NHS Trusts (Hansard, 21 February 1990)

§ Mr. Austin Mitchell
To ask the Secretary of State for Health (1) how self-governing trusts will be asked to alter employees' contracts, conditions of service and superannuation rights;
(2) whether self-governing trusts will be allowed to opt out of the Whitley system;
(3) whether the employment conditions and employment protection rights for self-governing hospital trusts will differ from the present arrangements in the National Health Service.
836W

§ Mrs. Virginia Bottomley
Staff who transfer from health authority to NHS trust employment will retain their existing contracts and all rights arising from them, subject to the substitution of the new employer for the old and any consequential technical changes. It will be open to the NHS trusts to seek to introduce changes in existing contracts at any time after transfer. In doing so, they will be free to decide whether to continue to adopt Whitley council conditions or to make alternative arrangements if they so wish.
Employees of NHS trusts will be eligible to stay in or to join the NHS superannuation scheme. However, subject to the passage of the National Health Service and Community Care Bill, trusts will have the power to establish their own arrangements for providing pensions if they wish.

§ Mr. Austin Mitchell
To ask the Secretary of State for Health if he has any plans to introduce any change to the ratio of trained nurses coupled with untrained nurses in the National Health Service; and whether self-governing trusts will be under any obligation to maintain any given ratio.

§ Mrs. Virginia Bottomley
The Department does not lay down any ratio of qualified to other nursing staff in the National Health Service. The planning and setting of staffing establishments is a matter for individual health authorities to determine in the light of local needs and priorities. National Health Service trusts will be free to determine the number, skill and grade mix of nurses they employ.

§ Mr. Austin Mitchell
To ask the Secretary of State for Health if self-governing hospital trusts may decide to give up self-governing status.

§ Mrs. Virginia Bottomley
Yes.

§ Mr. Austin Mitchell
To ask the Secretary of State for Health if there will be any changes to the skill and grade mix of nurses who work in the self-governing trusts.

§ Mrs. Virginia Bottomley
NHS trusts will be free to determine the number, skill and grade mix of nurses they employ.

§ Mr. Austin Mitchell
To ask the Secretary of State for Health what changes are planned for the education and training of nurses; what requirements of education and training he intends to impose on self-governing trusts; and whether he intends to allow competition in training.

§ Mrs. Virginia Bottomley
We intend to ensure that NHS trusts participate in the training of key professional staff, including nurses. Detailed proposals for dealing with the education and training implications of the White Paper "Working for Patients" are set out in working paper 10, a copy of which is in the Library. This document has been the subject of a widespread consultation exercise, which ended on 31 January 1990. The comments which we have received are being carefully studied: we shall announce decisions as soon as possible.

§ Mr. Austin Mitchell
To ask the Secretary of State for Health what control his Department will exercise over the accounts of self-governing hospital trusts; what will be the position should self-governing trusts go bankrupt; and who will be accountable to Government for providing continuity of health service in this eventuality.
837W

§ Mrs. Virginia Bottomley
NHS trusts will be required to keep proper accounting records and to draw up accounts each year as directed by my right hon. and learned Friend the Secretary of State with the approval of the Treasury.
Should a trust become financially unsound and the services which it provides still be needed, it might be necessary to transfer responsibility for managing those services to another trust or to a health authority. In the event of the financial failure of any provider unit, district health authorities will be responsible for securing continued provision of health care for their residents.

§ Mr. Austin Mitchell
To ask the Secretary of State for Health what industrial relations rights Royal College of Nursing stewards will have in the self-governing trusts; and what structure of industrial relations he intends to propose for them.

§ Mrs. Virginia Bottomley
NHS trusts will be free to make their own arrangements for union representation for their employees.

§ Mr. Austin Mitchell
To ask the Secretary of State for Health what information systems need to be installed to set up self-governing trusts.

§ Mrs. Virginia Bottomley
NHS trusts will be expected to have information systems which are adequate for the effective and efficient management of the trust.

§ Mr. Austin Mitchell
To ask the Secretary of State for Health what rights staff will have to opt out of self-governing trusts and to safeguard their employment, pension and other rights in this event.

§ Mrs. Virginia Bottomley
Staff of a hospital which is to become an NHS trust will transfer to employment by the trust unless other arrangements have been individually agreed with them beforehand. A member of staff who is transferred to trust employment will retain the right to terminate his contract of employment if a substantial change to his detriment in his working conditions is brought about by the transfer; no such right will arise solely by reason of the change in employer on transfer.

