NHS Trust Boards: Membership (Hansard, 24 February 1998)

§ The Minister of State, Department of Health (Baroness Jay of Paddington)

Substantial progress has been made to meet the Government's election manifesto commitment to make National Health Service trust boards more representative of their local communities.

Working within the parameters for public appointments established by the Commissioner for Public Appointments, Sir Leonard Peach, and following the Secretary of State for Health's consultation with him, a number of substantial changes were announced last June to apply to the 1997 round of appointments of chairmen and non-executives to NHS trusts to fill 1,005 vacancies out of a total of 2,509 places on trust boards:

(a) The person specification for non-executives and chairmen has been changed to encourage more NHS users and carers. Candidates are expected to live in the area served by the trust.
(b) Interview panels have been instructed to ensure that all candidates are personally committed to the NHS and can bring a user's perspective to the board.
(c) Members of Parliament and local authorities have been asked to nominate candidates for consideration. These are not for reserved places but to widen the local base from which candidates can be drawn.
(d) The balance of board membership will move in favour of ordinary users and carers and those with a community voice.
(e) The commitment to the goals set for women and ethnic minorities on NHS boards has been reinforced.

Over 1,800 nominations were received from Members of Parliament and local authorities. Both these nominated candidates and those responding to public advertisements were considered against the new criteria. All appointments were made on merit under the Nolan rules, candidates having gone through the same selection process, including an interview with a panel including an independent member.

At 23 February, the Secretary of State for Health has made 884 appointments to NHS trusts and a further 121 are currently under consideration. Of those appointed as non-executive directors in this round, 52.3 per cent. are women. Of those appointed as chairs, 35.5 per cent. are women. This is a significant improvement on the position inherited from the previous government at 1 May.

We have also significantly improved representation of people from ethnic minorities. The previous government set the target that each NHS trust with 10 per cent. of people from ethnic minorities in their local population should have a board member from an ethnic minority. They failed to achieve this in 19 of the NHS trusts to which appointments had to be made in 1997. The Secretary of State for Health has made appointments of members from ethnic minorities in all but two of these. One was a specialist orthopaedic trust to which I appointed a disabled member. The other is to be merged in the summer of 1998. In total, 9 per cent. of appointments since 1 May have been of people from ethnic minorities, taking the total from 5 per cent. to 7.2 per cent.

Around a third of those appointed were existing board members reappointed for a further term of office after a previous period of satisfactory service.

Of those appointed, 620 have declared no political activity and 264 have declared that they have been politically active within the definition used by the Commissioner for Public Appointments. Twenty-five have been active on behalf of the Liberal Democrats, 29 on behalf of the Conservatives including a former Cabinet Minister, 206 on behalf of Labour and 4 other. Many of these people represent their community as serving councillors; 117 Labour, 6 Conservative, 16 Liberal Democrats and 3 other.

The Government are committed to an open and transparent process for NHS appointments. The appointments process which we inherited from the previous Government was not consistent and varied from place to place. This is most unsatisfactory. In consultation with the regional chairmen the Secretary of State has produced guidelines which are to be followed in every part of the country. The guidelines also stipulate that there should be a standard procedure for assessing the performance of individual non-executive directors and chairmen. These guidelines have been cleared with the Commissioner for Public Appointments and we will be placing copies in the Library.

These procedures will be used to identify candidates for the 302 vacancies for the boards of health authorities 90WA which will fall due in March. We are committed to ensuring that health authorities, like NHS trusts, have board members who represent the interests of local NHS users and carers. Public advertisements have already been placed and we have asked Members of Parliament and chief executives of local authorities to make nominations. Around 3,000 completed applications have already been received. To enable proper consideration to be given to all these candidates, especially as in future health authorities will be required to discharge additional duties, and to enable proper notice to he given to all appointees, the Secretary of State intends to ask the 302 incumbents to serve for an additional three months until 30 June 1998.

Full details of appointments to NHS bodies will be published in the Department of Health's public appointments annual report in March.