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.

    81/448 page 59
    19 February, 1957.] [Continued. Manchester and this part of the region is recognised as the most densely populated part of Europe. North of Preston and South of the Manchester conurbation the area is predominantly rural in character with concentrations of population on the coast round Blackpool, in the vicinity of Lancaster and at Barrow-in-Furness. The hospitals under the control of the Board number 190; in addition, there are 30 ad hoc out-patient clinics of various kinds. The day to day management of the hospitals and clinics is carried out by 33 Hospital Management Committees appointed by the Board. A list of the Committees and of the hospitals for which they are responsible is given in Appendix —.* (2) Discharge by Board of their financial responsibilities As a general preface to any statement of how the Board discharge their financial responsibilities, it must be said that, in the absence of more complete costing information, the methods employed by the Board for the distribution between the Management Committees of the global allocation received from the Ministry have necessarily had to be based on historical expenditures, adjusted in the light of information which is continuously being gathered by the Board. (Note: A limited costing experiment under Ministry of Health sponsorship is to be introduced on the Ist April, 1957.) The Management Committees in the Autumn of each year furnish the Board with a forecast of their financial needs for the year commencing on the following Ist April. This forecast or estimate is in the form shown in paragraph (3) below. The Board, after examining these estimates, and paring them where necessary, forward them to the Ministry, together with the Board’s estimate of their own requirements. In due course the Ministry, without comment on the estimates of any individual Management Committee or of the Board, advise the Board of the global sum which will be available to them for the maintenance of all the services within the region. This sum is invariably less than the total sum indicated in the estimates supplied to the Ministry. The Board, having deducted from the global sum the amount necessary for their own directly administered services and for certain regional reserves (a further reference to these reserves is later made in this paragraph) then proceed to divide up the balance between the various Management Committees. This they do by reference to the current approved expenditure of each Committee making adjust- ments up or down to meet development trends and other known factors of unavoid- able increases and, of course, prospective savings; also adjustments to meet wage awards, price increases, etc. Further adjustments become necessary and are in fact made at the revised estimates stage, half way through the financial year. Among the methods employed by the Board for ensuring maximum economy by the Hospital Management Committees are— (a) The use of Regional Reserves: The Board operates a system of regional reserves. The actual amounts of the reserves are related to and dependent on the Board’s global alloca- tion from the Ministry and may vary from year to year. They are, how- ever, of the approximate order of— Deferred Maintenance ae ee he £175,000 Developments and Improvements... Sts £175,000 General contingencies te cs aa £100,000 These reserves are created out of monies temporarily withheld from the Management Committees. They have two virtues. First they enable the Board, acting from a regional standpoint, to apply expenditure in the directions which they consider will produce the maximum advantage; secondly, by limiting the initial allocations to Hospital Management Committees to the amounts necessary to meet essential needs, good house- keeping is stimulated. (b) The issue to all Management Committees of annual cost statements for all hospitals in the region with the object of stimulating self-criticism in relation to comparatively high costs or comparatively low bed occupancy.
    digitised image 1
    digitised image 2
    digitised image 3