Clause 1 - English Health Authorities: change of name
NHS Reform and Health Care Professions Bill
4:30 pm
Dr Andrew Murrison (Westbury, Conservative)
It is a fairly fundamental law of physics that large bodies tend to consume small ones, and one of my concerns about SHAs relates to their size. As far as we are able to tell, they will be of diverse size. One of the stringencies placed upon those deciding on their boundaries is that the authorities should relate to a tertiary centre, such as a major teaching centre or major hospital. My own area of the south-west provides an example of where the proposals fall well short of that. The minnow that is Somerset and Dorset—I mean that in the nicest possible way—relates at best to Taunton, which is not a major centre. That will leave Devon and Cornwall looking towards the Peninsula medical school and Plymouth, which is a major tertiary centre. The remaining area of Avon, Gloucestershire and Wiltshire will look towards Bristol royal infirmary and the Bristol teaching hospitals.
That creates real instability. It is likely that there will be some mergers as time goes by. In the south-west, the three SHAs will probably reduce to two, with Somerset and Dorset being split between the SHA for the far west and Avon, Gloucestershire and Wiltshire. Such changes bring more uncertainty for those who work in the service. We should be able to anticipate that to ensure from the outset that SHAs can plan for the long term in a period of some stability. Members of the Committee have commented on the importance of stability in the national health service, which has undergone almost perpetual change since 1974. This is one area where the Government can give a steer by offering the prospect of stability at SHA level.
Of course, reducing the number of SHAs in the south-west from three to two and repeating that across the country would strip out a layer of bureaucracy and associated costs, as well as giving many of them much more cogency. I urge the Minister to think in terms of reducing the number of SHAs, perhaps by increasing the numbers of people that they will serve.