Eleventh report from the Select Committee on Estimates : together with the minutes of evidence taken before sub-committee E and appendices, session 1950-1951: regional hospital boards and hospital management committees.

Great Britain. Parliament. House of Commons. Select Committee on Estimates

Date:: [1951]

Credit: Eleventh report from the Select Committee on Estimates : together with the minutes of evidence taken before sub-committee E and appendices, session 1950-1951: regional hospital boards and hospital management committees. Source: Wellcome Collection.

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$15 February, 1951.] {Continued. 797. I am given to understand that at a time when there was an appeal by the Government to departments to reduce staffs by ten per cent. and to keep down salaries, at the same time the Ministry of Health gave a sanction for increases in salaries which were not altogether justified. That is the complaint, and I would like to know what is the position?—I will get you precise information upon that. Mr. Diamond. 798. Can I refer back to this question of medical records?—-I do understand that you as a regional board have a medical committee which would advise you, if necessary, on the need for medical statistics of one sort and another?—(Sir Basil Gibson.) Yes, Sir, that is correct. We have one or two members of the staff dealing with statistics. 799. Has that committee ever requested you, or suggested to your Board, that the statistics kept by an individual management committee were excessive and unnecessary? —Not to my recollection, and I do not think they would. Every group of hospitals has a group medical committee. They are responsible or advising upon the manage- ment of hospitals and for the treatment of patients. I think they would look rather sternly upon any suggestion of the regional board that the medical committee of the Board should lay down the methods con- sultants should follow in dealing with medical records. It is purely a hospital matter. Miss Ward. would be rather difficult to really?—-They ought to be 800. It standardise standardised. 801. There is a fairly wide variation in the methods of hospital management com- mittees?—Yes. Chairman. 802. I think we have got to the point when I can put to you rather a wider ques- tion. You have just expressed yourself as being in favour of standardisation in one respect, and I think you rather suggested that your Board has not adequate control in a number of directions over the activities of hospital management committees?—I think that is true. 803. Would you prefer that your control should be exercised in detail so that you would in effect be doing a second time over some of the work of the hospital manage- ment committees, or would you prefer to exercise it by purely financial means?—I do not think I should want to exercise it purely financially. 804. The point I am putting to you is this: it has been suggested in a number of quarters that it would be a sound way to administer hospitals by giving what is called a block grant. Could you, by means of a block grant system as _ between hospitals and the management committees, look to an improvement in the administra- tion of the hospitals themselves?—You are putting to me a question upon which there is a division of opinion amongst the chair- men of regional boards. One chairman is very strongly in favour of a block. grant, and I am just as strongly opposed to a block grant. 805. Can you give reasons, from your experience as a chairman of a regional board, why you think a block grant would not work?—The simple reason is that this is not a static service. It is a service which has just been commenced. It is a service which has inherited old buildings; it has inherited unsatisfactory equipment; it has inherited a bed deficency ; it has inherited a staff deficiency in nurses and to some ex- tent in doctors. I do not see myself how any block grant could be estimated which would cover all these factors. If you had a static service and said here is so much money to run this service, you could pos- sibly do that; but this is not a static ser- vice. It has not grown up yet. It needs in my opinion ten years before you could say this service was complete from A to Z. That is the difficulty about any block grant system. 806. You think a block grant would necessarily have the effect of standardising matters?—It would have the effect of res- tricting the activities of management com- mittees and of hospital boards. 807. Of restricting activities?—I think it would restrict. 808. Activities, but not responsibilities? —No. There is no point in having respon- sibilty unless you are able to discharge it, and if the money is not sufficient to dis- charge it you soon get rid of the responsi- bility. 809. You fear that a block grant would tend to be a standard grant for a long period, and that, as your region was rather behind at the beginning, it would prejudice you. I think that is what you are saying? —I think it would stultify the whole Ser- vice. That is my own view. I have very strong views about it. Mr. Thomas Reid. _ 810. And ossify it?—And possibly ossify 1t. Mr. Turton. 811. As far as I can see it is conceivable that there may be for a number of years other claims on Government expenditure, and that those will tend to increase. Is your suggestion that, notwithstanding that, the regional boards should make expanding claims on the national revenue?—That I am afraid is a question entirely outside my$