§ Mr. Arnoldasked the Secretary of State for Social Services what representations he has received with regard to the appointment of National Health Service staff to area and regional health authorities.
§ Mr. DeakinsFollowing the issue of a consultative document "Democracy in the National Health Service" in May 1974, the Government received representations on this question from a variety of interested bodies. More recently the TUC has put forward proposals, and discussions are proceeding on the implications of particular levels of staff representation on health authorities.
§ Mr. Arnoldasked the Secretary of State for Social Services whether he has any evidence to show that single district health authorities provide for a more effective administrative structure than the multi-district areas.
§ Mr. EnnalsThis is not a matter on which evidence as such exists; but there is a considerable body of opinion in the National Health Service in favour of single-district areas, and prima facie the absence of an administrative tier should enable faster and more effective decision-taking. The whole question is one on which I look forward to the recommendations of the Royal Commission on the National Health Service.
§ Mr. Arnoldasked the Secretary of State for Social Services what criterion he adopts for a health authority to achieve single district status.
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§ Mr. EnnalsAlthough we have ruled out any major and fundamental changes in the structure of the National Health Service until the Report of the Royal Commission has been received and considered, I am prepared to consider proposals for the merger of existing health districts or for the establishment of single-district areas.
Before approving such a change, I would need to be satisfied that the proposal would lead to a more effective delivery of services and improved management efficiency; that there had been full and adequate consultation with staff interests and with district management, local authorities and community health councils; and that both regional and area health authorities approved the change proposed.
§ Mr. Arnoldasked the Secretary of State for Social Services what representations he has recently received in favour of single district health authorities.
§ Mr. EnnalsI have agreed that Liverpool Area Health Authority (Teaching) should become a single-district area and I have also received a formal submission from South Western Regional Health Authority requesting my approval to the merger of the two districts in Gloucestershire Area Health Authority. I am aware also of several other authorities which are considering the possibility of a single-district structure.