National Health Service

Oral Answers to Questions — Social Services – in the House of Commons at 12:00 am on 4th November 1975.

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Photo of Mr Clement Freud Mr Clement Freud , Isle of Ely 12:00 am, 4th November 1975

asked the Secretary of State for Social Services what is the estimated cost of administration of the National Health Service; and what proportion of total spending on the National Health Service this represents.

Photo of Mrs Barbara Castle Mrs Barbara Castle , Blackburn

Final accounts for 1974–75 are not yet available, but the cost of administration of the National Health Service for that year is estimated at £235 million, equivalent to about 7½ per cent. of the total budget. Nearly half of this relates to costs in operational units and services that have not previously been classified as administration.

Photo of Mr Clement Freud Mr Clement Freud , Isle of Ely

In view of the right hon. Lady's proposals to cut the salaries of junior doctors and agency nurses, will she propose spreading these cuts evenly among administrators in the health service, which appears to be the only growth industry at the moment? Will she confirm that the Royal Commission will look into the setting up of the administrative system?

Photo of Mrs Barbara Castle Mrs Barbara Castle , Blackburn

I am sorry that the hon. Member is so badly out of touch with what has been happening in the health service. If he were in touch he would have appreciated that, far from having cut the salaries of junior hospital doctors, this Government gave them an increase of 30 per cent. up to April, and are currently introducing a new contract, for which they have long asked. On the second part of the question, it will be possible for the Royal Commission to consider the use of manpower in the National Health Service, as that is part of its terms of reference.

Photo of Mr Selwyn Lloyd Mr Selwyn Lloyd , Wirral

Mr. Snape—I apologise, I meant to say Mr. Garrett.

Photo of Mr John Garrett Mr John Garrett , Norwich South

Does my right hon. Friend agree that there is almost certainly one level too many in the National Health Service hierarchy, and that that is probably the region? Is she happy with the situation whereby her Department's finance division supervises the work of finance officers in the regions, who in turn supervise the work of finance officers in the regions, who in turn super-vice the work of finance officers in areas, who in turn supervise the work of district treasurers?

Photo of Mrs Barbara Castle Mrs Barbara Castle , Blackburn

We on the Labour side of the House have never hidden our dislike of the overstructured, over-tiered reorganisation introduced by our Conservative predecessors. We disliked it at the time, and I am sure that if we had been in a position to start the reorganisation from scratch we would never have introduced such a top-heavy managerial structure. I see that that goes, too, for hon. Members on the Opposition Front Bench, who, unfortunately, supported it at the time that it was going through the House. But we have to realise that the structure has been in operation for only just over a year. People are only just in post. They are only just settling down after the trauma of reorganisation. It would be contrary to the needs of patient care if we were to turn it all upside down again.

Photo of Mr Evelyn King Mr Evelyn King , South Dorset

What the right hon. Lady has said is interesting, and I hope that she will bear that in mind and act upon it. Is it not a fact that administrators are being paid almost as much, in total, as doctors? How many administrators are now being paid more than £10,000 a year? Does that number run into hundreds, as I am informed? I am being non-party on this matter. Will the right hon. Lady give up her time and attention to investigate the question whether or not administration is inefficient?

Photo of Mrs Barbara Castle Mrs Barbara Castle , Blackburn

The hon. Gentleman says that he is being non-party. I am glad to see that Labour Party policy on the matter is now accepted, and that we have converted the Opposition, which carried out the reorganisation of which they now complain. It is impossible to turn the structure upside down before people are in post. We must give them some continuing stability.

The Royal Commission has the right to examine the use of manpower in the service, but what I am concerned about now is helping those who were put in their jobs by the previous Government to do a good job. That must be my priority at present.

As for the details for which the hon. Gentleman asked, if he cares to table a Question I shall be glad to answer it.

Photo of Mr Selwyn Lloyd Mr Selwyn Lloyd , Wirral

I should apologise to the hon. Member for Norwich, South (Mr. Garrett). I wish that hon. Members would give me notice of facial changes.