departmental approval. The number of requests for additional consultant posts, and the number approved are given below:

1975–76 1976–77 1977–78 1978–78
Specialty Requests made Approval given Requests made Approval given Requests made Approval given Requests made Approval given
Anaesthetics 4 2 3 3 4 1 12 4
Geriatric medicine 4 Nil 1 1 2 Nil 6 1
Radiology 4 1 1 1 2 Nil 6 Nil