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]
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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.

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    Dr. Fa N. The only thing the Regional Board can do is to make recommendations to the Hospital Management Committee: to advise the H.M.C., and ask the H.M.C. But the spending is done by the H.M.C., and if the H.M.C. does not want to play ball with its Regional Board and wants to kick over the traces, there is no one who can stop them from doing it. Chairman. 683. That is a most significant remark? —][ should say it is true. 684. That there is very little the Regional Board can do to pull in the reins, as it were, on an H.M.C. which does not want to play ball? Except- ing this, that, of course, the Regional Board would not grant the allocation of money to it. But af the H.M.C. enters into a commitment which has to be met, as far as I know, there is only one source out of which that money can come. 685. Dr. Marshall, you say, is the key man? On all the medical appoint- ments. 686. And on what you might call the contracts entered into on the medical side. Apart from the fact that you are public spirited and intelligent, what, be- sides your own conscience, makes you keep a close watch on the public purse? (Dr. Marshall.) I suppose the same things which guide any chief officer of any organisation. It is a matter of conscience all the time in the promotion of efficiency. 687. It is also a matter of not getting money you ask for if you ask for too much. Does that apply in your case? Well, of course, it is a matter of balancing the various planes. 688. Perhaps I may help you out. It is up to you to do your best, according to your Own conscience and your sense of duty, and there is no sanction that can be applied to you? No, I do not think so. Sir Henry D’ Avigdor-Goldsmid. 689. I wonder if I might come back to the question I raised before: the ques- tion of underspending, which aroused so much astonishment in your Treasurer? Do you have examples which you can think of where your H.M.C.s have in fact underspent their estimates on par- ticular items? (Mr. Agnew.) Oh, yes. 690. Do you think those are as fre- quent as they might be? Let me put it another way: does the underspending in one year not colour very much the esti- mate for the next year? No. Now, that is one thing it does not do. We do not let our H.M.C.s think, just because they have underspent this year, that necessarily is going to be their alloca- tion for next year. That we do not do. Mr. Holt. 691. May I just follow up the point the Admiral made about the centrally controlled civil service. The analogy be- tween what he described in the Hospital Service is perhaps not exactly compar- able because, of course, the whole of the Regional Boards and the H.M.C.s are volunteers. They themselves are not part of the Civil Service. If the kind of thing suggested in his question were to take place and all the professional appointments were made centrally from the Ministry downwards—secretaries, treasurers and so on—would you say this would completely undermine the authority and perhaps even the interest of the Regional Boards and the H.M.C.s in their work? I should say the inter- est, certainly ; and I should say if that happened, the Minister would have to set about finding an awful lot of new Regional Board Chairmen. 692. And the reason would be because you would feel there was no real respon- sibility? Because there is still in the Hospital Service a certain amount of voluntary spirit—that old spirit which we had in days gone by. I think if you are going to put all the appointments of all the senior staff of all the Hospital Service in the hands of the Ministry, that is not helping that local voluntary spirit. Chairman. 693. There is this point, however. The professional staff are solely employed by one Regional Hospital Board or one H.M.C. There is no likelihood of their being promoted from one _ Regional Board to another? Oh, yes. I do not say that my ‘Treasurer would be appointed Treasurer of another Board,
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