We have no current plans to change the role of regional health authorities, although we will be examining their role as we continue to implement our reforms to improve the health service.
It is odd that the Secretary of State makes no mention of the newly created regional outposts of the NHS management executive, which are assuming powers in relation to opted-out hospitals that were previously the province of regional health authorities. Unlike those authorities, regional outposts do not meet in public or have members who are accountable to the public, and they were not established by statute. Will the Secretary of State describe the role of the new regional outposts, explain what will be left for regional health authorities to do, and state whether there will be a statutory basis for the outposts-or will they be part of a secret, centralised, east European-style command economy for the national health service?
The six regional outposts will essentially monitor the financial effectiveness of NHS trusts and report back to the management executive. The role of the regions will remain as it is—that of central authorities seeing through the priorities established by Ministers and the management executive. This year, regions are charged with ensuring further progress with the patients charter, which is a central element in our health programme, seeing through the further implementation of community care and enhancing the health of the nation. They work by monitoring and, with the family health services and district health authorities, strengthen the purchasing power which, as the hon. Gentleman will be aware, is the key to securing the quality improvements that are so important to the nation's health.
Does my right hon. Friend agree that regional health authorities are too vast, bureaucratic and remote, and that the sooner we move to a system of direct funding for the capital works of district health authorities, the better the service will be run?
My hon. Friend will be reassured to learn that the number of staff working in regional health authorities has fallen in recent years. The authorities have a function—to form a link between the management executive and Ministers, and the district health authorities—and it is important for the task that they are undertaking to benefit the districts and to be properly understood. I shall bear my hon. Friend's comments in mind.
Is the Secretary of State aware that many regional health authorities are not releasing sufficient funds to get community care up and running? How does she intend to ensure that local authorities have enough resources from the regions to be able to put community care into operation?
The hon. Lady will know that the success of community care depends on an effective relationship between social service departments and regional health authorities. At present, we ask them to report to us every six months—and more often—to make certain that the work is under way.
District health authorities have been involved for 20 or 30 years in community care for people with learning disabilities, the mentally ill and elderly patients. The question of resources for social service departments arises regularly in the yearly local authority spending round, and we have made it clear that community care will be fairly funded.