Number of abortions performed in England and Wales, 1988 by statutory grounds: 2 (alone) and 3 (with or without 2), by (a) age of mother, (b) marital status, (c) number of previous children, (d) number of previous abortions, and (e) category of premises, for residents and also non-residents, at 18 weeks and over gestation.

Residents Statutory grounds Non-Residents Statutory grounds

2 (alone) 3 (with or without 2) 2 (alone) 3 (with or without 2)

Number Per cent. Number Per cent. Number Per cent. Number Per cent.

(a) Age of Mother

All ages 5,343 82.90 394 6.11 3,208 98.22 40 1.22

Under 16 301 98.69 4 1.31 120 100.00 — —

16 to 19 2,085 95.38 56 2.56 882 99.66 3 0.34

20 to 44 2,948 74.92 331 8.41 2,190 97.59 37 1.65

45 and over 8 44.44 3 16.67 16 94.12 — —

Unknown 1 100.00 — — — — — —

(b) Marital Status

Single 4,446 92.99 199 4.16 2,544 99.18 16 0.62

Married 468 42.24 106 9.57 355 92.93 16 4.19

Widowed/divorced/separated 322 75.94 75 17.69 236 96.72 7 2.87

Not stated 107 81.06 14 10.61 73 97.33 1 1.33

(c) Number of Previous Children

0 4,084 93.73 23 0.53 2,325 99.53 5 0.21

1 660 63.04 165 15.76 468 95.90 14 2.87

2 348 57.81 127 21.10 242 96.03 7 2.78

3 149 55.39 55 20.45 95 88.79 11 10.28

838W

§ Mr. Austin Mitchell
To ask the Secretary of State for Health whether all staff affected by the establishment of a self-governing trust will be eventually transferred to the self-governing trust.

§ Mrs. Virginia Bottomley
All staff who were employed at a unit which is to become an NHS trust will transfer to employment by the trust from the date when it becomes fully operational unless other arrangements have been individually agreed beforehand. Special arrangements will be made for splitting the contracts of employees who work partly in a unit which is to become a trust but will continue to work partly in other units.

§ Mr. Austin Mitchell
To ask the Secretary of State for Health whether(a) trade unions, (b) local government, (c) local business, (d) medical representatives and (e) nursing representatives will be represented on the boards of self-governing trusts.

§ Mrs. Virginia Bottomley
All NHS trusts which are established to manage hospital or community health services will have executive medical and nursing directors on their boards. The non-executive directors on NHS trust boards will be chosen for the personal contribution they can make to the effective management of the trust and not to represent any interest group. In the case of trusts with a significant teaching commitment one of the non-executive directors will be drawn from the relevant university or medical or dental school.

Number of abortions performed in England and Wales, 1988 by statutory grounds: 2 (alone) and 3 (with or without 2), by (a) age of mother, (b) marital status, (c) number of previous children, (d) number of previous abortions, and (e) category of premises, for residents and also non-residents, at 18 weeks and over gestation.
	Residents Statutory grounds	Non-Residents Statutory grounds
	2 (alone)	3 (with or without 2)	2 (alone)	3 (with or without 2)
	Number	Per cent.	Number	Per cent.	Number	Per cent.	Number	Per cent.
(a) Age of Mother
All ages	5,343	82.90	394	6.11	3,208	98.22	40	1.22
Under 16	301	98.69	4	1.31	120	100.00	—	—
16 to 19	2,085	95.38	56	2.56	882	99.66	3	0.34
20 to 44	2,948	74.92	331	8.41	2,190	97.59	37	1.65
45 and over	8	44.44	3	16.67	16	94.12	—	—
Unknown	1	100.00	—	—	—	—	—	—
(b) Marital Status
Single	4,446	92.99	199	4.16	2,544	99.18	16	0.62
Married	468	42.24	106	9.57	355	92.93	16	4.19
Widowed/divorced/separated	322	75.94	75	17.69	236	96.72	7	2.87
Not stated	107	81.06	14	10.61	73	97.33	1	1.33
(c) Number of Previous Children
0	4,084	93.73	23	0.53	2,325	99.53	5	0.21
1	660	63.04	165	15.76	468	95.90	14	2.87
2	348	57.81	127	21.10	242	96.03	7	2.78
3	149	55.39	55	20.45	95	88.79	11	10.28