Health and Personal Social Services (Hansard, 11 June 1981)

§ Mr. John Patten

I welcome the opportunity to report to the House on this review, which was conducted in the light of the recommendations of the Royal Commission on the National Health Service and the corresponding services in Northern Ireland. Widespread consultations have taken place on improvements in the structure and management arrangements established for these services in 1973. Throughout this process it has been my aim to secure the widest possible consensus among those involved in the services on the scope and need for change. I am grateful to all those who have given me the benefit of their experience and advice.

I have decided to retain the basic structure of the four health and social services boards as agents of the Department for the planning and management of health and personal social services in their areas, and also to retain the Central Services Agency and Staffs Council which provide certain common services for boards. I do not propose to establish either a separate regional authority or a contractors' committee for the family practitioner services, as advocated by some interests particularly in the initial stages of consultation. I am satisfied that any weaknesses which have been identified in present arrangements can and should be remedied within the existing structure rather than by creating new bodies, and I am supported in this by the impressive consensus of opinion which emerged in the later stages of discussion.

Three main areas for improvement have been identified. First, there must be greater delegation of authority to local units of management within boards, so that operational decisions can be taken promptly in response to the needs of patients, clients and staff. Boards and their chief officers will thus be freed to concentrate on their main role of policy formulation, planning, resource allocation, financial control and the monitoring of services. Boards are now being asked to review their management arrangements to secure these objectives, on the basis of firm guidelines issued by the Department. In doing so, they will be required to reduce their management costs to the minimum compatible with efficiency.

Secondly, the regional support services provided by the Department, the Central Services Agency and the Staffs Council need to be matched more closely to the requirements of the user boards.

Thirdly, in the medical field, the planning, funding and monitoring of the vital specialist hospital services provided on a regional basis require greater attention, and 166W the general practitioner services need to be more closely involved in the planning and delivery of care in the community.

The further reviews and studies required for these purposes are to be completed by the end of this year. Changes will be phased in from April 1982, and will all be fully implemented by April 1983. To preserve continuity in the transitional stages, I have decided, subject to any changes in membership arising from the district council elections, to offer reappointment to existing members of the boards and associated bodies for a period of 12 months to July 1982. Meanwhile I shall consider further the size and composition of the membership of these bodies. I propose to retain consumer participation in the provision of services, but I shall also want to give further thought to the present system of district consumer committees in the light of the review of management arrangements being undertaken by boards. The interests of staff affected by management changes will be protected on the same basis as in Great Britain.

I am satisfied that the basic structure established for these services, which uniquely in the United Kingdom provides integrated planning and management of health and personal social services, has proved its worth, and that the detailed changes now to be made will ensure a more effective, efficient and economical service to the community. For the information of hon. Members, I am placing copies of this statement in the Library, together with copies of the detailed circular which is being issued today to the interests concerned in Northern Ireland.