Sixth report from the Select Committee on Estimates : together with the minutes of evidence taken before sub-committee D and appendices, session 1956-1957: Running costs of hospitals.

  • Great Britain. Parliament. House of Commons. Select Committee on Estimates
Date:
[1957]
Catalogue details

Licence: Public Domain Mark

Credit: Sixth report from the Select Committee on Estimates : together with the minutes of evidence taken before sub-committee D and appendices, session 1956-1957: Running costs of hospitals. Source: Wellcome Collection.

    111/448 page 89
    26 February, 1957.] (Continued. In the early years of the service the Board retained a larger “ general purpose’ reserve, to be allocated to Management Committees during the year as the Board saw how expenditure was going. This practice was discontinued, however, as Management Committees knew of the existence of the reserve and there was a tendency not to be unduly anxious if the rate of expenditure appeared to be in excess of estimates. The Board have found that they get better results by placing the fullest confidence in their Management Committees, who are given the largest possible initial allocation, the Board only retaining sufficient to finance additional nurse recruitment and approved developments and improvements on the lines already indicated. The Board do their utmost to estimate needs as closely as possible so as to achieve a fair distribution between Hospital Manage- ment Committees, and the latter know that they must live within the limits of their allocation. (c) Throughout the year the Finance Committee of the Board receives from Management Committees monthly returns of expenditure showing the actual out-turn compared with the proportionate part of the approved sum for the year. This information is supplied under the established sub-heads. Any apparent over-spendings under these sub-heads are taken up at once with the Committee. Apart from the estimates procedure outlined above, the following additional! arrangements are in force:— (d) Consideration by the Board of the National Health Service Hospital Costing Returns published annually by the Ministry of Health and the observations thereon submitted by Management Committees at the Board’s request. Alongside with this practice which has been in existence for three years, the Board’s Finance Committee initiate from time to time ad hoc enquiries into such items as the cost of provisions “‘ per person fed”, the numbers of staff employed in various departments, and the investigation of drugs expenditure as between hospitals of similar types. Discussions take place with members and officers of Management Committees and at all times the Chairman of the Board maintains the closest contact with Chairmen of Management Committees. (e) Audit reports on Management Committee’s accounts sometimes bring to light information which may lead to economies (e.g. losses on farms and gardens), and there is a standing arrangement that all audit reports are considered by the Finance Committee of the Board. (f) Another avenue of approach is the interchange of information with Secre- taries and Treasurers of other Boards, which is passed on to Management Committees, and (as stated in the answer to Question (9) in more detail), the Board always endeavour to bring about economies and increased efficiency in the service. The following have already been put into effect :— more efficient heating of hospitals; review of catering arrangements and comparisons with outside firms; the introduction of more economical purchasing methods ; the installation of laundry equipment to reduce the use of outside laundries; the setting up of a regional printing service ; the installation of a regional accounting bureau; and investigations by the Organisation and Methods Department of the Ministry at the Board’s invitation. ‘The Board themselves are constantly taking the initiative in studies aimed at reducing expenditure. Generally speaking, in view of the statutory relationship between Regional Hospital Boards and Hospital Management Committees, effective control depends on the maintenance of good personal relations between the Board and their officers on the one hand and the Management Committees and their officers on the other.
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